image_name,path,type,report 28e38959-b2836d33-cf2f81f1-f8a95d2d-6b7aef70.jpg,validate/p19/p19997293/s56531048/28e38959-b2836d33-cf2f81f1-f8a95d2d-6b7aef70.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Single-chamber pacemaker insertion. AP and lateral radiographs of the chest were reviewed in comparison to ___. The left-sided pacemaker was inserted with the leads terminating over the expected location of the left ventricle. Heart size and mediastinum are stable. Right basal consolidation is redemonstrated. No pneumothorax or interval development of new consolidation is seen. Small amount of right pleural effusion is better appreciated on the lateral view. The spinal hardware is unchanged in appearance. " 1cd21706-7cba8a79-90b2cb3c-3cd0541b-ecc4128b.jpg,validate/p12/p12227650/s50151670/1cd21706-7cba8a79-90b2cb3c-3cd0541b-ecc4128b.jpg,validation," WET READ: ___ ___ ___ 7:19 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough // eval for pnrumonia 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. " 2ced8ea1-c77d9483-9fd10384-e01c9fec-18efd812.jpg,validate/p14/p14666276/s50991915/2ced8ea1-c77d9483-9fd10384-e01c9fec-18efd812.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, question acute process. COMPARISONS: ___. TECHNIQUE: PA and lateral chest radiographs were 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. " 1b3fc53b-dbd92cb6-c0bcf863-7fbc243b-af724c92.jpg,validate/p19/p19314531/s55491379/1b3fc53b-dbd92cb6-c0bcf863-7fbc243b-af724c92.jpg,validation," FINAL REPORT PA AND LATERAL CHEST. CLINICAL HISTORY: ___-year-old woman with a history of tracheobronchomalacia, COPD, recent treatment of COPD flare, with worst cough. IMPRESSION: PA and lateral chest compared to ___ and ___: Hyperinflation due to emphysema is chronic. There has been surgical resection of the mid portion of the right fifth posterior rib. Large scale hilar lymph node calcification, left greater than right and granulomatous calcifications in the left apex are longstanding. Cardiomediastinal and hilar silhouettes and pleural surfaces are otherwise normal. There are no lung findings to suggest pneumonia, or findings of appreciable atelectasis or bronchiectasis. " 2ff5ad55-686fc8b9-68f535a2-6696b1ba-822264e7.jpg,validate/p18/p18031757/s55842372/2ff5ad55-686fc8b9-68f535a2-6696b1ba-822264e7.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: None available. 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. " 8b3bc5d6-b73f3699-9273fe20-4aac09c6-d0ef8954.jpg,validate/p16/p16508811/s54074259/8b3bc5d6-b73f3699-9273fe20-4aac09c6-d0ef8954.jpg,validation," FINAL REPORT HISTORY: Fever, weakness. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Suggestion of mitral anulus calcification is seen. IMPRESSION: No acute cardiopulmonary process. " 095836d2-4549e322-76173a65-25f7947c-8d656f4c.jpg,validate/p14/p14305942/s55736476/095836d2-4549e322-76173a65-25f7947c-8d656f4c.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chills and left chest pain. COMPARISON: ___. CHEST, AP UPRIGHT AND LATERAL: The lungs are clear. Cardiomediastinal and hilar contours are normal. Mild relative elevation of the left hemidiaphragm could be due to gastric distension, or new splenomegaly. There are no pleural effusions or pneumothorax. IMPRESSION: Possible splenomegaly. " a21d88a0-bf6eefab-1a1aa93d-ba2682b9-f2a36393.jpg,validate/p16/p16190725/s52120116/a21d88a0-bf6eefab-1a1aa93d-ba2682b9-f2a36393.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p pericardial window // eval for LLL collapse eval for LLL collapse IMPRESSION: In comparison with the study of ___, other areas little overall change. Again there is enlargement of cardiac silhouette in a patient with intact midline sternal wires. Left chest tube is in place without evidence of pneumothorax. Volume loss is again seen at the left base with associated effusion. No definite vascular congestion. " 5734d80a-4a567294-5d992b37-0e7ef705-dfeedcc3.jpg,validate/p19/p19696532/s59698971/5734d80a-4a567294-5d992b37-0e7ef705-dfeedcc3.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with chest pain // r/o infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: Lung volumes are low, however the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A rounded calcific density projecting over the heart on the lateral view is unchanged from prior and may represent a coronary stent. IMPRESSION: No acute cardiopulmonary process. " e1e621d7-6aee0ca2-ff4e2c99-1c7e5577-2e4748d3.jpg,validate/p13/p13445415/s54588574/e1e621d7-6aee0ca2-ff4e2c99-1c7e5577-2e4748d3.jpg,validation," WET READ: ___ ___ 9:05 AM Subsequent radiographs demonstrate advancement of a Dobbhoff tube into the stomach. There has been interval improvement in the mild pulmonary edema. Small bilateral pleural effusions are noted. No pneumothorax. Left internal jugular central venous catheter is unchanged. WET READ VERSION #1 ___ ___ 1:06 AM Subsequent radiographs demonstrate advancement of a Dobbhoff tube into the stomach. There has been interval improvement in the mild pulmonary edema. Small bilateral pleural effusions are noted. No pneumothorax. Left internal jugular central venous catheter is unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DHT placed // eval position COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received the new Dobbhoff catheter. The course of the catheter is unremarkable, the tip projects over the distal parts of the stomach. No complications, notably no pneumothorax. The other monitoring and support devices as well as the pacemaker leads are in unchanged position. Minimal improvement of the bilateral pleural effusions, the lung bases are better ventilated than on the previous image. Unchanged cardiac silhouette. " b9d80af0-47f2cafb-b4e7b488-0338b633-8794fc86.jpg,validate/p12/p12614920/s51596734/b9d80af0-47f2cafb-b4e7b488-0338b633-8794fc86.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of cough, fever, dyspnea. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. 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. " dd1fcc11-a5da54a2-932a451e-e1cc7aa1-2a1f30ea.jpg,validate/p14/p14995589/s58184528/dd1fcc11-a5da54a2-932a451e-e1cc7aa1-2a1f30ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with CVA, HTN, CHF, afib, presenting with worsening ___ edema and SOB. COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Cardiomegaly is noted, mild with bilateral small pleural effusions noted. Suture material is noted in the right mid lung. There is mild hilar engorgement without frank pulmonary edema. Mediastinal contour stable. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild cardiomegaly, small bilateral pleural effusions and mild hilar engorgement. " 3d640f95-fa001191-f819fe73-5124024d-19e2865a.jpg,validate/p15/p15199994/s50468739/3d640f95-fa001191-f819fe73-5124024d-19e2865a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Epilepsy, increased seizures, evaluation for infection. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing opacities at the lung bases are seen in unchanged manner. On the left, the opacity appears to be caused by an area of fibrosis. On the right, the opacity is overlaying the rib crossing and could be projectional. Neither the right nor the left opacity suggest acute pneumonia. Otherwise, normal lung parenchyma. Normal size of the cardiac silhouette. No pleural effusions. " ebd2d83f-4d1d93b4-e3a9d104-bf9bf144-71bfb1e6.jpg,validate/p18/p18046197/s55712822/ebd2d83f-4d1d93b4-e3a9d104-bf9bf144-71bfb1e6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Acute shortness of breath, evaluation for acute lung pathology. COMPARISON: ___. FINDINGS: Known and CT documented mediastinal lipomatosis, visualized previously on the ___. This finding accounts for the right predominant mediastinal widening seen on the chest radiograph and that is unchanged as compared to ___. Low lung volumes. Borderline size of the cardiac silhouette without pleural effusions, pulmonary edema or pneumonia. No pneumothorax. " e646af11-e7367e60-646c4599-577a33f3-2bf90bfb.jpg,validate/p16/p16644826/s59800497/e646af11-e7367e60-646c4599-577a33f3-2bf90bfb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON WITH A CHEST CT FROM ___ AS WELL AS A CHEST CT FROM ___ CLINICAL HISTORY: Lower GI bleed, intermittent dizziness, assess pneumonia or CHF. FINDINGS: PA and lateral views of the chest were obtained. Right axillary clips are noted. Right breast shadow is absent compatible with prior mastectomy. The lungs are hyperinflated with upper lobe lucency compatible with underlying emphysema. There is no sign of pneumonia or CHF. No pleural effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. Emphysema. " 3e986d3c-f1e0c707-800b2096-20177169-72024be8.jpg,validate/p11/p11900721/s57043350/3e986d3c-f1e0c707-800b2096-20177169-72024be8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cryptogenic cirrhosis and variceal bleeding s/p TIPS with abd/thoracic hematoma complaining of more SOB and abd fullness // evidence of worsening hematoma vs pulmonary cause of SOB IMPRESSION: As compared to ___ radiograph, cardiomediastinal contours are stable. Pulmonary vascular congestion is accompanied by mild edema and increasing small bilateral pleural effusions. Worsening left retrocardiac opacity is likely a combination of pleural effusion and atelectasis, but superimposed infection in this region is not excluded radiographically " 7f370f5c-16f5a0ae-6c609b4b-1fc0d53e-2c70c0f1.jpg,validate/p16/p16061352/s50556493/7f370f5c-16f5a0ae-6c609b4b-1fc0d53e-2c70c0f1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AI hepatitis/cirrhosis p/w dyspnea and hypoxia s/p EGD. any interval improvement? // interval improvement? interval improvement? IMPRESSION: Comparison to ___. Lung volumes remain low. Unchanged moderate left pleural effusion with left basilar atelectasis and mild cardiomegaly. No pulmonary edema. The left axillary clips are constant in appearance. " 271860e5-4d32b6e7-6ad57a3b-3dc9e145-272b5766.jpg,validate/p13/p13041517/s53043767/271860e5-4d32b6e7-6ad57a3b-3dc9e145-272b5766.jpg,validation," FINAL REPORT HISTORY: Motor vehicle collision. COMPARISON: None available. TECHNIQUE: Frontal chest, right hip and right femur for a total of three views. FINDINGS: Evaluation is limited by overlying trauma board and electronic device over the left lung base. Heart size is top normal. The cardiomediastinal silhouette is otherwise unremarkable. Lungs are grossly clear. There is no large pleural effusion or pneumothorax. The thoracic cage is grossly intact. The right hip joint space is well preserved. There is a displaced transverse fracture through the mid right femur with medial displacement of the distal fragment. IMPRESSION: 1. Transverse fracture through the right mid femur with medial displacement of the distal fragment. 2. No acute cardiopulmonary abnormality. " a19d6995-90cf58c9-07bda657-74fc03b4-1bd5b969.jpg,validate/p17/p17006872/s50392612/a19d6995-90cf58c9-07bda657-74fc03b4-1bd5b969.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Possible pneumothorax. Evaluate with expiratory radiograph. IMPRESSION: PA inspiration and expiration and lateral chest radiograph compared to ___ through ___: There is no pneumothorax or pleural effusion. Postoperative atelectasis and residual hemorrhage along chain suture in the right upper lobe has not changed since ___, having improved over the preceding week. Expiratory view shows minimal change in lung volumes suggesting small airway obstruction. Heart size is normal. Hilar and mediastinal contours are unremarkable. " 7641a6e4-7c84daee-c76e1ee5-e7c56b3a-19ebc7a0.jpg,validate/p14/p14289175/s58279114/7641a6e4-7c84daee-c76e1ee5-e7c56b3a-19ebc7a0.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman chest pain, shortness breath on exertion. Evaluate heart size. 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. IMPRESSION: No acute cardiopulmonary disease. " 427d905b-2e8eb726-84a98692-de2d9c74-de1f3f22.jpg,validate/p17/p17197198/s51440372/427d905b-2e8eb726-84a98692-de2d9c74-de1f3f22.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest pain. There is mild cardiomegaly. The aorta is tortuous. There is no evidence of pneumonia, CHF, pneumothorax or pleural effusion. The main pulmonary arteries are enlarged as before. " a68a8c5b-f65567bf-ebf7a6a3-a82fed8a-a4d0ba3a.jpg,validate/p14/p14763771/s53363364/a68a8c5b-f65567bf-ebf7a6a3-a82fed8a-a4d0ba3a.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f0b2ff9c-bf1dcc0c-1b6a165d-fd03325d-6d57f834.jpg,validate/p11/p11759245/s51973580/f0b2ff9c-bf1dcc0c-1b6a165d-fd03325d-6d57f834.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with anoxic brain injury, worsening resp status // pls eval for volume overload, reversible causes of hypoxia IMPRESSION: As compared to ___ radiograph, right lower lobe opacity has nearly resolved, but a left lower lobe opacity has progressed. In a patient with a neurological condition, recurrent aspiration and or developing aspiration pneumonia should be considered. Exam is otherwise remarkable for removal of nasogastric tube and development of distended loops of bowel in the imaged upper abdomen, incompletely evaluated on this portable chest radiograph. " d953023f-3c7fe1ae-2b46289e-052d511d-d0d7fa6e.jpg,validate/p13/p13594538/s53022504/d953023f-3c7fe1ae-2b46289e-052d511d-d0d7fa6e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 2wks s/p tracheobronchoplasty // Eval post-op tracheobronchoplasty Eval post-op tracheobronchoplasty IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. The lungs are now essentially clear with no evidence of pneumothorax or vascular congestion. There is again soft tissue prominence posterior to the trachea on the lateral view no, slightly less than the study of ___, but substantially more from the preoperative study of ___. " b0681c58-d88e3db8-11ce40c3-76fab865-e2e44f03.jpg,validate/p11/p11296936/s51326459/b0681c58-d88e3db8-11ce40c3-76fab865-e2e44f03.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath, to rule out pneumonia. COMPARISON: Chest radiograph ___. SINGLE PORTABLE AP CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are stable, with the heart in the upper limits of normal. The lungs are well expanded. Bilateral diffuse ground-glass opacities and prominent interstitial markings in the right lung base, indicate mild-to-moderate pulmonary edema. A small right pleural effusion is present. There is no pneumothorax. No consolidation is identified to suggest pneumonia. IMPRESSION: Small right pleural effusion and mild-to-moderate pulmonary edema. " c95e48a5-65919825-544126f3-77fef854-bc305a04.jpg,validate/p11/p11625962/s57615339/c95e48a5-65919825-544126f3-77fef854-bc305a04.jpg,validation," FINAL REPORT HISTORY: Chest tightness, dizziness, shortness of breath. Evaluate interval worsening or resolution of PNA. COMPARISON: Prior chest radiograph from ___ and chest CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is moderately enlarged. There is mild pulmonary edema. As compared to prior chest radiograph from ___, there is improved aeration of the right lung base. Persistent bibasilar opacities likely reflect chronic interstitial abnormality as on prior chest CT ___. No new focal consolidations are noted. There are improved bilateral pleural effusions. There is no pneumothorax. IMPRESSION: Mild pulmonary edema. Improved right lung base opacity likely reflecting resolving pneumonia with persistent bibasilar interstitial opacities, which likely relate to known chronic lung disease. " 73edb6e6-e0cc75c2-f964d962-a1d1033c-d8c3b114.jpg,validate/p11/p11947526/s55301767/73edb6e6-e0cc75c2-f964d962-a1d1033c-d8c3b114.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain, history of polysubstance abuse, evaluate for pneumonia or pneumothorax. COMPARISON: ___. FINDINGS: PA and lateral views of the chest demonstrate well-expanded and clear lungs. The heart is normal in size and cardiomediastinal contour is unremarkable. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " b3150f35-b192bc41-73586fa9-b171383e-f27a9897.jpg,validate/p16/p16969166/s55515452/b3150f35-b192bc41-73586fa9-b171383e-f27a9897.jpg,validation," FINAL REPORT INDICATION: Abdominal pain, nausea and vomiting. Evaluate for free air. COMPARISON: Chest radiograph, ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There is no free air below the hemidiaphragms. IMPRESSION: 1. No acute cardiopulmonary process. 2. No evidence of free air below the hemidiaphragms. " cabafac7-bb0e0aaf-27ea5fa8-8b94ee94-0e647a8a.jpg,validate/p16/p16388630/s50747911/cabafac7-bb0e0aaf-27ea5fa8-8b94ee94-0e647a8a.jpg,validation," FINAL REPORT INDICATION: History: ___F with trach, PICC, cough // eval PICC line, aspiration PNA TECHNIQUE: Portable frontal view of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: There is a tracheostomy tube in stable position. A nasogastric tube enters the stomach and off the radiograph. A new left PICC ends at the confluence of the right brachiocephalic vein and the superior vena cava. The bilateral lower lobe opacities represent known aspiration pneumonia that is slightly improved since ___. Small bilateral pleural effusions are stable since ___. No pneumothorax. The cardiac and mediastinal contours are stable. IMPRESSION: A new left PICC ends at the confluence of the right brachiocephalic vein and the superior vena cava. There is no pneumothorax. Bilateral lower lobe opacities represent known aspiration pneumonia that is slightly improved since ___. Small bilateral pleural effusions are relatively stable since ___. " f52b7f44-bd6ddb6e-1a92e476-c1e02fed-e4bd762d.jpg,validate/p18/p18009599/s58922444/f52b7f44-bd6ddb6e-1a92e476-c1e02fed-e4bd762d.jpg,validation," FINAL REPORT HISTORY: Chest tube removal, to assess for pneumothorax. FINDINGS: In comparison with the study of ___, the left chest tube has been removed and there is no evidence of acute pneumothorax. Hazy opacification bilaterally with preservation of pulmonary vessels, more prominent on the right, is consistent with layering pleural effusions. The other monitoring and support devices are essentially unchanged. " bdc993a4-3f5ebef2-f0d4967b-9ca96d06-380bf006.jpg,validate/p10/p10601483/s54483737/bdc993a4-3f5ebef2-f0d4967b-9ca96d06-380bf006.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain and shortness of breath since last night. COMPARISON: None. FINDINGS: There is minimal lingular atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 2365fbcb-4c4665de-7dd6d9e0-f0ee3610-02604380.jpg,validate/p13/p13725044/s53379595/2365fbcb-4c4665de-7dd6d9e0-f0ee3610-02604380.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with PICC line in L arm. Here for workup of numbness/tingling // pls eval for PICC line. also eval for pna or other cardiopulm process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Left-sided PICC terminates in the low SVC without evidence of pneumothorax.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. " f7d62660-77f07f36-d59f34a1-6d85b296-66521013.jpg,validate/p10/p10364180/s54752515/f7d62660-77f07f36-d59f34a1-6d85b296-66521013.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD, leukocytsois // infiltrate vs atelectasis COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The endotracheal tube and the nasogastric tube have been removed. The large parenchymal opacities at the right lung basis and in the left perihilar areas, however, are unchanged. Unchanged appearance of the moderately enlarged cardiac silhouette. No larger pleural effusions. No new parenchymal opacities. " 1d4cedf2-b3fd355d-479ba233-e09caa11-0fa89ecf.jpg,validate/p12/p12177220/s52223470/1d4cedf2-b3fd355d-479ba233-e09caa11-0fa89ecf.jpg,validation," FINAL REPORT INDICATION: ___F with cough and fever // pna? 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. " 821912c1-67336c85-07a341f0-b65e76cd-8b8b43fa.jpg,validate/p16/p16568164/s55748391/821912c1-67336c85-07a341f0-b65e76cd-8b8b43fa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p R port-a-cath placement. // Pls assess for pneumothorax. Wet read to nursing in ___ ___. Thank you! Pls assess for pneumothorax. Wet read to nursing in ___ COMPARISON: There are no prior chest radiographs available. IMPRESSION: A right subclavian infusion port ends in the mid SVC. There is no pneumothorax or mediastinal widening. Rightward mediastinal shift, elevation of the right hemidiaphragm and the appearance of the right infrahilar lung suggests substantial lower lobe atelectasis. Atelectasis in the left lower lung is less severe. Pleural effusions are small if any. " 59ac9858-f3f9391d-43422ea6-3cb2b808-27c64b42.jpg,validate/p17/p17295095/s54958422/59ac9858-f3f9391d-43422ea6-3cb2b808-27c64b42.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of likely allergic reaction versus asthma, shortness of breath, and mild wheezing. 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. IMPRESSION: No acute cardiopulmonary process. " a63edae7-3aaa59f4-84ed27f8-308a115c-7b26c94f.jpg,validate/p14/p14178898/s52562907/a63edae7-3aaa59f4-84ed27f8-308a115c-7b26c94f.jpg,validation," FINAL REPORT AP CHEST, 12:08 P.M. ON ___ HISTORY: Possible pneumothorax after tube removals. IMPRESSION: AP chest compared to ___: A small right apical pneumothorax is new since ___. Small bilateral pleural effusions and left lower lobe atelectasis are stable. Cardiomediastinal silhouette has a normal postoperative appearance. Two midline drains still in place. Right jugular introducer ends at the origin of the superior vena cava. " da2e3909-2cd0e34b-c9428023-5c56786a-462b831a.jpg,validate/p13/p13179346/s58262821/da2e3909-2cd0e34b-c9428023-5c56786a-462b831a.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with shortness of breath for weeks worse this morning, evaluate acute cardiopulmonary process. TECHNIQUE: PA and lateral views. COMPARISON: Chest x-ray from ___. FINDINGS: There has been no significant change compared to prior study with pleural thickening along the lateral aspect of the left lung as well as the left lung base. No focal consolidation is seen. The cardiac silhouette is unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: Unchanged left lateral and basilar pleural thickening and calcifications. No focal consolidation. " c8141e5b-9a1bd704-5cc1f1a9-b58b85f7-32e70eda.jpg,validate/p13/p13408504/s50654095/c8141e5b-9a1bd704-5cc1f1a9-b58b85f7-32e70eda.jpg,validation," WET READ: ___ ___ ___ 9:49 PM NG tube tip in stomach. No other change from recent prior. ___ p___WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with seizures s/p ngt placement // ngt position COMPARISON: ___, 19:12. IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The tube shows a normal course, the site or projects several cm below the gastroesophageal junction. Moderate cardiomegaly and mild fluid overload persist. No new focal parenchymal opacities. No change in position of the tracheostomy tube. " 7ed3fd4a-431cca7e-63778d39-1dea9001-96572c29.jpg,validate/p11/p11296936/s55621327/7ed3fd4a-431cca7e-63778d39-1dea9001-96572c29.jpg,validation," WET READ: ___ ___ ___ 1:29 PM Mild pulmonary interstitial edema/ vascular congestion with trace right pleural effusion, similar to ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___-year-old man did not finish dialysis today, here to evaluate for fluid overload. TECHNIQUE: Upright AP and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: There is an placement of a right HD dialysis catheter since the prior chest radiograph of ___. The cardiac silhouette is top normal in size. The mediastinal contours are within normal limits. There is minimal calcification of the aortic knob. A small amount of right pleural fluid is again seen. No left pleural effusion is seen. There is mild interstitial pulmonary edema and prominence of the pulmonary vasculature. No pneumothorax is seen. IMPRESSION: Mild pulmonary interstitial edema/ vascular congestion with trace right pleural effusion, similar to ___. " 4bb30807-2815836c-6c0c052a-ba84b760-42064dd0.jpg,validate/p15/p15238443/s51572043/4bb30807-2815836c-6c0c052a-ba84b760-42064dd0.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough for two weeks and diffuse rales. Evaluate for pneumonia. COMPARISON: No prior study available for comparison. CHEST, PA AND LATERAL VIEWS: Increased opacity projecting over the heart on the lateral view, probably corresponds to lingular pneumonia. There is no consolidation or mass elsewhere. There is no pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette, hilar contours, and pulmonary vasculature are normal. IMPRESSION: Probable lingular pneumonia. Radiographic followup in ___ weeks following treatment is recommended to ensure resolution. Findings discussed with Dr. ___ by phone at 11:20 a.m. on ___. " a72f6d09-9b90a5f9-1a334fe9-ac971702-f22d9aa4.jpg,validate/p19/p19454512/s58575387/a72f6d09-9b90a5f9-1a334fe9-ac971702-f22d9aa4.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with mechanical fall. Evaluate for traumatic injury. COMPARISON: Chest radiograph and CT from ___. FINDINGS: Chest, PA and lateral. No acute fracture is identified. Persistent elevation of the right hemidiaphragm is chronic. Linear opacity in the left mid lung zone is unchanged. There is a small left pleural effusion. Mild pulmonary vascular congestion is noted. There is no pneumothorax. Mediastinal contours are normal. There are surgical clips in the right upper quadrant of the abdomen. IMPRESSION: 1. Mild pulmonary vascular congestion and small left pleural effusion. 2. Stable elevation of the right hemidiaphragm and linear scarring in the left mid lung zone. " 5c325211-54b76657-ba4139e1-ce999cc7-b3ae03d2.jpg,validate/p16/p16817573/s50716714/5c325211-54b76657-ba4139e1-ce999cc7-b3ae03d2.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with metastatic renal cell carcinoma, known right-sided pneumothorax, evaluate for change in pneumothorax size. FINDINGS: PA and lateral chest views obtained with patient in upright position demonstrate again a residual right-sided pneumothorax located to the axillary region. No significant interval change can be identified when comparing the multiple chest examinations obtained during ___, ___ and ___. The general findings of advanced pulmonary metastases remain and superior mediastinal mass also unchanged. " fca04660-29bb0c85-1a722366-763e0da8-36c45c55.jpg,validate/p15/p15619921/s54877397/fca04660-29bb0c85-1a722366-763e0da8-36c45c55.jpg,validation," FINAL REPORT CLINICAL INDICATION: Weakness and acute cardiopulmonary disease. COMPARISON: None. PORTABLE SUPINE FRONTAL VIEW OF THE CHEST: There are median sternotomy wires. The aortic knob is calcified. The heart size is top normal. There is a moderate left and small right pleural effusion. Prominence of the vasculature indicates vascular congestion. No pneumothorax. there is retrocardiac opacity compatible with volume loss/effusion/infiltrate. IMPRESSION: CHF. " 9fedcaa5-1f56fe5d-8ff5553d-0f0d3fdf-36e7fe75.jpg,validate/p14/p14474735/s51018055/9fedcaa5-1f56fe5d-8ff5553d-0f0d3fdf-36e7fe75.jpg,validation," FINAL REPORT PORTABLE CHEST FILM ___ AT 9:31. CLINICAL INDICATION: ___-year-old with tracheal stenosis status post cervical tracheal resection and reconstruction. Rule out pneumothorax. Comparison to ___ at 7:35. Portable AP upright chest film ___ at 9:31 is submitted. IMPRESSION: 1. Surgical drain overlies the upper mediastinum. Lung volumes remain low, but lungs are grossly clear without evidence of focal airspace consolidation, pleural effusion, pneumothorax, or pulmonary edema. Overall, cardiac and mediastinal contours are unchanged. " 63fecff7-c2e46360-69a78f5a-6542c317-0d6c283b.jpg,validate/p11/p11321986/s53091499/63fecff7-c2e46360-69a78f5a-6542c317-0d6c283b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough and abnormal lung exam. Rule out right lower lobe infiltrate. COMPARISON: Multiple prior chest radiographs, most recently ___. FINDINGS: Frontal and lateral views of the chest were obtained. Mild cardiomegaly is unchanged. Cardiomediastinal contours are stable. Lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. Sternotomy wires are intact. IMPRESSION: Unchanged mild cardiomegaly. No pneumonia. " 6eacfd08-256ca53d-0c612065-0e191ee4-ab0fbb9f.jpg,validate/p11/p11658225/s57084217/6eacfd08-256ca53d-0c612065-0e191ee4-ab0fbb9f.jpg,validation," FINAL REPORT INDICATION: ___F smoker with h/o liposarcoma (right thigh ___) c new RLL lung nodule found on surveillance scanning now s/p R VATS RLL wedge s/p chest ___ tube removal // pneumothorax? Please perform at 1:30 PM. COMPARISON: Radiographs from ___ IMPRESSION: The right-sided chest tube has been removed. Cardiomediastinal silhouette is within normal limits. There are small bilateral pleural effusions and subsegmental atelectasis at the lung bases. There is no focal consolidation or pneumothoraces. " 9bddedcb-39d627ba-944cf0fb-0001b17e-ceec58c5.jpg,validate/p18/p18548867/s59605502/9bddedcb-39d627ba-944cf0fb-0001b17e-ceec58c5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Nausea, question pneumonia. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm. " 2d81b490-0917d79f-11cd3223-539edc97-e5097727.jpg,validate/p14/p14086236/s52901222/2d81b490-0917d79f-11cd3223-539edc97-e5097727.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: Dual-chamber pacemaker appears in standard position. Elevation of the right hemidiaphragm is chronic.No focal parenchymal consolidation of pleural effusion, pneumothorax. Mild right infrahilar atelectasis. Moderate cardiomegaly is stable. IMPRESSION: 1. Moderate cardiomegaly and persistently elevation of the right hemidiaphragm, however no evidence of pneumonia or heart failure. " e1024a68-5a9d9b5f-18f3c1f3-08c85eee-eb31664c.jpg,validate/p12/p12150181/s55929631/e1024a68-5a9d9b5f-18f3c1f3-08c85eee-eb31664c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of chronic cough // causes of chronic cough causes of chronic cough IMPRESSION: The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " cd61147e-2c17861d-b935741f-22fccb39-f2b79fb8.jpg,validate/p14/p14482958/s50568602/cd61147e-2c17861d-b935741f-22fccb39-f2b79fb8.jpg,validation," WET READ: ___ ___ 9:53 PM No acute process ______________________________________________________________________________ FINAL REPORT HISTORY: Anorexia, question acute process. CHEST, TWO VIEWS: COMPARISON: ___. Possible pectus excavatum. The heart is not enlarged and in fact appears relatively small. No CHF, focal infiltrate, effusion or pneumothorax is detected. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy or pulmonary nodule is detected. There appears to be mild right convex scoliosis centered at T4-5. No vertebral compression fracture or gross degenerative change is detected in the thoracic spine. Compared with ___, the NG tube is no longer visible. Otherwise, I doubt significant interval change. " 1c8a508f-276d5f98-eac5bbb9-39f4c6eb-3e30447e.jpg,validate/p18/p18068560/s50966378/1c8a508f-276d5f98-eac5bbb9-39f4c6eb-3e30447e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic lung cancer presenting with massive hemoptysis, intubated, s/p 2 bronchoscopies to remove clot from left mainstem. // please assess location of ET tube please assess location of ET tube COMPARISON: ___ IMPRESSION: Complete opacification of left hemithorax is unchanged. There is slightly more pronounced vascular enlargement on the right. No other substantial changes demonstrated compared to previous study. " 0220e683-8f202cf6-919777c6-d4e30008-80fa02fe.jpg,validate/p19/p19380289/s52258443/0220e683-8f202cf6-919777c6-d4e30008-80fa02fe.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is mildly enlarged with a left ventricular predominance. The aorta is unfolded. There may be a small hiatal hernia. Mediastinal and hilar contours are otherwise unremarkable. Hyperinflation of the lungs with flattening of the diaphragms may suggest underlying COPD. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 17678e5b-699f9f9e-d9be2076-9889b601-96db2890.jpg,validate/p18/p18065731/s58566987/17678e5b-699f9f9e-d9be2076-9889b601-96db2890.jpg,validation," FINAL REPORT HISTORY: Right renal failure concern for fluid overload reference exam ___. COMPARISON: FINDINGS: There is increased infiltrate in the left lung most marked laterally again seen is dense retrocardiac opacity. The right-sided chest tube is again seen. There is a right lateral pneumothorax that is small but is better visualized on today's study than on the study from the prior day. Volume loss is present right lower lung as well. " f48c9181-892c26b8-19252e9e-cefec0cf-b302bfe4.jpg,validate/p17/p17946205/s56213886/f48c9181-892c26b8-19252e9e-cefec0cf-b302bfe4.jpg,validation," 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. " 88656a91-e223ea7f-b2cc3d06-840c6fb7-3480e60c.jpg,validate/p19/p19864559/s53915009/88656a91-e223ea7f-b2cc3d06-840c6fb7-3480e60c.jpg,validation," 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. " 90a18cf0-eed9d288-bd6a10ec-9a6a2905-0a9c796b.jpg,validate/p12/p12807272/s58661684/90a18cf0-eed9d288-bd6a10ec-9a6a2905-0a9c796b.jpg,validation," FINAL REPORT HISTORY: Recent pneumonia, to assess for resolution. FINDINGS: In comparison with the study of ___, the right mid lung opacification laterally appears to be slightly smaller. There is little change in the appearance of the opacification in the left lung at approximately the same level. Tenting of the right hemidiaphragm is again seen. A repeat study within approximately two weeks would be helpful to demonstrate further clearing of this process. " 88515e58-1e418234-dc2fedd5-fc697ff5-8eb901a6.jpg,validate/p19/p19760609/s53429045/88515e58-1e418234-dc2fedd5-fc697ff5-8eb901a6.jpg,validation," FINAL REPORT INDICATION: History: ___F with cough, fever // eval for pna COMPARISON: None. FINDINGS: PA and lateral chest radiographs. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Mild dextroscoliosis of the thoracic spine is noted. IMPRESSION: No acute cardiopulmonary process. " e4fcdd40-76601233-bc4c8d75-4946ae32-d2feb7eb.jpg,validate/p17/p17285723/s52853903/e4fcdd40-76601233-bc4c8d75-4946ae32-d2feb7eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. Atherosclerotic calcifications are noted in the aortic knob. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. S-shaped scoliosis of the thoracolumbar spine is again noted. Fractured posterior fusion hardware within the thoracolumbar spine is incompletely imaged but visualized aspect of the hardware appears grossly unchanged compared to the previous exam. IMPRESSION: No acute cardiopulmonary abnormality. " 3716d953-cd64b0c7-b7b6337a-c52d9d34-e00b7def.jpg,validate/p18/p18328384/s52281715/3716d953-cd64b0c7-b7b6337a-c52d9d34-e00b7def.jpg,validation," 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. " e7d4e068-306cec6b-140f2e23-4534086d-e80680d2.jpg,validate/p19/p19720782/s53953586/e7d4e068-306cec6b-140f2e23-4534086d-e80680d2.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, COPD, and small cell lung cancer in the past. Please assess for interval change. COMPARISON: Multiple chest radiographs, the latest from ___ and a CT of the chest from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show a persistent right mediastinal opacity consistent with radiation fibrosis from known lung cancer treatment. A right lower lobe loculated effusion appears unchanged. The cardiomediastinal silhouette and left hilar contours are normal. No pneumothorax is present. IMPRESSION: Essentially unchanged right paramediastinal fibrosis with a loculated right lower lobe effusion. " f7b36dc9-8f81519c-b1d8503b-01ce4d1e-145aa7fa.jpg,validate/p13/p13286565/s51375803/f7b36dc9-8f81519c-b1d8503b-01ce4d1e-145aa7fa.jpg,validation," FINAL REPORT HISTORY: Transbronchial biopsy, to check for pneumothorax. FINDINGS: Following transbronchial biopsy, there is no evidence of pneumothorax. No acute cardiopulmonary disease. Dual-channel pacer device remains in place. " 0a6b2c5d-8275e07c-00f3ce29-b32df20c-4e2248c7.jpg,validate/p17/p17100806/s58018807/0a6b2c5d-8275e07c-00f3ce29-b32df20c-4e2248c7.jpg,validation," WET READ: ___ ___ ___ 9:11 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: Cholecystitis, preop for laparoscopic cholecystectomy. CHEST, SINGLE AP PORTABLE VIEW: COMPARISON: Chest x-ray dated ___. Lungs are probably slightly hyperinflated. There is mild cardiomegaly. The aorta is unfolded. Right paratracheal soft tissues are prominent, but likely accentuated by lordotic positioning. No CHF, focal infiltrate or effusion is identified. Lucencies surrounding the liver and along the lateral edge of the liver and spleen likely reflect some physiologic retroperitoneal fat. Compared with ___, the cardiomediastinal silhouette is slightly more prominent. The paratracheal soft tissues are slightly more prominent. Otherwise, I doubt significant interval change. IMPRESSION: 1. Possible background hyperinflation. 2. No acute pulmonary process identified. 3. Mild cardiomegaly.Poor visualization of the cardiac apex likely reflects the presence of a fat pad. 4. Prominence of right paratracheal soft tissues could reflect vascular structures accentuated by lordotic technique. " ca55481f-3895ec03-76a040b8-d0fbd6ec-bcac13eb.jpg,validate/p11/p11309915/s51462743/ca55481f-3895ec03-76a040b8-d0fbd6ec-bcac13eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with gastric outlet obstruction s/p NGT placement // ?ngt placement ?ngt placement IMPRESSION: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends into the lower body of the stomach with the side port distal to the esophagogastric junction. The remainder of the examination is unchanged, except for free gas beneath the hemidiaphragm related to the the recent abdominal procedure. NOTIFICATION: This information has been telephoned to Dr. ___, ___ was aware of the small pneumoperitoneum. " 9e2bc75b-1ad3c385-11347d12-71535de5-574d5642.jpg,validate/p18/p18999116/s57126020/9e2bc75b-1ad3c385-11347d12-71535de5-574d5642.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with chronic dry cough since two months. No fever, mild shortness of breath, rule out infiltrate. COMPARISON: ___. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are normal. There is no pneumothorax or pleural effusion. CONCLUSION: There is no acute cardiopulmonary process. The exam is unchanged since ___. " 853aec42-ccbc9086-103b68dd-e1d295c2-783561dc.jpg,validate/p15/p15883265/s55948905/853aec42-ccbc9086-103b68dd-e1d295c2-783561dc.jpg,validation," FINAL REPORT INDICATION: Unresponsive episode, intubated. COMPARISON: Comparison is made to chest radiograph performed at outside hospital ___. FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. Patient is intubated with endotracheal tube terminating 2.8 cm above the carina. Nasogastric tube is coiled within the fundus. Bilateral low lung volumes identified with increased opacification within the right lung base compared to next preceding study, may represent atelectasis, though given unresponsive state, aspiration is a consideration. No pleural effusion or pneumothorax evident. IMPRESSION: Endotracheal tube 2.8 cm above the carina. Well-positioned nasogastric tube. Increased opacification of right lung base, atelectasis versus aspiration pneumonitis. " d58e111c-eb923def-6e103d94-e46c789a-58b1c823.jpg,validate/p16/p16406717/s51977342/d58e111c-eb923def-6e103d94-e46c789a-58b1c823.jpg,validation," WET READ: ___ ___ ___ 8:19 PM Lung volumes are low which may make the tip of the PICC line appear low. With better inspiration the tip is likely near the cavoatrial junction. Opacity at the left base could reflect atelectasis and small pleural effusion, however infection cannot be excluded in the proper clinical setting. WET READ VERSION #___ ___ ___ 8:01 PM Lung volumes are low which may make the tip of the PICC line appear low. With better inspiration the tip is likely near the cavoatrial junction. Opacity at the left base could reflect atelectasis and small pleural effusion, however infection cannot be excluded in the proper clinical setting. WET READ VERSION #___ ___ ___ ___ 8:16 PM Lung volumes are low which may make the tip of the PICC line appear low. With better inspiration the tip is likely near the cavoatrial junction. Opacity at the left base could reflect atelectasis and small pleural effusion, however infection cannot be excluded in the proper clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with PICC line from outside hospital // cONFIRM PICC line placement COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: The patient is somewhat kyphotic in positioning. The right PICC line tip is in the SVC right atrial junction. There is no pneumothorax. There is atelectasis/consolidation in the left lung base. There may be a small left effusion. " d57a613a-cefd66fd-4eb18781-68acd9de-cf43e7e9.jpg,validate/p13/p13762124/s54257063/d57a613a-cefd66fd-4eb18781-68acd9de-cf43e7e9.jpg,validation," FINAL REPORT COMPARISON: Chest radiographs, ___, ___, ___, ___. TECHNIQUE: Single Portable frontal chest radiograph. HISTORY: Female with respiratory failure, on ventilation. Assess for interval change. FINDINGS: ET tube tip is 4.5 cm above the level of the carina and is in appropriate position. NG tube with side port below the gastroesophageal junction enters into proximal stomach and is out of view. Swan-Ganz catheter with tip in proximal right pulmonary artery is unchanged. Left brachial line with tip at the junction of subclavian and axillary vein. Mild interval improvement in moderate diffuse bilateral heterogeneous opacities with both interstitial and parenchymal components. No pneumothorax or pleural effusion. Heart size, mediastinal contour and hila are normal. IMPRESSION: 1. Right Swan-Ganz catheter tip is in the proximal right pulmonary artery and is unchanged. 2. Mild improvement in diffuse moderate bilateral heterogeneous opacities which may represent moderate pulmonary edema. " da6b825b-2abc49e6-5efc7c6c-ea70040e-fc644b39.jpg,validate/p12/p12285052/s50834142/da6b825b-2abc49e6-5efc7c6c-ea70040e-fc644b39.jpg,validation," FINAL REPORT PORTABLE AP CHEST, ___ AT 4:08 CLINICAL INDICATION: ___-year-old with respiratory failure and pneumothorax status post chest tube removal, assess for interval change. Comparison to prior study dated ___ at 8:30. Portable semi-supine chest film, ___ at 4:09 is submitted. IMPRESSION: 1. Endotracheal tube, nasogastric tube, left internal jugular central line are unchanged in position. Persistent patchy opacities at both bases, which could reflect patchy atelectasis, although pneumonia or aspiration should also be considered. No evidence of pulmonary edema. No pleural effusions or pneumothorax. Overall, cardiac and mediastinal contours are stable. Slightly prominent interstitium most likely reflects age-related or small airways related changes. No evidence of pulmonary edema. " 947ba68e-ba967649-992a0845-8dccde70-1ea141b8.jpg,validate/p18/p18097775/s52571624/947ba68e-ba967649-992a0845-8dccde70-1ea141b8.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old male with chest pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusion. The cardiac silhouette is enlarged. Dual-lead pacing device is seen with lead tips in the right ventricular apex and right atrium. The osseous and soft tissue structures are grossly unremarkable, noting hypertrophic changes in the spine. IMPRESSION: Cardiomegaly, but no evidence of active failure or consolidation. " 677b795e-5b603138-9a53eab1-7b6a3787-0fd11b6f.jpg,validate/p13/p13188852/s56145913/677b795e-5b603138-9a53eab1-7b6a3787-0fd11b6f.jpg,validation," FINAL REPORT AP CHEST, 5:38 P.M., ___ HISTORY: ___-year-old man with neutropenic fever. IMPRESSION: AP chest compared to ___: Tip of the right subclavian line ends in the mid-to-low SVC. No pneumothorax, pleural effusion or mediastinal widening. Heart size normal. Lungs grossly clear. Healed left lower lateral rib fractures noted. " 88c7a1f9-8e5befde-554637b7-6e396294-cf44d3b8.jpg,validate/p15/p15591081/s50406790/88c7a1f9-8e5befde-554637b7-6e396294-cf44d3b8.jpg,validation," FINAL REPORT PATIENT HISTORY: ___-year-old man status post cardiac arrest and return of spontaneous circulation after six to eight minutes of downtime, now intubated, status post cooling protocol. INDICATION: Evaluation of interval changes. COMPARISON: Exam is compared to ___. FINDINGS: The ET tube ends at 4 cm from the carina bifurcation. The sidehole of the NG tube is in mid gastric cavity. The right jugular catheter ends in mid SVC. Lung volume is normal, without evidence of consolidation. There is no pleural effusion or pneumothorax. Cardiac size is normal. Mild aortosclerosis. Mild vascular congestion. IMPRESSION: Mild vascular congestion. All the monitoring device are unchanged. " ca10f7f9-593535b0-92b28b49-b4d3dfe5-77eb7da8.jpg,validate/p10/p10427568/s55572041/ca10f7f9-593535b0-92b28b49-b4d3dfe5-77eb7da8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // r/o acute process COMPARISON: Prior study from ___. FINDINGS: PA and lateral views of the chest provided. Lung volumes somewhat low. Crowding of bronchovascular markings in the lower lungs likely accounts for equivocal hazy opacity at the lung bases. Lungs are otherwise clear. No effusion or pneumothorax. No signs of congestion or edema. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " 34dde7cd-c662a10c-15e45d38-ba2d22ae-89fa0c9c.jpg,validate/p13/p13299285/s56248051/34dde7cd-c662a10c-15e45d38-ba2d22ae-89fa0c9c.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient with question small effusion in setting of SIRS related to PJ leakage. Study requested for evaluation of interval change. COMPARISON: Prior portable chest radiographs from ___ through ___. TECHNIQUE: Portable semi-erect chest radiograph. FINDINGS: As compared to previous radiograph from ___, there has been no significant change. There is moderate cardiomegaly with mild-to-moderate pulmonary edema. There are likely small bilateral pleural effusions. There is retrocardiac atelectasis. Monitoring and support devices are unchanged. IMPRESSION: Unchanged chest radiograph with moderate cardiomegaly and mild-to-moderate pulmonary edema. " 3a79c2f1-b637b4e4-8739013f-b4936471-7e0fd03e.jpg,validate/p13/p13030805/s51879796/3a79c2f1-b637b4e4-8739013f-b4936471-7e0fd03e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are within normal limits. Pulmonary vasculature is not engorged. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 1ef349a3-ace82362-07b5d29b-fd408b43-dfb5e698.jpg,validate/p15/p15497465/s58856482/1ef349a3-ace82362-07b5d29b-fd408b43-dfb5e698.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: evaluate for acute process, abdominal free air. Pain and vomiting. TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: The lungs are hyperinflated but clear except for upper lung apex scarring. There is no pleural effusion or pneumothorax. Cardiac size is within normal limits. There is no intra-abdominal free air identified. IMPRESSION: No evidence of acute cardiopulmonary process. No free air. Hyperinflated lungs. " 9a485653-4f5b1c64-fd8c70ae-6f13a5b1-367405cf.jpg,validate/p17/p17581149/s52309863/9a485653-4f5b1c64-fd8c70ae-6f13a5b1-367405cf.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with h/o SCC with tracheostomy now with low grade fever // eval pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiographs dated ___, CT chest dated ___, and PET-CT dated ___. . FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are detected. IMPRESSION: No evidence of acute cardiopulmonary process. " 3e179ec6-2dd8aea9-b1ef694b-eafe6ce6-0a175813.jpg,validate/p17/p17763117/s54899257/3e179ec6-2dd8aea9-b1ef694b-eafe6ce6-0a175813.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old female patient with delirium, leukocytosis, evaluate for pneumonia. FINDINGS: Patient's condition required examination in sitting upright position using AP frontal view and left lateral views. Comparison is made with the next preceding portable chest examination of ___. As before, there is status post sternotomy. Moderate cardiac enlargement is seen. Previously identified permanent pacer with dual intracavitary electrodes and ICD device in unchanged position. The same holds for the recently placed right-sided PICC line which is now seen to reach in the upper third of the right atrium. Moderate cardiac enlargement as before. No signs of acute CHF and no acute parenchymal infiltrates are present. Lateral and posterior pleural sinuses are free from any fluid accumulation. IMPRESSION: Stable chest findings, no evidence of new acute pneumonia. " ab8af34a-deefbe56-aa7f7220-1cd93898-c99587e5.jpg,validate/p12/p12176298/s52679036/ab8af34a-deefbe56-aa7f7220-1cd93898-c99587e5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with lung cancer after right upper lobectomy. AP radiograph of the chest was compared to ___. The patient was extubated in the meantime interval. The right upper chest air collection has minimally decreased. There is on the other hand right lower lung atelectasis and potential accumulation of right pleural effusion. The left lung appears to be unchanged. The right chest tube is in place as well as the mediastinal drain. " 5ad338bb-545471e8-38533899-5fedc1a8-2dcb88dc.jpg,validate/p13/p13153136/s52247188/5ad338bb-545471e8-38533899-5fedc1a8-2dcb88dc.jpg,validation," FINAL REPORT INDICATION: History: ___F s/p unwitnessed fall // unwitnessed fall; poor historian; left eye ecchymosis and edema COMPARISON: The comparison is made with prior studies including ___. FINDINGS: Since the prior study, there is marked interval change with obscuration of the right lung base. There appears to be a large effusion on the lateral film and there is atelectasis in the right lung base. There is added density in the region of the right hila which could represent atelectasis, adenopathy or mass. There is a gas density in the right lower chest which could represent lung or possibly subdiaphragmatic air or bowel. I would recommend a right-side-up decubitus film to evaluate for pneumoperitoneum or pneumothorax. There is blunting of the left CP suggesting small effusion. There is no CHF. Degenerative changes are present in the spine. IMPRESSION: There is obscuration of the right lung base and there appears to be a large effusion present and adjacent atelectasis. There is added density in the region of the right hila which could represent atelectasis, adenopathy or mass. A right-side-up lateral decubitus exam is recommended to evaluate for the possibility of subdiaphragmatic gas or pneumothorax. These findings were discussed with Dr. ___ in the emergency room. NOTIFICATION: Dr. ___ reported the findings to Dr. ___ by telephone on ___ at 4:17 PM, 5 minutes after discovery of the findings. " a780c20d-026b096c-84c1d67e-7ac7e379-b618e88e.jpg,validate/p16/p16743731/s58778955/a780c20d-026b096c-84c1d67e-7ac7e379-b618e88e.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with tachycardia and fever. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Left IJ central venous catheter is no longer seen. The lateral demonstrates small to moderate size bilateral effusions. The lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Small-moderate bilateral pleural effusions. " bb9a6b62-8a566b66-85f82952-10b0672e-f820e54c.jpg,validate/p12/p12043836/s57333020/bb9a6b62-8a566b66-85f82952-10b0672e-f820e54c.jpg,validation," FINAL REPORT HISTORY: Lactic acidosis with concern for sepsis. FINDINGS: In comparison with the study of ___, there is again huge enlargement of the cardiac silhouette. Relatively mild pulmonary vascular congestion, with discordancy raising the possibility of pericardial effusion or cardiomyopathy. Area of increased opacification at the right base could merely reflect crowding of vessels, though the possibility of developing consolidation would have to be considered in the appropriate clinical setting. The left hemidiaphragm is not as sharply seen, consistent with some volume loss in the left lower lung. " 0de8f7c7-9b77010a-d8accd16-9aca9293-6d568c8d.jpg,validate/p17/p17397284/s54762380/0de8f7c7-9b77010a-d8accd16-9aca9293-6d568c8d.jpg,validation," FINAL REPORT HISTORY: Chronic pain with MVC. FINDINGS: In comparison with the study of ___, there is continued and probably worsening opacification in the left hemithorax with obliteration of the hemidiaphragm, consistent with increasing layering fluid in the pleural space. The status of the underlying lung is difficult to assess. The right lung is essentially clear. " a6d21c78-91aa7afd-e79982c1-75ad474d-93138f42.jpg,validate/p15/p15034985/s51649509/a6d21c78-91aa7afd-e79982c1-75ad474d-93138f42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p thoracotomy LLL lobectomy // please assess for ptx please assess for ptx COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: As seen best on the lateral view, a new left paraspinal air and fluid collection is more likely in the pleural space than the mediastinum, and there is a smaller air and fluid collection loculated anteriorly. A very small pleural air collection is present at the apex. Left apical pleural drain is unchanged in position. No nasogastric tube is present in the stomach is moderately distended with air and fluid, and improvement since ___. Atelectasis at the base of the right lung is mild. Heart is normal size. Epidural infusion catheter is still in place. NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 3:12 PM, 5 minutes after discovery of the findings. " b4723d89-bb2ad618-697f37ba-958741b5-1d845b99.jpg,validate/p14/p14682236/s57110984/b4723d89-bb2ad618-697f37ba-958741b5-1d845b99.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with cough and wheezing. COMPARISON: ___. Note that images were acquired on ___ at 4:20 available for radiologist's review until ___ at 11:30. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well inflated and clear. No focal consolidation, effusion, pneumothorax is present. Cardiac and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " a354529d-58895e20-2250ffa2-d88ebbf5-00875a42.jpg,validate/p16/p16773335/s59336199/a354529d-58895e20-2250ffa2-d88ebbf5-00875a42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, now intubated // any interval change? tubes in the right place? TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is increase in the pulmonary vascular redistribution and patchy areas of alveolar infiltrate most marked in the left lower lung. There is volume loss in both lower lobes. The heart is moderately enlarged. There small bilateral pleural effusions left greater than right. The ET tube and NG tube are unchanged. . IMPRESSION: Worsened pulmonary vascular congestion. " 5ea925b4-23f167ba-5fd11a77-2bb184ba-879ceb63.jpg,validate/p13/p13417577/s56849204/5ea925b4-23f167ba-5fd11a77-2bb184ba-879ceb63.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and hypoxia. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. There has been interval removal of the right PICC. Again seen are opacities in the left base, improved compared to ___. This is likely due to a large left pleural effusion, probable superimposed atelectasis. A new opacity is seen in the lateral right base, concerning for pneumonia. A left apical cavitary lesion is unchanged. No pneumothorax is seen. IMPRESSION: 1. New opacity in the lateral right lung base, concerning for pneumonia or aspiration. 2. Persistent opacity in the left lung base, likely due to a combination of pleural effusion and superimposed atelectasis. " 1f78095e-1a83fd6c-51fd10af-041df508-3c83906b.jpg,validate/p16/p16026540/s59102428/1f78095e-1a83fd6c-51fd10af-041df508-3c83906b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph PA and lateral INDICATION: ___ year old woman with refractory epilepsy with multiple falls sustained during seizure activity // Please assess integrity of vagus nerve stimulator implanted in her left chest area with lead extending up to her vagus nerve in her neck/lower cervical area- assess for any loosened connections or fractured leads. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The vagus nerve stimulator is again seen in the left chest wall, and is without evidence of lead fracture. The lungs are clear bilaterally, without focal consolidations, pleural effusions or pneumothorax. The mediastinum, hila and heart are within normal limits. Mild dextroscoliosis, unchanged from prior. No acute osseous abnormalities. IMPRESSION: Vagus nerve stimulator is appropriately positioned, without evidence of lead fracture. " a807429c-52ea5ec6-a6decb0e-da72b011-9e602d00.jpg,validate/p10/p10751261/s50106268/a807429c-52ea5ec6-a6decb0e-da72b011-9e602d00.jpg,validation," FINAL REPORT INDICATION: Dyspnea on exertion. Evaluate for acute process. 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. " ada71e83-b199814a-95a6e5ac-e05483eb-1ba63c56.jpg,validate/p12/p12538793/s53948237/ada71e83-b199814a-95a6e5ac-e05483eb-1ba63c56.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY ___ COMPARISON: ___. FINDINGS: Left PICC continues to terminate in the mid superior vena cava. Heart size is normal, and lungs are clear. " 98f738ce-496a7693-a7b54048-a73dd6b9-ad24d38c.jpg,validate/p15/p15280616/s52676204/98f738ce-496a7693-a7b54048-a73dd6b9-ad24d38c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with increasing WBC count, previously seen pneumonia // evaluate for infection COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral views of the chest provided. Moderate-to-severe cardiomegaly. Pacer leads follow their expected course to the right atrium and ventricle. The consolidation in the right lower lobe has mildly improved, consistent with resolving pneumonia. No new focal consolidation is seen. Pulmonary vascular congestion is mildly improved. The right hilum is enlarged, for which attention on follow-up studies is recommended. Mediastinal contours are unchanged. No pneumothorax or pleural effusion. Thoracic compression fracture is again seen. IMPRESSION: Mildly improved right lower lobe consolidation, consistent with resolving pneumonia. Mildly improved pulmonary vascular congestion. " f05b8ca2-70f99210-415364e0-4791fe5b-bd1e4631.jpg,validate/p16/p16296993/s55931575/f05b8ca2-70f99210-415364e0-4791fe5b-bd1e4631.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with COPD, acute onset dyspnea today // ?infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes and mild vascular congestion. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mild to moderately enlarged. Compression of a vertebral body at the thoracolumbar junction is again noted. IMPRESSION: Low lung volumes and mild vascular congestion. Mild to moderate enlargement of the cardiac silhouette. " f710a8a7-e8cab5d9-c059498f-0efd4cc5-00a4e01a.jpg,validate/p15/p15558620/s58082617/f710a8a7-e8cab5d9-c059498f-0efd4cc5-00a4e01a.jpg,validation," 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. " f7ad8a6f-716cf82e-497c3b52-91fd210f-fddfa546.jpg,validate/p11/p11057136/s53228392/f7ad8a6f-716cf82e-497c3b52-91fd210f-fddfa546.jpg,validation," 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 ___. " 20f5f2f7-b1e33dab-8ef4b606-11976605-dc0a9d7d.jpg,validate/p19/p19172465/s59735783/20f5f2f7-b1e33dab-8ef4b606-11976605-dc0a9d7d.jpg,validation," FINAL REPORT INDICATION: Positive PPD. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary nodule. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of active or prior pulmonary tuberculosis. " 17d0983e-222737d2-8f4ce065-967f8a6a-e8c377dc.jpg,validate/p14/p14338126/s58825079/17d0983e-222737d2-8f4ce065-967f8a6a-e8c377dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with RNYGB, known marginal ulcer with severe abdominal pain. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is mild left basal platelike atelectasis. Otherwise lungs are clear. 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: No acute intrathoracic process. " 73ede048-70891c20-2f0f245d-8ef80135-184157aa.jpg,validate/p18/p18727860/s57003295/73ede048-70891c20-2f0f245d-8ef80135-184157aa.jpg,validation," FINAL REPORT HISTORY: Prolonged cough. FINDINGS: No previous images. There is hyperexpansion of the lungs suggesting some underlying chronic pulmonary disease. However, no evidence of cardiomegaly, vascular congestion, pleural effusion, or acute focal pneumonia. " 3fbf1535-d4677754-8036e144-ffef3d20-0c093229.jpg,validate/p19/p19404491/s52936250/3fbf1535-d4677754-8036e144-ffef3d20-0c093229.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain radiating to back, to evaluate for mediastinal widening. COMPARISON: Chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are normal. The lungs are are hyperinflated, consistent with COPD. No consolidation or pulmonary edema is seen. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary pathology. " 3ac39e05-c25b6fa6-aa666d6c-871554cd-3e7f55ef.jpg,validate/p13/p13295971/s55077492/3ac39e05-c25b6fa6-aa666d6c-871554cd-3e7f55ef.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with hypothermia // r/o acute process COMPARISON: CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY ___ IMPRESSION: Heart size top-normal. Previous pulmonary vascular engorgement has improved. There is no edema or pneumonia no evidence of pleural effusion. Mild enlargement of the azygos vein suggests elevated central venous pressure. " 4d570418-d3ca8bd4-9742e68b-72473734-cfc92f53.jpg,validate/p16/p16093698/s58826528/4d570418-d3ca8bd4-9742e68b-72473734-cfc92f53.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever. Question pneumonia. 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. " 9a8a7f9d-53724715-3300fccc-1317eb07-d715568b.jpg,validate/p12/p12368086/s59939626/9a8a7f9d-53724715-3300fccc-1317eb07-d715568b.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: 6 days of productive 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. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " dddef9c1-9218f092-735ff1e9-bdc36d05-8973705f.jpg,validate/p16/p16163176/s51108315/dddef9c1-9218f092-735ff1e9-bdc36d05-8973705f.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and COPD. 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 disease. " 1e92b54e-6342a5cb-dc8bdcb3-baa7023e-420a6ac5.jpg,validate/p14/p14987339/s54114707/1e92b54e-6342a5cb-dc8bdcb3-baa7023e-420a6ac5.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT 10:22 CLINICAL INDICATION: ___-year-old with HIV, admitted for cellulitis, now with nonproductive cough. Comparison to ___. PA and lateral views of the chest, ___ at 10:22 are submitted. IMPRESSION: Lungs are well inflated without evidence of focal airspace consolidation, to suggest pneumonia. No pleural effusions, pulmonary edema or pneumothorax. Overall, cardiac and mediastinal contours are upper limits of normal given PA technique. No acute bony abnormality. " f3803d55-26f28d54-1e954fdb-9a8e8e72-6f514e94.jpg,validate/p18/p18043576/s50840973/f3803d55-26f28d54-1e954fdb-9a8e8e72-6f514e94.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // interval change TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: ___. FINDINGS: The patient has had prior median sternotomy. Sternotomy wires are intact and aligned. All support devices, including ET tube, feeding tube, and right IJ central line remain in satisfactory position. A moderate layering left pleural effusion has increased. A small layering right pleural effusion is unchanged. There is no pneumothorax. There is stable elevation of the right hemidiaphragm. IMPRESSION: Increased moderate layering left pleural effusion. Developing infection at the left lung base with possible empyema should be considered. Stable small layering right pleural effusion. " a5b27c74-2745d23d-f3dcae84-5772b4d0-0b5dc081.jpg,validate/p11/p11744921/s54000464/a5b27c74-2745d23d-f3dcae84-5772b4d0-0b5dc081.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with hx asthma/DM2/morbid obesity presenting with RUQ pain. // pneumonia or rib pathology? TECHNIQUE: AP and lateral views 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 process. " 87d0e94b-041e93c6-82d97cfb-40771798-c33f14b3.jpg,validate/p19/p19890943/s51557306/87d0e94b-041e93c6-82d97cfb-40771798-c33f14b3.jpg,validation," FINAL REPORT PORTABLE CHEST FROM ___ AT 9:06 CLINICAL INDICATION: ___-year-old status post pericardiocentesis for pericarditis, question reaccumulation of fluid. Comparison is made to the patient's prior study of ___ at 5:39. A portable AP upright chest from ___ at 9:06 is submitted. IMPRESSION: 1. Interval removal of the pericardial catheter. Overall, cardiac contour appears stable. There is patchy retrocardiac opacity which may represent partial lower lobe atelectasis, although pneumonia cannot be excluded. No pulmonary edema, large effusion or pneumothorax. " fbdfd91c-654ca758-124cf79e-adf6bfaf-40b85a6e.jpg,validate/p11/p11508828/s50490976/fbdfd91c-654ca758-124cf79e-adf6bfaf-40b85a6e.jpg,validation," FINAL REPORT INDICATION: ___ year old man with ARDS awaiting AVR/CABG // Interval improvement? // TECHNIQUE: Portable AP view of the chest, 2 exposures COMPARISON: Series of radiographs dating back to ___ FINDINGS: Over the course of the past week, the patient's previously diffuse interstitial pulmonary abnormalities have improved. Compared to the most recent prior exam, there is little overall change in the still mild pulmonary abnormalities and bibasilar atelectasis, right greater than left. Small pleural effusions are likely present. A right jugular catheter terminates in the superior SVC. No pneumothorax is present. Dense aortic valve calcifications are present. IMPRESSION: Overall similar appearance of the mild interstitial opacities with bibasilar atelectasis compared to the most recent radiograph. " b37d5364-2f9fc035-cef2c97b-26193561-c5d75423.jpg,validate/p19/p19130309/s54720556/b37d5364-2f9fc035-cef2c97b-26193561-c5d75423.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph appear INDICATION: ___M with dyspnea, weakness. Assess for pulmonary congestion, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are moderately well inflated with bilateral perihilar interstitial opacities. There is mild cephalization of vasculature. Trace pleural effusion is only seen on lateral view limiting evaluation for side. No pneumothorax. Stable mild cardiomegaly. Mediastinal contour and hila are otherwise unremarkable. A left chest wall pacer device is seen with lead tips in the right atrium and right ventricle. Intact median sternotomy wires are again noted. IMPRESSION: Mild pulmonary edema with trace pleural effusion, cephalization of vasculature, and stable mild cardiomegaly. " 205e6fc7-4ea2b1ab-160468b0-405ecdc1-3b3bd71d.jpg,validate/p19/p19550773/s58029116/205e6fc7-4ea2b1ab-160468b0-405ecdc1-3b3bd71d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with pleural effusion, PTX with chest tube in place. // Any change in pneumothorax TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier today FINDINGS: A right pleural pigtail catheter remains in place with interval re-expansion of the right lung. A trace right pneumothorax likely persists. Unchanged right hilar prominence as well as a small right pleural effusion. The left lung is clear. No significant interval change in appearance of the cardiomediastinal silhouette. IMPRESSION: Interval re-expansion of the right lung with a suspected persisting trace pneumothorax. Small right pleural effusion. " 81045bbb-0ff47e0f-e6832f53-a8620841-66e813f0.jpg,validate/p18/p18828251/s56632211/81045bbb-0ff47e0f-e6832f53-a8620841-66e813f0.jpg,validation," FINAL REPORT HISTORY: Cough and fever, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. Continued enlargement of the cardiac silhouette in a patient with intact midline sternal wires after CABG. No evidence of vascular congestion. The overall discordancy raises possibility of cardiomyopathy. Calcification is again seen in coronary vessels. No evidence of acute focal pneumonia. " 790d05b4-6c7dd118-48c70f39-f3ea9a27-0385c9cd.jpg,validate/p10/p10183375/s50835710/790d05b4-6c7dd118-48c70f39-f3ea9a27-0385c9cd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fever and pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the tip of the nasogastric tube is at the level of the gastroesophageal junction. The lung volumes remain low. There are unchanged areas of atelectasis at the lung bases. Moderate cardiomegaly without overt pulmonary edema. No newly appeared focal parenchymal opacities that could represent pneumonia. " d5d037cf-62686598-3ce0b1a1-4124ad59-10a76880.jpg,validate/p12/p12784114/s55787555/d5d037cf-62686598-3ce0b1a1-4124ad59-10a76880.jpg,validation," FINAL REPORT INDICATION: Status post intubation. Evaluate tube placement. COMPARISON: Chest radiograph from ___ at 17:01 obtained at ___ ___. TECHNIQUE: Supine AP views of the chest were obtained with a total of three exposures. Each exposure performed after further manipulation of the enteric tube. FINDINGS: An endotracheal tube is in satisfactory position with the tip 3.2 cm from the carina. Multiple attempts at passing a nasogastric tube beyond the diaphragm were unsuccessful with each image showing the nasogastric tube in the distal esophagus. The lungs volumes are low which accentuates the bronchovascular structures. There is a new right mid lung zone opacity, likely aspiration. Additionaly, there is new mild pulmonary edema. There is no pleural effusion or pneumothorax. The mediastinal contour is within normal limits allowing for technique. The heart size is difficult to assess given the low lung volumes. Contrast material is seen within the upper abdomen from the recent CT. IMPRESSION: 1. Satisfactory position of the endotracheal tube. 2. Nasogastric tube with the tip in the distal esophagus. 3. New right mid lung zone opacity, likely aspiration. 4. New mild pulmonary edema. Results were discussed with Dr. ___ at 10:30 AM on ___ via telephone by Dr. ___. " 0ca4cf95-9753b535-e4ea8069-40e5f292-7d30796f.jpg,validate/p19/p19130309/s56697475/0ca4cf95-9753b535-e4ea8069-40e5f292-7d30796f.jpg,validation," 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. " 632aa920-047fa58d-57bb9ec3-53497e57-ab6df53a.jpg,validate/p10/p10750092/s59472868/632aa920-047fa58d-57bb9ec3-53497e57-ab6df53a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post fall two days ago with cervical spinal fractures and worsening respiratory status, status post intubation. FINDINGS: In the interim, the patient has been intubated, the endotracheal tube tip lies no less than 1.3 cm from the level of the carina. The lungs remain hyperexpanded, with no pneumothorax or pleural effusion. The cardiac silhouette remains normal in size, the mediastinal contours are notable for aortic ectasia. There is a healed fracture of the posterolateral right fifth rib. An NG tube remains in place with its tip and sidehole within the stomach. Note is made of mitral annular calcifications. IMPRESSION: 1. Interval intubation, endotracheal tube tip is at least 1.3 cm from the level of the carina. 2. Hyperexpansion, with no acute chest abnormality. " ef470bcc-2d8c51ef-0454d6f7-5332e446-e296a6ec.jpg,validate/p12/p12831242/s51110085/ef470bcc-2d8c51ef-0454d6f7-5332e446-e296a6ec.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with fever. COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: PICC line is new extending from the left arm into the region of the SVC. An NG tube passes out of view below the diaphragm. Bilateral pleural effusions are increased with associated bibasilar opacity, likely atelectasis. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pneumothorax is present. IMPRESSION: Interval placement of PICC line. Increase in Bilateral pleural effusions with bibasilar atelectasis, cannot exclude pneumonia. " b903f0c6-bc9eb119-d3985a6a-91ea0ab2-cd008a52.jpg,validate/p18/p18427024/s57485499/b903f0c6-bc9eb119-d3985a6a-91ea0ab2-cd008a52.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Right crackles, pulmonary edema. FINDINGS: AP upright and lateral views of the chest are provided. The lungs are clear without focal consolidation, effusion, or pneumothorax. The heart is normal in size. Minimal prominence of the right pulmonary hilum appears essentially stable allowing for slight differences in technique and may be slightly magnified given technique. Atherosclerotic calcification along the aortic knob noted. Bony structures are intact. Arthropathy of the right AC joint is noted. IMPRESSION: No acute intrathoracic process. Mild prominence of the right pulmonary hilum is likely attributable to technical factors, though consider a dedicated PA and lateral view to more fully assess. " 7f014587-164647ec-3f56eda7-a57d4467-e365936d.jpg,validate/p18/p18572896/s55160514/7f014587-164647ec-3f56eda7-a57d4467-e365936d.jpg,validation," 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. " ab2b668a-9373765b-54ea2e38-e28dfb55-2d08e069.jpg,validate/p17/p17545517/s56098603/ab2b668a-9373765b-54ea2e38-e28dfb55-2d08e069.jpg,validation," 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. " d708ff44-73a6bd36-9b91ae3f-28aead5a-4c67a462.jpg,validate/p18/p18279430/s52514698/d708ff44-73a6bd36-9b91ae3f-28aead5a-4c67a462.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis and shock // s/p NGT IMPRESSION: As compared to the previous radiograph from earlier today, a nasogastric tube is been placed, terminating within the stomach. " 5fb305d6-4de27317-01d87f1b-2f383947-234c9daf.jpg,validate/p11/p11360363/s55709119/5fb305d6-4de27317-01d87f1b-2f383947-234c9daf.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral chest radiograph 2 views. COMPARISON: Multiple chest radiographs dating back to ___, CT chest ___. FINDINGS: The heart size is normal. The cardiomediastinal silhouette and hilar contour is stable. There is bibasilar atelectasis. The lungs are otherwise clear without focal consolidation, effusion or pneumothorax. Post-surgical changes in the right axilla. IMPRESSION: No acute intrathoracic process. " fae3a9cc-8ef84eb3-f6379fb7-7e98b439-e267f9a2.jpg,validate/p17/p17477304/s56372248/fae3a9cc-8ef84eb3-f6379fb7-7e98b439-e267f9a2.jpg,validation," 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. " 55dd7bc5-f1882361-463c3bc0-2b2f3d2b-aa161f04.jpg,validate/p11/p11017660/s50815479/55dd7bc5-f1882361-463c3bc0-2b2f3d2b-aa161f04.jpg,validation," FINAL REPORT HISTORY: ___-year-old man status post renal transplant, now with body aches. Question acute process. FINDINGS: Right middle lobe opacity is consistent with pneumonia. Streaky atelectasis is present bibasilarly. No pleural effusion or pneumothorax. IMPRESSION: Right middle lobe pneumonia. Recommend repeating the radiograph after treatment to ensure resolution. " caf20349-2eb55a72-4f9a7368-c50bd8b9-49958a4d.jpg,validate/p13/p13576844/s54403740/caf20349-2eb55a72-4f9a7368-c50bd8b9-49958a4d.jpg,validation," 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. " aca7cf35-1c733024-06f26a14-28983ba8-e6e42c68.jpg,validate/p17/p17500951/s56372333/aca7cf35-1c733024-06f26a14-28983ba8-e6e42c68.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg and ct removal // r/o ptx COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, all monitoring and support devices have been removed. The lung volumes are low and mild areas of atelectasis are seen at both the left and the right lung basis. There is no pneumothorax. No larger pleural effusions. Borderline size of the cardiac silhouette without pulmonary edema. Normal alignment of the sternal wires. " 8ae67678-6ce76443-fd99e064-f3358f54-63ad8ec4.jpg,validate/p15/p15968244/s50585160/8ae67678-6ce76443-fd99e064-f3358f54-63ad8ec4.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Permanent pacemaker remains in place, with leads in the right atrium and right ventricle, and no evidence of pneumothorax. Heart is normal in size with left ventricular configuration. Lungs are clear except for minimal symmetrical biapical thickening and a calcified granuloma in the right middle lobe, both unchanged since ___. IMPRESSION: Permanent pacemaker leads terminate in right atrium and right ventricle, with no evidence of pneumothorax. " e4fad32e-0a3cae8b-b7d8088a-58324d0c-4a906cb2.jpg,validate/p15/p15106152/s56317265/e4fad32e-0a3cae8b-b7d8088a-58324d0c-4a906cb2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for years. // r/o infiltrate IMPRESSION: As compared to ___ chest radiograph, cardiomediastinal contours are stable. Lungs are well expanded and grossly clear, and there are no pleural abnormalities. " 09250d59-eb7f95c4-0e395d3d-08db09e8-dcd60d81.jpg,validate/p19/p19554621/s57193513/09250d59-eb7f95c4-0e395d3d-08db09e8-dcd60d81.jpg,validation," 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. . " 936f2054-f19a613e-a7d62e70-041f533b-729998f7.jpg,validate/p14/p14558830/s51538618/936f2054-f19a613e-a7d62e70-041f533b-729998f7.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess for reaccumulation of pleural effusion. Comparison is made with prior study ___. Moderate right pleural effusion has minimally increased. Aeration of the right lower lobe has improved. Cardiomediastinal contours are unchanged. Loss of volume in the right hemithorax is stable. Right perihilar post-radiation changes better seen in prior CT. The left lung is clear. There is no evident pneumothorax. " b4926cb0-4a46e200-4c4b2591-48b73e3e-553f6427.jpg,validate/p10/p10405305/s57402582/b4926cb0-4a46e200-4c4b2591-48b73e3e-553f6427.jpg,validation," WET READ: ___ ___ ___ 8:15 AM No evidence of pneumothorax. Right basilar chest tube in place. The lungs are grossly clear. Apparent widening of the mediastinal contour likely related to patient positioning as well as AP technique. WET READ VERSION #1 ___ ___ ___ 8:08 PM No evidence of pneumothorax. Right basilar chest tube in place. The lungs are grossly clear. Apparent widening of the mediastinal contour likely related to patient positioning as well as AP technique. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p thoracotomy and multiple wedge resections // please evaluate tube placement and for pneumothorax IMPRESSION: Widening of the cardiomediastinal contours is likely due to accentuation by patient rotation and low lung volumes, but repeat radiograph would be helpful to confirm this impression. Exam is otherwise remarkable for minor bibasilar atelectasis. There is no evidence of pneumothorax. " 17879503-7cdec38b-ab7f98e2-3683de59-7b82da52.jpg,validate/p11/p11828962/s55817491/17879503-7cdec38b-ab7f98e2-3683de59-7b82da52.jpg,validation," FINAL REPORT AP CHEST, 4:01 A.M., ___ HISTORY: A ___-year-old woman with subsegmental pulmonary embolus and bilateral pleural effusions. Evaluate for interval change. IMPRESSION: AP chest compared to ___, 9:04 p.m.: Large left pleural effusion has increased slightly, while evidence of mild biventricular decompensation is now restricted to the right heart. Small right pleural effusion stable. No pneumothorax. Left lung largely atelectatic except for the apex where vasculature is congested. Left pleural effusion is presumed to be hemothorax, alternatively empyema. Subsequent chest radiograph showing pleural drainage, performed at 5:24 a.m. is available at the time of this review. " 21782779-e02bf21f-cdb733c7-91346577-e55a7fb0.jpg,validate/p17/p17477304/s56631417/21782779-e02bf21f-cdb733c7-91346577-e55a7fb0.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. COMPARISONS: ___ and ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: A dialysis catheter terminates in the right atrium, as before. The lung volumes are low. The cardiac, mediastinal and hilar contours appear unchanged. There is no definite pleural effusion or pneumothorax. There is mild persistent relative elevation of the left hemidiaphragm. Opacification in the left lower lobe along the hemidiaphragm has increased although similar to the earlier of two comparison studies. The pulmonary interstitium is minimally prominent, probably due to slight fluid overload. IMPRESSION: Increasing left lower lobe opacity, although similar to the earlier of two studies. Recurrence of pneumonia versus waxing and waning atelectasis could be considered. Findings also suggest very mild fluid overload. " 15918c5c-adab399d-752d7611-fe28ab57-1991e32d.jpg,validate/p12/p12248064/s54523017/15918c5c-adab399d-752d7611-fe28ab57-1991e32d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with cough, fevers, suspect pna // eval for fevers and cough TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. Linear airspace opacity within the mid to lower left lung is noted on both the AP and lateral views, and likely represents linear atelectasis. The cardiomediastinal silhouette is within normal limits. IMPRESSION: Platelike atelectasis within the left mid lung. Otherwise, no evidence for acute cardiopulmonary process. " 73b1c3ac-952bfcea-831dfde6-73a53888-f01841b6.jpg,validate/p16/p16518959/s54844727/73b1c3ac-952bfcea-831dfde6-73a53888-f01841b6.jpg,validation," WET READ: ___ ___ ___ 12:16 AM Left lower lobe pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with fever. Assess for infection TECHNIQUE: Chest PA and lateral COMPARISON: CT chest with contrast ___, chest radiograph ___. FINDINGS: The lungs are hypoinflated with crowding of vasculature. The right lung is clear. There is a new heterogeneous left lower lobe opacity. No pleural effusion or pneumothorax. Heart size and hila are unremarkable. There is stable prominence of the left mediastinal contour, which is consistent with mediastinal lipomatosis as seen on ___ CT chest. Limited assessment of the osseous structures demonstrates multiple bridging anterior osteophytes. IMPRESSION: Left lower lobe pneumonia. " 8fd56394-25707cfe-8f674bbb-5ca97454-b1855adf.jpg,validate/p11/p11728419/s59530732/8fd56394-25707cfe-8f674bbb-5ca97454-b1855adf.jpg,validation," 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. " 2876892c-9a38069a-e2cf1491-82ef0d5f-a4935ae3.jpg,validate/p11/p11052935/s50367895/2876892c-9a38069a-e2cf1491-82ef0d5f-a4935ae3.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with fever, cough, and shortness of breath. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is ill-defined opacity in the left upper lobe. There has been interval resolution of the left lower lobe consolidation. Heart and mediastinal contours are within normal limits. No pneumothorax is seen. Biapical pleural thickening is present. Underlying emphysematous changes are noted. IMPRESSION: Left upper lobe pneumonia. Recurrent infection in an area that is chronically abnormal may be due to atypical mycobacterial infection. Findings discussed with Dr. ___ by Dr. ___ by telephone at 11:30 p.m. on ___ at the time of discovery of these findings and at the time of wet read request. Additional diagnostic consideration of atypical mycobacterical infection was discussed with Dr. ___ by Dr. ___ by phone at 8:03 a.m. on ___ after attending radiologist review. " c37d09f0-dccbf034-620235fa-aeffbeac-caca9af7.jpg,validate/p11/p11820335/s53030712/c37d09f0-dccbf034-620235fa-aeffbeac-caca9af7.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with recent removal of chest tube. COMPARISON: Portable upright chest radiograph, ___. TECHNIQUE: AP portable upright chest radiograph. FINDINGS: There is no pneumothorax. The previously seen pneumoperitoneum is slightly reduced in volume. The previously seen left chest tube has been removed. Lungs are well expanded and clear bilaterally with no focal consolidation or pleural effusion. The cardiomediastinal silhouette is stable and within normal limits. The pleural surfaces are unremarkable. Numerous surgical clips are seen in the left axilla. Clips are seen in the right upper quadrant, consistent with recent right nephrectomy. IMPRESSION: No pneumothorax. Decreasing pneumoperitoneum. " 95c929ea-4ae398a5-f38422ea-13fe9741-6ad31f50.jpg,validate/p15/p15287471/s58812820/95c929ea-4ae398a5-f38422ea-13fe9741-6ad31f50.jpg,validation," FINAL REPORT AP CHEST, 6:41 A.M., ___ HISTORY: A ___-year-old woman with respiratory distress after intubation. IMPRESSION: AP chest compared to ___, 5:10 a.m.: Moderately severe pulmonary edema has probably improved, but moderate bilateral pleural effusions have worsened and there is either a fissural pleural effusion in the right major fissure superiorly or new consolidation in the right upper lobe. If there is concern for pneumonia given transient bronchial cannulation with the feeding tube, currently passing into the stomach and out of view. ET tube is in standard placement. No pneumothorax. Dr. ___ was paged at 10:15 a.m., and the findings were discussed at 10:18 a.m. by telephone. " 36f95a6e-f77b8996-82398d54-0b309594-799021f2.jpg,validate/p12/p12177591/s50240028/36f95a6e-f77b8996-82398d54-0b309594-799021f2.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain status post airbag, evaluate for rib fractures and pneumothorax. COMPARISON: Radiograph from ___, CT of the chest from ___. TWO VIEWS OF THE CHEST: Evaluation of the chest is limited due to mild levoscoliosis. Within these limitations, the lungs are hyperexpanded and show unchanged right upper lobe nodular opacity. A nodule projecting over the left upper lung is not well visualized. No pneumothorax is present, although there is mild blunting of the left costophrenic angle. The cardiomediastinal silhouette and hilar contours are normal. IMPRESSION: No radiographic evidence of injury. " 4799a146-647ebf93-5904973f-7ba87264-e735a90b.jpg,validate/p19/p19343087/s56239549/4799a146-647ebf93-5904973f-7ba87264-e735a90b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with epigastric pain and high WBC // eval pna TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Low lung volumes results in crowding of the bronchovascular structures. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is stable. Moderate-sized hiatal hernia is unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. " 2173e2e9-480aa17b-1f178c51-21dd5958-4363970e.jpg,validate/p15/p15103276/s52752441/2173e2e9-480aa17b-1f178c51-21dd5958-4363970e.jpg,validation," 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. " c1491e00-80d95cf2-e955e845-0cae5f0e-c0a69196.jpg,validate/p17/p17424385/s55338219/c1491e00-80d95cf2-e955e845-0cae5f0e-c0a69196.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with stage II renal cell cancer, for intrathoracic disease. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is top normal, stable. Mediastinum is stable. Lungs are essentially clear. Of note is nodular opacity projecting over the left lower lung, approximately 8.5 mm in diameter, not clearly seen on prior examination. Given patient's history, re-assessment with chest CT is required for precise characterization of this abnormality. There is no pleural effusion or pneumothorax. " ec43b08b-ce18e911-e914f6a0-d5f5d8da-4061d9e5.jpg,validate/p12/p12598850/s59362132/ec43b08b-ce18e911-e914f6a0-d5f5d8da-4061d9e5.jpg,validation," WET READ: ___ ___ ___ 7:38 PM Right middle lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. ______________________________________________________________________________ FINAL REPORT INDICATION: Cough with phlegm and syncope. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are normal. Right middle lobe consolidative opacity is compatible with pneumonia. Left lung is clear. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is seen. IMPRESSION: Right middle lobe pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. " 9a6d7187-0567e2a8-adb6fec7-1e97099b-50abfd15.jpg,validate/p15/p15199651/s55227343/9a6d7187-0567e2a8-adb6fec7-1e97099b-50abfd15.jpg,validation," FINAL REPORT INDICATION: ___ year old man with respiratory failure // eval lungs COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: The left IJ line has been removed. The Port-A-Cath, PICC line, and nasogastric tube are unchanged. There is is stable by basilar patchy density more pronounced on the right. There is no pneumothorax or CHF. " 2eaf3fee-4cabd284-88fab8ae-d2012901-19686ab0.jpg,validate/p18/p18264393/s51707796/2eaf3fee-4cabd284-88fab8ae-d2012901-19686ab0.jpg,validation," FINAL REPORT INDICATION: ___-year-old male admitted to the intensive care unit, status post left MCA stroke. Assess Dobbhoff tube placement. COMPARISON: Chest radiograph from ___ and ___. PORTABLE SUPINE SEMI-ERECT CHEST RADIOGRAPHS: Two serial radiographs were obtained portably to assess the position of the Dobhoff feeding tube. The initial radiograph shows the feeding tube in the proximal stomach. The subsequent radiographs shows that the tube has been advanced in to the distal stomach. There has been no significant interval change since recent prior radiograph. IMPRESSION: New Dobhoff feeding tube in the distal stomach. No other change from recent prior. " 3a2d73c8-dbcdb1e3-e76a51b1-3be59a42-f93dcac5.jpg,validate/p14/p14992257/s56279214/3a2d73c8-dbcdb1e3-e76a51b1-3be59a42-f93dcac5.jpg,validation," FINAL REPORT CLINICAL HISTORY: Aortic dissection, rising white cell count, increasing cough. CHEST AP COMPARISON: ___. Since the previous film, there has been an increase in the size of both the right and the left effusion. There is volume loss in the left lower lobe and this is probably due to atelectasis, but a pneumonia in this region would give a similar appearance. Some opacification in the right upper lobe adjacent to the mediastinum is present. This did not appear to be present on the prior chest x-ray and may represent an aspiration pneumonia, though the position is unusual. " dac7190d-06d79b1f-a6612fa3-76e56852-c62b3ae7.jpg,validate/p12/p12514721/s56534437/dac7190d-06d79b1f-a6612fa3-76e56852-c62b3ae7.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: An ___-year-old woman with previous pneumothorax. Chest tube removed. IMPRESSION: AP and lateral chest compared to ___: Lungs are hyperinflated but clear. There is no pneumothorax or appreciable pleural effusion. The intrathoracic portion of the stomach is more readily visible due to the increased volume of the emphysematous lungs. " 08123e4a-a9e62d5e-218eae99-5d28ef30-4e871875.jpg,validate/p19/p19778971/s54552976/08123e4a-a9e62d5e-218eae99-5d28ef30-4e871875.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post VATS for decortication, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The two left-sided chest tubes are in unchanged position. There is unchanged evidence of a small left apical pneumothorax and a relatively extensive re-expansion edema. On the right, there is unchanged evidence of a small pleural effusion but an otherwise normal lung. Endotracheal tube is in unchanged position. Unchanged appearance of the cardiac silhouette. " 495a8ce8-5fab94fc-e0cef602-b66c27f9-8c84f445.jpg,validate/p16/p16194267/s59460085/495a8ce8-5fab94fc-e0cef602-b66c27f9-8c84f445.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with polytrauma, tube position. COMPARISON: ___ and CT scan of ___. FINDINGS: The endotracheal tube is in adequate position at 5.7 above the carina. The nasogastric tube is unchanged, with the side port just below the gastroesophageal junction. There is no pneumothorax and no pleural effusion. The lungs are clear except for small stable bibasilar atelectasis. The mediastinal and cardiac contour are normal. CONCLUSION: There is no significant change since the previous exam. " a5e5550e-2aab1874-3e30b3ce-bbb7e2d2-c4bff14f.jpg,validate/p18/p18014061/s56754406/a5e5550e-2aab1874-3e30b3ce-bbb7e2d2-c4bff14f.jpg,validation," FINAL REPORT INDICATION: Anemia, confusion, lethargy, and left lower lobe crackles. COMPARISONS: ___. FINDINGS: AP and lateral chest radiographs. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 22cdd269-47f9dce9-f9446436-8833fa3f-9d76bd55.jpg,validate/p10/p10550621/s52635361/22cdd269-47f9dce9-f9446436-8833fa3f-9d76bd55.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___ and a CT torso from ___. CLINICAL HISTORY: Lung cancer history with increased amylase, assess for acute intrathoracic process. FINDINGS: PA and lateral views of the chest were obtained. Elevated right hemidiaphragm is again noted with right lower lobe consolidation, similar, though slightly improved from a prior CT torso from ___. There is otherwise no focal consolidation. A small right pleural effusion is again noted. Heart size appears mildly enlarged. Mediastinal contour appears normal. Bony structures are intact. IMPRESSION: Stable elevation of the right hemidiaphragm with tiny right pleural effusion and right lower lobe consolidation, minimally improved from the prior CT torso. Mild cardiomegaly also again noted. " 0ac88df6-91dd9011-ae508c68-7d8dfb79-217dfeb7.jpg,validate/p12/p12505527/s59271559/0ac88df6-91dd9011-ae508c68-7d8dfb79-217dfeb7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with shortness of breath, chest pain, peripheral swelling / TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Streaky opacity within the left lung base with suggestion of bronchiectasis and airway wall thickening is noted. Right lung is clear. No pleural effusion, focal consolidation or pneumothorax is seen. No acute osseous abnormality is identified. IMPRESSION: Streaky left basilar opacity with suggestion of bronchiectasis and air wall thickening may be due to an infectious process. " 8efd0404-a942f8c7-7929d559-3f2aaf19-a0ac1250.jpg,validate/p13/p13117065/s57955630/8efd0404-a942f8c7-7929d559-3f2aaf19-a0ac1250.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: PA and lateral chest x-ray ___, CTA chest ___. PA and lateral chest x-ray ___. INDICATION: ___-year-old with small cell lung cancer and left-sided pneumothorax. Evaluate interval change. FINDINGS: There is a small left pneumothorax which is stable in size compared to prior study. Architectural distortion with linear and pleural opacities at the right apex is stable and consistent with history of prior treatment. There is also a right lower lung nodule, better seen on the CT scan dated ___. Cardiomediastinal and hilar contours are stable. Left chest port remains with tip in the low SVC. IMPRESSION: Small left pneumothorax is stable in size compared to prior study. " a1441549-f6a35eae-0a482947-d87a5ae8-54bee47b.jpg,validate/p16/p16393879/s50098158/a1441549-f6a35eae-0a482947-d87a5ae8-54bee47b.jpg,validation," WET READ: ___ ___ 1:00 AM 1. ETT in standard position. 2. Possible tiny right apical pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with intubation. Evaluate ETT. TECHNIQUE: Portable AP radiograph view of the chest. COMPARISON: None. FINDINGS: The ETT tip is in standard position, projecting approximately 2.7 cm from the carina. A right Port-A-Cath tip projects over the expected region of the right atrium. The enteric tube tip and side-port project over the expected region of the stomach in the left upper mid abdomen. The lungs are well-expanded and clear. No focal consolidation, effusion, or edema. The apices are incompletely evaluated. There is right apical pleural thickening. The mediastinum is not widened. The heart is normal in size. No acute osseous abnormality on this nondedicated exam. IMPRESSION: 1. ETT in standard position. 2. Incompletely evaluated apices; right apical pleural thickening. " 51a8be2a-c9db50c4-6765e8b3-31ddb795-f5268257.jpg,validate/p16/p16865608/s55575461/51a8be2a-c9db50c4-6765e8b3-31ddb795-f5268257.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and left sided rales // Pneumonia vs CHF started on ABX today Pneumonia vs CHF started on ABX today IMPRESSION: Comparison to ___. Enlargement of the bilateral pulmonary hilar vascular structures, suggestive of pulmonary hypertension. Signs of mild pulmonary edema with basal apical blood flow redistribution. Additional mild right basal parenchymal opacity, potentially representing pneumonia. No pleural effusions. " bae5237a-19e72819-b16d3b6f-725351a5-0cdfb38d.jpg,validate/p10/p10188275/s57260832/bae5237a-19e72819-b16d3b6f-725351a5-0cdfb38d.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient is status post tracheobronchoplasty and chest tube removal. Comparison is made with prior study performed the same day earlier in the morning. Right chest tube has been removed. There is evident pneumothorax. Widened mediastinum and apparent abnormal contour of the cardio-mediastinum is due to the projection of the study that is craniocaudal. In the prior study, the cardiomediastinal silhouette was within normal limits. Increased opacities in the right upper lobe and left lower lobe could be due to worsening atelectasis, but aspiration / infection cannot be excluded. Close followup is recommended. Right lower lobe atelectasis is grossly unchanged. There are no enlarging pleural effusions. Subcutaneous emphysema is stable. " 9b248e43-94114e92-2e19ff18-6719b4a6-e756cc7b.jpg,validate/p18/p18871802/s58167141/9b248e43-94114e92-2e19ff18-6719b4a6-e756cc7b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M 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. " c8a84fbe-2a349cda-337c02df-320b91ef-93f61283.jpg,validate/p10/p10157508/s53992660/c8a84fbe-2a349cda-337c02df-320b91ef-93f61283.jpg,validation," 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. " ba57dee8-59e883e5-d17511ed-5d5fada6-f150f16e.jpg,validate/p15/p15862156/s52604445/ba57dee8-59e883e5-d17511ed-5d5fada6-f150f16e.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Chest radiographs dating between ___ and ___. FINDINGS: Lung volumes are relatively low. With this factor in mind, cardiomediastinal contours are within normal limits and without change. Pleural and parenchymal scarring with associated volume loss is present in the right hemithorax, consistent with previous history of partial resection of the right lung, presumably prior right lower lobe resection. No focal areas of consolidation are present, and there are no pleural effusions. IMPRESSION: 1. No radiographic evidence of pneumonia. 2. Postoperative scarring and volume loss following partial resection of the right lung. " 3ca6714d-fb8ff79a-8bda6f70-9f9a9876-f25d1e62.jpg,validate/p16/p16651060/s59221328/3ca6714d-fb8ff79a-8bda6f70-9f9a9876-f25d1e62.jpg,validation," FINAL REPORT INDICATION: ___F with MG and DM being seen in the ED for DKA. Evaluate for infection. TECHNIQUE: Chest AP and lateral COMPARISON: Multiple priors with direct comparison made to study from ___ FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette is stable. There is mild pulmonary vascular congestion likely from fluid resuscitation. No pleural effusion or pneumothorax is identified. Osseous structures are grossly intact. IMPRESSION: Mild pulmonary vascular congestion. No focal consolidation. " 04b7d725-353af6f3-8fd604bf-5ce47733-2b36f83b.jpg,validate/p14/p14364774/s55357138/04b7d725-353af6f3-8fd604bf-5ce47733-2b36f83b.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain, right-sided weakness and tingling, question of infection. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no pneumothorax or pleural effusion. The cardiac, mediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 7bf1b3a2-993136e9-91ed7f0b-366faaa1-fe9c5ce2.jpg,validate/p19/p19336751/s52844729/7bf1b3a2-993136e9-91ed7f0b-366faaa1-fe9c5ce2.jpg,validation," WET READ: ___ ___ 10:46 PM Redemonstrated right and left apical parenchymal scarring, better seen on the prior CT Chest from ___. No focal consolidation identified. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with sob // eval pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: Multiple right and left apical focal opacities are compatible with parenchymal scarring seen on the ___ CT chest exam. Severe emphysematous changes are seen in the lungs with flattening of the diaphragm. There is no focal consolidation, pulmonary edema, or pneumothorax. The cardiomediastinal, hilar, and pleural surfaces are unchanged. Compression deformities in the lower thoracic/upper lumbar vertebral bodies are unchanged. IMPRESSION: Redemonstrated right and left apical parenchymal scarring, better seen on the prior CT Chest from ___. No focal consolidation identified. " fdf2f01a-5120be17-a34e0e24-142860b1-3aa4222e.jpg,validate/p10/p10969957/s53416175/fdf2f01a-5120be17-a34e0e24-142860b1-3aa4222e.jpg,validation," FINAL REPORT INDICATION: ___-year-old male post fall with aortic valve regurgitation. COMPARISON: ___. CHEST, PA AND LATERAL: The lungs are hyperexpanded with biapical hyperlucency, increased anteroposterior diameter, flattening of the hemidiaphragms, and widening of the retrosternal clear space. There is new mild central venous congestion and interstitial edema. Small bilateral pleural effusions/scarring and fluid thickening of the minor fissure. New opacity has developed at the right lung base. There is biapical pleural scarring and calcification. Heart size is mildly enlarged, with calcified and tortuous aortic arch. Changes of median sternotomy, with prosthetic aortic valve, vessel markers, and mediastinal clips. There is continued fracture of the uppermost sternal wire. Bones are diffusely demineralized, with moderate arthropathy of the right acromioclavicular joint. IMPRESSION: 1. Right lower lobe aspiration or pneumonia. 2. Congestive heart failure. 3. Emphysema. " a7dea0b5-74c0ab41-3bda5a9f-465038ef-7f99ce7b.jpg,validate/p19/p19284714/s58921695/a7dea0b5-74c0ab41-3bda5a9f-465038ef-7f99ce7b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Substernal chest pain. FINDINGS: PA and lateral views of the chest provided. AICD projects over the left chest wall with lead tip extending to the region of the right ventricle. The heart is mildly enlarged. There is no evidence of pneumonia or CHF. No effusion or pneumothorax seen. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " a1125005-f2644cfe-ea556bb5-fd19f1be-ff6d8daf.jpg,validate/p10/p10855973/s54580743/a1125005-f2644cfe-ea556bb5-fd19f1be-ff6d8daf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of lung nodule vs lymph node on outside CXR // Lymphadenopathy or nodule? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has undergone vertebral fixation device implantation. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. No pulmonary edema. No lung nodules or masses. No evidence of lymphadenopathy. " 2d7c1313-8b763057-a04c06b2-982c9013-91fd5308.jpg,validate/p18/p18124266/s57525600/2d7c1313-8b763057-a04c06b2-982c9013-91fd5308.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o Hep C and liver transplant ___ years ago coming in due to a fall // ? Infection or cardiopulmonary process TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are unchanged in appearance including substantial scoliosis. There is no pleural effusion or pneumothorax. Lungs are essentially clear. Aortic calcifications and Coronary artery calcifications are extensive " 359b0e5d-faa3b0c2-a96f1f3e-5bb160c4-4771753b.jpg,validate/p19/p19849930/s52054554/359b0e5d-faa3b0c2-a96f1f3e-5bb160c4-4771753b.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath. TECHNIQUE: Single portable AP radiograph. COMPARISON: Radiograph dated ___. FINDINGS: Single AP upright radiograph demonstrates an enlarged heart. Perihilar patchy opacity, cephalization of vessels, and vascular congestion are suggestive of pulmonary edema. There is likely a small left pleural effusion. There is no pneumothorax. Patient is status post sternotomy, wires which appear intact. Numerous clips are noted along the left mediastinal border. A left clavicular deformity appears chronic. No acute osseous abnormalities detected. IMPRESSION: Enlarged heart with evidence to suggest moderate pulmonary edema. " c53c9863-81edade8-7648da13-b9ac15d5-544f702a.jpg,validate/p11/p11976958/s57176688/c53c9863-81edade8-7648da13-b9ac15d5-544f702a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fevers and chills // Please eval for any 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. " 2890d9e7-2eeb56af-bf8b272c-e27fd47b-004f1626.jpg,validate/p19/p19825347/s59357766/2890d9e7-2eeb56af-bf8b272c-e27fd47b-004f1626.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with productive cough // r/o pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the left basilar and right apical nodular opacities are completely unchanged in extent and severity. The stability and there are morphologic appearance suggests calcified parenchymal and pleural changes. No new parenchymal opacities. Unchanged mild widening of the right hilar structures without pathological correlate in the hilar regions on the lateral radiograph. Normal size of the heart. Unchanged moderate elongation of the descending aorta. " a194eb88-aecaa8a9-3d5f0d04-6911991a-5ef32cd8.jpg,validate/p12/p12006801/s54925497/a194eb88-aecaa8a9-3d5f0d04-6911991a-5ef32cd8.jpg,validation," WET READ: ___ ___ 6:28 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // evaluate for pneumonia 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. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " ad99e187-9c276397-bb1d646e-93bc4bf9-e446c847.jpg,validate/p12/p12043836/s55874186/ad99e187-9c276397-bb1d646e-93bc4bf9-e446c847.jpg,validation," FINAL REPORT HISTORY: Septic shock, to assess volume status. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. There is again substantial enlargement of the cardiac silhouette with moderate pulmonary edema. The opacification at the right base, most likely representing pleural effusion and compressive atelectasis, is less prominent. This could reflect either decreased pleural fluid or merely a more erect position of the patient. The left lung is relatively clear with some mild retrocardiac atelectasis. " 68ad0229-fbf719ec-6407d47e-398368ac-1c4ffe02.jpg,validate/p18/p18088902/s56895618/68ad0229-fbf719ec-6407d47e-398368ac-1c4ffe02.jpg,validation," FINAL REPORT INDICATION: History: ___F with upper back pain after lifting, pleuritic cp // r/o pneumothorax TECHNIQUE: Two views COMPARISON: ___ FINDINGS: Lungs: The lungs are well inflated. There is no consolidation. Pleura: Her hemidiaphragm is elevated as it was in the past. This is likely due to hepatic enlargement or diaphragmatic paresis. Heart: The heart is not enlarged. Mediastinum and hila: There is no mediastinal mass. Osseous structures: The osseous structures are normal for age. Other findings: None IMPRESSION: Lungs clear. Elevated right hemidiaphragm " 72841edc-25781439-288de1e1-a22858d1-c9bf01c3.jpg,validate/p13/p13637699/s55840866/72841edc-25781439-288de1e1-a22858d1-c9bf01c3.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with s/p trach placement // s/p trach TECHNIQUE: Portable chest radiograph COMPARISON: Multiple chest radiographs since ___, most recently ___ at 05:26. FINDINGS: Since the last radiograph performed earlier today, there has been interval placement of a tracheostomy tube which terminates approximately 4 cm above carina. The enteric tube and endotracheal tube have been removed. The left sided PICC line is unchanged in position terminating in the distal SVC. Bilateral pleural effusions appear to have improved since the prior CXR performed earlier today, but this may partially be due to patient position. There is no pneumothorax. There are no changes to the cardial mediastinal silhouette. IMPRESSION: 1. Interval placement of a tracheostomy tube, terminating 4 cm above the carina. 2. Enteric tube and endotracheal tube have been removed. " fea36623-4aa0886a-05cb102a-d065d62d-25138f3a.jpg,validate/p19/p19710521/s56922602/fea36623-4aa0886a-05cb102a-d065d62d-25138f3a.jpg,validation," FINAL REPORT HISTORY: Right lower lobe rales. FINDINGS: In comparison with study of ___, the area of increased opacification in the left upper zone is less prominent, though still probably reflecting pneumonia. Bibasilar atelectasis and trace effusions are again seen and the dual-channel pacer device remains in place. " 274b77d2-de8dc7e0-8c530480-773f2ef5-4ff94473.jpg,validate/p15/p15193875/s59903206/274b77d2-de8dc7e0-8c530480-773f2ef5-4ff94473.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with GBM recent port placement. Check for placement. COMPARISON: ___ radiographs. FINDINGS: A right-sided Port-A-Cath is seen in the chest wall with tip terminating in the high SVC. Entire catheter is not visualized on the field of view; however, there is an apparent clockwise turn, the same was seen on ___ exam. No kinks are noted. The remainder of the lungs are clear without any evidence of focal opacities concerning for infectious process or pneumothorax or pleural effusion. Mediastinal opacities were present on prior radiographs and likely just due to the patient's posistioning. IMPRESSION: Port-A-Cath tip in the high SVC but again there is an abnormal loop in the region of the internal jugular vein insertion. " 8244b304-f8382a05-2fd6276d-be3c7bbd-2594ed6b.jpg,validate/p17/p17818027/s54489490/8244b304-f8382a05-2fd6276d-be3c7bbd-2594ed6b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post hemorrhoidectomy with abdominal distention and pain. COMPARISON: None listed. FINDINGS: PA and lateral views of the chest. The lungs are hyperinflated but clear consolidation or effusion. Cardiomediastinal silhouette is within normal limits. There is no free air below the diaphragm. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. No free air below the diaphragm. " 8f8220aa-d878dca2-cb159ad9-e1ab482e-39cc563d.jpg,validate/p15/p15430734/s58937588/8f8220aa-d878dca2-cb159ad9-e1ab482e-39cc563d.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with weakness. No prior examinations for comparison. CHEST, PA AND LATERAL: The lungs are clear. Cardiomediastinal and hilar contours are normal. There are no pleural effusions or pneumothorax. IMPRESSION: Normal chest. " 9740dd03-f5abd340-c85c3c3a-aab3d51e-30e333ea.jpg,validate/p14/p14021217/s50738747/9740dd03-f5abd340-c85c3c3a-aab3d51e-30e333ea.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with cirrhosis here with ascities and HE // r/o PNA TECHNIQUE: Portable frontal view of the chest COMPARISON: ___ FINDINGS: Heart size is difficult to evaluate due to positioning. There is mild tortuosity of the thoracic aorta. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 3a9d0ebb-2fcffb51-aed46dbd-bf14943e-6650a7f4.jpg,validate/p15/p15957831/s51572701/3a9d0ebb-2fcffb51-aed46dbd-bf14943e-6650a7f4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest pain and cough // r/o pneumonia R/O PNA, CHEST PAIN AND COUGH PT HAS ASTHMA IMPRESSION: Comparison to ___. No relevant change. No evidence of pneumonia. Borderline size of the cardiac silhouette without pulmonary edema. Mild elongation of the descending aorta. No pleural effusions. Cervical fixation devices in situ. " 7b7195f2-6b5a4413-5aa6086a-8d59103b-15b2a435.jpg,validate/p14/p14478032/s50516482/7b7195f2-6b5a4413-5aa6086a-8d59103b-15b2a435.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with progressive chest pain with exertion. Please evaluate for cardiomegaly, congestive heart failure, pleural effusion or wedge defect. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. The aorta is tortuous. The cardiac silhouette is top-normal. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " e945b5eb-6ec9ad3b-255992b8-9aed1460-14d91f4e.jpg,validate/p16/p16974046/s52129017/e945b5eb-6ec9ad3b-255992b8-9aed1460-14d91f4e.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with metastatic prostate cancer status post fall with increasing pain. COMPARISON: Outside hospital CT of the chest from ___. FINDINGS: 2 portable views of the chest. Mixed areas of lucency and sclerosis seen throughout all of the osseous structures compatible with patient's known metastatic disease. There is no definite superimposed consolidation in the lungs noting that visualization is somewhat obscured due to the overlying osseous disease. The cardiomediastinal silhouette is within normal limits. Old healed left 5th rib fracture is identified. IMPRESSION: No definite acute cardiopulmonary process. Diffuse osseous metastases. " 3ca3942e-38bf0b19-07b98366-f349d0a1-74eeb013.jpg,validate/p17/p17396346/s58588125/3ca3942e-38bf0b19-07b98366-f349d0a1-74eeb013.jpg,validation," FINAL REPORT INDICATION: ___F with CHF, CAD now with chest pain // edema? PNA? TECHNIQUE: AP and lateral views the chest COMPARISON: ___ pre FINDINGS: Exam is limited secondary to AP technique and patient body habitus. Increased hazy opacity in lungs is likely due to these reasons although superimposed vascular congestion is possible. Streaky right basilar opacities on the frontal view may be due to atelectasis. There is no large effusion or confluent consolidation. Moderate cardiac enlargement is again noted. Surgical clips project over the left axilla. IMPRESSION: Enlarged cardiac silhouette and possible vascular congestion. No confluent consolidation. " 86d272c2-d350745e-9442afb5-70415266-d7881741.jpg,validate/p19/p19376171/s54854294/86d272c2-d350745e-9442afb5-70415266-d7881741.jpg,validation," 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. " 5b06ef67-f9086ef6-f77532b0-eb5085b9-fc07be2c.jpg,validate/p14/p14458470/s50252029/5b06ef67-f9086ef6-f77532b0-eb5085b9-fc07be2c.jpg,validation," 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. " 85ce01b1-cb30e3ea-ec733027-0296e251-60f4ca0c.jpg,validate/p17/p17008145/s59252467/85ce01b1-cb30e3ea-ec733027-0296e251-60f4ca0c.jpg,validation," FINAL REPORT HISTORY: Neutropenic fever, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Aortic tortuosity is again seen but there is no vascular congestion or pleural effusion. Streak of atelectasis is seen at the left base. Central catheter tip extends to the mid to lower portion of the SVC. " 7a520eeb-e88c0d77-2d051d7a-378bd783-0356a2de.jpg,validate/p17/p17535980/s59122743/7a520eeb-e88c0d77-2d051d7a-378bd783-0356a2de.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with altered mental status // eval heart and lungs COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. Patient's chin obscures the superior mediastinum limiting assessment. There is interval development of mild hilar congestion with with probable mild interstitial pulmonary edema. No large effusion or pneumothorax is seen. No convincing signs of pneumonia. Cardiomediastinal silhouette appears grossly stable. The imaged bony structures appear relatively unchanged with significant degenerative disease at the right shoulder. IMPRESSION: Mild congestion and interstitial pulmonary edema. " ecd38a1a-a066f8ff-860275d8-be7ba46b-09449675.jpg,validate/p11/p11226572/s59951875/ecd38a1a-a066f8ff-860275d8-be7ba46b-09449675.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest congestion, cough and fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Mild left base and lingular linear atelectasis/scarring is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " d5181809-b9a7ae3e-d4607a19-06a5ccc4-34f9d84f.jpg,validate/p16/p16377954/s51518297/d5181809-b9a7ae3e-d4607a19-06a5ccc4-34f9d84f.jpg,validation," FINAL REPORT INDICATION: History of AML and neutropenia and shortness of breath. 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 a tortuous aorta. The bones are intact. IMPRESSION: No acute cardiopulmonary process. " bc47a565-081b1e43-629c6118-ec64953a-5c81ba64.jpg,validate/p18/p18471732/s57164284/bc47a565-081b1e43-629c6118-ec64953a-5c81ba64.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ___ mos of nonproductive cough, distant h/o of industrial chemical exposure // r/o infiltrate, emphysema, other lung process COMPARISON: ___. FINDINGS: Cardiomediastinal contours are stable. Chronic volume loss in the right hemi thorax with associated mild elevation of the right hemidiaphragm appears unchanged as well as posttraumatic deformities in left chest wall. No new areas of consolidation are identified to suggest the presence of pneumonia, there are no pleural effusions. IMPRESSION: No evidence of pneumonia or other acute cardiopulmonary process. " 0582386e-20923e01-71247f00-b518a7b8-9f4ede82.jpg,validate/p17/p17419105/s58329748/0582386e-20923e01-71247f00-b518a7b8-9f4ede82.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with likely seizure, fall // Eval for acute process, trauma COMPARISON: Prior exam from ___ FINDINGS: AP upright and lateral views of the chest provided. Overlying EKG leads are present. The lungs appear grossly clear bilaterally. The heart is top-normal in size. The mediastinal contour is normal. No large effusion or pneumothorax is seen. The imaged bony structures are intact. No displaced fracture is seen. IMPRESSION: Top normal heart size, otherwise unremarkable. " 45204a71-5211771d-b536d644-1845e4f4-48ab5f41.jpg,validate/p10/p10964281/s51196089/45204a71-5211771d-b536d644-1845e4f4-48ab5f41.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fall and right hip pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pneumothorax. Skinfolds identified over the mid lungs bilaterally. The cardiomediastinal silhouette is within normal limits. No acute displaced fractures identified. Chronic deformity of the mid left clavicle and chronic compression deformity in the lower thoracic spine is again noted. IMPRESSION: No acute cardiopulmonary process. " e524c890-4f498cb5-89c91407-baf9e154-b2140a2a.jpg,validate/p11/p11966980/s52131876/e524c890-4f498cb5-89c91407-baf9e154-b2140a2a.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with colon cancer status post port placement for chemotherapy. Assess tip placement and for pneumothorax. COMPARISON: CXR ___ and ___. FINDINGS: A frontal upright view of the chest was obtained portably. A new left chest port ends in the right atrium. Lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. No upper abdominal or osseous abnormality is identified. A 1.2 cm nodule in the right upper lobe and another at the left lung base are better assessed on CT ___, due to known metastatic disease. IMPRESSION: Left port ends in the right atrium. No pneumothorax. Findings discussed with Dr. ___ (surgery) in person at 8 p.m. ___. " 56c1ddd2-62c79588-b99e49f5-1087519e-44fd697a.jpg,validate/p13/p13362979/s58418864/56c1ddd2-62c79588-b99e49f5-1087519e-44fd697a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with diplopia. CXR requested by neuro TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is mildly enlarged. The aorta is diffusely calcified. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Minimal streaky atelectasis is seen in the lung bases. There is mild blunting of the costophrenic angles posteriorly which could suggest trace bilateral pleural effusions. No pneumothorax is identified. No acute osseous abnormality is seen. There are mild to moderate multilevel degenerative changes in the thoracic spine. IMPRESSION: Mild blunting of the costophrenic angles posteriorly suggests trace bilateral pleural effusions. Mild bibasilar atelectasis. " e930ab51-838b5ce8-8ac825df-f94b9fa0-41bd6ee8.jpg,validate/p16/p16454913/s56447811/e930ab51-838b5ce8-8ac825df-f94b9fa0-41bd6ee8.jpg,validation," FINAL REPORT AP CHEST 4 A.M. ___ HISTORY: ___-year-old man after a tracheoplasty. IMPRESSION: AP chest compared to ___ through post-operative chest radiographs ___: Severe widening of the upper mediastinum continues to improve post-operatively and previous pulmonary edema has now cleared. Substantial bibasilar atelectasis left greater than right has not. I do not see a significant pneumothorax and previous small right pleural effusion has virtually resolved. An apical pleural tube is in place. ET tube ends approximately 2 cm above the upper margin of the clavicles, higher than it was yesterday when the patient was supine and the tip was at the upper margin of the manubrium. Tracheobronchial airway is virtually obscured, presumably by edema and secretions, but really not assessed. Nasogastric tube passes into the stomach and out of view. Heart is top normal size, exaggerated by low lung volumes. " b67a5d66-21da9e58-170ab8a5-aa4ad450-c525d2a0.jpg,validate/p14/p14642407/s59997145/b67a5d66-21da9e58-170ab8a5-aa4ad450-c525d2a0.jpg,validation," FINAL REPORT INDICATION: History of hypoxia, shortness of breath and cough. Question pneumonia. COMPARISONS: ___. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: The lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. A small right upper lobe nodule is consistent with a calcified granuloma. Bones are intact. IMPRESSION: No acute cardiopulmonary process. " c1a466b4-2a64beb3-a8b54dc9-efb48f48-426bc554.jpg,validate/p12/p12437452/s50098822/c1a466b4-2a64beb3-a8b54dc9-efb48f48-426bc554.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with recent admission for pancreatitis presenting with positive blood cultures, question of consolidation. COMPARISON: Chest radiograph on ___ and ___. FINDINGS: PA and lateral views of the chest. Lungs are clear. The cardiac, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Heart size is normal. IMPRESSION: No acute cardiopulmonary process. " 13c28cbf-a2e86d9c-0feb5dc8-18b28bf8-624d6b90.jpg,validate/p11/p11874868/s54138117/13c28cbf-a2e86d9c-0feb5dc8-18b28bf8-624d6b90.jpg,validation," 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. " af8e5624-ae9673b1-b6eb4693-9b294fd4-94c71deb.jpg,validate/p13/p13742877/s51248187/af8e5624-ae9673b1-b6eb4693-9b294fd4-94c71deb.jpg,validation," FINAL REPORT INDICATION: Right-sided chest pain. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Compared to prior study, the small bilateral pleural effusions have decreased. Mild bibasilar atelectasis is redemonstrated. There is no focal consolidation and no pneumothorax. Previously noted mild pulmonary edema has improved. The cardiomediastinal and hilar contours are stable. IMPRESSION: Small bilateral pleural effusions, decreased from prior study, and interval improvement in mild pulmonary edema. " c7bc1921-88952705-c6399681-ef010fbe-dee29b39.jpg,validate/p11/p11828962/s59897869/c7bc1921-88952705-c6399681-ef010fbe-dee29b39.jpg,validation," FINAL REPORT AP CHEST., 9:04 P.M., ___ HISTORY: ___-year-old woman with right pulmonary embolus and bilateral pleural effusions, worsening tachypnea. IMPRESSION: AP chest compared to ___: New large left pleural effusion could be due to hemorrhage or empyema. Increase in heart size and pulmonary mediastinal vascular congestion suggests increased intravascular venous pressure or volume. Subsequent chest radiographs on ___ showing both increase in size of the left pleural effusion and subsequent pleural drainage are present at the time of this review. " 13dfa221-0f95a434-1a452c68-e0051619-c16c292f.jpg,validate/p15/p15792095/s57577619/13dfa221-0f95a434-1a452c68-e0051619-c16c292f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain. 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. Clips in the right upper quadrant again noted. IMPRESSION: No acute findings in the chest. " 9e27001d-4c317034-6b60ec95-8da09712-7b3d5eba.jpg,validate/p12/p12056448/s58752901/9e27001d-4c317034-6b60ec95-8da09712-7b3d5eba.jpg,validation," 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. " 83c1507d-2e4b14ef-e78d109f-384d44e9-a6fc2dab.jpg,validate/p17/p17058328/s50178318/83c1507d-2e4b14ef-e78d109f-384d44e9-a6fc2dab.jpg,validation," FINAL REPORT INDICATION: Reported hypoxia at group home. Assess for infiltrate. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Moderate cardiac enlargement is redemonstrated, with unchanged tortuosity of the thoracic aorta. No vascular congestion or edema is seen. The lungs are clear without pleural effusion or pneumothorax. " 38ef85cb-4e96cca8-6ce38fb7-94c1b6b0-7c94d0b0.jpg,validate/p15/p15970954/s55010727/38ef85cb-4e96cca8-6ce38fb7-94c1b6b0-7c94d0b0.jpg,validation," FINAL REPORT INDICATION: History of right ___ rib fractures, right pneumothorax. Please evaluate. COMPARISONS: Multiple chest radiographs dated back to ___ and chest CT from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There appears to be a slight interval increase in displacement of the posterior right fifth rib fracture compared to the prior exam. Again seen are multiple right-sided rib fractures. There appears to be slight interval worsening of the right apical pneumothorax compared to prior exam. There is stable extensive subcutaneous gas along the right side from the mid abdomen to the mid neck, overall unchanged compared to prior exam. There is stable mild cardiomegaly. Note is made of stable bibasilar atelectasis. Small left pleural effusion is stable. IMPRESSION: Apparent interval increase in the right-sided apical pneumothorax and displacement of the posterior right fifth rib fracture compared to the prior exam, could be accounted for by differences in technique. These findings were discussed with Dr. ___ by Dr. ___ by telephone at 10:20 a.m. on the day of the exam. " 5039c905-1d668612-0ca887f3-364a1445-27ae0b62.jpg,validate/p12/p12916556/s59139033/5039c905-1d668612-0ca887f3-364a1445-27ae0b62.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. . INDICATION: ___M with 50% pneumothorax s/p lung biopsy, s/p CT placed at OSH TECHNIQUE: AP upright view of the chest. COMPARISON: Chest radiograph ___. PET-CT ___. CT interventional procedure images ___. FINDINGS: The cardiomediastinal contours are normal. There is no large pleural effusion. A right chest tube is present, terminating at the right lung apex. There is no definite residual pneumothorax. The lungs are well-expanded. Increased haziness at the right lower lobe and left hilum may represent postprocedural changes and underlying nodule. There is no focal consolidation concerning for pneumonia. Soft tissue gas along the right upper lateral chest wall is second to chest tube placement. IMPRESSION: 1. Right chest tube with tip terminating in the right apex. No definite residual pneumothorax. 2. Haziness in the right lower lung and left hilum may be post procedural and underlying nodule. Attention on follow-up is recommended. " b2ba939d-46d6a98a-abbbccc4-00f506b1-521265a9.jpg,validate/p17/p17033324/s58274705/b2ba939d-46d6a98a-abbbccc4-00f506b1-521265a9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with dyspnea, fever COMPARISON: ___ and ___. FINDINGS: AP portable upright view of the chest. Patient is slightly rotated to his right. 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 " c32a373f-a2bb23da-b6caf9a5-a1138ca3-87b27cad.jpg,validate/p11/p11535886/s57084829/c32a373f-a2bb23da-b6caf9a5-a1138ca3-87b27cad.jpg,validation," FINAL REPORT AP CHEST, 5:50 A.M. ON ___ HISTORY: ___-year-old woman with a nasogastric tube repositioned. IMPRESSION: AP chest compared to 5:08 a.m.: Nasogastric tube which was looped in the mid esophagus has been repositioned in the distal esophagus and would need to be advanced 15 cm to move all the side ports into the stomach. Moderate pulmonary edema, bilateral pleural effusions, cardiomegaly and left lower lobe atelectasis are all unchanged. Right PIC line ends in the upper-to-mid SVC. Lung apices are excluded from the examination. There is no pneumothorax on any of the other pleural margins. " 8eaa9402-08a3de93-c6e93c3e-1d0e9b36-38589857.jpg,validate/p17/p17105437/s57136510/8eaa9402-08a3de93-c6e93c3e-1d0e9b36-38589857.jpg,validation," FINAL REPORT INDICATION: ___ year old man with recurrent pneumonias, concern for aspiration pneumonias, LLL crackles // r/ o aspiration pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Tortuous descending aorta. 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: Tortuous descending aorta. Otherwise normal chest radiograph without evidence of pneumonia " 69fdd20b-0dc2ffdd-fc06e024-e6617986-3757541f.jpg,validate/p10/p10388318/s50821863/69fdd20b-0dc2ffdd-fc06e024-e6617986-3757541f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, questionable ILD, history of tobacco use. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal appearance of the lung parenchyma. No pneumonia, no pulmonary edema. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. " bf204d22-272a4abb-f77522c8-51f8c7f7-08c924e0.jpg,validate/p12/p12730395/s57890947/bf204d22-272a4abb-f77522c8-51f8c7f7-08c924e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with R sided pleural effusion s/p ___Fr for drainage with possible loculations // Eval for interval changes TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiograph and CT chest ___ FINDINGS: The patient is status post right sided chest tube insertion. The chest tube is difficult to visualize but is grossly unchanged in position, the tip appears to be close to the mediastinum. There is a persistent right basal pneumothorax, similar in extent when compared to the prior study. There is a small right-sided pleural effusion. Increased airspace opacity in the right mid lung likely reflects atelectasis but superimposed infection cannot be excluded. Previous median sternotomy noted, surgical clips consistent with coronary artery bypass graft surgery. The left lung is grossly clear. IMPRESSION: No significant interval change when compared to the prior study. " a052064a-9a82ea53-15eecd48-0f2f2f6f-80f3cab3.jpg,validate/p18/p18628103/s52219863/a052064a-9a82ea53-15eecd48-0f2f2f6f-80f3cab3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with several previous intraparynchmal hemorrhages p/w HA and AMS // Headache and AMS TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is subsegmental atelectasis at the left lung base. No focal consolidation, pleural effusion or pneumothorax. Mild pulmonary vascular congestion is noted. Heart remains enlarged. There is also an enlarged and tortuous thoracic aorta, similar to the prior study on the frontal view. No acute osseous abnormalities are identified. There are several healed rib fractures on the right. IMPRESSION: 1. Mild pulmonary vascular congestion, without overt pulmonary edema. 2. Tortuous and enlarged thoracic aorta, similar to prior studies on the frontal view. " a534dcdb-ba3c1427-4ab5f7b6-e2efae67-c5f2d214.jpg,validate/p13/p13748721/s56801785/a534dcdb-ba3c1427-4ab5f7b6-e2efae67-c5f2d214.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left arm parasthesias/weakness and right headache TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Borderline enlargement of the cardiac silhouette is unchanged. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 1376b807-8fd7515f-852d270d-2a47b455-5a4d61fc.jpg,validate/p16/p16996460/s51450593/1376b807-8fd7515f-852d270d-2a47b455-5a4d61fc.jpg,validation," WET READ: ___ ___ ___ 7:55 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with nausea, diaphoresis, EKG changes // eval for CHF/pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are hyperexpanded but clear. The heart is not enlarged. The aorta is tortuous. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " c107ad25-daf102fc-41e32e7b-dd26d5bd-d71e303d.jpg,validate/p12/p12534815/s54721440/c107ad25-daf102fc-41e32e7b-dd26d5bd-d71e303d.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Chronic cough, smoker, ___-pound weight loss, infiltrative process to rule out cancer or other acute process. COMPARISON: No prior chest x-ray. Abdominal CT done yesterday. FINDINGS: The lungs are mildly hyperinflated, but there is no focal lesion. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: Except for hyperinflation, the remaining of the lungs are unremarkable. " 131b9c72-90c2db36-635fc49a-0eedac0a-ba32d4d4.jpg,validate/p15/p15760813/s50398782/131b9c72-90c2db36-635fc49a-0eedac0a-ba32d4d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ILD, s/p endobronchial bx, re-intubated for hypoxemia // eval for interval change eval for interval change COMPARISON: Comparison to ___ at 16:35 FINDINGS: Portable semi-erect chest radiograph ___ at 04:59 is submitted. IMPRESSION: Nasogastric tube coursing below the diaphragm. Endotracheal tube unchanged in position. Right subclavian PICC line with its tip in the distal SVC near the cavoatrial junction. Bilateral interstitial abnormality is again seen although appears to be somewhat improved, possibly related to difference in technique or resolving interstitial edema. Clinical correlation is recommended. More focal consolidation in the retrocardiac region persists which could reflect a combination of parenchymal disease and/or pleural fluid. No pneumothorax. " 1f4ddc97-30d4ebbe-b8276453-a0e993d3-23a42d2b.jpg,validate/p13/p13902721/s50648830/1f4ddc97-30d4ebbe-b8276453-a0e993d3-23a42d2b.jpg,validation," FINAL REPORT INDICATION: Chest pain, rule out infiltrate. TECHNIQUE: PA and lateral views of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The cardiomediastinal silhouette is normal. The lungs are clear without focal consolidation, effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " afbcdf36-a5bbd308-e9863256-ab325e8f-f77355ed.jpg,validate/p14/p14106799/s52815374/afbcdf36-a5bbd308-e9863256-ab325e8f-f77355ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and shortness of breath. Rales at bases // r/o pneumonia r/o pneumonia IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is mild prominence of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia. Some coarseness of interstitial markings could reflect chronic pulmonary disease, mild elevation of pulmonary venous pressure, or both. " f2983e81-aed345fa-cd7dcea9-25cb2e56-3a635c38.jpg,validate/p19/p19416143/s59756572/f2983e81-aed345fa-cd7dcea9-25cb2e56-3a635c38.jpg,validation," FINAL REPORT INDICATION: Mental status change. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. Linear bibasilar atelectasis is present. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " 240e4e61-7d8ec8b2-8154dd4c-0a90fbd9-22e91628.jpg,validate/p18/p18464327/s53083642/240e4e61-7d8ec8b2-8154dd4c-0a90fbd9-22e91628.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ CLINICAL HISTORY: ___-year-old woman with cough for several weeks, shortness of breath and new anemia. Crackles at the left base. Rule out abnormality. IMPRESSION: AP chest compared to ___: Patient has had right mastectomy and axillary node dissection. Mediastinal widening is attributable to fat deposition seen on a torso CT of ___ which also showed mild bilateral hilar lymph node enlargement. A slight interval increase in hilar caliber is not sufficient to raise concern about clinically significant adenopathy, suggesting instead pulmonary arterial enlargement. Heart is normal sized. A small-to-moderate hiatus hernia is larger today than it was in ___. There is new mild atelectasis in the lingula, but no pulmonary edema or good evidence for pneumonia. Right apical pleural parenchymal irregularity is scarring. Transvenous right atrial and right ventricular pacer leads follow their expected courses. No pneumothorax. " 47a31816-19c56687-4ff799e0-bd74fb57-3898faf2.jpg,validate/p11/p11108032/s50089094/47a31816-19c56687-4ff799e0-bd74fb57-3898faf2.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with MS, TR, and pulmonary HTN presenting with dyspnea on exertion. // Pulmonary edema? TECHNIQUE: Portable upright AP chest COMPARISON: Radiographs the chest ___ and ___. FINDINGS: The lungs are normally expanded and clear. There is no focal airspace opacity or pulmonary edema. Heart size is top normal. The mediastinal and hilar contours are normal. There is no large pleural effusion. There is no pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 720470da-91130eb9-b4e6fd87-ef6bafc4-619ea4f4.jpg,validate/p17/p17353218/s53788457/720470da-91130eb9-b4e6fd87-ef6bafc4-619ea4f4.jpg,validation," FINAL REPORT INDICATION: ___M with cough, fevers, right sided chest pain history of pna feels similar // cough, history of pna TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are again notable for subtle right middle lobe opacity. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. Hypertrophic changes are seen in the spine without acute osseous abnormalities. IMPRESSION: Subtle persistent right middle lobe opacity similar compared to prior, could represent resolving infection. Follow-up to document resolution in several weeks is suggested. " c7c10eb0-b7f2849b-eb146f10-bd5bd71d-ee3a16e2.jpg,validate/p15/p15945073/s51531677/c7c10eb0-b7f2849b-eb146f10-bd5bd71d-ee3a16e2.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with new NG tube, evaluate position. 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 ___. An NG tube can be identified and although nondetectable in the lower esophagus related to cardiac motion, one can see the distal NG tube to reach well in the stomach where it is curved up in the fundus and the tip pointing towards the pylorus. There is no pneumothorax or any other possibly placement-related complication. The on previous examination still persisting left lower lobe pulmonary parenchymal densities, interpreted as atelectasis or possible aspiration pneumonitis, has improved. No new abnormalities are seen. The position of the previously described right internal jugular approach central venous line is unchanged. " a4fd73f8-0428f0e7-65938b7f-1fd366d7-5c05d59a.jpg,validate/p19/p19783898/s55655942/a4fd73f8-0428f0e7-65938b7f-1fd366d7-5c05d59a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough for 3 weeks. COMPARISON: Multiple prior exams, most recently of ___. FINDINGS: Frontal and lateral views of the chest. Equivocal retrocardiac opacity appears to project over the lower thoracic spine on the lateral view. No pleural effusion or pneumothorax. Heart size and cardiomediastinal contours are normal. IMPRESSION: Equivocal retrocardiac opacity could represent atelectasis or pneumonia in the appropriate clinical setting. " dba5261a-101acc25-528c2d6d-cca8b278-9bc1fa5b.jpg,validate/p15/p15165629/s51342735/dba5261a-101acc25-528c2d6d-cca8b278-9bc1fa5b.jpg,validation," FINAL REPORT INDICATION: History: ___F with back pain following MVA // please assess for fracture TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart size is top 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. No definite fracture identified. " 5c552a50-da57ccd9-c265139a-783cb864-c399ba4b.jpg,validate/p17/p17767787/s56782185/5c552a50-da57ccd9-c265139a-783cb864-c399ba4b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___-year-old man with recent PNA, now with stroke symptoms. TECHNIQUE: AP and lateral view of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Compared to ___, there is no large interval change in the appearance of the chest. A dialysis catheter ends in the right atrium. Mild cardiomegaly is unchanged. There are increased interstitial markings diffusely. There is are small bilateral pleural effusions. There is no focal lung consolidation. IMPRESSION: 1. Mild interstitial edema. 2. Stable cardiomegaly. " 8706ff81-e8c8d94a-ec548fd0-19cf6247-e89e7ae7.jpg,validate/p13/p13689440/s59695936/8706ff81-e8c8d94a-ec548fd0-19cf6247-e89e7ae7.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p right VATS converted to open wedge ___ for adenoca stage 1a // eval for interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Dual lead pacemaker in situ. Cardiomediastinal shadow unchanged. Post CABG changes are stable. Interval improvement in the density (presumed posterior chest wall hematoma) projecting over the right hilum. Persistent right-sided pleural thickening/ layering pleural effusion. No pneumothorax. The left lung is clear. Spondylotic changes of the thoracic spine. Surgical clips seen in the left upper abdomen suggesting previous splenectomy. IMPRESSION: As above " cbd19c07-02e67056-9d069d0b-d48968e4-3b309a17.jpg,validate/p16/p16089191/s56265918/cbd19c07-02e67056-9d069d0b-d48968e4-3b309a17.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with sob // ? pna COMPARISON: Prior exam from ___ and ___. FINDINGS: PA and lateral views of the chest provided. There is platelike left basal atelectasis. Otherwise the lungs appear clear. Cardiomediastinal silhouette is normal. No large effusion or pneumothorax. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No convincing evidence for pneumonia. Mild left basal platelike atelectasis. " dfa3ca9c-2ec06356-1c59bfe9-2c52782a-9c2845e6.jpg,validate/p19/p19604761/s52455345/dfa3ca9c-2ec06356-1c59bfe9-2c52782a-9c2845e6.jpg,validation," FINAL REPORT INDICATION: History: ___F with dyspnea // r/o acute 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. " bf3bb599-825b0955-4c012870-5f08e13b-da048d61.jpg,validate/p11/p11110395/s51038543/bf3bb599-825b0955-4c012870-5f08e13b-da048d61.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Seizure. 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. " f702082a-b2bbcd66-030ed703-9334d382-59114387.jpg,validate/p11/p11879411/s50529136/f702082a-b2bbcd66-030ed703-9334d382-59114387.jpg,validation," FINAL REPORT INDICATION: Evaluate for acute cardiopulmonary process, pneumonia versus widened mediastinum, in a patient with severe chest pain radiating from the back. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs demonstrate a likely normal cardiomediastinal silhouette. Left base opacity is likely related to a combination of a small to moderate left pleural effusion and associated consolidation. There is no pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: 1. Small to moderate left pleural effusion with associated adjacent opacities. A CT should be considered to evaluate for an underlying cause for the pleural effusion. 2. Normal cardiomediastinal silhouette. " cf4d81df-a727c6a5-bc63f944-5c530da2-f4d083f4.jpg,validate/p16/p16556728/s52006419/cf4d81df-a727c6a5-bc63f944-5c530da2-f4d083f4.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain, question cardiomegaly. COMPARISON: PA and lateral chest radiograph from ___. FINDINGS: PA and lateral chest radiographs are provided. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 72bb9e72-9e86d50d-efcff3f5-548de330-9592d1ad.jpg,validate/p12/p12333387/s55867225/72bb9e72-9e86d50d-efcff3f5-548de330-9592d1ad.jpg,validation," FINAL REPORT INDICATION: History: ___F with sputum/dyspnea/coughing/sore throat, crackles on exam, please eval for pna // ___F presenting with cough, sputum, some dyspnea, sore throat x1 week, with some crackles appreciated on lung exam- please evaluate for pna TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Cardiomediastinal silhouette is stable. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " f300c2ff-5da6f7e6-36bf8039-1017b5eb-fa38a61e.jpg,validate/p19/p19986230/s52326948/f300c2ff-5da6f7e6-36bf8039-1017b5eb-fa38a61e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with productive cough // 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. " 7d1881a9-2bd6ce62-81d8e9a4-673c9325-3f62e77d.jpg,validate/p18/p18719314/s55399567/7d1881a9-2bd6ce62-81d8e9a4-673c9325-3f62e77d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with dypsnea // evaluate pulm edema or effusion TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph FINDINGS: In comparison in ___ portable chest radiograph, bilateral lungs volumes are low-normal. There is platelike atelectasis of the left mid lung. No consolidation nor pleural effusions nor pneumothorax seen. The heart size is top normal. There is no pulmonary vascular congestion nor pulmonary edema. There has been interval placement of skin ___ in the anterior chest wall which are aligned and intact. There is no acute bony abnormality. IMPRESSION: 1. Low-normal lung volumes with platelike atelectasis of the mid-left lung. 2. Stable mild cardiomegaly without pulmonary vascular congestion or edema. 3. No radiographic evidence of pneumonia 4. Interval placement of skin ___ in the anterior chest wall when compared to ___ portable chest radiograph. " 4c0188a7-e7624ede-ecc00143-e09653e5-90a20f95.jpg,validate/p15/p15692257/s57138981/4c0188a7-e7624ede-ecc00143-e09653e5-90a20f95.jpg,validation," FINAL REPORT INDICATION: Melanoma, assess for disease recurrence. COMPARISON: ___. FINDINGS: Two views were obtained of the chest. The lungs are well expanded. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " c8df31c5-281042b2-3875f464-c4a73f71-2e0fb027.jpg,validate/p14/p14597448/s56637911/c8df31c5-281042b2-3875f464-c4a73f71-2e0fb027.jpg,validation," WET READ: ___ ___ ___ 8:03 AM Overall improved appearance of the lungs, particularly in the left mid and lower lung. Persistent scattered parenchymal opacities in both lungs. Central venous catheter tip is at the cavoatrial junction. No pleural effusion or pneumothorax. -___ WET READ VERSION #1 ___ ___ ___ 7:49 PM Overall improved appearance of the lungs, particularly in the left mid and lower lung. Persistent scattered parenchymal opacities in both lungs. Central venous catheter tip is at the cavoatrial junction. No pleural effusion or pneumothorax. -___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman w h/o hypoplastic MDS/aplastic anemia s/p Allo now with nocardia infection in the lung // please re-evaluate for infection etc. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The pre-existing parenchymal opacity on the left has improved but bilateral scattered areas of parenchymal opacities, part of which have nodular components, are still clearly visible. Mild overinflation. Normal size of the cardiac silhouette. No pleural effusions. " ff3393a7-2386a2ce-06bc4fec-762d5e1f-8f42e550.jpg,validate/p13/p13138475/s55535682/ff3393a7-2386a2ce-06bc4fec-762d5e1f-8f42e550.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pneumonia and Wegener after reintubation. Portable AP radiograph of the chest was reviewed in comparison to ___ obtained at 04:13 a.m. The ET tube tip is approximately 4.7 cm above the carina. Left internal jugular line tip is at the level of mid SVC. The rest of the findings are unchanged. " e7410ba5-7e0e5983-cd192f59-7312d0ac-4a3746f9.jpg,validate/p17/p17071972/s58067882/e7410ba5-7e0e5983-cd192f59-7312d0ac-4a3746f9.jpg,validation," FINAL REPORT INDICATION: Weakness. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CT ___. FINDINGS: The lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation. Linear atelectasis at the left lung base. The heart is normal size. The mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " cee626fe-0ba94e42-7a1114d1-d23bf482-eb9001f6.jpg,validate/p12/p12884654/s50689464/cee626fe-0ba94e42-7a1114d1-d23bf482-eb9001f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with likely aspiration pneumonia, please evaluate for interval change // interval change interval change IMPRESSION: Compared to chest radiographs ___. Those probably mild pulmonary edema on ___ which has resolved. There are no focal findings to suggest active pneumonia. Heart size normal. No pleural effusion. " 1f30c7df-3f959322-1310a3e0-aa8489da-f7772d04.jpg,validate/p16/p16662264/s55866796/1f30c7df-3f959322-1310a3e0-aa8489da-f7772d04.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with IgG deficiency, asthma, diabetes. Evaluate for infiltrate. COMPARISON: Multiple prior chest radiographs dating from ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded lungs. There is obscuration of the left border, which may represent early lingular pneumonia, and is not definitely seen on the lateral view. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Obscuration of the left heart border which may represent early lingular pneumonia, and is not definitely seen on the lateral chest x-ray. COMMENTS: These findings were submitted to the critical results dashboard at 5:30pm on ___. " 32dfa029-36d47206-7ce7c8b1-3f933bda-5a62fc72.jpg,validate/p11/p11020816/s51987442/32dfa029-36d47206-7ce7c8b1-3f933bda-5a62fc72.jpg,validation," WET READ: ___ ___ ___ 11:56 AM Coarse irregular lung markings bilaterally, possibly secondary to COPD. Minimal, subtle left basilar opacity - if PNA is of clinical concern, could do short term f/u CXR. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with altered mental status. Question pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. There are bilateral coarse irregular lung markings likely secondary to COPD. There is also a minimal left basilar opacity. There is no evidence of pneumothorax or pleural effusions. IMPRESSION: 1. Coarse irregular lung markings bilaterally, likely secondary to COPD. 2. Minimal left basilar opacity may be secondary to subtle pneumonia; short-term follow-up chest x-ray may be helpful to reassess. " 3b98c0d5-878e03e0-a9a62bb4-3fe6405c-f957e711.jpg,validate/p16/p16669225/s59862608/3b98c0d5-878e03e0-a9a62bb4-3fe6405c-f957e711.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F CAD, MR, htn/hl, ?COPD, who p/w fever and cough and is found to have PNA and is treated with CTX/azithro. On HD #2, BP in 80s and HR in 130s-150s (Afib w/RVR); BPs drop after iv metop ___ mg x 3 and dilt ___ mg, so patient transferred to MICU for BP stabilization. Started on dilt drip and heparin, before being sent back to floor on ___. Now on PO dilt and PO warfarin. Found to have loculated effusion on ___ concerning for empyema. S/p R chest tube placement on ___. // interval change in pleural effusion? change in consolidation?interval change in pleural effusion? change in consolidation IMPRESSION: In comparison with the study of ___, there is little change and the appearance of the right upper lobe consolidation bounded inferiorly by the minor fissure. Pigtail catheter remains in place without definite pneumothorax. Remainder of the study is unchanged. " c5f1bed8-823add82-2075dfe4-ba916f5f-b53c2fb3.jpg,validate/p13/p13747362/s55657833/c5f1bed8-823add82-2075dfe4-ba916f5f-b53c2fb3.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: AVR. Question effusion. IMPRESSION: AP chest compared to ___: Moderate right pleural effusion is smaller, previous borderline interstitial edema has resolved. There is no longer any pneumothorax. Small left pleural effusion is probably decreased as well. Postoperative enlargement of the cardiac portion of the mediastinal silhouette is stable. The mediastinal vascular component has decreased. A left PIC line can be traced as far as the region of the superior cavoatrial junction, although the tip is indistinct. Transvenous pacer defibrillator lead ends in the right ventricle, proximal electrode spans the superior vena cava and upper right atrium. " 5342c2ca-9de6cede-63c724cf-5ebcc57e-e742a23b.jpg,validate/p17/p17237809/s50862169/5342c2ca-9de6cede-63c724cf-5ebcc57e-e742a23b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with doe // sob COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Moderate cardiomegaly is noted with mild central congestion. Hilar fullness is noted. There are small bilateral pleural effusions. No convincing sign of pneumonia. Mediastinal contour stable. No pneumothorax. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild central congestion, small effusions. " 33e04e8f-b43ac01d-21d16f19-7327e3cd-59dfa666.jpg,validate/p17/p17980556/s55176841/33e04e8f-b43ac01d-21d16f19-7327e3cd-59dfa666.jpg,validation," FINAL REPORT HISTORY: NG tube manipulation. FINDINGS: In comparison with the study of ___, the nasogastric tube extends to the mid body of the stomach. Side hole is distal to the esophagogastric junction. There is continued enlargement of the cardiac silhouette with some decrease in pulmonary vascular congestion. The monitoring and support devices remain in place. " 61bef5a3-d1311424-e4ec7776-eec7b4cd-7375cb7c.jpg,validate/p19/p19247418/s57032498/61bef5a3-d1311424-e4ec7776-eec7b4cd-7375cb7c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough, wheezing // pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is subtle with pneumomediastinum best visualized in the right superior mediastinal region extending superiorly into the lower right cervical region. A hazy opacity at the right lung base may represent early pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Pneumomediastinum. No pneumothorax. A hazy opacity at the right lung base may represent early pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:21 AM, 20 minutes after discovery of the findings. " ec7f69ee-0c9b76aa-01698082-442e324d-3c1b0973.jpg,validate/p11/p11476759/s51724544/ec7f69ee-0c9b76aa-01698082-442e324d-3c1b0973.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with pericardial effusion s/p pericardiocentesis, worsening hypotension // eval interval change TECHNIQUE: AP portable view of the chest COMPARISON: ___ IMPRESSION: Pacemaker with leads terminate in appropriate position. Small bilateral pleural effusions as well as mild fluid overload has worsened since the ___ radiograph. Cardiac size has also mildly increased. A catheter is seen projecting over the right side of the abdomen of unclear origin. " 35748fbd-d5f0a2c3-77010c1a-94d41f9d-7540c3c9.jpg,validate/p13/p13383248/s57743302/35748fbd-d5f0a2c3-77010c1a-94d41f9d-7540c3c9.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with cough with a recently diagnosis of shingles. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette remains mildly enlarged but stable. Tortuosity of the aorta is again noted. Again visualized is mild-to-moderate dextroscoliosis of the upper thoracic spine as well as degenerative changes involving the mid thoracic spine and calcifications of the costochondral cartilages. IMPRESSION: No acute cardiopulmonary process. " aceb40d2-d8ab5a1f-6d34795e-addf60fa-3c30bd8b.jpg,validate/p16/p16116450/s59530442/aceb40d2-d8ab5a1f-6d34795e-addf60fa-3c30bd8b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o renal cell carcinoma // pls evaluate for mets pls evaluate for mets IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs and no evidence of acute cardiopulmonary disease. Specifically, no evidence of pulmonary or skeletal metastases. " 554de454-4727f6b3-3f2726c1-13c507c6-2f63723d.jpg,validate/p16/p16605694/s53983117/554de454-4727f6b3-3f2726c1-13c507c6-2f63723d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for 4 months, no shortness of breath or wheezes. No tobaco use // Eval cough COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. Moderate cardiomegaly with elongation of the descending aorta. And signs of mild fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia. The lateral radiograph reveals a moderate to severe scoliosis. " 14a92166-6ee55ecc-1838bbee-ace75cb9-9b34002f.jpg,validate/p10/p10677942/s53188837/14a92166-6ee55ecc-1838bbee-ace75cb9-9b34002f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with LUL nodules, ? present on CXR in ___. PA/LAT advised for comparison with ___ film // eval LUL changes to compare with PA/Lat CXR in ___ COMPARISON: Chest CTs from ___ and ___ as well as multiple prior chest radiographs including ___ FINDINGS: 2 focal nodular left upper lobe opacities are again demonstrated and have been present radiographically since at least ___. Is difficult to assess for subtle change over time due to positional and projectional differences between these exams, but there has not been a dramatic interval change during the long time interval. Heart size, mediastinal and hilar contours are normal. There is no pleural effusion or acute skeletal findings. IMPRESSION: 2 left upper lobe nodular opacities have been present radiographically since ___ and are probably stable since that time. Positional and projectional differences limit assessment for subtle change. With this in mind, a 6 month followup CT may be helpful to confirm stability and to exclude an active process. " b0022f5a-b20bacff-88cd121f-6069400a-104bd582.jpg,validate/p15/p15070138/s56590155/b0022f5a-b20bacff-88cd121f-6069400a-104bd582.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with multiple myeloma being worked up for transplant. Eligibility workup. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. Heart size is within normal limits. No typical configurational abnormality is seen. 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. Skeletal structures of the thorax grossly unremarkable in this patient with history of multiple myeloma. The next preceding chest examination of ___ demonstrated an acute parenchymal infiltrate in the left lower lobe. This process has resolved. " 94d1e33e-2418c8e1-c1aa73e8-6e914a34-bc9cf33e.jpg,validate/p19/p19778971/s52140555/94d1e33e-2418c8e1-c1aa73e8-6e914a34-bc9cf33e.jpg,validation," FINAL REPORT HISTORY: Respiratory decompensation. FINDINGS: In comparison with the earlier study of this date, there is little overall change. Again there are extensive bilateral pulmonary opacifications. No evidence of pneumothorax. " 3075dd3e-808c141a-82e766ee-1c6f4d0a-5f7beca8.jpg,validate/p19/p19048729/s59964559/3075dd3e-808c141a-82e766ee-1c6f4d0a-5f7beca8.jpg,validation," WET READ: ___ ___ ___ 4:52 PM Endotracheal tube terminates 4.5 cm above the carina. Enteric tube courses below the diaphragm, but terminates at the GE junction. Recommend advancement so that it is well within the stomach. Low lung volumes. Patchy bibasilar opacities most likely present at atelectasis versus aspiration. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M s/p arrest with worsening academia and hypoxia // ?cardiopulmonary process TECHNIQUE: Single frontal view of the chest COMPARISON: ___, earlier today, at 11:52 FINDINGS: Endotracheal tube terminates approximately 4.5 cm above the carina. Enteric tube courses below the diaphragm but terminates at the GE junction. Recommend advancement so that it is well within the stomach. Lung volumes remain low. Patchy bibasilar opacities most likely represent atelectasis versus aspiration. No large pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Endotracheal tube terminates 4.5 cm above the carina. Enteric tube courses below the diaphragm, but terminates at the GE junction. Recommend advancement so that it is well within the stomach. Low lung volumes. Patchy bibasilar opacities most likely present at atelectasis versus aspiration. " 02021e0a-fe3a1da4-14be0415-3a6c530f-c46fb38a.jpg,validate/p13/p13948622/s57079543/02021e0a-fe3a1da4-14be0415-3a6c530f-c46fb38a.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with dyspnea. COMPARISON: None. FINDINGS: The lungs demonstrate mild interstitial abnormality, best seen on the lateral view. There is no focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The mediastinal contours are unremarkable. The pulmonary vasculature appears normal. IMPRESSION: Mild interstitial abnormality, which in a young patient may be seen in asthma or history of heavy smoking. " 3268e434-038c7db4-9e1ba62f-8ab632fe-7927dce4.jpg,validate/p19/p19685014/s51208988/3268e434-038c7db4-9e1ba62f-8ab632fe-7927dce4.jpg,validation," 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. " 99f16fdd-116b4ce2-a602daae-3892b54a-f8054596.jpg,validate/p19/p19864166/s56931464/99f16fdd-116b4ce2-a602daae-3892b54a-f8054596.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with ?aspiration // ?aspiration TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The lungs volumes are slightly low but clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Hyperdense material within partially imaged bowel in the mid abdomen likely reflects retained barium. IMPRESSION: Slightly low lung volumes. No evidence of aspiration. " 28460aea-4364926a-dc4cb67f-718219d8-7dd21e82.jpg,validate/p12/p12960546/s59742096/28460aea-4364926a-dc4cb67f-718219d8-7dd21e82.jpg,validation," FINAL REPORT AP CHEST, 10:53 A.M. ON ___ HISTORY: ___-year-old man with severe aortic stenosis and acute-on-chronic CHF, now delirious. IMPRESSION: AP chest compared to ___: Moderate right pleural effusion may be slightly smaller. Small left pleural effusion and mild pulmonary edema are worse. The heart is moderately enlarged. Concurrent pneumonia cannot be excluded, but does not need to be invoked to explain all the radiographic findings. Transvenous right atrial and right ventricular pacer leads in standard placements. No pneumothorax. " 9936c739-d2d2fcb7-adf3955d-c1f6151a-09d85201.jpg,validate/p18/p18208210/s50137060/9936c739-d2d2fcb7-adf3955d-c1f6151a-09d85201.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with functional decline // C/f sarcoidosis C/f sarcoidosis IMPRESSION: 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 prominence of interstitial markings " 548a605d-a19e3a25-5ced67d9-de7b4b1e-85f6d82d.jpg,validate/p17/p17079941/s54737694/548a605d-a19e3a25-5ced67d9-de7b4b1e-85f6d82d.jpg,validation," FINAL REPORT AP CHEST, 4:31 P.M., ___ HISTORY: ___-year-old woman with new Dobbhoff tube placed. IMPRESSION: AP chest compared to ___, 5:51 a.m.: Severe infiltrative pulmonary abnormality has been stable in the right lung for several days. Left lung has improved. Precise nature of this abnormality is unclear to me. It is not due to cardiogenic edema since heart is normal size and there is no mediastinal vascular engorgement. Series of three sequential radiographs shows ultimate positioning of the Dobbhoff feeding tube, initially in the hypopharynx, ultimately in the upper stomach, looping just beyond the gastroesophageal junction. There appears to be another tube in the upper esophagus, ending roughly at the level of the aortic knob. I have paged the house officer caring for this patient for clarification. No pleural effusion or pneumothorax. " 66f7baed-ec6ef5e5-7c2b3f87-118c70e4-01283d13.jpg,validate/p12/p12878814/s55755556/66f7baed-ec6ef5e5-7c2b3f87-118c70e4-01283d13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with follicular lymphoma, s/p allo cord transplant day +___ with hypoxia. Lungs CTAB. // focal consolidation? pleural effusion? focal consolidation? pleural effusion? IMPRESSION: In comparison with the study of ___, there is increasing bibasilar opacification, more prominent on the left, consistent with layering pleural effusions and volume loss in the lower lobes. An some indistinctness of pulmonary vessels raises the possibility of elevated pulmonary venous pressure. Central catheter is unchanged. NOTIFICATION: To Dr. ___ " 88599fd0-57288634-2d77f19e-73726d34-90158ecc.jpg,validate/p19/p19028690/s58640644/88599fd0-57288634-2d77f19e-73726d34-90158ecc.jpg,validation," FINAL REPORT INDICATION: ___-year-old male 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. Lung volumes are slightly low. There may be an azygous lobe. Pulmonary vascular prominence is again seen with interval improvement in mild interstitial edema. Heart size is mildly enlarged. IMPRESSION: Persistent pulmonary vascular prominence with interval improvement in mild interstitial edema. " 4f5f0b56-cd22d318-56c01b86-ec76d343-5b3ed6d5.jpg,validate/p18/p18562936/s53913993/4f5f0b56-cd22d318-56c01b86-ec76d343-5b3ed6d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis w/ emboli to lungs, hx of drained sanguineous pleural effusions // Any e/o worsening pleural effusion Any e/o worsening pleural effusion IMPRESSION: Compared to prior chest radiographs ___ through ___. Moderate left pleural effusion unchanged. Left hilar adenopathy is now more obvious or larger. Small right pleural effusion stable. No pulmonary edema. Consolidation is likely at both lung bases, difficult to distinguish from atelectasis, unchanged since ___. No pneumothorax. Right PIC line ends in the mid SVC. " dccb0eb1-febf9be2-a37461de-6f9dfdd8-a4c8afc0.jpg,validate/p17/p17598360/s54315661/dccb0eb1-febf9be2-a37461de-6f9dfdd8-a4c8afc0.jpg,validation," WET READ: ___ ___ ___ 6:08 PM ETT ends 1.5 cm from the carina. Swan Ganz catheter was removed. Enteric tube is not fully visualized, left IJ line unchanged. Bilateral edema and effusions unchanged. ___ d/w ___ at 607pm on ___ by phone. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with ARDS and decannulation AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 1.5 cm above the carina. Heart size and mediastinum are grossly stable. Interstitial opacities are noted, widespread, overall similar to the prior examination and might be consistent with mild interstitial pulmonary edema, although underlying ARDS can contribute to the findings as well. No appreciable pleural effusion is seen. Pleural thickening is noted bilaterally. Heart size is overall unremarkable. Post-sternotomy wires are present. There is a possibility given the cardiac silhouette is slightly different from expected that the patient might have had prior cardiac surgery, potentially in childhood. " c17975c0-e99850d7-c81c2e2c-995d6d2e-9b9accbb.jpg,validate/p19/p19842175/s52656656/c17975c0-e99850d7-c81c2e2c-995d6d2e-9b9accbb.jpg,validation," 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. " ab17408d-6d240880-76b94878-3f7970cc-91f15e37.jpg,validate/p15/p15967773/s50496434/ab17408d-6d240880-76b94878-3f7970cc-91f15e37.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: New left pigtail placement. COMPARISON: ___. FINDINGS: Single frontal view of the chest was obtained. There has been interval placement of a left-sided pigtail catheter with interval decrease in left-sided pneumothorax which is no longer well evident. Left chest wall subcutaneous emphysema is seen. The left lung is better expanded, although overall there are low lung volumes symmetrically bilaterally. No definite focal consolidation is seen. There is streaky left basilar opacity, most likely atelectasis rather than pulmonary consolidation. No definite fracture is identified. " c9490c4a-80e7ee92-40bd3e76-69547302-ef506333.jpg,validate/p16/p16696931/s57336416/c9490c4a-80e7ee92-40bd3e76-69547302-ef506333.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with right sided chest pain and previous congestive heart failure 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. No pulmonary edema. " 7ca5f624-685bca85-5063bb5d-3943445a-80e1b8b4.jpg,validate/p18/p18762761/s51952725/7ca5f624-685bca85-5063bb5d-3943445a-80e1b8b4.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with brachial artery aneurysm, now repaired, with significant surrounding erythema around incision site. // interval changes TECHNIQUE: Chest portable FINDINGS: As compared to chest radiograph from 1 day prior, moderate cardiomegaly is stable. Right lower lobe opacity a combination of atelectasis and effusion is a stable. Retrocardiac opacities have improved also a combination of pleural effusion and adjacent atelectasis. No evident pneumothorax. Patient has known emphysema. Right IJ catheter tip is in the mid SVC IMPRESSION: Overall, no substantial change with persistent combination of atelectasis and effusions in the lung bases. " ec677241-20f5a69c-0b139579-d527a4b4-6a2a41d7.jpg,validate/p15/p15923118/s55727132/ec677241-20f5a69c-0b139579-d527a4b4-6a2a41d7.jpg,validation," FINAL REPORT HISTORY: Evaluation for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple chest radiographs the most recent on ___ FINDINGS: The lung volumes are low. 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 pneumonia. " 12af039e-2513a9ee-f2076865-37c4e9e6-33b2933d.jpg,validate/p18/p18734362/s51945277/12af039e-2513a9ee-f2076865-37c4e9e6-33b2933d.jpg,validation," FINAL REPORT HISTORY: COPD and pneumonia, to assess for change. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Cardiac silhouette remains at the upper limits of normal in size. Some indistinctness of pulmonary vessels raises the possibility of elevated pulmonary venous pressure. The left hemidiaphragm is more sharply seen. Mild bibasilar atelectatic change. No definite acute focal pneumonia. " d7b23af3-fc81771f-b3f764a3-13bdfa51-81ee91bb.jpg,validate/p12/p12221629/s56707998/d7b23af3-fc81771f-b3f764a3-13bdfa51-81ee91bb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with worsening LLL consolidation // pneumonia, CHF TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: Improved lung volumes bilaterally. Interval increase in left pleural effusion and persistent small right pleural effusion. Bibasilar opacities left greater than right is unchanged. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unchanged. Dual lead pacemaker with pacer leads in the right atrium right ventricle in expected positions. IMPRESSION: Increase in moderate left pleural effusion and persistent small right pleural effusion. No significant change in left lower lobe consolidation. " 725f4d29-7c4751ec-4a005afc-84479972-5124dab7.jpg,validate/p18/p18255016/s57895148/725f4d29-7c4751ec-4a005afc-84479972-5124dab7.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with shortness of breath and pain. Evaluate for fracture or pneumothorax. 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. Lungs are hyperinflated, but otherwise clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. The osseous structures are unremarkable. No rib fractures are identified. No radiopaque foreign body. IMPRESSION: No acute cardiopulmonary process. No fracture or pneumothorax. " 4419603a-31a18c09-54539462-fdabba7d-52ee85af.jpg,validate/p14/p14727290/s52865788/4419603a-31a18c09-54539462-fdabba7d-52ee85af.jpg,validation," FINAL REPORT PORTABLE AP UPRIGHT CHEST FROM ___ at 6:05 CLINICAL INDICATION: ___-year-old with hypertension, end-stage renal disease with wheezing, shortness of breath. Evaluate pulmonary edema. Comparison is made to the patient's prior study of ___ at 5:46 a.m. Portable AP upright chest film, ___ at 6:05 a.m. is submitted. IMPRESSION: 1. Right internal jugular central line has its tip in the distal SVC, unchanged. There is some overlying motion. However, there are worsening bibasilar and interstitial opacities, consistent with worsening pulmonary edema. Overall, cardiac and mediastinal contours are difficult to assess given marked patient rotation on the current examination. No large pneumothorax is seen. There are likely small layering bilateral effusions. " 85efd4e0-99babadb-fb619454-983ef4fb-1e2d240c.jpg,validate/p16/p16529821/s56346815/85efd4e0-99babadb-fb619454-983ef4fb-1e2d240c.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with seizure. 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. " 8959e402-2175d68d-edba5a6c-baab51c3-9359f700.jpg,validate/p10/p10000898/s54205396/8959e402-2175d68d-edba5a6c-baab51c3-9359f700.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cough and back pain // evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiographs 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 frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. There is persistent thoracic kyphosis with mild wedging of a mid thoracic vertebral body. IMPRESSION: No evidence of acute cardiopulmonary process. " 14e56b20-eb8b21e5-13cb379d-b0c76c73-ee8936c3.jpg,validate/p15/p15835816/s53911657/14e56b20-eb8b21e5-13cb379d-b0c76c73-ee8936c3.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Leukocytosis. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. The bones are probably demineralized. IMPRESSION: No evidence of acute cardiopulmonary disease. " aeae6b49-f1823474-02293686-029f9af4-5ce96e0e.jpg,validate/p19/p19065401/s51045913/aeae6b49-f1823474-02293686-029f9af4-5ce96e0e.jpg,validation," FINAL REPORT INDICATION: Lethargy and leukocytosis. Evaluate for pneumonia. COMPARISON: Chest radiograph ___, ___ and ___. CTA chest ___. TECHNIQUE: Supine portable AP radiograph of the chest. FINDINGS: Left pectoral pacemaker has leads terminating in the right atrium and right ventricle. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The heart is not enlarged. The mediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary abnormality. " 607fd65f-641e2690-f762333c-4985cf20-34380bf1.jpg,validate/p10/p10374990/s57614506/607fd65f-641e2690-f762333c-4985cf20-34380bf1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylothorax s/p new chest tube placement with 920mL // ? PTX ? PTX IMPRESSION: Compared to prior chest radiographs ___ through ___. Small right pleural effusion is substantially smaller. No pneumothorax. Right basal pigtail drainage catheter in place. Heart size normal. Aortic graft in place. No pneumonia. Stabilization hardware in the upper thoracic spine. " 56c16107-1b4f1a08-b64740ff-038d7186-55a12a69.jpg,validate/p10/p10983866/s51822953/56c16107-1b4f1a08-b64740ff-038d7186-55a12a69.jpg,validation," WET READ: ___ ___ 9:35 PM Indistinct pulmonary vasculature compatible with mild pulmonary edema. Increased retrocardiac and medial right base opacities are compatible with pneumonia in the appropriate clinical setting. ___ d/w Dr. ___ via phone on ___ at ___. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ chest radiograph. FINDINGS: Left lower lobe opacity has worsened since the recent radiograph and could reflect an evolving pneumonia given clinical suspicion for this entity. Newly developed right lower lobe opacity could reflect additional site of infection or, alternatively, focal aspiration or atelectasis. Allowing for relatively low lung volumes, exam is otherwise unchanged with persistent bilateral upper lobe bullous disease with adjacent confluent areas of fibrosis and scarring accompanied by calcified granulomas. " e9be2848-df972a67-e86838a5-bf1754ab-e384d39e.jpg,validate/p10/p10410110/s54909961/e9be2848-df972a67-e86838a5-bf1754ab-e384d39e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent RML PNA. // f/u PNA COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the recent middle lobe pneumonia has completely resolved. There is no remnant opacity on both the frontal and the lateral radiograph. No interval recurrence of new opacities. No complications, no pleural effusions. Normal appearance of the cardiac silhouette. Mild elongation of the descending aorta. " 100d27ca-98099c46-0d5a5d24-5b4c5c16-cc31d850.jpg,validate/p15/p15672432/s50256487/100d27ca-98099c46-0d5a5d24-5b4c5c16-cc31d850.jpg,validation," FINAL REPORT INDICATION: History: ___M with CP // Pneumonia? Pneumothorax? TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs most recent on ___ FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Note there is minimal atelectasis base the left lung. IMPRESSION: No acute cardiopulmonary abnormality. Minimal left basal atelectasis. " bb633e4d-ce39c4d3-afd25621-77dbe04b-7cfc5548.jpg,validate/p12/p12959560/s54975742/bb633e4d-ce39c4d3-afd25621-77dbe04b-7cfc5548.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with cough, wheezing and reported fevers. TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___. FINDINGS: Lungs are clear and hyperinflated. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Visualized osseous structures demonstrates no acute abnormality. IMPRESSION: No acute findings. " eb6e3669-a8bd7a6c-119d2017-8ade017a-04e64cea.jpg,validate/p10/p10913302/s58227880/eb6e3669-a8bd7a6c-119d2017-8ade017a-04e64cea.jpg,validation," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right right-sided Port-A-Cath tip terminates at the junction of the SVC with right atrium. Heart size is normal. Mediastinal and hilar contours are unremarkable. Low lung volumes are present with streaky bibasilar opacities likely reflective of atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. IMPRESSION: Low lung volumes with mild bibasilar atelectasis. " be7cf4bf-9c5bfa92-c7038f7b-1c738d9f-220254c9.jpg,validate/p14/p14483422/s55599009/be7cf4bf-9c5bfa92-c7038f7b-1c738d9f-220254c9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___ as well as a prior CT torso dated ___. CLINICAL HISTORY: Non-small cell lung cancer, status post fall, assess for rib fracture. FINDINGS: PA and lateral views of the chest are provided. There is a left paramediastinal mass which is better assessed on the prior CT, compatible with known primary lung cancer. The lungs are otherwise clear, though changes from known emphysema are noted. No pleural effusion is seen. Overall cardiomediastinal contour appears unchanged from prior CT. Bony structures are intact. Of note, no displaced rib fractures are seen. A wedge deformity of the upper thoracic spine is stable. IMPRESSION: Stable mediastinal prominence compatible with known left paramediastinal mass. Emphysema. No acute injury is seen. Please refer to subsequent CT chest for additional details. " 0ad4f352-0b521723-adcebf72-fae9c3ce-9679e4f0.jpg,validate/p14/p14151932/s52345663/0ad4f352-0b521723-adcebf72-fae9c3ce-9679e4f0.jpg,validation," FINAL REPORT HISTORY: Status post exploratory laparotomy for a gastric perforation after a Whipple's procedure, now desaturating after T-piece trial. COMPARISON: Multiple chest radiographs dating back to ___, the most recent on ___. FINDINGS: A portable frontal chest radiograph demonstrates the endotracheal tube with the tip 4.5 cm above the carina, a left subclavian catheter with the tip in the mid SVC, and a nasogastric tube extending into the stomach. Lung volumes are low and there are persistent bibasilar consolidations, right greater than left, which are improved minimally since ___ and likely represent pneumonia. A small left pleural effusion is new. The cardiomediastinal silhouette is unchanged and there is no pneumothorax. IMPRESSION: 1. Minimally improved bibasilar consolidations, right greater than left, likely represent pneumonia. 2. New small left pleural effusion. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___. " 73dcd74d-46dd018b-77b1e8c9-8c4c9b64-7b644306.jpg,validate/p10/p10900387/s53386748/73dcd74d-46dd018b-77b1e8c9-8c4c9b64-7b644306.jpg,validation," FINAL REPORT HISTORY: Pneumonia. Evaluate for interval progression. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest. The previously seen right basilar consolidation has improved, although still present. There is no interval progression or new focal opacities concerning for worsening pneumonia. The cardiac size is enlarged but stable. Mildly tortuous descending aorta is noted. No pleural abnormality. IMPRESSION: Interval improvement in right lower lobe pneumonia with continued airspace opacity. No new foci of pneumonia. These findings were relayed to Dr. ___, by Dr. ___ and as requested. " 58525071-e3dc3c59-5d8a3944-c6fbe920-aaee6ffb.jpg,validate/p15/p15596774/s53435029/58525071-e3dc3c59-5d8a3944-c6fbe920-aaee6ffb.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with fever of unknown origin. 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 radiographic evidence of acute cardiopulmonary process. " 1d9c326e-71a17319-b90b5177-0605b2c5-54a7299a.jpg,validate/p11/p11595068/s51868288/1d9c326e-71a17319-b90b5177-0605b2c5-54a7299a.jpg,validation," FINAL REPORT INDICATION: ___F with fall with left distal femur fx // pre-op requested by Ortho TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear of focal consolidation besides linear right basilar atelectasis. Skin folds overly the upper lungs bilaterally. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 01042a65-62f7aa21-54397bb0-a456947e-6c33a1ba.jpg,validate/p16/p16916629/s59415049/01042a65-62f7aa21-54397bb0-a456947e-6c33a1ba.jpg,validation," FINAL REPORT HISTORY: Altered mental status with history of CHF. COMPARISON: ___. FINDINGS: Supine frontal views of the chest were obtained portably. Low lung volumes results in bronchovascular crowding. A large left pleural effusion with little aeration of left lung is worse than on ___. Pulmonary vascular congestion is noted on the right. No large pneumothorax is seen. The patient is status post median sternotomy with surgical hardware and clips. The cardiac silhouette is obscured. A port ends in the right atrium, unchanged. IMPRESSION: Large left pleural effusion and pulmonary vascular congestion. " d0680bc4-a5d16828-2f3a36af-df2e022d-9867d737.jpg,validate/p19/p19352450/s53209101/d0680bc4-a5d16828-2f3a36af-df2e022d-9867d737.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " ac0162b1-8aad7e51-74f0ac4a-cd7265eb-fb3850d5.jpg,validate/p16/p16519254/s52112246/ac0162b1-8aad7e51-74f0ac4a-cd7265eb-fb3850d5.jpg,validation," FINAL REPORT HISTORY: Tachycardia and tachypnea, to assess for pneumonia. FINDINGS: No previous images. The cardiac silhouette is at the upper limits of normal in size, but there is no vascular congestion or pleural effusion. No convincing evidence of acute focal pneumonia. " 84748956-b699ef06-ab2a23dd-a24c6cf8-163d74b2.jpg,validate/p17/p17469778/s52294463/84748956-b699ef06-ab2a23dd-a24c6cf8-163d74b2.jpg,validation," FINAL REPORT PORTABLE CHEST, ___. COMPARISON STUDY: ___. FINDINGS: Interval extubation. Cardiomediastinal contours are within normal limits and without change. Layering moderate left pleural effusion has apparently increased in size and is accompanied by worsening left retrocardiac opacity, suggestive of atelectasis. Minor atelectatic changes are present in the right lower lobe, with otherwise clear right lung, and no evidence of a right pleural effusion. " c04561aa-eac5b154-d1a80bb3-e295a1bd-5468b03a.jpg,validate/p16/p16239957/s54185269/c04561aa-eac5b154-d1a80bb3-e295a1bd-5468b03a.jpg,validation," FINAL REPORT HISTORY: TIA. 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 or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. No change from the x-ray from four hours prior. " 19fdace5-a50cf1a4-5a6252b1-1c3a1992-d334b74f.jpg,validate/p16/p16023137/s51477211/19fdace5-a50cf1a4-5a6252b1-1c3a1992-d334b74f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with new onset aflutter. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is moderate to severely enlarged. Mediastinal contours are unremarkable. There is mild pulmonary edema. No pleural effusion, focal consolidation or pneumothorax is present. Streaky opacities in lung bases likely reflect areas of atelectasis. Multiple clips are noted within the neck likely reflective prior thyroidectomy. No acute osseous abnormalities detected. IMPRESSION: Mild pulmonary edema. " 609dfe4b-c41a11b2-709834d1-ad481e80-8fe62f8b.jpg,validate/p12/p12916556/s50927635/609dfe4b-c41a11b2-709834d1-ad481e80-8fe62f8b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with chest tube removal // ?pneumothorax COMPARISON: Radiographs from ___ at 18:37. IMPRESSION: There has been removal of the right-sided chest tube. There is a very tiny right apical pneumothorax. There has been improvement of the subcutaneous emphysema along the right lateral chest wall. There is atelectasis at the left base with elevation of left hemidiaphragm. Heart size is within normal limits. " 012c807f-f5fe3f36-803f59fb-c1df23e8-fe73fc08.jpg,validate/p10/p10116621/s55009631/012c807f-f5fe3f36-803f59fb-c1df23e8-fe73fc08.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___M with CP // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest CTA dated ___ and chest radiograph dated ___ FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion, pulmonary edema or pneumothorax. No displaced rib fracture. IMPRESSION: No acute process. " f152b434-a49b1e1d-5e721167-b1191508-aecf333c.jpg,validate/p19/p19643415/s57838905/f152b434-a49b1e1d-5e721167-b1191508-aecf333c.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___M with mild chest pain and SOB // eval for acute process eval for acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: A left Port-A-Cath catheter is stable in position, terminating in the mid SVC. The cardiomediastinal and hilar contours are within normal limits. There is redemonstration of prominent bronchovascular markings. No focal consolidation is identified. There is scarring at the lingula. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 3f1513cd-ca13e0d9-8ce6a39b-16b566fd-75de836c.jpg,validate/p18/p18562936/s59547564/3f1513cd-ca13e0d9-8ce6a39b-16b566fd-75de836c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis // Interval change Interval change IMPRESSION: In comparison with the study of ___, there is continued left pleural effusion with compressive basilar atelectasis and the development of right pleural effusion with similar compressive atelectasis at the bases. Cardiac silhouette remains within upper limits of normal in size. No vascular congestion or definite focal consolidation. Right subclavian PICC line again extends to the mid portion of the SVC. " 8f1a0715-46f97854-bfedb2b9-35aaa000-b25470a2.jpg,validate/p12/p12979215/s53074441/8f1a0715-46f97854-bfedb2b9-35aaa000-b25470a2.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain. 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. Old right rib fracture is again noted. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 77fe1023-12c4cf8e-ba5edf8c-0bd6c780-1bcd74cb.jpg,validate/p16/p16441183/s54178596/77fe1023-12c4cf8e-ba5edf8c-0bd6c780-1bcd74cb.jpg,validation," FINAL REPORT HISTORY: Pancreatitis and fever with sputum production. FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Continued low lung volumes are most likely the cause of the prominence of the transverse diameter of the heart. Areas of atelectatic change are seen at both bases, though there is no focal pneumonia or evidence of pulmonary vascular congestion. " b925bd9f-3be51d82-ccdef19f-6599952f-1de00e8e.jpg,validate/p17/p17585916/s51573251/b925bd9f-3be51d82-ccdef19f-6599952f-1de00e8e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with trauma, possible aspiration before intubated // Please eval interval change IMPRESSION: Exam is severely limited by difficulties with patient positioning. With this limitation in mind, there has not been a substantial change in the appearance of the chest since the recent study of 1 day earlier except for removal of a nasogastric tube. . " b530b23c-eedd7263-2d44c022-ad08aa73-a15936c0.jpg,validate/p15/p15338361/s52795837/b530b23c-eedd7263-2d44c022-ad08aa73-a15936c0.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with bigeminy // r/o CHF TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Earlier today, ___, at 14:41 FINDINGS: There has been no significant interval change since the prior study. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. No pulmonary edema. " 4060d8d3-04c3e668-c6cb079e-c4e76621-093126d3.jpg,validate/p19/p19845120/s59095778/4060d8d3-04c3e668-c6cb079e-c4e76621-093126d3.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Assessment of nasogastric tube. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the tip of the nasogastric tube now projects over the proximal part of the stomach. No complications. No change in appearance of the lung bases. Moderate cardiomegaly persists. " d8c3575d-e8c271c9-b07a3d61-c387a08f-e9397c73.jpg,validate/p17/p17756937/s55515422/d8c3575d-e8c271c9-b07a3d61-c387a08f-e9397c73.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Left chest tube with increased secretions and new NG tube. FINDINGS: Two images were obtained to show the course of the NG tube which is with the tip either in the distal stomach or proximal duodenum. There is increased left pleural effusion, a component of which is loculated laterally. Multiple left-sided rib fractures are visualized. There is left-sided subcutaneous emphysema similar in amount compared to prior. There is left lower lobe volume loss. The heart is mildly enlarged, and there is pulmonary vascular redistribution suggesting an element of fluid overload. " 221487b3-e3438392-97461300-560aaadd-cd028f99.jpg,validate/p12/p12277308/s55809022/221487b3-e3438392-97461300-560aaadd-cd028f99.jpg,validation," FINAL REPORT INDICATION: ___ year old man with recent h/o URI, evaluate for resolution of infiltrate seen in the last CXR - month ago TECHNIQUE: Chest PA and lateral COMPARISON: Prior CT of the abdomen and pelvis dated ___. FINDINGS: Ill-defined bibasilar airspace opacities may represent atelectasis, aspiration,, or early pneumonia, depending on the clinical setting. The left lung base is likely similar to the prior CT, wall the right lung base opacification is new. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette, including a mildly tortuous descending aorta, is unchanged. IMPRESSION: Ill-defined bibasilar airspace opacities, similar on the left and new on the right, may represent atelectasis, aspiration, or early pneumonia, depending upon the clinical setting. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 2:30 PM, 5 minutes after discovery of the findings. " a094a974-5c47cde0-79dbaacb-d3221372-bf24a92f.jpg,validate/p15/p15562667/s54322548/a094a974-5c47cde0-79dbaacb-d3221372-bf24a92f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with recent discontinuation of thyroid medication w/ cough, wheezing, 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. " 938ccea8-36397bea-37ea5286-3ec0f308-ea1b065b.jpg,validate/p14/p14766138/s56798768/938ccea8-36397bea-37ea5286-3ec0f308-ea1b065b.jpg,validation," 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 but requiring frequent instillation of TPA for loculations // please assess for interval change in pleural effusion please assess for interval change in pleural effusion COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Moderate left pleural effusion which decreased on ___, has not resolved, despite the left basal pleural drainage catheter. Atelectasis is moderately severe in the left lower lobe and lingula, milder at the right base. The heart is moderately enlarged. There is no evidence of cardiac decompensation. " 3a06bb1f-9d8b5f48-b1dacac7-80ad73ca-2774a640.jpg,validate/p11/p11459120/s57101262/3a06bb1f-9d8b5f48-b1dacac7-80ad73ca-2774a640.jpg,validation," FINAL REPORT INDICATION: History of fall, left shoulder and hip pain. Evaluate for traumatic process. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. Lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. Left chest wall pacemaker is noted with leads in the right atrium and right ventricle. The visualized cardiac silhouette is normal. The bones are intact. A left humeral replacement is noted. IMPRESSION: No acute cardiopulmonary process. " 80611cb1-6dee1ec1-d9e8214d-97a1ac54-be35817d.jpg,validate/p18/p18422065/s57982548/80611cb1-6dee1ec1-d9e8214d-97a1ac54-be35817d.jpg,validation," FINAL REPORT HISTORY: Syncope and cough for 5 days. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest. AP projection and low lung volumes exaggerate heart size, which is top normal. Upper mediastinal contours are stable. Small opacity in the right lung base projects over the lower thoracic spine. No pleural effusion or pneumothorax. IMPRESSION: Focal right lower lobe opacity may represent pneumonia, aspiration, or atelectasis. Short interval follow-up CXR may be helpful. " 7785f167-d694c321-a750356e-43e4306f-df574c51.jpg,validate/p14/p14806510/s54422797/7785f167-d694c321-a750356e-43e4306f-df574c51.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with injury // r/o fracture COMPARISON: None 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. " 84443011-d4e120c0-ff646af7-da888446-ea92ce7d.jpg,validate/p15/p15584013/s58506898/84443011-d4e120c0-ff646af7-da888446-ea92ce7d.jpg,validation," WET READ: ___ ___ ___:___ PM Interval removal of a right pigtail catheter, with slight interval improvement of a tiny right apical pneumothorax compared to the prior study. Stable small bilateral pleural effusions. Right IJ with tip in distal SVC. ___ d/w Dr. ___ by Dr. ___ by telephone at ___p on the day of the exam. ______________________________________________________________________________ FINAL REPORT STUDY: PA and lateral chest radiograph, ___. CLINICAL HISTORY: ___-year-old woman with pneumothorax following central line placement. FINDINGS: Comparison is made to previous study from ___ at 9:___ a.m. The right apical chest pneumothorax is no longer seen. The pigtail catheter has been removed. There remains a right IJ central line with its distal lead tip at the cavoatrial junction. There has been improvement in the pleural effusion on the left side since the prior study. Heart size is within normal limits. " 52f283fe-1045ff9a-a279f7aa-3f6607ce-0d0a271c.jpg,validate/p17/p17957742/s54440817/52f283fe-1045ff9a-a279f7aa-3f6607ce-0d0a271c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PNA // interval change interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Asymmetric pulmonary edema has worsened in the right lung since ___. The left perihilar abnormality has been consistently more severe since at least ___ could be concurrent pneumonia. Heart size is normal. Pleural effusions are presumed, but not large. Pleural calcifications noted. Tip of the endotracheal tube is above the upper margin of the clavicles, no less than 9 cm from the carina, and should be advanced at least 5 cm for more secure positioning. Right subclavian line ends low in the right atrium. Left jugular line ends at the origin of the SVC. Esophageal drainage tube passes into the stomach and out of view. NOTIFICATION: Dr. ___ reported the findings to Nurse ___ answering for ___ by telephone on ___ at 11:21 AM, 1 minutes after discovery of the findings. " 87613219-9607c374-f310c048-9275c822-198959db.jpg,validate/p10/p10362716/s58015735/87613219-9607c374-f310c048-9275c822-198959db.jpg,validation," 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. " da7aa02f-7cea4f69-db528454-be4407ef-20be0ed5.jpg,validate/p12/p12547577/s53094138/da7aa02f-7cea4f69-db528454-be4407ef-20be0ed5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever of unclear etiology. // Please eval for e/o pneumonia. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Severe scoliosis with subsequent asymmetry of the ribcage. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions. " 951a2307-9c4bdc09-aac7251e-82675196-68da895e.jpg,validate/p14/p14464902/s57615684/951a2307-9c4bdc09-aac7251e-82675196-68da895e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is improved transparency of the lung parenchyma, likely reflecting improved ventilation. Minimal fluid overload remains present but is certainly less severe than on the previous image. Moderate cardiomegaly, left pectoral pacemaker. " 28bd08e2-5f3be391-8c298081-aacf1f37-fa7f8466.jpg,validate/p11/p11500480/s51251135/28bd08e2-5f3be391-8c298081-aacf1f37-fa7f8466.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with near-syncopal event. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: Normal chest radiographs. " f7a12e58-32807e1d-65f5ef68-0a562a21-8855a40a.jpg,validate/p19/p19108524/s52067712/f7a12e58-32807e1d-65f5ef68-0a562a21-8855a40a.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with cough since a month. COMPARISON: There are no prior chest x-ray for comparison at the time of dictation. FINDINGS: PA and lateral views of the chest show normal lung volumes without consolidation or nodules. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest x-ray. " c369376f-db897777-2b42be68-4af657e1-b20eaaaf.jpg,validate/p12/p12390274/s56561557/c369376f-db897777-2b42be68-4af657e1-b20eaaaf.jpg,validation," 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. " 1bc4bb56-40a80d30-0904d766-9ea3f506-ff336f7c.jpg,validate/p16/p16141003/s51636809/1bc4bb56-40a80d30-0904d766-9ea3f506-ff336f7c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F s/p fall, now with chest pain, tenderness to palpation on R ribcage. // rib fx? PTX? 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 displaced rib fractures are seen. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. No displaced rib fractures. If strong clinical concern for rib fracture, a dedicated rib series is advised. " dbe87b9f-b0a72bb2-cb4a3bf0-3c142de6-95450074.jpg,validate/p14/p14497007/s55365457/dbe87b9f-b0a72bb2-cb4a3bf0-3c142de6-95450074.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with multiple myeloma. // Continued cough. Reevaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are hyperinflated but clear without focal consolidation concerning for pneumonia. A right chest port is present with tip terminating in the upper SVC. The patient is status post posterior spinal surgery. With several inter disc spacers in the midthoracic spine. The upper abdomen is unremarkable in appearance. IMPRESSION: No acute cardiopulmonary process. " a28fc5cb-18629b16-32898e88-12dceedf-d4718149.jpg,validate/p11/p11927057/s56563568/a28fc5cb-18629b16-32898e88-12dceedf-d4718149.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with upper respiratory symptoms. COMPARISON: PA and lateral chest radiograph ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded bilaterally with no areas of focal consolidation, mass lesions, pleural effusion. There is no pneumothorax. Cardiomediastinal silhouette is within normal limits. The pleural surfaces are unremarkable. IMPRESSION: Normal chest radiograph. No evidence of malignancy or infection. " 730ac1af-3955adbd-dbef8bfd-248e4f6d-bf0e50f9.jpg,validate/p15/p15584013/s57749854/730ac1af-3955adbd-dbef8bfd-248e4f6d-bf0e50f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo F with febrile neutropenia, persistently febrile despite tigecycline levifloxacin // ___ yo F with febrile neutropenia, persistently febrile despite tigecycline levifloxacin ___ yo F with febrile neutropenia, persistently febrile despite tigecycline levifloxacin COMPARISON: Chest radiograph and chest CT from ___ IMPRESSION: Port-A-Cath catheter. Terminates at the level of lower SVC, unchanged. Compared to both previous chest radiograph in chest CT there is substantial increase in widespread parenchymal opacities nodular and reticular, with slightly more peripheral than central predominance, highly concerning to progression of multifocal infection that has been mentioned on the previous chest CT. Some of the areas particularly nodular, for example in the right mid lung, lateral to the projection of the Port-A-Cath port and does fungal infection is a high possibility. More consolidative appearance seen projecting over the spine on the lateral view, new and potentially might represent additional substantially areas of infection, either fungal or bacterial. No pleural effusion or pneumothorax is seen. RECOMMENDATION(S): Further assessment with chest CT is required for pre size characterization of this finding, highly concerning for infectious process. " 5f3b29f5-af9b78b3-4f7b099a-3012ea24-c465f232.jpg,validate/p13/p13827974/s55132144/5f3b29f5-af9b78b3-4f7b099a-3012ea24-c465f232.jpg,validation," 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. " 8f10c654-f0be3149-dbc733af-44bace96-bf739128.jpg,validate/p15/p15510824/s59780992/8f10c654-f0be3149-dbc733af-44bace96-bf739128.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with unclear process- aml vs sepsis of unknown source, s/p ___+ L of LR, now with increased vent needs. // eval for pulm edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: Previous study obtained the same the early a IMPRESSION: ET tube tip is too high, approximately 8 cm above the carinal and should be advanced with least 2 cm. There is improvement of the right upper lobe opacity but progression of the right lower lobe opacity. Pericardial drain is in place. No interval increase in pleural effusion or development of pneumothorax demonstrated. " b334ec7d-a471076c-60974885-edb78e4b-917f8c79.jpg,validate/p16/p16571206/s54334527/b334ec7d-a471076c-60974885-edb78e4b-917f8c79.jpg,validation," FINAL REPORT INDICATION: ___F with nephrotic syndrome, chest pressure, fluid overload // eval heart and lungs TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Persistent small bilateral effusions are seen, left greater than right not dramatically changed since last week's exam. Opacity in the retrocardiac region is likely due to atelectasis, similar to prior. The lungs are otherwise grossly clear noting that the right lung apex is not assessed due to patient's overlying hair. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Persistent left-greater-than-right pleural effusions, not dramatically changed. " 5c857e46-f1777491-ebac0fe4-f3458970-d58b3a28.jpg,validate/p16/p16050648/s52174862/5c857e46-f1777491-ebac0fe4-f3458970-d58b3a28.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old woman with recent pneumonia. // Confirm resolution of findings on CXR (and CT scan) TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: Previous identified right perihilar opacities have resolved. Lungs are fully expanded and clear, excepting mild biapical scarring. No pleural abnormality. Heart size is normal. Cardiomediastinal hilar silhouettes are unremarkable. Dense mitral annulus calcifications are noted. IMPRESSION: Resolved right perihilar opacities. No evidence of acute cardiopulmonary abnormality. " e9a3681b-b2858429-56b663a5-d19a8a57-14d4096a.jpg,validate/p11/p11144826/s59814430/e9a3681b-b2858429-56b663a5-d19a8a57-14d4096a.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with cough, congestion, low-grade fever, history of asthma, rule out pneumonia. COMPARISON: ___. FINDINGS: The lungs are clear. There is no consolidation. Cardiac contour is normal. There is no pleural effusion or pneumothorax. Right thyroid nodule, already investigated by ultrasound, measuring 1.4 cm, is probably too small to explain the tracheal deviation to the left. CONCLUSION: There are no acute cardiopulmonary findings. There is no evidence of pneumonia. " d7c33d1d-01823230-fae7352a-a732f181-434f2ade.jpg,validate/p17/p17334661/s56218511/d7c33d1d-01823230-fae7352a-a732f181-434f2ade.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with sepsis after PTC. 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 stable. Bilateral pleural effusions are unchanged as well as interstitial vascular engorgement. There is no pneumothorax seen. The biliary drainage is projecting over the right upper quadrant. " 6c465b91-4508b121-747a3f7f-cbb89523-e317d01b.jpg,validate/p17/p17193228/s52311093/6c465b91-4508b121-747a3f7f-cbb89523-e317d01b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new intubation // Evaluate ett placement Evaluate ett placement COMPARISON: There are no prior chest radiographs. IMPRESSION: With the chin in neutral position, tip of the endotracheal tube less than 2 cm from the carina is two cm below optimal placement. This is corrected on a subsequent chest radiograph available the time of this review. Left pleural effusion is small. Lungs are low in volume but grossly clear. The heart is top-normal size. No pneumothorax. Gastric fundus is distended with air, but assessment of overall gastric size is not possible since most of the stomach it is out of the field of view. " 733fb6f2-54dc9fdc-3c317f00-04b53b0d-533035cc.jpg,validate/p17/p17328272/s51414854/733fb6f2-54dc9fdc-3c317f00-04b53b0d-533035cc.jpg,validation," FINAL REPORT INDICATION: ___-year-old female patient with ongoing cough for more than four weeks, not improving. Study requested for evaluation of lung abnormality and to rule out PNA. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The inspiratory lung volumes are appropriate. No focal consolidation concerning for pneumonia, pleural effusion or pneumothorax is detected. The pulmonary vasculature is not engorged and there is no evidence of pulmonary edema. Cardiac silhouette is normal in size. The aorta is calcified and elongated, unchanged from prior examination. The mediastinal and hilar contours are within normal limits. IMPRESSION: No evidence of an acute pulmonary infiltrate. " b53a5d0c-beb58dcc-f874282d-0102846b-2e781894.jpg,validate/p14/p14147380/s55599778/b53a5d0c-beb58dcc-f874282d-0102846b-2e781894.jpg,validation," 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. " 0c296231-0cd77277-d246c842-2a987742-810a0334.jpg,validate/p18/p18490309/s58811579/0c296231-0cd77277-d246c842-2a987742-810a0334.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // int change int change COMPARISON: Chest radiographs since ___, most recently ___. Comparison: Chest CT and chest radiographs since ___ most recently ___. IMPRESSION: The tip of the endotracheal tube is above the upper margin of the clavicles, no less than 9 cm above the carina, 4 cm above standard placement. An esophageal drainage tube passes below the diaphragm and out of view. Large bore right subclavian catheter ends at the origin of the right brachiocephalic vein. There is no pneumothorax or appreciable pleural effusion. Heterogeneous opacification in both lower lungs is probably pneumonia. Previouslung nodules are difficult are difficult to assess. Heart size is normal. " fc0aaa6d-337d5ad9-431cb5d7-670b4060-42272a16.jpg,validate/p16/p16936480/s59610277/fc0aaa6d-337d5ad9-431cb5d7-670b4060-42272a16.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with hx of CML. Cough. Please r/o PNA. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___. FINDINGS: The heart size, mediastinal and hilar contours are normal. The lungs are clear bilaterally. IMPRESSION: No pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 12:02 PM, 20 minutes after discovery of the findings. " cf790d77-338eacd8-b128b565-f0a73414-713d4bbf.jpg,validate/p15/p15798014/s57932626/cf790d77-338eacd8-b128b565-f0a73414-713d4bbf.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with pleural effusion, evaluate. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding AP portable chest examination of ___. Patient is known to have a right upper lobe mass which appears unchanged in size in comparison with the next previous study. The lesion involves also the apical pleural space. Right-sided elevated hemidiaphragm as before and blunting of the lateral pleural sinus is observed. Lateral view discloses some loculated pleural densities occupying the posterior pleural space. There is moderate cardiac enlargement as before with predominant left ventricular contour and some general widening of the thoracic aorta but the pulmonary vasculature is not congested. IMPRESSION: Unchanged appearance of previously identified pulmonary malignancy in right upper lobe. No new interval changes since ___. " d72a1c6c-89ce56ac-6b851797-c2f1c8a5-56c66a13.jpg,validate/p12/p12196030/s50229791/d72a1c6c-89ce56ac-6b851797-c2f1c8a5-56c66a13.jpg,validation," FINAL REPORT INDICATION: History of sepsis, central line placement. Please evaluate. COMPARISONS: Chest radiograph from ___ performed at 2:00 a.m. dated back to ___. FINDINGS: There has been interval placement of a right-sided internal jugular line which terminates at the cavoatrial junction. There is mild perihilar vascular congestion and mild pulmonary edema. No definite focal consolidations concerning for pneumonia are identified. There is no large pleural effusion or pneumothorax. IMPRESSION: 1. Right-sided internal jugular line terminates at the cavoatrial junction. 2. Mild diffuse pulmonary edema. " e509066c-202b8316-51ff47d6-c4a7036f-cc4f0c10.jpg,validate/p10/p10413783/s53521575/e509066c-202b8316-51ff47d6-c4a7036f-cc4f0c10.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with alcohol abuse, known seizure disease status post meningioma removal, presenting with seizure TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is mildly enlarged, unchanged. The aorta is mildly tortuous and demonstrates mild atherosclerotic calcifications at the aortic knob, unchanged. Pulmonary vasculature is not engorged. There is minimal atelectasis in the left lung base. No focal consolidation, pleural effusion or pneumothorax is present. Mild multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 18f8108c-0c32d2ae-6c8e9c29-76bbd186-56771bbd.jpg,validate/p18/p18921352/s50652759/18f8108c-0c32d2ae-6c8e9c29-76bbd186-56771bbd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with palpitations, lightheadedness // pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac silhouette size is normal. The aorta is mildly unfolded. Mediastinal and hilar contours are otherwise normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 2bc1b376-6e94e0b8-a74e7e43-e79da11a-59d512d4.jpg,validate/p13/p13219691/s55510659/2bc1b376-6e94e0b8-a74e7e43-e79da11a-59d512d4.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Stroke. 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. There are no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute disease. " 70ba231d-3b04d324-e815948f-dcb4991c-188c635b.jpg,validate/p17/p17207561/s59555087/70ba231d-3b04d324-e815948f-dcb4991c-188c635b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with advanced dementia, HIV and fever. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are stable. Lungs are well inflated. This potentially new opacity in the right lower lung, most likely reflecting area of atelectasis, but aspiration would be another possibility. Although there is a suspicion for a fracture of the posterior aspect of the right tenth rib, not clearly seen on the prior examination: New? " ab08fd3f-6b3c0288-9a733765-de93a46b-29830d24.jpg,validate/p12/p12111976/s55396654/ab08fd3f-6b3c0288-9a733765-de93a46b-29830d24.jpg,validation," FINAL REPORT PORTABLE CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old man with V tach, shock, question pneumonia. FINDINGS: Portable AP supine view of the chest provided. An AICD is again seen with lead tip extending into the region of the right ventricle. The heart is top normal in size. There are no convincing signs of pneumonia or edema. No pneumothorax or effusion. Mediastinal contour is normal. Midline sternotomy wires again noted. Bony structures are intact. IMPRESSION: Top normal heart size without signs of edema or pneumonia. " 4dabbeba-5de63b4c-a740e149-988207ad-5b1ce49e.jpg,validate/p15/p15558137/s52410668/4dabbeba-5de63b4c-a740e149-988207ad-5b1ce49e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. Postsurgical cardiomediastinal silhouette is unremarkable. Sternal wires appear intact. Hilar contours are unremarkable. Lungs are clear. Replacement aortic valve is best seen on lateral view. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 446122fa-5f4e984e-37ada2af-b3ac6a61-e2867fea.jpg,validate/p14/p14659758/s53223268/446122fa-5f4e984e-37ada2af-b3ac6a61-e2867fea.jpg,validation," FINAL REPORT CLINICAL INDICATION: Assault with complaint of head, face, neck and left-sided chest pain. Evaluate for fractures. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Linear opacity at the left lung base likely represents atelectasis, otherwise, normal heart, lungs, pleural and mediastinal surfaces. No rib fracture is identified. If there are focal areas of pain, dedicated views of those areas are recommended. IMPRESSION: Opacity in the left lung base is new since ___ and most likely represents atelectasis, however, aspiration could have a similar appearance. " 94379354-43041574-0caf5b58-0f369b3f-5a940a0d.jpg,validate/p15/p15945590/s52718106/94379354-43041574-0caf5b58-0f369b3f-5a940a0d.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Fever. COMPARISON: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The patient is intubated. An endotracheal tube terminates about 8 cm above the carina. The portion with the balloon is not well visualized, lying superior to the films. A dialysis catheter terminates in the uppermost right atrium. A right-sided PICC line is been removed. The cardiac, mediastinal and hilar contours appear unchanged including marked enlargement of the main pulmonary artery contour. Incidental note is made of an azygos fissure, a common normal variant. There is mild opacification in the retrocardiac area but markedly decreased. Elsewhere, the lungs appear clear. Small pleural effusions are likely but also markedly decreased. IMPRESSION: 1. Persistent left basilar opacity but markedly decreased. Although active infection is not excluded, this appearance could be explained by resolving atelectasis or recent prior infection. 2. Status post endotracheal intubation with high-lying endotracheal tube, not fully visualized including its balloon. Advancing the tube by several cm may be appropriate. " 326bbd3e-31da85d7-9f354900-2d492502-76ff0d3a.jpg,validate/p17/p17608002/s59761757/326bbd3e-31da85d7-9f354900-2d492502-76ff0d3a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulmonary htn, ? PVOD, chf, cad, copd p/w dyspnea requiring bipap // ? effusions, edema, ptx ? effusions, edema, ptx COMPARISON: ___ IMPRESSION: Right central venous line tip terminates at the level of mid to lower SVC. There is interval development of left basal consolidation not seen on the previous study, concerning for massive aspiration or rapidly developing infectious process. The re- is no evidence of pulmonary edema. No appreciable increase in pleural effusions demonstrated. " 9572e00a-1118e249-913010f8-78a92822-fc697343.jpg,validate/p15/p15509505/s57470784/9572e00a-1118e249-913010f8-78a92822-fc697343.jpg,validation," 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. " 5fdbf270-8b282ecb-093139dc-198a4178-f2a0f4ee.jpg,validate/p11/p11037551/s55817951/5fdbf270-8b282ecb-093139dc-198a4178-f2a0f4ee.jpg,validation," WET READ: ___ ___ ___ 11:43 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with HIV, p/w cough, general malaise // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 1e98a7f9-0ce34c6a-0643906c-ae93dc23-1a53cb6d.jpg,validate/p11/p11647908/s55848467/1e98a7f9-0ce34c6a-0643906c-ae93dc23-1a53cb6d.jpg,validation," FINAL REPORT HISTORY: History of dyspnea, wheezing, history of asthma but no exacerbation in the past ___ years. Question pneumonia. COMPARISON: Prior chest radiographs from ___, ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiographs from ___, there is persistent elevation of the right hemidiaphragm. Increased focal opacity at the right lung base likely reflects atelectasis as it has not significantly changed since prior examination from ___. No focal abnormality to suggest pneumonia is identified. There is no large pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. Recent development of elevated right hemidiaphragm, could be secondary to diaphragmatic injury or phrenic palsy. " 2d457530-94a0aee5-277dc8c6-852ccab4-cf9081c5.jpg,validate/p12/p12953693/s57225649/2d457530-94a0aee5-277dc8c6-852ccab4-cf9081c5.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with onset of CP and SOB PTA // Rule out CP, PNA vs pneumothorax vs aortic dissection 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. " 8ffb60fb-e167334d-838430de-f74dcd1e-a5903385.jpg,validate/p19/p19497735/s57766879/8ffb60fb-e167334d-838430de-f74dcd1e-a5903385.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with cholangiocarcinoma, shock, respiratory failure // Acute interval change with intubation TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___, ___, ___, ___. FINDINGS: Since ___, increased small to moderate bilateral pleural effusions, right greater than left, with increased small to moderate bibasilar atelectasis are seen. Lung volumes remain low. There is new mild pulmonary edema. Moderate cardiomegaly is unchanged. No pneumothorax. Tip of the endotracheal tube is seen 4.8 cm above the carina. Right Port-A-Cath placement is unchanged. New feeding tube is seen in the region of the stomach in continues out of view. IMPRESSION: 1. Increased small to moderate bilateral pleural effusions, right greater the left, with increased bibasilar atelectasis and new mild pulmonary edema since ___. 2. Support devices are in the appropriate position. NOTIFICATION: The findings were discussed by Dr. ___ with RN ___ ___ on the telephoneon ___ at 12:13 PM, 5 minutes after discovery of the findings. " 391a7a96-96941ddc-46fb2579-6818230d-594a57fa.jpg,validate/p14/p14982705/s50540347/391a7a96-96941ddc-46fb2579-6818230d-594a57fa.jpg,validation," 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. " 738d5905-adb6856f-a68624bb-791ff9d9-5b867a96.jpg,validate/p19/p19381010/s50310232/738d5905-adb6856f-a68624bb-791ff9d9-5b867a96.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p TAV ___ // Evaluate effusions Evaluate effusions IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is substantial enlargement of cardiac silhouette without vascular congestion, raising the possibility of cardiomyopathy or pericardial effusion. An there is again a left pleural effusion with compressive atelectasis obscuring the hemidiaphragm. Right lung is essentially clear. " 110d42ef-53768380-a3f5d94a-ffb8ab69-67fa0c77.jpg,validate/p10/p10607312/s57902505/110d42ef-53768380-a3f5d94a-ffb8ab69-67fa0c77.jpg,validation," WET READ: ___ ___ 9:49 PM Severe cardiomegaly and moderate pulmonary edema. Small left lower lobe pleural effusion and atelectasis. ______________________________________________________________________________ FINAL REPORT HISTORY: Shortness of breath, to assess for pulmonary edema. FINDINGS: In comparison with study of ___, there is substantial enlargement of the cardiac silhouette with pulmonary vascular congestion and left pleural effusion. In the appropriate clinic setting, some of the bilateral opacification could reflect supervening pneumonia. " 462f1640-15f81d5e-06d6ab0a-bbe02055-12fb022e.jpg,validate/p11/p11812613/s57171433/462f1640-15f81d5e-06d6ab0a-bbe02055-12fb022e.jpg,validation," FINAL REPORT HISTORY: Patient with multifocal pneumonia on CT, chronic respirator due to laryngeal cancer, rule out pneumonia. COMPARISON: CT scan from ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The previous right middle and right lower lobe consolidations are still present, but improved. Left lung is essentially clear with a few linear streaks of atelectasis at the lung base. No new area of consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The cardiomediastinal silhouette and hilar contours are within normal limits. IMPRESSION: Improving multifocal pneumonia. Recommend followup in four weeks to assess for complete resolution. " 7acfe635-ce05a2b9-e0a3c8c6-534b75ae-87a8bc89.jpg,validate/p13/p13172704/s57205066/7acfe635-ce05a2b9-e0a3c8c6-534b75ae-87a8bc89.jpg,validation," FINAL REPORT INDICATION: Patient status post fall. COMPARISONS: ___. FINDINGS: Portable upright view of the chest demonstrates low lung volumes. There is moderate-large right pleural effusion, which has increased since ___ exam. Left costophrenic angle is blunted, suggestive of small pleural effusion. There is perihilar vascular congestion. Cardiac size is difficult to assess due to adjacent opacities, which is likely enlarged. Aortic arch calcifications are again noted. Biapical scarring persists. There is no pneumothorax. Partially imaged upper abdomen is unremarkable. IMPRESSION: Moderate to large right pleural effusion has increased since ___ exam. Small left pleural effusion. Pulmonary vascular congestion. " 660d87f2-2c1aba02-59c6676a-d823a078-ec2e2738.jpg,validate/p17/p17843231/s51385597/660d87f2-2c1aba02-59c6676a-d823a078-ec2e2738.jpg,validation," FINAL REPORT INDICATION: History: ___M with recurrent seizures undergoing w/u // eval ? infection TECHNIQUE: AP and lateral COMPARISON: None available FINDINGS: AP and lateral chest radiograph demonstrate clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax, pleural effusion, or evidence of pulmonary edema. Imaged upper abdomen is unremarkable. IMPRESSION: No acute intrathoracic abnormality. " a67e2e2b-c5902ccf-adf291f3-51b417af-5b71eeaa.jpg,validate/p17/p17327592/s52874049/a67e2e2b-c5902ccf-adf291f3-51b417af-5b71eeaa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and CABG. Heart size is normal. The mediastinal contours are unchanged. Right hemidiaphragm remains elevated with associated right basilar atelectasis. Pulmonary vasculature is not engorged. Left lung is grossly clear. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. Mild to moderate multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: Unchanged chronic elevation of the right hemidiaphragm with right basilar atelectasis. No new focal consolidation. " 872935b9-98c7f03f-18d33d93-942126f5-9052b102.jpg,validate/p18/p18097775/s52571624/872935b9-98c7f03f-18d33d93-942126f5-9052b102.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old male with chest pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusion. The cardiac silhouette is enlarged. Dual-lead pacing device is seen with lead tips in the right ventricular apex and right atrium. The osseous and soft tissue structures are grossly unremarkable, noting hypertrophic changes in the spine. IMPRESSION: Cardiomegaly, but no evidence of active failure or consolidation. " fe44b25b-80f1ef89-303652db-1c2946b5-4a8beb7d.jpg,validate/p11/p11885997/s59877636/fe44b25b-80f1ef89-303652db-1c2946b5-4a8beb7d.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest tube removal. Comparison is made with prior study performed seven hours earlier. Widened mediastinum has improved. There is elevation of the right hemidiaphragm. Vascular congestion has almost resolved. Small right pneumothorax has increased from prior studies. Right mediastinal mass and right middle lobe medial consolidation are better seen on prior CT from ___. Right pleural effusion is small. Right subcutaneous emphysema has minimally increased from prior study. Findings were discussed with Dr. ___ by phone on ___ at the time of the discovery of the findings at 7:55 a.m. " 07056baf-2eda9891-2e1b8b3f-7f4f5915-0e4637fe.jpg,validate/p18/p18624005/s50049318/07056baf-2eda9891-2e1b8b3f-7f4f5915-0e4637fe.jpg,validation," 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. " 9b45defc-252d511e-da48ff99-88439dbe-2d1081a7.jpg,validate/p14/p14727713/s59175536/9b45defc-252d511e-da48ff99-88439dbe-2d1081a7.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Upright AP view of the chest. COMPARISON: None. FINDINGS: Right-sided Port-A-Cath tip terminates in the mid SVC. There is evidence of volume loss in the right lung with a juxtaphrenic peak noted and chain sutures in the right suprahilar region, compatible with prior upper lobectomy. Moderate cardiomegaly is demonstrated. Aortic knob calcifications are present. The mediastinal and hilar contours are otherwise unremarkable. There is mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities demonstrated. IMPRESSION: Mild pulmonary vascular congestion. " 55d66460-abf35b3f-0a051cb0-2df8b7f9-cde2b261.jpg,validate/p16/p16108772/s59441409/55d66460-abf35b3f-0a051cb0-2df8b7f9-cde2b261.jpg,validation," FINAL REPORT HISTORY: Male with history of ischemic/nonischemic cardiomyopathy and COPD. Assess for retrocardiac density on previous radiograph. COMPARISON: Chest radiograph, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Partial clearing of retrocardiac opacity with minimal residual opacity remaining. Stable tortuous aorta with mildly enlarged heart and moderate scoliosis. No new focal opacity, pleural effusion, pneumothorax or pulmonary edema. Mediastinal contour and hila appear normal. No additional bony abnormality. IMPRESSION: Partial clearing of left retrocardiac opacity with minimal residual opacity remaining. Results were conveyed via telephone to ___, RN by Dr. ___ on ___ at 1:45 p.m. within 15 minutes of results. " 3eda8839-79902532-ddf0552c-44af821e-04dec59e.jpg,validate/p10/p10900387/s55261002/3eda8839-79902532-ddf0552c-44af821e-04dec59e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man extubated, s/p NGT replacement // please evaluate for NGT placement COMPARISON: ___ IMPRESSION: Mild cardiomegaly improved since ___, stable since ___. Borderline pulmonary vascular engorgement unchanged. No definite edema and no appreciable pleural effusion. Increasing opacification at the base of the left lung, now obscuring the margin of the descending thoracic aorta, raises concern for new atelectasis or developing pneumonia. Since the patient was recently extubated, atelectasis is more likely. Right lung pneumonia has effectively cleared. No pneumothorax. Right PIC line ends low in the SVC. An upper enteric drainage tube ends in the lower esophagus and needs to be advanced at least 12 cm to move all side ports into the stomach. NOTIFICATION: Dr. ___ paged ___ (In Hospital, On Page), ___ to discuss the findings on ___ 16:59 minutes after discovery of the findings, ultimately reported by telephone to on 5:01 PM " e2737b50-d04747a6-458845ce-735346dc-a21c6de5.jpg,validate/p13/p13445140/s52494724/e2737b50-d04747a6-458845ce-735346dc-a21c6de5.jpg,validation," 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. " 065ba498-592f87c6-4e64d537-bf9110af-e6ba77ff.jpg,validate/p17/p17434263/s51341926/065ba498-592f87c6-4e64d537-bf9110af-e6ba77ff.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Multifocal pneumonia. Comparison is made with prior study, ___. Cardiac size is normal. Multifocal consolidations have improved, consistent with improving pneumonia. The lungs are hyperinflated, consistent with COPD. There is no pneumothorax. Bilateral effusions are small, decreased from prior study. ET tube is in standard position. Left IJ catheter tip is in the mid SVC. NG tube tip is in the stomach, can be advanced for a more standard position at least 5 cm. " 98515474-42ec678f-a869916c-1ed5b973-4d7de441.jpg,validate/p14/p14766138/s52333725/98515474-42ec678f-a869916c-1ed5b973-4d7de441.jpg,validation," FINAL REPORT HISTORY: CKD with hypertension and worsening kidney function. Evaluate for volume overload. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top 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 intrathoracic process. No edema. " cbf52ce6-c91c7238-012ec3c0-5f74561b-c82a5513.jpg,validate/p11/p11826927/s58955869/cbf52ce6-c91c7238-012ec3c0-5f74561b-c82a5513.jpg,validation," FINAL REPORT HISTORY: Hypotension. COMPARISON: CXR ___, ___; CTA chest ___. FINDINGS: Frontal upright AP and lateral views of the chest were obtained. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. Heart size is normal. Mediastinal silhouette and hilar contours are normal. An inferior approach dialysis catheter ends in the right atrium. There is no acute osseous abnormality. No free air under the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " a758912e-be7c3c30-acd9f773-41fe1e6c-66ec6a65.jpg,validate/p15/p15353701/s53070393/a758912e-be7c3c30-acd9f773-41fe1e6c-66ec6a65.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R chest tube // please evaluate effusion, interval changes please evaluate effusion, interval changes IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the chest tube at the right base with no evidence of pneumothorax. There is slightly more blunting of the right costophrenic angle. This could represent some re-accumulation of pleural fluid, although it could also be merely a slightly more supine position of the patient. The remainder the study is unchanged. " 8cbf637e-f959721a-f754e773-f9bbeda0-b25f55bc.jpg,validate/p13/p13445415/s56045425/8cbf637e-f959721a-f754e773-f9bbeda0-b25f55bc.jpg,validation," FINAL REPORT INDICATION: Atrial fibrillation with rapid ventricular response and an elevated white count. Evaluate for pneumonia. TECHNIQUE: Single upright AP view of the chest. COMPARISON: Multiple chest radiographs, including the most recent from ___. CTA of the chest from ___. FINDINGS: Since the prior exam, the bibasilar consolidations have improved. No new opacity is identified to suggest pneumonia. Small bilateral pleural effusions are unchanged. No pneumothorax is identified. The cardiomediastinal silhouette is mildly enlarged. A left pacemaker with leads in the right atrium and right ventricle is unchanged. IMPRESSION: Improved aeration at the bilateral bases. No evidence of pneumonia. Unchanged small bilateral pleural effusions. " 9f63b86a-e9913368-c0f8c60f-95e1dc90-06519ff3.jpg,validate/p16/p16112569/s58711400/9f63b86a-e9913368-c0f8c60f-95e1dc90-06519ff3.jpg,validation," FINAL REPORT INDICATION: Tachycardia. COMPARISON: None available. FINDINGS: The lungs are clear with no sign of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: No evidence of an acute cardiopulmonary process. " 7c13e5b2-29fb4417-a9b5ba6e-77783445-e0e726f5.jpg,validate/p12/p12110495/s51927672/7c13e5b2-29fb4417-a9b5ba6e-77783445-e0e726f5.jpg,validation," FINAL REPORT INDICATION: Cough. COMPARISONS: Chest radiograph ___. CT chest ___. FINDINGS: There is opacification at the right base, which is mostly accounted for by the diaphragm, but superior to the diaphragm, there is a small parenchymal opacity which is concerning for a possible pneumonia. Stable hazy opacification at the left base is consistent with calcified pleural plaques. There is mild prominence of the pulmonary vasculature, but no overt pulmonary edema. There is no pleural effusion or pneumothorax. The cardiac silhouette is moderately enlarged and stable. There is atherosclerosis of the aorta. A right-sided dual-chamber pacemaker is present and in unchanged position. IMPRESSION: 1. Opacification at the right base is mostly due to the diaphragm, but a small parenchymal opacity is present and concerning for pneumonia. 2. Pulmonary vascular prominence without overt pulmonary edema or pleural effusions. 3. Stable moderate cardiomegaly. " 559fb55c-1088528a-79db712f-fe441bbf-bb9c5705.jpg,validate/p12/p12278337/s57217276/559fb55c-1088528a-79db712f-fe441bbf-bb9c5705.jpg,validation," FINAL REPORT INDICATION: ___-year-old female status post fall. Question acute process. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. Calcifications are seen in the aortic arch. Hyperexpansion of lungs are redemonstrated, with persistent blunting of the left costophrenic angle and mild left hemidiaphragmatic elevation, which appear chronic. There is no pneumothorax or vascular congestion. A small left effusion is present. Note is made of a vague density over the left posterior 4th rib, raising question of bony irregularity, which could be further assessed by oblique view and clinical correlation with focal tenderness. IMPRESSION: 1. Small left pleural effusion. No pneumothorax, consolidation, or edema. 2. Vague density overlying left posterior 4th rib raises qestion of bony irregularity. Recommend oblique view for further assessment and clinical correlation with focal tenderness. Findings reported to Dr. ___ at 7 a.m. on ___ via phone. " a3b0f03c-1f2c2419-6bdf7f76-070ef1bb-c244c3e7.jpg,validate/p14/p14997223/s54176903/a3b0f03c-1f2c2419-6bdf7f76-070ef1bb-c244c3e7.jpg,validation," WET READ: ___ ___ ___ 8:07 PM Large right and trace left pleural effusions, increased from the prior examination with large amount of resultant right sided atelectasis. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with hepatic hydrothorax, alcoholic cirrhosis, worsening shortness of breath. COMPARISONS: ___ to ___. FINDINGS: A large right pleural effusion has increased in size since ___ and now occupies nearly the entire right hemithorax. Right sided volume loss has also increased, resulting in rightward mediastinal shift. A small left effusion is also present. Moderate cardiomegaly is unchanged. IMPRESSION: Increasing large right effusion and atelectasis results in near complete opacification of the right hemithorax. " 6a33740f-e589419e-3c125cc1-3f0380a6-21a0e3a5.jpg,validate/p11/p11759245/s57517109/6a33740f-e589419e-3c125cc1-3f0380a6-21a0e3a5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman on antibiotics for pneumonia, now with worsening respiratory distress // change from prior, pnuemonia COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous exam. The patient is rotated to the right, which slightly increases the radiodensity on the right side. No new focal parenchymal opacities. No pleural effusions. No pulmonary edema. Unchanged normal size of the cardiac silhouette. " e7bb9ba3-f5ed4f4b-e162530c-df3c7337-846bb440.jpg,validate/p12/p12643221/s53496529/e7bb9ba3-f5ed4f4b-e162530c-df3c7337-846bb440.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with dyspnea on exertion, wheezing and lower extremity edema, evaluate for pulmonary effusion and congestion. 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 ___. There is moderate cardiac enlargement. The configuration suggests a prominence of the left ventricular contour to the left and posteriorly, but there is no marked left atrial enlargement. The thoracic aorta is generally widened and elongated and shows calcium deposits in the wall, mostly at the level of the arch. Pulmonary vasculature demonstrates an upper zone re-distribution pattern; however, there is no evidence of acute interstitial or alveolar edema. Also, the lateral and posterior pleural sinuses are free from any fluid accumulation and no evidence of pneumothorax exists in the apical area. A thin plate atelectasis in the left hemithorax mid portion appears to represent the scar as it is completely unchanged in comparison with the examination almost one year ago. Comparison with the previous examination demonstrates that the cardiac enlargement existed already earlier. The patient appeared to be slightly more congested on the previous examination. There is no remaining evidence of any right upper lobe pneumonia which was diagnosed on a chest examination of ___. IMPRESSION: Cardiac enlargement with configuration compatible with systemic hypertension, possibly mild congestion but no evidence of advanced interstitial or alveolar edema. No acute parenchymal infiltrates. " cba3dd1b-a259e83d-44a38f7b-2fd09033-cacf31b2.jpg,validate/p17/p17924064/s50849431/cba3dd1b-a259e83d-44a38f7b-2fd09033-cacf31b2.jpg,validation," FINAL REPORT HISTORY: Anorexia. FINDINGS: No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " e102f9fd-31241e4a-07e2fb2b-0265d29a-33645a5c.jpg,validate/p16/p16222579/s56288892/e102f9fd-31241e4a-07e2fb2b-0265d29a-33645a5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough, high fever // 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. " 3dc494aa-2f66d310-353e37a5-8421e723-283be13c.jpg,validate/p18/p18011403/s55080651/3dc494aa-2f66d310-353e37a5-8421e723-283be13c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dobbhoff catheter. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the previously placed Dobbhoff catheter has been removed. Although a small piece of catheter is seen entering the mouth of the patient, this catheter is neither coiled in the pharynx nor does it traverse through the esophagus. Unchanged position of the right PICC line. " 731262f0-597cea3c-40fd74c3-171e62b2-9578d214.jpg,validate/p19/p19017919/s58505587/731262f0-597cea3c-40fd74c3-171e62b2-9578d214.jpg,validation," FINAL REPORT INDICATION: ___ year old man with reposition of ETT // interval changes in ETT position and comment on overall pulmonary changes FINDINGS: As compared to ___, the ETT remains 5 cm from the carina. Left IJ catheter remains near the origin of the upper SVC and left brachiocephalic vein. The feeding tube tip is not visualized. Increasing moderate left pleural effusion and right basal atelectasis. Mild pulmonary edema and and the heart size has minimally increased with moderate cardiomegaly. IMPRESSION: ETT is 5 cm from the carina. Mild pulmonary edema increasing left moderate pleural effusion. " 8348f15b-dbc1f1d7-6cf62ab6-21686f94-a10e8be8.jpg,validate/p12/p12156923/s59557648/8348f15b-dbc1f1d7-6cf62ab6-21686f94-a10e8be8.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old woman with placement of right PICC and removal of right PA catheter // eval for PICC line tip COMPARISON: None. FINDINGS: Compared to the prior film, the Swan-Ganz catheter has been removed. It replaced with a sheath that overlies the proximal/mid SVC. Again seen is a right subclavian PICC line. The PICC line is now visible in the mediastinum. The tip overlies the upper right atrium. This could be retracted by approximately 3 cm to lie in the distal SVC near the SVC/RA junction. Otherwise, I doubt significant interval change. No pneumothorax is detected. IMPRESSION: Right subclavian PICC line tip overlies the upper right atrium and could be retracted by approximately 3 cm. " d301d789-c1393cfd-63856c44-96617a62-a5540500.jpg,validate/p13/p13031024/s50637311/d301d789-c1393cfd-63856c44-96617a62-a5540500.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain and shortness of breath. Evaluate for CHF versus pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: The lungs are well inflated and clear. There is mild cardiomegaly. Hilar contours are normal. There is no pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly. Clear lungs. " e41ebbab-8e350c02-f44e40ef-dc0b9537-e958d101.jpg,validate/p10/p10967928/s54242037/e41ebbab-8e350c02-f44e40ef-dc0b9537-e958d101.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with epigastric/lower chest pain x 36 hours, recent cocaine use 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. " 7ead592f-3e199cfa-f3d9b154-88d3df15-e3f659d3.jpg,validate/p17/p17810083/s58091448/7ead592f-3e199cfa-f3d9b154-88d3df15-e3f659d3.jpg,validation," FINAL REPORT INDICATION: ___M with L sided cp // eval for cp TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 5920ac67-abbcd96c-fa896eaa-337f6a2c-99475c40.jpg,validate/p13/p13992060/s56059995/5920ac67-abbcd96c-fa896eaa-337f6a2c-99475c40.jpg,validation," FINAL REPORT INDICATION: ___ year old man with ESRD for pre kidney transplant eval // r/o cardiopulmonary abnormalities TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unchanged with marked tortuosity of the thoracic aorta. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute radiographic intrathoracic pulmonary disease. " bcfbc6f0-a434f096-0cf988f2-f46ffd09-3bec4a18.jpg,validate/p11/p11600572/s58806453/bcfbc6f0-a434f096-0cf988f2-f46ffd09-3bec4a18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with rigors r/o infection // r/o infection TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. No infiltrate IMPRESSION: No change. " 7f813234-6fdda133-53668e93-508749f5-20da0406.jpg,validate/p11/p11350319/s52743314/7f813234-6fdda133-53668e93-508749f5-20da0406.jpg,validation," FINAL REPORT INDICATION: Fever and shortness of breath. COMPARISON: Chest radiograph, ___, ___. TECHNIQUE: Single view chest radiograph. FINDINGS: The cardiomediastinal silhouette is stable. There are patchy opacities throughout the lungs, particularly in the perihilar and bibasilar regions, suggestive of pulmonary edema. There is blunting of the left costophrenic angle, suggestive of a small effusion. A right-sided subclavian dual-lumen catheter terminates in the lower superior vena cava and right atrium. Sternotomy wires are in place. Multiple surgical clips project over the mediastinum and right upper quadrant. No acute bony abnormality is identified. IMPRESSION: Patchy pulmonary opacities suggestive of pulmonary edema. However, underlying infection cannot be excluded based on this radiographic appearance. " 4cb1bd94-3a2e2646-90c56c57-d0592074-060abc63.jpg,validate/p11/p11945463/s58345271/4cb1bd94-3a2e2646-90c56c57-d0592074-060abc63.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with DOE // ? lesion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: Mild scoliosis again noted. 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 or lesion noted. NOTIFICATION: The findings were discussed with ___, practice assistant. by ___, M.D. on the telephone on ___ at 2:23 PM, 10 minutes after discovery of the findings. " f2676cc1-bfd50158-56f812f2-2270dc9c-c2398072.jpg,validate/p18/p18686554/s53603595/f2676cc1-bfd50158-56f812f2-2270dc9c-c2398072.jpg,validation," FINAL REPORT HISTORY: Cough, myalgias. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are hyperinflated, suggestive of underlying COPD. Heart size is normal. The aortic knob is calcified. Mediastinal and hilar contours are within normal limits. The pulmonary vasculature is normal. Minimal streaky left basilar opacity could reflect early infection or atelectasis. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: Streaky left basilar opacity could reflect early infection or atelectasis. " d837192d-4e108865-7d2f518c-a5309748-14f6f630.jpg,validate/p13/p13826513/s50022463/d837192d-4e108865-7d2f518c-a5309748-14f6f630.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with alcoholic cirrhosis c/b HE and refractory ascites on weekly paracentesis, COPD, and gastric bypass being evaluated for liver transplant // Is there any evidence of infection? TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Left PICC line is in the right atrium and should be pulled back at least 3.5 till 4 cm. Widespread parenchymal opacities appear to be minimally improved since the prior study. Cardiomediastinal silhouette is unchanged. " a8677d01-071fb9a1-4c969364-9e509822-1bff928c.jpg,validate/p12/p12257206/s54964749/a8677d01-071fb9a1-4c969364-9e509822-1bff928c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Asthma, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. " 3b6ada98-4fed8294-3b815145-663dc116-f7ffd17b.jpg,validate/p10/p10706635/s50738678/3b6ada98-4fed8294-3b815145-663dc116-f7ffd17b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD, vomiting and SOB // Please eval for aspiration pna, or PE given long hospital stay COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Known ill-defined left midlung opacity. Known low lung volumes and atelectasis at both the right and the left lung base. The right PICC line is in constant position. No pneumonia, no pulmonary edema. " 80833a95-629fd906-976ff4e2-cd55cbc2-48fe72e9.jpg,validate/p13/p13509135/s56852630/80833a95-629fd906-976ff4e2-cd55cbc2-48fe72e9.jpg,validation," FINAL REPORT INDICATION: History: ___M with syncope // ? pna TECHNIQUE: Portable AP Chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: There is no focal consolidation or pneumothorax. There is a small right pleural effusion. The left costophrenic angle is obscured by a lead and wire. The cardiomediastinal silhouette is unremarkable and unchanged from the prior study. IMPRESSION: Small right pleural effusion. " c5080fbd-37cf0ea9-fdc2cd50-41f852af-5ed627f8.jpg,validate/p12/p12763897/s50803666/c5080fbd-37cf0ea9-fdc2cd50-41f852af-5ed627f8.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: An enteric tube is seen which courses through the stomach and tip appears to be post pyloric in position. Lung volumes are low. The cardiac, mediastinal and hilar contours are normal. Patchy opacities in the lung bases may reflect aspiration or infection and appear progressed in the interval. No pleural effusion or pneumothorax is seen. There is no pulmonary edema. IMPRESSION: Patchy opacities in the lung bases are worse compared to the previous exam, and may reflect areas of aspiration or infection. " 388becf8-521c7453-f247a382-81cfe03e-11682df3.jpg,validate/p14/p14432776/s53104248/388becf8-521c7453-f247a382-81cfe03e-11682df3.jpg,validation," FINAL REPORT INDICATION: History: ___F with fall onto L upper extremity, left chest wall pain // presence of rib fxs COMPARISON: Same day chest CT FINDINGS: AP upright and lateral views of the chest provided. Lungs are clear without focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette appears grossly within normal limits. Anterior-inferior dislocation of the left hand humeral head is noted. No acute displaced rib fracture. IMPRESSION: 1. Anterior inferior left shoulder dislocation. 2. No acute intrathoracic process. Please refer to same-day CT chest for further details. " ff15bfc3-707d398a-ef32a7b8-b4f4f269-d10f05af.jpg,validate/p14/p14034311/s53949145/ff15bfc3-707d398a-ef32a7b8-b4f4f269-d10f05af.jpg,validation," FINAL REPORT INDICATION: ___ year old man with SOB // r/o acute CP process TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Right basal atelectasis with volume loss and elevated right hemidiaphragm. The cardiomediastinal silhouette, hilar, and pleural surfaces are normal. There is no pneumothorax nor effusions seen. There are no acute bony abnormalities. Median sternotomy wires are intact and aligned. Mediastinal surgical clips are seen. IMPRESSION: 1. Right basal atelectasis with volume loss. Otherwise no acute cardiopulmonary process. " ddbf4abc-c6899f5b-cfb0a1aa-0fe63946-6f4d945b.jpg,validate/p12/p12132246/s59994128/ddbf4abc-c6899f5b-cfb0a1aa-0fe63946-6f4d945b.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient status post valve sparing root replacement. Coronary artery re-implantation, evaluate for post-operative fever source. 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 ___. Status post sternotomy and remaining significant enlargement of the heart silhouette remains. The pulmonary vascular pattern does not show increased congestion and is practically unaltered in comparison with the next preceding examination. The left-sided basal and retrocardiac positioned atelectatic left lower lung changes have regressed moderately and show improved aeration. Similarly basal densities on the right base appear more translucent and the right lateral pleural sinus remains free. On the lateral view, the mostly posteriorly located atelectatic densities demonstrate some degree of improved central aeration. No new other parenchymal infiltrates are seen and no pneumothorax remains in the apical area. Progressively improving bilateral basal atelectasis which appeared post-operatively. Improvement is observed during the latest two-day examination interval but some atelectatic changes remain. Additional comparison is made with the pre-operative chest examination of ___, it can be noted that moderate cardiac enlargement existed already on the pre-operative chest examination. The atelectatic changes on both bases, however, did not exist at that time. " b7976e40-7ffc6292-2440bf84-79cecba2-b38b13a9.jpg,validate/p12/p12960142/s59685683/b7976e40-7ffc6292-2440bf84-79cecba2-b38b13a9.jpg,validation," FINAL REPORT INDICATION: ___F with neutropenia, fever, vomiting // evaluate for infectiohn TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-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. " e38bbb26-56cee940-689d6fc1-7406c9de-f1bfb85c.jpg,validate/p16/p16859561/s55790122/e38bbb26-56cee940-689d6fc1-7406c9de-f1bfb85c.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Productive cough. Cardiac size is top normal. Aside from linear atelectasis in the bases of the lungs, the lungs are clear. There is no pneumothorax or pleural effusion. Moderate degenerative changes are in the thoracic spine. IMPRESSION: No evidence of pneumonia. " e24903c2-d2d4355b-0cae9ff1-53fc21d2-0e7b0261.jpg,validate/p11/p11658675/s51888479/e24903c2-d2d4355b-0cae9ff1-53fc21d2-0e7b0261.jpg,validation," 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. " 4384b9e0-d0b9a953-a4dbea99-93a3c758-fcd2a430.jpg,validate/p11/p11549535/s56568384/4384b9e0-d0b9a953-a4dbea99-93a3c758-fcd2a430.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Left IJ. Cardiac size is normal. The aorta is tortuous. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " 097ab301-7de5890c-db6e02e8-f6f6989b-1101f1ac.jpg,validate/p14/p14476701/s50846245/097ab301-7de5890c-db6e02e8-f6f6989b-1101f1ac.jpg,validation," FINAL REPORT INDICATION: Ten days of cough. COMPARISON: Radiographs 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 pneumonia. These findings were communicated by Dr. ___ to Dr. ___, ___ telephone, at the time of interpretation, 11:15 a.m. on ___. " fcdfb689-1557f1b1-c9739aa7-4b935b1c-62315813.jpg,validate/p14/p14766138/s57122256/fcdfb689-1557f1b1-c9739aa7-4b935b1c-62315813.jpg,validation," FINAL REPORT HISTORY: ___F with body aches, fever, chills TECHNIQUE: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: The lungs are well expanded and clear. There has been interval resolution of previously noted opacity in the mid left lung. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Surgical clips in the right upper quadrant. IMPRESSION: Unremarkable chest radiographic examination. " eaf47166-1c936826-5a88745c-814a569c-752481ef.jpg,validate/p14/p14558435/s58900549/eaf47166-1c936826-5a88745c-814a569c-752481ef.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old woman with a right pleural effusion. Pigtail drainage catheter placed yesterday. IMPRESSION: A PA and lateral chest compared to ___: Overall volume of right pleural fluid has decreased, now moderate, largely replaced by air. Findings suggest the right lower lobe may be partially restricted by thickened pleura. Left lung clear. Heart size normal. Dr. ___ was paged. " ff6a3dc6-6bc56e79-eb5ca6a1-29dbacbc-866dd6b4.jpg,validate/p13/p13063001/s59674577/ff6a3dc6-6bc56e79-eb5ca6a1-29dbacbc-866dd6b4.jpg,validation," 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. " 0345ae1e-516462b4-3a4f41dc-ed2c8118-44cb0ca2.jpg,validate/p11/p11630519/s55179841/0345ae1e-516462b4-3a4f41dc-ed2c8118-44cb0ca2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ___M with h/o Afib, CHF, DM, HTN, CVAs, admitted after mechanical fall on anticoagulation with intracranial bleeding. Course complicated by toxic metabolic encephalopathy, AFib RVR, complicated UTI and infectious colitis. He remains inpatient receiving stroke rehabilitation. Recurrent seizure AM of ___, ?infection // Assess for infiltrate, acute process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate to severe cardiomegaly and widening mediastinum are unchanged. There is mild vascular congestion. There is no pneumothorax or pleural effusion. There are low lung volumes. . " d0a34de8-bc20a20a-7328475e-d44ffe33-70926c2b.jpg,validate/p14/p14009236/s51646167/d0a34de8-bc20a20a-7328475e-d44ffe33-70926c2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, fever and bloody sputum. // Infiltrate? TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: None available. FINDINGS: On the frontal view, ___ with 8 mm wide rounded opacity projects over the cardiac silhouette and the medial left ninth posterior interspace. This might correspond to a 3.5 cm elliptical opacity which on the lateral view projects over the aortic root placing the lesion in the lingula, 4, instead it may correspond to a 2 cm wide opacity projecting over the lower thoracic spine. A dedicated chest CT is warranted for further evaluation. The lungs are otherwise clear. There is no pneumothorax or pleural effusion. The heart and mediastinum are within normal limits. The IMPRESSION: A chest CT is recommended to evaluate one or 2 lung lesions, either of which could be infectious or neoplastic. RECOMMENDATION(S): A chest CT is recommended to evaluate one or 2 lung lesions, either of which could be infectious or neoplastic. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:08 AM, 10 minutes after discovery of the findings. " f73a006a-c7a9f5dd-03fcc7d4-5c23eca9-d1caeb9b.jpg,validate/p17/p17595883/s55857326/f73a006a-c7a9f5dd-03fcc7d4-5c23eca9-d1caeb9b.jpg,validation," WET READ: ___ ___ 3:10 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with epigastric pain // eval infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ and ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unchanged. The aorta is tortuous. No pneumothorax, pleural effusion, or consolidation. No free air beneath the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " b44392bd-f7cce55a-35f0f342-d62de1ef-6f64bc2f.jpg,validate/p11/p11459120/s53962571/b44392bd-f7cce55a-35f0f342-d62de1ef-6f64bc2f.jpg,validation," FINAL REPORT INDICATION: History of COPD, now with bibasilar rales. Evaluate for pulmonary edema versus pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. There is a widespread interstitial abnormality, likely secondary to mild pulmonary edema. Moderate cardiomegaly is not significantly changed. Aortic calcifications are noted. Mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Multilevel degenerative changes of the thoracolumbar spine are noted. There is a left-sided pacemaker with right atrial and right ventricular leads. There is also re-demonstration of left shoulder hardware. IMPRESSION: 1. Findings suggestive of mild interstitial pulmonary edema. 2. Moderate cardiomegaly, not significantly changed. " 540229af-b66cf767-7b7c6371-8e20373a-e8263d2b.jpg,validate/p16/p16333059/s50634437/540229af-b66cf767-7b7c6371-8e20373a-e8263d2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with fall down stairs // ? ptx COMPARISON: None 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. " 8feedfb8-851c46be-ac231080-a398240f-8c0561d2.jpg,validate/p10/p10706968/s58498858/8feedfb8-851c46be-ac231080-a398240f-8c0561d2.jpg,validation," FINAL REPORT HISTORY: CHF COMPARISON: ___ FINDINGS: Moderate cardiomegaly is is stable. Aorta is tortuous. The lungs are grossly clear. There is mild vascular congestion and there is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine IMPRESSION: Mild vascular congestion Stable cardiomegaly " ff913dd4-0d220950-364eea6d-f2d87dbd-9ccaf639.jpg,validate/p11/p11290019/s54585305/ff913dd4-0d220950-364eea6d-f2d87dbd-9ccaf639.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with sob // ? 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. Re- demonstrated are multiple old left-sided rib deformities and mild eventration of the left hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 820b9bc1-68aba15d-739e6f7a-b9aec46b-caaceedb.jpg,validate/p14/p14913896/s57431060/820b9bc1-68aba15d-739e6f7a-b9aec46b-caaceedb.jpg,validation," FINAL REPORT INDICATION: History: ___F with left posterior lower rib pain after fall, and ongoing cough, weakness pneumonia in ___ // r/o fx, infiltrate COMPARISON: The comparison is made with prior studies including ___ 0 ___. IMPRESSION: The previously noted consolidation in the right base has improved as compared to ___. Small areas of patchy atelectasis or scarring are present in both lung bases. There is no dense consolidation, pneumothorax, effusion or CHF. Degenerative changes are present in the spine. " 4521b5c4-f7015e0d-32d5561f-6d8f8d28-6565df2c.jpg,validate/p12/p12190636/s54516743/4521b5c4-f7015e0d-32d5561f-6d8f8d28-6565df2c.jpg,validation," FINAL REPORT EXAM: Chest, AP and lateral views. CLINICAL INFORMATION: Generalized malaise, tachycardia. COMPARISON: ___. FINDINGS: Dual-lead left-sided pacemaker is seen, unchanged in position, with leads extending to the expected positions of the right atrium and right ventricle. The patient is status post median sternotomy. The lungs remain relatively hyperinflated. There is minimal left base atelectasis/scarring. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal. Mediastinal and hilar contours are stable. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " a64aded2-d0baf6cf-61905fe9-5339d7ac-ff899441.jpg,validate/p18/p18899080/s54187328/a64aded2-d0baf6cf-61905fe9-5339d7ac-ff899441.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with malignant effusion s/p chest tube // Assess pleural effusion Assess pleural effusion IMPRESSION: As compared to ___, there has been a slight increase in extent of the known left pleural effusion. No pneumothorax. The left pleural catheter is in unchanged position. Moderate cardiomegaly. Mild pulmonary edema and low lung volumes. " df4a651d-611d3f32-23f30bc4-571f6fcb-7a3eb3c9.jpg,validate/p19/p19778971/s56258434/df4a651d-611d3f32-23f30bc4-571f6fcb-7a3eb3c9.jpg,validation," FINAL REPORT HISTORY: Intubation for airway protection. FINDINGS: In comparison with the earlier study, the endotracheal tube tip lies approximately 7.2 cm above the carina. Little overall change in the appearance of the heart and lungs. " fbd549ca-e0c8566d-16963beb-c1ff88e5-67162a4f.jpg,validate/p17/p17535980/s54788194/fbd549ca-e0c8566d-16963beb-c1ff88e5-67162a4f.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Choking episodes, status post recent discharge. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The heart is mildly enlarged. The lung volumes are low. The mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no pleural effusions or pneumothorax. Small-to-moderate anterior osteophytes are present along the lower thoracic spine. IMPRESSION: No evidence of acute disease. " 927d018c-e422db93-a8351a69-95c3ef5f-79ef52b1.jpg,validate/p15/p15364782/s57628876/927d018c-e422db93-a8351a69-95c3ef5f-79ef52b1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PTX s/p chest tube on L // eval for increased PTX COMPARISON: Prior CT and chest radiograph performed earlier today. FINDINGS: AP portable upright view of the chest. Endotracheal tube and orogastric tubes are unchanged. There is a left chest tube in unchanged position. No definite pneumothorax is seen. No significant change from prior exam. Multiple left rib fractures as well as a left clavicular midshaft deformity again noted. IMPRESSION: No pneumothorax visualized. " 3137a382-5380801b-abadb4c9-631104b0-6204ebe8.jpg,validate/p11/p11180265/s52263696/3137a382-5380801b-abadb4c9-631104b0-6204ebe8.jpg,validation," FINAL REPORT HISTORY: Thrombocytosis and abnormal findings on CTA chest from ___. Evaluate for acute change, evaluate for pneumonia. COMPARISON: Chest radiograph from ___ in conjunction with CTA chest from ___. FINDINGS: There is slight improvement in the left lower lobe retrocardiac opacity with residual opacity and cystic lucencies persisting. There is no new focal consolidation. No pleural effusion or pneumothorax is present. The cardiomediastinal silhouette is unchanged. There is no evidence of pulmonary vascular congestion. IMPRESSION: Slight improvement in retrocardiac opacity compared with ___ with no new focal consolidation. " cab0de8c-4461d2a3-4bd32ff3-d8796297-d2744436.jpg,validate/p14/p14246614/s53456860/cab0de8c-4461d2a3-4bd32ff3-d8796297-d2744436.jpg,validation," FINAL REPORT INDICATION: Evaluate endotracheal tube position after being pulled back 3 cm. COMPARISONS: Chest radiograph from ___. TECHNIQUE: A single AP supine view of the chest was obtained. FINDINGS: The endotracheal tube has been repositioned, and is now in satisfactory position 3.2 cm from the carina. An orogastric tube courses below the diaphragm with the tip out of the field of view. A right internal jugular central venous catheter and left hemodialysis catheter are in unchanged position. Again, there is unchanged moderate pulmonary edema, small bilateral pleural effusions, and associated basilar atelectasis. There is no new opacity. There is no pneumothorax. The cardiomediastinal silhouette is unchanged, with persistent moderate cardiomegaly. IMPRESSION: Satisfactory position of the endotracheal and orogastric tubes. Otherwise no significant change. " a9ec206e-7a1b9c23-df4a4574-cf69d4da-494085ae.jpg,validate/p10/p10452422/s54487807/a9ec206e-7a1b9c23-df4a4574-cf69d4da-494085ae.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, abdominal pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Right-sided Port-A-Cath tip terminates in the proximal right atrium. Lung volumes are low. Heart size is borderline enlarged. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Streaky opacities in the lung bases likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 6da0f25e-d3ef71ff-d6177ec4-fa1242e6-d9b91462.jpg,validate/p15/p15245907/s58780053/6da0f25e-d3ef71ff-d6177ec4-fa1242e6-d9b91462.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p bronchoscopy // R/o pneumothorax TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Left PICC line tip is in the right atrium. Heart size and mediastinum are overall unchanged. There is interval improvement of pulmonary edema with large bilateral pleural effusions demonstrated. " f12aeb4b-97ac02a5-ca00f34c-0eba166e-714a951e.jpg,validate/p14/p14501307/s52575559/f12aeb4b-97ac02a5-ca00f34c-0eba166e-714a951e.jpg,validation," WET READ: ___ ___ ___ 3:47 PM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with intermittent chest pain associated with shortness of breath. // Evaluate for pulmonary edema, any consolidation. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 91da0767-75ea7d31-e58c7203-6509bcbb-fa35072a.jpg,validate/p17/p17561108/s54715024/91da0767-75ea7d31-e58c7203-6509bcbb-fa35072a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with right hematoma and pneumothorax. Assess for change. COMPARISON: FINDINGS: IMPRESSION: AP chest compared to ___: The small volume of residual fissural pleural fluid in the right hemithorax has decreased substantially since ___. Basal and paramediastinal components of right pleural effusion are smaller as well. Mild enlargement of the cardiac silhouette is stable, but improved since earlier in ___. Left lung is grossly clear. Abnormalities in the right lung are probably areas of atelectasis but should be re-evaluated after the pleural process is under control. Area infusion port catheter ends in the upper SVC. No pneumothorax. " 5b40ec7f-bec27a23-9b6c3329-ddc5edae-73a4c6c3.jpg,validate/p16/p16753060/s56225460/5b40ec7f-bec27a23-9b6c3329-ddc5edae-73a4c6c3.jpg,validation," FINAL REPORT HISTORY: Confusion and weakness. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well aerated lungs which are clear. No focal consolidation, vascular congestion, pleural effusion, or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary process. " b24e2cd7-8eb7f5e2-539475b7-d4b8ddf7-0fb93ad7.jpg,validate/p14/p14828338/s52666970/b24e2cd7-8eb7f5e2-539475b7-d4b8ddf7-0fb93ad7.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with recent discharge from hospital on ___ now presenting with fever to ___F, chills, and fatigue. Patient is also two weeks status post chemotherapy. COMPARISON: Chest radiograph from ___. PA AND LATERAL CHEST RADIOGRAPH: 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. No evidence of pneumonia. " 2793f813-f9dd26b3-01f738cc-ecfa60ad-1eda6e02.jpg,validate/p18/p18429024/s58426056/2793f813-f9dd26b3-01f738cc-ecfa60ad-1eda6e02.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post motor vehicle collision with difficulties ventilating. COMPARISONS: Earlier radiographs from the same day. TECHNIQUE: Chest, semi-upright AP portable. FINDINGS: The patient remains intubated. An orogastric tube coils once in the stomach, as before. The mediastinal and hilar contours appear unchanged. Each hilum shows ill defined perihilar opacity and focal opacity in the right lower lung persists. There is now a small right-sided pneumothorax with a measured distance between the outer pleural line and chest wall measuring up to 7 mm; otherwise, aside from increased lung volumes, there is no other change. No definite fracture is appreciated. IMPRESSION: New small right-sided pneumothorax. Dr. ___ ___ the findings with the clinician caring for the patient at the time of discovery and communication at 1:55 p.m. by telephone. " 51664f90-f80604ec-8a4da84e-6281cf0b-c51063eb.jpg,validate/p11/p11551927/s50239385/51664f90-f80604ec-8a4da84e-6281cf0b-c51063eb.jpg,validation," FINAL REPORT REASON FOR EXAM: Assess Dobhoff tube. Comparison is made with prior study performed 6 hours earlier. Dobhoff tube tip is at the fourth portion of the duodenum. There are no other interval changes. " dbbdc930-2b995e93-a3809249-2ad5a93f-c0ad2680.jpg,validate/p14/p14512291/s55878002/dbbdc930-2b995e93-a3809249-2ad5a93f-c0ad2680.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with PMHx of DM2, afib on pradaxa, gout (recent flare, prescribed colchicine) presenting to the ED with bradycardia, hypotension, and hyperglycemia. New O2 requirement // ?pulmonary edema TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Severe pulmonary edema is new. Bilateral pleural effusions larger on the right side have markedly increased with associated adjacent atelectasis. There is no evident pneumothorax. Cardiac size is top-normal. Right IJ catheter tip is in the cavoatrial junction " 9eddcfea-806e9a07-81c8dc9f-4ed492f7-5c87c140.jpg,validate/p19/p19646078/s52323491/9eddcfea-806e9a07-81c8dc9f-4ed492f7-5c87c140.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with removal of mediastinal tubes // eval for PTX, atelectasis COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: The mediastinal tubes, endotracheal tube, nasogastric tube and Swan-Ganz lines have been removed. Chest tubes are present in both lung bases and there is a central venous catheter on the right the tip in the superior vena cava. There is no pneumothorax or pneumomediastinum. There is stable patchy density in both lung bases. There are no new regions of consolidation. " 1fef84fc-82e4ef1b-30f31982-5fe9fe52-a104edd1.jpg,validate/p10/p10488031/s51742979/1fef84fc-82e4ef1b-30f31982-5fe9fe52-a104edd1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory distress // eval for interval change IMPRESSION: As compared to previous radiograph of 1 day earlier, asymmetrical pattern of pulmonary edema has slightly worsened with associated increasing small right pleural effusion. Large bulla is again noted at the left apex accounting for hyperlucency in this region. " fdf4c906-fbede8d6-fa2dc7f1-48adba30-b20bd9c6.jpg,validate/p18/p18829312/s57240949/fdf4c906-fbede8d6-fa2dc7f1-48adba30-b20bd9c6.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with leukemia and increasing cough. Assess for abnormality. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiograph. " 2fe51400-7dd20270-94956e5f-d64daa15-ca8f4194.jpg,validate/p19/p19275261/s59181765/2fe51400-7dd20270-94956e5f-d64daa15-ca8f4194.jpg,validation," 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. " 01a50411-d9e02b1a-946854e0-b4df3b26-f7ebea63.jpg,validate/p11/p11543398/s53718677/01a50411-d9e02b1a-946854e0-b4df3b26-f7ebea63.jpg,validation," 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. " bba492b3-e59e33c2-d2159bb6-7ae15ae1-ca098ac7.jpg,validate/p19/p19178984/s59170517/bba492b3-e59e33c2-d2159bb6-7ae15ae1-ca098ac7.jpg,validation," 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. " 659f436a-6a4e741c-996eab0e-ad9c3398-e0b183fa.jpg,validate/p10/p10670085/s50480611/659f436a-6a4e741c-996eab0e-ad9c3398-e0b183fa.jpg,validation," FINAL REPORT INDICATION: ___F with bibasilar crackles. CHF hx. SOB // PNA? CHF exacerbation? TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Exam is limited secondary to portable technique and patient body habitus. There is some evidence of interstitial edema as on prior. No definite new confluent consolidation identified. Pleural effusions are difficult to exclude. Cardial silhouette is enlarged but similar compared to prior. Prosthetic aortic valve is noted as well as anterior chest wall hardware. IMPRESSION: Limited exam with probable interstitial edema. " 21f5d569-fbea9364-9b53ded9-e319085f-c8e1fed0.jpg,validate/p14/p14614404/s52801857/21f5d569-fbea9364-9b53ded9-e319085f-c8e1fed0.jpg,validation," WET READ: ___ ___ ___ 7:05 PM Left pleural drains terminate in the left lung apex and deep in the posterior left costophrenic angle. Previously seen left pleural effusion has significantly decreased with residual left base atelectasis. No pneumothorax. There is slight blunting of the right costophrenic angle, but the right lung is otherwise clear. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male status post left VATS decortication. COMPARISON: Chest radiograph dated ___. FINDINGS: Portable chest radiograph demonstrates two pleural drains terminating in the left apex and posterior left costophrenic angle. There is no pneumothorax. There is a persistent left pleural effusion which appears significantly decreased. Bibasilar atelectasis persists. The right lung is grossly clear. The stomach is moderately distended. Heart size appears normal. IMPRESSION: No pneumothorax. " 9c7fbb0f-517f39a3-721cdfd1-192d344b-219b5f55.jpg,validate/p18/p18204932/s59188618/9c7fbb0f-517f39a3-721cdfd1-192d344b-219b5f55.jpg,validation," FINAL REPORT INDICATION: ___M with trauma, evaluate for injuries, pneumothorax. TECHNIQUE: AP lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal silhouette is within normal limits. The bilateral hila are unremarkable. Linear opacities near the left lung base are probably platelike atelectasis. More diffuse airspace in the right lower lung medially obscuring the right heart border may represent atelectasis, developing infection or sequelae of aspiration, or possibly small pulmonary contusions in the setting of recent trauma. Otherwise, the lungs are clear. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Right lower lung consolidation, either pneumonia, aspiration, or possibly pulmonary contusions from recent trauma. 2. Left lower lung platelike atelectasis. 3. No evidence of displaced rib fracture. Note, chest x-ray is not sensitive for the detection of subtle or nondisplaced rib fractures. " c3d27e49-454aff02-ce1dd844-2389678e-0177e87e.jpg,validate/p15/p15435415/s54802753/c3d27e49-454aff02-ce1dd844-2389678e-0177e87e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p avr-reintubated // check ett/ogt placement TECHNIQUE: Chest single view COMPARISON: ___ at 21:09 FINDINGS: Endotracheal tube tip is 1.8 cm above carina. Right IJ Swan-Ganz catheter tip in the right pulmonary artery. Enteric tube tip is in the distal stomach. Increased heart size, similar. Increased pulmonary vascularity, minimally improved. Right basilar opacity, likely atelectasis, similar. There are small pleural effusions, similar. There are degenerative changes in the lumbar spine. Normal bowel gas pattern in the visualized abdomen. IMPRESSION: Endotracheal tube tip 1.8 cm above carina. Mildly improved pulmonary vascular congestion " 5fdea574-dd7b7fd2-6671b588-0b7325ae-889d11b5.jpg,validate/p16/p16907705/s50502004/5fdea574-dd7b7fd2-6671b588-0b7325ae-889d11b5.jpg,validation," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH INDICATION: Weakness. Evaluate for infectious process. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: ___. REPORT: There is cardiomegaly in this patient with status post sternotomy. Bilateral pleural effusions as well as peribronchial cuffing suggestive of congestive changes are noted. There is no definitive finding to suggest an acute pneumonic process. The visualized osseous structures appear grossly normal. I noted double right heart border, suggestive of mitral valve disease. CONCLUSION: Findings are consistent with congestive change. No definitive pneumonia. " 14f3cdf7-dae47867-d1d7af5f-6c56396f-e6803d3d.jpg,validate/p19/p19850525/s59616328/14f3cdf7-dae47867-d1d7af5f-6c56396f-e6803d3d.jpg,validation," FINAL REPORT INDICATION: ___M with shortness of breath // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: Left axillary dual lead pacemaker is present with tip terminating in the right atrium and right ventricle as expected. Moderate cardiomegaly is again noted. The mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are well-expanded without focal consolidation concerning for pneumonia. Mild vascular congestion is present. Multiple healed rib fractures in the right posterior ribcage are noted. IMPRESSION: 1. Mild vascular congestion. 2. Stable moderate cardiomegaly. " 5c7283c5-e7009c3f-6c6cdf24-c041328d-0cdb2237.jpg,validate/p11/p11177105/s58550825/5c7283c5-e7009c3f-6c6cdf24-c041328d-0cdb2237.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with altered mental status. COMPARISON: None. FINDINGS: AP view of the chest. Electronic device overlies the right lung base. Where visualized, the lungs are clear of consolidation. The cardiomediastinal silhouette is within normal limits given technique and rotation. No acute osseous abnormalities identified. IMPRESSION: No definite acute cardiopulmonary process. " 70c4b74b-0342be73-5c3c2f97-17db83b2-f1e59ded.jpg,validate/p11/p11938224/s54926007/70c4b74b-0342be73-5c3c2f97-17db83b2-f1e59ded.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever, concern for possible pneumonia. // ? of pneumonia? COMPARISON: Chest x-ray from ___ at 17 16 FINDINGS: Inspiratory volumes are slightly low. The cardiomediastinal silhouette is not significantly changed, allowing for differences in technique. Right paratracheal soft tissues are again noted to be prominent. There is minimal atelectasis at both bases. No CHF, focal consolidation, or effusion is identified. Probable background hyperinflation/COPD. IMPRESSION: Minimal bibasilar atelectasis. No definite infectious infiltrate. " 7a98e569-f713f0c8-f908d36a-05c3510f-98ce92d6.jpg,validate/p14/p14987072/s59431035/7a98e569-f713f0c8-f908d36a-05c3510f-98ce92d6.jpg,validation," FINAL REPORT INDICATION: ___ year old woman POD5 L crani for tumor resection with fever // evaluate for PNA TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: The patient is rotated. An opacity projects over the lower right mediastinum and may reflect normal hilar structures. Minimal left basilar atelectasis. No pleural effusion or pneumothorax identified. IMPRESSION: Suboptimal radiograph of the patient is markedly rotated. Increased opacity projecting over the lower right mediastinum may reflect normal hilar structures however underlying consolidation or atelectasis cannot be excluded. Minimal left basilar atelectasis. " a14f52b1-3a08cf54-801f18ad-c124a1ca-37676e05.jpg,validate/p17/p17777282/s51898467/a14f52b1-3a08cf54-801f18ad-c124a1ca-37676e05.jpg,validation," FINAL REPORT INDICATION: Anterior chest pain. COMPARISON: Chest radiographs, ___ and ___. CTA chest, ___. FINDINGS: PA and lateral chest radiographs. Bilateral hilar and mediastinal lymphadenopathy is unchanged from prior examinations. There is no focal consolidation, pleural effusion or pneumothorax. Tortuosity of the descending aorta is stable. Mild opacification of the left mid lung is seen on only one view and most likely due to poor penetration from overlying breast tissue. Increased sclerosis of the left first rib is unchanged. IMPRESSION: No acute cardiopulmonary process. Stable bilateral hilar and mediastinal lymphadenopathy. " 5bd4c3f7-c7294c9b-28428aba-d52d1ba2-8bb24eb6.jpg,validate/p11/p11543398/s50695120/5bd4c3f7-c7294c9b-28428aba-d52d1ba2-8bb24eb6.jpg,validation," FINAL REPORT INDICATION: ___F with hx of CHF and dyspnea // ?pneumonia or pulmonary edema TECHNIQUE: Portable view of the chest. COMPARISON: ___. FINDINGS: The patient is rotated to the right. There are probable bilateral pleural effusions. Degree of pulmonary edema, likely moderate is grossly unchanged for perhaps minimally improved. Cardiac silhouette is enlarged. Chronic changes noted at the shoulders. Included image of the distal left humerus is also notable for likely chronic appearing deformity, similar to scout from CT scan from ___. Left upper extremity vascular access line seen terminating at the left brachial/ lower axillary level. IMPRESSION: No significant interval change. Likely moderate pulmonary edema and suspected pleural effusions with cardiomegaly. Catheter projecting over the left upper extremity as above. " 4ff8252c-793c773f-a85e6521-e052ba22-a1c892f9.jpg,validate/p11/p11098660/s58411833/4ff8252c-793c773f-a85e6521-e052ba22-a1c892f9.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p redo, AVR, Asc. aorta-- CTs d/c'd // evaluate for pneumothorax TECHNIQUE: Portable AP chest COMPARISON: Chest radiographs ___ and ___. FINDINGS: Right internal jugular central venous catheter terminates in the upper SVC. Median sternotomy wires appear intact. Pleural drains have been removed. Lung volumes remain low with bibasilar atelectasis. Moderate cardiomegaly is unchanged. Faint lucency along the left heart border is diminishing, likely reflecting resolving pneumopericardium. Mild interstitial pulmonary edema is improved. There is no large pleural effusion or pneumothorax. IMPRESSION: 1. Stable mild cardiomegaly with mild improved interstitial pulmonary edema. 2. No pneumothorax.Resolving pneumopericardium. " dd8dabc4-b6fd8f30-9a556033-a63ad99f-09baf823.jpg,validate/p16/p16803132/s58592253/dd8dabc4-b6fd8f30-9a556033-a63ad99f-09baf823.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with COPD, cough and hypoxia. COMPARISON: None available. FINDINGS: The lungs appear hyperexpanded suggestive of chronic obstructive pulmonary disease. A focal nodule is noted posterior to the sternum. Additionally, there is enlargement of the left main pulmonary artery. Cardiac silhouette is normal. Bibasilar opacities are visualized likely representative of bronchiectasis and fibrosis. Calcifications of the origin of the great vessels are noted. IMPRESSION: 1. There are bibasilar parenchymal opacities likely representative of chronic scarring. 2. There is a small retrosternal nodule. Follow up with CT is recommended. 3. Left pulmonary artery appears prominent suggestive of pulmonary artery hypertension or pulmonic stenosis. " 4ce3c842-c8d7dfeb-4a127359-a208711b-e65ddfb1.jpg,validate/p12/p12479159/s50024673/4ce3c842-c8d7dfeb-4a127359-a208711b-e65ddfb1.jpg,validation," FINAL REPORT HISTORY: CHF, worsening of stroke symptoms, question infectious process, CHF. CHEST, TWO VIEWS. The lungs are hyperinflated. There is cardiomegaly, with an unfolded aorta. There is upper zone redistribution, without other evidence of CHF. There is bibasilar atelectasis. No definite superimposed consolidation. No effusion identified. " 52c3a15d-8c650ccb-17feb35b-7522548f-3d10f157.jpg,validate/p11/p11531307/s59412305/52c3a15d-8c650ccb-17feb35b-7522548f-3d10f157.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx severe 3v CABG, COPD, dCHF, p/w chest pressure and sob, found to have PE, pna, sob improved with diuresis, w/ interval worsening sob // state of pneumonia and COPD state of pneumonia and COPD IMPRESSION: Compared to chest radiographs ___ through ___. Pulmonary vascular congestion has increased. Mild cardiomegaly is stable. Greater peribronchial opacification in the right upper lobe and the right lung base could be early edema or pneumonia. Left lung is grossly clear. Right pleural effusion is small. No pneumothorax. Indwelling right PIC line ends close to the anticipated location of the superior cavoatrial junction. " 92e98a31-78beee04-da1f5957-53e90440-d68f010f.jpg,validate/p16/p16581134/s58973755/92e98a31-78beee04-da1f5957-53e90440-d68f010f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated w/recurrent mucus plugging // assess position of ETT, any worsening RLL consoldiaiton? COMPARISON: Chest x-ray from ___ at 06:47 FINDINGS: An ET tube is present, tip approximately 4.4 cm above the carina. An NG tube is present, tip extending beneath diaphragm to overlie the expected site of the gastric fundus. Right IJ central line tip overlies the distal SVC. No pneumothorax is detected. The cardiomediastinal silhouette is probably unchanged, allowing for technical differences. The right hemidiaphragm remains elevated compared to the left. There is mild vascular plethora and slight blurring, which is probably not significantly changed allowing for technique. There is subsegmental atelectasis at the left and right bases, similar to the prior study. Probable small left effusion. IMPRESSION: Appearance is overall similar to the prior study, with mild vascular plethora, bibasilar subsegmental atelectasis, and small left pleural effusion. No evidence for interval worsening of the right lower lobe opacity. " 50ef72f2-df9cf442-b4d80fc3-5ca01215-637253eb.jpg,validate/p13/p13560495/s56352214/50ef72f2-df9cf442-b4d80fc3-5ca01215-637253eb.jpg,validation," 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. " 10d7e522-8c948752-667eef1e-b27e03ff-6d5840a6.jpg,validate/p15/p15123549/s51654658/10d7e522-8c948752-667eef1e-b27e03ff-6d5840a6.jpg,validation," FINAL REPORT HISTORY: History of PE, eclampsia, HELLP, DIC, current acute hypoxia to ___%. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 7:33 a.m., the inspiratory volumes are slightly lower. Minimal patchy opacity in the right cardiophrenic region is new. Slight increased retrocardiac density is similar to the prior film. Elsewhere, the lungs are grossly clear, without CHF, focal infiltrate, effusion or pneumothorax. The cardiomediastinal silhouette is unchanged allowing for technical differences and the mediastinum remains midline. Left-sided indwelling catheter and right IJ sheath tips both overlie the proximal SVC, essentially unchanged. Equivocal slight prominence of the mid abdominal bowel loops. Right upper quadrant cholecystectomy clips noted. " 2124b625-626af61c-3b22b502-75df0fbb-1ad30e09.jpg,validate/p14/p14371035/s58557416/2124b625-626af61c-3b22b502-75df0fbb-1ad30e09.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. COMPARISONS: ___ and ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no pleural effusions or pneumothorax. Sequela of prior rib injuries appear unchanged. The bones are probably demineralized to some degree. Severe degenerative changes are noted along the right shoulder. The left humeral head also shows upward subluxation. High-riding humeral heads may indicate underlying rotator cuff pathology. Moderate spinal curvature is also unchanged. IMPRESSION: No evidence of acute disease. " d51adca8-1b835c46-3167ed82-d4380cd2-a33f2f5f.jpg,validate/p13/p13272752/s53806363/d51adca8-1b835c46-3167ed82-d4380cd2-a33f2f5f.jpg,validation," WET READ: ___ ___ ___ 6:35 PM Near complete opacification of the left hemi thorax, likely reflecting left effusion and consolidation, with associated shift of midline structures to the right. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea on exertion COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is near complete opacification of the left hemi thorax, with minimal residual aeration in the left apex. Shift of midline structures to the right is noted. The right lung is clear. Heart size and mediastinal contours difficult to characterize given left hemi thorax opacification. Bony structures are intact. IMPRESSION: Near complete opacification of the left hemi thorax, likely reflecting left effusion and consolidation, with associated shift of midline structures to the right. " d37aac2d-21f90649-22140395-94f45b1a-11c25e19.jpg,validate/p14/p14556716/s51484603/d37aac2d-21f90649-22140395-94f45b1a-11c25e19.jpg,validation," FINAL REPORT INDICATION: Fever and productive cough, question pneumonia. 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. There is an opacity adjacent to the right heart border. IMPRESSION: Opacity adjacent to the right heart border, which may represent a benign fat collection or benign cyst. No pneumonia. " 4a3a37f7-159fe41c-24a0ff64-dabfd2e2-16be702b.jpg,validate/p16/p16887429/s55671526/4a3a37f7-159fe41c-24a0ff64-dabfd2e2-16be702b.jpg,validation," FINAL REPORT HISTORY: Metastatic prostate cancer, to assess for pulmonary lesions. FINDINGS: In comparison with the study of ___, there is little change. Again there is a large hiatal hernia. No acute focal pneumonia or vascular congestion. No definite metastases identified. However, there is the vague suggestion of opacification overlying the most posterior portion of the left fifth rib just above the level of the aortic arch. An apical lordotic view could be considered to determine whether this represents a true finding. At the same time, repeat PA view could be helpful to see whether this appearance merely reflects a fortuitous overlap of shadows. Of incidental note are calcifications in the region of the carotid bifurcations bilaterally. " 8d701ccb-db76aefd-31f9d1ac-b3b0a3c9-62d1bd95.jpg,validate/p11/p11452424/s58394867/8d701ccb-db76aefd-31f9d1ac-b3b0a3c9-62d1bd95.jpg,validation," FINAL REPORT CLINICAL INDICATION: Cough and palpitations. Evaluate for infiltrate. COMPARISON: None. FRONTAL AND LATERAL VIEWS OF THE CHEST: The lungs are hyperexpanded. Calcified densities throughout both lung fields most likely represent pleural plaques. There is moderate cardiomegaly. The aortic knob is calcified. There is no focal opacity, pleural effusion or pneumothorax. " 79ec48fb-5a5fa59d-a4e2fe3f-bed5fe1c-179c05ee.jpg,validate/p11/p11857921/s54442540/79ec48fb-5a5fa59d-a4e2fe3f-bed5fe1c-179c05ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are grossly clear. Vague opacity in the bilateral bases may represent pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Vague bibasilar opacities may represent multifocal pneumonia in the appropriate clinical context. Follow-up examination in ___ weeks is recommended to document resolution. " 669158d1-60b0f5e8-d714ad99-6bb6e038-e431e977.jpg,validate/p17/p17506723/s52449443/669158d1-60b0f5e8-d714ad99-6bb6e038-e431e977.jpg,validation," 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. " 01b99a1d-d88b561d-fd7a36f4-29bd0252-ac47b7b2.jpg,validate/p19/p19778971/s52173724/01b99a1d-d88b561d-fd7a36f4-29bd0252-ac47b7b2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Seizure, evaluate position for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has an unchanged nasogastric tube. The size of the cardiac silhouette is unchanged. Unchanged moderate bilateral pleural effusions, accompanied by parenchymal opacities, most likely atelectatic in origin, but coexisting pneumonia cannot be excluded. No newly appeared focal parenchymal opacities. Unchanged moderate tortuosity of the calcified thoracic aorta. " 65a8df12-9c3a0644-ac80bbc8-5b004c98-c2ae192e.jpg,validate/p19/p19668880/s50088318/65a8df12-9c3a0644-ac80bbc8-5b004c98-c2ae192e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain SOB // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 52c38ae5-92f63029-f309ac19-64924c27-7d22de72.jpg,validate/p10/p10708404/s52428729/52c38ae5-92f63029-f309ac19-64924c27-7d22de72.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with recent opiate overdose, requiring mechanical ventilation. Right pleural effusion or consolidation. IMPRESSION: PA and lateral chest compared to ___: Appearance of the right lower chest on the frontal view is consistent with either basal consolidation or pleural effusion. The lateral projection today shows that the finding is primarily due to severe consolidation of all the basal segments on the right, generally a finding of atelectasis rather than pneumonia. There may be a small accompanying pleural effusion commonly seen with basal atelectasis. Findings do point to aspiration or retained secretions. Left lung is clear. Heart size is normal. " e10dce98-f112a01c-c672648a-0a3a9316-e65f53ff.jpg,validate/p19/p19729398/s50269379/e10dce98-f112a01c-c672648a-0a3a9316-e65f53ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with point tenderness over the right second rib // assess for fracture TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Cardiomediastinal silhouette is stable including post sternotomy wires in replaced aortic valve. . Right pleural effusion is loculated, moderate, unchanged. Lungs are well aerated was no substantial change since the prior study. No abnormality that can explain reported tenderness of the rib demonstrated on the current examination. Pacemaker leads terminate in the expected location of the right ventricle. " 779f07d5-1bb03073-647a3219-d699d2c4-6606861c.jpg,validate/p10/p10871684/s59894670/779f07d5-1bb03073-647a3219-d699d2c4-6606861c.jpg,validation," 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. " 3020df64-0ef1fef9-31bdb4b6-bd057ca3-f436e44f.jpg,validate/p17/p17330198/s59376920/3020df64-0ef1fef9-31bdb4b6-bd057ca3-f436e44f.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Altered mental status for three days. 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. Degenerative changes at the right shoulder joint with some subchondral cyst formation. IMPRESSION: No acute cardiopulmonary process. " 5aaa8a83-23ad02a9-ffd81996-4dd2486b-49ff9c18.jpg,validate/p17/p17107992/s55760890/5aaa8a83-23ad02a9-ffd81996-4dd2486b-49ff9c18.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pressure, worsening with inspiration. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear with the exception of trace linear atelectasis in the left base. There is no pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: Trace left basilar dependent atelectasis. No definite evidence of acute cardiopulmonary process. " bc949339-67a88a2e-c6282a92-113b6b06-d837a552.jpg,validate/p10/p10233307/s52922125/bc949339-67a88a2e-c6282a92-113b6b06-d837a552.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NGT placed, would like to confirm that tip is in the stomach prior to extubation // pls confirm NGT placement pls confirm NGT placement IMPRESSION: There to prior chest radiographs, ___ through ___. Progressive increase in moderate enlargement of cardiac silhouette and mediastinal vascular distention company by new mild pulmonary edema flexed volume overload and/or cardiac decompensation. Greater opacification at both lung bases could be due to combination of atelectasis and dependent edema. Follow up is is advise to exclude pneumonia particularly due to aspiration. ET tube and esophageal drainage tube are in standard placements respectively. Indwelling left jugular dual channel catheter ends at the origin of the SVC, as before. No pneumothorax. " 2af9a321-615c1e42-3b35914f-8f531e71-c25a0433.jpg,validate/p10/p10481190/s52282723/2af9a321-615c1e42-3b35914f-8f531e71-c25a0433.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p R VATS w/ wedge resection, s/p chest tube pull at 7 am. PLEASE DO AT 11AM THANK YOU // eval for PTX eval for PTX IMPRESSION: In comparison with study of ___, the right chest tube is been removed and there is little if any residual pneumothorax. Bibasilar opacification is consistent with atelectatic changes. " 7be42ec4-bed32887-94b05543-0f7d70c2-6f4d67b9.jpg,validate/p13/p13415352/s58627185/7be42ec4-bed32887-94b05543-0f7d70c2-6f4d67b9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. The lung volumes are low, though allowing for this, there is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 2fc5dfa6-74f7c34e-b946719f-2a48c05a-df3c472b.jpg,validate/p14/p14022439/s57167833/2fc5dfa6-74f7c34e-b946719f-2a48c05a-df3c472b.jpg,validation," WET READ: ___ ___ 8:15 PM No pneumothorax. Left lower lobe atelectasis. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest tube removal, to assess for pneumothorax. FINDINGS: In comparison with study of ___, all of the monitoring and support devices have been removed. Specifically, there is no evidence of pneumothorax. Atelectatic changes are seen at the left base. " c4257888-46ed122c-a584eb66-3bb5bb28-ed415109.jpg,validate/p11/p11020337/s53048830/c4257888-46ed122c-a584eb66-3bb5bb28-ed415109.jpg,validation," 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. " 348ebdca-b5874ce0-3a96d783-1f044bbe-ab0f0c80.jpg,validate/p18/p18562338/s53465065/348ebdca-b5874ce0-3a96d783-1f044bbe-ab0f0c80.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with polytrauma and right pneumothorax s/p pigtail placement // ?interval change in pneumothorax COMPARISON: ___. IMPRESSION: SUBSTANTIALLY IMPROVED EXPANSION OF THE RIGHT LUNG OF THE PIGTAIL INSERTION. THE LUNG, HOWEVER, IS STILL NOT FULLY EXPANDED. THE PIGTAIL CATHETER IS IN UNCHANGED POSITION. NO EVIDENCE OF TENSION. UNCHANGED APPEARANCE OF THE HEART AND OF THE LEFT LUNG. " 08669aa2-f0463065-d4588b92-74f8e885-f2aa6065.jpg,validate/p18/p18846518/s54688406/08669aa2-f0463065-d4588b92-74f8e885-f2aa6065.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with O2 requirement , crackles on exam // Assess for effusion, effusion TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable with moderate cardiomegaly. Right lower lobe atelectasis has almost completely resolved. There are no new lung abnormalities. . There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities. Improved right lower lobe atelectasis " 60dbafaa-ae50c873-ef0c0b13-ab14c701-bf928e98.jpg,validate/p16/p16217465/s51880679/60dbafaa-ae50c873-ef0c0b13-ab14c701-bf928e98.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, smoker, increased SOB // eval for resolution of opacity noted in ___ TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are hyperexpanded and clear. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities hyperexpanded lungs. " 27250d0f-670a0685-772d0371-d8ec11ef-45c4aad7.jpg,validate/p17/p17748063/s54189400/27250d0f-670a0685-772d0371-d8ec11ef-45c4aad7.jpg,validation," FINAL REPORT HISTORY: New fevers, assess for pneumonia. COMPARISON: Chest x-ray ___. FINDINGS: Frontal and lateral views of the chest demonstrate fully expanded and clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax or pleural effusion. Pleural surfaces are normal. IMPRESSION: Normal chest x-ray. Specifically, no evidence of pneumonia. " 85eeb1aa-19d9af84-95667b6a-56e2fef5-63fe1730.jpg,validate/p14/p14176606/s54857510/85eeb1aa-19d9af84-95667b6a-56e2fef5-63fe1730.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with left sided back pain // ? ptx, fx TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No fracture identified. IMPRESSION: No acute cardiopulmonary process. " 355eefd0-326a0aeb-adbd223d-890f32cd-3766e3b6.jpg,validate/p17/p17864837/s53127440/355eefd0-326a0aeb-adbd223d-890f32cd-3766e3b6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of tobacco use, fatigue, evaluation for abnormality. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of pathologic changes in the lung parenchyma. " b90c9ce2-5eb65f56-a27c7e86-f470b710-8b910e46.jpg,validate/p10/p10368327/s57068107/b90c9ce2-5eb65f56-a27c7e86-f470b710-8b910e46.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Right internal jugular venous catheter placement. COMPARISONS: Earlier on the same day. TECHNIQUE: Chest, AP supine. FINDINGS: A new right internal jugular central venous catheter terminates at the cavoatrial junction. There is a marked increase in hazy opacification of each lung, suggesting pulmonary edema in addition to layering pleural effusions, probably at least moderate in size on the right and also likely substantial on the left. Retrocardiac opacification is not specific, but would commonly be due to atelectasis. IMPRESSION: Marked worsening of pulmonary edema. Right internal jugular catheters terminating at the cavoatrial junction; no evidence of pneumothorax. " aff7ce69-d595a783-88980e8a-6f566f11-4c1b5f88.jpg,validate/p18/p18815377/s55578116/aff7ce69-d595a783-88980e8a-6f566f11-4c1b5f88.jpg,validation," FINAL REPORT HISTORY: History of right chest wall pain and tenderness status post fall landing on the right side. Evaluate for rib fracture or pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. There is no focal consolidation or pneumothorax. The lungs are well expanded. The cardiomediastinal silhouette is unchanged with mild tortuosity of the descending thoracic aorta. No displaced rib fractures. Clips are present in the neck. IMPRESSION: No displaced rib fractures or acute process. " ba4dfd4d-361f6521-4fc7c0f1-629e3fa0-d11a1ab3.jpg,validate/p14/p14045219/s59411831/ba4dfd4d-361f6521-4fc7c0f1-629e3fa0-d11a1ab3.jpg,validation," WET READ: ___ ___ ___ 12:11 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain, evaluate for acute cardiopulmonary disease. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs from ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. There is no displaced rib fracture. Mild levoscoliosis of the upper thoracic spine is unchanged. IMPRESSION: No acute cardiopulmonary process. " 2e60f98f-a86f94e6-6a9827ec-34e94660-7c17d13b.jpg,validate/p11/p11669958/s56166181/2e60f98f-a86f94e6-6a9827ec-34e94660-7c17d13b.jpg,validation," FINAL REPORT INDICATION: Patient with abdominal pain. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: There are no comparison studies available. FINDINGS: The lung volumes are low with mild secondary widening of the cardiomediastinal silhouette and mild vascular engorgement. There is no pleural effusion. No pneumothorax. No focal lung consolidation. IMPRESSION: No acute cardiothoracic process. " 5c319685-ba7feef9-35c279f8-d1413430-34408356.jpg,validate/p12/p12272471/s51682849/5c319685-ba7feef9-35c279f8-d1413430-34408356.jpg,validation," FINAL REPORT INDICATION: ___-year-old man status post thoracentesis for right-sided effusion, assess for pneumothorax. COMPARISONS: None. TECHNIQUE: Two views of the chest were obtained. FINDINGS: Small-to-moderate residual right-sided pleural effusion is seen, without evidence of pneumothorax. Trace left effusion may also be present. Heart is top normal in size with normal cardiomediastinal contours. Asymmetric opacification of the right base could be due to incomplete reexpansion. IMPRESSION: No pneumothorax and small-to-moderate residual right-sided pleural effusion. " 7eb30932-8842cab6-594aceb0-9600be60-58fdf427.jpg,validate/p15/p15899433/s55245975/7eb30932-8842cab6-594aceb0-9600be60-58fdf427.jpg,validation," FINAL REPORT AP CHEST 11:28 P.M. ON ___ HISTORY: ___-year-old female with a question of stroke or infection. IMPRESSION: AP chest compared to ___: Moderate cardiomegaly is chronic, but mild pulmonary edema is new. Pleural effusions are small if any. " 9da0b743-32e67cdb-d26a27bb-9841d3a8-ff08bcdb.jpg,validate/p13/p13325402/s53045859/9da0b743-32e67cdb-d26a27bb-9841d3a8-ff08bcdb.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient admitted with urosepsis with end-stage renal disease and after transplantation with early pulmonary edema. COMPARISON: CT abdomen from ___ as well as chest radiograph from ___. The left PICC line tip is at the level of mid SVC. The right internal jugular line has been removed. Heart size and mediastinum are unchanged in position including tortuous aorta. Left pleural effusion is redemonstrated with adjacent atelectasis, but no new consolidations have been seen. There is no pulmonary edema. " 15a44186-2507afaf-198be165-418afd3f-8082b5d8.jpg,validate/p18/p18036188/s56700117/15a44186-2507afaf-198be165-418afd3f-8082b5d8.jpg,validation," FINAL REPORT HISTORY: ___-year-old with right pleural effusion, left decortication, check for pneumothorax. TECHNIQUE: Portable AP chest radiograph was obtained with the patient in the semi-erect position. COMPARISON: Chest radiograph from ___. FINDINGS: As compared to the previous chest radiograph, no definite evidence of right pneumothorax is seen. Otherwise, no significant change from the most recent radiograph. Right chest tube is in the apical region, dialysis catheter is unchanged in position, and the left internal jugular central line remains in appropriate position. The cardiac and mediastinal contours are unchanged. No new focal consolidation or pulmonary edema is seen. IMPRESSION: No pneumothorax is seen. " fd9828a6-d1856697-0c899aac-4bbd2cab-8431ef6e.jpg,validate/p19/p19705710/s57861311/fd9828a6-d1856697-0c899aac-4bbd2cab-8431ef6e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: Prior exam dated ___. CLINICAL HISTORY: ___-year-old man with emesis status post fall, question aspiration. FINDINGS: AP portable upright chest radiograph was provided. Bibasilar opacities are unchanged from prior chest radiographs, dating back to ___, likely reflective of atelectasis or scarring. No new consolidation is seen to suggest superimposed aspiration. No large effusions or pneumothorax is seen, though the patient's chin partially obscures the right lung apex. The cardiomediastinal silhouette appears grossly stable. No definite acute bony abnormalities are seen. " 44d9c4b3-552b184e-7a85f6c9-5ea58b1f-7a8844f9.jpg,validate/p16/p16649269/s53415605/44d9c4b3-552b184e-7a85f6c9-5ea58b1f-7a8844f9.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with feeling unwell // ?pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes. 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. " 71025077-81f84c50-80b589a4-5d337cf9-bb6aa772.jpg,validate/p11/p11962176/s54435424/71025077-81f84c50-80b589a4-5d337cf9-bb6aa772.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p duodenal biopsy, now with facial swelling, hematemesis // eval for free air TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: The patient is intubated with the ET tube tip being 4.3 cm above the carinal. Large pneumoperitoneum is demonstrated. There is no definitive pneumothorax although small amount of pneumothorax cannot be excluded in the presence of extensive subcutaneous air. There is also presence of substantial amount of mediastinal air. The subcutaneous air involves chest bilaterally, left more than right as well as the neck. Findings would discussed with Dr. ___ is over the phone by Dr. ___ ___ ___:25 on ___ are 2 minutes after the observation was made " f0b9163d-077eef3f-42c280f9-7ca3d182-0965d5bd.jpg,validate/p17/p17244595/s56014717/f0b9163d-077eef3f-42c280f9-7ca3d182-0965d5bd.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old man with malpositioned L PICC // Please eval position L PICC s/p power flush TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 5 hours earlier. IMPRESSION: Although assessment of the cardiac silhouette is limited, Left PICC tip is likely at thecavoatrial junction. No other interval changes " 638e24cf-f58f78db-f2cb5bf9-1af95ba0-3b6abe19.jpg,validate/p13/p13505755/s50572323/638e24cf-f58f78db-f2cb5bf9-1af95ba0-3b6abe19.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y.o woman with sepsis and respiratory failure, anasarca // compare with prior COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The endotracheal tube, the nasogastric tube and the left central venous access line are constant. The pre-existing right pleural effusion has minimally decreased. The lung volumes remain low. Moderate cardiomegaly and mild to moderate pulmonary edema persist. The retrocardiac atelectasis is unchanged. No new focal parenchymal opacities. " 2bd3ca48-71b45e3f-e7e562fb-0c4cdefc-b5c7dd05.jpg,validate/p16/p16904987/s54429928/2bd3ca48-71b45e3f-e7e562fb-0c4cdefc-b5c7dd05.jpg,validation," 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. " 7f7eb4b1-c63c574b-7e85de99-56ddfc19-adff5644.jpg,validate/p17/p17875843/s56517361/7f7eb4b1-c63c574b-7e85de99-56ddfc19-adff5644.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion s/p pigtail catheter placement; please eval tube position // eval chest tube eval chest tube IMPRESSION: Comparison to ___. The pre-existing right pleural effusion has minimally decreased in extent. The right pigtail catheter is in unchanged position. Moderate cardiomegaly. No pulmonary edema. Unchanged correct alignment of the sternal wires. " d1048191-e796e5be-b08c3e07-2517c488-88b83e3e.jpg,validate/p12/p12479159/s57126624/d1048191-e796e5be-b08c3e07-2517c488-88b83e3e.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with stroke symptoms, question cardiomegaly. COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are low in volume and clear. The cardiac silhouette is normal. The mediastinal silhouette and hilar contours are normal. No pleural effusions or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " 341e3baa-d7a451c0-acc9e456-e9111cf4-894d17dc.jpg,validate/p13/p13954248/s56927208/341e3baa-d7a451c0-acc9e456-e9111cf4-894d17dc.jpg,validation," FINAL REPORT CLINICAL INDICATION: Abdominal pain and shortness of breath. Evaluate for pneumonia and congestive heart failure. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The lungs are clear. The cardiomediastinal silhouette is within normal limits. The osseous and soft tissue structures are unremarkable. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 2747e9ae-d2026d85-02bb0d01-89f339cf-b580c023.jpg,validate/p18/p18345333/s57333417/2747e9ae-d2026d85-02bb0d01-89f339cf-b580c023.jpg,validation," WET READ: ___ ___ ___ 8:42 AM Low lung volumes accentuate the heart size and crowds the pulmonary vascular structures. Bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleurtic chest pain // r/o pneumonia, widened mediastinum (aortic dissection) COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There are bilateral areas of atelectasis. At the lung bases. No larger pleural effusions are seen on the frontal and the lateral radiograph. Moderate cardiomegaly without pulmonary edema. Mild elongation of the descending aorta. No pneumonia, no mediastinal widening " f4fd57cc-1cbe7b71-71b06332-3eb06fda-af537e1f.jpg,validate/p17/p17527875/s52486078/f4fd57cc-1cbe7b71-71b06332-3eb06fda-af537e1f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS wedge // check interval change check interval change IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Bilateral pleural effusions with atelectatic changes in are again much more prominent on the right. No evidence of postoperative pneumothorax. " 4e3a1686-3c49bccc-28907066-eed448a4-41e55c0e.jpg,validate/p16/p16388704/s53503879/4e3a1686-3c49bccc-28907066-eed448a4-41e55c0e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with worsening shortness of breath and cough // Etiology of worsening shortness of breath, ?pulmonary edema vs. pneumonia Etiology of worsening shortness of breath, ?pulmonary edema IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE IS LITTLE INTERVAL CHANGE. NO EVIDENCE OF VASCULAR CONGESTION, PLEURAL EFFUSION, OR ACUTE FOCAL PNEUMONIA. " 8c278722-ae23e193-467fa76e-79cfa056-37777e1e.jpg,validate/p10/p10855190/s59448048/8c278722-ae23e193-467fa76e-79cfa056-37777e1e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 92% O2 sat on RA and bibasilar crackles // eval for pulmonary edema eval for pulmonary edema COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lung volumes are chronically very low, and subsegmental atelectasis is a feature of the left lower lung. There is more vascularity, background interstitial pulmonary abnormality, and bronchial cuffing on the 3 radiographs in ___, ___, ___, and today, than there was in ___. Heart size is borderline enlarged, but not recently so. Therefore is difficult to distinguish between a mild generalized interstitial lung disease and early recurrent congestive heart failure. There is no appreciable pleural effusion. Lateral view shows chronic gibbus deformity in the thoracolumbar spine at the site of moderate and severe compression fractures, not appreciably changed since ___. " 61e6be6a-947bce17-69e2e56d-07dba760-399f3a64.jpg,validate/p12/p12973912/s59099050/61e6be6a-947bce17-69e2e56d-07dba760-399f3a64.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post fall, laceration to the left eyebrow. Question fracture. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits aside from slight unfolding of the thoracic aorta. Slight blunting of each costophrenic sulcus is indeterminate but could reflect tiny effusions. The lateral view suggests interstitial changes, but probably mild, in the periphery of the posterior costophrenic sulci. This may correlate with vague reticular opacities in the lower lungs on the AP view. Otherwise, the lungs appear clear, however. There is no pneumothorax. The bones appear demineralized, but there is no evidence of fracture. Degenerative changes involve the shoulder, where the glenohumeral and acromioclavicular joints appear narrowed with prominent marginal osteophytes bilaterally. There is mild rightward convex curvature centered along the mid thoracic spine with small osteophytes along the thoracic spine. IMPRESSION: No evidence of injury. Findings suggesting mild interstitial abnormalities at the lung bases. Possible trace pleural effusions. " 2366ae1d-cf6f8a0f-9b4d8fb9-d873acc2-2b5c0cc2.jpg,validate/p13/p13875890/s52861116/2366ae1d-cf6f8a0f-9b4d8fb9-d873acc2-2b5c0cc2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p placement of NG tube. CXR to evaluate placement of NG tube. // CXR to evaluate placement of NG tube. CXR to evaluate placement of NG tube. IMPRESSION: Compared to chest radiographs ___ through ___. New region of consolidation in the right upper lobe marginates the minor fissure and a another in the left apex are consistent with progressive pneumonia. Residual pneumonia elsewhere in both lungs is relatively unchanged. No pneumothorax. Heart size normal. Pleural effusion small if any. Tracheostomy tube midline. Left PIC line probably enters the azygos vein. Nasogastric drainage tube ends close to the pylorus. " b0f342d3-2bcfa91f-7e32ecb8-eb22dd49-1b0ff10e.jpg,validate/p19/p19791178/s58452001/b0f342d3-2bcfa91f-7e32ecb8-eb22dd49-1b0ff10e.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. The sternotomy wires are intact. Coronary artery stents and/or calcifications are seen. Mediastinal clips are seen. There is prominence of epicardial fat on the left. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 8f854b98-75982183-c6ce3219-5b10b322-98e24d67.jpg,validate/p12/p12741327/s51900659/8f854b98-75982183-c6ce3219-5b10b322-98e24d67.jpg,validation," FINAL REPORT INDICATION: Chest pain, left arm pain. Evaluate for pneumonia, fluid overload. COMPARISON: Chest radiograph ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: The lungs are normally expanded without focal airspace opacity. There is mild bibasilar atelectasis. There is no pleural effusion or pneumothorax. The convexity of the ascending aortic arch, while similar to ___, is notably more prominent since the next most recent study. The cardiac countour is normal in size. IMPRESSION: 1. Prominent ascending aortic convexity raises the possibility of acute aortic syndrome. 2. Mild bibasilar atelectasis, but no evidence of pneumonia. Updated results telephoned to Dr. ___ by ___ at 8:30 am, ___, 5 minutes after discovery. " f2b7be06-5b7c64a4-603c843d-0e917537-b9c7cdfd.jpg,validate/p13/p13648633/s58677847/f2b7be06-5b7c64a4-603c843d-0e917537-b9c7cdfd.jpg,validation," WET READ: ___ ___ ___ 8:34 PM HISTORY: Male with cirrhosis and non-specific malaise. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Single frontal portable upright chest radiograph. FINDINGS: Mild interval increase in vascular engorgement and bibasilar atelectasis. Heart is top normal in size. Hilar prominence with calcified lymph nodes are seen adjacent to left hilus. No pleural effusion, pneumothorax, or focal opacity. Mediastinal contour is normal. No bony abnormality. IMPRESSION: 1. Mild interval increase in vascular congestion and bibasilar atelectasis. 2. Calcified lymph nodes. Results conveyed via telephone to Dr.___ by Dr.___ on ___ at 4:50PM within 15 minutes of results. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Male with cirrhosis and non-specific malaise. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Single frontal portable upright chest radiograph. FINDINGS: Mild interval increase in vascular engorgement and bibasilar atelectasis. Heart is top normal in size. Hilar prominence with calcified lymph nodes are seen adjacent to left hilus. No pleural effusion, pneumothorax, or focal opacity. Mediastinal contour is normal. No bony abnormality. IMPRESSION: 1. Mild interval increase in vascular congestion and bibasilar atelectasis. 2. Calcified lymph nodes. Results conveyed via telephone to Dr.___ by Dr.___ on ___ at 4:50PM within 15 minutes of results. " bc6cec9d-539f6cb9-0e023225-38e77aa8-0f61b4bb.jpg,validate/p17/p17614057/s53572658/bc6cec9d-539f6cb9-0e023225-38e77aa8-0f61b4bb.jpg,validation," 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. " a44bc7e6-3cb0b88e-77fe394c-53e04954-92b4adfd.jpg,validate/p10/p10476871/s57028851/a44bc7e6-3cb0b88e-77fe394c-53e04954-92b4adfd.jpg,validation," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with the study of ___, the nasogastric tube has been pulled back somewhat. The tip of the NGT is within the stomach. The side hole is in the region of the esophagogastric junction. Therefore, the tube should be pushed forward somewhat. Continued enlargement of the cardiac silhouette. Some fullness of pulmonary vessels is consistent with elevated pulmonary venous pressure. Opacification at the bases suggests some atelectatic change with subpleural effusions. " 4eac5999-c551d3f7-0fe94e7f-a9508f26-a89d4191.jpg,validate/p15/p15022658/s53824621/4eac5999-c551d3f7-0fe94e7f-a9508f26-a89d4191.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PNA in ___, has HIV // eval for PNA resolution eval for PNA resolution IMPRESSION: Comparison to ___. Lung volumes have increased, the previous parenchymal opacity at the right lung basis is no longer visualized. However, a nodular change in the left upper lobe is again visualized. The changes also documented on the CT examination from ___. The lesion should be followed until complete resolution. " 47653917-224e592f-1fbb7cf5-a2e81a48-7595c25d.jpg,validate/p19/p19023232/s59323097/47653917-224e592f-1fbb7cf5-a2e81a48-7595c25d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right pleural effusion s/p thoracentesis. // rule out pneumothorax COMPARISON: ___. FINDINGS: AP portable upright view of the chest. There is a persistent opacity at the right mid to lower hemi thorax now with a pigtail drain in place. Given that the opacity persists, a mass is difficult to exclude and for this reason a CT is recommended to further assess. Mild pulmonary edema is new from prior exam. A tiny left effusion persists. IMPRESSION: Persistent opacity at the right mid to lower lung status post chest tube placement. Recommend CT to further assess. Interval development of mild pulmonary edema. Stable trace left effusion. " 1c71427e-55736381-500689e7-03a6f7a1-c8e8009f.jpg,validate/p12/p12777977/s51593227/1c71427e-55736381-500689e7-03a6f7a1-c8e8009f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___ as well as a chest CT from ___. CLINICAL HISTORY: Weakness, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. Mild bibasilar atelectasis is noted. There is no convincing sign of pneumonia or CHF. No large effusion is seen. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild bibasilar atelectasis. " f30c9384-320a0996-0bcb2ff7-a03a5485-20824807.jpg,validate/p10/p10364180/s51503509/f30c9384-320a0996-0bcb2ff7-a03a5485-20824807.jpg,validation," FINAL REPORT HISTORY: COPD and CHF. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___, and ___. FINDINGS: As compared to the prior examination, there has been mild worsening of the patient's moderate to severe interstitial pulmonary edema. Small bilateral pleural effusions are stable. There is no focal consolidation or pneumothorax. Stable, mild cardiomegaly is noted. Aortic calcifications are seen. The mediastinal and hilar contours are grossly normal. IMPRESSION: Interval worsening of moderate to severe interstitial pulmonary edema, with associated small, bilateral pleural effusions. " 5cec565a-9ac4fe4c-8ba6cf9e-f468ff26-f2e62686.jpg,validate/p16/p16202057/s54127925/5cec565a-9ac4fe4c-8ba6cf9e-f468ff26-f2e62686.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Chest tube placement // r/o R PTC COMPARISON: Chest x-ray from ___ at 05:27 FINDINGS: Compared with earlier the same day, a right-sided pigtail catheter is now seen at the base of the right lung. No gross right-sided effusion is identified -- the previously suspected effusion is significantly decreased in size. No obvious right pneumothorax is detected. Minimal linear atelectasis at the right base is now visible, without other evidence of right base consolidation. On the left, the small effusion with underlying collapse and/or consolidation remains present. Some platelike atelectasis at the junction of the left middle lower zones is new. No pneumothorax is detected. There is upper zone redistribution, without overt CHF. The cardiomediastinal silhouette is either stable or slightly decreased in size, allowing for significant differences in degree of the patient rotation. IMPRESSION: Interval placement of right lung base pigtail catheter, with considerable improvement in the right pleural effusion. No pneumothorax detected. Minimal atelectasis at the right lung base. Persistent left effusion with underlying collapse and/or consolidation. New platelike atelectasis in the lower left lung. " 4a716b59-4357ec5f-b5329da2-4bc67107-7a03858f.jpg,validate/p11/p11119153/s57633778/4a716b59-4357ec5f-b5329da2-4bc67107-7a03858f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pre-op for right carotid endarectomy // Please evaluate Surg: ___ (R CEA) Please evaluate COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Moderate cardiomegaly slightly improved since ___. No pulmonary vascular engorgement or edema. No appreciable atelectasis or pleural effusion. No pneumothorax. " 36eeb68d-0a68f3b9-1fbc0908-b09f2f87-be2b7e1a.jpg,validate/p18/p18079519/s54321985/36eeb68d-0a68f3b9-1fbc0908-b09f2f87-be2b7e1a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea // ?pulm edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and mitral valve replacement. Pericardial calcifications are again seen, best seen on the lateral view. The cardiac silhouette remains mild to moderately enlarged. Aortic knob calcification is seen. The mediastinal contours are stable. There is slight blunting of the posterior left costophrenic angle which may be due to a trace effusion. No focal consolidation is seen. There is no pneumothorax. IMPRESSION: Possible trace pleural effusion. Persistently enlarged cardiac silhouette. " 073692a0-e3eca8f8-b3556a48-6758a75d-c6e3b8d5.jpg,validate/p15/p15805011/s51408396/073692a0-e3eca8f8-b3556a48-6758a75d-c6e3b8d5.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of left chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The diaphragms on the frontal view are somewhat obscured by overlying soft tissue; however, no definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. " a839244e-baac70a0-cc6d57c7-ba5ccf03-540e7203.jpg,validate/p19/p19422993/s53942319/a839244e-baac70a0-cc6d57c7-ba5ccf03-540e7203.jpg,validation," FINAL REPORT INDICATION: Productive cough. COMPARISON: Chest radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The patient is status post median sternotomy. The heart size is normal. The hilar and cardiomediastinal contours are within normal limits. The lungs are hyperinflated, likely reflecting chronic obstructive disease. The central pulmonary vessels are prominent, however, there is no interstitial edema. A left basilar density may reflect a consolidation with a possible effusion. There is no pneumothorax. IMPRESSION: Left lower lobe density concerning for pneumonia. Updated findings were discussed by Dr. ___ with Dr. ___ ___ telephone at 7:34 AM on ___. " 6034c008-a17708e1-00c902bf-22a171e0-bf470297.jpg,validate/p14/p14957008/s58082727/6034c008-a17708e1-00c902bf-22a171e0-bf470297.jpg,validation," WET READ: ___ ___ ___ 8:47 PM Moderate to severe pulmonary edema, significantly increased from ___. Underlying infection cannot be excluded. Findings discussed with Dr. ___ ___ telephone at 20:38 are on ___ by Dr. ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ___'s frequent aspirations now desating to 80s on NRB. // Please evaluate for PNA. Please evaluate for PNA. IMPRESSION: New moderate to severe centralized pulmonary edema. Moderate cardiomegaly. No pleural effusions. " f03ec224-90604902-5d4d52a8-2bd38f3a-4b65bdd6.jpg,validate/p15/p15789074/s50805725/f03ec224-90604902-5d4d52a8-2bd38f3a-4b65bdd6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman on Humira for Crohn's with night sweats // ?infection 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 " 343240da-9705fed3-12feeb08-3874543b-5b6670f0.jpg,validate/p10/p10350392/s53710178/343240da-9705fed3-12feeb08-3874543b-5b6670f0.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with cough. COMPARISON: None. FINDINGS: Two frontal and two lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 5c67767a-2a57dae0-87103a20-e4e547f9-105bd726.jpg,validate/p15/p15353344/s51998965/5c67767a-2a57dae0-87103a20-e4e547f9-105bd726.jpg,validation," FINAL REPORT INDICATION: ___-year-old female admitted for renal cyst fat stranding, found to have a left lower lobe pneumonia on CT, who presents for evaluation. COMPARISONS: CT abdomen and pelvis from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There is an opacity in the left lower lobe which is suggestive of a pneumonia. There is also a faint opacity in the right lower lobe which may correspond to pneumonia. No other focal opacities are seen. The heart size is normal. The hilar and mediastinal contours are unremarkable. The visualized osseous structures are unremarkable. There is no evidence of pneumothorax or pleural effusions. IMPRESSION: Left lower lobe pneumonia. Probable right lower lobe pneumonia. These findings were discussed with Dr. ___ at 12:22pm by Dr. ___ by telephone. " 68f062c9-f78bee32-13bf7bc5-ee2a1f4b-919829e2.jpg,validate/p19/p19441625/s54191315/68f062c9-f78bee32-13bf7bc5-ee2a1f4b-919829e2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, weight gain // evaluate for CHF TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are within normal limits. The pulmonary vasculature is not engorged. Linear opacities within the lung bases bilaterally are compatible with areas of subsegmental atelectasis. Remainder of the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Mild subsegmental bibasilar atelectasis. No evidence for congestive heart failure. " c7427f95-b71d2d11-ed43a341-c13a16db-de503c5a.jpg,validate/p16/p16826047/s57361130/c7427f95-b71d2d11-ed43a341-c13a16db-de503c5a.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with HIV/AIDS, CHF, shortness of breath. COMPARISONS: ___ to ___. FINDINGS: A right pleural effusion has increased since ___ and is now large. The left lung is clear. No left effusion or pneumothorax is present. A right-sided Port-A-Cath tip remains in the mid SVC. Cardiomegaly is unchanged. IMPRESSION: Significant progression of a large right pleural effusion. Discussed with Dr ___ ___ phone at ___. " 190563e0-19ad83b5-9524c03b-c5472042-10832d3e.jpg,validate/p13/p13912710/s52123729/190563e0-19ad83b5-9524c03b-c5472042-10832d3e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p R VATS mediastinal LN bx // eval R PTX eval R PTX IMPRESSION: There is no evidence of post -procedure pneumothorax. Central catheter extends to the lower SVC. There is hyperexpansion of the lungs but no evidence of acute pneumonia or vascular congestion. " 417b04f8-80bb40ac-676c2ce0-4844b638-a717b61f.jpg,validate/p14/p14485079/s54620786/417b04f8-80bb40ac-676c2ce0-4844b638-a717b61f.jpg,validation," WET READ: ___ ___ 9:28 PM persistent small apical PTX. ___ ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after stab above the sternum with left chest tube now back to water seal. PA and lateral upright chest radiographs were reviewed in comparison to ___ obtained at ___ a.m. Left chest tube is in place. Minimal apical pneumothorax is unchanged. Cardiomediastinal silhouette is unchanged. " f32ebb5c-f8930d4e-59f9ed43-a98cef18-43c1f29b.jpg,validate/p15/p15584013/s59929225/f32ebb5c-f8930d4e-59f9ed43-a98cef18-43c1f29b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AML // Increasing cough. Assess for abnormality Increasing cough. Assess for abnormality IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute pneumonia, vascular congestion, or pleural effusion. Right upper lobe scarring is again noted. " cc159b8d-806ee01e-d0527c84-9815a809-0ede1f63.jpg,validate/p10/p10250308/s53086655/cc159b8d-806ee01e-d0527c84-9815a809-0ede1f63.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after biventricular ICD placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. Pacemaker defibrillator leads terminate in the expected location of right atrium and right ventricle, and most likely left ventricle epicardial vein, with appearance as expected based on the desired location. No break in the leads is seen. There is no pneumothorax. Heart size and mediastinum are unchanged in appearance including tortuosity of the descending aorta. Lungs are essentially clear with no pleural effusion. " f7f67afb-ab8b0af4-073a0eed-2552d7b5-19eba55b.jpg,validate/p18/p18170845/s58625164/f7f67afb-ab8b0af4-073a0eed-2552d7b5-19eba55b.jpg,validation," FINAL REPORT INDICATION: ___M with cirrhosis who presents with abdominal distention // eval for pneumonia TECHNIQUE: PA and lateral views of 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. Surgical clips are noted in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 394eeb6d-a6546d00-7ea0291c-5ce5b258-0e3615e6.jpg,validate/p10/p10131482/s58952759/394eeb6d-a6546d00-7ea0291c-5ce5b258-0e3615e6.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: The left costophrenic angle is incompletely imaged on frontal view. No focal consolidation, pleural effusion, or pneumothorax is seen. Mild interstitial prominence is likely chronic, most commonly due to smoking or other respiratory irritant. Heart and mediastinal contours are within normal limits. IMPRESSION: Mild interstitial abnormality, probably not related to the patient's acute chest pain. " f5a21b31-f21e8b50-da4f8ef7-7c4a98fd-2b04d16a.jpg,validate/p12/p12816661/s51812456/f5a21b31-f21e8b50-da4f8ef7-7c4a98fd-2b04d16a.jpg,validation," FINAL REPORT INDICATION: Hypertension with bolus of food obstructed. Evaluation for esophageal obstruction. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. The lungs are clear. There is no pleural effusion. No esophageal distention is visible. The heart size is top normal. IMPRESSION: No acute cardiopulmonary process. " 4405b529-d230819d-096d8a07-d3e9749a-f78c09c0.jpg,validate/p10/p10019003/s56482942/4405b529-d230819d-096d8a07-d3e9749a-f78c09c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with h/o undifferentiated myeloproliferative disorder admitted for aspiration event during EGD with hypoxia and fevers // f/u aspiration f/u aspiration IMPRESSION: ET tube tip is 5 cm above the carinal. NG tube tip is in the stomach. There is interval improvement of left basal atelectasis but still there is a persistent left perihilar opacities that might represent residua of aspiration or developing pneumonia. Reassessment of the patient in ___ hr is recommended. Mild vascular enlargement is not excluded. " b108beae-b1bbec51-431cee88-6a5ecfdd-69a85a45.jpg,validate/p14/p14763475/s51478615/b108beae-b1bbec51-431cee88-6a5ecfdd-69a85a45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // ?pna COMPARISON: ___ IMPRESSION: No relevant change as compared to the prior image. No evidence of pneumonia, no other pathologies of the lung parenchyma. Normal size of the cardiac silhouette. No pleural effusions. " 15319403-2dbb80b4-927c6668-7352a558-975f3f66.jpg,validate/p14/p14787420/s57607301/15319403-2dbb80b4-927c6668-7352a558-975f3f66.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Shortness of breath, evaluate for pneumonia. FINDINGS: PA and lateral views of the chest were provided. Bilateral pectoral deep brain stimulator devices are again noted. Lungs are clear bilaterally. No focal consolidation to suggest pneumonia. No effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " e37c0b9e-8c53f59a-a067d9df-eb672b15-9f048abb.jpg,validate/p17/p17550028/s53071392/e37c0b9e-8c53f59a-a067d9df-eb672b15-9f048abb.jpg,validation," FINAL REPORT INDICATION: ___ year old man with left lung collapse s/p bronch x2. Assess for pulm re-expansion TECHNIQUE: Portable semi-upright AP chest COMPARISON: Multiple chest radiographs from ___ FINDINGS: Right internal jugular central venous catheter is in the upper SVC. Enteric tube courses into the stomach. The ET tube is 3.4 cm from the carina. Right PICC line is in the upper right atrium. There is persistent collapse of the left lower lobe. Opacities in the left mid and upper lung are slightly improved, however there are worsening opacities at the right base likely reflecting worsening mild pulmonary edema. Moderate cardiomegaly is unchanged. There is no pneumothorax. Small bilateral pleural effusions are likely unchanged. There is no pneumothorax. IMPRESSION: 1. Persistent collapse of the left lower lobe. 2. Worsening mild pulmonary edema with stable moderate cardiomegaly. 3. Unchanged small bilateral pleural effusions. " 1dc7b9ce-8258cd72-9c74f889-73aedf2a-93859238.jpg,validate/p18/p18699864/s55486487/1dc7b9ce-8258cd72-9c74f889-73aedf2a-93859238.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with dyspnea, 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. Lungs are hyperinflated, but clear. There is no pneumothorax or pleural effusion. There is no acute osseous abnormality. IMPRESSION: Hyperinflated, but clear lungs. " 89f2201c-32f98b80-626ac104-ef4451e2-53019f35.jpg,validate/p16/p16829454/s53985873/89f2201c-32f98b80-626ac104-ef4451e2-53019f35.jpg,validation," FINAL REPORT HISTORY: Nausea vomiting. Question pneumonia. COMPARISON: None FINDINGS: The lungs are grossly clear. The cardiac silhouette is normal in size. There are no hilar or mediastinal abnormalities. There is no evidence of pneumonia, pneumothorax, pulmonary edema, or pleural effusion. IMPRESSION: No evidence of acute pulmonary process. " 2283312c-c459e9b4-90f76077-d397e855-0fc79275.jpg,validate/p17/p17062932/s55659052/2283312c-c459e9b4-90f76077-d397e855-0fc79275.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiographs of one day earlier. FINDINGS: Bilateral pigtail pleural catheters remain in place, with small, slightly improved bilateral pleural effusions, but no visible pneumothorax. Bibasilar lung opacities have also slightly improved and likely represent atelectasis. Interval removal of right-sided vascular catheters, with no visible pneumothorax. Otherwise, no relevant short interval changes. " db09ac36-abb306c0-11b9f94c-ed81893c-34236b02.jpg,validate/p10/p10297774/s59326831/db09ac36-abb306c0-11b9f94c-ed81893c-34236b02.jpg,validation," WET READ: ___ ___ ___ 12:10 PM No evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dizziness/weakness // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The patient is status post CABG with sternotomy wires that are intact appropriately aligned. There is a left pectoral pacemaker with leads appropriate and unchanged in position since ___. There is stable enlargement of the cardiomediastinal silhouette. No focal consolidations. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. No evidence of pneumonia. 2. Stable enlargement of the cardiomediastinal silhouette status post CABG. " c830f5bb-3aee3a50-d7b22761-7aeffa35-9e2c3180.jpg,validate/p10/p10967333/s55467188/c830f5bb-3aee3a50-d7b22761-7aeffa35-9e2c3180.jpg,validation," 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. " 333a893d-db1fda48-3ac48703-216e37fd-c1793b6f.jpg,validate/p15/p15753793/s56579779/333a893d-db1fda48-3ac48703-216e37fd-c1793b6f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent hypoxemia. // etiology of underlying hypoxemia TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ and ___ IMPRESSION: Cardiomegaly is substantial involving all chambers. Patient continues to demonstrate bilateral upper lobe predominant but also lower lobe opacities, that are progressing as compared to ___ and might potentially represent fluctuating pulmonary edema although infectious process is a possibility. Bilateral pleural effusion is noted, small. Infectious process in particular in the right upper lobe is a possibility as well although on the other hand that might represent mitral regurgitation, correlation with echocardiography is required Pacemaker defibrillator lead terminates in the right ventricle. " 65b2cd25-7cc16dc7-5713d011-a640cb0f-2f5e7e2c.jpg,validate/p11/p11437035/s54485138/65b2cd25-7cc16dc7-5713d011-a640cb0f-2f5e7e2c.jpg,validation," WET READ: ___ ___ ___ 3:49 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with sob and cough // Pneumonia? 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 acute osseous abnormalities are identified. A left paravertebral opacity at the level of the mid thoracic spine represents a prominent osteophyte. IMPRESSION: No acute cardiopulmonary process. " 53a422ed-cea5856a-2c235057-3d6687ee-8f67cf45.jpg,validate/p12/p12045067/s56477464/53a422ed-cea5856a-2c235057-3d6687ee-8f67cf45.jpg,validation," WET READ: ___ ___ 10:13 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with fever, post-operative day 1 after foot surgery. IMPRESSION: PA and lateral chest compared to pre-operative chest radiograph ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. No appreciable atelectasis or pneumonia. " c02f831c-e7cb2fdc-1820df19-15e75185-71499ef0.jpg,validate/p11/p11098660/s59312206/c02f831c-e7cb2fdc-1820df19-15e75185-71499ef0.jpg,validation," FINAL REPORT INDICATION: History: ___M with dypsnea // acute cardiopulm disease TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___. FINDINGS: Moderate to severe cardiomegaly is unchanged. There is no focal consolidation, pleural effusion, or pneumothorax. Sternotomy wires and mediastinal clips are stable. IMPRESSION: Stable moderate to severe cardiomegaly. Otherwise unremarkable. " 7a645c32-6157a832-f77ac788-8cb195a5-6b04cd6c.jpg,validate/p13/p13609730/s55362161/7a645c32-6157a832-f77ac788-8cb195a5-6b04cd6c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, ___ edema, SOB // pulmonary edema TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. There is no evidence of pulmonary edema " 5ca31c1f-666513d7-0551690a-63d62b06-9967a5fd.jpg,validate/p12/p12773009/s50757369/5ca31c1f-666513d7-0551690a-63d62b06-9967a5fd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CLL, AFib, CHF. Here with AMS, subdural and leukocytosis. ? Infection // r/o pulmonary infection COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung volumes have slightly decreased, causing mild areas of atelectasis at the lung bases, right more than left. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. No pneumothorax. " fce03393-43fefd9d-46ceb64e-b60b2c58-6a7584d6.jpg,validate/p11/p11517525/s50685832/fce03393-43fefd9d-46ceb64e-b60b2c58-6a7584d6.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with recent pneumonia, followed by pleural effusion. IMPRESSION: PA and lateral chest compared to most recent prior chest radiograph, ___: Lungs are well expanded and clear. The heart is moderately enlarged. Peripheral pulmonary vasculature is normal. Both hila are enlarged and lobulated, reflecting adenopathy that has been present according to CT findings, since at least ___. Extent of mediastinal adenopathy at that time is consistent with current radiologic findings. There is no pneumonia. " e5ca4669-695d6a23-edb22c97-54d32789-7c39c505.jpg,validate/p13/p13812710/s57368912/e5ca4669-695d6a23-edb22c97-54d32789-7c39c505.jpg,validation," 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 ___. " 1b1fd740-0bd686a0-735d1326-1e03ceb3-6d2347c2.jpg,validate/p14/p14493120/s54097911/1b1fd740-0bd686a0-735d1326-1e03ceb3-6d2347c2.jpg,validation," FINAL REPORT HISTORY: Left-sided pleuritic chest pain. Rule out pneumothorax or infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size. The mediastinal and hilar contours are normal. No pleural effusion or pneumothorax. Calcified granulomas are noted. The lungs are otherwise clear. IMPRESSION: No pneumothorax or pneumonia " 13fd09d4-8b826ddb-90a32c47-a544f6b7-be950e12.jpg,validate/p16/p16041782/s55669693/13fd09d4-8b826ddb-90a32c47-a544f6b7-be950e12.jpg,validation," WET READ: ___ ___ ___ 7:46 AM Prominence of bilateral hila suggesting underlying adenopathy or central consolidation. Dedicated chest CT could be considered for further evaluation. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with fever, cough, evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Mediastinal widening in the right paratracheal and aorticopulmonary window is accompanied by bilateral hilar enlargement with lobulated contours. There is no pleural effusion, pulmonary edema, or pneumothorax. The heart is not enlarged. IMPRESSION: Findings concerning for mediastinal and bilateral hilar lymphadenopathy, potentially due to sarcoid. Differential diagnosis includes other causes of lymphadenopathy infection such as TB and lymphoma, as well as prominent vasculature simulating lymph node enlargement. Dedicated contrast enhanced chest CT could be considered for further evaluation. RECOMMENDATION(S): Contrast-enhanced chest CT NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 8:59 AM, 15 minutes after discovery of the findings. " cc733389-4d735235-36be426e-66647e5b-849f80ec.jpg,validate/p17/p17175688/s58206031/cc733389-4d735235-36be426e-66647e5b-849f80ec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ TECHNIQUE: Single frontal view of the chest COMPARISON: Enlargement of the cardiomediastinal silhouette is grossly stable, given differences in lung volumes. There are relatively low lung volumes. No focal consolidation is seen. There is no pleural effusion or pneumothorax. FINDINGS: No significant interval change. " 6b9d8fea-e5614ed0-4171256c-26b11515-45665021.jpg,validate/p14/p14417189/s57751526/6b9d8fea-e5614ed0-4171256c-26b11515-45665021.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with worsening cough, sob, rhonchi throughout // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: No priors FINDINGS: The cardiomediastinal shadow is normal. No pleuropulmonary disease. No sinister bony lesions. IMPRESSION: Essentially normal chest radiograph. " 48f65bd6-fd930f65-27b3123b-39cb33cc-049a89be.jpg,validate/p11/p11226572/s53521127/48f65bd6-fd930f65-27b3123b-39cb33cc-049a89be.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with sarcoid and COPD with worsening productive cough. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are hyperinflated. Multifocal bilateral opacities are concerning for multifocal pneumonia atypical infection or viral infection. No pleural effusion, edema, or pneumothorax. Heart size is normal. Hilar contours are unchanged. No mediastinal widening. IMPRESSION: Multifocal pneumonia, atypical or viral. NOTIFICATION: Dr. ___ was paged on ___ at 4:40 PM, 15 minutes after discovery of the findings, but response was still pending at the time of this dictation. Therefore, the impression and recommendation above was entered by Dr. ___ on ___ at ___:54 into the Department of Radiology critical communications system for direct communication to the referring provider. " a5deb33e-2dd6976b-9628651a-ed64a0fd-3ec2cc92.jpg,validate/p13/p13688556/s57146592/a5deb33e-2dd6976b-9628651a-ed64a0fd-3ec2cc92.jpg,validation," 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. " 414512cf-1b97a357-a011787a-b8d1ad04-d74463fd.jpg,validate/p19/p19802326/s55138549/414512cf-1b97a357-a011787a-b8d1ad04-d74463fd.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with hypoxia and altered mental status. Question pneumonia. COMPARISON: ___. FINDINGS: Single frontal view of the chest demonstrates a prominent cardiac silhouette, likely accentuated by AP technique. The mediastinal and hilar contours are within normal limits. There is new increased left greater than right bibasilar opacities, which could reflect developing pneumonia in the appropriate clinical setting, alternatively aspiration could have a similar appearance. There may be trace left effusion. There is no pneumothorax. Pulmonary vascular congestion is mild. IMPRESSION: New left greater than right bibasilar opacities could reflect infection versus aspiration. Findings paged to Dr. ___ at pager #___ at 17:30 on ___. " 9188d253-7432f199-b8668189-c4b015e6-24ed4f79.jpg,validate/p17/p17962324/s59875098/9188d253-7432f199-b8668189-c4b015e6-24ed4f79.jpg,validation," FINAL REPORT HISTORY: Hypoxic with ambulation. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple chest radiographs, The most recent on ___. FINDINGS: An opacity at the base of the right lung is not similar in appearance to chest radiograph on ___ and may represent overlapping structures. However, an opacity in the retrocardiac clear space on the left is new. Additionally, there is an opacity at the left posterior costophrenic The cardiomediastinal silhouette and hilar contours are normal. There is no pneumothorax. Sternotomy wires and surgical clips are again seen and not significantly changed in appearance. IMPRESSION: Left basilar opacity which could be compatible with infection. Recommend repeat imaging after treatment. If no clincal concern for infection, consider chest CT for further evaluation. " 93e6f1ce-4067550f-38909ae3-910ab844-c93b59ad.jpg,validate/p11/p11250426/s57817361/93e6f1ce-4067550f-38909ae3-910ab844-c93b59ad.jpg,validation," WET READ: ___ ___ ___ 3:54 PM Calcified pleural plaques. Although there is no prior to assess for interval change, there is suspected superimposed consolidation at the right lung base which could represent pneumonia. Correlation with prior exams would be helpful to assess for interval change. Followup will be necessary. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with productive cough, dyspnea // evaluate for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There are calcified pleural plaques particularly at the lung bases. Linear opacities in the retrocardiac region on the lateral view is also suggestive of a calcified pleural plaque, likely localizing to the right mid/upper lung on the frontal view. There are some regions of opacity particularly at the right lung base medially which could represent a superimposed consolidation within the lungs. Blunting of the lateral costophrenic angles on both sides may be due to chronic scarring versus small underlying effusions. Cardiac silhouette is top normal in size. Left chest wall dual lead pacing device is identified. IMPRESSION: Calcified pleural plaques. Although there is no prior to assess for interval change, there is suspected superimposed consolidation at the right lung base which could represent pneumonia. Correlation with prior exams would be helpful to assess for interval change. Followup will be necessary. " 12efdf4e-59090cd9-ffa8047a-0133277b-02e49a4d.jpg,validate/p12/p12738736/s52790177/12efdf4e-59090cd9-ffa8047a-0133277b-02e49a4d.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and edema. Question effusion. COMPARISON: None. 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 or pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " d2ed2c26-4fd1f532-5795373e-efccf959-0e91d0e1.jpg,validate/p16/p16454295/s58902143/d2ed2c26-4fd1f532-5795373e-efccf959-0e91d0e1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with recent kidney/pancreas transplant, fever, cough // evaluate for pneumonia COMPARISON: Chest radiographs ___ through ___ aligned non in ___. IMPRESSION: Chest radiographs over the preceding 4 months show chronic recurrent pulmonary edema, most recently ___. The edema present at that time might obscure some but probably not all of the heterogeneous peribronchial infiltration and consolidation seen in both the right mid and right lower and left suprahilar wall lungs. Given the clinical history, pneumonia should be the fi normal size. There is no pleural effusion. Consideration, but if there is failure to resolve with antibiotics PTLD should be considered. Heart is normal size. There is no pleural effusion. NOTIFICATION: Dr. ___ reported the findings to DR. ___ By telephone on ___ at 10:29 AM, 10 minutes after discovery of the findings. " 1104ad04-c3a37465-6a1c572f-e65bcb91-6c69d1a0.jpg,validate/p16/p16946732/s57026365/1104ad04-c3a37465-6a1c572f-e65bcb91-6c69d1a0.jpg,validation," WET READ: ___ ___ ___ 8:46 PM Clear lungs. Endotracheal tube in appropriate position. Enteric tube in the stomach. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fevers, persistent vent requirements // eval for infiltrate, ET placement eval for infiltrate, ET placement IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lungs low in volume but clear. Previous pulmonary edema has resolved. No appreciable pleural effusion. Heart size normal. ET tube in standard placement. Right central venous infusion catheter ends in the low SVC. Severe osseous sclerosis due to either metabolic bone disease or widespread metastasis. " 31c7145a-bc952ff0-ad9037a8-6b884fbe-bc918022.jpg,validate/p10/p10267709/s55427191/31c7145a-bc952ff0-ad9037a8-6b884fbe-bc918022.jpg,validation," FINAL REPORT INDICATION: ___-year-old man status post intubation. TECHNIQUE: Frontal chest radiographs were obtained with the patient in the supine position. COMPARISON: Radiograph from ___ and ___. FINDINGS: An endotracheal tube terminates in appropriate position, and an enteric tube terminates in the stomach. The patient is status post median sternotomy and CABG. The lung volumes cause crowding of the bronchovascular structures. There are bibasilar opacities which may represent aspiration. IMPRESSION: Appropriate position of endotracheal tube and enteric tube. Bibasilar opacities may represent aspiration. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:14 AM, after wet read change. " d215d6c0-fadea97b-018bb522-88ee4da8-9108908e.jpg,validate/p12/p12734486/s54869911/d215d6c0-fadea97b-018bb522-88ee4da8-9108908e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fevers // pls eval for PNA pls eval for PNA IMPRESSION: In comparison with the study of ___, the obliquity of the patient has decreased. Cardiac silhouette is again enlarged with elevation of pulmonary venous pressure and bibasilar opacification consistent with pleural fluid and atelectasis, especially involving the left lower lobe. The right IJ catheter has been removed. Endotracheal tube remains in good position. The nasogastric tube can only be followed to the upper stomach, where it crosses the lower margin of the image. " 9f9d0a3c-8349477a-e2a940cd-09850c7f-cea1b7d8.jpg,validate/p15/p15889331/s54078637/9f9d0a3c-8349477a-e2a940cd-09850c7f-cea1b7d8.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY OF ___. COMPARISON: Radiograph of ___. FINDINGS: As compared to the recent study, there has been little change in the appearance of the chest except for a worsening left retrocardiac opacity which could reflect atelectasis and/or infectious consolidation accompanied by an adjacent persistent small left pleural effusion. " e5d52718-ab784ced-6690332c-9f02d555-0ac03b87.jpg,validate/p10/p10110764/s50947907/e5d52718-ab784ced-6690332c-9f02d555-0ac03b87.jpg,validation," FINAL REPORT PORTABLE CHEST FROM ___ AT 5:11 CLINICAL INDICATION: ___-year-old with distal colonic perforation status post sigmoid colectomy, now with fevers. Comparison to prior study dated ___. Portable semi-erect chest film ___ at 5:12 is submitted. IMPRESSION: 1. Left subclavian central line, endotracheal tube and nasogastric tube are in unchanged position. Overall cardiac and mediastinal contours are stable. There are layering bilateral effusions with associated patchy opacities at both bases suggestive of patchy atelectasis, although a superimposed infectious process cannot be entirely excluded. No evidence of pulmonary edema. No large pneumothoraces. The mediastinal contours are stable. Overall, there has been no significant interval change. " 99cf57d1-850e95da-c9b9c05a-451892b8-8b7c7e7a.jpg,validate/p19/p19898586/s51031326/99cf57d1-850e95da-c9b9c05a-451892b8-8b7c7e7a.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old male with fevers and choledocholithiasis, tachycardia and cough. Assess for pneumonia. FINDINGS: The heart size has left ventricular prominence. There are no signs for overt pulmonary edema. There are some hazy densities at the left base likely representing atelectasis as opposed to focal infiltrates. No pneumothoraces are identified. Bony structures demonstrate old healed fractures of the left lateral clavicle and degenerative changes of the left glenohumeral joint. " 430cbfbc-7307ccf2-d39ed488-9a78e4e4-3f3b2ae0.jpg,validate/p11/p11455001/s57599663/430cbfbc-7307ccf2-d39ed488-9a78e4e4-3f3b2ae0.jpg,validation," FINAL REPORT HISTORY: Hiatal hernia repair, to assess for pneumothorax. FINDINGS: No previous images. There is extensive subcutaneous gas along the lateral chest walls extending into the neck. Gas in the pectoral region makes evaluation of the upper lungs somewhat difficult, though no substantial pneumothorax is present. Mild atelectatic changes are seen at the bases. " 5baf34e2-2f8c6f3a-bf6d357b-e48cb597-dedc00b4.jpg,validate/p15/p15245907/s59503589/5baf34e2-2f8c6f3a-bf6d357b-e48cb597-dedc00b4.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with pneumonia, evaluation for pulmonary edema. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: Mild pulmonary edema and right lower lung minimal opacity have improved. Mediastinal and cardiac contours are unremarkable in this patient with chronic left hemidiaphragm elevation. There is no pleural effusion or pneumothorax. CONCLUSION: Mild pulmonary edema and right lower lung opacity have improved. " c1f8a6de-acf2df9b-eb5ce6f4-cbe235e5-83f59d06.jpg,validate/p18/p18246895/s51763716/c1f8a6de-acf2df9b-eb5ce6f4-cbe235e5-83f59d06.jpg,validation," 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. ___. " 0afc619f-9dc6c0a8-8cb8b548-2360dd62-3be83770.jpg,validate/p14/p14502109/s58365465/0afc619f-9dc6c0a8-8cb8b548-2360dd62-3be83770.jpg,validation," 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. " 0bf4ce04-1a1975cb-30d2e4c3-72803b59-f383d941.jpg,validate/p12/p12056668/s59247330/0bf4ce04-1a1975cb-30d2e4c3-72803b59-f383d941.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old status post hiatal hernia repair with lots of crepitus, evaluate for pneumothorax. Comparison is made to the patient's previous study dated ___ at 835. Portable AP supine chest film on ___ at ___ is submitted. IMPRESSION: 1. Endotracheal tube has its tip 5 cm above the carina. Right subclavian PICC line continues to have its tip in the mid SVC. There has been interval appearance of extensive subcutaneous emphysema. There continues to be elevation of the left hemidiaphragm with lucency beneath it likely corresponding to distended bowel. No definite pneumothorax is seen on this supine film, although the sensitivity to detect a pneumothorax is diminished given supine technique. There are likely small layering effusions and bibasilar patchy opacity which may reflect partial lower lobe atelectasis. Followup imaging in the upright or semi-erect position may be helpful to exclude an underlying pneumothorax. No pulmonary edema. " b6d74c1f-f33afea0-36c57d9d-f22e322a-dc06b71d.jpg,validate/p11/p11636284/s59208918/b6d74c1f-f33afea0-36c57d9d-f22e322a-dc06b71d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: This patient is status post median sternotomy, mitral and aortic valve replacements. Heart size is normal. Mediastinal and hilar contours are within normal limits. Minimal scarring is seen within the right mid lung field. The lungs are clear. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is detected. There are no acute osseous abnormalities. Two clips project over the region of the right neck. IMPRESSION: No acute cardiopulmonary abnormality. " 85e8a603-b0fe87ef-9868f5ef-5ac5dbaa-4c535457.jpg,validate/p12/p12303894/s51706745/85e8a603-b0fe87ef-9868f5ef-5ac5dbaa-4c535457.jpg,validation," 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. " 2c0dd038-38964e4c-87447b05-ba6def10-e0db4c61.jpg,validate/p13/p13585638/s57115775/2c0dd038-38964e4c-87447b05-ba6def10-e0db4c61.jpg,validation," FINAL REPORT HISTORY: Liver malignancy, to assess for pleural disease. FINDINGS: No previous images. The heart is normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. No evidence of parenchymal, pleural, or skeletal malignancy. " a7ad88ab-b0ff8ad5-8e50f820-4b34b177-a7d6252a.jpg,validate/p13/p13176838/s53729646/a7ad88ab-b0ff8ad5-8e50f820-4b34b177-a7d6252a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with recent admission for febrile neutropenia and presumed taxol reaction/hypersensitivity pneumonitis. BAL + for AFB // Eval progression of pneumonitis. Eval evidence of mycobacterial disease TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. FINDINGS: The left-sided Port-A-Cath terminates in the cavoatrial junction. The cardiomediastinal silhouette is unremarkable. The previously seen retrocardiac opacity has nearly resolved. There are no new focal consolidations. There is no pulmonary edema, pneumothorax, or pleural effusions. IMPRESSION: Nearly resolved left lower lobe pneumonia. " cc82416d-8a8366f6-91dfc709-8f9190b1-824b68d5.jpg,validate/p19/p19388814/s50735678/cc82416d-8a8366f6-91dfc709-8f9190b1-824b68d5.jpg,validation," 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. " c500b0df-e46e34b3-f69d4b5c-f1b5ee65-fb061908.jpg,validate/p17/p17042687/s52774964/c500b0df-e46e34b3-f69d4b5c-f1b5ee65-fb061908.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Status post colectomy with fever. FINDINGS: There is free air under the right hemidiaphragm compatible with the patient's history of recent colectomy. There is small left pleural effusion. There is no focal infiltrate. " 07088624-06c8d27a-12fc3277-ec9fa149-4432bb25.jpg,validate/p14/p14359057/s54610360/07088624-06c8d27a-12fc3277-ec9fa149-4432bb25.jpg,validation," FINAL REPORT INDICATION: Urinary tract infection with sepsis. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal chest radiograph. FINDINGS: A right IJ catheter has been retracted to the upper SVC. An endotracheal tube terminates 4.8 cm above the carina. Orogastric tube terminates within the stomach. The heart size is normal. The hilar and mediastinal contours are unchanged since the ___ examination. There is no pneumothorax. A persistent left retrocardiac opacity reflects atelectasis versus focal consolidation. A small left pleural effusion is unchanged. IMPRESSION: 1. Unchanged left retrocardiac opacity and small left pleural effusion, reflecting possible consolidation. 2. No new pulmonary opacity. " 2dff4eaa-b35c46b5-eb43eab8-c7edf95f-4743d619.jpg,validate/p15/p15784687/s59869395/2dff4eaa-b35c46b5-eb43eab8-c7edf95f-4743d619.jpg,validation," WET READ: ___ ___ 9:08 PM low lung volumes. mild perihilar vascular congestion. right lung base heterogeneous opacities, atelectasis or infection in the appropriate clinical setting. ___ ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with shortness of breath, question congestion. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Heart is moderately enlarged, pulmonary vasculature engorged, and interstitial abnormality at the lung base is probably mild edema. Small bilateral pleural effusions are dependent, and probably minimize the visual impact of mild hyperinflation. A cluster of smaller irregular opacities in the axillary region of the right lung are of uncertain chronicity and significance, and should be evaluated at least with repeat chest radiographs over the next several weeks. CT scanning may ultimately be necessary unless prior imaging can be obtained. Transvenous right atrial and right ventricular pacer leads are continuous from the left axillary generator. No pneumothorax. " 7216fa3d-21d5105b-64a9ad4f-f3e994bb-a8a73097.jpg,validate/p11/p11054411/s57222918/7216fa3d-21d5105b-64a9ad4f-f3e994bb-a8a73097.jpg,validation," FINAL REPORT INDICATION: Severe pancreatitis and chest pain. Evaluate for pleural effusion. COMPARISON: None available. TECHNIQUE: Portable upright chest radiograph. FINDINGS: The lungs are well expanded. Bibasilar ill-defined opacities are present, more conspicuous in the right lower lung in a paramediastinal location, with mild peribronchovascular thickening in these areas. There is no pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are grossly unremarkable, allowing for slight high positioning of the aortic knob, unchanged, and probable scattered atherosclerotic calcification. Note is made of an old healed left posterior rib fracture and ? old healed right ___ rib fx. No obvious acute rib fxs detected on these lung technique films. A right-sided IJ line ends in the right atrium, approximately 5 cm below the cavoatrial junction. IMPRESSION: 1. Bibasilar opacities, right worse than left, suggestive of pneumonia versus aspiration. 2. IJ line ends in the right atrium. Withdrawal of approximately 5 cm is recommended for placement in the lower superior vena cava. 3. No gross pleural effusion identified. A small effusion might not be apparent on this view. " 5e3b8f6e-d34c0048-01b3f88e-25a96ba0-a5dd9cf1.jpg,validate/p14/p14743875/s57597283/5e3b8f6e-d34c0048-01b3f88e-25a96ba0-a5dd9cf1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with Chiari malformation and chronic R sided weakness presenting with presyncopal episode/episode of weakness at routine MD appt as well as concern for UTI // ? Pneumonia ? Pneumonia IMPRESSION: In comparison with the study of ___, there is again hyperexpansion of the lungs with postoperative changes with scarring in the right upper lobe. And the impression on the right cside of the lower cervical trachea is less prominent. No evidence of acute pneumonia or vascular congestion. " d3c1d94d-d386e994-bb283b75-3118be5b-507a2a06.jpg,validate/p12/p12801688/s56388345/d3c1d94d-d386e994-bb283b75-3118be5b-507a2a06.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Ulcerative colitis, leukocytosis and potential bowel perforation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size and shape of the cardiac silhouette. Normal appearance of the lung parenchyma. No pleural effusions. No hilar or mediastinal lymphadenopathy. Normal course and position of a left-sided PICC line. " 195a74c3-5228baf2-4e66f5b5-da8c718f-03dcd675.jpg,validate/p17/p17960552/s54631957/195a74c3-5228baf2-4e66f5b5-da8c718f-03dcd675.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with + PPD, no symptoms needs cxr to confirm no active TB // pls eval- no active TB COMPARISON: ___ IMPRESSION: No change as compared to the prior image. Normal size of the heart. No pleural effusions. Normal appearance of the lung parenchyma. No active or non-active TB. " 3adf8a3f-a43615dd-9c349397-209e7b66-1fad52cb.jpg,validate/p15/p15280647/s55641996/3adf8a3f-a43615dd-9c349397-209e7b66-1fad52cb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o prostate Ca. Now with unexplained ___ lb. weight loss // r/o underlying pathology COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. No evidence of lung parenchymal pathologies, in particular no evidence of primary or secondary neoplastic disease. The sagittal diameter of the thorax is slightly increased, potentially suggesting overinflation. No pleural effusions. If clinical symptoms persist, CT should be performed, given the higher sensitivity in the detection of small or mediastinal lesions. " c52b94bb-fab4f7b9-821403ec-1a1eea41-58221c2d.jpg,validate/p11/p11848597/s55271410/c52b94bb-fab4f7b9-821403ec-1a1eea41-58221c2d.jpg,validation," WET READ: ___ ___ 8:15 AM Unchanged from radiograph performed 9 hours prior. Cardiomegaly. Lines and supportive devices unchanged. WET READ VERSION #1 ___ ___ ___ 7:20 PM Unchanged from radiograph performed 9 hours prior. Cardiomegaly. Lines and supportive devices unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) PORT INDICATION: ___ year old man with recent NSTEMI, now with persistent leuokcytosis. // Please assess for PNA, edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Right internal jugular vein catheter. Moderate cardiomegaly. Left pectoral pacemaker. Borderline size of the cardiac silhouette. No pulmonary edema. No pleural effusions. No pneumonia. " d15b0a9a-7f46d1fd-c9566fb6-f932ca60-345698f7.jpg,validate/p16/p16936839/s56068169/d15b0a9a-7f46d1fd-c9566fb6-f932ca60-345698f7.jpg,validation," WET READ: ___ ___ ___ 6:19 PM Moderate cardiomegaly unchanged. No convincing signs of edema or pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with c/o ""sick all over"", eval for pna COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. Right chest wall single lead pacer is again noted with single lead extending into the region of the right ventricle. Midline sternotomy wires and prosthetic cardiac valve are again seen. The heart remains moderately enlarged. The mediastinal contour is normal. There is no focal consolidation concerning for pneumonia. No large effusion or pneumothorax seen. No signs of congestion or edema. Imaged bony structures are intact. No free air below the right hemidiaphragm seen. IMPRESSION: Moderate cardiomegaly unchanged. No convincing signs of edema or pneumonia. " 0e55f262-165ded19-b6e46fff-cbc9610e-f8fe8760.jpg,validate/p12/p12953281/s51440475/0e55f262-165ded19-b6e46fff-cbc9610e-f8fe8760.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of hypertension and chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are 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. " 23942e96-ff838654-0a4a657a-22ed6026-b84ead8a.jpg,validate/p10/p10577647/s55049554/23942e96-ff838654-0a4a657a-22ed6026-b84ead8a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with leukocytosis and history c.diff // assess pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Left-sided Port-A-Cath is stable in position, terminating in the proximal right atrium. There are relatively low lung volumes. No focal consolidation is seen. There maybe minimal central vascular congestion. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No focal consolidation to suggest pneumonia. " 058c31cc-7830106d-ed228203-a36d742c-53bb6064.jpg,validate/p17/p17078350/s59348109/058c31cc-7830106d-ed228203-a36d742c-53bb6064.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with minimal breath sounds on R, recurrent hepatic hydrothorax // assess R effusion TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomediastinal silhouette is enlarged but unchanged. Right pleural effusion is moderate. Pulmonary edema is demonstrated bilateral, new. No left pleural effusion increased demonstrated but left basal opacity has increased in its concerning for part of the worsening edema " 1e39fd8c-e5a53d42-08018c85-9a6f4ff1-25dcb005.jpg,validate/p15/p15403852/s54564617/1e39fd8c-e5a53d42-08018c85-9a6f4ff1-25dcb005.jpg,validation," WET READ: ___ ___ ___ 1:10 AM The ETT tip projects over the T4 vertebral body level. Lung volumes remain low, slightly worse from the prior exam. Otherwise, no significant interval change. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with POD___ s/p AVR/MVR reintubated for hypoxia // eval cardiopulmonary changes, position of ETT eval cardiopulmonary changes, position of ETT COMPARISON: Prior chest radiographs since ___ through ___. IMPRESSION: Mild to moderate pulmonary edema has worsened again. Moderate enlarged of the postoperative cardiomediastinal silhouette is stable. Pleural effusions are presumed, but not large. No pneumothorax. Lines and tubes in standard placements. " 513c2a6c-c081efd7-5d2b0a10-5ae31d2c-1664a879.jpg,validate/p14/p14312560/s50617748/513c2a6c-c081efd7-5d2b0a10-5ae31d2c-1664a879.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation and lines, trip to OR // tube lines drain placement tube lines drain placement COMPARISON: Chest radiographs since ___ most recently ___ and ___ at 03:14. IMPRESSION: Mild cardiomegaly has worsened since ___:14 accompanied by increasing pulmonary vascular engorgement, indicating greater intravascular volume or mild biventricular heart failure is developing. Right infrahilar consolidation consistent with pneumonia is unchanged. ET tube in standard placement. Swan-Ganz catheter ends in the main pulmonary artery, right jugular introducer ends in the upper SVC, and a nasogastric tube ending in the upper stomach would need to be advanced at least 8 cm to move all the side ports below the diaphragm. " 6e42b70e-0124e96f-143b5b24-b056f8c6-49b0033a.jpg,validate/p10/p10599949/s51164984/6e42b70e-0124e96f-143b5b24-b056f8c6-49b0033a.jpg,validation," FINAL REPORT INDICATION: History: ___F with frequent falls. History of c-spine fracture TECHNIQUE: AP upright and lateral views of the chest COMPARISON: Chest radiograph ___ and chest CT ___ FINDINGS: Assessment is limited due to patient rotation and the patient's chin projecting over and obscuring the lung apices. Moderate to severe cardiomegaly persists. Mediastinal contours appear grossly unchanged with tortuosity of the thoracic aorta again demonstrated. Hilar contours are normal. Pulmonary vasculature is not engorged. No gross focal consolidation, pleural effusion or pneumothorax is identified. Mild atherosclerotic calcifications are noted at the aortic knob. There is diffuse demineralization of the osseous structures with multiple compression deformities re- demonstrated, but poorly assessed. Remote left-sided rib fractures are also again identified, though no acutely displaced fractures clearly seen. IMPRESSION: Limited exam. No gross acute cardiopulmonary abnormality. Poor re- demonstration of multiple thoracic vertebral compression deformities. Remote left-sided rib fractures. No acutely displaced rib fractures identified. " 845f6c8e-7d7b8429-a2defe43-4c0dfe58-e8286d1b.jpg,validate/p11/p11909506/s52611924/845f6c8e-7d7b8429-a2defe43-4c0dfe58-e8286d1b.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough. 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. " 1d3a9eb7-afd1d81d-b9db9d2a-ef729e1c-1f8677ce.jpg,validate/p15/p15618507/s59960068/1d3a9eb7-afd1d81d-b9db9d2a-ef729e1c-1f8677ce.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dizziness // evidence of bleed/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 stable. The cardiac silhouette remains mildly enlarged. The aorta is calcified. Thoracic scoliosis is again noted. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 53ee20b8-0a45850b-9e125e91-3ef88d56-8a933890.jpg,validate/p19/p19419696/s51919211/53ee20b8-0a45850b-9e125e91-3ef88d56-8a933890.jpg,validation," FINAL REPORT INDICATION: ___M with C/O GEN WEAKNESS WITH FEVER/CHILLS // ? PNA TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Vague opacity is identified at the right lung base on the frontal view. It is better seen on 1 of the 2 lateral views than on the other. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: Vague right basilar opacity, potentially atelectasis although infection is not excluded. " 0eabd1bd-7c2d93bc-fc9a971a-acc66023-23845fcd.jpg,validate/p16/p16047967/s55768179/0eabd1bd-7c2d93bc-fc9a971a-acc66023-23845fcd.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with hypertension. Question cardiomegaly. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Low lung volumes are again noted with crowding of the pulmonary vascular markings. There is no evidence of confluent consolidation or effusion. The cardiac silhouette appears slightly enlarged, but this is likely accentuated due to low inspiratory effort. This is unchanged from prior exam. Osseous and soft tissue structures are unremarkable. IMPRESSION: No definite acute cardiopulmonary process. Prominent cardiomediastinal silhouette is likely accentuated due to low lung volumes. " d774fc11-67ce1bed-64be1d3a-92e6bf30-f83ae5a4.jpg,validate/p13/p13325402/s51451093/d774fc11-67ce1bed-64be1d3a-92e6bf30-f83ae5a4.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F w/shortness of breath, please eval for pna // ___F w/shortness of breath, please eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph from ___, ___ FINDINGS: The lung volumes are low, accentuating interstitial markings. Retrocardiac opacity is likely atelectasis, consolidation cannot be excluded. However, compared to prior exams, there is evidence of worsening moderate cardiomegaly and bilateral reticular opacities, concerning for increased pulmonary pressure. No pleural effusion or pneumothorax is seen. IMPRESSION: Mild pulmonary edema. Retrocardiac atelectasis, less likely pneumonia. " f02ac3d4-14afeb97-d6acb29e-29f270d4-f63bbbec.jpg,validate/p11/p11167924/s53564850/f02ac3d4-14afeb97-d6acb29e-29f270d4-f63bbbec.jpg,validation," 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. " 25750b5a-03c84aef-712f309a-18453403-c7ff2044.jpg,validate/p12/p12315713/s55059598/25750b5a-03c84aef-712f309a-18453403-c7ff2044.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral radiographs of chest were reviewed in comparison to prior radiographs from ___ and as far as up to ___. FINDINGS: Both lungs are hyperexpanded. Coarse interstitial markings in bilateral lungs consistent with chronic pulmonary disease have been stable since ___. There are no discrete lung opacities concerning for pneumonia. Mild blunting of the posterior costophrenic sulcus on the right side, unchanged since ___, is likely scarring or chronic pleural thickening. N0 pleural effusion. Heart size, mediastinal and hilar contours have been stable. IMPRESSION: No pneumonia. " b4c18ca7-4cf5e1fa-7924d550-2b98c41e-a5b819db.jpg,validate/p17/p17033046/s59877196/b4c18ca7-4cf5e1fa-7924d550-2b98c41e-a5b819db.jpg,validation," FINAL REPORT INDICATION: History of CABG, status post chest tube removal. Please evaluate for pneumothorax. COMPARISONS: Chest radiographs dated back to ___. TECHNIQUE: Single AP portable radiograph of the chest. FINDINGS: The patient is status post midline sternotomy and CABG. Mild cardiomegaly, slight increased compared to the prior exam from ___, and mediastinal widening are expected immediately post-operatively. Right-sided Swan-Ganz catheter sheath terminates in the upper SVC. There has been slight interval increase in mild bilateral pulmonary edema and mild bibasilar atelectasis. Small bilateral pleural effusions are persistent. There may be a tiny left apical pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. Tiny left apical pneumothorax status post left-sided chest tube removal. 2. Slight interval increase in bilateral mild pulmonary edema. 3. Prominence of the cardiomediastinal contours, is expected immediately post-operatively. ___ were d/w Dr. ___ by Dr. ___ by phone at 1:___p on the day of the exam. " 95b27e79-ea3c7094-9355e1de-cb292fa2-fd0dac47.jpg,validate/p14/p14823694/s53148886/95b27e79-ea3c7094-9355e1de-cb292fa2-fd0dac47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with aortic stenosis and heart failure // evaluate for interval change IMPRESSION: Since a recent radiograph of ___, bilateral pleural effusions and adjacent bibasilar opacities have decreased in extent. Stable cardiomegaly and pulmonary vascular congestion without overt pulmonary edema. " 4b930df7-097d940a-23358127-fb8f244a-6325fe0d.jpg,validate/p12/p12537194/s55784313/4b930df7-097d940a-23358127-fb8f244a-6325fe0d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with SOB/backpain found to have R pleural effusion and mets from lung cancer // Trend R pleural effusion COMPARISON: Radiographs from ___ IMPRESSION: There is a right-sided chest tube. There remains a hydropneumothorax with whiteout of most of the right lung. There has been slight decrease in the apical pneumothorax since previous. The left lung is relatively clear. " bb94a89c-144f590a-4d74dcc7-32e4cbed-5506ad3a.jpg,validate/p14/p14913896/s54353659/bb94a89c-144f590a-4d74dcc7-32e4cbed-5506ad3a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough // ? pna COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Lungs appear hyperinflated with upper lobe lucency suggesting underlying emphysema. Cardiomediastinal silhouette is stable. There is subtle opacity in the lateral right lung base which in the correct clinical setting may represent a very early/mild pneumonia. No large effusion or pneumothorax seen. IMPRESSION: Subtle opacity in the right lateral lung base is concerning for an early pneumonia. " 9c324724-82ecaaa2-40d7d445-40c01f7a-464e53e9.jpg,validate/p13/p13033872/s52422789/9c324724-82ecaaa2-40d7d445-40c01f7a-464e53e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p brain bx POD 1 with low grade fever // atelectasis atelectasis IMPRESSION: Heart size and mediastinum are stable. Lungs are clear. No pleural effusion or pneumothorax is present. Overall no abnormality to explain patient's fever noted within the chest. " 95bc54f7-4eb1cd0d-b8f2819b-e99ffbc6-f88f04e9.jpg,validate/p13/p13975291/s51140249/95bc54f7-4eb1cd0d-b8f2819b-e99ffbc6-f88f04e9.jpg,validation," FINAL REPORT EXAM: Chest AP erect frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of DKA, question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. There has been interval removal of a previously seen right central venous catheter. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal to mildly enlarged. The aortic knob is calcified. No overt pulmonary edema is seen. IMPRESSION: No findings to suggest pneumonia. " 3df1118c-9f01116e-26677f7e-6e3447c2-6ecbee86.jpg,validate/p10/p10678664/s58663059/3df1118c-9f01116e-26677f7e-6e3447c2-6ecbee86.jpg,validation," FINAL REPORT INDICATION: ___F with worsening DOE // Eval for PNA, CHF TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Lungs are clear. There is no consolidation or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 0b127937-b9a0831d-547bcefa-e5604899-98ff4238.jpg,validate/p18/p18036814/s51177793/0b127937-b9a0831d-547bcefa-e5604899-98ff4238.jpg,validation," FINAL REPORT INDICATION: ___M with cough, fever // eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ as well as chest CT dated ___. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Streaky opacity at the left lung base is most consistent with atelectasis. Cardiomediastinal and hilar contours are within normal limits. There is no large pleural effusion. There is no pneumothorax or evidence of pulmonary edema. Imaged osseous structures and upper abdomen are without an acute abnormality. IMPRESSION: No evidence of pneumonia. " ce8bc953-c5743acd-af933313-624a7d57-8b09ab0b.jpg,validate/p19/p19730870/s52419272/ce8bc953-c5743acd-af933313-624a7d57-8b09ab0b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with acute onset dizziness, epigastric discomfort, more pronounced t waves lateral leads COMPARISON: Prior exam dated ___. FINDINGS: PA and lateral views of the chest provided. 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. " d8985be7-811f316d-8495e492-a1030b4f-d0cc9f97.jpg,validate/p17/p17030818/s54878577/d8985be7-811f316d-8495e492-a1030b4f-d0cc9f97.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p CABG, CTs d/c'd // evaluate for pneumothorax TECHNIQUE: Portable chest x-ray. COMPARISON: Prior radiographs of chest dated ___ through ___. FINDINGS: Portable semi upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. The patient is status post CABG with expected postoperative cardiac silhouette. There is bibasilar atelectasis, left greater than right, with small bilateral pleural effusions. There has been interval removal of the endotracheal tube and bilateral chest tubes. A right internal jugular central venous line is at the distal SVC. There is no pneumothorax. IMPRESSION: No pneumothorax. " 6a3f8ea5-1bb168a0-5021160d-73bde37c-b067c186.jpg,validate/p12/p12118473/s53626319/6a3f8ea5-1bb168a0-5021160d-73bde37c-b067c186.jpg,validation," FINAL REPORT INDICATION: A ___-year-old man with cough and fevers at home, has renal graft. Question pneumonia. COMPARISON: PA and lateral chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is stable. Pacemaker leads are seen and are in appropriate position, unchanged from prior study. There are calcifications of the aortic knob. There is a right pleural-based calcified plaque. IMPRESSION: No acute cardiopulmonary process. " b0afa9a7-a911d38c-1d110ba9-680e353b-ba2232e5.jpg,validate/p11/p11836353/s51346697/b0afa9a7-a911d38c-1d110ba9-680e353b-ba2232e5.jpg,validation," 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. " adaaa6c7-d0a7c80b-e48e4add-23b60c5f-8e8e29c2.jpg,validate/p18/p18458646/s54142680/adaaa6c7-d0a7c80b-e48e4add-23b60c5f-8e8e29c2.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: CLL and 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, as are the hilar contours. IMPRESSION: No significant interval change. " 84f11679-3d7b2b83-26d48481-33790c2d-c010d0dc.jpg,validate/p16/p16561549/s51253607/84f11679-3d7b2b83-26d48481-33790c2d-c010d0dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever, on long term steroids // 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. " aa6689d3-1365227d-8dec57ec-4251ee54-33522d5c.jpg,validate/p13/p13235049/s59630821/aa6689d3-1365227d-8dec57ec-4251ee54-33522d5c.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: End-stage liver disease in a patient with left internal jugular line placement and right internal jugular line placement and fluid overload, followup. Portable AP radiograph of the chest was reviewed The position of tubes and lines is unchanged since prior study. There is mild interval improvement in vascular engorgement with almost normal appearance of the vessels in the right and left apices but still present basal and perihilar vascular engorgement. The left retrocardiac consolidation is unchanged. Prominence of the pulmonary artery might be consistent with pulmonary hypertension, correlation with echocardiography is suggested if clinically warranted. " 4a041077-47e39276-f45b2512-d183addf-be44b12f.jpg,validate/p19/p19993776/s58668196/4a041077-47e39276-f45b2512-d183addf-be44b12f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with shortness of breath, concern for STEMI TECHNIQUE: Portable upright AP view of the chest COMPARISON: None. FINDINGS: The patient is status post median sternotomy and CABG. Left-sided pacemaker device is noted with leads terminating in the regions of the right atrium and right ventricle. The heart size is at least mild to moderately enlarged. Atherosclerotic calcifications are demonstrated in the aortic knob. Moderate pulmonary edema is demonstrated along with a moderate left and small right pleural effusion. Bibasilar airspace opacities likely reflect compressive atelectasis. No pneumothorax is demonstrated though the lung apices is somewhat obscured by the patient's neck projecting over this area. Multilevel degenerative changes are seen within the thoracic spine. IMPRESSION: Moderate congestive heart failure with moderate left and small right bilateral pleural effusions. Bibasilar airspace opacities likely reflect compressive atelectasis. " 211b921c-ae6ffe4e-5d256237-c7d7692f-aa8fdbb7.jpg,validate/p16/p16962402/s51199996/211b921c-ae6ffe4e-5d256237-c7d7692f-aa8fdbb7.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after mitral valve repair for assessment of pleural effusions. PA and lateral upright chest radiographs were reviewed. Post-sternotomy wires are unremarkable. Heart size is unchanged since the prior studies. Bibasal areas of atelectasis are noted. Small amount of bilateral pleural effusion is seen. No definitive pneumothorax is noted at the apices. Anterior pleural hydropneumothorax is noted, better appreciated on the lateral view. " e354841b-65fdb83e-cd70170b-a6e42d48-207253aa.jpg,validate/p13/p13396234/s56347725/e354841b-65fdb83e-cd70170b-a6e42d48-207253aa.jpg,validation," 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. " 0e7fb1ce-67acba98-08d45dc5-912e6bb0-32f98a6b.jpg,validate/p18/p18116982/s51269759/0e7fb1ce-67acba98-08d45dc5-912e6bb0-32f98a6b.jpg,validation," FINAL REPORT INDICATION: History of bone marrow transplant with cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. The mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia, edema, or effusion. " bd3df0f9-c2920103-ea596839-295e003e-07a99f4d.jpg,validate/p15/p15957987/s54060704/bd3df0f9-c2920103-ea596839-295e003e-07a99f4d.jpg,validation," FINAL REPORT HISTORY: Bilateral chest pigtails, question pneumonia, pleural effusion change. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 14:39 p.m., I doubt significant interval change. Again seen are a large right effusion with underlying collapse and/or consolidation and a small left effusion. There are bilateral pigtail catheters at the lung bases. No pneumothorax is detected. Biapical pleural fluid and/or thickening is again noted. An esophageal stent overlying the mid mediastinum is again noted. A left indwelling catheter is also again noted. No CHF. IMPRESSION: No significant change compared with ___ at 14:39 p.m. " cff9259e-cf61e722-260778d5-d0ef9c49-b221b1b6.jpg,validate/p19/p19132022/s54928350/cff9259e-cf61e722-260778d5-d0ef9c49-b221b1b6.jpg,validation," WET READ: ___ ___ ___ 2:58 PM Mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with AMS // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Left-sided pacemaker and wires are appropriate position. Moderate cardiomegaly is stable. There is a mild increase in interstitial markings which may represent mild pulmonary edema. There is a small left effusion. No definite focal consolidations. No pneumothorax. IMPRESSION: Mild pulmonary edema. " 9c25e7fb-4302ce4d-e126546d-acd903d1-a4db7e34.jpg,validate/p19/p19296934/s50793576/9c25e7fb-4302ce4d-e126546d-acd903d1-a4db7e34.jpg,validation," WET READ: ___ ___ ___ 8:50 AM An equivocal area of increased opacity is seen along the right cardiac border in this patient with mild pectus deformity. If the decision to treat depends on this finding, more radiographic certainty could be obtained through an additional film in the left anterior oblique position. WET READ VERSION #1 ___ ___ ___ 1:13 AM Increased opacity along the right cardiac border is concerning for right middle lobe pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with fever // R/O pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ and CT chest dated ___. FINDINGS: There is mild pectus deformity. An equivocal area of increased opacity is seen along the right cardiac border. A right-sided Port-A-Cath tip ends in the distal SVC. The heart is not enlarged. There is no pneumothorax or pleural effusion. IMPRESSION: An equivocal area of increased opacity is seen along the right cardiac border in this patient with mild pectus deformity. If the decision to treat depends on this finding, more radiographic certainty could be obtained through an additional film in the left anterior oblique position. RECOMMENDATION(S): Re-evaluation of the right middle lobe with left anterior oblique chest radiograph. " b39d6f67-2a09698a-64c61466-456153a9-339e5bad.jpg,validate/p18/p18111896/s57397393/b39d6f67-2a09698a-64c61466-456153a9-339e5bad.jpg,validation," WET READ: ___ ___ 8:27 PM PRELIMINARY REPORT: ET tube, right IJ sheath and NG tube appropriate. Clear lungs. Left IJ line in distal left brachiocephalic vein. A ___ ______________________________________________________________________________ FINAL REPORT HISTORY: IJ line placed. The tip of the left IJ line appears to have been withdrawn slightly and now lies in the distal left brachiocephalic vein. The position of the right IJ line and endotracheal tube is satisfactory and unchanged. Nasogastric tube could be advanced a few centimeters as the side hole lies in the region of the gastroesophageal junction. The cardiac size is unchanged. No failure is identified. IMPRESSION: Nasogastric tube could be advanced, side hole at the gastroesophageal junction. " 789c59bd-fa5ded0b-32ccb589-5756efc0-e899888e.jpg,validate/p15/p15340094/s59223059/789c59bd-fa5ded0b-32ccb589-5756efc0-e899888e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // eval for pNA TECHNIQUE: Chest PA and lateral 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 " 8f783d10-12768ac0-78d0009d-ae0ec476-ed2e589b.jpg,validate/p11/p11522912/s51644751/8f783d10-12768ac0-78d0009d-ae0ec476-ed2e589b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure with increased FIO2 requirements on vent, unequal lung sounds // eval for tube placement, pneumothorax, effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are in constant position. Moderate to severe cardiomegaly with mild to moderate pulmonary edema. Bilateral pleural effusions, left more than right, and subsequent areas of atelectasis. No new focal parenchymal opacities suggesting pneumonia. No pneumothorax. " 1daf23be-fd13c661-0fc75283-bffe8c04-e5cb1a98.jpg,validate/p17/p17328613/s50151077/1daf23be-fd13c661-0fc75283-bffe8c04-e5cb1a98.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with NASH w/ pain after liver biopsy and hypoxia // evaluation for diaphragm injury from liver biopsy TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiographs ___. FINDINGS: Mild bibasilar atelectasis.No focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Mild bibasilar atelectasis. No pneumothorax or pneumonia or other acute cardiopulmonary process noted. " 791cf9ba-fb9112bf-60e104cf-3e1d5226-b99a6ad6.jpg,validate/p16/p16112569/s53204111/791cf9ba-fb9112bf-60e104cf-3e1d5226-b99a6ad6.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old man with ETOH. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4b6f36c0-007b8834-d93f2a93-65ad950b-dd5dc3ad.jpg,validate/p17/p17967970/s53666380/4b6f36c0-007b8834-d93f2a93-65ad950b-dd5dc3ad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with cough and SOB, history of wedge resection in the bilateral upper lungs COMPARISON: ___, PET CT from ___ FINDINGS: AP upright and lateral views of the chest provided. There is interval increase in size of a right pleural effusion, small to moderate. Chain sutures project over the upper lungs bilaterally as on prior. Small amount of loculated fluid and gas is seen at the right lung apex. Loculated fluid also noted along the periphery of the right lower lung as on prior. No definite signs of pulmonary edema. Difficult to exclude an pneumonia in the right lower lung. Overall heart size appears grossly stable below the right heart border is partially obscured. Mediastinum is unchanged. Bony structures are intact. IMPRESSION: Increased right pleural effusion with loculated pleural fluid at the right lateral lung base loculated fluid and gas at the right apex, unchanged from prior. Right basal compressive atelectasis, difficult to exclude pneumonia. Followup to resolution advised. " fb41c648-7540620c-977b6e5a-e738dbe8-123c9a97.jpg,validate/p19/p19977310/s50001683/fb41c648-7540620c-977b6e5a-e738dbe8-123c9a97.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Fever, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Atherosclerotic calcification seen along the aortic knob. The bony structures are intact. No free air below the right hemidiaphragm. Degenerative anterior spurring in the mid and lower thoracic spine noted. IMPRESSION: No acute findings in the chest. " 71c6b469-f2eb96f7-0e5c4447-8a469ab0-375c42e2.jpg,validate/p12/p12234198/s50460202/71c6b469-f2eb96f7-0e5c4447-8a469ab0-375c42e2.jpg,validation," FINAL REPORT INDICATION: ___-year-old man status post trauma, fall; evaluate for consolidation/effusion. TECHNIQUE: Erect portable chest view was read in comparison with prior chest radiograph from ___. FINDINGS: Both lungs are well expanded and clear. There are no lung opacities of concern. Heart size, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumothorax or consolidation or pleural effusion. " 41acba4c-e5be85b9-8973ba70-6401deb1-2c20f828.jpg,validate/p10/p10380616/s50385800/41acba4c-e5be85b9-8973ba70-6401deb1-2c20f828.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tracheoplasty // check interval change check interval change IMPRESSION: Compared to prior chest radiographs, ___ through ___. No pneumothorax, appreciable pleural effusion, or atelectasis. Postoperative widening of the upper mediastinum has improved since ___, stable since ___. Heart size normal. " 13b90edb-1bfcd692-3f7b7426-2d6d5557-b587eee8.jpg,validate/p18/p18651563/s54576164/13b90edb-1bfcd692-3f7b7426-2d6d5557-b587eee8.jpg,validation," 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. " 4f85987b-0444f99c-2339c443-04dea4af-b22f642c.jpg,validate/p18/p18414177/s59352632/4f85987b-0444f99c-2339c443-04dea4af-b22f642c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) PORT INDICATION: ___M with seizure // eval for 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. " 8908ed67-dfe3a344-b8b6a018-d22c9013-0f81dcfa.jpg,validate/p11/p11453452/s53497232/8908ed67-dfe3a344-b8b6a018-d22c9013-0f81dcfa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with lethargy, headache. Fall 1 week ago with head strike TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph, ___ CT abdomen pelvis FINDINGS: Lung volumes are low. Heart size remains moderately enlarged. Mediastinal and hilar contours are unremarkable. Crowding of bronchovascular structures is present without overt pulmonary edema. Patchy opacities are seen in the lung bases likely reflective of atelectasis. No definite focal consolidation, pleural effusion or pneumothorax is present. Marked degenerative changes with diffuse idiopathic skeletal hyperostosis is noted in the imaged thoracolumbar spine. Additionally diffuse increased sclerosis of the vertebral bodies is unchanged compared to the prior CT. IMPRESSION: Low lung volumes with probable bibasilar atelectasis. Diffuse increased sclerosis of multiple vertebral bodies within the imaged thoracolumbar spine, unchanged from the prior CT, and clinical correlation with any history of malignancy is recommended. " 49f02eaa-94d82d79-c2fbc98b-60bd8e7e-df9bf55a.jpg,validate/p10/p10989799/s51643519/49f02eaa-94d82d79-c2fbc98b-60bd8e7e-df9bf55a.jpg,validation," 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. " f361cbbd-d7fcac57-0d10840c-39ae4480-b85326d5.jpg,validate/p19/p19071346/s51702832/f361cbbd-d7fcac57-0d10840c-39ae4480-b85326d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with polytrauma, intubated // ? effusion, consolidation TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiographs dated ___. CTA abdomen and pelvis dated ___. FINDINGS: Compared to chest radiographs from ___, right infrahilar, right basilar, retrocardiac and left basilar opacities have increased, concerning for worsening atelectasis or aspiration. There is increasing central vascular congestion and new moderate pulmonary edema. Small right pleural effusion has worsened. No appreciable effusion on the left. No pneumothorax. Mildly tortuous and calcified thoracic aorta is stable. ETT in standard placement, unchanged. Left subclavian central line terminates in the upper right atrium. Enteric tube descends below the diaphragm and out of the field-of-view. IMPRESSION: 1. Increased central vascular congestion with new moderate pulmonary edema. 2. Worsening small right pleural effusion. 3. Increased right infrahilar, right basilar, retrocardiac and left basilar opacities, suggestive of worsening atelectasis or aspiration. " 516b0a87-e6d0939d-6f1a8cf9-d9af1dbd-b5aa924c.jpg,validate/p13/p13680434/s52089893/516b0a87-e6d0939d-6f1a8cf9-d9af1dbd-b5aa924c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with IVDA, sob // 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. " 64bbb616-1d2a5e26-2bcf3e41-a7836d0c-54784c13.jpg,validate/p14/p14111916/s54257702/64bbb616-1d2a5e26-2bcf3e41-a7836d0c-54784c13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with likely CVA, hypoxia, tachypnea // Eval for acute process Eval for acute process IMPRESSION: No previous images. The cardiac silhouette is at the upper limits of normal in size or mildly enlarged. No evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " b6969433-77a25bdd-9feebf5d-9b2265d0-fda9ce3a.jpg,validate/p18/p18089630/s59378876/b6969433-77a25bdd-9feebf5d-9b2265d0-fda9ce3a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Status post fall with question of chest trauma. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. Subpleural reticulation in the upper lungs likely represents scarring. No effusion or pneumothorax is seen. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. " 41152fc5-4d536d99-1da1de14-919d63b0-c7872263.jpg,validate/p16/p16074663/s52156739/41152fc5-4d536d99-1da1de14-919d63b0-c7872263.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with liver disease and shortness of breath. Question pleural effusion. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Low lung volumes are again noted. The lungs are clear. There is no effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process, no evidence of effusion. " ec11ec7c-97363fb7-8c11e814-73e24b62-5d0fbd5a.jpg,validate/p19/p19504814/s55029337/ec11ec7c-97363fb7-8c11e814-73e24b62-5d0fbd5a.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with chest pain. Evaluate for infection or reason for chest pain. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: 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. " 834ec1f6-6f37e13b-31825f44-65bfbeb9-da8ac011.jpg,validate/p16/p16952127/s55991601/834ec1f6-6f37e13b-31825f44-65bfbeb9-da8ac011.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure, intubated // Interval changes TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: A femoral line is seen to cross midline and no into the left upper chest, presumably in to the left pulmonary artery. It would have to be pulled back 5 cm to be in the pulmonary outflow tract. Otherwise the appearance of the lungs and tubes are unchanged IMPRESSION: Femoral Swan-Ganz catheter out slightly far on the left " f6e9ae3a-15bea9e5-b1a3a8bf-f3be49aa-611c4bc8.jpg,validate/p15/p15562667/s54322548/f6e9ae3a-15bea9e5-b1a3a8bf-f3be49aa-611c4bc8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with recent discontinuation of thyroid medication w/ cough, wheezing, 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. " 12bdb69c-0a532dab-6347dabc-0c3dd244-5fb1cca7.jpg,validate/p10/p10390732/s53829755/12bdb69c-0a532dab-6347dabc-0c3dd244-5fb1cca7.jpg,validation," WET READ: ___ ___ ___ 6:32 PM A left chest Port-A-Cath terminates at the left innominate vein. A right mediastinal vascular stent is noted. There is no pneumothorax. The opacity in the right lower lobe is more dense compared to study from ___ and likely represents an infectious process. There is now an opacity at the left lung base concerning for infection. There are bilateral small pleural effusions as well as moderate interstitial pulmonary edema. Findings discussed with Dr.___ by Dr.___ ___ telephone at 6:30pm on ___, ___ min following discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p port-a-cath placement // assess for placement/PTX assess for placement/PTX COMPARISON: Chest radiographs ___. IMPRESSION: Pulmonary and mediastinal vascular engorgement are new, mild to moderate cardiomegaly has increased, suggesting that new pulmonary opacification mid and lower lung zones is probably dependent edema due to cardiac decompensation. Small bilateral pleural effusions are new. Pneumonia or pulmonary infarction would be difficult to appreciate given the concurrent findings. Left internal jugular line does not extend far or at all into the left brachiocephalic vein. The lateral angulation of the tip suggests it is in a small vein such as the left internal mammary or left superior intercostal. There is no pneumothorax. Because of mediastinal widening, I cannot exclude a new mediastinal hematoma. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 9:35 AM, 90 minutes a series of pages to other physicians beginning immediately after discovery of the findings. " 0a82480f-7b2fcdc3-fcc3b4e2-64906f0d-e26028fc.jpg,validate/p16/p16606885/s54004515/0a82480f-7b2fcdc3-fcc3b4e2-64906f0d-e26028fc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxic resp fail, just intubated // ETT placement ETT placement IMPRESSION: Comparison to ___. The patient has been intubated. The tip of the endotracheal tube projects 4 cm above the carina. The course of the nasogastric tube is unchanged. No complications, no pneumothorax. " f8a009fd-51cabf67-b00c7def-820a3841-fa183eec.jpg,validate/p13/p13858896/s50293765/f8a009fd-51cabf67-b00c7def-820a3841-fa183eec.jpg,validation," FINAL REPORT INDICATION: Dizziness. Evaluate for pneumonia. COMPARISON: None. TECHNIQUE: Upright PA and lateral radiograph of the chest. FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette and hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 18e73e5f-42b5be1b-2bbd6d23-da39261e-11c11970.jpg,validate/p16/p16798076/s55826842/18e73e5f-42b5be1b-2bbd6d23-da39261e-11c11970.jpg,validation," FINAL REPORT HISTORY: To assess for left lower lobe collapse. FINDINGS: In comparison with the study of ___, there is increased opacification at the left base with a triangular opacification extending from medial to lateral. This is consistent with volume loss in the left lower lobe, possibly related to mucus plugging. Remainder of the study shows hyperexpansion, but no acute focal pneumonia. " df1e9317-5109f749-8ada0ac4-ec112d85-9c3debe1.jpg,validate/p13/p13733398/s56944045/df1e9317-5109f749-8ada0ac4-ec112d85-9c3debe1.jpg,validation," FINAL REPORT HISTORY: Cough, nausea, vomiting, diarrhea, and HIV positive. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 349498a9-658cbefd-09c312fd-216ea436-059a006f.jpg,validate/p14/p14073122/s55847766/349498a9-658cbefd-09c312fd-216ea436-059a006f.jpg,validation," FINAL REPORT HISTORY: Dizziness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are unchanged and within normal limits. The pulmonary vascularity is not engorged. Minimal streaky bibasilar airspace opacities likely reflect atelectasis. There is no focal consolidation. No pleural effusion or pneumothorax is identified. Scarring within the lung apices is re- demonstrated. No acute osseous abnormalities are visualized. IMPRESSION: Mild bibasilar atelectasis. " 8d5cca03-4c98cf7c-dc207d62-eecff0c4-7b99233f.jpg,validate/p16/p16839777/s59433948/8d5cca03-4c98cf7c-dc207d62-eecff0c4-7b99233f.jpg,validation," 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. " efc42f13-14671c67-968064d4-39de8318-5a3cff53.jpg,validate/p13/p13551252/s51523296/efc42f13-14671c67-968064d4-39de8318-5a3cff53.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sepsis of unclear etiology // r/o PNA, r/o aspiration IMPRESSION: In comparison to ___ chest radiograph, there has not been a relevant change in the appearance of the chest. " 1745bc9e-b64a097e-a15af34d-424b9b17-02bf354c.jpg,validate/p13/p13138475/s51945242/1745bc9e-b64a097e-a15af34d-424b9b17-02bf354c.jpg,validation," FINAL REPORT HISTORY: Wegener's with worsening respiratory status. FINDINGS: In comparison with the study of ___, there appears to be some increasing opacification in the retrocardiac region with poor definition of the descending aorta. This could reflect increased volume loss in the left lower lobe or possibly a region of consolidation if consistent with the clinical scenario. Remainder of the study is unchanged with extensive bilateral parenchymal opacities and pleural plaques. Tracheostomy tube remains in place. " 9383805d-2193b413-1def527a-f4d90f01-e4a260bb.jpg,validate/p14/p14508231/s54690639/9383805d-2193b413-1def527a-f4d90f01-e4a260bb.jpg,validation," FINAL REPORT HISTORY: Asthma and left anterior chest pain. CHEST, TWO VIEWS. Probable mild hyperinflation. Heart size is borderline, with mild prominence of the right heart border. No CHF, focal infiltrate, or effusion. No pneumothorax identified. At the edge of these films, fixation hardware in the lower cervical spine is noted. " 02f50125-e13d0c8f-3a219afc-d5d4db33-05788258.jpg,validate/p10/p10305245/s59931108/02f50125-e13d0c8f-3a219afc-d5d4db33-05788258.jpg,validation," WET READ: ___ ___ ___ 5:00 PM Subtle left basilar opacity seen on the frontal view, potentially atelectasis noting infection is not entirely excluded. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with fever // eval for evidence of infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: There is subtle left basilar opacity seen on the frontal view, not confirmed on the lateral. Elsewhere, lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Subtle left basilar opacity seen on the frontal view, potentially atelectasis noting infection is not entirely excluded. " c56b26dd-400bae15-17b8a32e-a78efedf-347520f2.jpg,validate/p15/p15394622/s57599309/c56b26dd-400bae15-17b8a32e-a78efedf-347520f2.jpg,validation," FINAL REPORT CLINICAL HISTORY: Low-grade fevers and leukocytosis, status post distal pancreatectomy and splenectomy. CHEST: There are low lung volumes. Atelectasis is present at the left base and a left pleural effusion is present. No evidence of failure is seen. The right lung appears clear. What appears to be a chest tube is present overlying the right lower lung medially. A drainage tube is also seen in the left upper quadrant. Multiple small air-fluid levels are present in this region consistent with the recent surgery. IMPRESSION: Appearances consistent with recent surgery, atelectasis and left effusion. " ce8df465-dca4f499-9615131f-3e95c038-c0fc6b6e.jpg,validate/p12/p12070979/s58727625/ce8df465-dca4f499-9615131f-3e95c038-c0fc6b6e.jpg,validation," FINAL REPORT COMPARISONS: Yesterday, ___. FINDINGS: Repeat PA and lordotic views of the chest were interpreted in conjunction with PA and lateral radiographs from yesterday. There is no suspicious lesion at the right apex at the site of prior concern. No additional nodule, consolidation, effusion, or pneumothorax is present. IMPRESSION: Questionable opacity at the right apex is not apparent on these subsequent views and was likely artifact secondary to summation of shadows. " 00f6367a-bb53009c-e373833e-14201ddd-5edb8f5f.jpg,validate/p10/p10021927/s56863750/00f6367a-bb53009c-e373833e-14201ddd-5edb8f5f.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with COPD PNA hypoxemic resp failure // et tube placement TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: Interval intubation with the tip of the endotracheal tube tip projecting 2.5 cm above the carina. The gastric tube projects over the body of the stomach. Increasing bilateral diffuse airspace opacities which can be seen in the setting of multifocal pneumonia and pulmonary edema. Small left pleural effusion. No pneumothorax identified. The size of the cardiac silhouette is mildly enlarged. IMPRESSION: Increasing and diffuse bilateral airspace opacities, concerning for pulmonary edema however superimposed multifocal pneumonia cannot be excluded. " deace0eb-cee82031-ce0b9f7e-2bd274e4-2a7678ba.jpg,validate/p17/p17422041/s54104338/deace0eb-cee82031-ce0b9f7e-2bd274e4-2a7678ba.jpg,validation," WET READ: ___ ___ 7:13 PM Persistent left lateral lung opacity. While this may represent recurrent pneumonia, given presence since ___ the possibility of underlying mass lesion is not excluded. Followup is recommended 6 weeks post treatment to document resolution. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with dementia with new AMS // eval pna TECHNIQUE: Single portable view of the chest. COMPARISON: Prior chest x-rays from ___, ___, and ___. FINDINGS: There is a persistent opacity at the lateral aspect of the left lung since ___. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. Folds lateral right clavicular fracture is again noted. IMPRESSION: Persistent left lateral lung opacity. While this may represent recurrent pneumonia, given presence since ___ the possibility of underlying mass lesion is not excluded. Followup is recommended 6 weeks post treatment to document resolution. " 02586c40-1a4ebaac-c256149d-830c9341-15eb63d5.jpg,validate/p16/p16748184/s59022955/02586c40-1a4ebaac-c256149d-830c9341-15eb63d5.jpg,validation," WET READ: ___ ___ 5:39 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with sob // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: An opacity seen on the lateral view overlying the heart is most consistent with basilar atelectasis. Cardiomediastinal and hilar contours are normal. No pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia. " f368f5ff-009f76dc-862ec94d-b3490c47-00596c93.jpg,validate/p11/p11329913/s53837061/f368f5ff-009f76dc-862ec94d-b3490c47-00596c93.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Questionable small nodular opacity seen on the lateral view overlying the anterior T9 vertebral body, most likely due to overlapping structures. Resolution of this finding with shallow oblique radiographs from the lateral projection should be obtained, and shown to a radiologist to confirm technical adequacy. // Questionable small nodular opacity seen on the lateral view overlying the anterior T9 vertebral body, most likely due to overlapping structures. Resolution of this finding with shallow oblique radiographs from the lateral COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre described rounded prevertebral opacity is no longer visualized. In the interval, minimal pleural effusions have newly occurred. No other relevant changes are seen. " 48c1bad4-f6bca39f-6b4bb2f6-e83fde7c-9b21276e.jpg,validate/p10/p10504635/s58014374/48c1bad4-f6bca39f-6b4bb2f6-e83fde7c-9b21276e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with swan-ganz catheter in place // evaluate for interval change, swan-ganz catheter placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the position of the Swan-Ganz catheter is unchanged, with the peak projecting over the outflow tract of the right ventricle. Moderate cardiomegaly persists. No pneumothorax. No pulmonary edema. No larger pleural effusions. " 8d59dbc1-2f04e284-5de516ee-4be802ac-b131dc15.jpg,validate/p13/p13766606/s51251007/8d59dbc1-2f04e284-5de516ee-4be802ac-b131dc15.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) IN O.R. INDICATION: ___ year old man with AS admitted for TAVR // pre operative eval please Surg: ___ (TAVR) pre operative eval please IMPRESSION: No previous images. Cardiac silhouette is mildly enlarged. There is mild prominence of interstitial markings at the bases, which could reflect chronic pulmonary disease, elevated pulmonary venous pressure, or both. No evidence of vascular congestion or acute focal pneumonia. Areas of lucency air seen beneath the hemidiaphragms. This is consistent with the appearance on the recent CT scan and would not suggest free intraperitoneal gas and less there are appropriate clinical symptoms. " d5b267ab-78f21997-f8698b06-a40128ac-1882d854.jpg,validate/p13/p13666088/s50468366/d5b267ab-78f21997-f8698b06-a40128ac-1882d854.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pericardial effusion s/p pericardiocentesis with drain in place. // Interval change IMPRESSION: Since a recent radiograph of ___, a part pericardial drain has apparently been removed, with stable radiographic appearance of the cardiac silhouette. No other relevant change. " 8593eea7-6186d972-940a1303-b207f6c0-d2b4d86e.jpg,validate/p19/p19175407/s59949294/8593eea7-6186d972-940a1303-b207f6c0-d2b4d86e.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with a history of refractory angina who presents for evaluation for evidence of congestive heart failure or infiltrate. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is mildly enlarged. Sternal wires and multiple surgical clips are seen throughout the heart, stable compared to the prior exam. The hilar and mediastinal contours are unremarkable. There is no evidence of interstitial edema or pulmonary vascular congestion. No focal opacities suggestive of an infection are identified. There is no pleural effusion or pneumothorax. IMPRESSION: No new infiltrates suggestive of infection. No secondary signs suggestive of congestive heart failure. " 31ad4166-cf362579-ac18fac1-9305c14e-79c569a5.jpg,validate/p11/p11543398/s51608029/31ad4166-cf362579-ac18fac1-9305c14e-79c569a5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new oxygen requirement. // eval for pneumonia vs. aspiration pneumonitis. TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Patient is rotated and there is S-shaped scoliosis. Allowing the limitations of the study there are lower lung volumes with increasing bibasilar opacities right greater than left could be atelectasis or pneumonia. There is no pneumothorax. New right upper lobe opacities could represent aspiration. Cardiac size cannot be evaluated. Mediastinal silhouette is unchanged " 67f2e0c6-328a1cc9-721c3fac-1572b297-bbc709d7.jpg,validate/p16/p16097039/s56006269/67f2e0c6-328a1cc9-721c3fac-1572b297-bbc709d7.jpg,validation," WET READ: ___ ___ 10:30 PM New peripheral opacity in left lower lung; likely atelectasis but small infarct possible. Correlation with risk of pulmonary embolism suggested. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain that worsens with deep breath. Status post recent fall two days ago. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: Patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear stable. There is a peripheral wedge-shaped opacity at the base of the left chest associated probably with the lingula, most likely atelectasis. Elsewhere, the lungs appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: Peripheral opacity in the left lower lung suggesting atelectasis, although small infarct could have a similar appearance. " 407dece4-b327c18a-b296376b-71612b42-e39ab9d7.jpg,validate/p14/p14889227/s50455825/407dece4-b327c18a-b296376b-71612b42-e39ab9d7.jpg,validation," FINAL REPORT INDICATION: Left-sided chest pain. TECHNIQUE: Two views of the chest. COMPARISON: None available. FINDINGS: The lungs are fully expanded and clear. No pleural effusion, pulmonary edema, or pneumothorax is seen. The heart, mediastinal and pleural surface contours are normal. IMPRESSION: No acute cardiopulmonary process. " fd4cd37e-6713ffe4-9e749bbc-4522937e-363a94e7.jpg,validate/p19/p19670845/s58942265/fd4cd37e-6713ffe4-9e749bbc-4522937e-363a94e7.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with chest pain // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. No focal consolidation, edema, effusion, pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila is unremarkable. No acute osseous abnormality. IMPRESSION: Normal chest radiograph. " cf4ec6e3-2afe1223-291a0ec1-495dd68f-8e39154c.jpg,validate/p15/p15808515/s56593621/cf4ec6e3-2afe1223-291a0ec1-495dd68f-8e39154c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: _ _ pneumonia ___ check for resolution // pneumonia ___ check for resolution pneumonia ___ check for resolution IMPRESSION: Comparison to ___. The pre-existing pneumonia has almost completely resolved. The structure and transparent see of the lung parenchyma has returned to knee a normal levels. Complete resolution of the pre-existing pleural effusions is also noted. Stable normal appearance of the cardiac silhouette. " 568f5274-fc790d60-92e1899d-75a9fe2f-93b697c8.jpg,validate/p12/p12576058/s58297399/568f5274-fc790d60-92e1899d-75a9fe2f-93b697c8.jpg,validation," WET READ: ___ ___ 10:20 PM Lung volumes are slightly low resulting in crowding of the bronchovascular structures. Bibasilar opacities are present, worse on the right. While this may represent atelectasis, superimposed infection is also possible. ______________________________________________________________________________ FINAL REPORT HISTORY: Increased work of breathing, to assess for vascular congestion or pneumonia. FINDINGS: In comparison with study of ___, there is increase in ill-defined pulmonary vessels, consistent with some pulmonary vascular congestion. A more focal area of opacification at the right base could conceivably represent a developing infiltrate in the appropriate clinical setting. Blunting of the costophrenic angles with mild atelectatic changes at the bases. " a003da9b-d35ac0e5-60cd65c6-79719d64-fbd14a73.jpg,validate/p17/p17175688/s53620418/a003da9b-d35ac0e5-60cd65c6-79719d64-fbd14a73.jpg,validation," 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. " 5661152a-1cc3ee2e-846341a9-560f2acb-7f414fa3.jpg,validate/p11/p11312914/s53200910/5661152a-1cc3ee2e-846341a9-560f2acb-7f414fa3.jpg,validation," 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. " 299b665d-d52fce0a-063b51e8-d987c198-ebed31fc.jpg,validate/p16/p16167724/s52040178/299b665d-d52fce0a-063b51e8-d987c198-ebed31fc.jpg,validation," WET READ: ___ ___ 7:06 PM No pulmonary edema. Large right pleural effusion with underlying atelectasis. Underlying consolidation not excluded. Left lung without focal consolidation. Pneumomediastinum still present. Trach and L PICC in unchanged positions. G tube partly imaged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with SBP in 190's and possible pulmonary edema. FINDINGS: Comparison is made to prior study from ___. There is likely right lower lobe collapse with pleural effusion at the base. There is a left-sided PICC line with distal lead tip at the cavoatrial junction. The left lung is clear. There is no pulmonary edema. Catheters are seen projecting over the upper abdomen. There is a tracheostomy whose distal tip is 6.8 cm above the carina. There is lucency along the right trachea suggestive of pneumomediastinum. This is better assessed on the prior CT scan from ___. " 25322908-2629e11f-5b2b90b5-6dbec5b5-1dbf2a39.jpg,validate/p13/p13280844/s56350188/25322908-2629e11f-5b2b90b5-6dbec5b5-1dbf2a39.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of breast cancer with chronic cough // please evaluate for pulm lesion please evaluate for pulm lesion IMPRESSION: In comparison with the study of ___ from an outside facility, there are slightly improved lung volumes. Substantial enlargement of the cardiac silhouette with tortuosity of the AA or tele. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Elevation of the right hemidiaphragmatic contour is again seen. At the resolution limits of plain radiography, no definite pulmonary or skeletal metastasis. " 3f283aa4-87d44540-9f498da3-e29a2d12-95b7bc3b.jpg,validate/p19/p19262736/s51059854/3f283aa4-87d44540-9f498da3-e29a2d12-95b7bc3b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with worsening hypoxemia // Eval for interval changes IMPRESSION: In comparison to ___ chest radiograph, pulmonary edema has substantially improved, and bilateral pleural effusions have decreased in size. Residual asymmetrically distributed opacities may reflect resolving asymmetrical edema and/or multifocal infection. No other relevant change. " 58ac12f2-fbab0170-9f20f7c9-066619f5-d563557f.jpg,validate/p12/p12816661/s51812456/58ac12f2-fbab0170-9f20f7c9-066619f5-d563557f.jpg,validation," FINAL REPORT INDICATION: Hypertension with bolus of food obstructed. Evaluation for esophageal obstruction. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. The lungs are clear. There is no pleural effusion. No esophageal distention is visible. The heart size is top normal. IMPRESSION: No acute cardiopulmonary process. " d7df37c3-81f42997-9fd3d901-20b26a56-3d8e6409.jpg,validate/p13/p13247581/s51885741/d7df37c3-81f42997-9fd3d901-20b26a56-3d8e6409.jpg,validation," WET READ: ___ ___ ___ 11:50 PM Stable blunting of the left costophrenic angle. Picc tip in the mid SVC. Modereate cardiomegally. No focal consolidation. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Worsening leukocytosis, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The pre-existing parenchymal opacity at the lung bases, extensively described in the report from ___, has not changed in severity and extent. There is no evidence of newly occurred opacity. Unchanged moderate cardiomegaly. The previously malpositioned PICC line is now in correct position. No larger pleural effusions. No pneumothorax. No pulmonary edema. " bb39837d-18b2ac67-38d64c36-cb33b087-5dc08eb1.jpg,validate/p14/p14232172/s52990240/bb39837d-18b2ac67-38d64c36-cb33b087-5dc08eb1.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with exertional dyspnea and systolic murmur. // Cardiac disease? Other cause for dyspnea,? TECHNIQUE: Chest PA and lateral COMPARISON: PA and lateral chest radiographs dated ___ FINDINGS: Since the chest radiographs obtained ___, no significant changes are appreciated. Moderate cardiomegaly is unchanged. No evidence of pulmonary vascular congestion, pulmonary edema, or pleural effusion. The lungs are otherwise fully expanded and clear. Posterolateral right seventh rib fracture is unchanged. Cardiomediastinal hilar silhouettes are unremarkable. IMPRESSION: Unchanged moderate cardiomegaly without pulmonary vascular congestion, pulmonary edema, or pleural effusion. No acute cardiopulmonary abnormality. " 0e184fc3-a78c258f-2612d8f2-0dd27612-3d30c14a.jpg,validate/p18/p18312252/s52630014/0e184fc3-a78c258f-2612d8f2-0dd27612-3d30c14a.jpg,validation," FINAL REPORT INDICATION: ___F with dizziness // ?pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation or edema. Blunting of the posterior costophrenic angles could be due to atelectasis or trace effusions. Relative elevation of left hemidiaphragm is again noted. Left chest wall dual lead pacing device is in stable position. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 70ef162d-b0f8c5bd-0521f55b-5757c8fe-f74157b6.jpg,validate/p11/p11107643/s52630474/70ef162d-b0f8c5bd-0521f55b-5757c8fe-f74157b6.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Moderate cardiomegaly is re- demonstrated. There are low lung volumes which result in bronchovascular crowding. No overt pulmonary edema is identified. Retrocardiac opacity may reflect atelectasis but infection cannot be excluded. No definite large pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with probable retrocardiac atelectasis, although infection cannot be excluded in the correct clinical setting. No pulmonary edema. " 6c97e53f-af1a8ca1-c4296a72-1d9b19de-1ec524d0.jpg,validate/p10/p10779064/s57718352/6c97e53f-af1a8ca1-c4296a72-1d9b19de-1ec524d0.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with fever and white count. IMPRESSION: PA and lateral chest compared to ___: Over the course of six days, previous pulmonary edema has cleared. Small bilateral pleural effusions remain. Heart size normal. " 380a20f7-5bfe3cb5-9b7d6e4b-44d6023b-9ce00849.jpg,validate/p13/p13762124/s58315311/380a20f7-5bfe3cb5-9b7d6e4b-44d6023b-9ce00849.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: ARDS, evaluation for tubes and lines. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. This includes the Swan-Ganz catheter, pericardial drain, the endotracheal tube, the nasogastric tube and the cervical stabilization devices. The appearance of the lung parenchyma is not substantially changed as compared to the previous image. There is no pneumothorax. Constant appearance of the cardiac silhouette. No larger pleural effusions. " 9d32177e-ef29df9a-202a12c4-65d885f3-d74795a2.jpg,validate/p10/p10209390/s56420518/9d32177e-ef29df9a-202a12c4-65d885f3-d74795a2.jpg,validation," FINAL REPORT HISTORY: History of metastatic renal cell carcinoma with known effusion, worsening shortness of breath. COMPARISON: Chest x-ray from ___. CHEST, SINGLE AP VIEW: There is essentially complete opacification of the left hemithorax. A small faint area of residual lucency is seen in the upper zone, but this is decreased compared with ___. The mediastinum remains grossly midline, though the possibility of slight rightward shift of mediastinum would be difficult to exclude. The right lung remains grossly clear, without CHF, focal infiltrate or effusion. Possible minimal atelectasis at right lung base. IMPRESSION: Worsening opacification of the left hemithorax. Only minimal residual aeration present. Right lung grossly clear. " 2d96cfa7-bbebf7de-14ad4cb3-4dd49b25-fea22374.jpg,validate/p18/p18652728/s53189993/2d96cfa7-bbebf7de-14ad4cb3-4dd49b25-fea22374.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cough and dyspnea. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is top normal, stable. Mediastinum is stable. There is no interval development of focal consolidation to suggest interval development of infectious process. Mild vascular engorgement is noted, but no overt pulmonary edema is seen. " 498c940b-d66e4fe7-948dc750-bb91ff5f-461b72c7.jpg,validate/p15/p15132671/s53918315/498c940b-d66e4fe7-948dc750-bb91ff5f-461b72c7.jpg,validation," 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. " 62d87ecb-84177874-3e69aeed-85493647-94531706.jpg,validate/p18/p18179234/s56270212/62d87ecb-84177874-3e69aeed-85493647-94531706.jpg,validation," WET READ: ___ ___ ___ 5:12 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with DMI presenting in DKA // eval for infection. TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ and ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates well expanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion or, or consolidation. Two screws are seen in the right humeral head. IMPRESSION: No acute cardiopulmonary process. NOTIFICATION: These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at approximately 17:00 on ___, at the time of discovery. " 2fcb66d9-4467f533-0e945ebe-2e2ab59f-f3b54760.jpg,validate/p18/p18145610/s51075513/2fcb66d9-4467f533-0e945ebe-2e2ab59f-f3b54760.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // post-op baseline post-op baseline COMPARISON: Comparison to ___ at 09:06 FINDINGS: PA and lateral views of the chest ___ at 16:37 are submitted. IMPRESSION: Right internal jugular central line is unchanged in position. Stable postoperative cardiac and mediastinal contours status post median sternotomy for CABG. Small left layering effusion with minimal residual patchy atelectasis at the left base. No evidence of pulmonary edema or pneumothorax. " 487b5c98-ff17f8b1-37d798ca-bb4f0747-416d083b.jpg,validate/p10/p10781100/s50189893/487b5c98-ff17f8b1-37d798ca-bb4f0747-416d083b.jpg,validation," FINAL REPORT INDICATION: Patient with recent pneumonia, now with worsening cough. COMPARISONS: ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate left lung base air space opacity, slightly more conspicuous on the PA view since ___ but partially improved on lateral view. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Heart size is normal. Bronchial wall thickening at the right lung base is noted. IMPRESSION: Left lower lobe opacity, concerning for persistent or recurrent pneumonia. Recommend repeat radiographs in 4 weeks to document complete resolution after appropriate therapy. " b1979cab-1da03b0f-e6993f84-08f19715-7bb338a9.jpg,validate/p16/p16308412/s59156452/b1979cab-1da03b0f-e6993f84-08f19715-7bb338a9.jpg,validation," FINAL REPORT INDICATION: History of metastatic lung cancer, altered mental status and new oxygen requirement. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: PET-CT on ___, chest radiograph on ___. FINDINGS: There are new bibasilar opacities, greater on the left. The left hilum is prominent. The heart is normal in size. A nodule in the right upper lobe corresponds to the FDG-avid right upper nodule identified on prior PET-CT. Focal lucencies indicate that this lesion may be cavitated. IMPRESSION: 1. New bibasilar opacities may represent peribronchial pneumonia. 2. Right upper lobe nodule is probably a metastasis and may have become cavitary since PET-CT on ___. " ddef041c-8d526d11-d15646e5-73dbe7c3-595a9691.jpg,validate/p12/p12773009/s51206696/ddef041c-8d526d11-d15646e5-73dbe7c3-595a9691.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with left pleural effusion after thoracocentesis. AP radiograph of the chest was reviewed in comparison to ___. Left mid lung consolidation appears to be grossly unchanged or slightly worse. There is also worsening of the right lower lobe opacity. Small bilateral pleural effusions are redemonstrated, unchanged. IMPRESSION: No evidence of pneumothorax. As compared to the prior study from ___, interval decrease in left pleural effusion. No change in the right pleural effusion. No pneumothorax. Right upper lobe nodular opacity appears to be redemonstrated, corresponding to abnormality seen on the chest CT from ___. " 394d20fb-8386e27d-7ab4afbf-cea07c22-f4f8688b.jpg,validate/p11/p11868033/s57197153/394d20fb-8386e27d-7ab4afbf-cea07c22-f4f8688b.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Followup pneumonia. Comparison is made with prior study ___. Moderate cardiomegaly and tortuous aorta are unchanged. Hiatal hernia is again visualized. Left lower lobe consolidation has resolved. There are no new lung abnormalities, pneumothorax or pleural effusion. Moderate-to-severe degenerative changes are again noted in the thoracic spine. There are minimal atelectases in the left lower lobe better seen in the lateral view. IMPRESSION: Resolved pneumonia. " e4594dc2-29f1530e-19578880-5676f70c-8ee68287.jpg,validate/p14/p14120635/s59666950/e4594dc2-29f1530e-19578880-5676f70c-8ee68287.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with iph, hygromas, difficult to extubate // pna pna IMPRESSION: Comparison to ___. The endotracheal tube has been pulled back and is now 5.5 cm above the carina. The other monitoring and support devices are constant. Previously mild pulmonary edema has decreased in severity. A mild to moderate left pleural effusion persists. Subsequent left lower lobe atelectasis is unchanged. No evidence of pneumonia. " 10d6522a-68953d74-2d14e2b6-437a03f3-681adfd5.jpg,validate/p12/p12337553/s53399156/10d6522a-68953d74-2d14e2b6-437a03f3-681adfd5.jpg,validation," FINAL REPORT INDICATION: History: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette with a tortuous aorta and hyperinflated lungs without focal consolidation, pleural effusion, or pneumothorax. Cervical spinal hardware is incompletely assessed. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8c5f943d-1ab11e3b-4b9732fb-87fb62ee-3d1dc75f.jpg,validate/p18/p18303550/s53694077/8c5f943d-1ab11e3b-4b9732fb-87fb62ee-3d1dc75f.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with left pleural effusion s/p thoracentesis, evaluate for pneumothorax.. COMPARISON: Comparison is made to chest radiograph from ___ TECHNIQUE Frontal lateral view of the chest. FINDINGS: Compared to prior, there is interval decrease in size of a now small left pleural effusion tracking along the lateral pleura. There is no pneumothorax. The cardiomediastinal silhouette is normal. There is left basilar atelectasis, but no focal consolidation. IMPRESSION: Interval decrease in size of a now small left pleural effusion, no pneumothorax. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:04 PM, 12:45 minutes after discovery of the findings. " 6828bf4f-5d4a52d7-194692f5-16419e3c-52cd5ef4.jpg,validate/p14/p14222445/s59781491/6828bf4f-5d4a52d7-194692f5-16419e3c-52cd5ef4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung ca s/p bronchoscopy // Assess for interval change COMPARISON: No comparison IMPRESSION: Complete collapse of the left lung, caused by an endobronchial mass visualized on the CT examination from ___. Subsequent shift of the mediastinum and the heart to the left. The right lung is slightly overinflated but shows no relevant acute abnormalities. No right pleural effusion. " c601256d-bf4abdfb-9c198e75-5ff9b831-06deacba.jpg,validate/p13/p13687044/s56404456/c601256d-bf4abdfb-9c198e75-5ff9b831-06deacba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___: COMPARISON: Prior exam from earlier today. CLINICAL HISTORY: Diffuse alveolar hemorrhage status post PICC line, assess PICC position. FINDINGS: Portable supine AP view of the chest was provided. There is a small right pneumothorax, which is slightly more conspicuous compared with prior exam. There is no evidence of tension. This finding was discussed with Dr. ___ at approximately 11:15 a.m. on date of exam. There is an unchanged right pleural effusion which is overall small to moderate in size. Diffuse ground-glass opacity within the right lung is compatible with known alveolar hemorrhage. There is left lower lobe atelectasis. The heart is top normal in size. The left PICC line has been retracted with its tip now well situated at the level of the upper SVC. A right IJ central venous catheter tip is seen in the mid SVC. The endotracheal tube tip appears low in the trachea with its tip at the level of the carina. Retraction is advised by at least 2 cm. The enterostomy tube is not well visualized due to underpenetrated technique. IMPRESSION: 1. Small right pneumothorax, slightly increased from prior exam. Followup advised. Findings discussed with Dr. ___ in MICU at the time of this dictation. 2. Low-lying endotracheal tube with its tip at the level of the carina. Retraction by at least 2 cm is advised. This recommendation was made with Dr. ___ at the time of this dictation. 3. Improved position of left PICC line with its tip residing in the upper SVC. " f111f974-8f388a4b-186cab5b-867cf3d9-b5811777.jpg,validate/p18/p18065731/s56430721/f111f974-8f388a4b-186cab5b-867cf3d9-b5811777.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Decreased saturation, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is increased radiodensity in the left upper lobe, and also surrounding the left hilus. Changes are slightly more extensive than on the previous image. At the bases of the right lung, there is an area of atelectasis, associated with a small pleural effusion. Moderate cardiomegaly is unchanged. Unchanged right internal jugular vein dialysis catheter. Because of the slightly more extensive opacity in the left upper lobe, the referring physician, ___. ___ was paged for notification at the time of dictation and observation, 8:03 a.m., on ___. " ab2b5ad1-e377648a-3121c348-e48a8291-308d54a5.jpg,validate/p15/p15677077/s55643786/ab2b5ad1-e377648a-3121c348-e48a8291-308d54a5.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, history of pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is mild bilateral lower lobe atelectasis without definite focal consolidation. No pleural effusion is seen. There is no pneumothorax. Chronic-appearing changes are seen at the right lung apex, possibly emphysematous. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No definite focal consolidation to suggest pneumonia, although comparison with priors would be helpful. " 85bd876f-947f6d77-19c08925-ca7b6672-2bed7dd7.jpg,validate/p17/p17665442/s52371484/85bd876f-947f6d77-19c08925-ca7b6672-2bed7dd7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hypoxia // Pulm edema? 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. " f92d06d0-6b6e62cc-dcf459cc-ad684a29-f648d456.jpg,validate/p13/p13131801/s50444640/f92d06d0-6b6e62cc-dcf459cc-ad684a29-f648d456.jpg,validation," FINAL REPORT INDICATION: History: ___M with dry hacking cough x 4 weeks // ? pneumonia COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: The lungs are clear. There is mild hyperinflation. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. " a6eb25ee-b562da21-1a46cca6-a998dbf2-b125c44e.jpg,validate/p13/p13413293/s56531401/a6eb25ee-b562da21-1a46cca6-a998dbf2-b125c44e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cerebellar IPH s/p crani and evacuation. New leukocytosis and findings on imaging concerning for PNA // Evaluate for aspiration PNA Evaluate for aspiration PNA IMPRESSION: Compared to chest radiographs compared to ___. Moderate enlargement of the cardiac silhouette is stable, but moderate right and small left pleural effusion are new, accompanied by generalized pulmonary vascular engorgement and mild pulmonary edema. The bulbous quality of the upper pole of the right hilus is presumably due to vascular engorgement. Followup advised. " 961b7f0a-4c1cb8a0-fd1298cf-2ff4ba17-5621cefb.jpg,validate/p10/p10109413/s52925083/961b7f0a-4c1cb8a0-fd1298cf-2ff4ba17-5621cefb.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with back pain radiating to the chest. COMPARISON: None available. PA AND LATERAL CHEST RADIOGRAPH: Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Cardiomediastinal and hilar contours are within normal limits. The thoracic aorta follows a tortuous course, though is non-aneurysmal. IMPRESSION: No acute cardiopulmonary process If there is clinical concern for vascular pathology (aorta) as a cause of the patient's pain, recommend CTA of the chest for further assessment. " 1ccec7de-5ea11c21-ad785d7c-734dd4d7-974a0ed9.jpg,validate/p15/p15225349/s56612363/1ccec7de-5ea11c21-ad785d7c-734dd4d7-974a0ed9.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with s/p recent surgery with chest pain // pna? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are moderate left and small right bilateral pleural effusions with overlying atelectasis. No pneumothorax is seen. Cardiac and mediastinal silhouettes are grossly stable. There is diffuse demineralization. IMPRESSION: Bilateral pleural effusions, moderate on the left, small on the right. " 77b5a472-5ec6043d-da39467a-8cae5c9c-73b46241.jpg,validate/p12/p12560500/s50864137/77b5a472-5ec6043d-da39467a-8cae5c9c-73b46241.jpg,validation," FINAL REPORT AP CHEST, 9:30 A.M., ___ HISTORY: ___-year-old woman with fever. Possible pneumonia. IMPRESSION: AP chest compared to ___: Lower lung volumes are than on ___, producing vascular crowding and make it difficult to exclude new mild pulmonary edema. Mediastinum has been widened in the region of a heavily calcified and distorted aortic knob for at least a year since chest CT showed a contained aortic arch ulcer or pseudoaneurysm on ___, as well as progressive soft tissue infiltration of the upper mediastinum. Interval widening in the right paratracheal region since ___ is presumably due to vascular engorgement, and perhaps edema. The large bore hemodialysis catheter insertion may have produced some bleeding, and radiographic followup is strongly advised. There is no pneumothorax or pleural effusion. Heart is top normal size, unchanged. If patient becomes hemodynamically unstable or the mediastinal widening progresses disproportionate with hypervolemia, CTA of the chest would be indicated. There are no findings of pneumonia. Dr. ___ was paged at 10 a.m. and we discussed the findings by telephone at 10:05am. " 1d2eae56-aca1446e-78e09b18-02818224-5f58634a.jpg,validate/p11/p11893091/s50901361/1d2eae56-aca1446e-78e09b18-02818224-5f58634a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Endotracheal tube placement. COMPARISON: Fluoroscopy from ___ and chest x-ray from ___. FINDINGS: As compared to the previous image, the patient has received an external pacemaker. The tip of the pacemaker is in expected correct position, as documented on the previous fluoroscopy. Unchanged position of the other monitoring and support devices. Moderate cardiomegaly with signs of mild pulmonary edema. No pleural effusions. No pneumothorax. Left apical pleural calcification. Mild atelectasis at the left lung bases. No evidence of pneumonia. " fdc1f4a8-47258561-369f3766-12b0a962-0f17d1f0.jpg,validate/p15/p15234245/s58716458/fdc1f4a8-47258561-369f3766-12b0a962-0f17d1f0.jpg,validation," FINAL REPORT INDICATION: ___M with syncope // infiltrate? TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest x-ray from ___. FINDINGS: Left chest wall dual lead pacing device is noted. The lungs are clear without consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " db806824-34de7587-691208b6-19301aaa-15cca66c.jpg,validate/p15/p15479525/s52041478/db806824-34de7587-691208b6-19301aaa-15cca66c.jpg,validation," 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. " bf98110f-4bc885e8-fceeb786-e2ab1ce2-fe6e7906.jpg,validate/p11/p11051985/s56237223/bf98110f-4bc885e8-fceeb786-e2ab1ce2-fe6e7906.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: intubated // confirm ETT TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: Endotracheal tube terminates 6.8 cm above the level of the carina. Enteric tube courses below the diaphragm, terminating in the left upper quadrant. The side port appears to be at the level of the GE junction. Consider advancement so that it is well within the stomach. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette is top-normal. Mediastinal contours are grossly unremarkable. Areas of osseous sclerosis are consistent with reported history of prostate metastatic disease. IMPRESSION: Endotracheal tube terminates approximately 6.8 cm above the level of the carina. Enteric tube terminates in expected location of the stomach, side port at the level the GE junction; consider advancement so it is well within the stomach. No focal consolidation. Osseous sclerosis consistent with history of prostate metastases. " b2ab013c-3d27ecdf-492190b6-87657122-18c37771.jpg,validate/p11/p11658675/s52080767/b2ab013c-3d27ecdf-492190b6-87657122-18c37771.jpg,validation," 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. " b78ed58f-58a0c8d4-82a1a3e0-4fa6f16d-563869ed.jpg,validate/p10/p10609749/s54882034/b78ed58f-58a0c8d4-82a1a3e0-4fa6f16d-563869ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with subacute traumatic fall and intoxicated 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. " ef9644b5-f534f655-2a88c258-b8d91ad0-17236c9b.jpg,validate/p12/p12488897/s59827007/ef9644b5-f534f655-2a88c258-b8d91ad0-17236c9b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes with extensive areas of atelectasis and lateral pleural effusions. Moderate cardiomegaly with signs of mild fluid overload. Unchanged monitoring and support devices. " 2b5edbbf-116df0e3-d0fea755-fabd7b85-cbb19d84.jpg,validate/p18/p18034814/s50390186/2b5edbbf-116df0e3-d0fea755-fabd7b85-cbb19d84.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with right breast ca sp mastectomy and te recon, extra instruments opened in or // Rule out retained instruments TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right breast expander in situ. Surgical clips centrally in the right chest wall. Surgical drain in situ in the right breast. IMPRESSION: No retained instruments " e217cc9f-51f82bb4-e843becc-85054480-8bd08c47.jpg,validate/p11/p11551769/s55040573/e217cc9f-51f82bb4-e843becc-85054480-8bd08c47.jpg,validation," WET READ: ___ ___ ___ 7:43 PM No significant change in the right upper lobe and left perihilar opacities at the concerning for pneumonia. Moderate to large right pleural effusion with overlying atelectasis is stable. ______________________________________________________________________________ FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: AML, dyspnea. COMPARISON: ___ at 11:46 a.m. FINDINGS: There is a right-sided PICC which terminates in the upper to mid SVC. Right upper lobe and left perihilar opacities are again seen. There is persistent blunting of the right costophrenic angle likely due to a small-to-moderate pleural effusion with overlying atelectasis. The right pleural effusion appears stable to possibly minimally decreased as compared to the prior study. No left pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Right upper lobe and left perihilar opacities again seen; as before, raise concern for pneumonia. Persistent right pleural effusion is stable to possibly very minimally decreased, with overlying atelectasis. " 6404d615-22059674-9107ddf0-13bcdc97-4060e626.jpg,validate/p12/p12480796/s52534864/6404d615-22059674-9107ddf0-13bcdc97-4060e626.jpg,validation," FINAL REPORT INDICATION: ___F with syncope // evaluate for cardiomegaly, fractures TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Apparent increased density projecting over the right lower lung is due to overlying breast implant. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 16bc783d-fd009a37-a0c5c02b-97cde4dc-398936e2.jpg,validate/p15/p15649276/s57043660/16bc783d-fd009a37-a0c5c02b-97cde4dc-398936e2.jpg,validation," FINAL REPORT HISTORY: Chest pain on inspiration. COMPARISON: None available. 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. " 02e9477c-659b97b0-28c5c1b2-6f4e0865-3e04a039.jpg,validate/p16/p16553329/s55534474/02e9477c-659b97b0-28c5c1b2-6f4e0865-3e04a039.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with shortness of breath. COMPARISON: Multiple prior chest radiographs, most recently ___. FINDINGS: Frontal view of the chest was obtained. Large bilateral pleural effusions are present with adjacent opacities most consistent with compressive atelectasis. Cephalization and indistinct appearance of the pulmonary vasculature are consistent with pulmonary edema. Heart size is not well assessed but appears enlarged. Mediastinal contours are stable. IMPRESSION: Pulmonary edema with bibasilar opacities consistent with moderate to large pleural effusions with adjacent atelectasis. Superimposed infection cannot be excluded. " 1a5d9ae3-3ed3d313-1c7d4f66-02782ed5-7227dc4c.jpg,validate/p13/p13712284/s54319265/1a5d9ae3-3ed3d313-1c7d4f66-02782ed5-7227dc4c.jpg,validation," WET READ: ___ ___ ___ 10:23 PM There are small bilateral pleural effusions, right greater than left which appears slightly decreased from the prior study done on ___. There is persistent bibasilar atelectasis. No evidence of pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effuson s/p drainage // Assess interval change TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: ___. FINDINGS: The right pleural effusion is redistributed, and there is worsening right lower lobe atelectasis. A small left pleural effusion is unchanged. There is no pneumothorax. The heart and mediastinum cannot be accurately assessed. IMPRESSION: Redistribution of small to moderate right pleural effusion with worsening right lower lobe atelectasis. Stable small left pleural effusion. " 9c08e880-a92a7c9e-a915bdaf-7a95b3ca-97c89191.jpg,validate/p18/p18550032/s58525839/9c08e880-a92a7c9e-a915bdaf-7a95b3ca-97c89191.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with type 2 diabetes, Portal htn, ETOH Cirrhosis, and h/o of smoking // please assess for any cardiopulmonary abnormalities. new liver transplant eval. please assess for any cardiopulmonary abnormalities. new liver transplant eval. IMPRESSION: No previous images. The cardiac silhouette is within normal limits and there is no evidence of vascular congestion or acute focal pneumonia. Blunting of the right costophrenic angle could represent a small pleural effusion or pleural thickening. " 83182f4c-8c560580-4dc23db0-b68a8e48-e0dad985.jpg,validate/p10/p10380616/s54152644/83182f4c-8c560580-4dc23db0-b68a8e48-e0dad985.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old woman s/p tracheobronchoplasty // interval change, please evaluate COMPARISON: Chest radiographs dated ___ and ___. Chest radiograph dated ___. FINDINGS: Persistent small right pleural effusion and pleural thickening, unchanged since at least ___. Focal opacity in the right lung base, best seen on the lateral view with obscuring of the right hemidiaphragm, is overall unchanged, and may suggest aspiration. Stable postoperative appearance of the cardiomediastinal silhouette with mild cardiomegaly. Perhaps mild increased pulmonary vascular congestion compared to the prior exam, but no frank pulmonary edema. No pneumothorax. No left pleural effusion. Surgical clips projecting over the right upper quadrant are unchanged. Compression deformity in the thoracic spine vertebrae are unchanged since ___. IMPRESSION: No change in right pleural thickening or pleural effusion for several days. No change in right lower lobe consolidation best seen on lateral view. " 1089ca50-3f02aed6-2ce1e378-3b70d504-988275ae.jpg,validate/p14/p14546527/s55096689/1089ca50-3f02aed6-2ce1e378-3b70d504-988275ae.jpg,validation," 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. " 023f99b3-5122daf3-c9158348-9a546875-2d719b13.jpg,validate/p12/p12805811/s54424547/023f99b3-5122daf3-c9158348-9a546875-2d719b13.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: There has been no substantial short interval change in the appearance of the chest since the recent study of one day earlier. " afe34628-1fd7ede8-2d34a569-b86efe4a-48699501.jpg,validate/p14/p14987339/s55448313/afe34628-1fd7ede8-2d34a569-b86efe4a-48699501.jpg,validation," FINAL REPORT HISTORY: Cough and chest pain. TECHNIQUE: Single upright chest radiograph. COMPARISON: Multiple chest radiographs were reviewed through ___. FINDINGS: Heart size is normal. The cardiomediastinal silhouette is stable and normal. The hilar contour is stable. Lungs are clear without focal consolidations, effusions or pneumothorax. No acute bony abnormality. IMPRESSION: No acute intrathoracic process. " 9b919b7e-97eab457-8446b8e2-7020a8f6-38f45c6a.jpg,validate/p15/p15068871/s58036287/9b919b7e-97eab457-8446b8e2-7020a8f6-38f45c6a.jpg,validation," 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. " 0b98af39-1a2a0059-03edb209-b6f928b7-b468af36.jpg,validate/p14/p14688791/s56496112/0b98af39-1a2a0059-03edb209-b6f928b7-b468af36.jpg,validation," 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. " c2173842-f897e9d4-5cd80ab1-2a60028c-6468a7ce.jpg,validate/p17/p17451002/s55839669/c2173842-f897e9d4-5cd80ab1-2a60028c-6468a7ce.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent rib fractures one month ago on the left, now abnormal breath sounds in left lower lung. Rule out pneumonia. On the left, there are healing fractures of the fifth and sixth posterior ribs. No evidence of left pneumothorax or pneumonia. Minimal atelectasis at the left lung base. On the right, however, there is an area of pleural thickening. The frontal image shows the pleural thickening projecting over the lateral lung regions, on the lateral radiograph this corresponds to mild fissural thickening, not present on the previous examination. Otherwise, the radiograph is unchanged as compared to ___. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. No pulmonary edema. No pneumonia. IMPRESSION: Healing left rib fractures without complications, minimal left basal atelectasis. Lateral thickening of the right major fissure. A followup radiograph should be obtained in six to eight weeks, in order to rule out increase in extent of newly appeared change. No other change as compared to ___. " b6293ee8-f71102a4-a4d2673a-0a754e39-c7d9b025.jpg,validate/p15/p15432819/s56336924/b6293ee8-f71102a4-a4d2673a-0a754e39-c7d9b025.jpg,validation," FINAL REPORT HISTORY: Shortness of breath, hypoxia, rales. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph and CT torso ___. FINDINGS: Moderate enlargement of cardiac silhouette is unchanged. The mediastinal contours are stable. Atherosclerotic calcifications of the thoracic aorta are again noted. There is no pulmonary vascular congestion. Enlargement of the hila bilaterally reflects dilated pulmonary arteries, suggestive of pulmonary arterial hypertension. Small right pleural effusion persists. Bibasilar atelectasis is noted and elevation of the right hemidiaphragm is again seen. There is no pneumothorax. Multilevel degenerative changes in the thoracic spine are again present. Cholecystectomy clip in the right upper quadrant the abdomen is again noted. IMPRESSION: Unchanged small right pleural effusion and bibasilar atelectasis. Bilateral hilar enlargement suggestive of underlying pulmonary arterial hypertension. " 98df3859-e84ca88b-4fc2d2f7-e1a4adee-84a055c9.jpg,validate/p11/p11183093/s58135686/98df3859-e84ca88b-4fc2d2f7-e1a4adee-84a055c9.jpg,validation," 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 " a1c7266e-979b9f2b-aff57d43-3e659f01-c50eb210.jpg,validate/p14/p14422845/s59063508/a1c7266e-979b9f2b-aff57d43-3e659f01-c50eb210.jpg,validation," FINAL REPORT HISTORY: Vomiting. COMPARISON: ___. 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 evidence of pneumomediastinum. There is right lower lobe opacity is similar to prior scan and likely represents summation of vascular shadows and. IMPRESSION: No acute cardiopulmonary process. " 51f6ff7c-dfab5ccc-3c28e781-6aa76703-6352a465.jpg,validate/p18/p18654576/s51884901/51f6ff7c-dfab5ccc-3c28e781-6aa76703-6352a465.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest pain, sickle cell disease // infiltrate infiltrate IMPRESSION: Compared to prior chest radiographs since ___ most recently ___. Mild cardiomegaly has increased since ___ but there is no pulmonary edema, vascular engorgement, or more than a minimal left pleural effusion. Lungs are essentially clear. " 6b11726a-bb5276e2-ed7cea38-0f40d8a3-2c4bd4ce.jpg,validate/p14/p14875942/s53881298/6b11726a-bb5276e2-ed7cea38-0f40d8a3-2c4bd4ce.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PMH Afib, DMII, admitted with abdominal pain c/f SBO now w/ complaints of SOB. // evaluate possible cause of SOB evaluate possible cause of SOB IMPRESSION: In comparison with study of ___, the nasogastric tube is been removed. Continued substantial enlargement of the cardiac silhouette with pacer leads in place. Mild indistinctness of pulmonary vessels could reflect some elevated pulmonary venous pressure. Especially on the lateral view, there is retrocardiac opacification that could represent an area of consolidation. " 65db5554-60d071ba-fb5ca206-b5430591-c7bcbfc1.jpg,validate/p12/p12492828/s55825008/65db5554-60d071ba-fb5ca206-b5430591-c7bcbfc1.jpg,validation," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient status post VATS, with localized left upper lobe wedge resection on ___. Evaluate for interval change. 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 ___. As before, no evidence of cardiac enlargement or pulmonary congestion. The, on previous examination identified local density at the site of the wedge resection has now changed into more linear density compatible with scar formations. No new parenchymal abnormalities seen. Previously described pleural fat pad obliterating cardiac apex remains as before. No new pleural abnormalities are seen and no pneumothorax is identified in the apical area. Previously remaining local chest wall emphysema has disappeared. IMPRESSION: Satisfactory findings on followup examination. Postoperative scar formation but no pneumothorax. " 25af42ee-c665348d-366713d1-7960acb9-d8f4ae4f.jpg,validate/p11/p11165557/s54185864/25af42ee-c665348d-366713d1-7960acb9-d8f4ae4f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever, recent travel to ___, assess for pneumonia. FINDINGS: PA and lateral views of the chest are obtained. Lung volumes are low which limits the evaluation. While there is no focal consolidation, there is a mild increase in interstitial opacity bilaterally could reflect crowding of bronchovasculature. An atypical pneumonia cannot be excluded, however. No large pleural effusion or pneumothorax is seen. Heart size is normal. Mediastinal contour is unremarkable. Bony structures are intact. IMPRESSION: No lobar consolidation, though mild increase in interstitial opacity raises concern for atypical pneumonia. " 5fb8769a-de90ba98-dfdc4fdc-b473cd26-e992999d.jpg,validate/p11/p11694393/s57154206/5fb8769a-de90ba98-dfdc4fdc-b473cd26-e992999d.jpg,validation," FINAL REPORT INDICATION: Evaluate NG tube placement. COMPARISONS: Chest radiograph ___. FINDINGS: A new NG tube is seen with the tip in the mid esophagus. A left Port-A-Cath is in unchanged position with the tip in the low SVC. The left hemidiaphragm is elevated, which is new from the prior exam in ___. Dilated loops of bowel are noted, although better evaluated on the abdominal radiographs. The lungs are essentially clear without consolidation, pulmonary edema, pleural effusion, or pneumothorax. Old fractures of the right seventh rib and left clavicle are unchanged. IMPRESSION: 1. NG tube in the mid esophagus. 2. Mild elevation of the left hemidiaphragm. Results were discussed with Dr. ___ at 1:50 p.m. on ___ via telephone by Dr. ___ at the time the findings were discovered. " 227e6134-c4dc8a7a-fea60d48-dcf6f3e1-85051f36.jpg,validate/p10/p10613392/s56770979/227e6134-c4dc8a7a-fea60d48-dcf6f3e1-85051f36.jpg,validation," 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. " c924eb05-144e7f7f-8738a1c9-7a56998f-43b50cab.jpg,validate/p16/p16042873/s56228466/c924eb05-144e7f7f-8738a1c9-7a56998f-43b50cab.jpg,validation," FINAL REPORT INDICATION: History of DVT/PE with low saturations. Evaluate for reason for low O2 sats. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest demonstrates stable top-normal heart size. Low lung volumes with bibasilar atelectasis. Mild pulmonary vascular congestion is new from yesterday. No pleural effusion or pneumothorax. " b6f27ff1-49a23bc0-45b4c7e1-42cfb8e6-967950f1.jpg,validate/p18/p18208210/s53897106/b6f27ff1-49a23bc0-45b4c7e1-42cfb8e6-967950f1.jpg,validation," WET READ: ___ ___ ___ 2:07 AM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with h/o alzheimer's with worsening symptoms over previous 2 weeks // eval pneumonia 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. " d69651ae-dc7bacca-a05efc02-1d5882cd-001c77c4.jpg,validate/p10/p10001401/s56534136/d69651ae-dc7bacca-a05efc02-1d5882cd-001c77c4.jpg,validation," WET READ: ___ ___ ___ 6:21 AM An enteric tube courses below the level of the diaphragm. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with SBO s/p NG*** WARNING *** Multiple patients with same last name! // NG tube placement TECHNIQUE: Single AP view COMPARISON: Chest radiograph from the same date. FINDINGS: The right costophrenic angle is not imaged. Otherwise, the lungs are clear. The heart size is upper limits of normal. Enteric tube courses below the level of the diaphragm. There is no pneumothorax. IMPRESSION: An enteric tube courses below the level of the diaphragm. " e2f698a0-e796c08c-8c882db8-24851a67-deff355e.jpg,validate/p14/p14477164/s57605043/e2f698a0-e796c08c-8c882db8-24851a67-deff355e.jpg,validation," FINAL REPORT INDICATION: Cough and dyspnea, here to evaluate for acute cardiopulmonary process. COMPARISON: Chest radiographs dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are decreased. There is mild increased opacification of the left lung base, which is most compatible with atelectasis. No focal airspace opacity concerning for pneumonia is detected. There is no significant pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is mildly enlarged but stable. The mediastinal contours are unchanged from ___ with tortuosity of the thoracic aorta. The hilar contours are within normal limits. The trachea is midline. There is no free air beneath the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 2b5b4d2e-e276f51c-5d3a81c6-88fcd25e-eed2e2cb.jpg,validate/p16/p16454913/s50373593/2b5b4d2e-e276f51c-5d3a81c6-88fcd25e-eed2e2cb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Ischemic bowel, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The tracheostomy tube and the left internal jugular vein catheter are in constant position. Moderate cardiomegaly and relatively extensive left pleural effusion persists. The opacities at the right lung bases are also constant. No new parenchymal opacities. Unchanged mild widening of the mediastinum. " c8fccdce-e1cb44db-68038262-4290bccd-17bb2b28.jpg,validate/p17/p17293739/s59904517/c8fccdce-e1cb44db-68038262-4290bccd-17bb2b28.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with fall down 8 stairs w/ headstrike 3 days ago, w/ dizziness, headache, and right hip pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The heart is top-normal in size. Mediastinal contour is normal. No focal consolidation, large effusion or pneumothorax is seen. No signs of congestion or edema. Bony structures are intact. No displaced rib fracture is identified. IMPRESSION: No radiographic sequela of trauma. " 4a552167-3bd77c10-6c6f17e9-310fb9f3-ee984e36.jpg,validate/p10/p10157508/s52148300/4a552167-3bd77c10-6c6f17e9-310fb9f3-ee984e36.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hx of melanoma // please evaluate disease status TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ through ___.. FINDINGS: Frontal and lateral radiographs of the chest demonstrate hyperexpanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No evidence of intrathoracic malignancy. " 69d5c3a2-bdee2130-ddb1275d-a9575a46-9199502a.jpg,validate/p13/p13031024/s57008838/69d5c3a2-bdee2130-ddb1275d-a9575a46-9199502a.jpg,validation," FINAL REPORT INDICATION: History: ___F with chest pain and SOB // ?pulmonary edema present TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, ___, ___ and ___. FINDINGS: Findings compatible with langerhans histiocytosis were seen on prior CT, and there is no focal consolidation, pleural effusions or pneumothorax. The mediastinal contours are normal. The heart size is normal. IMPRESSION: No acute cardiopulmonary process. " 884a1ae2-fe3e2ae2-4d05c3a0-684e94c5-73a1027b.jpg,validate/p19/p19739276/s52019201/884a1ae2-fe3e2ae2-4d05c3a0-684e94c5-73a1027b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with anemia, acute kidney injury from OSH status post 2L IVF, 2U pBRC // eval ? evolving edema TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ at 13:08 FINDINGS: Right-sided Port-A-Cath tip terminates in the mid SVC. Mild enlargement of the cardiac silhouette persists. The mediastinal hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacities are noted in the right lung base likely reflective of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is identified. IMPRESSION: Right basilar atelectasis. No pulmonary edema. " 43a10680-b4bed387-8da72cff-5b45a7c0-2400448d.jpg,validate/p16/p16681170/s59814070/43a10680-b4bed387-8da72cff-5b45a7c0-2400448d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, fever // eval for infiltrate TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Again, there is diffuse increase in interstitial markings bilaterally consistent chronic interstitial lung disease. No new focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Chronic interstitial lung disease. No definite new focal consolidation. " f18d8616-f4a9c899-7d618f88-2f0e36a2-a4a6916f.jpg,validate/p14/p14210409/s50525995/f18d8616-f4a9c899-7d618f88-2f0e36a2-a4a6916f.jpg,validation," FINAL REPORT INDICATION: Altered mental status, aspiration risk from dysphagia. 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 moderately enlarged. The mediastinal contour is widened, with mild tortuosity of the thoracic aorta which demonstrates calcifications. Crowding of bronchovascular structures is noted. There are bilateral lower lobe opacities, likely atelectasis, though non-specific. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is visualized. IMPRESSION: Low lung volumes, which limits assessment of the lung bases. Probable bibasilar atelectasis, though repeat study with improved inspiration is recommended if there is continued concern for aspiration. " 531d6db9-b30782ea-92688304-6217e44d-e316216e.jpg,validate/p19/p19173603/s51002329/531d6db9-b30782ea-92688304-6217e44d-e316216e.jpg,validation," WET READ: ___ ___ ___ 1:29 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: AP CHEST X-RAY INDICATION: ___ year old man a history of a thoracic aortic aneurysm presents complaining of worsening lightheadedness, evaluate for pneumonia. TECHNIQUE: Single AP upright chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: Again seen is a mildly tortuous thoracic aorta. Otherwise, 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 biapical pleural-parenchymal scarring. There is no pneumothorax or pleural effusion. Old healed left tenth rib fracture. Unchanged thoracic scoliotic curve. IMPRESSION: No acute cardiopulmonary process. " 82431bc9-d7b7a662-9bd5a0e9-9fd674a0-c6183986.jpg,validate/p13/p13353252/s53798119/82431bc9-d7b7a662-9bd5a0e9-9fd674a0-c6183986.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Acute onset dyspnea on exertion and rales on exam. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Streaky basilar retrocardiac opacity seen on the lateral view, may be overlying the right lung base on the frontal view, could be due to atelectasis but infection is not excluded in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Streaky basilar retrocardiac opacities may be due to atelectasis, but infection is not excluded in the appropriate clinical setting. " 6761652b-89da033a-b8e7a696-9fcef341-f10df8f1.jpg,validate/p16/p16023485/s55996974/6761652b-89da033a-b8e7a696-9fcef341-f10df8f1.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with LLL pulm nodule now s/p VATs wedge resection, CT x1, evaluate post-op baseline, obtain in PACU TECHNIQUE: Portable chest radiograph. COMPARISON: Chest CTA ___, reference chest radiograph ___. . FINDINGS: A left chest tube ends in the upper lungs. Lung volumes are low. There is no pneumothorax. Increased opacification at the right lung apex is noted with mild elevation of the right hemidiaphragm. IMPRESSION: Low lung volumes post VATS. Possible right upper lobe collapse. " 2049300a-76d71cdb-597bfb8e-99fbe7df-4dfa3db2.jpg,validate/p14/p14908521/s53200190/2049300a-76d71cdb-597bfb8e-99fbe7df-4dfa3db2.jpg,validation," 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. " 32bfe7a2-6fa10c03-a7cf790d-ec83ec16-fbb3e33e.jpg,validate/p12/p12288695/s50975181/32bfe7a2-6fa10c03-a7cf790d-ec83ec16-fbb3e33e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: New onset of altered mental symptom. PA and lateral upright chest radiographs were reviewed. COMPARISON: ___. Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. IMPRESSION: No evidence of acute cardiopulmonary process. " 776adda5-814bb609-841d3143-9e424dd0-4759895a.jpg,validate/p17/p17155697/s51488177/776adda5-814bb609-841d3143-9e424dd0-4759895a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with metastatic myxoid liposarcoma status post right lower anterior rib resection. Assess for hemothorax or pneumothorax. COMPARISON: Chest radiograph ___, ___, ___, ___, MRI chest of ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: There is a small right pleural effusion and a sharply demarcated homogeneous noncalcified opacity the density of soft tissue in the right lower lobe obscuring the right hemidiaphragm. On the lateral view it is seen as a triangular sharply demarcated opacity projecting posterior to the left ventricle with likely opacification of the right middle lobe. No additional focal opacity, pneumothorax, pulmonary edema, or left pleural effusion. Heart size, mediastinal contour and hila are normal. No bony abnormality. IMPRESSION: 1. Small right pleural effusion. 2. Homogeneous sharply demarcated triangular opacity is likely a soft tissue density and may be fluid collected posterior to the graft. 3. No pneumothorax. " dad09f86-b6c6fc07-fd229cef-898aa907-d60a5a02.jpg,validate/p11/p11607177/s54779281/dad09f86-b6c6fc07-fd229cef-898aa907-d60a5a02.jpg,validation," WET READ: ___ ___ ___ 8:19 AM Lines and tubes in stable positions. Severe cardiomegaly persists. Small bilateral pleural effusions are likely present. Left pneumothorax appears stable. Pulmonary edema may be slightly worsened. WET READ VERSION #1 ___ ___ ___ 10:11 PM Lines and tubes in stable positions. Severe cardiomegaly persists. Small bilateral pleural effusions are likely present. Left pneumothorax appears stable. Pulmonary edema may be slightly worsened. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p VAD // eval for PTX COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are in constant position. The known minimal left pneumothorax is stable. Moderate pulmonary edema and small bilateral pleural effusions persist. " cb90b1df-4ba2dba3-b8865ae2-30a039cb-4cbfdc58.jpg,validate/p19/p19792705/s55194684/cb90b1df-4ba2dba3-b8865ae2-30a039cb-4cbfdc58.jpg,validation," FINAL REPORT INDICATION: ___F with weakness // ? acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Compared to the prior radiograph there has been no significant change. There is no focal consolidation or pneumothorax. Linear opacity in the right lung base is most consistent with atelectasis. Small bilateral pleural effusions are stable. The cardiomediastinal silhouette is unchanged. IMPRESSION: Stable small bilateral pleural effusions. No significant change. " 57b31cae-363ec866-c776967f-0f71a3c4-71186642.jpg,validate/p14/p14021217/s51279017/57b31cae-363ec866-c776967f-0f71a3c4-71186642.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with confusion TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Assessment of the chest is somewhat limited by patient rotation. Lung volumes are low. Heart size is mildly enlarged but not substantially changed in the interval. Mediastinal and hilar contours are grossly unchanged. Pulmonary vasculature is not engorged. Minimal streaky right opacity in the right lung base likely reflects an area of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities identified. IMPRESSION: Limited study due to patient rotation. Minimal atelectasis in the right lung base. " 77a70ae2-8bed5bfc-d1984d3a-f761a727-9a50f022.jpg,validate/p10/p10426710/s59777012/77a70ae2-8bed5bfc-d1984d3a-f761a727-9a50f022.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated s/p exlap // intubated, sepsis, evaluate lung fields. intubated, sepsis, evaluate lung fields. IMPRESSION: Compared to chest radiographs ___ through ___ at 12:22. There has been a substantial increase in moderate left pleural effusion. Extensive consolidation has developed in the left lung without definite volume loss,, normal a attributable to pneumonia, but conceivably atelectasis in the setting of the new left pleural effusion. Mild pulmonary edema in the right lung is worsened by redirection of blood flow. Heart size is indeterminate, but could be larger today than yesterday when cardiomegaly was mild. Small right pleural effusion is likely. No pneumothorax. ET tube tip at the upper margin of the clavicles should not be withdrawn any further. Left jugular Swan-Ganz catheter ends in the right pulmonary artery. Right jugular line ends close to the superior cavoatrial junction. Esophageal drainage tube ends in the mid stomach. Left peripheral catheter ends in the axilla. NOTIFICATION: The findings were discussed with ___ (In Hospital, On Page), ___, M.D. by ___, M.D. on the telephone on ___ at 9:36 AM, 1 minutes after discovery of the findings. " eca9707a-70280b23-f9861ed1-731571c0-21aaf9c8.jpg,validate/p16/p16645602/s56264980/eca9707a-70280b23-f9861ed1-731571c0-21aaf9c8.jpg,validation," FINAL REPORT INDICATION: Seizure, rule out infectious etiology. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: A nerve stimulator projects over the left chest. The lung volumes are low. This results in crowding of the bronchovascular structures. Within this limitation, there is no pleural effusion, pneumothorax or focal airspace consolidation. Heart size is top normal. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5bd06f37-8d4a3d04-d0ba915f-7bf6874c-942d7623.jpg,validate/p11/p11966397/s56015440/5bd06f37-8d4a3d04-d0ba915f-7bf6874c-942d7623.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p RUL // check interval change IMPRESSION: In comparison with the study of ___, the subcutaneous gas has cleared. . The areas of increased opacification in the right perihilar and lower lung zone are substantially decreased. Postsurgical changes on in the left apex processed and there are atelectatic changes at the left base. " 2c294aa8-2d087ae8-a779532d-4c437b68-b52c2562.jpg,validate/p14/p14659758/s50109927/2c294aa8-2d087ae8-a779532d-4c437b68-b52c2562.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with GI bleed, alcoholic hepatits, polysubstance abuse who is now tachypnic. // Is there an acute process in the chest? Is there an acute process in the chest? COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Patient is no longer intubated, Lung volumes are still extremely low and there has been a substantial increase in atelectasis in both lungs. Heart size is normal. There is no pulmonary edema or appreciable pleural abnormality. " ea0f4eeb-130c8e3d-e2fda218-b96a6c13-cc5eb0e0.jpg,validate/p16/p16487246/s59980235/ea0f4eeb-130c8e3d-e2fda218-b96a6c13-cc5eb0e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with mi, s/p ___ ___, still chest pain // r/p pulm process r/p pulm process COMPARISON: There are no prior chest radiographs. IMPRESSION: Lungs clear. Heart size normal. Mediastinal and hilar silhouettes and pleural surfaces unremarkable. " dd2c4fd6-8bc17bcc-e88a1a8c-bfbb55b1-02eb5fb7.jpg,validate/p19/p19270938/s56513587/dd2c4fd6-8bc17bcc-e88a1a8c-bfbb55b1-02eb5fb7.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old man with ? pulmonary nodule on outside CXR, details unavailable. // r/o nodule COMPARISON: ___ FINDINGS: A subtle nodular opacity is present in the right upper lobe at the level of the second right anterior rib, difficult to assess due to overlap with the adjacent scapular border at apparently new compared to the prior radiograph. No additional nodules are observed in the remainder of the lungs. Heart is enlarged but stable in size. There is no pleural effusion. Scoliosis is again demonstrated. IMPRESSION: Right upper lobe nodular opacity, not fully evaluated by chest radiography. Recommend chest CT for confirmation and further characterization. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 11:07 into the Department of Radiology critical communications system for direct communication to the referring provider. " 75e77956-1127fe37-364d6f1c-9623828d-72994209.jpg,validate/p19/p19960115/s50165807/75e77956-1127fe37-364d6f1c-9623828d-72994209.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pancreatic cancer, hx pleural effusion, worsening DOE // f/u pleural effusion, eval for pneumonia f/u pleural effusion, eval for pneumonia IMPRESSION: Compared to prior chest radiographs, ___ through ___. Large right and moderate left pleural effusion have increased obscuring much of the lower lungs, mild edema has developed in the upper lungs, and there may be a new region of right suprahilar consolidation due to pneumonia. Heart size top-normal. No pneumothorax. Left central venous infusion port ends in the SVC. NOTIFICATION: Yet data is a its which tumor ___ this afternoon as I which your target not The findings were discussed with ? ___ , M.D. by ___, M.D. on the telephone min after the initial page placed immediately following on ___ at 12:37 PM, 20 minutes after discovery of the findings. " 25573606-60650e6b-746dd491-482090cf-95a0ed9d.jpg,validate/p14/p14325424/s51695608/25573606-60650e6b-746dd491-482090cf-95a0ed9d.jpg,validation," FINAL REPORT INDICATION: Pneumothorax, status post bronchoscopic valve placement, evaluate for endotracheal tube placement. COMPARISON: ___ at 7:46 a.m. FINDINGS: Right PICC ends in the right brachiocephalic vein. New left chest tube ends in the upper hemithorax. Endotracheal tube ends 4.9 cm from the carina. An enteric tube ends in the stomach. The small left pneumothorax is mildly increased in size from prior study with a deep sulcus sign. Right infrahilar opacity is unchanged. The heart size is normal. Mediastinal and hilar contours are normal. IMPRESSION: 1. Interval placement of left chest tube. Appreciably increase in left pneumothorax, still not more than moderate. 2. Right PICC ends in the right brachiocephalic vein. 3. Unchanged right infrahilar opacity. " 3af58dd7-9056d041-4b5746b5-8e081b5a-3eeaf8c8.jpg,validate/p17/p17477876/s50333519/3af58dd7-9056d041-4b5746b5-8e081b5a-3eeaf8c8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with COPD, left sided back pain down left arm // eval for large mass 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. " 7cb10588-cc40cd90-cde6fc1d-269f8514-aad3941f.jpg,validate/p17/p17051420/s56998073/7cb10588-cc40cd90-cde6fc1d-269f8514-aad3941f.jpg,validation," 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. " 6ee694f0-a28927c1-7eac3ed7-3f8a27c0-7374bb38.jpg,validate/p14/p14504631/s54439632/6ee694f0-a28927c1-7eac3ed7-3f8a27c0-7374bb38.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung cancer s/p robotic RLL lobectomy // eval post-op baseline, please perform in PACU eval post-op baseline, please perform in PACU IMPRESSION: No comparison. Status post right lower lobectomy. The right postoperative chest tube is in situ. Minimal right pleural effusion but no evidence of right pneumothorax. Minimal retrocardiac atelectasis and overinflation of the stomach. Moderate cardiomegaly without pulmonary edema. " 5ac72214-718f5236-d825bcbe-017da993-7fd768a4.jpg,validate/p15/p15557817/s54904015/5ac72214-718f5236-d825bcbe-017da993-7fd768a4.jpg,validation," FINAL REPORT INDICATION: Newly placed nasogastric tube. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal chest radiograph. FINDINGS: A Dobbhoff tube terminates within the stomach. The heart size is normal. The hila and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: Dobhoff tube terminating within the stomach. " 1a41a7da-dd4f8b31-d9682d48-4a9bdcb0-ce8fd1ce.jpg,validate/p17/p17959674/s55976828/1a41a7da-dd4f8b31-d9682d48-4a9bdcb0-ce8fd1ce.jpg,validation," WET READ: ___ ___ ___ 7:49 AM No focal consolidation to suggest pneumonia. Nodules are better evaluated on FDG PET-CT from ___. WET READ VERSION #1 ___ ___ ___ 2:33 AM No focal consolidation to suggest pneumonia. Nodules are better evaluated on FDG PET-CT from ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hairy cell leukemia, persistent fevers // evaluate tachypnea, new cough evaluate tachypnea, new cough COMPARISON: Comparison to ___ at 18:35 FINDINGS: Portable upright chest radiograph ___ at 19:47 is submitted. IMPRESSION: Stable cardiac and mediastinal contours in this patient with known mediastinal lymphadenopathy. Lungs remain well inflated without evidence of focal airspace consolidation to suggest pneumonia. No pneumothorax or pulmonary edema. Faint opacity in the periphery of the left upper lobe likely corresponds to a mass seen on CT dated ___. The other of lung nodules seen on CT are not well appreciated on plain radiograph. Deformity of the right midclavicle consistent with prior fracture. " 20b5a5b4-8711844d-5b54cc55-55ecb53c-dfddddd8.jpg,validate/p11/p11349715/s57518086/20b5a5b4-8711844d-5b54cc55-55ecb53c-dfddddd8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: chest pain. COMPARISON: ___. FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. At the medial aspect of the right lung bases, seen in the right lower lobe on the lateral radiograph, is an area of increased radiodensity with air bronchograms. In the appropriate clinical setting, this could reflect pneumonia. No other changes. No pleural effusions. Normal hilar and mediastinal structures. At the time of dictation and observation, 3:55 p.m., on ___, the referring physician, ___. ___, was paged for notification and the findings were discussed over the telephone. " 66840a95-1939e764-f3617427-14a18cc3-d5e3f4d0.jpg,validate/p14/p14744387/s51945521/66840a95-1939e764-f3617427-14a18cc3-d5e3f4d0.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. FINDINGS: Prominence of the right upper and lower paratracheal region is likely from enlarged mediastinal paratracheal lymph nodes and is better assessed from prior chest CT from ___. Both lungs are clear. There are no lung opacities concerning for pneumonia. There is no pleural abnormality. Heart size and hilar contours are normal. " 8cb711b4-d3dd0e7b-c6083b5a-68773a40-74c42929.jpg,validate/p18/p18912622/s55581278/8cb711b4-d3dd0e7b-c6083b5a-68773a40-74c42929.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with lethargy, shortness of breath and cough. Wheeze is on exam. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is a focal opacity at the left lung base obscuring the left heart border which is new from prior which is also seen on the lateral. Elsewhere the lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormality detected. IMPRESSION: Lingular opacity compatible with pneumonia in the proper clinical setting. " 0015ca95-f3f845c0-4d5fb0be-4fe24471-147939ed.jpg,validate/p19/p19905646/s55173652/0015ca95-f3f845c0-4d5fb0be-4fe24471-147939ed.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: Prior study is dated ___. CLINICAL HISTORY: Chest pain, assess for acute abnormalities. FINDINGS: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal clips are noted compatible with prior CABG. The lungs are clear. No pleural effusion or pneumothorax is seen. Heart and mediastinal contours appear normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " ae5c8476-900261b2-2fded5a7-8dad690d-b63493e6.jpg,validate/p15/p15057394/s54183245/ae5c8476-900261b2-2fded5a7-8dad690d-b63493e6.jpg,validation," FINAL REPORT PORTABLE CHEST ___, ___ COMPARISON: Radiograph of ___. FINDINGS: The patient is status post median sternotomy and coronary bypass surgery. Cardiomediastinal contours are unchanged. Patchy opacity at the right lung base medially favors atelectasis in the recent postoperative setting, but early focus of infection is also possible as well as localized area of aspiration. Linear opacities in left mid and lower lung are probably due to scarring given similar appearance on prior study. " 0698a9f6-428f1128-1a8ddc6d-75ab5c9d-905cccdf.jpg,validate/p18/p18326030/s56637797/0698a9f6-428f1128-1a8ddc6d-75ab5c9d-905cccdf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right sided pleural effusion // any interval change? any interval change? IMPRESSION: Compared to chest radiographs since ___, most recently ___. Very large right pleural effusion has grown, now collapses the right lung entirely and shifts the mediastinum more severely into the left hemi thorax. There is no pneumothorax. Due to displacement, moderate atelectasis in the left lower lobe has worsened. There is no pulmonary edema. NOTIFICATION: The findings were discussed with ___ (In Hospital, On Page), ___, M.D. by ___, M.D. on the telephone on ___ at 1:42 PM, 1 minutes after discovery of the findings. " bc029029-cd6090e1-1be1cd9d-676e6b2a-99544b56.jpg,validate/p19/p19736038/s53283753/bc029029-cd6090e1-1be1cd9d-676e6b2a-99544b56.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest tube, may have pulled tube out slightly with movement. // Evaluate for movement of chest tube. Evaluate for movement of chest tube. IMPRESSION: Comparison to ___. The pigtail catheter on the left is still in intrathoracic location. No substantial change is seen as compared to the previous image. The extent of the pleural effusion is also stable. " 608cc31d-becace66-e6f752f3-aaefaad0-245f2593.jpg,validate/p17/p17995224/s59049864/608cc31d-becace66-e6f752f3-aaefaad0-245f2593.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with septic knee joint // 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 cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 33eed8ee-7e74b8f0-8b703b90-d3d46004-897da399.jpg,validate/p13/p13031024/s59596599/33eed8ee-7e74b8f0-8b703b90-d3d46004-897da399.jpg,validation," 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. " 00f98303-b3807662-2016bee3-af666ff0-a6012b60.jpg,validate/p18/p18593476/s54079586/00f98303-b3807662-2016bee3-af666ff0-a6012b60.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain and shortness of breath eval pna, pnx 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, hypertrophic changes are noted in the spine. IMPRESSION: No acute cardiopulmonary process. " 4127b46f-198cdc31-45fc489e-9e863685-e36bf603.jpg,validate/p15/p15539637/s50947654/4127b46f-198cdc31-45fc489e-9e863685-e36bf603.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, fevers // ? acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Patchy lingular opacity, best seen on the frontal view, pneumonia versus atelectasis. No pleural effusion or pneumothorax is seen. The cardiac right is top-normal. Mediastinal contours are grossly unremarkable. No pulmonary edema is seen. IMPRESSION: Patchy lingular opacity, pneumonia versus and/or atelectasis. No priors for comparison. " 65cd2196-97db9f9b-ae121493-343d5925-ab3c1bf2.jpg,validate/p13/p13434904/s51650581/65cd2196-97db9f9b-ae121493-343d5925-ab3c1bf2.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with persistent pleuritic chest pain and shortness of breath. Evaluate. 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 unremarkable. No mediastinal abnormalities are seen. 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 apical area on frontal view. When comparison is made with the next previous study of ___, no significant interval change can be identified. IMPRESSION: Normal chest findings. No evidence of pleural effusions. " eddba5b7-28ed68d0-d87cf209-38f08abb-3d4946be.jpg,validate/p11/p11517178/s52207786/eddba5b7-28ed68d0-d87cf209-38f08abb-3d4946be.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Tracheostomy, check interval change. REFERENCE EXAM: ___. Compared to the prior study, there is no significant interval change. " d682a9d5-d6ccc44f-63abdfbf-1a0dfb2a-4f7f570f.jpg,validate/p19/p19085766/s56727188/d682a9d5-d6ccc44f-63abdfbf-1a0dfb2a-4f7f570f.jpg,validation," FINAL REPORT HISTORY: Weakness, fall. COMPARISON: Comparison is made with chest radiographs ___. FINDINGS: PA and lateral images of the chest. The lungs are well expanded and clear. Mild prominence of the pulmonary vasculature is noted. No mass or consolidation is seen. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is mildly enlarged, stable from prior exam. Possible mitral annulus calcification is seen. IMPRESSION: Mild prominence of the pulmonary vasculature. " fb45baec-bd62c6e4-527a21e8-a26b1e7b-35c83f7d.jpg,validate/p19/p19454512/s54953697/fb45baec-bd62c6e4-527a21e8-a26b1e7b-35c83f7d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with body aches // Eval for pneumonia COMPARISON: ___ and ___. FINDINGS: AP upright and lateral views of the chest provided. Chronic elevation of the right hemidiaphragm is again noted. Clips project over the right upper quadrant. There is a stable appearance of the chest with scattered reticular and ground-glass opacities which appear grossly unchanged from a prior CT from ___ suggesting a chronic inflammatory process. No large effusion or pneumothorax. An IVC filter projects over the upper abdomen. No pneumothorax. Bony structures demineralized and intact. IMPRESSION: Stable appearance of the chest as compared with a prior CT from ___ with scattered ground-glass and reticular opacities likely reflecting a chronic inflammatory process. " 260ea760-2238b6cf-0f7dbbf9-1bd46f96-b17a2c66.jpg,validate/p12/p12113630/s56350620/260ea760-2238b6cf-0f7dbbf9-1bd46f96-b17a2c66.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain after trauma to chest. // r/o displacement of pacer wire, ? rib fx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Single lead left-sided AICD is seen with lead extending to the expected position of the right ventricle.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. " 9b6ca71f-48884066-e76a2980-ea9baf20-5c3e41c1.jpg,validate/p19/p19213399/s53765929/9b6ca71f-48884066-e76a2980-ea9baf20-5c3e41c1.jpg,validation," FINAL REPORT AP AND LATERAL CHEST X-RAY OF ___ No prior studies for comparison. FINDINGS: Heart size is normal. Aorta is mildly tortuous. Prominence of the central pulmonary arteries is present bilaterally. Lungs are slightly overexpanded but grossly clear except for focal linear atelectasis versus scar at the left lung base. There are no pleural effusions or acute skeletal findings. IMPRESSION: Focal linear opacity in left lower lobe is a very nonspecific finding, but linear atelectasis can be observed in the setting of pulmonary embolism, the clinically suspected diagnosis provided in the history for this exam. With this in mind, further evaluation with CT pulmonary angiogram should be considered to more definitively evaluate for the possibility of pulmonary embolism given the clinical suspicion for this entity. " 5628accb-5196c2f5-2bfd37ca-41a069a8-2b95f4ff.jpg,validate/p15/p15267202/s54532010/5628accb-5196c2f5-2bfd37ca-41a069a8-2b95f4ff.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post aortic valve replacement with shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Low lung volumes are again seen with crowding of the pulmonary bronchovascular markings with likely superimposed vascular congestion. There is no large effusion or confluent consolidation. Streaky bibasilar opacities suggestive of atelectasis, more so on the left, as noted on prior. Postoperative changes of aortic valve replacement seen with median sternotomy wires and prosthetic aortic valve. No acute osseous abnormality is detected. IMPRESSION: Pulmonary vascular congestion without definite superimposed acute consolidation or large effusion. " 9d1c66e0-efd58beb-673d5a6f-ec010b21-998efea5.jpg,validate/p12/p12994825/s51284007/9d1c66e0-efd58beb-673d5a6f-ec010b21-998efea5.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Left arm numbness an EKG changes. 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. IMPRESSION: No evidence of acute disease. " 7e5abd60-7deb29db-ef7e1631-207ea419-658ee3f5.jpg,validate/p11/p11017644/s59167484/7e5abd60-7deb29db-ef7e1631-207ea419-658ee3f5.jpg,validation," FINAL REPORT HISTORY: ET placement and possible pneumothorax. FINDINGS: The tip of the endotracheal tube measures approximately 3.3 cm above the carina. Left IJ catheter extends to the mid to lower portion of the SVC. Nasogastric tube extends well into the stomach. No evidence of pneumothorax. There is a patchy area of increased opacification in the left mid and lower zone laterally, raising the possibility of aspiration. Contrast material is seen within the stomach. The right lung is essentially clear. " f6b9f86e-90cb3586-ecee1557-a3909236-173d1fa0.jpg,validate/p18/p18092465/s57196091/f6b9f86e-90cb3586-ecee1557-a3909236-173d1fa0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___F w/severe ARDS. // Evaluate for interval change. COMPARISON: Chest radiographs since ___, most recently ___ at 01:01. impression IMPRESSION: Tip of the repositioned endotracheal tube, with the chin down, is 3 cm from the carina, appropriately positioned. Nasogastric tube passes into the mid portion of the stomach, and out of view. Right jugular line ends close to the superior cavoatrial junction. Severe, heterogeneously distributed consolidation is unchanged in both lungs. Relative contributions of edema, hemorrhage, and pneumonia radiographically indeterminate. Heart is probably not severely enlarged. No pneumothorax. " ded0245c-5401c849-1780b4df-6dd37b6e-8c9428b3.jpg,validate/p17/p17990475/s56432923/ded0245c-5401c849-1780b4df-6dd37b6e-8c9428b3.jpg,validation," FINAL REPORT INDICATION: Recent colonoscopy now with back pain. Evaluate for air under the diaphragm or pneumatosis. TECHNIQUE: Upright frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are normal and the lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. The mediastinal and hilar contours are unremarkable. There is no free air seen underneath either diaphragm. IMPRESSION: No free intra-abdominal air. " 6683cd94-8e5f4163-19ec7e6d-6f83b168-aae427a7.jpg,validate/p10/p10765644/s52220727/6683cd94-8e5f4163-19ec7e6d-6f83b168-aae427a7.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with history of CHF presenting with abnormal labs. COMPARISON: Portable AP chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricles. Nonstandard termination of right atrial lead may indicate it is not embedded. Cardiomegaly is stable since ___. Bilateral pleural effusions are again noted; moderate on the left and small on the right. Retrocardiac opacity likely represents pleural effusion with atelectasis similar to ___. Left costophrenic sulcus is obscured by the pacer generator on the frontal view. No pneumothorax. " 5636e6ed-b6d10243-4218b12c-a78cc4ec-20510889.jpg,validate/p11/p11547745/s58216586/5636e6ed-b6d10243-4218b12c-a78cc4ec-20510889.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with increasing hypoxia // PNA? Pulmonary Edema? PNA? Pulmonary Edema? IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lung volumes are lower exaggerating the increase in moderate pulmonary edema, central pulmonary vascular congestion, and left lower lobe atelectasis. Heart size is normal. Small pleural effusions unchanged. No pneumothorax. Right jugular line ends close to the superior cavoatrial junction. " bb204dfa-45b508cb-153d6a44-c40da58d-fc5cb330.jpg,validate/p19/p19402811/s55883782/bb204dfa-45b508cb-153d6a44-c40da58d-fc5cb330.jpg,validation," 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. " 806c966c-ea965e39-adc321d5-01a0cab4-b098a66c.jpg,validate/p17/p17979567/s50414816/806c966c-ea965e39-adc321d5-01a0cab4-b098a66c.jpg,validation," FINAL REPORT AP CHEST, 7:27 A.M., ___ HISTORY: A ___-year-old man with fever and cirrhosis. IMPRESSION: AP chest compared to ___ through ___: Interval increase in mediastinal caliber at the level of the vascular pedicle, the pulmonary outflow tract, and upper lobe pulmonary vessels suggest volume overload. Heart size increased slightly. No pulmonary edema as yet. No pleural effusion. " 76e84760-9c34dd9f-53648845-e983ec8c-340a4bbe.jpg,validate/p17/p17051420/s51981524/76e84760-9c34dd9f-53648845-e983ec8c-340a4bbe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CTA ___, chest CT ___ FINDINGS: Mild to moderate enlargement of the cardiac silhouette is unchanged. The mediastinal and hilar contours are similar. No pulmonary vascular congestion is visualized. Subtle increased interstitial opacities are demonstrated diffusely within the lungs, likely reflective of known chronic interstitial lung disease and chronic airways disease, better assessed on the previous chest CT. Atelectasis is also noted in both lung bases. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: Mild chronic interstitial abnormality better assessed on the previous chest CT from ___. No focal consolidation to suggest pneumonia. Bibasilar atelectasis. " 1c4d2e04-29a7b738-55000b00-b698d27a-e15f67f1.jpg,validate/p15/p15139456/s57327711/1c4d2e04-29a7b738-55000b00-b698d27a-e15f67f1.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Persistent cough and right upper lobe rhonchi. IMPRESSION: PA and lateral chest reviewed in the absence of any prior chest radiographs: Lungs are fully expanded and clear. The heart is not enlarged. Effacement of the mediastinal contours in the region of the aortopulmonic window can be a normal finding in young women. This study does not constitute a full evaluation of the central airways, although there are no findings to suggest abnormality. If symptoms persist and signs point to a tracheobronchial abnormality, then CT scanning would be definitive, but I would proceed that with an attempt at imaging the tracheobronchial region with oblique views as well as conventional radiographs. IMPRESSION: Probably normal chest radiograph. If symptoms persist, I would repeat PA, lateral and oblique chest radiographs in no more than six weeks. " 0e201b93-862230fc-e32d6af1-426ee55c-f475cd9e.jpg,validate/p15/p15606157/s59948002/0e201b93-862230fc-e32d6af1-426ee55c-f475cd9e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with fever // PNA? TECHNIQUE: Portable AP radiograph view of the chest COMPARISON: PA and lateral chest radiograph dated ___. Reference is made to the CT chest dated ___. FINDINGS: Lung volumes are slightly lower compared to the prior exam. Slightly asymmetric increased opacity in the right infrahilar region could reflect bronchovascular crowding and atelectasis but an early bronchopneumonia cannot be excluded, particularly in the setting of prior CT showing an opacity in the right lower lobe. No effusion, edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. Aortic knob calcifications are unchanged. No acute osseous abnormality. IMPRESSION: Possible early bronchopneumonia in the right lower lung. Subtle opacity in right perihilar region, which may correspond to a superior segment right lower lobe abnormality detected on CT of ___, at which time the three-month followup CT was recommended. RECOMMENDATION(S): CT scan in ___ to reassess superior segment right lower lobe abnormality which is been more fully characterized on CT of ___ as. NOTIFICATION: Results and recommendation were communicated via telephone to the inpatient team on ___ at 915 am. " b9857ab9-621ac729-757a2513-a134d755-ccbbde63.jpg,validate/p11/p11103524/s55808561/b9857ab9-621ac729-757a2513-a134d755-ccbbde63.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Left upper chest pain and cough. COMPARISONS: ___. 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 no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are within normal limits. IMPRESSION: No evidence of acute disease. " 2dd12533-dc444b01-0d157039-5e6d20ae-029861b0.jpg,validate/p14/p14252529/s59800040/2dd12533-dc444b01-0d157039-5e6d20ae-029861b0.jpg,validation," FINAL REPORT HISTORY: Epigastric pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The 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. Several clips are noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary process. " 0f1ef45a-74870378-ab2ad45e-fb80398d-b6d44700.jpg,validate/p12/p12276698/s59621345/0f1ef45a-74870378-ab2ad45e-fb80398d-b6d44700.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and shortness of breath. COMPARISON: ___. FINDINGS: PA and lateral views of the chest demonstrate minimal left lower lobe atelectasis or scarring. The lungs are clear of opacities concerning for infection. Cardiomediastinal silhouette and hilar contours are unremarkable. No current pleural effusion. Old right eighth rib deformity is noted posteriorly. IMPRESSION: No evidence of acute cardiopulmonary process. " 8de8381d-0f2202a2-3af12183-528f7db4-cd42d102.jpg,validate/p14/p14240547/s50211520/8de8381d-0f2202a2-3af12183-528f7db4-cd42d102.jpg,validation," 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. " ddfb6461-f46307d6-a0dce254-baba4fbb-995c09c0.jpg,validate/p18/p18036188/s53418493/ddfb6461-f46307d6-a0dce254-baba4fbb-995c09c0.jpg,validation," FINAL REPORT HISTORY: Chest tube clamped, to assess for pneumothorax. FINDINGS: In comparison with the earlier study of this date, no definite pneumothorax is appreciated, though multiple overlying bony structures makes at the right apex difficult to assess. Otherwise, little change. " 1509175b-71294267-73aa218a-d7df09bb-56b71f33.jpg,validate/p19/p19190114/s56225589/1509175b-71294267-73aa218a-d7df09bb-56b71f33.jpg,validation," 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 clear. No pleural effusion or pneumothorax is seen. Degenerative changes are noted throughout the spine. " c569a7b8-0f7d38a8-7cf4df42-87916895-ad28cd97.jpg,validate/p13/p13998587/s54881935/c569a7b8-0f7d38a8-7cf4df42-87916895-ad28cd97.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cough tachypnea, pls eval pna // ___ year old man with cough tachypnea, pls eval pna TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomediastinal silhouette is unchanged including relatively wide mediastinum, most likely reflecting mediastinal lipomatosis but slight interval increase since the prior study obtained in ___ has been demonstrated and correlation with repeated chest CT to exclude the possibility of mediastinal abnormality is required. No definitive evidence of pulmonary edema or pneumonia is present. " 805a9238-8052f99c-2b610d27-dc3cd053-a0faa0fd.jpg,validate/p15/p15961741/s58240151/805a9238-8052f99c-2b610d27-dc3cd053-a0faa0fd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post PICC line placement. History of lymphoma. COMPARISONS: ___. TECHNIQUE: Chest, AP upright portable. FINDINGS: There is a right-sided PICC line in situ, which probably terminates in the upper part of the superior vena cava shortly below the confluence of the brachiocephalic veins, somewhat pulled back from its prior position. However, because of overlying soft tissue attenuation, the catheter is difficult to follow into the mediastinum, so it may terminate somewhat lower in the superior vena cava. The cardiac, mediastinal, and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: PICC line apparently terminating in the upper superior vena cava, although owing to poor visualization of its course in the mediastinum, it may protrude somewhat inferiorly than is apparent from this image. No evidence of acute disease. " 36b4b38a-45d6f597-6efef295-7b3fb2a1-f947471c.jpg,validate/p14/p14280192/s59095800/36b4b38a-45d6f597-6efef295-7b3fb2a1-f947471c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p OGT placement s/p OGT placement IMPRESSION: In comparison with the study ___ ___, a view of the abdomen shows that the nasogastric tube extends to the antrum. Little overall change in the appearance of the heart and lungs. " 19763255-d3618f4b-bc39ce10-e5e044ed-37e44274.jpg,validate/p15/p15455450/s53884698/19763255-d3618f4b-bc39ce10-e5e044ed-37e44274.jpg,validation," 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. " 5f89408f-9d945a59-85067ab3-9d40bd55-6f0fb388.jpg,validate/p17/p17535980/s58908195/5f89408f-9d945a59-85067ab3-9d40bd55-6f0fb388.jpg,validation," 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. " 677a8318-799ff08f-c7b2c543-9603330d-5bcba80b.jpg,validate/p19/p19988077/s55486582/677a8318-799ff08f-c7b2c543-9603330d-5bcba80b.jpg,validation," FINAL REPORT PORTABLE CHEST, ___. COMPARISON: ___. FINDINGS: Lung volumes remain low. Cardiomediastinal contours are stable. Interval improvement in extent of bibasilar atelectasis. Persistent small left pleural effusion. Questionable ascites accounting for diffuse haziness of imaged upper abdomen. " 685dc9d8-229a39c6-07050e29-e7af77f4-a47de808.jpg,validate/p19/p19348515/s52025793/685dc9d8-229a39c6-07050e29-e7af77f4-a47de808.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Shortness of breath, cheat pain and effusions. Comparison is made to the prior study, ___. Mild-to-moderate cardiomegaly is stable. Moderate right and small left pleural effusions are grossly unchanged. Bibasilar atelectasis, larger on the right side, have minimally increased. Mild pulmonary edema is stable. Opacity in the left mid lung is grossly unchanged; could be asymmetric edema or pneumonia. Right basal pigtail catheter is again noted. Sternal wires are aligned. " d404c9bd-f77cc584-00555b43-493c633a-18f228e5.jpg,validate/p10/p10801854/s50944794/d404c9bd-f77cc584-00555b43-493c633a-18f228e5.jpg,validation," FINAL REPORT HISTORY: Malignant effusions, to assess for change. FINDINGS: In comparison with the study of ___, there again are moderate pleural effusions bilaterally with compressive atelectasis at the bases, more prominent on the right. No evidence of pulmonary vascular congestion. The lung volumes are decreased since the previous study. " b6133957-0c5a65b9-08a1d086-2442edfd-66db92a0.jpg,validate/p17/p17001135/s57482600/b6133957-0c5a65b9-08a1d086-2442edfd-66db92a0.jpg,validation," WET READ: ___ ___ 2:48 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with sob // sob 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. Again seen is S-shaped scoliosis of the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 9397c42c-f89358b6-cea25dc0-53224905-a2b2f31e.jpg,validate/p15/p15938425/s58788212/9397c42c-f89358b6-cea25dc0-53224905-a2b2f31e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. Question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs remain clear. There is no effusion or pulmonary vascular congestion. Cardiac silhouette is stable. Median sternotomy wires again seen. No acute osseous abnormality detected. Surgical clips seen in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 6d0fbad9-b01c31db-04b7beca-c0637897-7837c69e.jpg,validate/p13/p13921089/s58207130/6d0fbad9-b01c31db-04b7beca-c0637897-7837c69e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with epigastric pain, known stones, evaluate for pneumothorax. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal silhouettes are 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. There is no free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. No pneumothorax. " 11b025c0-d55ed350-49b399b0-95e326b1-4850564a.jpg,validate/p18/p18100158/s51901206/11b025c0-d55ed350-49b399b0-95e326b1-4850564a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with cough, weakness // pna? TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Chest CT from ___ and chest CTA from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is a moderate-sized right pleural effusion which allowing for differences in technique appear slightly increased in size since prior CT examinations. Focal lucency and air-fluid level within the pleural fluid suggests the presence of a hydropneumothorax. No focal consolidation is identified. IMPRESSION: Moderate-sized right pleural effusion, which allowing for differences in technique, appears slightly increased in size since prior CT examinations. Focal lucency and an air-fluid level within the right pleural fluid suggests the presence of a hydropneumothorax. " ee9d9d3b-ee620500-fba340fe-f7a96e2c-d42af023.jpg,validate/p15/p15007903/s54669414/ee9d9d3b-ee620500-fba340fe-f7a96e2c-d42af023.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with history of COPD (2L nocturnal O2), CAD s/p 1 stent, HTN, HLD, prior severe diverticulitis s/p colostomy and reversal, prior tracheostomy and reversal here with pneumoperitoneum // interval change TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ and ___ IMPRESSION: Right hilar enlargement is suspected, concerning for substantial lymphadenopathy. Right paratracheal strip enlargement is also noted also highly concerning for lymphadenopathy. Right upper lobe opacity is noted, potentially new O but unclear if present on the previous examination. Right PICC line tip is at the level of superior SVC. Pneumoperitoneum is re- demonstrated, at least similar to previous examination if not increased. Father assessment with CT chest is required for characterization of the above described right hilar and paramediastinal findings. " 320f1a2e-1a0e66bb-f22bdb98-2a9a7ec8-bcbdce90.jpg,validate/p14/p14973190/s50287742/320f1a2e-1a0e66bb-f22bdb98-2a9a7ec8-bcbdce90.jpg,validation," FINAL REPORT A PORTABLE CHEST FILM ___ AT 541 CLINICAL INDICATION: ___-year-old with fluid overload, assess for interval change. Comparison made to prior study of ___ at ___. Portable semi-erect chest film ___ at 6 a.m. is submitted. IMPRESSION: 1. Right internal jugular central line and nasogastric tube are unchanged in position. 2. Interval worsening of mild-to-moderate pulmonary edema. Layering effusions, left greater than right with associated retrocardiac consolidation likely reflecting compressive atelectasis. Superimposed pneumonia cannot be excluded. No pneumothorax. Overall, cardiac and mediastinal contours are likely stable. " 49512340-6987d732-a13d67e1-f7435703-3f493097.jpg,validate/p14/p14755254/s54085514/49512340-6987d732-a13d67e1-f7435703-3f493097.jpg,validation," 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. " 0079a961-24e4535b-ed911dbe-f35c513b-fac9d7eb.jpg,validate/p19/p19336651/s53045297/0079a961-24e4535b-ed911dbe-f35c513b-fac9d7eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF here for GI bleed. // Please assess for interval change Please assess for interval change COMPARISON: Chest radiographs since ___ most recently ___ and ___. IMPRESSION: Moderate left pleural effusion, with a paraspinal component is unchanged since ___. Pulmonary vascular congestion has worsened. Moderate to severe cardiomegaly is stable. There is no pulmonary edema. No pneumothorax. " f8eba1f5-73e7d8a0-db7ede28-e7d93d9d-346d5e6b.jpg,validate/p16/p16619721/s54996690/f8eba1f5-73e7d8a0-db7ede28-e7d93d9d-346d5e6b.jpg,validation," WET READ: ___ ___ ___ 8:11 PM Improving right lower lobe airspace opacities, which may reflect resolving pneumonia. Persistent blunting of the bilateral costophrenic angles may reflect chronic scarring, atelectasis, or trace effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with emphysema, pHTN, pulmonary edema // Please evaluate for acute processes before lung scan TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomegaly is moderate, unchanged. There is interval improvement in pulmonary edema with still present bilateral pleural effusions and bibasal atelectasis. Improving right lower lobe airspace opacity might represent improving of pneumonia or aspiration. " 28fb6553-8ba10482-f539a895-f1988384-6706ded2.jpg,validate/p14/p14240547/s52885587/28fb6553-8ba10482-f539a895-f1988384-6706ded2.jpg,validation," 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. " d81428f3-92284264-045b50d1-7e273590-a7c7de24.jpg,validate/p10/p10409079/s50940879/d81428f3-92284264-045b50d1-7e273590-a7c7de24.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man swallowed sharp object s/p EGD // ?mediastinal air ?mediastinal air IMPRESSION: No previous images. There are low lung volumes that accentuate the transverse diameter of the heart. Endotracheal tube tip is at the clavicular level, approximately 4.5 cm above the carina. No evidence of vascular congestion. Thick band of atelectasis is seen in the left lower lung. No definite acute pneumonia. Specifically, there is no evidence of pneumomediastinum or pneumothorax. Generalized adynamic ileus. " 0bce5c02-16e58869-8169a860-740a8a87-34892c81.jpg,validate/p10/p10055694/s59844689/0bce5c02-16e58869-8169a860-740a8a87-34892c81.jpg,validation," 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. " f9c9598e-11bd0dae-46c7bdb0-1b565ade-8d982c1f.jpg,validate/p13/p13405890/s59635065/f9c9598e-11bd0dae-46c7bdb0-1b565ade-8d982c1f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of pleural effusion and shortness of breath. PA and lateral upright chest radiographs were reviewed in comparison to ___. There is interval resolution of pulmonary edema. Still present small bilateral pleural effusions are noted associated with bibasal atelectasis. Cardiomegaly is substantial. Upper mediastinum is unremarkable. There is no evidence of pneumothorax. " 25eca98a-48796511-c16aeafe-cc1d4b84-1b117225.jpg,validate/p19/p19427735/s58735131/25eca98a-48796511-c16aeafe-cc1d4b84-1b117225.jpg,validation," 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. " b34e85d9-7e4d80ff-4a90a6fd-927eca4b-31d76f87.jpg,validate/p12/p12384095/s59789761/b34e85d9-7e4d80ff-4a90a6fd-927eca4b-31d76f87.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Multiple rib fractures. COMPARISONS: Radiographs from ___ and earlier CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The aorta is again moderately tortuous with patchy calcification. Streaky left basilar opacity suggests minor atelectasis or scarring in the left lower lobe. There is a small suspected left-sided pleural effusion. There are mildly displaced fractures involving the anterior left second through fifth ribs. There is displacement among left anterior second, third, and fifth fractures by nearly a half shaft width. These show vague sclerosis, particularly the fifth, suggesting callus, but without complete remodeling. IMPRESSION: Multiple rib fractures, including three mildly displaced fractures with suspected early callus formation. Small left-sided pleural effusion. " 7c81c038-4010cd41-ce6f5019-041a433d-57614c5c.jpg,validate/p18/p18916540/s55625983/7c81c038-4010cd41-ce6f5019-041a433d-57614c5c.jpg,validation," FINAL REPORT INDICATION: Chest pain, rule out infectious process. COMPARISON: None. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Heart size is top normal. The osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 23aeb63a-e5bade3d-3bc0b85f-0e804ace-c01f9b49.jpg,validate/p14/p14353305/s58215939/23aeb63a-e5bade3d-3bc0b85f-0e804ace-c01f9b49.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with primary spontaneous ptx // ptx COMPARISON: CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY PREOPERATIVE CHEST RADIOGRAPH ___. IMPRESSION: Tiny residual left apical pneumothorax well lung repair. 2 left pleural drains in place. No appreciable left pleural effusion are atelectasis. Right lung clear. Normal postoperative appearance the cardiomediastinal silhouette. " c99386c3-b4d90fe8-58c6dce6-c3b1d489-82c3c451.jpg,validate/p19/p19310285/s50737820/c99386c3-b4d90fe8-58c6dce6-c3b1d489-82c3c451.jpg,validation," FINAL REPORT INDICATION: Status post cervical tracheal resection. COMPARISON: CT trachea ___. FRONTAL PORTABLE CHEST RADIOGRAPH: A moderate right pneumothorax is seen. No left pneumothorax. Low lung volumes result in bronchovascular crowding with linear atelectasis in the left mid lung. There may be a small amount of right pneumomediastinum. No pleural effusion is identified. Heart size is top normal allowing for lung volumes. Mediastinum is widened but not signifcantly changed from preoperative CT appearance. IMPRESSION: Moderate right pneumothorax and possible right pneumomediastinum. Dr. ___ ___ the findings with Dr. ___ by phone at 2:44 p.m. on ___ upon discovery. " 82a5ad65-6bc3b9fa-a3d9920e-5cbd8199-e751ffaa.jpg,validate/p11/p11296936/s55559093/82a5ad65-6bc3b9fa-a3d9920e-5cbd8199-e751ffaa.jpg,validation," FINAL REPORT INDICATION: Dyspnea, here to evaluate for pneumonia. COMPARISON: Multiple prior chest radiographs dated ___, ___, ___ and ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: There is mild interstitial pulmonary edema and vascular congestion increased from the most recent prior study of ___. There is no focal consolidation. A small right pleural effusion is minimally increased. There is no definite left pleural effusion. Mild-to-moderate enlargement of the cardiac silhouette is stable in comparison to prior studies. The mediastinal contours are within normal limits. No pneumothorax is detected. IMPRESSION: Increased mild interstitial pulmonary edema/vascular congestion with stable small right pleural effusion are suggestive of fluid overload. " d8a092f9-c4dfbdcf-4f40614d-da2b1bb4-a8218170.jpg,validate/p15/p15709365/s59066735/d8a092f9-c4dfbdcf-4f40614d-da2b1bb4-a8218170.jpg,validation," 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. " 29478296-6e763a46-311e1ee3-96f7603b-441452b2.jpg,validate/p13/p13290560/s54645063/29478296-6e763a46-311e1ee3-96f7603b-441452b2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p chest tube placement // Confirm chest tube is in place, interval change? Confirm chest tube is in place, interval change? COMPARISON: Chest radiographs ___ through ___. Chest CT ___. IMPRESSION: Left lower lobe is still collapsed, upper lobe also substantially atelectatic, without improvement since ___. Left basal pigtail pleural drainage catheter unchanged in position. Relative contribution of left pleural effusion to the opacified left hemithorax is probably minimal. Moderate pulmonary edema and small to moderate right pleural effusion have both worsened. Heart size is indeterminate. Cavitary mass right upper lobe noted. ET tube in standard placement. Nasogastric tube passes below the diaphragm and out of view. No pneumothorax. " 95135609-701107c3-660c8622-ccc0549a-8fb913da.jpg,validate/p14/p14304779/s55849428/95135609-701107c3-660c8622-ccc0549a-8fb913da.jpg,validation," 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. " edf0798f-b3a2fdbf-00c812b0-c8d3b152-10d90abf.jpg,validate/p13/p13313381/s54976328/edf0798f-b3a2fdbf-00c812b0-c8d3b152-10d90abf.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p R foot debridement and monorail application // PICC eval TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The left PICC line is again seen approaching the chest wall and enters into a smaller axillary vein. The lungs are clear. The heart size is unchanged. There is no pneumothorax, pulmonary edema, pneumonia, or pleural effusion. IMPRESSION: 1. The tip of the left PICC line is seen in a small axillary vein. RECOMMENDATION(S): Recommend the left PICC line be replaced or readjusted. NOTIFICATION: The findings were discussed with ___ , M.D. by ___, M.D. on the telephone on ___ at 4:36 PM, 20 minutes after discovery of the findings. " 4a61a2e0-dc3c7f9b-c5abbd19-b522e563-608185f3.jpg,validate/p15/p15373430/s52922002/4a61a2e0-dc3c7f9b-c5abbd19-b522e563-608185f3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ESRD and immunosupressed with new onset fevers and altered mental status // Atypical pneumonia COMPARISON: ___, 01:05 IMPRESSION: As compared to the previous radiograph, there is increasing evidence of a right basal parenchymal opacity with air bronchograms and a strong interstitial component. A similar opacity of 0 more subtle, is seen at the bases of the left lung. These opacities are combined with signs of mild fluid overload. The longitudinal ___ and distribution of changes suggests the presence of pneumonia. No pleural effusions. Borderline size of the cardiac silhouette. " bf812b6e-e79ed0f3-b3bb92bd-850adfe6-13edd1da.jpg,validate/p17/p17767787/s57368804/bf812b6e-e79ed0f3-b3bb92bd-850adfe6-13edd1da.jpg,validation," 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. " 476bcdbb-367a0007-31b56c03-cd0aa7b7-a6d6ea2f.jpg,validate/p17/p17052884/s56574845/476bcdbb-367a0007-31b56c03-cd0aa7b7-a6d6ea2f.jpg,validation," WET READ: ___ ___ ___ 8:24 AM Left PICC now in appropriate position ending in the cavoatrial junction. Otherwise little interval change in the appearance of the chest. WET READ VERSION #1 ___ ___ ___ 9:18 PM Left PICC now in appropriate position ending in the cavoatrial junction. Otherwise little interval change in the appearance of the chest. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Left PICC // Additional image to see if PICC repositioned after power flush. COMPARISON: ___. IMPRESSION: The left PICC line is now in correct position. The tip projects over the cavoatrial junction. No complications, notably no pneumothorax. " fa691642-20da1bdc-e832192c-53ba50a1-60892790.jpg,validate/p18/p18656167/s53865119/fa691642-20da1bdc-e832192c-53ba50a1-60892790.jpg,validation," FINAL REPORT INDICATION: History of COPD with respiratory distress. Evaluate for infection. COMPARISONS: Chest radiograph from ___. Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: There is a subtle opacity in the right medial lower lobe which is new from the prior two radiographs. No other focal consolidation is identified. There is no pulmonary edema, pleural effusion or pneumothorax. The lungs are mildly hyperinflated, similar to priors. The cardiomediastinal silhouette is normal. IMPRESSION: Subtle right lower lobe opacity; while this could be atelectasis, a pneumonia is difficult to completely exclude. " b6f76bb8-66f6359a-df9147f7-1a6fb0ab-a3627b9f.jpg,validate/p10/p10056209/s55555237/b6f76bb8-66f6359a-df9147f7-1a6fb0ab-a3627b9f.jpg,validation," WET READ: ___ ___ ___ 9:43 PM 1. No pneumonia. 2. Abnormal contour along the left heart with a corresponding increase in density on the lateral view. The differential includes but is not limited to absence of the pericardium, ventricular aneurysm or pericardial cyst. If no prior imaging is available, a CT would be recommended. ______________________________________________________________________________ FINAL REPORT HISTORY: Weakness and elevated lactate. Evaluate for pneumonia. COMPARISON: None. FRONTAL AND LATERAL VIEWS THE CHEST: Lung volumes are low, resulting in crowding of bronchovascular structures. Obscuration of the left costophrenic sulcus is likely from the pericardial fat. There is an abnormal contour to the left heart with corresponding increase in density seen on the lateral view. There is no pneumothorax or focal airspace consolidation worrisome for pneumonia. The mediastinal and hilar structures are unremarkable. Sternotomy wires, mediastinal clips and carotid calcifications are incidentally noted. IMPRESSION: 1. No pneumonia. 2. Abnormal contour along the left heart with a corresponding increase in density on the lateral view. The differential includes but is not limited to absence of the pericardium, ventricular aneurysm or pericardial cyst. If no prior imaging is available, a CT would be recommended. " 82181b3a-262c5f4f-ba05d73f-81498f22-8a4101e6.jpg,validate/p16/p16454913/s52383070/82181b3a-262c5f4f-ba05d73f-81498f22-8a4101e6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from earlier today. CLINICAL HISTORY: Extensive past medical history, patient in ICU with osteomyelitis of the sacrum with respiratory complaints and new right upper lobe opacity, assess layering effusion or pneumonia. FINDINGS: Portable AP upright chest radiograph obtained. Patient has a tracheostomy tube which appears grossly unchanged. NG tube courses into the left upper abdomen. A right arm PICC line is seen, tip extending into the lower SVC/right atrium. As seen previously, there is extensive opacity in the right lung concerning for pneumonia, though a component of loculated effusion is also suggested. There is likely superimposed pulmonary edema. No large left effusion. No pneumothorax. Overall, cardiomediastinal silhouette is difficult to assess. IMPRESSION: Persistent opacity involving the right lung is concerning for pneumonia with superimposed pulmonary edema. Right pleural effusion appears loculated. " 6c2cee61-2f22d306-6a310461-14ef3819-55f18f27.jpg,validate/p12/p12518771/s51300712/6c2cee61-2f22d306-6a310461-14ef3819-55f18f27.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with diastolic heart failure exacerbation // eval for edema COMPARISON: Chest x-ray from ___ at ___ FINDINGS: No lateral view was obtained on the ___ study. Allowing for this, the appearance on the frontal view is essentially unchanged. Again seen is an effusion at the right lung base, with underlying collapse and/or consolidation. The overall size of the opacity is similar to the prior study. Today's lateral view shows fluid extending along the fissure anteriorly as well as a small effusion posteriorly. The right hemidiaphragm itself is mostly obscured. The cardiomediastinal silhouette is enlarged but unchanged. There is upper zone redistribution and very mild vascular plethora, without other evidence of CHF. In the left lung, no focal infiltrate or gross effusion is seen. Minimal blunting of the left posterior costophrenic angle could be present. IMPRESSION: Based on the frontal views, doubt significant interval change compared with ___. Again seen is the effusion at the right lung base, with considerable obscuration of the right hemidiaphragm. Cardiomediastinal silhouette and mild vascular plethora are also not significantly changed. " e476ecf7-472aebcf-7c553b67-9934dd40-fcee5c39.jpg,validate/p15/p15232493/s50196778/e476ecf7-472aebcf-7c553b67-9934dd40-fcee5c39.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with h/o HFpEF, with ? crakles left base // ? edema TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___, ___ FINDINGS: Heart size continues to be mildly enlarged. Calcifications are again seen in the aorta. No pneumothorax or pulmonary edema. Opacities are seen in the left lower lobe, corresponding to opacities on the thoracic spine on lateral view, which are concerning for pneumonia. Additional opacities are seen adjacent to the aortic knob, which likely represent atelectasis. IMPRESSION: Left lower lobe pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 4:12 PM, 20 minutes after discovery of the findings. " fcce7d5a-6a58dba4-1a6d20ed-41c88ca0-79a69045.jpg,validate/p13/p13417577/s50291084/fcce7d5a-6a58dba4-1a6d20ed-41c88ca0-79a69045.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multifocal pna // pneumonia interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Suture material projecting over the left upper lung compatible with prior resection. Again seen is a focal opacity in the right lower lobe and left mid lung not significantly changed compared to prior study. Small bilateral pleural effusions are unchanged. IMPRESSION: 1. Persistent focal opacities in the right lung base and left mid lung consistent with multi focal pneumonia. 2. Small bilateral pleural effusions. " 4d712dda-6aaaa92b-cddbd8b2-4e91f171-cdadb142.jpg,validate/p16/p16336316/s52163828/4d712dda-6aaaa92b-cddbd8b2-4e91f171-cdadb142.jpg,validation," WET READ: ___ ___ 5:03 AM No evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chest pain and cough // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Lungs are well expanded clear. Mediastinal contours, hila, and cardiac silhouette are normal. No pneumothorax or pleural effusion. IMPRESSION: No evidence of pneumonia. " d8d3cf39-0508fb80-53d8508b-ce02494e-99976edf.jpg,validate/p18/p18583455/s54371683/d8d3cf39-0508fb80-53d8508b-ce02494e-99976edf.jpg,validation," FINAL REPORT INDICATION: Confusion. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes which accentuate bronchovascular markings. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Heart is mildly enlarged. There is no pulmonary edema. Spinal stimulator device is stable in position. Partially imaged upper abdomen is unremarkable. IMPRESSION: Low lung volumes. No consolidation. " a6c241f2-1ca9d801-5d1d81ed-24e0064e-22377247.jpg,validate/p10/p10877695/s54323790/a6c241f2-1ca9d801-5d1d81ed-24e0064e-22377247.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever and 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. Evidence of a hiatal hernia is seen with a retrocardiac air-fluid level. IMPRESSION: No acute cardiopulmonary process. " a839abd1-5537bcbc-36b2ea33-390e0e8d-78ff7cbb.jpg,validate/p15/p15474097/s55982118/a839abd1-5537bcbc-36b2ea33-390e0e8d-78ff7cbb.jpg,validation," WET READ: ___ ___ ___ 8:12 PM No acute cardiopulmonary process. Mild bibasilar atelectasis. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Post-operative fever and low blood pressure. Portable AP radiograph of the chest was reviewed in comparison to ___ and chest CT from ___. Heart size is enlarged, unchanged. Mediastinum is stable. Assessment of the lung parenchyma demonstrates bibasal opacities as well as perihilar vascular engorgement, thus findings are concerning for mild interstitial edema. There is most likely present small bilateral pleural effusion. There is no pneumothorax. " e80a478e-2cef3ccb-2149ccf5-ccd4b52a-46d3f814.jpg,validate/p16/p16454913/s50536873/e80a478e-2cef3ccb-2149ccf5-ccd4b52a-46d3f814.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old male intubated status post tracheostomy. Evaluate ET tube position as well as right upper lobe opacity. FINDINGS: Comparison is made to previous study from ___. The endotracheal tube tip has been pulled back slightly and is at the level of the clavicular heads, 6 cm above the carina. There remains cardiomegaly and prominence of mediastinum. There is a right-sided chest tube whose distal tip is at the lung apex. There is improvement of the subcutaneous emphysema along the right chest wall. There are again seen bilateral pleural effusions, which are stable. There is also some improvement of the airspace opacities since the previous study. " ff47511b-eb026575-83a15176-04437df7-f55edec1.jpg,validate/p12/p12459180/s50391805/ff47511b-eb026575-83a15176-04437df7-f55edec1.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with L-sided pleuritic chest pain // evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: As compared to the prior examination, there has been no relevant interval change. Mild left basilar atelectasis is noted. There is no lobar consolidation, pleural effusion, or pneumothorax. The thoracic aorta is mildly ectatic, unchanged. Cardiac size is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 5839f968-7f8b4b12-fe37f970-81be4bbf-37dc2505.jpg,validate/p14/p14485766/s59112089/5839f968-7f8b4b12-fe37f970-81be4bbf-37dc2505.jpg,validation," WET READ: ___ ___ 2:09 AM Since the study of ___ the opacity at the right base appears worsened, however this is not significantly different from the study of ___ likely reflecting some combination of pleural effusion and consolidation. In the proper clinical setting an underlying pneumonia would be difficult to exclude on the basis of this study. The remaining lung fields are clear. The heart is mildly enlarged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with endocarditis, cough and septic emboli with cough and spiking fever on ___ // PNA? PNA? COMPARISON: Prior chest radiographs ___ through ___ at 08:09. IMPRESSION: Moderate right pleural effusion is larger. There is still substantial could consolidation at the right lung base, which has changed in distribution, improved centrally, possibly worsened peripherally. Findings are still concerning for pneumonia, but not pulmonary edema, although moderate cardiomegaly is chronic. Left lung is clear. Right PIC line still ends in the low SVC. " dbcd95ba-5e24b50b-d1c01b33-b103d669-ceb01b37.jpg,validate/p13/p13593286/s54432319/dbcd95ba-5e24b50b-d1c01b33-b103d669-ceb01b37.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with left pneumothorax status post G-tube placement to suction, evaluate interval change. COMPARISON: ___. TECHNIQUE: AP radiograph, single view. FINDINGS: Left chest tube points towards the apex and appears unchanged in position. There is a lucency adjacent to the left heart border extending inferiorly deep into the left lateral sulcus. This is highly suggestive of an anterior pneumothorax. Cardiomediastinal contours are unchanged. Lungs are clear. No pleural effusions. IMPRESSION: Left anterior pneumothorax. Upright or right lateral decubitus radiographs are recommended for evaluation and confirmation. " d352fe84-10dca505-056a6f2d-15570f26-edc7d204.jpg,validate/p18/p18056741/s59843407/d352fe84-10dca505-056a6f2d-15570f26-edc7d204.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough, shortness of breath, history of breast cancer. Evaluate for evidence of CHF or any other intrathoracic opacity. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well inflated, and no focal opacities are noted. The cardiomediastinal and hilar contours are unremarkable. There is no evidence of pneumothorax. In the lateral view, there is blunting of the left costophrenic angle which is stable since ___. IMPRESSION: No evidence of acute intrathoracic process. " 9748d26b-62549e8c-0a4fec22-48ae4480-691c7013.jpg,validate/p13/p13473495/s57333607/9748d26b-62549e8c-0a4fec22-48ae4480-691c7013.jpg,validation," FINAL REPORT INDICATION: History of end-stage renal disease. Please evaluate. COMPARISONS: Multiple prior chest radiographs dated back to ___, most recently from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Moderate cardiomegaly is all stable compared to the prior exams dated back to at least ___. There has been an interval increase in bilateral moderate pulmonary edema with interstitial thickening and perihilar vascular congestion compared to the prior exam from ___. There may be small bilateral pleural effusions. There is no evidence of pneumothorax. The visualized osseous structures are unremarkable. Note is made of a left subclavian stent, overall unchanged in position compared to the prior exam. IMPRESSION: Moderate pulmonary edema, overall increased compared to the prior exam from ___. " 31f7aa4d-2197fdb7-5f09fd9c-434e6cb3-d6e69603.jpg,validate/p14/p14508231/s59333922/31f7aa4d-2197fdb7-5f09fd9c-434e6cb3-d6e69603.jpg,validation," WET READ: ___ ___ 10:39 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with chest pain. TECHNIQUE: Chest: PA and Lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are within normal limits. Cervical spine and left shoulder arthroplasty hardware are again seen. IMPRESSION: No acute cardiopulmonary process. " 16aebfe2-2ef3ea20-4ba7fb14-e896816c-d1da35f3.jpg,validate/p11/p11589725/s55577690/16aebfe2-2ef3ea20-4ba7fb14-e896816c-d1da35f3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M h/o seizures alcoholism s/p fall down stairs resulting in status epilepticus and right IPH, unchanged bilateral SDH, unchanged SAH, and acute fracture of the inferior left parietal bone with associated 2 mm epidural hematoma. Position of ETT. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: A new endotracheal tube terminates 4.8 cm above the carina. The NG tube has been advanced, with all sideholes contained within the stomach. No pleural effusion, pneumothorax, or large focal consolidation. Left-sided PICC line is unchanged in position, terminating in the mid SVC. Opacity in the medial right lower lung is likely due to crowding of vessels, given the projection. IMPRESSION: 1. New endotracheal tube terminates 4.8 cm above the carina. 2. Opacity in the medial right lower lung is likely due to crowding of vessels, given the projection. However, in the correct clinical setting, pneumonia is not excluded. 3. NG tube has been advanced several cm, now with all sideholes contained within the stomach. " 3c420576-cd10290d-c1bc8a8d-2b0a13dc-e43b5185.jpg,validate/p16/p16454913/s54955192/3c420576-cd10290d-c1bc8a8d-2b0a13dc-e43b5185.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post right colectomy, open abdomen, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in unchanged position. Signs of overinflation, mild cardiomegaly and mild areas of atelectasis at both lung bases. In addition, a left pleural effusion might be present. No new focal parenchymal opacity suggesting pneumonia. " 8a3d16f4-3f7806ae-cbdc7b11-62a2c5ac-09f39b98.jpg,validate/p14/p14819550/s57625922/8a3d16f4-3f7806ae-cbdc7b11-62a2c5ac-09f39b98.jpg,validation," FINAL REPORT INDICATION: ___M with several days fever, cough, now afib w/ RVR // eval ? infiltrate, edema, free air TECHNIQUE: 2 portable views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation nor effusion. Calcific densities projecting over the hemidiaphragms are most compatible with calcified pleural plaques. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 14d2a6bb-c1cebc47-182befac-e3f6b744-94a74a57.jpg,validate/p18/p18532425/s56801477/14d2a6bb-c1cebc47-182befac-e3f6b744-94a74a57.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with altered mental status, SBP in the setting of ETOH cirrhosis, now intubated for airway protection. // evaluate for interval change evaluate for interval change IMPRESSION: The in comparison with the study of ___, the monitoring and support devices are unchanged. Again there are low lung volumes with substantial enlargement of the cardiac silhouette. Mild elevation of pulmonary venous pressure is again seen. Opacification at the left base is consistent with pleural effusion and underlying compressive atelectasis. " f76cf21a-7019c106-6917139e-d8ac3cc8-dd8dc6af.jpg,validate/p18/p18780736/s58403014/f76cf21a-7019c106-6917139e-d8ac3cc8-dd8dc6af.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recent attempted thoracentesis on right effusion // pneumothorax? pneumothorax? COMPARISON: ___ IMPRESSION: Port-A-Cath catheter tip terminates at the level superior SVC. Bilateral pleural effusions are large, unchanged. There is no pneumothorax. Bibasal multifocal opacities as well as mid lung opacity are concerning fall multifocal infection. Overall the findings are similar to previous examination. Left upper lobe (apical close (lesion is better appreciated on the chest CT as well right mid lung lesion. " 0e9c9a32-437d8a0d-728284b5-db7d6449-50ed57c2.jpg,validate/p18/p18202111/s54545030/0e9c9a32-437d8a0d-728284b5-db7d6449-50ed57c2.jpg,validation," FINAL REPORT INDICATION: ___-year-old female patient with gastroparesis, new NG tube placement. COMPARISON: Prior chest CT from ___ and prior chest radiograph from ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: There has been interval placement of a NG tube, which projects along the expected location of the gastric fundus. However, the tip is not visualized in this examination. As compared to prior chest radiograph from ___, there has been no significant change. The heart size is normal. The mediastinal and hilar structures are normal. Again seen are nodular-appearing densities in the left lower lobe. There are no pleural effusions or pneumothorax. IMPRESSION: 1. Interval placement of NG tube which projects along the expected location of the gastric fundus. Tip is not included in this examination. 2. Unchanged nodular densities in the left lower lobe, consistent with previously identified rheumatoid nodules. These findings were discussed with Dr. ___ by Dr. ___ via telephone on ___ at 11:55 a.m., at the time of discovery. " 38da6235-6774a0f8-d8d02b81-02b493e7-f5e1c0a6.jpg,validate/p10/p10108435/s58170356/38da6235-6774a0f8-d8d02b81-02b493e7-f5e1c0a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Chest pain and dyspnea. TECHNIQUE: Chest, AP upright portable. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours appear stable within the limitations of technique. The lungs appear clear. There are no pleural effusions or pneumothorax. No fracture is identified. IMPRESSION: No evidence of acute cardiopulmonary disease or injury. " 058c94da-594be6f2-3f7d4e51-92536325-bb781790.jpg,validate/p16/p16030116/s54296304/058c94da-594be6f2-3f7d4e51-92536325-bb781790.jpg,validation," WET READ: ___ ___ 12:47 AM No substantial change from prior. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ARDS, now with desat // interval change COMPARISON: Chest radiographs ___ through ___ at 03:49. IMPRESSION: Increasing consolidation at in the right lower lung compared to earlier in the day could be atelectasis is patient has positive pressure ventilator support has decreased. Peribronchial infiltration in the left mid and lower lung zone has changed in distribution worsened slightly, suggesting the same cause and effect. Alternatively there may be increased secretions in the right lung and mild interstitial edema, explaining both findings. There is no pneumothorax. Pleural effusion is minimal if any. Heart size normal. ET tube and right internal jugular line are in standard placements and a feeding tube ends in the stomach. " fff1bb97-3c77c90f-02b5e068-5e5f1576-02943956.jpg,validate/p16/p16741854/s56075519/fff1bb97-3c77c90f-02b5e068-5e5f1576-02943956.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with CHF EF ___%, ESRD on HD, DM, who is s/p PEA cardiac arrest w/ LLL consolidation on CTA chest. Currently intubated // intubated COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Left lung was completely collapsed on ___, partially re-expanded the same day and improved on ___. The explanation was at least in part unilateral right main stem intubation, and retained secretions in the left lower lobe bronchus. Extensive possibly constrictive calcific left pleural thickening may be contributory. However the left lower lobe remains densely consolidated, which could be due to pneumonia. Moderate cardiomegaly is chronic. Mild edema or a developing region of consolidation is new at the right lung base since ___ and should be carefully monitored. ET tube, esophageal drainage tube, and right internal jugular line are in standard placements " 1e01204a-162c40f9-0fc07c79-3029079b-e65e14be.jpg,validate/p13/p13877204/s55020785/1e01204a-162c40f9-0fc07c79-3029079b-e65e14be.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: New pacemaker, evaluation for lead position. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Unchanged size of the cardiac silhouette. Unchanged course of the pacemaker leads. No evidence of pneumothorax. The leads are in expected position, with one lead projecting over the right atrium and one over the right ventricle. " ea38f794-ab0e0b62-e68b2b1b-0fd1462c-7d827018.jpg,validate/p19/p19303239/s52425209/ea38f794-ab0e0b62-e68b2b1b-0fd1462c-7d827018.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Colorectal cancer, metastatic, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there are bilateral areas of newly appeared parenchymal opacities. The opacities are alveolar in nature on the left side. On the right, there is a predominantly middle lobe located consolidation with several air-fluid levels. These changes are accompanied by small pleural effusion. They reflect either necrotizing pneumonia or a group of communicating abscesses. Normal size of the cardiac silhouette. Normal course of the left pectoral Port-A-Cath. The referring physician ___. ___ was contacted by telephone at the time of dictation, 1:59 p.m., on ___. " b9beb0e2-defd06c5-14582310-b29bb60a-28ca337b.jpg,validate/p17/p17071231/s55005041/b9beb0e2-defd06c5-14582310-b29bb60a-28ca337b.jpg,validation," 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. " 6004a95e-1f08ab22-aef98b5d-1722001b-95698864.jpg,validate/p12/p12598063/s56699413/6004a95e-1f08ab22-aef98b5d-1722001b-95698864.jpg,validation," 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. " 5efe14cc-3e7e2ff9-c1e9aa54-79221cac-c935f3a1.jpg,validate/p16/p16444875/s52827982/5efe14cc-3e7e2ff9-c1e9aa54-79221cac-c935f3a1.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There is a minimal right basilar atelectasis. No focal consolidation or pneumothorax. There is blunting of the right costophrenic angle which could be due to a small pleural effusion. The cardiac silhouette is top normal. The aorta is somewhat tortuous. IMPRESSION: Minimal right basilar atelectasis. Blunting of the right costophrenic angle may due to a small pleural effusion. " d609d5fa-1827779f-90ce14b1-44c9c8a2-2bc49e50.jpg,validate/p18/p18468814/s51438082/d609d5fa-1827779f-90ce14b1-44c9c8a2-2bc49e50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new neutropenia, fever, of unclear etiology. new tachypnea to 40s and new O2 requirement // evidence of pulm edema evidence of pulm edema IMPRESSION: Heart size and mediastinum are similar to previous study but there is interval development of pulmonary edema with bilateral pleural effusions. Superimposed infectious process is a possibility. Reassessment after diuresis is required. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 11:31 AM, 4 minutes after discovery of the findings. " 2c3b1520-07cd7276-5c88596f-43c64c70-bef170e3.jpg,validate/p16/p16030116/s50006881/2c3b1520-07cd7276-5c88596f-43c64c70-bef170e3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with DM, recent sig PNA requiring intubation, needs f/u xray to assess for resolution // eval for resolution compared to ___ COMPARISON: Chest radiographs ___ IMPRESSION: Lungs are clear, heart size is normal, and there is no pleural abnormality. Diffuse widening of the mediastinum could be due to fat deposition. If there is reason to suspect adenopathy, CT scanning would be indicated immediately. Otherwise centered recommend repeating routine chest radiographs in 3 months. " 63717c1e-11b7faf9-591fa586-70f44e31-87994716.jpg,validate/p19/p19779960/s53467819/63717c1e-11b7faf9-591fa586-70f44e31-87994716.jpg,validation," FINAL REPORT INDICATION: ___ year old man with pancreatitis and new hypoxemia // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: The when compared to ___ chest radiograph, both lung volumes are low. There is interval development of small (left greater than right) pleural effusions. However there are no consolidations nor opacities to suggest pneumonia. The cardiomediastinal and hilar contours are normal. There is no pneumothorax. IMPRESSION: 1. There is interval development of small (left greater than right) pleural effusions when compared to ___ chest radiograph. However there are no consolidations nor opacities to suggest pneumonia. " fcd8ad39-f4c13aff-82b89a3f-0f0d2759-218bad90.jpg,validate/p19/p19393174/s51210456/fcd8ad39-f4c13aff-82b89a3f-0f0d2759-218bad90.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest 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. " f895a064-5a2a9745-28a9d52d-af9fbd2b-acfdaa1f.jpg,validate/p19/p19657904/s53597821/f895a064-5a2a9745-28a9d52d-af9fbd2b-acfdaa1f.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with dyspnea. COMPARISON: Multiple prior chest x-rays, most recently from ___. PA AND LATERAL VIEWS OF THE CHEST: The heart is enlarged, stable. Aorta is tortous. No focal opacities are seen. Previously seen right middle lobe opacity is no longer evident. No pneumothoraces are seen. Bones are intact. IMPRESSION: No acute intrathoracic process. " bcb6053f-e827b512-d9980366-ce0465d7-da669711.jpg,validate/p14/p14953396/s53485232/bcb6053f-e827b512-d9980366-ce0465d7-da669711.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman status post MVC. COMPARISON: ___. FINDINGS: A frontal upright view of the chest was obtained portably. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is mild bibasilar atelectasis. No free air is seen in the diaphragm. Heart size is normal. Mediastinal silhouette and hilar contours are normal. No acute fracture is identified. Bilateral symmetric 1.8 cm opacities projecting over the lower lung fields bilaterally are likely nipple shadows. IMPRESSION: No acute intrathoracic process. " 27f57c5b-fa955243-17bbeb5e-a4da4468-ea230ab2.jpg,validate/p16/p16004600/s57667768/27f57c5b-fa955243-17bbeb5e-a4da4468-ea230ab2.jpg,validation," FINAL REPORT HISTORY: Stroke, to assess for aspiration. FINDINGS: In comparison with the study of ___, there may be minimal atelectatic changes at the bases. Cardiac silhouette is within upper limits of normal in size. No evidence of vascular congestion. Dobbhoff tube again coils within the upper stomach. " fda77853-9436ba0b-6b68a534-e0d43d05-d96beaf8.jpg,validate/p18/p18959963/s59795191/fda77853-9436ba0b-6b68a534-e0d43d05-d96beaf8.jpg,validation," WET READ: ___ ___ ___ 11:10 AM Mild peribronchial cuffing and prominence of the pulmonary vasculature consistent mild fluid overload. WET READ VERSION #1 ___ ___ ___ 5:16 AM No acute cardiopulmonary abnormality. WET READ VERSION #2 ___ ___ ___ 5:20 AM Mild peribronchial cuffing prompt the pulmonary vasculature consistent mild fluid overload. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with N/V, lightheadedness, crackles on lung exam R >L w/ no prior hx lung disease // eval ? infiltrate, edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Mild to moderate enlargement of the cardiac silhouette is unchanged since ___. Lung volumes are low. There is mild peribronchial cuffing and prominence of the pulmonary vasculature consistent mild fluid overload. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. The lungs are mildly hyperinflated. IMPRESSION: Mild pulmonary edema. Chronic mild to moderate cardiomegaly. " 63f1c395-2e08a0ed-4f1838bc-330da059-f069e28c.jpg,validate/p19/p19507787/s54097613/63f1c395-2e08a0ed-4f1838bc-330da059-f069e28c.jpg,validation," WET READ: ___ ___ ___ 7:52 PM The previous heterogeneous opacification at the right lung base and infrahilar left lung is stable to somewhat improved. Again, this could reflect pneumonia or atelectasis. Small effusions are suspected. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new PE, with AP portable CXR concerning for pneumonia. // Please evaluate for evidence of pneumonia. Please evaluate for evidence of pneumonia. IMPRESSION: Mild generalized interstitial pulmonary abnormality persists. Previous heterogeneous consolidation right lower lobe, probably pneumonia, has improved. Small right pleural effusion persists. Borderline cardiomegaly unchanged. " b74fb426-dcb87b01-4b47d208-1d82f2e4-38c630f0.jpg,validate/p19/p19287958/s57579350/b74fb426-dcb87b01-4b47d208-1d82f2e4-38c630f0.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with lethargy for 3 weeks, infectious work-up. // Eval PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes. Underpenetration of the lung bases due to patient body habitus makes assessment slightly suboptimal. Prominence and indistinctness of the hila and perihilar opacity suggest pulmonary edema. Linear left mid lung atelectasis/scarring is seen. Small right and possibly small left pleural effusions are seen. There is no evidence of pneumothorax. The cardiac silhouette is mild to moderately enlarged. IMPRESSION: Mild to moderate cardiomegaly, pulmonary edema, and small pleural effusions suggest CHF, underlying infection/pneumonia difficult to exclude. " dcb9a5ac-81529768-d630b5cf-01837e8f-348fb320.jpg,validate/p15/p15136836/s59252993/dcb9a5ac-81529768-d630b5cf-01837e8f-348fb320.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with question of pulmonary hypertension. TECHNIQUE: Chest PA and lateral COMPARISON: V/Q scan obtained on the same date. FINDINGS: PA and lateral chest radiograph demonstrates an enlarged heart. Lungs appear clear. Right hilar prominence appears to open present on chest CT dated ___ as a confluence of prominent vascular structures. Eventration of the right hemidiaphragm is incidentally noted. There is no pleural effusion. Blunting of bilateral costophrenic angles likely reflects scarring. No overt pulmonary edema. IMPRESSION: Enlarged heart without evidence of overt pulmonary edema. Right hilar prominence better delineated on chest CT dated ___ as a confluence of vascular structures. " 58d89bd3-abad8ebd-f5864329-f0c90dd5-ad07f67f.jpg,validate/p11/p11098660/s52749837/58d89bd3-abad8ebd-f5864329-f0c90dd5-ad07f67f.jpg,validation," FINAL REPORT HISTORY: Right pleural effusion COMPARISON: Chest radiograph ___ through ___. FINDINGS: Two PA and 1 lateral chest radiograph were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion or pneumothorax. Median sternotomy wires and aortic valve replacement are intact. Mild cardiomegaly is stable. IMPRESSION: Resolution of right pleural effusion. No acute cardiopulmonary process. " 123e6a48-99823eca-6fb03ad0-f2b3baab-17873cc8.jpg,validate/p15/p15805011/s51726414/123e6a48-99823eca-6fb03ad0-f2b3baab-17873cc8.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with syncope. COMPARISONS: ___ to ___. FINDINGS: PA and lateral chest radiographs are limited by body habitus. Despite limitations, the lungs are well inflated and clear. No focal consolidation, effusion, or pneumothorax is present. Prominent left lateral pleural lipomatosis is unchanged. The cardiac and mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " ba7cc4de-d676139d-50f37f99-5fbf06c9-e32cbf93.jpg,validate/p14/p14948236/s56863487/ba7cc4de-d676139d-50f37f99-5fbf06c9-e32cbf93.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Neutropenic fevers, assessment for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia, no pleural effusion. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. Right pectoral Port-A-Cath in situ. " a0efa25c-7e3a092e-cfd9dcec-d4e2f5e7-baced566.jpg,validate/p18/p18160122/s56417792/a0efa25c-7e3a092e-cfd9dcec-d4e2f5e7-baced566.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with febrile neutropenia and cough, evaluate for pneumonia COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. Pulmonary vasculature is normal. Cardiomediastinal and hilar contours are normal. Pleural surfaces are normal. Right sided central catheter terminates in the low SVC. There is no pneumothorax. IMPRESSION: No pneumonia. " d1911f0e-5e19a989-f40eb078-626f4a3f-f929fba3.jpg,validate/p17/p17729267/s55285907/d1911f0e-5e19a989-f40eb078-626f4a3f-f929fba3.jpg,validation," FINAL REPORT HISTORY: Multiple sclerosis with increasing symptoms. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The lungs are clear and the pulmonary vascularity is normal. There are no pleural effusions or pneumothoraces. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " 65f6dc78-dd1cac69-4c8f1ff5-1f6c0a37-4477bcf3.jpg,validate/p10/p10969957/s50730810/65f6dc78-dd1cac69-4c8f1ff5-1f6c0a37-4477bcf3.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with weakness and confusion. Frequent falls. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Biapical scarring is again noted. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is stable. Aortic valve replacement again noted. Fracture of the most superior median sternotomy wire is again noted. There is apparent ossification of anterior longitudinal ligament throughout. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " a18bc58c-2c979b0e-ae3f09fd-083de78f-b278dfaa.jpg,validate/p15/p15202542/s54742018/a18bc58c-2c979b0e-ae3f09fd-083de78f-b278dfaa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent h/o parapneumonic effusions // please assess for interval change TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Left PICC line tip is at the level of cavoatrial junction. Heart size and mediastinum are unchanged. Interval minimal decrease in bilateral pleural effusions is noted although might be related to different positioning of the patient (upright). The effusions are currently at least moderate. There is potentially also loculation along the major fissure. No pneumothorax is seen. " 0a6432b2-94123382-1bddda33-92a7315f-f8f8a9e4.jpg,validate/p17/p17472053/s55360762/0a6432b2-94123382-1bddda33-92a7315f-f8f8a9e4.jpg,validation," 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. " 1a35f02e-649677f8-d144768b-c932ee63-3e432d91.jpg,validate/p11/p11966397/s53038485/1a35f02e-649677f8-d144768b-c932ee63-3e432d91.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lobe resection and ?bacterial pneumonia +/- parenchymal lung disease // interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no change is seen in appearance of the relatively extensive right lower lung parenchymal opacity. Also unchanged is a retrocardiac atelectasis. Status post bilateral lobar resection. Unchanged size of the cardiac silhouette. " 569e42f8-3ebf5f93-43e8767c-2b34f2ad-a8d28fb7.jpg,validate/p12/p12514721/s54859886/569e42f8-3ebf5f93-43e8767c-2b34f2ad-a8d28fb7.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Increasing shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The aortic arch is calcified. A moderate hiatal hernia projects over the lower mediastinum, not significantly changed. More generally, the cardiac, mediastinal, and hilar contours are stable. The lungs appear clear. There are no pleural effusions or pneumothorax. The chest is hyperinflated. Minimal degenerative change is noted along the mid thoracic spine. IMPRESSION: No evidence of acute disease. Moderate hiatal hernia. Hyperinflation. " a5b37b45-2b3795ee-2d6e5230-ba7173c5-1538a31e.jpg,validate/p17/p17107992/s55127499/a5b37b45-2b3795ee-2d6e5230-ba7173c5-1538a31e.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old woman with new dyspnea on exertion. FINDINGS: Comparison is made to previous study from ___. There has been some improvement of the pleural effusion since the previous study. However, this may be partially due to patient positioning. These effusions remain moderate in size. There is cardiomegaly. There are no signs for overt pulmonary edema. No pneumothoraces are seen. " 0288ee85-59cd974f-26867413-e3db935a-407a4f6f.jpg,validate/p11/p11548762/s59573589/0288ee85-59cd974f-26867413-e3db935a-407a4f6f.jpg,validation," WET READ: ___ ___ ___ 11:00 AM Low lung volumes. Mild central vascular congestion without overt pulmonary edema. Bibasilar atelectasis, with right upper lobe collapse and ipsilateral tracheal deviation. No focal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with sob and cyanosis // pulmonary edema TECHNIQUE: Single frontal view of the chest. COMPARISON: None provided. FINDINGS: Lung volumes are low. Small bilateral pleural effusions, right greater than left. No focal consolidation. No pneumothorax. There is moderate central vascular congestion without evidence of overt pulmonary edema. Bibasilar atelectasis, as well as volume loss in the right upper lobe with ipsilateral tracheal deviation, consistent with prior right upper lobe VATS wedge resection. Mediastinal silhouette is widened, owing to an unfolded descending thoracic aorta. There is heavy calcification of the ascending aorta and aortic knob. Heart size is likely enlarged, though cannot be accurately assessed in the presence of bilateral effusions. IMPRESSION: 1. Moderate central vascular congestion without overt pulmonary edema. 2. Small bilateral pleural effusions, right greater than left. 3. Right upper lobe atelectasis with ipsilateral tracheal deviation consistent with prior right upper lobe VATS wedge resection. Moderate bibasilar atelectasis. 4. Likely moderate cardiomegaly, though heart size cannot be completely assessed in the presence of bilateral effusions. " d7c1817e-2be65777-de1bc1b3-94d3b2ff-9914b985.jpg,validate/p13/p13686671/s51064187/d7c1817e-2be65777-de1bc1b3-94d3b2ff-9914b985.jpg,validation," FINAL REPORT AP CHEST, 12:30 P.M. ON ___ HISTORY: Alcohol withdrawal. On a ventilator. Assess Dobbhoff tube placement. IMPRESSION: Frontal view of the supine torso centered at the umbilicus shows a feeding tube with wire stylet in place ending in the upper stomach, and a nasogastric tube extending just beyond to the mid stomach. " 5c6113dd-44927282-47adab96-4ce5956b-dd347c99.jpg,validate/p10/p10768040/s57078939/5c6113dd-44927282-47adab96-4ce5956b-dd347c99.jpg,validation," FINAL REPORT HISTORY: Recurrent aspiration, altered mental status with fevers. COMPARISON: ___. TECHNIQUE: AP and lateral chest radiograph, two views. FINDINGS: Again noted are scattered bilateral densities as well as increased density, particularly in the left lung base compatible with progressive aspiration. There is no pleural effusion or pneumothorax. IMPRESSION: Persistent bilateral scattered densities with increased focal density of the left lung base compatible with progressive aspiration/pneumonia. " 54b57a2a-18f802a5-a14aa9a4-65b64418-85f3e09f.jpg,validate/p10/p10860292/s54018590/54b57a2a-18f802a5-a14aa9a4-65b64418-85f3e09f.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough, question pneumonia. COMPARISONS: None. FINDINGS: PA and lateral views of the chest are provided. There is no focal consolidation, pneumothorax or pleural effusion. Cardiomediastinal silhouette is normal. IMPRESSION: No acute pulmonary process. " de4c5826-6deb63b6-f3bf9f0c-e690d6a0-04f0b417.jpg,validate/p14/p14273001/s56189204/de4c5826-6deb63b6-f3bf9f0c-e690d6a0-04f0b417.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with epigastric pain, lung cancer COMPARISON: No priors FINDINGS: PA and lateral views of the chest provided. There is a round mass projecting over the right lower lobe measuring approximately 4.1 x 4.4 x 4.0 cm, likely representing patient's known lung cancer. There is no focal consolidation concerning for pneumonia. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. No free air below the right hemidiaphragm. Bony structures are intact. IMPRESSION: Right lower lobe mass measuring 4.1 x 4.4 x 4.0 cm. " 3a10784d-b3700562-413bd2b5-53b12de5-39fb0204.jpg,validate/p15/p15949474/s55792438/3a10784d-b3700562-413bd2b5-53b12de5-39fb0204.jpg,validation," FINAL REPORT INDICATION: ___ year old man with new diagnosis of acute leukemia, planning to initiate chemotherapy // Please eval for any cardiopulmonary abnormality pre-chemotherapy TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are well expanded and clear. The heart size is normal. The mediastinal and hilar contours are normal. No pleural abnormalities are seen. Nipple markers are seen. IMPRESSION: No acute to cardiopulmonary abnormalities. " 3c2ac918-b93e5169-9709a297-8a672c22-a8ae47af.jpg,validate/p18/p18454049/s52416806/3c2ac918-b93e5169-9709a297-8a672c22-a8ae47af.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with shortness of breath. Evaluate for pneumonia. TECHNIQUE: PA and lateral COMPARISON: ___, ___, CT chest without contrast ___ FINDINGS: PA and lateral views of the chest were provided. Overlying EKG leads are present. Left left basal opacities most compatible with atelectasis though difficult to exclude a subtle early pneumonia/ aspiration. No large effusion or pneumothorax. Cardiomediastinal silhouette appears stable. Bony structures are intact. IMPRESSION: Left basal opacity most compatible with atelectasis though difficult to exclude an early pneumonia/aspiration. " 018e0444-9c188be3-d644fbee-9c87fa76-5f989b77.jpg,validate/p14/p14997223/s58242747/018e0444-9c188be3-d644fbee-9c87fa76-5f989b77.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post removal of the Dobbhoff with new Dobbhoff placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a new Dobbhoff has been placed. The course of the new tube is unremarkable, the tip projects over the middle parts of the stomach. No evidence of complications, notably no pneumothorax. The pleural effusions, low lung volumes and areas of atelectasis as well as the extent of the cardiomegaly is unchanged. " 243f2094-1b8d0ebc-5c9c590b-6c850dd4-2678660b.jpg,validate/p10/p10071620/s50877078/243f2094-1b8d0ebc-5c9c590b-6c850dd4-2678660b.jpg,validation," 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. " d64ca9fd-90bbab07-1930becd-536285b5-6787373f.jpg,validate/p19/p19548803/s55742905/d64ca9fd-90bbab07-1930becd-536285b5-6787373f.jpg,validation," WET READ: ___ ___ ___ 12:33 AM No consolidation, pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dyspnea // please eval for pulm edema, effusion, pna please eval for pulm edema, effusion, pna IMPRESSION: Compared to prior chest radiographs ___. Heart is mildly enlarged, predominantly the left atrium. Mediastinal contours now normal. No pleural abnormality. Lungs are essentially clear, and pulmonary vasculature is unremarkable. This examination neither suggests nor excludes the diagnosis of pulmonary embolism. " 2a3fb7e7-d9c15d64-ec12e631-b9c8cf17-df9f1012.jpg,validate/p15/p15793371/s50467798/2a3fb7e7-d9c15d64-ec12e631-b9c8cf17-df9f1012.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: HIV and productive cough, assessment for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right PICC line has been removed. The size of the cardiac silhouette is normal. Normal hilar and mediastinal contours. There is no evidence of pneumonia or other acute or chronic lung disease. No pleural effusions. No evidence of lymphadenopathy. " 20e3b304-e09afaed-b6f30a36-87d828f7-83f4d616.jpg,validate/p19/p19572730/s52230103/20e3b304-e09afaed-b6f30a36-87d828f7-83f4d616.jpg,validation," FINAL REPORT HISTORY: A ___-year-old male with HIV CD4 count 180, not taking meds. TECHNIQUE: Chest, frontal and lateral views. COMPARISON: ___. FINDINGS: Subtle retrocardiac opacity projecting over the lower thoracic spine on the lateral view may relate to vascular structures however, underlying consolidation cannot be excluded in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Slight increase in retrocardiac opacity on the lateral view most likely relates to vascular structures, but underlying consolidation is difficult to exclude in the appropriate clinical setting. No diffuse opacity is seen to suggest PCP, ___, chest CT is more sensitive in evaluating for PCP. " 499cf3bb-643949dc-28c87fa8-4487ed75-0064dd9d.jpg,validate/p18/p18795084/s50231684/499cf3bb-643949dc-28c87fa8-4487ed75-0064dd9d.jpg,validation," WET READ: ___ ___ ___ 12:30 PM No radiographic explanation for chest pain. Unchanged mild cardiomegaly. Further evaluation with echocardiogram may be warranted in the right clinical setting if this is not been previously evaluated. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with chest pain evaluate for pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Mild cardiomegaly is unchanged from ___. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No radiographic explanation for chest pain. Unchanged mild cardiomegaly. Further evaluation with echocardiogram may be warranted in the right clinical setting if this is not been previously evaluated. " 34331308-fb37187c-d0c53c37-431988bf-c64d68e5.jpg,validate/p16/p16783070/s52052172/34331308-fb37187c-d0c53c37-431988bf-c64d68e5.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old female with a pleural effusion status post thoracentesis, rule out pneumothorax. COMPARISON: AP chest x-ray performed same day at 12:35 hours. FINDINGS: There is persistent veil-like opacity over the left lower chest, though there is interval resolution of a moderate-sized left pleural effusion. There is no pneumothorax. IMPRESSION: Residual veil-like opacity over the left lower chest is noted with interval resolution of moderate left pleural effusion. These finding may represent persistent consolidation and/or atelectasis and lateral view or CT could be performed to further assess. " 6279b179-c8f61803-8d728c6b-f57f5ce2-e64b6adf.jpg,validate/p16/p16261645/s55914825/6279b179-c8f61803-8d728c6b-f57f5ce2-e64b6adf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with neuromuscular resp. failure with new tracheostomy // interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has been extubated and a tracheostomy tube was placed. No evidence of pneumothorax or other complications. Unchanged low lung volumes. Bilateral basal areas of atelectasis as well as a borderline sized cardiac silhouette without pulmonary edema. No larger pleural effusions. " d2d90daa-b89dc629-8993feef-4079e11c-12446c6d.jpg,validate/p18/p18567979/s58341117/d2d90daa-b89dc629-8993feef-4079e11c-12446c6d.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Recent community-acquired pneumonia with persistent hypoxia and leukocytosis. Comparison is made with prior study, ___. Small right and moderate left pleural effusions are probably unchanged allowing the difference in positioning of the patient. Bibasilar consolidations, larger on the left side, could be due to atelectasis and/or pneumonia. Cardiomediastinal contours are unchanged. There is mild pulmonary edema. " 02093805-35fbf984-752a8454-e3ee3720-ea8fdc0c.jpg,validate/p15/p15742695/s56167679/02093805-35fbf984-752a8454-e3ee3720-ea8fdc0c.jpg,validation," FINAL REPORT HISTORY: History of productive cough. Rule out pneumonia. COMPARISON: 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. The visualized osseous structures are unremarkable. IMPRESSION: No pneumonia. " e773f9f4-c2f3b193-0805fa02-e1c94ffd-55419197.jpg,validate/p16/p16346361/s59922507/e773f9f4-c2f3b193-0805fa02-e1c94ffd-55419197.jpg,validation," FINAL REPORT HISTORY: Lower lobe crackles, possibly related to CHF. FINDINGS: In comparison with the study of ___, there is little interval change. The asbestos-related pleural plaques with calcification are unchanged in this patient who has had previous resection of two lung nodules. Cardiac silhouette is within normal limits and there is no definite vascular congestion, pleural effusion, or acute focal pneumonia. Atelectatic changes are seen at the bases. No change in the compression fracture in the upper thoracic region. " 80bec5d4-030031f6-1a0deab6-615a1017-5fed5cb8.jpg,validate/p13/p13728317/s51274738/80bec5d4-030031f6-1a0deab6-615a1017-5fed5cb8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with lung cancer p/w lightheadedness and presyncope // eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Reference made to CT from ___ FINDINGS: Known pulmonary nodules/ lesions are better assessed on CT. No definite new focal consolidation is seen. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Known multiple pulmonary nodule/opacities better assessed on prior CT. No definite new focal consolidation to suggest pneumonia. " 9c773163-6de45afe-8307cb01-af5f045a-e19dac56.jpg,validate/p17/p17160384/s53339593/9c773163-6de45afe-8307cb01-af5f045a-e19dac56.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with c/o fatigue and 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. " aa4782d1-153b87f1-51762b7a-9c3ca565-0fcf9174.jpg,validate/p10/p10852773/s54409370/aa4782d1-153b87f1-51762b7a-9c3ca565-0fcf9174.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with right pleural effusion, fever. Evaluate for interval change. Plan for thoracocentesis. COMPARISON: ___ through ___. FINDINGS: Unchanged small right pleural effusion. Minimal left pleural effusion has slightly distributed posteriorly, but the amount has not changed significantly. There is no new lung consolidation. A right basal nodularity measuring 11 mm is too high to be the nipple shadow. It was probably already present on ___, but not on ___. Close attention to this area on subsequent chest x-ray is suggested. There is no pneumothorax. " 7afb0f18-98c1462c-b54a21fd-d1178a5c-ff251b7a.jpg,validate/p14/p14235312/s59784128/7afb0f18-98c1462c-b54a21fd-d1178a5c-ff251b7a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea, bibasilar rales // ?pulm edema TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " ae186e8d-b18ca7be-194a011b-d7c4f068-ca7d6837.jpg,validate/p19/p19598034/s50665908/ae186e8d-b18ca7be-194a011b-d7c4f068-ca7d6837.jpg,validation," 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. " d45e9d95-41522dde-03ba7bb8-898490d6-f6db15c1.jpg,validate/p18/p18325765/s58927079/d45e9d95-41522dde-03ba7bb8-898490d6-f6db15c1.jpg,validation," 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. " 75349be0-033cb27e-f52d1bd1-c0e44bf8-7cda4fd5.jpg,validate/p15/p15690303/s51674070/75349be0-033cb27e-f52d1bd1-c0e44bf8-7cda4fd5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleural effusion, status post pleurodesis, now Pleurx catheter, evaluation for recurrence of effusion. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, one of the two left chest tubes has been removed. One chest tube on the left remains in situ. There is no evidence of pneumothorax. A linear scar at the left lung apex, adjacent to a rib fracture with cortical defect, is unchanged. The extent of pleural fluid on the left is decreased as compared to the previous image, but still clearly visible. Moderate retrocardiac atelectasis. Unchanged normal appearance of the right lung. " d5fd5d4c-0346a0ef-0f9be038-bad0ed97-e196bd65.jpg,validate/p11/p11131026/s54014077/d5fd5d4c-0346a0ef-0f9be038-bad0ed97-e196bd65.jpg,validation," WET READ: ___ ___ ___ 9:40 PM Mild pulmonary edema. More focal opacity in the retrocardiac region may represent a combination of edema and atelectasis, however in the appropriate clinical setting pneumonia cannot be excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with sob // PNA? TECHNIQUE: AP and lateral views. COMPARISON: Radiograph ___. FINDINGS: Lung volumes are low. Cardiomegaly is likely mild-to-moderate. There is mild pulmonary edema. There is a small left pleural effusion. More focal opacity in the retrocardiac region may be related to low volumes and atelectasis, however pneumonia cannot be excluded. IMPRESSION: Low lung volumes with suspected superimposed pulmonary edema. More focal opacity in the retrocardiac region may represent a combination of edema and atelectasis, however in the appropriate clinical setting pneumonia cannot be excluded. " ee28dd17-e46016ce-08fe796f-4482ccf9-393bba8d.jpg,validate/p16/p16490354/s50975437/ee28dd17-e46016ce-08fe796f-4482ccf9-393bba8d.jpg,validation," 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. " ba692f44-26c208e9-9ba84ccc-94c80a9c-2df15e1a.jpg,validate/p13/p13040755/s58815047/ba692f44-26c208e9-9ba84ccc-94c80a9c-2df15e1a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest tube tachycardia // PTX? tension? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 06:29 IMPRESSION: No substantial interval change in the appearance of the left pneumothorax is seen. The extensive opacities in the lung fields, left more than right are similar and no substantial change in the mediastinal position or position of the pigtail catheter demonstrated. " 97adb344-750be012-6c79cef5-d1a806a9-e16bd1ef.jpg,validate/p16/p16803184/s52911995/97adb344-750be012-6c79cef5-d1a806a9-e16bd1ef.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Fever and dry 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. Vague opacity in the lingula obscures the left cardiac contour. Elsewhere the lungs appear clear. IMPRESSION: Vague opacity suggesting pneumonia in the lingula. " 57479148-032ce299-f337c2df-3a1fb21a-4a961291.jpg,validate/p18/p18629931/s59121397/57479148-032ce299-f337c2df-3a1fb21a-4a961291.jpg,validation," WET READ: ___ ___ ___ 12:39 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with cough for 1 month // eval for infiltrate 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. " b30920ff-741d3a49-2becaf82-55365c74-fa420a2e.jpg,validate/p11/p11434374/s52916793/b30920ff-741d3a49-2becaf82-55365c74-fa420a2e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumothorax s/p chest tube pull // stability TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Small right pneumothorax has minimally increased. Left lower lobe opacities are unchanged. There is minimal increase in opacities in the right base. Cardiomediastinal contours are unchanged. Right IJ catheter tip is in the lower SVC. Residual contrast material is again noted in the colon. " e6bdaac9-cd2a30e9-5c7333a9-4b6ed71b-ba1f77ab.jpg,validate/p14/p14202013/s53769265/e6bdaac9-cd2a30e9-5c7333a9-4b6ed71b-ba1f77ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman s/p biventricular pacemaker upgrade via left axillary vein // r/o PTX; check lead positions COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Transvenous right atrial biventricular pacer leads follow their expected courses from the left axillary generator. No pneumothorax pleural effusion or mediastinal widening. Lungs are clear. Moderate cardiomegaly unchanged. " 5759b8db-fc75baba-e07f640b-696c471f-4f0c6842.jpg,validate/p17/p17967970/s53738837/5759b8db-fc75baba-e07f640b-696c471f-4f0c6842.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ PTX, pigtail catheter on R, eval for interval change // ___F w/ PTX, pigtail catheter on R, eval for interval change ___F w/ PTX, pigtail catheter on R, eval for interval change IMPRESSION: Tracheostomy is in place. Right PICC line tip is in the right atrium and should be pulled back 6 cm to secure it position at the cavoatrial junction or above. Cardiomediastinal silhouette is unchanged. Postsurgical changes in the left upper lung and in the right hemithorax are unchanged. Old rib fracture on the right is unchanged. Left pleural effusion is moderate, unchanged. Right pigtail catheter is similar in location as compared to previous examination. " c3198910-fd888ca2-0e1c5a82-8e318b2f-9901e350.jpg,validate/p13/p13097080/s59273362/c3198910-fd888ca2-0e1c5a82-8e318b2f-9901e350.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever cough and chest pain // 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. Apparent linear lucency along the right heart border is felt to most likely be artifactual and is not substantiated on the lateral view. IMPRESSION: No acute cardiopulmonary process. Apparent linear lucency along the right heart border is felt to be artifactual. " 3438b860-f5f4537c-9c912158-8b7c5d1e-d975e8a6.jpg,validate/p13/p13717902/s50375502/3438b860-f5f4537c-9c912158-8b7c5d1e-d975e8a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with hx PNA. COMPARISON: Portable chest radiograph ___ PA and lateral chest radiograph ___ FINDINGS: AP upright and lateral views of the chest provided. Please note evaluation is markedly limited due to motion artifact and suboptimal penetration on the lateral film and low lung volumes. Allowing for this, there is volume loss at the left lung base with linear density most likely indicative of atelectasis. There is blunting of the left CP angle on the lateral view suggesting at least a small joint effusion. The right lung appears grossly clear. The heart size appears relatively unchanged. Mediastinal contour is normal. Bony structures appear grossly intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Limited exam with left basal opacity most likely atelectasis with small left pleural effusion. Please note evaluation is markedly limited due to portable technique and if needed, a dedicated PA and lateral view may be helpful to further assess. " a3589cd1-b8a9a5b7-dd08adc6-f302ccf8-cd54ab81.jpg,validate/p14/p14685268/s52380210/a3589cd1-b8a9a5b7-dd08adc6-f302ccf8-cd54ab81.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PCP ___. Followup evaluation of pneumonia. COMPARISON: Chest radiograph from ___. Chest CT from ___. FINDINGS: Support Devices: None. There are persistent right lower lobe peripheral airspace opacities but these are fainter. There is no new opacity. A pleural calcification in the right upper chest is unchanged. The lungs are otherwise clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Faintly persistent right lower lobe peripheral pneumonia without interval development of new disease. " f07e125d-eccf8f85-94a5f381-ff0fea31-ab7614e9.jpg,validate/p10/p10585182/s53311419/f07e125d-eccf8f85-94a5f381-ff0fea31-ab7614e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure requiring bipap // interval change IMPRESSION: As compared to the previous radiograph of 1 day earlier, asymmetrically distributed airspace opacities have largely cleared on the left and substantially improved on the right. Observed findings may reflect asymmetric edema with or without coexisting pneumonia in the right lung. " 42516217-f624cd56-b870549c-0c73f937-cdf5f186.jpg,validate/p18/p18677225/s58227361/42516217-f624cd56-b870549c-0c73f937-cdf5f186.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old man with chest pain. COMPARISON: ___. 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 abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 74475cdb-b9f39800-e0791300-747989b5-00abd36d.jpg,validate/p17/p17995051/s55797206/74475cdb-b9f39800-e0791300-747989b5-00abd36d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R MCA stroke, trach'd - s/p bronch // interval change interval change IMPRESSION: In comparison with the study of ___, there has been removal of the left subclavian catheter. Other monitoring and support devices are unchanged. The patient has taken a slightly better inspiration with continued substantial atelectatic changes at the bases and probable left effusion. " 7023a023-9e944f07-edc86754-df0e9e4e-44fb6c8e.jpg,validate/p13/p13834513/s59371260/7023a023-9e944f07-edc86754-df0e9e4e-44fb6c8e.jpg,validation," 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. " 32226474-a97d2b4c-238c8af4-d7b832e2-a7311d17.jpg,validate/p14/p14695209/s54555699/32226474-a97d2b4c-238c8af4-d7b832e2-a7311d17.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman presenting with seizures and intubated for respiratory failure, now extubated. Recent CXR showing pleural effusions, want to reevaluate by repeat imaging. // Persistent pleural effusions? Persistent pleural effusions? IMPRESSION: Comparison to ___. All monitoring and support devices are removed. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pneumonia, no pulmonary edema, no pleural effusions. " a56a1172-051b1e28-23ea7151-97aa4497-0377cb21.jpg,validate/p17/p17731851/s54988231/a56a1172-051b1e28-23ea7151-97aa4497-0377cb21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with desaturation post-op, pre-extubation. no known lung disease. pre-op sat ___% off supplemental oxygen. // ?pulmonary edema; infiltrate ?pulmonary edema; infiltrate COMPARISON: Chest radiographs ___. IMPRESSION: Moderate cardiomegaly is slightly worse than ___ years ago. Lung volumes are once again quite low, and there is more pronounced bibasilar consolidation which could be pneumonia, but is more likely atelectasis. The other region of consolidation superior to the right hilus has a similar differential diagnosis, but atelectasis is less likely in the nondependent lungs. Tip of the endotracheal tube at the upper margin of the clavicles is no less than 5 cm from the carina. The chin is elevated, so the position is probably functional. Small right pleural effusion is likely. No pneumothorax. " b2eb2191-acb38b25-59aa4908-585921c9-28616730.jpg,validate/p18/p18584056/s52464544/b2eb2191-acb38b25-59aa4908-585921c9-28616730.jpg,validation," 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. " 956aef02-a34bf6fe-29b6136e-b50f3a67-2b3c1a21.jpg,validate/p11/p11658225/s57084217/956aef02-a34bf6fe-29b6136e-b50f3a67-2b3c1a21.jpg,validation," FINAL REPORT INDICATION: ___F smoker with h/o liposarcoma (right thigh ___) c new RLL lung nodule found on surveillance scanning now s/p R VATS RLL wedge s/p chest ___ tube removal // pneumothorax? Please perform at 1:30 PM. COMPARISON: Radiographs from ___ IMPRESSION: The right-sided chest tube has been removed. Cardiomediastinal silhouette is within normal limits. There are small bilateral pleural effusions and subsegmental atelectasis at the lung bases. There is no focal consolidation or pneumothoraces. " a60cb0a9-87b79810-487b0dbf-1c0c3033-65ca43dc.jpg,validate/p11/p11912473/s54080561/a60cb0a9-87b79810-487b0dbf-1c0c3033-65ca43dc.jpg,validation," FINAL REPORT STUDY: Chest radiograph. INDICATION: ___-year-old female with chest pain. Query cardiomegaly. TECHNIQUE: Two views of the chest were obtained. COMPARISON: None. REPORT: Cardiomediastinal silhouette is unremarkable. The lungs are clear. There is probably a pectus carinatum deformity. No acute cardiopulmonary finding. CONCLUSION: No acute cardiopulmonary findings. " 72c9ded6-c788fe5c-447c377f-81ab76a8-f6811354.jpg,validate/p12/p12152670/s56617009/72c9ded6-c788fe5c-447c377f-81ab76a8-f6811354.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with new onset weakness and sob / COMPARISON: ___ ___ FINDINGS: AP upright and lateral views of the chest provided. Cardiomegaly is again noted, severe, with mild to moderate pulmonary edema. No large effusion is seen. No pneumothorax. No asymmetric opacity to raise concern for pneumonia. Mediastinal contour is stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Stable severe cardiomegaly with mild to moderate pulmonary edema. " 8780d456-5dcb9421-81fc3a69-05743b36-dba2fc17.jpg,validate/p13/p13046313/s55615309/8780d456-5dcb9421-81fc3a69-05743b36-dba2fc17.jpg,validation," 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. " 34074932-546187c4-de0897d5-d03e240e-250cb7d1.jpg,validate/p18/p18116982/s57792638/34074932-546187c4-de0897d5-d03e240e-250cb7d1.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Low-grade fever. Prior study is CT from ___. Cardiomediastinal contours are normal. Left subclavian catheter tip is in the lower SVC. Faint opacities in the lower lobes bilaterally are a combination of small pleural effusions, decreased from prior study and adjacent atelectasis. Pleural effusions have markedly decreased from prior study. " 007fada7-7c679b09-7437f0d0-484c9b4c-c49874fe.jpg,validate/p13/p13258755/s59782422/007fada7-7c679b09-7437f0d0-484c9b4c-c49874fe.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with generalized weakness. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is a small right pleural effusion. Lung volumes are low, exaggerating heart size and pulmonary vascular prominence. It is difficult to exclude underlying pulmonary vascular congestion. Evaluation of the lung bases is suboptimal in the setting of low lung volumes. Right basilar opacity could be seen with atelectasis associated with elevated right hemidiaphragm. Aortic calcifications are again noted. Sternal wires are seen. Left subclavian line terminates in the region of the cavoatrial junction/high right atrium. IMPRESSION: Small right pleural effusion and mild pulmonary vascular congestion. Right basilar opacity is most likely atelectasis, but infection cannot be entirely excluded. These findings were discussed with Dr. ___ ___ by Dr. ___ by telephone at 10:03 p.m. on ___. " c2335b0d-68ed4263-edb579a8-650f88f7-c57b9743.jpg,validate/p17/p17402090/s50769822/c2335b0d-68ed4263-edb579a8-650f88f7-c57b9743.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with COPD // RENEW CROSSOVER Screening**Please ___ to ___ #___ TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Marked hyper inflation of the lungs a keeping with the patient's known COPD nodular opacities in the right upper lobe have improved when compared to the prior examination. No acute focal consolidation. The cardiomediastinal contours are unchanged. IMPRESSION: Severe hyperinflation, no acute cardiopulmonary process. " a1509d5d-888cfb6a-267d02fd-1f5e0a61-09394e74.jpg,validate/p12/p12959560/s54975742/a1509d5d-888cfb6a-267d02fd-1f5e0a61-09394e74.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with cough, wheezing and reported fevers. TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___. FINDINGS: Lungs are clear and hyperinflated. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Visualized osseous structures demonstrates no acute abnormality. IMPRESSION: No acute findings. " 667ed8c5-f5b4283c-a23fad85-54fab2b2-63dd8578.jpg,validate/p15/p15355458/s56571833/667ed8c5-f5b4283c-a23fad85-54fab2b2-63dd8578.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pelvic mass and respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous examination, the endotracheal tube has been pulled back by approximately 1 cm. Its tip now projects 3 cm above the carina. The course of the nasogastric tube is unchanged. The tip is not included in the image. Unchanged course and position of the left subclavian line. The lung volumes remain low, but the areas of atelectasis that pre-existed at both lung bases have decreased in severity. No new parenchymal opacities. Unchanged moderate cardiomegaly. No pneumothorax. " ec11b472-ea8b0eba-7f364024-32d5e395-b14fd8c4.jpg,validate/p18/p18835286/s59845192/ec11b472-ea8b0eba-7f364024-32d5e395-b14fd8c4.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with intermittent chest pain and dyspnea on exertion for 1 week. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Extremely low lung volumes are seen with secondary crowding of the bronchovascular markings. Superimposed intersitial edema is also possible. There is blunting of the posterior costophrenic angle, potentially due to small effusion or potentially a Bochdalek's hernia. There is also slightly more focal opacity at the right lung base potentially atelectasis although infection is not excluded. Cardiomediastinal silhouette is likely within normal limits. No acute osseous abnormalities detected. Repeat exam can be performed with improved inspiratory effort to further characterize all of the above findings. " 20005fe6-d265f6a5-e3e143c3-01f8ccd1-25cb1275.jpg,validate/p12/p12033847/s51063192/20005fe6-d265f6a5-e3e143c3-01f8ccd1-25cb1275.jpg,validation," FINAL REPORT INDICATION: Flu-like symptoms. 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. Partially imaged upper abdomen is unremarkable. An 8-mm opacity projecting over right lower lung ___, ___ represent calcified granuloma or possibly a bone island. IMPRESSION: No evidence of acute cardiopulmonary process. " 03aa3e18-3a790273-5e3e251f-a40b2c20-00239760.jpg,validate/p15/p15469243/s52691765/03aa3e18-3a790273-5e3e251f-a40b2c20-00239760.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough, COPD. // pneumonia? 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. " 0c4443db-448d1c7b-a400dfba-1b949df6-971f9d02.jpg,validate/p14/p14865002/s53575574/0c4443db-448d1c7b-a400dfba-1b949df6-971f9d02.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M h/o substance abuse including EtOH abuse (sober for ___ yrs), depression and anxiety (on daily benzos) who presents with 1 wk of confusion and tremors. // r/o acute cardiopulmonary process r/o acute cardiopulmonary process COMPARISON: There are no prior chest radiographs available. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. " b181b451-f855fece-371514b7-b2a8d7f7-a9e0a2af.jpg,validate/p17/p17569828/s52997585/b181b451-f855fece-371514b7-b2a8d7f7-a9e0a2af.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with dyspnea // ?pna COMPARISON: None FINDINGS: AP portable upright view of the chest. Underpenetration limits evaluation. The heart appears mildly enlarged though likely in part magnified due to AP technique. The mediastinal contour appears normal. There is no focal consolidation concerning for pneumonia. No large effusion or pneumothorax. No overt signs of edema though congestion difficult to exclude. Bony structures are intact. IMPRESSION: Findings as above. " d706afff-6597dcc1-1d6ab12f-79a1bc74-b7aff64c.jpg,validate/p12/p12455556/s53573057/d706afff-6597dcc1-1d6ab12f-79a1bc74-b7aff64c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with SOB // r/o acute process TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes. Linear bibasilar opacities are seen which may relate to atelectasis although developing infectious process is not excluded in the appropriate clinical setting. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable. IMPRESSION: Low lung volumes with linear bibasilar opacities likely representing atelectasis, underlying infectious process not excluded in the appropriate clinical setting. " 0f65ce74-125c13cb-ed94ea7a-4336fb1d-c3e6074c.jpg,validate/p12/p12554603/s53476048/0f65ce74-125c13cb-ed94ea7a-4336fb1d-c3e6074c.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with asthma and well-contolled HIV cough, SOB, fever // ?pneumonia EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: The opacity at the right lung base is slightly improved. Slight elevation of right hemidiaphragm is similar to ___. Cardiac silhouette is upper limits of normal and unchanged. IMPRESSION: The opacity at the right lung base could be pneumonia in the right clinical setting, and is slightly improved compared to ___ " e6fb49cd-73a2caae-65662f26-872c8b0a-1413360d.jpg,validate/p19/p19776354/s54187458/e6fb49cd-73a2caae-65662f26-872c8b0a-1413360d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with epigastric pain and history of ulcer. 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. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 2d3e83b0-edf1f23b-54bbfb52-5ef6e5af-04c8d949.jpg,validate/p14/p14365867/s50393969/2d3e83b0-edf1f23b-54bbfb52-5ef6e5af-04c8d949.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with AMS, ?stroke // code stroke COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is an ill-defined left perihilar mass as seen on prior CT exam. Interstitial prominence concerning for lymphangitic carcinomatosis. There is a small left pleural effusion. No pneumothorax. Cardiomediastinal silhouette grossly unchanged. Bony structures appear intact. IMPRESSION: Left perihilar mass concerning for primary malignancy with interstitial prominence concerning for lymphangitic carcinomatosis. " 93823282-425bd2dd-23ca7bf4-1efb6214-dfed36aa.jpg,validate/p16/p16140962/s56031719/93823282-425bd2dd-23ca7bf4-1efb6214-dfed36aa.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain 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. The lungs appear clear. Moderate S-shaped thoracolumbar scoliosis appears unchanged. IMPRESSION: No evidence of acute cardiopulmonary disease. Scoliosis. " 05b157d4-82cf6d16-56e61c25-ca81a536-fdb6eb71.jpg,validate/p13/p13580435/s55412572/05b157d4-82cf6d16-56e61c25-ca81a536-fdb6eb71.jpg,validation," 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. " 8bad5c1c-887ab59e-abfc1610-c3de58fb-eb4087de.jpg,validate/p11/p11374836/s53265443/8bad5c1c-887ab59e-abfc1610-c3de58fb-eb4087de.jpg,validation," WET READ: ___ ___ ___ 8:55 PM Battery pack overlies the left costophrenic angle on this single frontal portable image. Exact location difficult to assess. Wire from generator ascends to level of the left neck. Mild pulmonary vascular congestion. No consolidation or large effusions. No pneumothorax. ___ p_________________________________________________________________________________ FINAL REPORT AP CHEST, 5:18 P.M., ___ HISTORY: Vagal nerve stimulator battery change. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Low lung volumes explain bronchovascular crowding, but make it difficult to exclude mild interstitial edema. It also is likely responsible for atelectasis in the left lower lobe simulating consolidation. There is no pneumothorax or appreciable pleural effusion. Heart size is exaggerated by low lung volume. Electrode passes from the left low pectoral power pack to the left paraspinal neck. " 1e0ed501-82342300-7b11401a-df5b8fd1-fc8cb5b0.jpg,validate/p15/p15384486/s57714008/1e0ed501-82342300-7b11401a-df5b8fd1-fc8cb5b0.jpg,validation," FINAL REPORT INDICATION: ___/F s/p left TKA with hx of systolic CHF and persistent O2 requirement // ? pna vs atelectasis vs pleural effusion TECHNIQUE: Chest AP and lateral COMPARISON: ___ FINDINGS: Low lung volumes with mild to moderate pulmonary edema and pulmonary vascular congestion. Moderate cardiomegaly. Large pleural effusions. No pneumothorax. Retrocardiac opacity is likely atelectatic lung. IMPRESSION: Moderate pulmonary edema. " d1aca434-0f931551-2e597204-73136e80-bfb46048.jpg,validate/p10/p10456513/s55633628/d1aca434-0f931551-2e597204-73136e80-bfb46048.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___. FINDINGS: The heart size, mediastinal and hilar contours are normal and without change. The lungs are clear, and there are no pleural effusions or acute skeletal abnormalities. IMPRESSION: No radiographic evidence of pneumonia. " 1d152169-5f55707f-75ad7112-a337c6ca-e32a6412.jpg,validate/p17/p17724257/s58804377/1d152169-5f55707f-75ad7112-a337c6ca-e32a6412.jpg,validation," FINAL REPORT INDICATION: ___M with hx sCHF, ESRD s/p transplant with worsening renal function. No Contrast // ? fluid overload, PNA TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Linear left basilar opacities likely atelectasis versus scarring. The lungs are otherwise clear noting relatively low lung volumes. There is no overt pulmonary edema. The cardiomediastinal silhouette is accentuated by low lung volumes. Median sternotomy wires and mediastinal clips are noted. IMPRESSION: No acute cardiopulmonary process. " 3809a6de-471cb8d1-c66725cf-7b75f22c-bb47efff.jpg,validate/p15/p15754509/s59385047/3809a6de-471cb8d1-c66725cf-7b75f22c-bb47efff.jpg,validation," FINAL REPORT HISTORY: Diaphragmatic perforation and pneumothorax after repair, to assess for interval change. FINDINGS: In comparison with the earlier study of this date, there is again extensive subcutaneous gas with the monitoring and support devices in place. Bibasilar opacifications are consistent with atelectatic change and probable right effusion as well as some elevated pulmonary vascular pressure. Apices are somewhat difficult to evaluate due to overlying bony structures. Although not optimally seen, there appears to be a right pleural line consistent with a small pneumothorax. Small pneumoperitoneum is probably persisting. " b001fc3a-0e4a15ea-0e83171e-fcc6103f-8703f09c.jpg,validate/p13/p13562477/s54580851/b001fc3a-0e4a15ea-0e83171e-fcc6103f-8703f09c.jpg,validation," FINAL REPORT HISTORY: New Dobbhoff placement. CHEST, SINGLE AP PORTABLE VIEW. A Dobbhoff-type tube is present, with stylet apparently in place. Althugh midline over the upper mediastinum, it courses to the left of the lower mediastinum. The radiopaque tip overlies the left upper quadrant of the abdomen. This could lie within the gastric fundus, though is difficult to confirm on this single view. Cardiomediastinal enlargement, bilateral L>R effusions and underlying collapse and/or consolidation, as well as diffuse vascular blurring are similar to a film obtained ___ at 14:26 p.m. Clips again over left lower neck. " edfcb93a-dcc1e197-57e73423-6f736387-07b82794.jpg,validate/p11/p11651985/s54226367/edfcb93a-dcc1e197-57e73423-6f736387-07b82794.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with chest pain // acute process? COMPARISON: None 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. " 28605e70-83ccb04d-282ebca0-cfe6b6da-69af59c4.jpg,validate/p17/p17071231/s54064943/28605e70-83ccb04d-282ebca0-cfe6b6da-69af59c4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with recurrent falls TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. The mediastinal contour is unchanged with convex margin at the left lower mediastinal border compatible with known esophageal varices. Hilar contours are within normal limits and the pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Old fracture of the right posterior eighth rib is again seen. IMPRESSION: No acute cardiopulmonary abnormality. " 895720f6-61796d6c-ab3094cf-e65a32a9-8d631c47.jpg,validate/p18/p18189343/s57199012/895720f6-61796d6c-ab3094cf-e65a32a9-8d631c47.jpg,validation," FINAL REPORT CHEST RADIOGRAPH COMPARISONS: None. TECHNIQUE: Chest, PA upright. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. A small hyperdense nodular focus projecting over the right lower lung suggests either a granuloma with nipple shadow of doubtful significance. The lungs appear otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute disease. " 4e86b152-1ff75f8d-7f691e2e-425132e9-98798e7d.jpg,validate/p10/p10855190/s52926578/4e86b152-1ff75f8d-7f691e2e-425132e9-98798e7d.jpg,validation," FINAL REPORT HISTORY: Substernal chest pain and hypoxia. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: There is mild enlargement of the cardiac silhouette, increased from ___ with central vascular prominence without edema. There is no definite focal consolidation, although evaluation of the left lung base is limited. There is no pleural effusion or pneumothorax. A right humeral head replacement is incompletely imaged. IMPRESSION: Mild cardiomegaly with central pulmonary vascular congestion without frank interstitial edema. " 76998337-9aa62e89-48f1bd4a-42dac705-ea399df6.jpg,validate/p10/p10377337/s59571547/76998337-9aa62e89-48f1bd4a-42dac705-ea399df6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SBO. // Assess NGT placement. Please shoot a low CXR to visualize the stomach and prox duo. TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: The NG tube is in the proximal stomach with the proximal port just below the GE junction. There dilated loops of bowel in the abdomen consistent with patient's known small bowel obstruction. Left upper quadrant clips, elevated left hemidiaphragm, and mediastinal shift to the right are again seen. The endotracheal tube has been removed " a30f373d-e9278209-5db090a5-6d21aa41-48007c27.jpg,validate/p19/p19770723/s50963836/a30f373d-e9278209-5db090a5-6d21aa41-48007c27.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with productive cough and wheezing. Mild hemoptysis. Nonsmoker. Evaluate for possible infiltrates. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No configurational abnormality is identified. Unremarkable appearance of thoracic aorta and mediastinal structures. The pulmonary vasculature is not congested. There exists a small area of poorly delineated parenchymal infiltrates projecting partially over the left heart border identified on the lateral view to occupy the posterior segment of the left lower lobe. No other acute pulmonary parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free of any fluid accumulation. No pneumothorax seen in the apical area. Skeletal structures of the thorax grossly unremarkable. Our records do not include a previous chest examination available for comparison. IMPRESSION: Small poorly delineated patchy infiltrate in the left lower lobe posterior segment consistent with peribronchial pneumonia. No other pulmonary abnormalities are seen. Followup after successful treatment is recommended. " b1557343-55f58dfb-260cb45b-d4195888-c7059482.jpg,validate/p17/p17037392/s59622287/b1557343-55f58dfb-260cb45b-d4195888-c7059482.jpg,validation," 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. " 1b1cd0db-337f2465-10ab525a-90350432-90896e1d.jpg,validate/p15/p15085102/s57725007/1b1cd0db-337f2465-10ab525a-90350432-90896e1d.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough for ___ years. Shortness of breath. Upper lobe wheezing on exam. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 842c7296-1a191e57-7b329c19-520b518b-77860b5f.jpg,validate/p13/p13391297/s55319104/842c7296-1a191e57-7b329c19-520b518b-77860b5f.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: History of asthma, shortness of breath, wheezing, and hypoxia. Comparison is made with prior study, ___. Cardiomediastinal contours are unchanged. The aorta is tortuous. There is elevation of the right hemidiaphragm. There are bibasilar atelectases. The upper lungs are grossly clear. There is no pneumothorax or pleural effusion. Surgical clips project in the right upper quadrant. " 4db4950e-b2a995eb-23edb2a0-8a055af9-8e11ef07.jpg,validate/p17/p17251948/s59052630/4db4950e-b2a995eb-23edb2a0-8a055af9-8e11ef07.jpg,validation," FINAL REPORT HISTORY: Left chest pain. TECHNIQUE: 2 views of the chest. COMPARISON: ___. 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. IMPRESSION: No acute intrathoracic process. " 582156ce-071c5370-705ad3c8-9d13a418-0666d057.jpg,validate/p18/p18855788/s53814025/582156ce-071c5370-705ad3c8-9d13a418-0666d057.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fever and chest pain. COMPARISON: None available FRONTAL AND LATERAL CHEST RADIOGRAPH: The lungs are clear. No confluent opacity is identified. There is no pulmonary edema or pleural effusion. No pneumothorax is evident. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. No evidence of pneumonia. " 95daccc7-4033cd3c-862939ad-83ecf912-823f18ab.jpg,validate/p19/p19970838/s55320296/95daccc7-4033cd3c-862939ad-83ecf912-823f18ab.jpg,validation," FINAL REPORT EXAMINATION: PORTABLE CHEST RADIOGRAPH INDICATION: ___-year-old male with chest pain. TECHNIQUE: Frontal supine chest radiograph COMPARISON: Chest radiograph performed approximately 5 hr prior to this exam at outside institution. FINDINGS: Lung volumes are low, accounting for bronchovascular crowding. There is no focal opacity concerning for pneumonia. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Low lung volumes. No evidence of acute cardiopulmonary process. " b2d40ab1-9eccad81-bdb1e4f1-9b0582ec-af2ed9e7.jpg,validate/p18/p18628529/s52359956/b2d40ab1-9eccad81-bdb1e4f1-9b0582ec-af2ed9e7.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with sickle cell crisis. TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrate no focal opacity convincing for pneumonia. Elevation of the right hemidiaphragm appears to been present on prior study dated ___. Cardiomediastinal and hilar contours are within normal limits. A left chest wall Port-A-Cath is again identified, a catheter tip terminating in the low superior vena cava. There is no pleural effusion or pneumothorax. Visualized osseous structures are without an acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " fe7f8dcc-6d0d0d46-105a97ed-0380f22a-ce685df9.jpg,validate/p11/p11724294/s52125286/fe7f8dcc-6d0d0d46-105a97ed-0380f22a-ce685df9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG, post pull // eval ptx eval ptx IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged, as is the appearance of the heart and lungs. No evidence of pneumothorax. " b535c5d7-90f9bc54-f74a5554-be86fbb3-e70bba00.jpg,validate/p14/p14338126/s56847874/b535c5d7-90f9bc54-f74a5554-be86fbb3-e70bba00.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p major abdominal surgery, intubated, not ventilating well // cardiopulmonary process COMPARISON: ___ IMPRESSION: As compared to the previous image, lung volumes continue to be low. The extent and severity of the bilateral pleural effusions has not substantially changed. Mild pulmonary edema persists. Moderate cardiomegaly. Bilateral areas of atelectasis at the lung bases, left more than right. The monitoring and support devices are in unchanged position. " 29babd69-8f83ba77-b28036fb-96ca8dab-303ab24f.jpg,validate/p14/p14760908/s54439139/29babd69-8f83ba77-b28036fb-96ca8dab-303ab24f.jpg,validation," FINAL REPORT HISTORY: Fever. COMPARISON: radiographs available from ___. FRONTAL CHEST RADIOGRAPH: A Dobbhoff tube terminates at the stomach. The heart size is top-normal. The lung volumes are low. A left retrocardiac opacity worsened from ___ to ___ but has improved since ___, compatible with atelectasis. There is no pneumothorax or pleural effusion. There is decreased prominence of the central pulmonary vessels. No interstitial edema. IMPRESSION: 1. Improved central pulmonary vascular congestion. No pulmonary edema. 2. Improved left basilar atelectasis. " 29c32b03-c19949d0-8fb00eb7-bc001739-ab3ec89a.jpg,validate/p18/p18124225/s53677508/29c32b03-c19949d0-8fb00eb7-bc001739-ab3ec89a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p multiple unwitnessed falls with L rib fractures, L pneumothorax, and 1.7cm obstructing L UPJ stone with hydronephrosis now s/p L pigtail catheter placement. chest tube to suction // interval change IMPRESSION: As compared to the recent radiograph of 1 day prior, there has not been a relevant interval change in the appearance of the chest. " 8dc43612-a8d73c16-743c16d3-a003ab4a-18e83dff.jpg,validate/p15/p15795685/s55126649/8dc43612-a8d73c16-743c16d3-a003ab4a-18e83dff.jpg,validation," FINAL REPORT EXAMINATION: AP chest radiograph INDICATION: ___ year old woman with PICC in place for TPN at home // PICC line placement TECHNIQUE: Chest radiograph COMPARISON: ___ FINDINGS: Left PICC line tip terminates at the level of lower SVC. IMPRESSION: Left PICC line tip terminates at the level of lower SVC. Epidural catheter is in place. Cardiomediastinal silhouette is unchanged. Lungs are overall clear. Substantial pectus excavatum is present that contributes to the left mediastinal shift and indistinct right medial lung appearance. " 107771c9-65d7a511-f9de3ae8-5328efe9-004f45d0.jpg,validate/p12/p12763939/s54763928/107771c9-65d7a511-f9de3ae8-5328efe9-004f45d0.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: ___. FINDINGS: Tracheostomy tube and feeding tube remain in place. Right subclavian catheter has been removed with no visible pneumothorax. Cardiomediastinal contours are stable in appearance. Dense left retrocardiac opacity with associated inferior displacement of hilum appears unchanged and most likely represents collapse of the left lower lobe. Adjacent small-to-moderate left pleural effusion is present. Linear atelectasis in the right perihilar region is present but remainder of right lung is grossly clear. " fd7f56c2-5b65ced9-3fde80eb-5ba0e95d-258d89b1.jpg,validate/p16/p16441660/s51755928/fd7f56c2-5b65ced9-3fde80eb-5ba0e95d-258d89b1.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old male patient with ventricular tachycardia, ICD on amiodarone, evaluate for infiltrate related to amiodarone toxicity. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. On the present frontal view, the patient makes a very poor inspirational effort resulting in high positioned diaphragms and thereto related crowded appearance of the basal pulmonary vasculature. Heart size is not increased and no pulmonary vascular congestion has developed. As before, a permanent pacer is located in left anterior axillary position being connected to a total of three intracavitary electrodes. One of these is an ICD device that terminates in the right ventricle. A second line is a probably abandoned old right ventricular electrode. A third electrode terminates in the right atrium lateral posterior wall area and is located in unchanged position and comparison is made with the previous examination one and a half years ago. Appearance of lungs is unchanged paying attention to differences in inspiratory degree. Acute parenchymal infiltrates or interstitial fibrosis changes cannot be identified. No pneumothorax is seen in the apical area. The lateral and posterior pleural sinuses remain free. IMPRESSION: Stable chest findings, no significant interval change since ___. No suspicious findings for amiodarone toxicity. " 102c8ad2-dc60611c-e5b0fe94-0841fd4a-479e9432.jpg,validate/p14/p14815352/s59152040/102c8ad2-dc60611c-e5b0fe94-0841fd4a-479e9432.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough 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. " 86d652ec-3af18292-6a77dce3-f5dc3aac-22a7b4a0.jpg,validate/p16/p16742247/s50378868/86d652ec-3af18292-6a77dce3-f5dc3aac-22a7b4a0.jpg,validation," 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 " cd9147db-236477da-554dfdb4-d42c08f6-7ab3298c.jpg,validate/p11/p11183093/s58135686/cd9147db-236477da-554dfdb4-d42c08f6-7ab3298c.jpg,validation," 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 " 649c39bc-62b992e8-58050541-1a5461b3-93b5254c.jpg,validate/p19/p19599303/s52694419/649c39bc-62b992e8-58050541-1a5461b3-93b5254c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ASTHMA,COUGH IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute pneumonia, vascular congestion, or pleural effusion. " b2e83970-b8f7338c-5468671c-ac668b5d-58cfe3bf.jpg,validate/p11/p11445845/s56661989/b2e83970-b8f7338c-5468671c-ac668b5d-58cfe3bf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with CAD s/p stenting ___ years ago p/w chest pain of 2 days. // acute cardiopulmonary process 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. IMPRESSION: No acute intrathoracic process. " 4a8e2515-130c2e10-64fdeb25-b9aa0e41-27cd1709.jpg,validate/p12/p12764579/s51696083/4a8e2515-130c2e10-64fdeb25-b9aa0e41-27cd1709.jpg,validation," FINAL REPORT HISTORY: Fever with intubation. FINDINGS: In comparison with the study of ___, the patient has taken a poor inspiration. Endotracheal tube measures approximately 6 cm above the carina and is positioned well above the superior margin of the clavicles. There is some increased fullness of pulmonary vessels consistent with worsening pulmonary edema. Continued enlargement of the cardiac silhouette with basilar atelectatic changes. " 23fc65a9-c320ed04-713b0013-aa2e82de-26cce4c6.jpg,validate/p19/p19164077/s51082869/23fc65a9-c320ed04-713b0013-aa2e82de-26cce4c6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with L pneumo // ___M with spont. L pneumo. no outside imaging TECHNIQUE: Chest PA and Lateral COMPARISON: None FINDINGS: There is a large left tension pneumothorax with shift of the mediastinum to the right and flattening of the hemidiaphragm. The right lung is clear. No pleural effusion or pneumonia. IMPRESSION: Large left tension pneumothorax. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:09 PM, ___ upon discovery of the findings. " 73235ca4-e24a3d8a-5c8f28b6-b932026e-b196e685.jpg,validate/p13/p13640181/s52841719/73235ca4-e24a3d8a-5c8f28b6-b932026e-b196e685.jpg,validation," FINAL REPORT EXAMINATION: PORTABLE CHEST RADIOGRAPH INDICATION: ___-year-old male with chest pain. . TECHNIQUE: Frontal upright chest radiograph COMPARISON: None available FINDINGS: Assessment is limited due to exaggerated lordotic view. Allowing for this limitation, there is no pulmonary opacity or consolidation concerning for pneumonia. Streaky bibasilar consolidations are likely atelectasis. Moderate cardiomegaly is present. There is no pleural effusion or pneumothorax. No rib fractures are identified. IMPRESSION: No evidence of pneumonia. " 4e1e1cad-e6753076-d7b5b3e6-0b3cf7d3-3e370ace.jpg,validate/p12/p12089095/s57329456/4e1e1cad-e6753076-d7b5b3e6-0b3cf7d3-3e370ace.jpg,validation," FINAL REPORT INDICATION: ___M with confusion, concern for infxn // ? pna TECHNIQUE: PA and lateral views the chest. COMPARISON: None available. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d14d19a8-a94d90fc-bb23dcc6-0b6d8ada-421e97cc.jpg,validate/p13/p13050559/s59808777/d14d19a8-a94d90fc-bb23dcc6-0b6d8ada-421e97cc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with primary mediastinal b cell lymphoma with new fever overnight ___ // ? new pulmonary infiltrate ? new pulmonary infiltrate IMPRESSION: IN COMPARISON WITH THE STUDY ___ ___, THERE IS CONTINUED RIGHT UPPER LOBE VOLUME LOSS WITH HILAR AND MEDIASTINAL ADENOPATHY BILATERALLY. RIGHT SUBCLAVIAN PICC LINE EXTENDS TO THE MID TO LOWER PORTION OF THE SVC. " 25815f6d-29236c0d-f715c55d-d79c6184-0da067c3.jpg,validate/p17/p17925184/s53787157/25815f6d-29236c0d-f715c55d-d79c6184-0da067c3.jpg,validation," FINAL REPORT AP CHEST, 1:10 A.M., ___ HISTORY: COPD and worsening respiratory distress. IMPRESSION: AP chest compared to ___: Moderate bilateral pleural effusions decreased slightly since ___. The other reason for particular opacification at the lung bases is atelectasis seen on correlation of chest CT and conventional radiographic findings on ___. They have been a component of pulmonary edema on ___, but there is no evidence of that today. Heart is normal size, mediastinal veins are not dilated. Enlargement of the pulmonary outflow tract may reflect increased pulmonary vascular resistance from the severe atelectasis in the lower lobes and severe emphysema in the upper. Feeding tube ends in the upper part of non-distended stomach. Left PIC line ends in the SVC. No pneumothorax. " 0a3cf786-e27a3f3a-dfa7c022-48f929fa-58573506.jpg,validate/p14/p14816630/s58611021/0a3cf786-e27a3f3a-dfa7c022-48f929fa-58573506.jpg,validation," WET READ: ___ ___ ___ 11:28 PM STATUS POST BENTAL WITH EXPECTED POSTSURGICAL CHANGES. CARDIOMEGALY IS UNCHANGED. NO LARGE PNEUMOTHORAX IDENTIFIED. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Bentall // FAST TRACK EARLY EXTUBATION CARDIAC SURGERY Contact name: ___, ___: ___ FAST TRACK EARLY EXTUBATION CARDIAC SURGERY IMPRESSION: Compared to preoperative chest radiographs ___. Postoperative decrease in caliber of the still moderately enlarged cardiomediastinal silhouette suggests pericardial effusion was present preoperatively. Severe left lower lobe atelectasis and small left pleural effusion persist. No pneumothorax or right pleural effusion. Mild pulmonary vascular congestion, but no pulmonary edema. Swan-Ganz catheter ends in the pulmonary outflow tract. Other lines and tubes in standard placements. " e83a70f9-36d80019-0eff8d31-6f018891-932dba34.jpg,validate/p16/p16528352/s51091019/e83a70f9-36d80019-0eff8d31-6f018891-932dba34.jpg,validation," FINAL REPORT INDICATION: Patient status post fall. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrated a persistent small right pleural effusion. There is no left pleural effusion. Mild interstitial pulmonary edema has progressed since prior exam. Heart is mildly enlarged. Ascending aorta is mildly tortuous. Sternotomy wires are intact. Multiple surgical clips project over cardiac silhouette. No pneumothorax. A round density projecting over right lower lung likely represents a bone island of the scapula. IMPRESSION: Mild interstitial pneumonia and cardiomegaly has progressed since ___ exam. Small right pleural effusion persists. " 5a8e455e-2ad995e2-5d7c4fa1-aeccd79a-36a60e5c.jpg,validate/p10/p10049851/s55477894/5a8e455e-2ad995e2-5d7c4fa1-aeccd79a-36a60e5c.jpg,validation," FINAL REPORT INDICATION: History: ___M with crackles on lung exam // Eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiomediastinal silhouette is within normal limits. Increased opacity over the spine on the lateral view may represent pneumonia in the appropriate clinical context. There is no pleural effusion or pneumothorax. IMPRESSION: Increased airspace opacity over the spine could represent pneumonia in the appropriate clinical context. NOTIFICATION: The findings were discussed with Dr. ___, by ___, M.D. on the telephone on ___ at 11:25 AM, 10 minutes after discovery of the findings. " 880723e7-6ae7ac07-bf7adcd0-f9c2ccb5-e67dd18b.jpg,validate/p13/p13479418/s51348500/880723e7-6ae7ac07-bf7adcd0-f9c2ccb5-e67dd18b.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: The patient with right-sided opacity to see if it can be seen on chest x-ray. COMPARISON: Multiple prior chest CT, the last one ___. PET-CT of ___. Last chest x-ray ___. FINDINGS: Right upper lobe malignancy was treated with chemo and radiation therapy with stable paramediastinal scarring. Left lung opacification from ___ proven to be COP has completely resolved. Area of consolidation in right lower lung has increased in size from chest CT of ___ to PET-CT of ___. There is no pleural effusion or pneumothorax. Mediastinal and cardiac contours are unremarkable. CONCLUSION: The patient was treated for right upper lobe malignancy with chemo and radiation therapy. COP was proven on previous left lung opacification. New right lower lung opacity that appeared on chest CT of ___ has worsen as shown on recent PET-CT. " fe930713-745f1914-af595bff-0191c320-854be027.jpg,validate/p19/p19294289/s58984006/fe930713-745f1914-af595bff-0191c320-854be027.jpg,validation," FINAL REPORT HISTORY: ___-year-old febrile male with tachycardia and cough. STUDY: AP and lateral chest radiograph. COMPARISON: Chest CTAs from ___ and chest radiograph from ___. FINDINGS: The heart and mediastinal contours are within normal limits. The lung volumes are low, but there continues to be consolidation of the left lower lung without radiographic evidence of pleural effusion or pneumothorax, and diagnostic considerations include pneumonia versus infarct. " 388562eb-9e4c34fd-5385e4ad-3dc7b082-ac8e7a89.jpg,validate/p16/p16870844/s52299006/388562eb-9e4c34fd-5385e4ad-3dc7b082-ac8e7a89.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma who continues to feel short of breathe after exposure to a fire and a lot of smoke. Difficulty taking deep breathes because of pain extending from mid right back to right flank area. // evaluate for pathology 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. The osseous structures are unremarkable IMPRESSION: No acute cardiopulmonary abnormalities " f900f042-a8457081-fac3d6fc-16559fbf-bb37d9eb.jpg,validate/p13/p13561687/s57104047/f900f042-a8457081-fac3d6fc-16559fbf-bb37d9eb.jpg,validation," WET READ: ___ ___ 10:43 PM New small right pleural effusion blunts the posterior costophrenic sulcus. Besides the calcified granuloma in the right upper lobe the lungs are clear. ______________________________________________________________________________ FINAL REPORT HISTORY: History of cholangiocarcinoma, now with bacteremia, persistent fever, and left lower rales on exam. Evaluate for pneumonia. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. The lungs are well aerated and demonstrate a vague opacity in the left lung base, which may represent left lower lobe pneumonia. A right mid lung calcified granuloma is unchanged. There is also a new small right pleural effusion. There is no pneumothorax. IMPRESSION: 1. Possible left lower lobe pneumonia. 2. New small right pleural effusion. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___, approximately 30 minutes after discovery. " d5f03c44-e3b7efe0-551e85d6-614d8cec-59ea4645.jpg,validate/p19/p19827590/s57710002/d5f03c44-e3b7efe0-551e85d6-614d8cec-59ea4645.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with confusion, hypoxia COMPARISON: None FINDINGS: AP portable semi upright view of the chest. Cardiomegaly noted with hilar congestion and moderate pulmonary edema. No pneumothorax. Lower lung opacities, left greater than right likely reflect pleural effusions, and atelectasis, difficult to exclude pneumonia. Aortic calcification noted. Bony structures are intact. IMPRESSION: Pulmonary edema, pleural effusions, possible lower lung pneumonia. " 81bea2ca-c094c51e-11008169-d6b3b0ff-4f163dd2.jpg,validate/p17/p17653729/s52309094/81bea2ca-c094c51e-11008169-d6b3b0ff-4f163dd2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new hypotension. c. diff infection. // new infection new infection IMPRESSION: In comparison with the study of ___, of the monitoring and support devices remain in place. Hazy opacification at the bases is consistent with layering effusions and atelectatic changes. There may be mild residual elevation of pulmonary venous pressure. " d98cb471-40f82f21-52c03fcb-19f05571-80a9f890.jpg,validate/p13/p13118875/s53915046/d98cb471-40f82f21-52c03fcb-19f05571-80a9f890.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old male with acute abdomen, question free air. TECHNIQUE: Portable AP upright chest radiograph. COMPARISON: Radiograph dated ___. FINDINGS: Multiple overlying EKG leads are present. There is no free air below the right hemidiaphragm. There is mild bibasilar atelectasis. Otherwise the lungs are clear. The cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: No signs of pneumoperitoneum. Bibasilar atelectasis. " c11fa1cf-dbc04422-9ea48851-7c5d9142-6d0a883c.jpg,validate/p15/p15035317/s58053315/c11fa1cf-dbc04422-9ea48851-7c5d9142-6d0a883c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemia // ___ year old man with hypoxemia ___ year old man with hypoxemia COMPARISON: Chest radiograph is since ___ most recently ___. IMPRESSION: mild bronchial wall thickening is probably not new. There is no definite focal pulmonary abnormality. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal " a290bb32-bd036480-10380bf9-464ef0c3-cc00507b.jpg,validate/p12/p12906270/s54280431/a290bb32-bd036480-10380bf9-464ef0c3-cc00507b.jpg,validation," FINAL REPORT INDICATION: Chronic pain on the right side. Evaluation for fracture or consolidation. COMPARISONS: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate clear lungs. There may be mild atelectasis at the left lung base. There is no fracture, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 49d5c1fd-828374b4-50296ab6-12b3163e-c93fb9a0.jpg,validate/p16/p16841371/s58351320/49d5c1fd-828374b4-50296ab6-12b3163e-c93fb9a0.jpg,validation," WET READ: ___ ___ 9:18 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with abdominal pain, hematemesis // abdominal pain, hematemesis TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None provided. FINDINGS: Lung volumes are low-normal. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are normal. Heart size is normal. IMPRESSION: No acute intrathoracic process. " 0d2a50a2-3711662a-d7838521-4dc58d09-3732a3ad.jpg,validate/p11/p11569093/s57204814/0d2a50a2-3711662a-d7838521-4dc58d09-3732a3ad.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleural effusion, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The course of the left internal jugular vein catheter is constant. Constant extensive left parenchymal opacity and extensive right apicolateral consolidation. Moderate elevation of the right hemidiaphragm with small pleural effusion. Unchanged aspect of the left heart border. No pneumothorax, no new opacities. " d607cc8c-b89e35a1-5c627f23-a157a659-0297b8c0.jpg,validate/p18/p18807122/s52056669/d607cc8c-b89e35a1-5c627f23-a157a659-0297b8c0.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. 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. " 2424b381-b59f1e26-4ea64169-2f85cc56-30dd3e2e.jpg,validate/p11/p11816734/s59645532/2424b381-b59f1e26-4ea64169-2f85cc56-30dd3e2e.jpg,validation," FINAL REPORT HISTORY: Weakness. COMPARISON: Multiple prior studies including chest radiograph from ___ and chest CT from ___. FINDINGS: There is a small focus of increased opacity in the the right lower lobe which could be representative of an early infection, possibly due to aspiration, or atelectasis. Otherwise, the remainder of the lungs are clear with no other consolidations, effusions, or pnemothoraces. Bilateral hilar enlargement remains stable and suggests pulmonary arterial hypertension. Heart size is normal. Aorta is stably tortuous. No acute fractures are identified. IMPRESSION: Small focus of increased opacity in the right lower lobe which may be representative of an early infectious process in the proper clinical setting. " 94833a1c-c8d3cc20-a62da883-b109d989-8ddbe6fc.jpg,validate/p19/p19809073/s55719894/94833a1c-c8d3cc20-a62da883-b109d989-8ddbe6fc.jpg,validation," 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. " 88718d89-b984c336-b399c2d8-f89ee991-c8656f00.jpg,validate/p14/p14292412/s59767321/88718d89-b984c336-b399c2d8-f89ee991-c8656f00.jpg,validation," 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: Normal. " f03a6a23-3722ec75-6268e6fd-7fbd1fa8-3dc0c45f.jpg,validate/p10/p10175944/s52156909/f03a6a23-3722ec75-6268e6fd-7fbd1fa8-3dc0c45f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB // pls eval pulm edema, evidence of ASN IMPRESSION: As compared to prior radiograph of ___, the patient has been extubated. Cardiomediastinal contours are stable. Worsening pulmonary vascular congestion is accompanied by worsening bilateral airspace opacities which are most severe in the lung apices. Differential diagnosis includes asymmetrical edema, including neurogenic edema, as well as edema with secondary superimposed process such as multifocal aspiration, hemorrhage, or infectious pneumonia PA. " 7bf1e543-967792ef-b325a1ea-e9f20608-584bb3f1.jpg,validate/p11/p11166922/s50217218/7bf1e543-967792ef-b325a1ea-e9f20608-584bb3f1.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of abdominal distension, chronic pancreatitis, question free air or other acute cardiopulmonary process. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Small bilateral pleural effusions are seen with likely overlying atelectasis. No definite focal consolidation is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette top normal. Mediastinal silhouette is unremarkable. Degenerative changes are seen along the spine. IMPRESSION: Small bilateral pleural effusions. " ae96b785-d224f4fc-a9b4136a-6810c4e7-7747003e.jpg,validate/p19/p19047244/s54943949/ae96b785-d224f4fc-a9b4136a-6810c4e7-7747003e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Multiple myeloma being worked up for auto BMT // Pre-autoBMT workup. R/O Cardiac/pulmonary issues Pre-autoBMT workup. R/O Cardiac/pulmonary issues IMPRESSION: No previous images. Hyperexpansion of the lungs suggests some underlying chronic pulmonary disease. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. No evidence of parenchymal or skeletal metastases. " 7d7c584a-f9638ab5-21894476-9936654a-750be379.jpg,validate/p14/p14659758/s50144833/7d7c584a-f9638ab5-21894476-9936654a-750be379.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___/F POD#2 from left TKA with tachycardia, WBC ___, somnolence // ? pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has developed a moderate right pleural effusion, that occupies approximately ___% of the right hemi thorax. Subsequent atelectasis at the right lung bases. The extent of the effusion is better appreciated on the lateral than on the frontal radiograph. The left lung is unchanged. Borderline size of the cardiac silhouette. No overt pulmonary edema. An old healed rib fracture on the left is partially lead and by an ECG lead. " 90fc54c6-122dd0ae-508b10f4-6065ce13-b381a651.jpg,validate/p16/p16444272/s50289683/90fc54c6-122dd0ae-508b10f4-6065ce13-b381a651.jpg,validation," FINAL REPORT CHEST ON ___. HISTORY: Chronic chylothorax, pleurodesis. FINDINGS: The left-sided PICC line tip in the right atrium is again visualized. The appearance of the lungs is unchanged compared to the study from the prior evening. " 02c610bc-9bf0af53-230c83c5-cdccda31-9f262f5c.jpg,validate/p19/p19683840/s58982469/02c610bc-9bf0af53-230c83c5-cdccda31-9f262f5c.jpg,validation," 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. " 24187e25-66d62d15-be4e81e2-fab9cf40-5b7e9144.jpg,validate/p11/p11167924/s53564850/24187e25-66d62d15-be4e81e2-fab9cf40-5b7e9144.jpg,validation," 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. " dff672dc-054646a1-ca80bc9d-f389720f-73e0e866.jpg,validate/p19/p19197903/s50149531/dff672dc-054646a1-ca80bc9d-f389720f-73e0e866.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with idiopathic pulmonary fibrosis, cough, and fever. Evaluate for possible new 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 ___. Heart size is difficult to assess because of overlying left-sided pulmonary abnormalities. Heart size is probably normal as there is no evidence of pulmonary vascular congestion. Multiple previous chest examinations are reviewed in sequence, demonstrating that the fibrotic changes have progressed continuously since ___. Comparison with the next preceding chest examination of ___ demonstrates further progress to a lesser degree. Again, there are bilateral, mostly basal linear changes, most marked on the left side where there also blend with the mediastinal structures and obscure the cardiac contours. On the left base laterally, in the vicinity of the chest wall, there are increased local densities identified, which are suggestive of possibly new acute processes. The diagnosis is not conclusive in light of the previously existing rather advanced changes. It is therefore suggested to treat the patient for the present acute infection and take a followup chest examination with shorter time interval (one week) to see if these changes are regressing. IMPRESSION: Mild regression of chronic fibrotic changes since ___. Suspicion for local left lower lobe lateral infiltrate. Recommend followup. " 46ae7825-20274cf0-62def799-915151f0-5ab650e4.jpg,validate/p15/p15952632/s51610479/46ae7825-20274cf0-62def799-915151f0-5ab650e4.jpg,validation," FINAL REPORT HISTORY: Female status post open right partial nephrectomy with concern for pneumonia and unable to wean to room air. Assess for acute process. COMPARISON: Chest radiograph, ___, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: New right upper lobe opacity adjacent to right paratracheal stripe. Mild interval improvement in low lung volumes with mild right basilar atelectasis. Clear left lung. No pleural effusion or pneumothorax. Mild improvement in heart size with normal hila. Vascular clips noted in thoracic inlet. IMPRESSION: 1. New right upper lobe opacity which may represent mediastinal vein dilatation or in the appropriate clinical setting, pneumonia. If clinical concern for pneumonia, consider oblique and lordotic views for further assessment. If clinically asymptomatic, no further assessment is necessary. 2. Mild right basilar atelectasis. Results were conveyed via telephone to Dr. ___ nurse by Dr. ___ ___ on ___ at 11 a.m. within 15 minutes of results. " 9dd11718-91537917-07bc8ec5-b9353d0e-51a34c67.jpg,validate/p18/p18796351/s55324848/9dd11718-91537917-07bc8ec5-b9353d0e-51a34c67.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The biapical scarring, right greater than left, is unchanged. Cardiomediastinal and hilar contours are normal and unchanged. IMPRESSION: No acute cardiopulmonary process. " a80f3a4f-cb5eedee-2d765105-972a21c3-ab70d7e5.jpg,validate/p13/p13163471/s51236552/a80f3a4f-cb5eedee-2d765105-972a21c3-ab70d7e5.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with severe psoriasis and sepsis. Evaluate for interval change. COMPARISON: Multiple prior radiographs the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. Heart is top normal in size in the setting of low lung volumes. Persistent enlargement of the pulmonary vessels suggests ongoing pulmonary edema. Cardiomediastinal and hilar contours are unchanged. The right internal jugular central venous line ends at the cavoatrial junction. No pneumothorax. IMPRESSION: Persistent enlargement of the pulmonary vessels suggests ongoing pulmonary edema. " 37b46ab9-9615158b-57e30257-f2c46859-cece068a.jpg,validate/p16/p16040005/s55219861/37b46ab9-9615158b-57e30257-f2c46859-cece068a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with sternal chest pain, reports rib fractures diagnosed 3 weeks ago // eval for pneumonia, fracture TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No displaced rib fracture seen. IMPRESSION: No definite focal consolidation. No displaced rib fracture identified. If clinical concern persists, dedicated rib series or CT is more sensitive. " b06d4b94-662b5867-150a25a1-6d4a711a-837ac9a1.jpg,validate/p18/p18851269/s50142012/b06d4b94-662b5867-150a25a1-6d4a711a-837ac9a1.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post fall with multiple injuries. Comparison is made with CT torso on ___. ET tube tip is 4.5 cm above the carina. NG tube tip is out of view below the diaphragm. There are low lung volumes. Cardiac size is top normal. Widened mediastinum is due to lymphadenopathy better seen in prior CT. There is no evident pneumothorax. There is mild vascular congestion. There is a stable small left pleural effusion. Well-defined rounded hyperlucency in the left lower lobe is better characterized in prior CT. It could be due to a bulla , less likely lung laceration. " ca9d5e37-fef31164-e2726129-8c605103-6bac0322.jpg,validate/p17/p17697224/s52576935/ca9d5e37-fef31164-e2726129-8c605103-6bac0322.jpg,validation," FINAL REPORT INDICATION: ___ year old man with HTN emergency and NSTEMI now with HCAP on vanc/cef now with new fever // Change in infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiomegaly again noted. Thoracic aorta is generally large and tortuous, but not focally aneurysmal. Right-sided PICC line in place with the tip in the mid to lower SVC. The first of 2 radiographs shows no focal pulmonary consolidation; the second was performed at a lower level of inspiration. No pleural effusion. No pneumothorax. IMPRESSION: No pneumonia. " 75c58c15-a872bcc3-4a143957-be8566bd-e962f674.jpg,validate/p15/p15229604/s54207314/75c58c15-a872bcc3-4a143957-be8566bd-e962f674.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ESRD/T1DM for pre kidney/pancreas transplant eval // r/o infection, malignancy, nodules r/o infection, malignancy, nodules IMPRESSION: In comparison with the study of ___, the bibasilar opacifications have cleared. There is hyperexpansion of the lungs consistent with chronic pulmonary disease. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. Some atelectatic or fibrotic changes seen at the left base. Hemodialysis catheter extends to the right atrium. " f355ed37-13acc561-1c9ce110-ba5b6f25-fdae57b3.jpg,validate/p11/p11625041/s54912400/f355ed37-13acc561-1c9ce110-ba5b6f25-fdae57b3.jpg,validation," FINAL REPORT INDICATION: Abdominal pain and history of peptic ulcer disease, assess for free air. 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. No free intraperitoneal air is seen of the right hemidiaphragm. " 2c5867c1-3644b5f1-282b3eb2-7316a549-fc8ef063.jpg,validate/p15/p15830739/s53065420/2c5867c1-3644b5f1-282b3eb2-7316a549-fc8ef063.jpg,validation," FINAL REPORT AP CHEST, 4:44 A.M., ___ HISTORY: A ___-year-old woman with aspiration pneumonia. IMPRESSION: AP chest compared to ___: Lung volumes have improved dramatically and pulmonary and mediastinal vasculature are now normal. Atelectasis is mild to moderate at both lung bases, on the left the result of chronic elevation of the left hemidiaphragm. There are no findings to suggest pneumonia. There has been a substantial decrease in gaseous distention of the intestinal tract since ___. Heart size normal. Pleural effusions are small. No pneumothorax. ET tube and left internal jugular line are in standard placements. " ddf3bfbb-476e8d14-44876d7e-d2b294ae-a63d73e4.jpg,validate/p19/p19918971/s52149643/ddf3bfbb-476e8d14-44876d7e-d2b294ae-a63d73e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Recent pnwumonia at ___, feels fatigued and has sweats; r/o pleural effusion; lung exam ok // r/o pleural effusion r/o pleural effusion COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. " be27fa1a-0d332daa-d4d3dc23-48b7ab9f-31763fdb.jpg,validate/p17/p17451002/s59517814/be27fa1a-0d332daa-d4d3dc23-48b7ab9f-31763fdb.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Lower extremity swelling, question CHF. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are relatively hyperinflated, with flattening of the diaphragms. No focal consolidation, large pleural effusion, or evidence of pneumothorax is seen. There is no overt pulmonary edema. The cardiac silhouette is top normal. The aorta is calcified and tortuous. Degenerative changes are seen at the acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " 288c645e-b0ab7ef0-ffd84c0e-0d384d47-96cec76b.jpg,validate/p14/p14415891/s59525582/288c645e-b0ab7ef0-ffd84c0e-0d384d47-96cec76b.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with left-sided pleural effusion, status post thoracocentesis with 650 mL evacuated on ___. Evaluate for recurrence of effusion. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding PA and lateral chest examination of ___. Heart size, mediastinal structures, and pulmonary vasculature are within normal limits and unchanged. Again noted is the mild degree of left lateral pleural blunting extending mildly into the posterior pleural sinus. When comparison is made with the preceding study, the amount of pleural effusion remains small and is practically unchanged. No pneumothorax has developed, and no new infiltrates are seen. IMPRESSION: Stable chest findings. No evidence of recurrent pleural effusion. The small amount of low density is similar to what has been seen post thoracocentesis performed on ___. " b86d7453-c78cdee7-936d7524-614bd047-d7349b5f.jpg,validate/p13/p13211631/s54979816/b86d7453-c78cdee7-936d7524-614bd047-d7349b5f.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with persistant cough and fatigue, rales at bases // ? atypical ""walking"" pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Prior radiographs of the chest dated ___ to ___. 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. The hepatic flexure is interposed between the liver in the right hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 1e0299e4-8255720a-38fc3c0c-1d5579a5-6f7de09f.jpg,validate/p18/p18691929/s58709116/1e0299e4-8255720a-38fc3c0c-1d5579a5-6f7de09f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with AMS, ?facial droop with old stroke, unclear last normal or baseline COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. A Port-A-Cath is again seen projecting over the left chest wall with catheter tip in the region of the low SVC. Bibasilar atelectasis is again noted. There is no convincing evidence for pneumonia or edema. No large effusion or pneumothorax is seen. Cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: Bibasilar atelectasis, otherwise unremarkable exam. Port-A-Cath in place. " d1c574c2-8a54751d-fa2f7755-03f4cb29-5200cc97.jpg,validate/p19/p19473527/s58447936/d1c574c2-8a54751d-fa2f7755-03f4cb29-5200cc97.jpg,validation," 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. " e6cc71c7-a432181a-bdc5276d-989244ee-53517319.jpg,validate/p17/p17209971/s51737959/e6cc71c7-a432181a-bdc5276d-989244ee-53517319.jpg,validation," FINAL REPORT INDICATION: MVC. Evaluation for pneumothorax. COMPARISON: None. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. There is a possible right sixth lateral rib fracture. If indicated, a dedicated rib series can be performed. The cardiomediastinal silhouette is normal. " 252eb93e-83b04690-5a3fef9d-4288c1c5-f7a99b79.jpg,validate/p16/p16561549/s53397326/252eb93e-83b04690-5a3fef9d-4288c1c5-f7a99b79.jpg,validation," FINAL REPORT AP CHEST, 8:28 A.M., ___ HISTORY: Ventral hernia repair. Increasing wheezing and oxygen requirement. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Lung volumes are low, heart size is top normal, pulmonary vasculature minimally engorged. No large scale atelectasis, and no overinflation. No pneumothorax or appreciable pleural effusion. " e7500c5a-bde202d2-69d49fb2-71a65214-83eb5c50.jpg,validate/p12/p12210364/s59004869/e7500c5a-bde202d2-69d49fb2-71a65214-83eb5c50.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough, benzo withdrawal. 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 pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 3cfcd23f-991f7876-98da1d8e-d27d6948-64cba1d2.jpg,validate/p14/p14801770/s54249844/3cfcd23f-991f7876-98da1d8e-d27d6948-64cba1d2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with high fever and productive cough; normal exam // ?pneumonia COMPARISON: None available FINDINGS: Linear and a wedge-shaped opacities are present in both juxta hilar regions, and appear to correspond to the anterior segment of the right upper lobe and superior segments of the lower lobes. Subtle reticulonodular opacities are also present in the left perihilar region. Heart size is normal, and there is no definite mediastinal or hilar lymphadenopathy. There is no pleural effusion. IMPRESSION: Multifocal opacities in the juxta hilar regions, probably a combination of atelectasis and infectious consolidation in this patient with history of fever and cough. Short-term followup radiographs are recommended in 4 weeks after completion of antibiotic therapy to document resolution and to exclude obstructing lesions or a non infectious process such as AB with PA. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 13:48 into the Department of Radiology critical communications system for direct communication to the referring provider. " 18a769ae-55d07758-317dfe99-ff6b381b-a38e038b.jpg,validate/p19/p19667420/s51037900/18a769ae-55d07758-317dfe99-ff6b381b-a38e038b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with SOB // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The appearance of the chest is without significant interval change from 1 day prior. Re- demonstrated left base opacity likely due to loculated effusion with associated atelectasis, underlying consolidation not excluded. Re- demonstrated loculated appearing left pleural effusion. Re- demonstrated hyperinflated lungs with blunting of the right costophrenic angle. Cardiac and mediastinal silhouettes are stable. The position of the left-sided pacemaker is stable. IMPRESSION: No significant interval change from 1 day prior. " b6b8bd97-e18d5696-4c3e4cce-a324fb1b-296b8eab.jpg,validate/p17/p17866604/s58912356/b6b8bd97-e18d5696-4c3e4cce-a324fb1b-296b8eab.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT 9:44 CLINICAL INDICATION: A ___-year-old with cough and back pain, evaluate for pneumonia. Comparison is made to the patient's prior study of ___. PA and lateral views of the chest, ___ at 9:44 is submitted. IMPRESSION: Cardiac and mediastinal contours are within normal limits. Lungs are well inflated without evidence of focal airspace consolidation to suggest pneumonia. No pleural effusions, pulmonary edema or pneumothorax. Mild degenerative changes in the thoracic spine with no acute bony abnormality appreciated. " b8257b67-ab8278f0-beaf6fcc-1127457f-2d122542.jpg,validate/p10/p10884708/s56636538/b8257b67-ab8278f0-beaf6fcc-1127457f-2d122542.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with newly diagnosed breast cancer recently started on chemotherapy now with dyspnea and non-productive cough, here to evaluate for pneumonia. COMPARISON: Chest radiograph last performed on ___. 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 and no pulmonary edema is present. The cardiac silhouette is normal in size. Mediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. Findings were communicated by Dr. ___ to ___ by phone at 15:34 p.m. on ___. " 6d88a11c-bd4c8df6-7bf133a7-42b06718-3b50c7ae.jpg,validate/p10/p10933318/s57129951/6d88a11c-bd4c8df6-7bf133a7-42b06718-3b50c7ae.jpg,validation," 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. " 5fb2416c-34152d57-15770c43-50676129-362e03db.jpg,validate/p12/p12521370/s53064477/5fb2416c-34152d57-15770c43-50676129-362e03db.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: QUESTION PNEUMONIA CHF. COMPARISON: ___ AT ___ FINDINGS: The right-sided indwelling catheter tip overlies the distal SVC, unchanged. There are low inspiratory volumes. The cardiomediastinal silhouette is unchanged. Possible interval obscuration of the left costophrenic angle which could reflect either early collapse and/or consolidation or a small effusion. The apparent changes likely accentuated by underpenetrated technique, however. There is mild vascular engorgement slightly more pronounced. IMPRESSION: 1. Mild increase in vascular engorgement. 2. Interval obscuration of the left costophrenic angle. -- question small pleural effusion or early left lower lobe collapse and/or consolidation. If clinically indicated, an AP chest x-ray with increased inspiration and increased penetration and/or a lateral view could help for further assessment. " 881961ad-65f28bf2-1ca6ef46-b29b9a30-dce8c136.jpg,validate/p10/p10979480/s59144510/881961ad-65f28bf2-1ca6ef46-b29b9a30-dce8c136.jpg,validation," FINAL REPORT INDICATION: Fever, diarrhea, evaluate for pneumonia. COMPARISON: Comparison made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. On a background of mild interstitial edema, tiny nodular opacifications are present in the right lung base. No focal opacification concerning for pneumonia. No pleural effusion or pneumothorax evident. Accessed dialysis catheter terminates at the cavoatrial junction. Dialted loops of bowel are incompletely assessed. Spinal fusion hardware spanning the thoracolumbar spine is incompletely visualized. IMPRESSION: No focal opacification concerning for pneumonia. Mild interstitial edema. Tiny right lower lung nodules. Given history of prior malignancy recommend evaluation with chest CT. " c45a0d0c-d666b281-6ef8253f-676f6ea0-57653ba4.jpg,validate/p16/p16057835/s50406851/c45a0d0c-d666b281-6ef8253f-676f6ea0-57653ba4.jpg,validation," FINAL REPORT HISTORY: Possible pneumonia with COPD. FINDINGS: In comparison with the study of ___, there is progressive consolidation in the left upper zone. Continued bilateral pleural effusions, more prominent on the right, with compressive atelectasis at the bases. The difference in appearance may reflect the somewhat more upright position of the patient. Continued enlargement of the cardiac silhouette with prominence of central pulmonary vessels consistent with pulmonary artery hypertension. " a144a791-afd2c443-6739d667-8ec3a6e4-86eb5b56.jpg,validate/p15/p15406041/s50442260/a144a791-afd2c443-6739d667-8ec3a6e4-86eb5b56.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male status post fall, recently treated for pneumonia. New renal failure. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___ and chest CT from ___. Again seen are slightly low lung volumes. Increased interstitial markings seen primarily at the bases, perhaps more conspicuous on the current exam. There is no evidence of new confluent consolidation or large effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Increased interstitial markings potentially from chronic lung disease. Component of interstial edema is also possible. " fac08139-9a6f26f5-1befd6b5-863300f8-513a74e9.jpg,validate/p17/p17188422/s57425131/fac08139-9a6f26f5-1befd6b5-863300f8-513a74e9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman presenting after a fall. Evaluate for pneumothorax or rib fracture. TECHNIQUE: Portable supine AP radiograph view of the chest. COMPARISON: No prior imaging is available on PACS at the time of this dictation. FINDINGS: The lungs are well-expanded and clear. The heart is normal in size. The mediastinum is not widened. No pleural effusion or pneumothorax. No focal consolidation or edema. No evidence of acute fracture on these nondedicated views. There may an old right lower rib fracture. IMPRESSION: 1. No pneumothorax. 2. No evidence of rib fracture on this single portable chest radiograph. If clinical concern for rib fracture persists, dedicated rib radiographs are recommended with a BB marker placed on the area/s of focal exam findings. RECOMMENDATION(S): If clinical concern for rib fracture persists, dedicated rib radiographs are recommended with a BB marker placed on the area/s of focal exam findings. " a8d72f7e-396f3e87-f0fc0cdd-e3aea517-8eaead62.jpg,validate/p14/p14951077/s55191797/a8d72f7e-396f3e87-f0fc0cdd-e3aea517-8eaead62.jpg,validation," WET READ: ___ ___ 8:43 AM No radiopaque port products seen. WET READ VERSION #1 ___ ___ 3:13 AM No radiopaque port products seen. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p port removal, please eval for retained products // s/p port removal, please eval for retained products IMPRESSION: Following recent porta catheter removal, there is no evidence of pneumothorax or definite retained catheter fragment. Standard PA and lateral radiographs in the department would be more sensitive, however. Exam is otherwise unchanged since recent study of ___. " 721eb640-c586af5c-94ad3e52-bc9e3211-2385253a.jpg,validate/p11/p11625962/s57615339/721eb640-c586af5c-94ad3e52-bc9e3211-2385253a.jpg,validation," FINAL REPORT HISTORY: Chest tightness, dizziness, shortness of breath. Evaluate interval worsening or resolution of PNA. COMPARISON: Prior chest radiograph from ___ and chest CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is moderately enlarged. There is mild pulmonary edema. As compared to prior chest radiograph from ___, there is improved aeration of the right lung base. Persistent bibasilar opacities likely reflect chronic interstitial abnormality as on prior chest CT ___. No new focal consolidations are noted. There are improved bilateral pleural effusions. There is no pneumothorax. IMPRESSION: Mild pulmonary edema. Improved right lung base opacity likely reflecting resolving pneumonia with persistent bibasilar interstitial opacities, which likely relate to known chronic lung disease. " cd9c874a-97abe355-d815e227-24264573-8cba01ba.jpg,validate/p18/p18688402/s53873244/cd9c874a-97abe355-d815e227-24264573-8cba01ba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hip fracture, evaluation for intubation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 1.7 cm above the carina. The tube could be pulled back by approximately 1 cm. The nasogastric tube and the left PIC line are unchanged. Unchanged appearance of the lung parenchyma and the heart, with moderate bilateral pleural effusions and subsequent areas of atelectasis at the lung bases. " d7d9faf1-895b4690-fb20b616-5326b98f-4e3947b3.jpg,validate/p19/p19243413/s56602570/d7d9faf1-895b4690-fb20b616-5326b98f-4e3947b3.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with acute myelocytic leukemia with CNS involvement, status post bone marrow transplant, has acute mental status changes. Evaluate for possible acute intrapulmonary infection versus pulmonary edema. FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained on ___. Remarkable is that the heart size has increased during the latest 24 hours examination interval. There is no typical configurational abnormality, but the finding could be explained by increasing circulating blood volume. The pulmonary vasculature is slightly more distended but does not show any evidence of extravasation in the form of interstitial or alveolar edema and the lateral pleural sinus remain free. No evidence of new acute pulmonary parenchymal infiltrates are seen. No pneumothorax existing in the apical area. Remarkable is that the previously described right-sided PICC line projects now with its tip into the upper portion of the right atrium. This may be related to the described increase of the heart volume unless the PICC line has been advanced inadvertently. Observe that PICC line may cause mechanical arrhythmias if in contact with the right atrial wall. IMPRESSION: Heart size increased indicating augmented circulating blood volume, but no evidence of pulmonary edema or pleural effusion. Observe comments made regarding previously placed PICC line. " 47127272-25870fea-16442026-fff31968-4f1ec126.jpg,validate/p15/p15863098/s58006301/47127272-25870fea-16442026-fff31968-4f1ec126.jpg,validation," FINAL REPORT HISTORY: Status post pigtail catheter placement for tension pneumothorax. TECHNIQUE: Upright AP view of the chest. COMPARISON: ___ at 12:39 Pm. FINDINGS: Left-sided chest tube is seen with pigtail projecting over the left lower lung field. A residual small to moderate sized left-sided pneumothorax is present, with resolution of the previously seen signs of tension. The left lung has re-expanded, with streaky left basilar opacities possibly reflecting residual atelectasis. Right lung is clear. The cardiac, mediastinal, and hilar contours are normal is size and location, with resolution of the previously seen rightward shift. IMPRESSION: Status post placement of left-sided pigtail chest tube with interval re-expansion of the left lung, residual small to moderate left-sided pneumothorax, and resolution of the previously noted signs of tension. " 33d9e8f6-addcbfe0-6ac70c6b-18164c9a-9c82d2c0.jpg,validate/p19/p19931382/s58656299/33d9e8f6-addcbfe0-6ac70c6b-18164c9a-9c82d2c0.jpg,validation," FINAL REPORT INDICATION: Alcohol withdrawal with multifocal pneumonia. Evaluation for interval change. COMPARISON: Multiple priors from ___. FINDINGS: Portable AP chest radiograph. Right-sided IJ catheter and NGT are in stable position. Multifocal consolidations and peribronchial consolidations involving the right lung have progressed from 24 hours prior. However, confluent opacification of the left lower lobe remains the worst site. There is no pneumothorax. The cardiomediastinal silhouette is not well delineated due to the consolidations. IMPRESSION: Worsening multifocal pneumonia in the right lung. " b6fe0368-bb3b5479-e92fcd54-5a2792c7-cd5510f3.jpg,validate/p14/p14887088/s59325773/b6fe0368-bb3b5479-e92fcd54-5a2792c7-cd5510f3.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with polytrauma and bilateral pleural effusions. Status post left-sided pigtail catheter placement. Evaluation for worsening effusions. COMPARISON: Comparison is made to most recent prior study from 13 hours prior. FINDINGS: Since the prior study, there is no change in position of monitoring and support devices. Hardware in the thoracic spine is also unchanged in appearance. The cardiomediastinal silhouette is stable, as is the right pleural effusion. There is no pneumothorax. Left pigtail catheter is in place, and unchanged in position. No new parenchymal opacities are identified. IMPRESSION: No significant change since the prior study. " cb3d7e25-f7b15500-f9e7e5e6-e8d47b67-7e32bfe7.jpg,validate/p15/p15672432/s58530606/cb3d7e25-f7b15500-f9e7e5e6-e8d47b67-7e32bfe7.jpg,validation," FINAL REPORT INDICATION: History: ___M with 2 weeks running nose cough productive worsening 100.5T here, hx HIV well controlled TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrates heart size upper limits of normal in size. There are median sternotomy wires which appear intact. Multiple surgical clips project over the left mediastinal contour. There is central vascular engorgement. There is no large pleural effusion. Linear opacity at the left lung base is likely atelectatic in etiology. There is no pneumothorax. There is no opacity convincing for infectious process. IMPRESSION: Mild central vascular engorgement. No opacity convincing for pneumonia. " bb87412b-cdce2abe-49e4ec42-2df91681-4814b1fc.jpg,validate/p16/p16660031/s55394888/bb87412b-cdce2abe-49e4ec42-2df91681-4814b1fc.jpg,validation," FINAL REPORT PATIENT HISTORY: ___-year-old woman with COPD, failure to extubate, hypoxia, requiring intubation, cause of hypoxia. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: AP single view of the chest shows reduced lung volume with new right base opacity suspicious for pneumonia. The left base opacification is likely due to atelectasis. Prominent hila are due to vascular congestion. There is no pleural effusion or pneumothorax. Heart size is unchanged. IMPRESSION: Right base opacity compatible with pneumonia. Left base atelectasis and mild vascular congestion. " d22fac39-c812270a-d02d53ec-971651ee-b82b81ab.jpg,validate/p18/p18098232/s54390778/d22fac39-c812270a-d02d53ec-971651ee-b82b81ab.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph most recently dated ___. CLINICAL HISTORY: Gunshot wound to the right abdomen with concern for diaphragmatic injury, assess for diaphragmatic elevation. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear. The right hemidiaphragm is in its normal position and shows no signs of injury. No effusion or pneumothorax. Cardiomediastinal silhouette is normal. No radiopaque foreign bodies. Bony structures are intact. IMPRESSION: Unremarkable exam. " cd5ff586-80994476-93aa6f3c-eba5f4da-b42b6d5c.jpg,validate/p16/p16384483/s59407300/cd5ff586-80994476-93aa6f3c-eba5f4da-b42b6d5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with necrotizing fasciitis // lines/tubes IMPRESSION: In comparison to ___ chest radiograph, there has been some improved aeration in the left retrocardiac region. Additionally, the endotracheal tube tip now terminates 5.7 cm above the carina. No other relevant change. " a122f493-76110952-8b73a09d-9a333e78-287241a8.jpg,validate/p11/p11912550/s56641518/a122f493-76110952-8b73a09d-9a333e78-287241a8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: STEMI, pleuritic chest pain, leukocytosis, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a substantial decrease in lung volumes. Moderate cardiomegaly with signs of mild fluid overload. The presence of a small left pleural effusion cannot be excluded. Relatively extensive retrocardiac and left basal atelectasis but no indication for pneumonia. " 7112e474-f927c009-6c7c972b-b9fa02cf-30dcaeb9.jpg,validate/p12/p12111976/s51554661/7112e474-f927c009-6c7c972b-b9fa02cf-30dcaeb9.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with COPD presenting with cough and dyspnea. COMPARISON: Chest radiograph from ___ FRONTAL CHEST RADIOGRAPH: An ICD generator overlies the left chest wall. The single-lead is intact with the tip projecting over the expected position of the right ventricle. Median sternotomy wires appear intact on the single frontal view. There is increased opacification of the medial right lung base, which could reflect early developing pneumonia and/or focal congestion. There is no overt interstitial edema. No pneumothorax is identified. IMPRESSION: Subtle opacity in the medial right lung base may be due to early pneumonia and/or congestion. " f6874f9c-8379f3f1-68d26e3b-b66d0d53-56aa0f28.jpg,validate/p16/p16510199/s55939580/f6874f9c-8379f3f1-68d26e3b-b66d0d53-56aa0f28.jpg,validation," FINAL REPORT INDICATION: History: ___M with likely sepsis // ? acute cardiouplm process TECHNIQUE: AP and lateral views of the chest COMPARISON: Chest radiograph dated ___ as well as ___. FINDINGS: AP upright and lateral chest radiograph demonstrates elevation of the left hemidiaphragm with adjacent left basilar atelectasis. Lungs are without a focal consolidation. Allowing for patient positioning, cardiac and hilar contours appear within normal limits. There is no pneumothorax or large pleural effusion. No evidence of pulmonary edema. IMPRESSION: No evidence of pneumonia. Elevation of the left hemidiaphragm, present on multiple prior examinations dating ___. " 1ccda846-e096ebfb-00ab24b1-4782b1cb-3a7887bf.jpg,validate/p17/p17963990/s51110683/1ccda846-e096ebfb-00ab24b1-4782b1cb-3a7887bf.jpg,validation," 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. " 2dd09646-afedd073-bc0e70a9-b34b0f0e-f7be5050.jpg,validate/p15/p15079493/s52205099/2dd09646-afedd073-bc0e70a9-b34b0f0e-f7be5050.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with AMS s/p fall, C1 fracture, ARDS in setting of likely aspiration PNA // ? interval change TECHNIQUE: Frontal view of the chest COMPARISON: ___ FINDINGS: ET tube terminates 3.5cm above the carina. A transesophageal tube courses below the diaphragm and out of view. Right subclavian venous catheter terminates at the right atrium. Pulmonary edema was transiently clearing from ___ to ___, before it worsened on ___. On current study, the moderate pulmonary edema is improved. Left pleural effusion is small. Cardiomediastinal silhouette is normal size and stable. IMPRESSION: Pulmonary edema transiently cleared from ___ to ___ before it worsened on ___. Moderate pulmonary edema is improved on current study compared to ___. Remaining pulmonary opacities may reflect pulmonary edema, ARDS, or concurrent pneumonia. " d44c1a7b-b87061c9-955e1470-fe9eb86c-4db3c7c8.jpg,validate/p18/p18857939/s53715672/d44c1a7b-b87061c9-955e1470-fe9eb86c-4db3c7c8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with dementia and abdominal pain, nausea, vomiting, now with low grade temperature and oxygen saturations in low ___'s, high aspiration risk TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. Heart size remains moderately enlarged. Extensive tortuosity of the aorta is again noted. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Linear and patchy opacities are noted in the right lung base, likely atelectasis. No focal consolidation, pleural effusion or pneumothorax is detected. No acute osseous abnormality is present. There is no subdiaphragmatic free air. IMPRESSION: Right basilar atelectasis. No acute cardiopulmonary abnormality otherwise noted. " da0830eb-29a6baa0-2def569b-bc7edddf-544ee873.jpg,validate/p12/p12111815/s54676278/da0830eb-29a6baa0-2def569b-bc7edddf-544ee873.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISON: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. A hiatal hernia is visible on the frontal view. A small amount of air is visible within it. Patchy medial right lower lung opacity suggests minor atelectasis in the right middle lobe. Otherwise, the lungs appear clear. Moderate-to-severe degenerative changes affect the right acromioclavicular joint. A suture anchor projects along the left humeral head. IMPRESSION: No evidence of acute disease. Small to moderate hiatal hernia. Patchy medial right basilar opacity, suggestive of atelectasis. " f73c46a9-c3857e84-7660471f-0d0f3808-b61c326f.jpg,validate/p19/p19988137/s56510213/f73c46a9-c3857e84-7660471f-0d0f3808-b61c326f.jpg,validation," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Cough, low oxygen saturation. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette remains mildly enlarged. Mediastinal and hilar contours are stable. There is slight prominence of the vascular markings which may be due to mild congestion/edema. No focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: Persistent mild cardiomegaly with possible mild vascular congestion/edema. No focal consolidation seen. " e48969a1-1ae61b63-a897c778-78e76c3c-49cb5e19.jpg,validate/p13/p13510413/s51224424/e48969a1-1ae61b63-a897c778-78e76c3c-49cb5e19.jpg,validation," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with cough, history of smoking, evaluate cough. FINDINGS: PA and lateral chest views were obtained with patient upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Position and diaphragms obscure partially the heart silhouette, but significant cardiac enlargement is unlikely. The thoracic aorta is mildly widened and elongated but unchanged in comparison. 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 frontal view. Skeletal structures of the thorax are grossly within normal limits. IMPRESSION: Stable chest findings, no evidence of cardiac enlargement, pulmonary congestion or acute infiltrates in this ___-year-old male patient with history of cough. " ce2ce15e-96be4c30-4e92b36e-1bcf3fce-5b82d12e.jpg,validate/p18/p18926074/s51447993/ce2ce15e-96be4c30-4e92b36e-1bcf3fce-5b82d12e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with bladder ca // please evaluate for any abnormalites COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Mild overinflation. No pneumonia, no pulmonary edema. No pleural effusions. Moderate scoliosis. Normal size of the cardiac silhouette. " 32deb714-8da45c8d-83c49d57-09dc9dae-030acccc.jpg,validate/p14/p14865329/s50808752/32deb714-8da45c8d-83c49d57-09dc9dae-030acccc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with Dementia with ___ Bodies, seizure disorder, chronic bradycardia with RBBB who was found down, now with anterior endplate fracture C5-C7 with concern on MRI for C5/C6 disc disruption now s/p C5-C6 anterior fusion // interval changes? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomegaly and widened mediastinum are stable. Bibasilar opacities larger on the left side have increased consistent with increasing consolidations and effusions . There is no pneumothorax. Right PICC tip is in the mid SVC. NG tube tip is out of view below the diaphragm. ET tube is in standard position " 6f3de291-9c5bbb14-a5eee127-1095330e-16057b16.jpg,validate/p19/p19243413/s52257496/6f3de291-9c5bbb14-a5eee127-1095330e-16057b16.jpg,validation," FINAL REPORT INDICATION: Pre-bone marrow transplant. COMPARISON: Chest radiographs from ___, ___ and ___. FINDINGS: Cardiomediastinal and hilar contours are stable with mild tortuosity of the descending aorta and normal heart size. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. A left PICC line is present with tip terminating in the mid SVC. IMPRESSION: No acute cardiopulmonary process. " 2dc1b572-ef03e4c9-34c79821-b2711faf-74f0a803.jpg,validate/p14/p14702885/s56757825/2dc1b572-ef03e4c9-34c79821-b2711faf-74f0a803.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with seizures, now satting in 90s // ? pna vs edema ? pna vs edema IMPRESSION: In comparison with the study of ___, there again are low lung volumes that accentuate the transverse diameter of the heart. Fullness of the pulmonary vessels process, consistent with elevated pulmonary venous pressure. Continued retrocardiac opacification with blunting of the costophrenic angle, consistent with volume loss in the left lower lobe and left pleural effusion. " 3a0772ad-9f1e17aa-3f2cbcb3-9572df22-aa1a05df.jpg,validate/p15/p15541966/s56996185/3a0772ad-9f1e17aa-3f2cbcb3-9572df22-aa1a05df.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever, leukocytosis and cough. 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. " 8a5d1857-42a0847d-5ae52bbd-cd87856a-8b5ecaaf.jpg,validate/p11/p11347967/s57721208/8a5d1857-42a0847d-5ae52bbd-cd87856a-8b5ecaaf.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest provided demonstrate clear hyperinflated 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. " 0289d85b-21efd43c-e213e3e3-7260c7a4-b9c743f2.jpg,validate/p11/p11287191/s59983428/0289d85b-21efd43c-e213e3e3-7260c7a4-b9c743f2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with increased work of breathing, tachypnea // increased work of breathing, tachypnea TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " acf9d0ea-620e9f3e-88070351-5e650e79-e6c87424.jpg,validate/p19/p19398915/s54867272/acf9d0ea-620e9f3e-88070351-5e650e79-e6c87424.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___. HISTORY: ___-year-old man with hepatic hydrothorax after thoracentesis. Evaluate reaccumulation. IMPRESSION: PA and lateral chest compared to ___: Small right pleural effusion has decreased substantially. No pneumothorax. Also improved is the multifocal, peribronchovascular and nodular abnormality most readily visible in the left lung. Clear cavitation in these lesions suggests the diagnosis of septic emboli. " 34f5088d-19f1e693-fb351e7a-695a33f7-1c9b899e.jpg,validate/p17/p17519354/s56501206/34f5088d-19f1e693-fb351e7a-695a33f7-1c9b899e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with bronchiectasis, worsening dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal contour is unremarkable. There is mild pulmonary vascular congestion with pulmonary vascular indistinctness. Hilar are enlarged bilaterally, possibly due to underlying lymphadenopathy. Blunting of the costophrenic angles posteriorly bilaterally on the lateral biew suggests small pleural effusions. Lungs are hyperinflated. Bibasilar bronchiectasis is demonstrated within bronchial wall thickening. Linear atelectasis is noted within the right upper lobe. No pneumothorax is identified. Scarring within the right apex is noted. IMPRESSION: Bibasilar bronchiectasis with bronchial wall thickening suggestive of airway inflammation or infection. Mild pulmonary vascular congestion and probable small bilateral pleural effusions. Bilateral hilar enlargement suggestive of underlying lymphadenopathy. " 4bec16c3-17b930b1-a0826d59-5d75a189-75ad4b4f.jpg,validate/p10/p10610461/s52844009/4bec16c3-17b930b1-a0826d59-5d75a189-75ad4b4f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with n/v, fever // eval for consolidation TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs: ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation worrisome for pneumonia. IMPRESSION: No acute cardiopulmonary process. " 9b53c585-fd41d10a-b8703f76-88875290-b59f446f.jpg,validate/p11/p11636169/s57610437/9b53c585-fd41d10a-b8703f76-88875290-b59f446f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Endotracheal tube placement. COMPARISON: ___, 4:38 p.m. FINDINGS: As compared to the previous radiograph, lung volumes have increased, reflecting improved ventilation. Unchanged position of the endotracheal tube and the nasogastric tube. Unchanged position of the left central venous access line. There is currently no evidence of pneumothorax, pulmonary edema, or pneumonia. Unchanged borderline size of the cardiac silhouette. " 9d0519f9-e27a3b09-934cb9d7-7afe488c-5b16abe0.jpg,validate/p16/p16007921/s58054804/9d0519f9-e27a3b09-934cb9d7-7afe488c-5b16abe0.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain and shortness of breath. TECHNIQUE: Chest, PA and lateral. COMPARISON: Radiographs from ___, and chest CT dated ___. FINDINGS: The left lung remains mostly clear but again shows several nodules which are not clearly changed although difficult to compare directly for small possible size changes using radiography. The right hemidiaphragm is again elevated with pleural thickening and right apical paramediastinal consolidation with dilated airways, often seen after radiation therapy. This appearance includes an unchanged small collection of air and fluid at the right lung apex. The only clear change is somewhat decreased aeration of the residual right lung which may be due to unilateral edema, lymphatic congestion or possibly an increased pleural effusion. A dilated segment of small bowel is visualized in the epigastric region measuring up to 4 cm in diameter. The patient is status post posterior thoracic spinal fusion with no clear change. IMPRESSION: Somewhat decreased aeration of the residual right lung but otherwise no significant change since earlier studies. Dilatation of small bowel in the epigastrium which is non-specific, not necessarily significant clinically, although correlation with clinical findings is recommended. " 0b9ddfdc-d5b29907-431d3921-e6e45f0e-c689ad62.jpg,validate/p15/p15707000/s58186146/0b9ddfdc-d5b29907-431d3921-e6e45f0e-c689ad62.jpg,validation," FINAL REPORT INDICATION: Patient with one week of cough and crackles in the right lower lung, concern 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. " 097cb1ac-cb00b113-c3812a9c-c1e4f626-c45cf7ba.jpg,validate/p11/p11846160/s52067681/097cb1ac-cb00b113-c3812a9c-c1e4f626-c45cf7ba.jpg,validation," FINAL REPORT AP CHEST, 11:02 A.M. ON ___ HISTORY: ___-year-old woman with recurrent right pleural effusion after thoracentesis. IMPRESSION: AP chest compared to ___ and ___: Right pleural effusion is now quite small. There is some relatively mild atelectasis in the right lower lung, but no appreciable pneumothorax. Very mild interstitial edema is seen in both lungs, presumably related to mild chronic cardiomegaly. " b01ad37a-e49911c6-c9db56af-cae3054a-e16c6779.jpg,validate/p18/p18634738/s51912005/b01ad37a-e49911c6-c9db56af-cae3054a-e16c6779.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PTX s/p chest tube // interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomediastinal silhouette is unchanged. Small right pneumothorax is unchanged. Right pigtail catheter is in unchanged position. Opacities in the right lung are grossly unchanged. " 33af991b-0d6efad6-27207690-bdde30f5-0e4efdcc.jpg,validate/p15/p15560336/s58892852/33af991b-0d6efad6-27207690-bdde30f5-0e4efdcc.jpg,validation," 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 ___. " 3e95803f-50ec337c-543aaf50-efce66b6-3268862a.jpg,validate/p15/p15073068/s53822245/3e95803f-50ec337c-543aaf50-efce66b6-3268862a.jpg,validation," 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. " 1fcfadd0-eb76a632-a73d4857-21f5a66e-052f7be5.jpg,validate/p10/p10900387/s50455884/1fcfadd0-eb76a632-a73d4857-21f5a66e-052f7be5.jpg,validation," FINAL REPORT HISTORY: Persistent cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to CTA chest dated ___, and chest radiographs dated ___. FINDINGS: As compared to the prior exam dated ___, the right lower lobe opacity is essentially unchanged. Given that no lesion was identified on the more recent CTA exam, this focus likely represents overlying pectoral muscle. The remainder of the lungs are essentially clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged from the prior exam. " 27bd2ff5-5a72ad05-db244c3d-559b896a-a049baa9.jpg,validate/p15/p15285136/s56587985/27bd2ff5-5a72ad05-db244c3d-559b896a-a049baa9.jpg,validation," WET READ: ___ ___ ___ 5:40 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with chest pain // acute process TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Heart size is within normal limits. The aorta is tortuous. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. " 4c9eef5d-a28108f5-40623446-a9e09b75-a3063258.jpg,validate/p15/p15035680/s53651792/4c9eef5d-a28108f5-40623446-a9e09b75-a3063258.jpg,validation," FINAL REPORT INDICATION: Cough and fever, currently undergoing INH and rifampin treatment for positive PPD. Evaluate for infection. COMPARISON: None. FINDINGS: Upright PA and lateral radiographs of the chest. Opacity obscuring the medial right hemidiaphragm resides in the lower lobe and is concerning for pneumonia. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: Right lower lobe opacity concerning for pneumonia. Results given in person to ___ by ___ at 11:50 pm, ___, at times of discovery. " 64d6c0d3-d62fedca-87c9c5db-773fe06f-e9308945.jpg,validate/p12/p12143980/s53014477/64d6c0d3-d62fedca-87c9c5db-773fe06f-e9308945.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe vasculopath with RCA stemi // pulm edema COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Left pacemaker is unchanged. Diffuse interstitial and alveolar opacities are worsened from ___. An azygos fissure is noted. Moderate bibasilar atelectasis is worsened. No pleural effusion or pneumothorax. Hilar contours are normal. Severe cardiomegaly is unchanged. IMPRESSION: 1. Diffuse interstitial and alveolar opacities in the setting of severe cardiomegaly are consistent with moderate pulmonary edema, worsened from ___. 2. Moderate bibasilar atelectasis is worsened. " 25251bfd-f29e035b-63d45c42-e30383b5-b5387d16.jpg,validate/p11/p11652381/s58913402/25251bfd-f29e035b-63d45c42-e30383b5-b5387d16.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent pneumonia, lung abscess, pleural effusion - // Please compare to ___ film - have her intrathoracic findings improved? Any recurrence of effusions? Please compare to ___ film - have her intrathoracic findings improved? Any recurrence of effusions? IMPRESSION: In comparison with the study of ___, extensive apical pleural calcification is again seen, consistent with old tuberculous disease. The opacification at the left base has virtually cleared and the hemidiaphragm is more sharply seen. However, the extensive opacification in the left mid lung is again seen, consistent with chronic necrotic pneumonia with abscess formation in the lingula. " 7670fb6d-dbfb6570-95cbb9d1-7829428a-b9f0831e.jpg,validate/p15/p15957987/s53438279/7670fb6d-dbfb6570-95cbb9d1-7829428a-b9f0831e.jpg,validation," FINAL REPORT HISTORY: MOnitoring PleurX catheter. CHEST, TWO VIEWS. Again seen is a small left apical pneumothorax, very slightly smaller than on the film obtained on ___ at 18:12 p.m. The catheter is again noted. Otherwise, I doubt significant interval change. " 78afcfdb-9d7b6a67-d1242fcf-8e35083e-b3c0e547.jpg,validate/p14/p14954759/s55540644/78afcfdb-9d7b6a67-d1242fcf-8e35083e-b3c0e547.jpg,validation," FINAL REPORT HISTORY: Acute limb ischemia, pre-operative chest. FINDINGS: In comparison with the study of ___, there is again some enlargement of the cardiac silhouette with tortuosity of the aorta. Opacification at the left base is again consistent with a small effusion and some basilar atelectatic change. Central vascular engorgement is again noted. No evidence of acute focal pneumonia. " 7f526a5a-35d3c58d-96e7cf97-9bd9e527-e314022e.jpg,validate/p15/p15852866/s51798946/7f526a5a-35d3c58d-96e7cf97-9bd9e527-e314022e.jpg,validation," FINAL REPORT INDICATION: ___M with left arm weakness // Acute cardiopulmonary process TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Median sternotomy wires are noted and mediastinal clips. The cardiomediastinal silhouette is within normal limits. Coronary artery stents are noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 75009e96-999b0bf9-ba857152-58fefabc-a80c02c1.jpg,validate/p17/p17624308/s51192948/75009e96-999b0bf9-ba857152-58fefabc-a80c02c1.jpg,validation," FINAL REPORT HISTORY: Left-sided chest pain. TECHNIQUE: Frontal and lateral views chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 0c8eb433-eb9684af-e5cd9e6a-fd8da28b-17ecd592.jpg,validate/p16/p16074678/s52035254/0c8eb433-eb9684af-e5cd9e6a-fd8da28b-17ecd592.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with revision of stoma, septic shock, ventilated, o2 sat decreasing // ?edema s/p fluid resuscitation TECHNIQUE: Portable chest COMPARISON: Portable chest radiograph dated ___ at 05:18 FINDINGS: In comparison to the chest radiograph obtained approximately 10 hours prior, there are new, very faint, right lower lung opacities, uterine dependent edema or developing pneumonia. Severe cardiomegaly and widening of the mediastinum are unchanged since at least ___. Lung volumes are very low and there is probable complete left lower lobe collapse. Probable bilateral pleural effusions are unchanged. An ET tube and right-sided IJ central venous catheter unchanged and appropriately positioned. IMPRESSION: New, faint, right lower lung opacities may be new, mild, dependent edema or a developing pneumonia. " b7153b86-b3126697-4b6270e4-ca9df2b9-ce24c4d7.jpg,validate/p11/p11593310/s53935374/b7153b86-b3126697-4b6270e4-ca9df2b9-ce24c4d7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with LEFT SIDED CP. Evaluate for PTX . TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is a small left apical pneumothorax. The lungs are clear without focal consolidation. No pleural effusion is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Small left apical pneumothorax. NOTIFICATION: Findings were communicated to the ED QA nurses by ___, M.D. on the telephone on ___ at 8:13 AM, 2 minutes after discovery of the findings. " 7a044eaf-ce418d6a-00198f2f-6a41cb3f-906d78c6.jpg,validate/p15/p15480974/s51416780/7a044eaf-ce418d6a-00198f2f-6a41cb3f-906d78c6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, wheezing, shortness of breath // 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. IMPRESSION: No acute cardiopulmonary process. " 310839ac-56c2cc54-2669cc63-e020c73d-14a92749.jpg,validate/p19/p19266021/s57320477/310839ac-56c2cc54-2669cc63-e020c73d-14a92749.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with exertional chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Despite low inspiratory effort, the lungs are clear. There is no consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 6f2dee1a-3dcbc1e3-1bee3c14-c4628a60-0ef2cdc6.jpg,validate/p10/p10855190/s57581801/6f2dee1a-3dcbc1e3-1bee3c14-c4628a60-0ef2cdc6.jpg,validation," 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. " 7a1e8584-12484cec-b2371710-86fe9b55-22eb3907.jpg,validate/p17/p17190208/s58214501/7a1e8584-12484cec-b2371710-86fe9b55-22eb3907.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___ year old man with long hospital course due to SDH, PE's, RP bleed, intubated for inability to protect airway // Any evidence of PNA? TECHNIQUE: Chest portable ___ COMPARISON: Portable AP chest radiograph dated ___ FINDINGS: Since the chest radiograph obtained 1 day prior, no significant changes are appreciated. Support devices are appropriately positioned. Lung volumes are low. There are probably left greater than right small pleural effusions with adjacent atelectasis. Moderate cardiomegaly is unchanged. No obvious pulmonary vascular congestion. No pulmonary edema. Calcified mediastinal and hilar lymph nodes are unchanged. IMPRESSION: No significant changes since radiograph 1 day prior. " 21c7abdc-4b8bf4e4-e359fd39-00063597-8f2bbde0.jpg,validate/p17/p17288913/s53706451/21c7abdc-4b8bf4e4-e359fd39-00063597-8f2bbde0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CP // evidence of pneumonia or pneumo TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. There is no significant change since the chest radiograph from ___ however please note that the opacities seen on the chest CT from the same day were not visualized on the radiograph at that time. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. The bones are intact. IMPRESSION: No acute cardiopulmonary process. " dc6a8b07-97a822a3-ceac5302-5dae501a-52e39baa.jpg,validate/p10/p10667727/s55009330/dc6a8b07-97a822a3-ceac5302-5dae501a-52e39baa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF now s/p swan // Eval for swan line position COMPARISON: ___ IMPRESSION: The Swan-Ganz catheter, the left internal jugular vein catheter and the pacemaker leads are in correct and unchanged position. The effusion on the right has minimally decreased in extent but still occupies large parts of the right hemi thorax, causing massive atelectasis at the right lung basis. On the left, the heart border and the appearance of the lung parenchyma are unchanged. " 696a1062-64d20a72-bf24b18d-f751381b-0bff890f.jpg,validate/p12/p12358216/s52266538/696a1062-64d20a72-bf24b18d-f751381b-0bff890f.jpg,validation," FINAL REPORT CLINICAL HISTORY: Status post chest tube placement on left side, now on waterseal, evaluate for pneumothorax. CHEST AP Left chest tube is present. No evidence of a pneumothorax is seen. The position of the endotracheal tube and nasogastric tube and right PICC line appears satisfactory. A moderate sized right pleural effusion is present. IMPRESSION: No pneumothorax. " aa32f2de-1f79a756-7ce0291a-c178ee13-d3504bb3.jpg,validate/p12/p12547577/s54781973/aa32f2de-1f79a756-7ce0291a-c178ee13-d3504bb3.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Increasing lethargy. 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. Thoracic scoliosis is again noted. IMPRESSION: No acute cardiopulmonary process. " 589f3623-5734b0bf-65aa508f-8b138c1a-e3959dc5.jpg,validate/p15/p15904173/s58516416/589f3623-5734b0bf-65aa508f-8b138c1a-e3959dc5.jpg,validation," FINAL REPORT INDICATION: ___M with hyperglycemia, possible DKA // c/f PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated but clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 485c618a-b6541e1f-9639a659-febbc65f-fa0ecef5.jpg,validate/p14/p14409926/s57317379/485c618a-b6541e1f-9639a659-febbc65f-fa0ecef5.jpg,validation," 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 " 0c1ffb3c-a766d0f7-103e5c99-4d9e212a-3ca8a388.jpg,validate/p12/p12095092/s54474136/0c1ffb3c-a766d0f7-103e5c99-4d9e212a-3ca8a388.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: COPD exacerbation. AP radiograph of the chest was reviewed and compared to ___. The mediastinum is stable. The patient was extubated in the meantime interval. Lungs are well aerated and essentially clear. Minimal amount of pleural effusion is suspected in the left costophrenic angle. Overall, the aeration of the lungs has improved since ___. " e05630e8-462adcc6-6b1109ac-53b6181b-889ca848.jpg,validate/p19/p19271682/s54387416/e05630e8-462adcc6-6b1109ac-53b6181b-889ca848.jpg,validation," FINAL REPORT HISTORY: Pleural effusion. FINDINGS: In comparison with study of ___, there is increased opacification at the right base with meniscus formation, consistent with small to moderate pleural effusion and underlying compressive atelectasis. Tiny effusion is seen on the left. Otherwise, there is little change in the appearance of the heart and lungs. " 50e4163a-c7da0a66-e4d4fa0d-cca6290b-d88d58e9.jpg,validate/p19/p19855045/s55218636/50e4163a-c7da0a66-e4d4fa0d-cca6290b-d88d58e9.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with shortness of breath. COMPARISON: ___. FINDINGS: Single portable view of the chest. Since prior, there has been interval improvement of the bilateral pulmonary edema. Bibasilar opacities, right greater than left, may represent atelectasis. Blunting of the right costophrenic angle may be due to small right pleural effusion. Superiorly, the lungs are clear and the cardiomediastinal silhouette is within normal limits. " c0ff6930-2c2d7941-67317e80-134b3da0-2ea2b066.jpg,validate/p19/p19997293/s50451467/c0ff6930-2c2d7941-67317e80-134b3da0-2ea2b066.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath and bradycardia. COMPARISON: Multiple chest radiographs, the latest from ___. ONE VIEW OF THE CHEST: The lungs are well expanded and show right lower lobe opacity, with a small right pleural effusion. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. Sternal wires are intact. Thoracic spinal fusion device is partially imaged. IMPRESSION: Right lower lobe opacity with an associated effusion could represent atelectasis or pneumonia. " ab740474-ebd46bde-d1a84dc4-a3542f82-346c7f6b.jpg,validate/p11/p11960316/s54881380/ab740474-ebd46bde-d1a84dc4-a3542f82-346c7f6b.jpg,validation," FINAL REPORT HISTORY: Sore throat with high fever. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No focal pneumonia, vascular congestion, or pleural effusion. " e94c01f0-bc549576-6926ceaa-53f6c9ee-c097421c.jpg,validate/p16/p16500918/s58108835/e94c01f0-bc549576-6926ceaa-53f6c9ee-c097421c.jpg,validation," FINAL REPORT HISTORY: Atrial fibrillation with rapid ventricular response. Evaluate for resolution of pleural effusions. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: The patient is status post sternotomy with sternotomy wires noted to be well-aligned. A right-sided pacemaker is noted with leads terminating in the right atrium and right ventricle. Redemonstrated is stable cardiomegaly, with improved pulmonary vascular congestion and interstitial edema. Again seen are bilateral, moderate pleural effusions, right greater than left. The remainder of the lungs are grossly clear without focal consolidation or pneumothorax identified. IMPRESSION: 1. Stable cardiomegaly with improved pulmonary vascular congestion and interstitial edema. 2. Stable, moderate bilateral pleural effusions, right greater than left. " 9c673b70-88ac8593-23332c4e-27470d93-9bde5948.jpg,validate/p16/p16645602/s51630121/9c673b70-88ac8593-23332c4e-27470d93-9bde5948.jpg,validation," 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. " 0ad76605-dfadc127-f2c085db-d84ed5e7-caa5d496.jpg,validate/p15/p15877362/s53799068/0ad76605-dfadc127-f2c085db-d84ed5e7-caa5d496.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with cough. Evaluate for PNA TECHNIQUE: Chest AP and lateral COMPARISON: Multiple prior chest radiographs, including ___ FINDINGS: Heart size is normal. There is calcification of the aorta, indicating atherosclerosis. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is normal. Lungs are clear. There may be slight blunting of the costophrenic angles. No pneumothorax is seen. There are no acute osseous abnormalities. Again seen is a partially visualized sclerotic, nonaggressive appearing lesion in the right proximal humerus, likely representing an enchondroma with bone infarct considered less likely. Degenerative changes of the visualized thoracolumbar spine. IMPRESSION: Blunting of the bilateral costophrenic angles, which may represent trace pleural effusions, mild atelectasis or pleural thickening. Otherwise, no acute cardiopulmonary abnormality. " 10e8a15d-813484f9-a55f18a0-a040a7a8-9e11d8fe.jpg,validate/p10/p10374990/s54085209/10e8a15d-813484f9-a55f18a0-a040a7a8-9e11d8fe.jpg,validation," FINAL REPORT HISTORY: ___ years old woman with right-sided effusion, shortness of breath, evaluation for change in effusion. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: Lung is well inflated, with mild hyperlucency of the upper lobes and flattening of the diaphragm, consistent with mild emphysema. Cardiomediastinal silhouette is normal. Persistent minimal right pleural effusion is unchanged since ___. There is no pneumothorax. IMPRESSION: Mild emphysema and stable small right pleural effusion " a6761d5a-ee9bb21a-e3f9e727-e2a0d75f-98f694ec.jpg,validate/p18/p18376342/s56695259/a6761d5a-ee9bb21a-e3f9e727-e2a0d75f-98f694ec.jpg,validation," FINAL ADDENDUM There may be minimal pulmonary vascular congestion. ______________________________________________________________________________ FINAL REPORT INDICATION:___ year old woman with epigastric pain. COMPARISON: Chest radiograph ___. AP AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable. The lungs are clear without consolidation, pleural effusion or pneumothorax. Linear scarring/atelectasis is seen in the left mid to lower lung. A right IJ approach hemodialysis catheter ends in the right atrium. No evidence of free air is seen beneath the diaphragms. IMPRESSION: No acute cardiopulmonary pathology. No evidence of free air seen beneath the diaphragms. " 867aa9bf-4f5f0c79-6ebfcaa4-301bd655-02b2f6ac.jpg,validate/p12/p12759249/s55259861/867aa9bf-4f5f0c79-6ebfcaa4-301bd655-02b2f6ac.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with preop chest radiograph for lumbar surgery. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Subtle increased opacity at the retrocardiac lung base (spine sign) could be due to atelectasis, although a right base consolidation cannot be entirely excluded. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. Multiple surgical clips are seen overlying the right axilla and right lower hemithorax. " 85db5f5c-ec290ebb-a8a3084e-83971fca-83644018.jpg,validate/p11/p11020337/s55417696/85db5f5c-ec290ebb-a8a3084e-83971fca-83644018.jpg,validation," FINAL REPORT CHEST, TWO VIEWS ___ HISTORY: ___-year-old man with breakthrough seizure. Evaluate for pneumonia. FINDINGS: PA and lateral views of the chest are compared to previous CT abdomen from ___ and chest x-ray from ___. Linear opacities at the left lung base suggest atelectasis. Slight increased focal opacity at the right lung base laterally could potentially also be due to atelectasis; however, acute infection is also possible. Increased density at the right cardiophrenic angle is compatible with previously identified prominent epicardial fat. Blunting of the right latter costophrenic angle may be due to small effusion or atelectasis in this region. Cardiomediastinal silhouette is stable, as are the osseous and soft tissue structures. IMPRESSION: Bibasilar opacities, potentially due to atelectasis; however, subtle increased opacity at the right lung base may be due to infection. Clinical correlation is recommended. " 7252b26e-3d0b5867-0b797952-f4300b02-adde8a64.jpg,validate/p18/p18968808/s56732103/7252b26e-3d0b5867-0b797952-f4300b02-adde8a64.jpg,validation," FINAL REPORT HISTORY: Increasing falls and inability to ambulate. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: None. FINDINGS: Lung volumes are low. The heart size is normal. The aorta is mildly tortuous. Mediastinal and hilar contours are otherwise unremarkable. There is crowding of the bronchovascular structures, but no overt pulmonary edema is demonstrated. Patchy opacities in the lung bases likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. Mild dextroscoliosis of the thoracolumbar spine is demonstrated with moderate to severe multilevel degenerative changes. IMPRESSION: Low lung volumes with probable bibasilar atelectasis. " f1511e26-1631d69d-c31958d8-838d5586-915bcff0.jpg,validate/p11/p11995575/s54977205/f1511e26-1631d69d-c31958d8-838d5586-915bcff0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cxr // cxr COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is increasing atelectasis at the left lung bases. Elevation of the right hemidiaphragm persists. No overt pulmonary edema. No larger pleural effusions. No evidence of pneumonia or pulmonary edema. " 0b8b6652-0ce83f5c-41125c1c-6186aa6e-968f6b9c.jpg,validate/p17/p17413521/s53895538/0b8b6652-0ce83f5c-41125c1c-6186aa6e-968f6b9c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hx cva and ams, pls eval for pna // History: ___F with hx cva and ams, 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. " 8a047100-ba2d46a8-e364df0b-ce38b0d5-94d4308a.jpg,validate/p11/p11506150/s57414809/8a047100-ba2d46a8-e364df0b-ce38b0d5-94d4308a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Seizures. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are hyperinflated but clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 674d473e-14dc1215-038e9190-205dbb48-71ce4f5c.jpg,validate/p17/p17509107/s51654003/674d473e-14dc1215-038e9190-205dbb48-71ce4f5c.jpg,validation," FINAL REPORT AP CHEST, 11:49 A.M., ___ HISTORY: ___-year-old man after liver transplant. Assess Dobbhoff tube placement. IMPRESSION: AP chest compared to ___. Three images are provided. #1 shows a feeding tube with the wire stylet in place looping in the lower esophagus, #2 with the loop in the upper esophagus, and #3 with the tube in the upper stomach, less distended with air and fluid than in the earlier two images. Lungs are low in volume but essentially clear. This exaggerates mild cardiomegaly. There is no pulmonary edema or pleural effusion. Findings were discussed by telephone with the patient's nurse at 3:10PM. " 4fa907e8-3688b042-52800538-bc36a430-63ab9afc.jpg,validate/p10/p10481162/s56128407/4fa907e8-3688b042-52800538-bc36a430-63ab9afc.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: SVT, history of metastatic breast cancer. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Since the prior study, there has been significant interval increase in left hemithorax opacity which involves the left mid and lower lung fields, which may be related to underlying metastatic disease with possible superimposed infection/pleural effusion. Mulitple pulmonary nodules are again seen. Patchy right base opacity is also seen, which could be due to infection and/or progression of metastatic disease. The cardiac silhouette is not well assessed due to the left-sided opacity. Mediastinal contours are stable. " 2fddc92b-8151d207-ac3e53d7-9bbb8304-a475ad81.jpg,validate/p11/p11825167/s51191342/2fddc92b-8151d207-ac3e53d7-9bbb8304-a475ad81.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever and cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 8ac45fe0-c46dea0b-a25258e0-2d8a2d3d-e08a8853.jpg,validate/p11/p11630519/s51151738/8ac45fe0-c46dea0b-a25258e0-2d8a2d3d-e08a8853.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: now spiking fevers // r/o pna TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " b4e3c039-ffd1ebde-642c1de0-83291837-d74ef0e1.jpg,validate/p11/p11899569/s53009854/b4e3c039-ffd1ebde-642c1de0-83291837-d74ef0e1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea, concern for PTX // eval for PTX COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. The extensive subcutaneous emphysema is noted. Also noted is pneumomediastinum. No large pneumothorax. Lungs appear relatively clear. Heart size is normal. Mediastinal contour is within normal limits. Fracture of the right tenth posterior rib noted. IMPRESSION: As above. " d70782ca-06dd6962-41c97653-c9a3cc4d-0c84232b.jpg,validate/p15/p15192329/s52768607/d70782ca-06dd6962-41c97653-c9a3cc4d-0c84232b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with chest pain x 3 days. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: No prior relevant imaging is available on PACS at the time of this dictation. FINDINGS: No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. Aortic knob calcifications are moderate. Median sternotomy wires and mediastinal clips appear intact. There is significant anterior wedging of a mid thoracic vertebral body with greater than ___% loss of vertebral body height anteriorly ; this is age indeterminate in the absence of prior imaging. Multi-level degenerative changes are noted otherwise with anterior osteophytes. IMPRESSION: 1. No acute cardiopulmonary process. 2. Significant (>___%) loss of anterior vertebral body height of a mid thoracic vertebral body, age-indeterminate in the absence of priors. Correlate with clinical assessment and any prior exams if available. MR could be performed to determine acuity if clinically necessary. RECOMMENDATION(S): Correlate with clinical assessment and any prior exams if available for mid thoracic vertebral body wedge fracture. MRI could be performed of the thoracic spine to determine acuity if deemed clinically necessary. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 11:57 AM, 1 minutes after discovery of the findings. " 10dae53b-91e50b87-fef60a2c-7fe0ddff-9d0ec63e.jpg,validate/p13/p13999026/s53266030/10dae53b-91e50b87-fef60a2c-7fe0ddff-9d0ec63e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg // s/p ct removal and dobhoff placement IMPRESSION: Since the recent study of ___, various support devices have been removed with no visible pneumothorax. Nasogastric tube is been exchanged for a feeding tube, terminating in the proximal stomach. Cardiomediastinal contours are stable. Interval development of a small right pleural effusion with adjacent right basilar atelectasis. No other relevant change. " 89cd2e44-de789594-0d519056-ae2776a7-5cb0c32a.jpg,validate/p15/p15139909/s54921833/89cd2e44-de789594-0d519056-ae2776a7-5cb0c32a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: A ___-year-old man with bilateral VATS. TECHNIQUE: Upright PA and lateral chest views were reviewed in comparison with prior chest radiographs, with the most recent from ___. Concurrently, a chest CT from ___, was reviewed. FINDINGS: Biapical pneumothorax is small on the right side and tiny on the left. A ___-mm nodular opacity in the right mid lung, concerning for deposit is better evaluated on recent chest CT dated ___. In addition, there are other multiple small nodules which are beyond the resolution of the chest radiograph. Very minimal atelectasis at the left lung base. There are no other opacities concerning for pneumonia or aspiration. The amount of subcutaneous air in the left lower and lateral chest is consistent with post-VATS procedure. Bilateral chest tubes have been removed. IMPRESSION: Over last 24 hours, bilateral chest tubes have been removed and a small right apical and tiny left apical pneumothorax are new. Minimal left lung base atelectasis. No opacities concerning for aspiration or pneumonia. " a68196cf-939912b9-7e269d0c-da43f772-69a4035c.jpg,validate/p18/p18062541/s52294209/a68196cf-939912b9-7e269d0c-da43f772-69a4035c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o CHF; on amiodarone // r/o CHF, pulmonary infiltrates r/o CHF, pulmonary infiltrates IMPRESSION: Comparison to ___. No relevant change. The pacemaker leads are in correct stable position. Moderate cardiomegaly. No pulmonary edema, no pleural effusions, no pneumothorax. " bcfa3bcb-76e64550-6e80bae7-c732ab6d-40b0f886.jpg,validate/p18/p18414177/s59352632/bcfa3bcb-76e64550-6e80bae7-c732ab6d-40b0f886.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) PORT INDICATION: ___M with seizure // eval for 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. " a01d50f9-6ef144f0-045ce627-2d86ec0a-eb05e086.jpg,validate/p15/p15167597/s53226220/a01d50f9-6ef144f0-045ce627-2d86ec0a-eb05e086.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Recent lysis of the adhesions, presenting with abdominal pain, question free air. FINDINGS: PA upright and lateral views of the chest were provided. Sternotomy hardware is noted. Clips are noted in the anterior mediastinal space. Underpenetrated technique limits evaluation of the lower lungs. Allowing for these limitations, the lungs appear clear. No convincing signs of free air below the right hemidiaphragm. No effusion or pneumothorax is seen. The cardiomediastinal silhouette appears normal. Imaged osseous structures appear intact. IMPRESSION: No acute findings in the chest. " c1bc59dd-84cd9dfe-58ad5c83-f5fc6ec6-310b0709.jpg,validate/p19/p19169852/s56474859/c1bc59dd-84cd9dfe-58ad5c83-f5fc6ec6-310b0709.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: CHF, EF ___%. Comparison is made with prior study, ___. Moderate-to-severe cardiomegaly is stable. Transvenous pacemaker leads terminate in unchanged standard position in the right atrium, right ventricle, and through the coronary sinus. There is no evidence of pneumonia, pulmonary edema, or pneumothorax. There is a small right pleural effusion associated with adjacent small atelectasis. " 0b913c70-f41204ba-9d6bb9a2-490d6b59-e737e28d.jpg,validate/p17/p17536316/s50598549/0b913c70-f41204ba-9d6bb9a2-490d6b59-e737e28d.jpg,validation," FINAL REPORT INDICATION: History: ___F with significant abdominal pain // Eval for any infiltrates, Eval for free air TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: AP and lateral chest radiographs demonstrate clear lungs bilaterally. Cardiomediastinal and hilar contours are within normal limits. There is no evidence of pleural effusion, pulmonary edema, or pneumothorax. Imaged upper abdomen demonstrates left gastric band which projects over the left upper quadrant. There is no free subdiaphragmatic gas. IMPRESSION: No acute intrathoracic abnormality. " 73fdbe86-36d745c8-fb05bbc9-36d88d28-64f5962a.jpg,validate/p17/p17755234/s56805867/73fdbe86-36d745c8-fb05bbc9-36d88d28-64f5962a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // ?acute intrapulmonary 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. " 218e74bc-1cab0322-870ca024-b40d6492-4e89d2d0.jpg,validate/p19/p19826220/s56143065/218e74bc-1cab0322-870ca024-b40d6492-4e89d2d0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with worsening cough x 1.5 weeks // e/o PNA, sarcoid TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs of___. FINDINGS: Bilateral hila are enlarged, compatible with hilar lymphadenopathy. The right hilum has increased in size relative to the prior study of ___. Several small ill defined opacities in the right lung have mildly increased from prior study correlating with progression of sarcoidosis. The right paratracheal stripe is enlarged, compatible with mediastinal adenopathy. There is no pleural effusion, pneumothorax, or pulmonary edema. IMPRESSION: 1. Enlarged hila and increased right parenchymal opacities compatible with progression of sarcoidosis. Lung involvement and lymphadenopathy was evaluated in prior CT ___ 2. No evidence of acute cardiopulmonary process. " 41a1ad1e-2954ef3d-ee6741b1-2891efa2-d42685db.jpg,validate/p15/p15573773/s51291017/41a1ad1e-2954ef3d-ee6741b1-2891efa2-d42685db.jpg,validation," FINAL REPORT INDICATION: Cough and increased oxygen requirements. COMPARISON: CT chest ___. Chest radiograph ___. FINDINGS: Upright AP image of the chest was obtained. A right basilar opacity likely reflects chronic consolidation. There is possible minimal diffuse bilateral interstitial edema. There are emphysematous changes. There is cardiomegaly. A PICC line entering via a right subclavian vein appears to end in the low superior vena cava. There is left upper arm hardware device. IMPRESSION: Minimal pulmonary interstitial edema. Stable cardiomegaly. Chronic consolidation in the right lung base. " 400d255d-84d163eb-c54a4987-eb83b886-6f7b9fb3.jpg,validate/p19/p19564280/s52790758/400d255d-84d163eb-c54a4987-eb83b886-6f7b9fb3.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Intoxication, shortness of breath, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is marked improvement in lung volumes, reflecting improved ventilation. There is no evidence of pneumonia, no pulmonary edema. No pleural effusions. Old displaced rib fractures on the right with small accompanying pleural thickening. " 8f9f7c61-b1fdac84-6b3bab27-306b9f49-4c5bc6ed.jpg,validate/p11/p11260814/s52410860/8f9f7c61-b1fdac84-6b3bab27-306b9f49-4c5bc6ed.jpg,validation," FINAL REPORT HISTORY: History of bronchiectasis and dyspnea. Evaluate for infection or edema. COMPARISON: Prior radiographs of chest dated ___ and ___, as well as CT of the chest dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate streaky opacities at the bilateral bases, consistent with atelectasis. There is no pneumothorax. There is a small left-sided pleural effusion. The cardiomediastinal hilar contours are unchanged. The heart is top normal in size. IMPRESSION: No acute cardiopulmonary process. " 4c43e2a2-b9f179aa-9b255063-08d77624-cb58eacf.jpg,validate/p15/p15950211/s54731069/4c43e2a2-b9f179aa-9b255063-08d77624-cb58eacf.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. Question pneumonia. COMPARISONS: None available. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The aorta is partly calcified with minimal unfolding. Otherwise, the mediastinal and hilar contours are unremarkable. The lungs appear clear aside from streaky left basilar opacities most suggestive of minor atelectasis or perhaps scarring. The lateral view, however shows a posterior opacity, compatible with atelectasis although infection is not excluded. The bones appear likely demineralized with mild-to-moderate degenerative changes along the mid-to-lower thoracic spine. IMPRESSION: Left basilar opacity which is compatible with atelectasis although infection is difficult to completely exclude. " 4668f3d9-f3f61e72-9b269dd8-f35ca992-0dde6be2.jpg,validate/p11/p11636304/s54610943/4668f3d9-f3f61e72-9b269dd8-f35ca992-0dde6be2.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with obstructive sleep apnea, admitted for ORIF of right ankle fracture. For preoperative assessment. COMPARISON: ___. SINGLE FRONTAL VIEW OF THE CHEST: Lung volumes are low. Linear atelectasis is noted at the right mid lung. There are no focal areas of consolidation. There is no pleural effusion or pneumothorax. Heart size is exaggerated by low lung volumes and lordotic techniqe and is likely normal in size. Mediastinal contours are within normal limits. " eb4e5109-5e00ecc2-52d0dc39-c75af13f-2bbe993f.jpg,validate/p16/p16625317/s56882477/eb4e5109-5e00ecc2-52d0dc39-c75af13f-2bbe993f.jpg,validation," WET READ: ___ ___ 1:40 PM 1. Persistent mild to moderate pulmonary vascular congestion with slight interval increase in small bilateral pleural effusions. 2. No focal consolidation to suggest pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with nausea, poor breath sounds evaluate for pneumonia. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: Moderate cardiomegaly is unchanged. Mild to moderate pulmonary vascular congestion is similar to the prior study with a slight increase in the size of small bilateral pleural effusions. There is no focal consolidation or pneumothorax. IMPRESSION: 1. Persistent mild to moderate pulmonary vascular congestion with slight interval increase in small bilateral pleural effusions. 2. No focal consolidation to suggest pneumonia. " b5e2ad57-03872dc2-d6409ba8-088212cf-cebf615f.jpg,validate/p13/p13138475/s51447481/b5e2ad57-03872dc2-d6409ba8-088212cf-cebf615f.jpg,validation," WET READ: ___ ___ ___ 8:46 PM L thoracentesis with small residual L and unchanged small R pleural effusions. Multifocal PNA, worsened in RUL and RLL. Hyperexpanded lungs. ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with effusion after thoracocentesis. Portable AP radiograph of the chest was reviewed in comparison to ___. The left internal jugular line tip is at the level of mid SVC. The patient is after left thoracocentesis with small residual pleural effusion and unchanged small right pleural effusion. The right upper lobe consolidation is redemonstrated, overall progressed since the prior study as well as there are multiple focal consolidations that appear to be more pronounced than on the prior examinations as well. " 126d0208-b146da26-24b73f0c-62c7f800-a08d3bd8.jpg,validate/p13/p13738282/s57097438/126d0208-b146da26-24b73f0c-62c7f800-a08d3bd8.jpg,validation," FINAL REPORT INDICATION: Cough. COMPARISON: ___. FINDINGS: The lungs are well expanded and clear. There is no focal consolidation, effusion, pneumothorax. Median sternotomy wires are intact. Mediastinal vascular clips are in stable position. IMPRESSION: No acute cardiopulmonary process. " 69087185-af10f431-1be20885-db5fb548-0cf70c36.jpg,validate/p10/p10705890/s53692708/69087185-af10f431-1be20885-db5fb548-0cf70c36.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG. PA and lateral upright chest radiographs were reviewed in comparison on ___. The heart size and mediastinum are stable. Left pleural effusion and retrocardiac atelectasis is noted, minimally improved since the prior study. Small amount of right pleural effusion is present. There is no pneumothorax. There is no evidence of pulmonary edema. " a67bc995-5bec4416-c6d83e2c-d26158f6-76776570.jpg,validate/p10/p10926537/s52512053/a67bc995-5bec4416-c6d83e2c-d26158f6-76776570.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with basilar infarcts with cerebellar and pontine involvement bilaterally. intubated // evaluate ETT placement evaluate ETT placement IMPRESSION: Compared to chest radiographs ___. Lung volumes have improved and pulmonary vasculature is no longer engorged. No appreciable focal pulmonary abnormality. Heart size top-normal. Pleural effusions small if any. No pneumothorax. ET tube and esophageal drainage tube in standard placements. " 9e19ddae-02901c31-7d9fafba-bf3757ab-24139f8b.jpg,validate/p19/p19895478/s55793581/9e19ddae-02901c31-7d9fafba-bf3757ab-24139f8b.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain, poss pulm nodule vs nipple shadow on last xr. please obtain w/ nipple markers // pulm nodule? please use nipple markers TECHNIQUE: PA and lateral views of the chest. COMPARISON: Exam from earlier the same day at 05:04. FINDINGS: Nodule seen at the left lung base on prior exam is compatible with nipple shadow. Lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits. Severe degenerative changes seen at the right shoulder. No acute osseous abnormalities. Pectus excavatum again noted. IMPRESSION: Nodular opacity at the left lung base is compatible with nipple shadow. " fcec5bed-99e7273a-259345cd-57f0b8a2-8977fdbc.jpg,validate/p10/p10152017/s56412155/fcec5bed-99e7273a-259345cd-57f0b8a2-8977fdbc.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPHS: Increased AP diameter of the chest with flattened hemidiaphragms suggest COPD, unchanged from prior. Bronchiectasis and peribronchial opacities have progressed in the left lower lobe and may reflect aspiration or inflammation. No confluent consolidation is identified. There is no pulmonary edema or pleural effusion. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: Hyperexpanded lungs with increased left lower lobe peribronchial opacities, possible interval aspiration. " f907eb7a-51e57053-a3cd1128-61061081-a2fb45f0.jpg,validate/p18/p18942108/s58076828/f907eb7a-51e57053-a3cd1128-61061081-a2fb45f0.jpg,validation," FINAL REPORT HISTORY: Asthma, shortness of breath, cough productive of yellow sputum. COMPARISON: Prior chest radiograph and chest CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is normal in size. There is tortuosity of the descending aorta. The hilar and mediastinal contours are otherwise normal. Increased right paratracheal density is compatible with normal vascular structures seen on CT. The lungs are well-expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 9cd4ddf8-4b892aa3-4d27233c-af28c884-4c5f9be8.jpg,validate/p17/p17128361/s59348201/9cd4ddf8-4b892aa3-4d27233c-af28c884-4c5f9be8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with pneumonia/CAP , on Rx, improved // follow up infiltrates COMPARISON: Chest radiograph ___ IMPRESSION: Lungs are now clear. Previous consolidation in the right middle lobe and right midlung, either posterior segment of the right upper lobe or superior segment of the right lower lobe, has resolved. There is no adenopathy or pleural effusion. Left lung is clear. Heart size normal. No further radiographic followup is indicated. " 0b3b1a4f-7bd2c0c4-a945d835-8ed34c85-bf9813fc.jpg,validate/p15/p15645388/s54062507/0b3b1a4f-7bd2c0c4-a945d835-8ed34c85-bf9813fc.jpg,validation," 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. " 60ecc565-c7a7a38c-016ea119-2ddf5d2e-806a4b5c.jpg,validate/p15/p15568805/s59983649/60ecc565-c7a7a38c-016ea119-2ddf5d2e-806a4b5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HIV, cerebral toxo, here w/seizures. // Is the ETT in the right location? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: ET tube tip is 1 cm above the carina should be withdrawn for more standard position. Cardiac size is top-normal accentuated by the projection. NG tube tip is out of view below the diaphragm. Bibasilar atelectasis are larger on the left. There is no evident pneumothorax or pleural effusion. Mild vascular congestion is new " 7cb5d0be-96168306-fd2da1ab-7e343c53-e02e27c7.jpg,validate/p15/p15472839/s56066127/7cb5d0be-96168306-fd2da1ab-7e343c53-e02e27c7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, hemoptysis // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest CT from ___ and chest radiograph from ___ FINDINGS: Patient with known underlying pulmonary emphysema. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable unremarkable. Small pulmonary nodules seen on prior CT were better assessed on CT. IMPRESSION: No acute cardiopulmonary process. " 7f8d1f4f-568e65e9-e214f2bd-3a54c48e-833e2026.jpg,validate/p10/p10765644/s59801232/7f8d1f4f-568e65e9-e214f2bd-3a54c48e-833e2026.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with a history of lymphoma. Chest pain. IMPRESSION: PA and lateral chest compared to ___: Moderate left pleural effusion unchanged since ___. Previous right pleural effusion has not recurred. Severe enlargement of the cardiac silhouette stable. Lungs grossly clear. Transvenous right atrial pacer lead directed more horizontally today than on the previous study on the frontal view, but identical on the lateral has probably not changed position. Transvenous right ventricular pacer defibrillator lead in standard placement, unchanged. " bdf41c3f-c99a497e-dbfdab90-2c88c2a5-57db83f6.jpg,validate/p15/p15448346/s50377168/bdf41c3f-c99a497e-dbfdab90-2c88c2a5-57db83f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man acute SOB s/p IR // assess for infiltrate, failure COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has developed moderate to severe pulmonary edema. Blunting of the left costophrenic sinus is likely caused by a mild pleural effusion. Retrocardiac atelectasis. Moderate cardiomegaly. Low lung volumes. At the time of dictation and observation, 14:19, on the ___, the referring physician ___. ___ was paged and the findings were discussed 1 min later over the telephone. " f15fa40c-a23d79d4-197ad908-8f647569-9646f4b7.jpg,validate/p15/p15908342/s53157595/f15fa40c-a23d79d4-197ad908-8f647569-9646f4b7.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Gastrointestinal bleeding. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appears unchanged. A smooth partly visualized shadow projecting over the left upper chest is unchanged and appears to represent a stable contour associated with overlying soft tissues. There is similar mild pleural thickening at each lung apex. Otherwise, the lung fields appear clear. The chest is hyperinflated. There is no pleural effusion or pneumothorax. The bones appear demineralized. Similar mild to moderate degenerative changes affect the mid through lower thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. " 9a42e9db-6f5ccf1d-a1432dfa-b879c23e-50a9e145.jpg,validate/p11/p11362933/s58358280/9a42e9db-6f5ccf1d-a1432dfa-b879c23e-50a9e145.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph obtained on ___ with a shunt series. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. A chest wall pacer is noted on the left with dual leads extending into the expected location of the right atrium and right ventricle, not significantly changed. A ventriculostomy shunt catheter traverses the anterior chest wall. Lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. No signs of CHF with cardiomediastinal silhouette remaining normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " 666659bb-20dc6d60-ae36cc8c-77f5f95c-7e1173b6.jpg,validate/p13/p13567471/s51123735/666659bb-20dc6d60-ae36cc8c-77f5f95c-7e1173b6.jpg,validation," WET READ: ___ ___ ___ 1:33 AM Area of opacification adjacent to the right heart border could represent a prominent fat pad but was not as well seen on previous examinations, and an infectious etiology is possible in the correct clinical setting. The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at 01:30, 1 min after discovery. ______________________________________________________________________________ FINAL REPORT AP CHEST 7:10 P.M. ___ HISTORY: A ___-year-old man with COPD, coronary artery disease and dyspnea. IMPRESSION: AP chest compared to ___: Compared to all recent prior radiographs, severe hyperinflation is worse, and heart size is at its smallest, normal ___. Lungs are clear of focal abnormality aside from severe bullous transformation, and there is no evidence of cardiac decompensation. Right PIC line ends in the upper SVC. No pneumothorax or appreciable pleural effusion. " c767aaee-b213a9ef-d214835e-89a76a27-da1d165d.jpg,validate/p13/p13528989/s58659686/c767aaee-b213a9ef-d214835e-89a76a27-da1d165d.jpg,validation," WET READ: ___ ___ ___ 9:26 PM Streaky opacities in the left lower lobe concerning for developing pneumonia. Low lung volumes causing crowding of bronchovascular structures but no overt edema. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Metastatic prostate cancer, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a minimal increase in visibility of the interstitial lung structures, likely reflecting increased interstitial fluid load. The pleural effusions and the bilateral areas of atelectasis are unchanged in extent and severity. No new parenchymal opacity suggesting pneumonia. Normal size of the cardiac silhouette. No pneumothorax. " 21fc3aeb-a0494c9e-c901ee46-20d9004d-06482fdb.jpg,validate/p14/p14648269/s54444363/21fc3aeb-a0494c9e-c901ee46-20d9004d-06482fdb.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough, subjective fever and dyspnea, now with wheezing on exam. COMPARISON: Comparison is made with chest radiograph from ___. FINDINGS: The lungs are well expanded and clear. There is some flattening and sharp inclination of the right hemidiaphragm, suggestive of hyperinflation. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. There is no evidence of pneumonia or other acute pulmonary or cardiac process. IMPRESSION: Mild hyperinflation. Otherwise, normal chest radiograph. These findings were communicated to Dr. ___ at 10:46 a.m. by telephone. " 5e248b79-7a1bc083-395aea1e-d62146c2-25613bd8.jpg,validate/p11/p11451979/s59357586/5e248b79-7a1bc083-395aea1e-d62146c2-25613bd8.jpg,validation," FINAL REPORT HISTORY: CAD and ESR with possible pneumonia. FINDINGS: In comparison with study of ___, there is again enlargement of the cardiac silhouette with pulmonary vascular congestion in a patient with intact midline sternal wires after CABG procedure. Central catheter extends to the lower portion of the SVC. There is some asymmetry of opacification especially at the right base. This could merely reflect asymmetric pulmonary edema. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. " 247d9a9d-0286be7d-c83aff0e-4faf6d29-3c19c113.jpg,validate/p17/p17477304/s50234854/247d9a9d-0286be7d-c83aff0e-4faf6d29-3c19c113.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Suspected aspiration with significant cough. AP and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is top normal, stable. Mediastinum is stable in appearance including slight narrowing of the mid portion of the trachea and might be related to prior intubations. Lungs are overall clear with no interval development of focal consolidation to suggest aspiration or pneumonia. What appears to be is a central venous line catheter or potentially hemodialysis catheter terminates in the expected location of the right atrium, unchanged since the prior study on both PA and lateral views. No appreciable pleural effusion demonstrated. Dense material is projecting over the expected location of the stomach. " f2fc5722-e060d603-14475ce6-2b1fa724-cf7ca2d8.jpg,validate/p10/p10967333/s56268259/f2fc5722-e060d603-14475ce6-2b1fa724-cf7ca2d8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with hx of asthma with cough and dyspnea // r/o infiltrate COMPARISON: ___ and ___ FINDINGS: PA and lateral views of the chest provided. Blunting of the right CP angles unchanged and may reflect chronic pleural thickening given unchanged appearance compared with ___. No signs of pneumonia or edema. Cardiomediastinal silhouette is normal. No acute bony abnormalities. IMPRESSION: As above peer " 18aee552-1b2aa4e9-d084ea4a-c14826e5-a82f68e3.jpg,validate/p13/p13392263/s57212612/18aee552-1b2aa4e9-d084ea4a-c14826e5-a82f68e3.jpg,validation," FINAL REPORT INDICATION: ___F with chest discomfort // eval for ptx or infiltrate TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___ per FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Aortic calcifications are noted. Orthopedic hardware seen in the proximal left humerus. IMPRESSION: No acute cardiopulmonary process. " 4eef5e18-cb27322c-51d732cf-6e610d69-0e0291ab.jpg,validate/p16/p16529821/s56346815/4eef5e18-cb27322c-51d732cf-6e610d69-0e0291ab.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with seizure. 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. " 7dbe5d5d-5b628f9e-d2737d8b-785fd8c1-b5008beb.jpg,validate/p18/p18279430/s54908269/7dbe5d5d-5b628f9e-d2737d8b-785fd8c1-b5008beb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with CHF exacerbation and SOB // Acute process for SOB COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Tripolar AICD is unchanged. Midline sternotomy wires is and mediastinal clips are again noted. The heart remains moderately enlarged. The mediastinal contour is stable. There is a small right pleural effusion which is new in the interval. The lungs appear clear without focal consolidation or edema. No pneumothorax. Bony structures are intact. IMPRESSION: Stable cardiomegaly. New small right pleural effusion. " 7e59d3c6-f90c8e0d-3fd407fe-9bb9bd36-7f45c42c.jpg,validate/p16/p16097039/s52918007/7e59d3c6-f90c8e0d-3fd407fe-9bb9bd36-7f45c42c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man POD3 CABG // effusion/atelectasis effusion/atelectasis IMPRESSION: In comparison with the study of ___, the postoperative appearance of the cardiac silhouette is unchanged. The atelectatic changes at the bases have decreased since the prior examination. " f28f6e5d-109693c1-6c2ec891-d251b498-0af1614e.jpg,validate/p16/p16566006/s58492210/f28f6e5d-109693c1-6c2ec891-d251b498-0af1614e.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with stroke and fever. Evaluate for pneumonia. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There are small areas of bibasilar atelectasis. There is a tiny left-sided pleural effusion. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax or consolidation or pulmonary edema. IMPRESSION: Small bibasilar atelectasis and tiny left-sided pleural effusion. No pneumonia. " c9e5ae22-655b6431-5213b851-f74d9509-53516d60.jpg,validate/p14/p14704668/s59023582/c9e5ae22-655b6431-5213b851-f74d9509-53516d60.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough ,chills ,fatigue. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Compared to prior, there are new irregular opacities in the right middle lobe, concerning for pneumonia. The heart size is normal. The mediastinal and hilar contours are normal. No pleural abnormality is seen. IMPRESSION: Right middle lobe pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 4:14 PM, 5 minutes after discovery of the findings. " 0e581139-ebf90329-adeb3ede-853ffc06-2fa0303b.jpg,validate/p18/p18797174/s58496993/0e581139-ebf90329-adeb3ede-853ffc06-2fa0303b.jpg,validation," FINAL REPORT INDICATION: History: ___F with dyspnea // PNA? edema COMPARISON: Multiple prior exams, most recently of ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Moderate cardiomegaly and mediastinal contours are stable. Interstitial markings are diffusely increased, consistent with mild pulmonary edema. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: CHF with mild interstitial edema. " 11768b21-cec7175e-576769c4-ac9ed6f8-4e40be69.jpg,validate/p19/p19028690/s50034238/11768b21-cec7175e-576769c4-ac9ed6f8-4e40be69.jpg,validation," FINAL REPORT HISTORY: Dyspnea and generalized weakness. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ chest radiograph and chest CTA. FINDINGS: Low lung volumes are present. The heart size is mildly enlarged. Mediastinal and hilar contours are unchanged with similar fullness of the superior mediastinum attributable to mediastinal fat. There is no pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is identified. There are multilevel degenerative changes in the thoracic spine. IMPRESSION: Low lung volumes. Otherwise no acute cardiopulmonary process. " 973b72a1-bcbe55c5-a6e25cac-be24cf48-76773ed4.jpg,validate/p18/p18708817/s51811364/973b72a1-bcbe55c5-a6e25cac-be24cf48-76773ed4.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Confusion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Marked enlargement of the cardiac silhouette persists which could be due to cardiomyopathy or pericardial effusion. Areas of left mid lung linear atelectasis is seen. There is no definite focal consolidation. There is no pleural effusion or pneumothorax. Minimal pulmonary vascular congestion may be present. IMPRESSION: 1. Persistent severe enlargement of the cardiac silhouette maybe due to cardiomyopathy or pericardial effusion. 2. Linear lingular atelectasis/scarring. Possible mild pulmonary vascular congestion. " 391708e5-fa1b2bf1-538be2e5-6e2a85af-16508c75.jpg,validate/p16/p16348494/s55769821/391708e5-fa1b2bf1-538be2e5-6e2a85af-16508c75.jpg,validation," 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. " d7ae7b42-6e03f81a-a394476f-074fb415-ef919a0c.jpg,validate/p10/p10848515/s59896775/d7ae7b42-6e03f81a-a394476f-074fb415-ef919a0c.jpg,validation," FINAL REPORT EXAMINATION: Supine frontal portable chest radiograph INDICATION: ___ year old man s/p placement of chest tube for hemothorax // ?tube placement, ?hemothorax TECHNIQUE: Supine frontal portable chest radiograph COMPARISON: Same-day CTA torso FINDINGS: Interval placement of a left thoracostomy drain with tip in the left lung base. No radiographically evident pneumothorax is visualized on this supine radiograph. Known manubrial and rib fractures are poorly visualized. Retrocardiac opacity may be due to residual pleural effusion/hemothorax and adjacent atelectasis. Cardiomegaly, as before. There is a left chest pacemaker with electrodes in expected positions. Aorta is calcified, indicating atherosclerosis. There asymmetric fullness of the right neck, compared to the left, consistent with known hematoma. Again seen are changes compatible with Paget's disease in the right humerus. IMPRESSION: Interval placement of a left thoracostomy drain with tip in the left lung base. No radiographically evident pneumothorax is visualized on this supine radiograph. Known manubrial and rib fractures are poorly visualized. There is asymmetric fullness of the right neck, compared to the left, consistent with known hematoma. " dc7c077c-92240140-deb8edb0-37bf8fa9-f2ff57c6.jpg,validate/p11/p11149673/s51182229/dc7c077c-92240140-deb8edb0-37bf8fa9-f2ff57c6.jpg,validation," FINAL REPORT INDICATION: Followup of left lower lobe resolving pneumonia. COMPARISON: ___ and ___. FRONTAL AND LATERAL VIEWS OF THE CHEST. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Left lower lobe consolidation has resolved. Heart size is normal. Mediastinal silhouette and hilar contours are normal aside from a mildly tortuous aorta, which is unchanged. Calcified right hilar nodes. IMPRESSION: Lungs clear with resolution of pleural effusions. No new opacity. " e12cb9b7-4e348563-f0b3fe75-987e1fa9-28ce3c0c.jpg,validate/p11/p11263526/s59392469/e12cb9b7-4e348563-f0b3fe75-987e1fa9-28ce3c0c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain. FINDINGS: AP upright and lateral views of the chest were provided. Lung volumes are markedly low, limiting evaluation. There is bibasilar atelectasis. The mid-upper lungs appear well aerated. The heart size cannot be assessed. The mediastinal contour is normal. No large effusion is seen. Extensive degenerative disease is seen within the lower thoracic and lumbar spine. There are compression deformities within the thoracic spine, which are stable from ___ radiograph. " 6ebe5157-f2772b4e-f427a3ea-9407ff78-a3a01be5.jpg,validate/p17/p17033046/s53706519/6ebe5157-f2772b4e-f427a3ea-9407ff78-a3a01be5.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p avr cabg // ? infiltrate TECHNIQUE: Semi-upright portable AP chest. COMPARISON: Chest radiographs ___, ___ and ___. CT chest ___. FINDINGS: Right IJ, ET and enteric tubes are in constant position, however the tip of the enteric tube is beyond the field of view. Median sternotomy wires and mediastinal surgical clips are re- demonstrated. There may be small bilateral pleural effusions. Bilateral airspace opacities compatible with known airspace and interstitial disease is not appreciably changed. No new focal opacities are detected. There is no cardiomegaly. The mediastinal and hilar contours are normal. IMPRESSION: There is no significant change in bilateral airspace and interstitial opacities. No definite new airspace opacity. " b63bd8f6-7d53e9a7-d2feb6ed-cb0a9a59-eb82ae62.jpg,validate/p15/p15781880/s59718983/b63bd8f6-7d53e9a7-d2feb6ed-cb0a9a59-eb82ae62.jpg,validation," FINAL REPORT EXAM: Chest, single supine AP portable view. CLINICAL INFORMATION: ET tube placement. COMPARISON: None. FINDINGS: Single supine AP portable view of the chest was obtained. Endotracheal tube is seen, terminating approximately 6.6 cm above the level of the carina. Enteric tube is seen coursing below the level of the diaphragm, the inferior aspect not definitively included on the exam. There are low lung volumes. Prominence and indistinctness of the hila suggest a component of fluid overload. Slight blunting of left costophrenic angle is seen and a trace left pleural effusion is not excluded. No displaced fractures are identified. The cardiac and mediastinal silhouettes are likely accentuated by supine, AP technique. The superior mediastinum is somewhat ill-defined, although this may relate to low lung volumes, supine AP portable technique, and volume overload. Chest CT is pending. " 35465e58-da5742f0-b4693ced-bb675a71-7da1fea6.jpg,validate/p15/p15957987/s55989902/35465e58-da5742f0-b4693ced-bb675a71-7da1fea6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypoxia, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided. Esophageal stent is in place. Port-A-Cath is again noted over the left chest wall with catheter tip extending into the expected location of the superior vena cava. There is a left-sided chest tube again noted. Increasing bilateral pleural effusions with lower lung consolidation compared with prior exam. No definite pneumothorax. Heart size cannot be assessed. Mediastinal contour appears stable. Bony structures are grossly intact. Clips in the right upper quadrant noted. Suture material is partially imaged along the medial right lung. IMPRESSION: Slight increased effusions and lower lobe opacities, concerning for pneumonia. " c039f36d-962c1137-e7e3095c-d74e0a66-1d28833a.jpg,validate/p12/p12902491/s52320556/c039f36d-962c1137-e7e3095c-d74e0a66-1d28833a.jpg,validation," FINAL REPORT INDICATION: ___ year old male patient with CHF, h/o afib admitted with PEA arrest now s/p cooling/rewarming and recent ventilator associated PNA. COMPARISON: Prior chest radiograph from ___ through ___. TECHNIQUE: Portable semi-erect AP chest radiograph. FINDINGS: As compared to prior chest radiograph from ___, there is persistent basal consolidation on the right and small to moderate bilateral pleural effusions. There is some vascular congestion. The azygos vein is slightly distended. There is no pneumothorax. Cardiomegaly is stable. A tracheostomy tube is slightly tilted, likely positional. A left pectoral pacemaker is unchanged with a single lead terminating in the right ventricle. IMPRESSION: Persistent right basal consolidation and small to moderate bilateral pleural effusions. " c4366380-27ab3491-5ce756c1-4337b7d4-0b2430ff.jpg,validate/p19/p19904800/s50332563/c4366380-27ab3491-5ce756c1-4337b7d4-0b2430ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with B cell lymphoma with fevers, cough diarrhea for 1 week. COMPARISON: Prior exam from ___. Prior CT from ___. FINDINGS: PA and lateral views of the chest provided. Overlying EKG leads are present. Bilateral breast implants are noted. Lungs are clear. No pleural effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: No acute findings. No pneumonia. Of note, mediastinal widening has improved as compared with chest radiograph from ___. " 90bc0278-09941a5f-d70d624d-5e651cbe-4810fedf.jpg,validate/p15/p15534375/s54271922/90bc0278-09941a5f-d70d624d-5e651cbe-4810fedf.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with hypertension, presyncope, question pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No effusion or pneumothorax. Aorta is tortuous. IMPRESSION: No evidence of acute cardiopulmonary process. " e626d870-de78e666-00cb4150-bbfd6293-2dbb55f9.jpg,validate/p15/p15498178/s56078345/e626d870-de78e666-00cb4150-bbfd6293-2dbb55f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with emphysema with brownish prod cough // eval pna COMPARISON: Prior CT chest from ___. FINDINGS: PA and lateral views of the chest provided. A peripheral nodular opacity in the left upper lobe is again seen measuring approximately 2.6 x 2.6 cm, better assessed on recent CT. Underlying fibrotic lung disease is noted. A similar pattern of lower lung opacities is seen compared with recent prior exam likely reflecting emphysema/ fibrosis. No large effusion or pneumothorax. Cardiomediastinal silhouette stable. Bony structures intact. IMPRESSION: 2.6 cm mass in the left upper lobe is concerning for a neoplasm. Extensive underlying emphysema/fibrosis. " 208a5e48-0475c48e-52617ca9-7d65df78-43283212.jpg,validate/p14/p14108973/s51691100/208a5e48-0475c48e-52617ca9-7d65df78-43283212.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Followup of the patient with pleural effusion. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable. The post-sternotomy appearance of the chest as well as left-sided pacemaker leads are unchanged. There is interval decrease up to almost entire solution of left pleural effusion and improvement of the left lung base aeration. Severe emphysema and hyperinflation are re-demonstrated. " 17da6e11-e0398673-7ef95254-19cb347f-cbf6382c.jpg,validate/p13/p13577794/s51416525/17da6e11-e0398673-7ef95254-19cb347f-cbf6382c.jpg,validation," 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. " 5ee3cea0-5936e52b-587548c8-c0702f79-8c2e182d.jpg,validate/p15/p15394622/s50213359/5ee3cea0-5936e52b-587548c8-c0702f79-8c2e182d.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with recent EGD and transient abdominal pain, rule out free air or infiltrate. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate clear lungs without effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. There is no intraperitoneal free air. IMPRESSION: Normal chest. " 783fcab7-d08c670d-66ac67f6-e39c9580-42990683.jpg,validate/p14/p14987339/s55022875/783fcab7-d08c670d-66ac67f6-e39c9580-42990683.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with infectious symptoms, HIV. COMPARISON: Chest radiograph from ___ and chest CTA from ___. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Osseous structures are normal. IMPRESSION: No acute cardiopulmonary process. " e13946eb-ed699c44-b0ea589d-56114c2a-1a601914.jpg,validate/p19/p19229277/s57776222/e13946eb-ed699c44-b0ea589d-56114c2a-1a601914.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___-year old male with HIV (uncontrolled), disseminated pan-sensitive MTB, suicide attempt with bleach ingestion s/p gastrectomy + distal esophagectomy + RY esophago-jejunostomy presents with clogged J-tube and report of non-adherence to TB medications. Now with GNR sepsis, L sided pna with large loculated empyema that smeared for GNR, now s/p chest tube. // eval for interval change in pneumothorax, empyemaPlease perform before 8am COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Small residual left pleural effusion unchanged for several days, left pleural drainage catheter in stable position in the middle level of the left hemi thorax. Substantial bibasilar atelectasis is stable. There is no pulmonary edema. Heart size is normal. " b69bdc56-a53ce177-9693b773-08aa2106-943065da.jpg,validate/p18/p18652728/s58368552/b69bdc56-a53ce177-9693b773-08aa2106-943065da.jpg,validation," FINAL REPORT HISTORY: Productive cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size remains borderline enlarged. The mediastinal and hilar contours are unremarkable. Streaky linear opacities are present within the lung bases, new compared to the previous exam. No pleural effusion, pulmonary edema, or pneumothorax is seen. There are mild degenerative changes in the thoracic spine. IMPRESSION: Streaky linear opacities in the lung bases most likely reflective of atelectasis. " 31341fd9-7368c40b-212c7bf7-2d53f1a4-dc0438ba.jpg,validate/p11/p11465548/s53808489/31341fd9-7368c40b-212c7bf7-2d53f1a4-dc0438ba.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea on exertion and lower extremity edema TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size remains severely enlarged. Mediastinal contour is unchanged. There is mild pulmonary vascular engorgement. Elevation of the right hemidiaphragm persists, and again raises concern for a subpulmonic effusion. Bibasilar opacities likely reflect atelectasis. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Severe cardiomegaly with mild pulmonary vascular congestion. Continued elevation of the right hemidiaphragm again raises concern for a subpulmonic effusion. Bibasilar atelectasis. " 1cba3aa1-ecd08c03-11cc502b-0cf982a0-d1b4af90.jpg,validate/p15/p15345462/s52229058/1cba3aa1-ecd08c03-11cc502b-0cf982a0-d1b4af90.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CP and hx of CAD // Pneumonia? widened mediastinum? COMPARISON: Chest radiograph ___ 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. " bcb5a35f-56a6b549-0decd09b-ba291de9-d020407e.jpg,validate/p10/p10850680/s58551055/bcb5a35f-56a6b549-0decd09b-ba291de9-d020407e.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Hypotension and altered mental status. There is moderate-to-severe cardiomegaly. There is mild vascular congestion. There is no pneumothorax, pleural effusion, or pneumonia. Patient is status post CABG. " 9ef725c8-ed7b6358-9be7a059-7f839fd8-84bfaa3f.jpg,validate/p12/p12665592/s58038368/9ef725c8-ed7b6358-9be7a059-7f839fd8-84bfaa3f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with copd and chf, now sob pls eval // History: ___F with copd and chf, now sob pls eval TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___, ___, and ___. Chest CT dated ___. FINDINGS: Diffuse interstitial abnormalities and multifocal airspace opacities are longstanding and variable in severity, accompanied by chronic bilateral hilar enlargement. Findings are minimally improved as compared to the prior examination dated ___, and are compatible with known interstitial lung disease. There may be new consolidation in the left lower lobe, and growth of an irregularly shaped 2cm focal lesion in the right upper lobe. There is no pleural effusion and probably no pulmonary edema. Mild cardiomegaly is stable from the prior exam. The descending aorta is partially calcified and tortuous. IMPRESSION: 1. Possible left lower lobe pneumonia. 2. Slight interval improvement in the patient's baseline interstitial lung disease. Longterm variability suggest an element of exposure, such as acute and chronic hypersensitivity pneumonia. 3. No evidence of acute congestive heart failure. 4. Possible right upper lobe mass or focal infection. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone ___ ___ at 10:10 AM, minutes after discovery of the findings. " 2b960662-d2fbe15c-a9b0ad0a-45827177-8f46c3b9.jpg,validate/p11/p11967908/s59197851/2b960662-d2fbe15c-a9b0ad0a-45827177-8f46c3b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // eval for any infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: ___, CT chest dated ___ FINDINGS: The patient has undergone prior right mastectomy and axillary dissection. The cardiomediastinal silhouette and pulmonary vasculature are unchanged since the prior examination. Calcifications projecting over the right mid and upper lung have been demonstrated to be pleural based and are unchanged since the prior examination. Again noted is right upper lobe scarring with volume loss. There is no pleural effusion or pneumothorax. No definite focal consolidation is identified. IMPRESSION: No acute intrathoracic abnormality. " 5b9f2c0e-aecfe211-9eaa290b-a376dfb7-c5955087.jpg,validate/p12/p12285052/s54188893/5b9f2c0e-aecfe211-9eaa290b-a376dfb7-c5955087.jpg,validation," WET READ: ___ ___ ___ 12:10 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with fever, tachycardia, R LLB ronchi // evaluate for fluid, pneumonia, PE. TECHNIQUE: Chest AP and lateral COMPARISON: Chest x-ray dated ___. FINDINGS: The cardiomediastinal silhouette is unchanged. There is no concerning focal consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 6c430ea8-dfd803c6-79271e22-517ebd13-92f18cae.jpg,validate/p11/p11415795/s57333772/6c430ea8-dfd803c6-79271e22-517ebd13-92f18cae.jpg,validation," FINAL REPORT HISTORY: Perforated appendicitis, here to evaluate for free air COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There are multiple median sternotomy wires and mediastinal clips consistent with prior coronary artery bypass graft surgery. The cardiomediastinal silhouette is stable. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The hilar contours are within normal limits. Aside from minimal bibasilar atelectasis, the lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no evidence of free air beneath the right hemidiaphragm. IMPRESSION: No evidence of free air beneath the diaphragms. No acute cardiopulmonary process. " 36e60d79-53a4543f-54ec7027-774fcd58-33fed9f9.jpg,validate/p17/p17651554/s50090538/36e60d79-53a4543f-54ec7027-774fcd58-33fed9f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF, diminished BS at the R base // please evaluate for pleural effusion, consolidation COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Previous moderately severe pulmonary edema has improved. Small right pleural effusion remains. Heart borderline enlarged unchanged. No pneumothorax. " 35f32c68-914160ac-d6d9f392-09a418cb-b444f96d.jpg,validate/p11/p11243888/s53474479/35f32c68-914160ac-d6d9f392-09a418cb-b444f96d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough // ? infiltrate COMPARISON: CT scan from ___ IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. Bony structures are intact. " 6aa9ffad-b0cf4e14-eea67f6d-2c065f6b-3ff07b14.jpg,validate/p18/p18408877/s54760215/6aa9ffad-b0cf4e14-eea67f6d-2c065f6b-3ff07b14.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with shortness of breath and cough, 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. Mild hyperinflation and flattening of the diaphragms are noted, consistent with chronic obstructive pulmonary disease. " 8c745a8b-4302c00f-136736fd-9a616b55-2791b781.jpg,validate/p15/p15005501/s51353768/8c745a8b-4302c00f-136736fd-9a616b55-2791b781.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hx of myeloma. Confusion with new neutropenia. Please further evaluation // ___ year old man with hx of myeloma. Confusion with new neutropenia. Please further evaluation TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Incidentally noted are bilateral cervical ribs. No acute osseous abnormality identified. IMPRESSION: No acute cardiopulmonary process. " 87f4f0f1-c147e6a1-35112ca3-7cb0644d-fe5d835d.jpg,validate/p12/p12876705/s55471940/87f4f0f1-c147e6a1-35112ca3-7cb0644d-fe5d835d.jpg,validation," FINAL REPORT INDICATION: Cough, dehydration, and presyncope. 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. " 2b65e96c-cf3d3935-c2ea0ef3-50de0535-2d51d3c0.jpg,validate/p12/p12982238/s50856389/2b65e96c-cf3d3935-c2ea0ef3-50de0535-2d51d3c0.jpg,validation," WET READ: ___ ___ ___ 3:47 PM No acute cardiopulmonary process. WET READ VERSION #___ ___ ___ ___ 3:29 PM No acute ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with chest pain // PTX? TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs ___ and ___. 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. " 0da6cc09-a7897581-3eb64402-21c59849-a9f6ba7f.jpg,validate/p16/p16564614/s50485222/0da6cc09-a7897581-3eb64402-21c59849-a9f6ba7f.jpg,validation," 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. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " c8913af9-734e331d-173b2e64-3bd029ab-fb2771ae.jpg,validate/p11/p11052935/s51137224/c8913af9-734e331d-173b2e64-3bd029ab-fb2771ae.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath and cough. Question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs appear hyperexpanded, in keeping with known emphysema. Previously seen left lower lobe opacity has resolved on the frontal view but may persist on lateral view obscuring the posterior costophrenic angle, which could represent a component of residual infection and/or atelectasis. There is trace basilar atelectasis on the right. There is no large effusion. Eventration is seen on the right, unchanged. IMPRESSION: Bibasilar dependent atelectasis. Persistent probable left lower lobe posterior opacity which could represent atelectasis or a component of residual infection, to be clinically correlated. Followup after treatment recommending to document resolution. " c9ed22cb-b8a7542b-ca5b7078-2b26bda5-720ac963.jpg,validate/p10/p10974611/s51048971/c9ed22cb-b8a7542b-ca5b7078-2b26bda5-720ac963.jpg,validation," FINAL REPORT INDICATION: ___M with ams, weakness // eval pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are clear without focal consolidation, edema, or effusion. Eventration of the right hemidiaphragm is noted. Cardiomediastinal silhouette is within normal limits noting a tortuous thoracic aorta with atherosclerotic calcifications at the arch. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 7110ca7b-eb7c6d9d-2e8973db-fefdce22-e879bafa.jpg,validate/p14/p14912272/s57562756/7110ca7b-eb7c6d9d-2e8973db-fefdce22-e879bafa.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with pleural effusion eval. COMPARISONS: Multiple prior radiographs, most recently from ___, CTA of the chest from ___. TECHNIQUE: PA and lateral chest radiographs are provided. Since the recent prior radiograph after thoracentesis on ___, there has been some re-accumulation of right pleural effusion as well as persistent moderate left pleural effusion. Again seen is the large right upper lobe mass with multiple nodules at the bases consistent with metastatic disease. Cardiomediastinal silhouette is stable with dense calcifications along the aorta. Bony structures are intact. IMPRESSION: Interval increase in moderate right pleural effusion after thoracentesis on ___. Stable moderate left pleural effusion. " 8dd5e393-48866d1e-afadd50d-365a7433-e69fe3f5.jpg,validate/p17/p17892707/s54555314/8dd5e393-48866d1e-afadd50d-365a7433-e69fe3f5.jpg,validation," WET READ: ___ ___ ___ 7:43 PM New moderate sized left pleural effusion with left base opacity, which could represent infection or atelectasis. ___ ___d/w Dr. ___ via phone ___ ___ at ___ pm ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: cough. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a newly-appeared left pleural effusion of moderate extent. In addition, a left basal opacity has newly occurred that could be infectious in origin. Unchanged appearance of the right lung, unchanged cardiac and mediastinal contours. At the time of observation a wet read was delivered. " 4eb14e38-a3a299e9-476fb00c-b5ec365a-c71da6a6.jpg,validate/p14/p14661372/s52957169/4eb14e38-a3a299e9-476fb00c-b5ec365a-c71da6a6.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with prolonged cough and right lower lobe crackles. COMPARISONS: ___ to ___. FINDINGS: The lungs are well inflated and clear. No focal consolidation, effusion, or pneumothorax is present. The cardiac and mediastinal contours are normal. IMPRESSION: Normal chest radiograph. Findings were discussed with Dr. ___ via telephone at ___ on ___. " c6b49ba0-7f1c2468-a7581d22-4e16a93c-d8eb7cf0.jpg,validate/p10/p10193071/s52890246/c6b49ba0-7f1c2468-a7581d22-4e16a93c-d8eb7cf0.jpg,validation," FINAL REPORT HISTORY: Abdominal pain status post colonoscopy, question free air. TECHNIQUE: AP portable upright view of the chest. COMPARISON: None. FINDINGS: There are relatively low lung volumes and likely bibasilar atelectasis. No definite focal consolidation is seen. There is no large pleural effusion or evidence of pneumothorax. The cardiac silhouette is top-normal. The aorta is slightly tortuous. There is gaseous distention of the partially imaged bowel, presumed related to recent colonoscopy. IMPRESSION: Low lung volumes. Gaseous distention of the partially imaged bowel. No evidence of free air. " 955cf3f3-9e3c3d79-f94eecba-0e894afb-d2601a30.jpg,validate/p18/p18947160/s53729842/955cf3f3-9e3c3d79-f94eecba-0e894afb-d2601a30.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old female with altered mental status. COMPARISON: None. FINDINGS: Portable frontal supine chest radiograph demonstrates left basilar opacity. There is linear atelectasis of the right lung base. Bilateral effusions are present, small on the right and moderate on the left. There is indistinctness of the pulmonary vasculature compatible with mild pulmonary edema. Heart size is enlarged, as is the main pulmonary artery. There is calcification of the aortic arch. IMPRESSION: 1. Left base consolidation, likely representing pneumonia in the appropriate clinical setting. There are small bilateral pleural effusions. Recommend dedicated upright view when clinically able to document resolution. The differential diagnosis includes an obstructive mass, or large pulmonary embolus. 2. Mild cardiac decompensation. Findings were discussed with Dr. ___ ___ the MICU at 8:50AM by phone. " 748d190b-b4ed2ef0-d63cae5f-88248746-363f9396.jpg,validate/p12/p12385889/s51759691/748d190b-b4ed2ef0-d63cae5f-88248746-363f9396.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with all sp allo and persistent fevers. Getting CT torso tomorrow, but needs premedication. Would like to eval with CXR tonight // Eval fever TECHNIQUE: AP portable chest radiograph COMPARISON: Multiple prior radiographs, most recently dated ___. CT scan of the neck dated ___ FINDINGS: No focal consolidation, pleural effusion or pneumothorax identified. There is minimal left basilar atelectasis. The size of the cardiac silhouette is within normal limits. There is prominence of the upper mediastinum which appears to be enlarged since ___ however represents abundant adipose tissue as seen on the CT scan of the neck dated ___. Interval removal of the right chest wall Port-A-Cath. IMPRESSION: No focal consolidation identified. Minimal left basilar atelectasis. Prominent upper mediastinum, which when compared to the CT scan of the neck dated ___ likely represents abundant adipose tissue. " bf6b8834-da331b7c-dc0c0355-ecd40557-6d106dda.jpg,validate/p16/p16387703/s52546682/bf6b8834-da331b7c-dc0c0355-ecd40557-6d106dda.jpg,validation," FINAL REPORT HISTORY: Chest pain. Evaluate mediastinum. COMPARISON: None available. FINDINGS: AP and lateral radiographs of the chest demonstrates clear lungs. The cardiac and mediastinal contours are normal. No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 52f47b22-3636c3af-39d80bdf-245577f1-f9c55302.jpg,validate/p18/p18906304/s52356217/52f47b22-3636c3af-39d80bdf-245577f1-f9c55302.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with fever, evaluate for pneumonia. COMPARISON: None Available. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: 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 radiographic evidence of pneumonia. " 3ded031f-ae26e5e2-16b3cb94-3cc86f18-33939ea1.jpg,validate/p13/p13163471/s52028801/3ded031f-ae26e5e2-16b3cb94-3cc86f18-33939ea1.jpg,validation," FINAL REPORT INDICATION: Tachycardia. Evaluate for pneumonia. COMPARISON: Multiple priors from ___. FINDINGS: AP chest radiograph ___ lung volumes. Aside from subsegmental atelectasis, the lungs are clear. There is no pleural effusion or pneumothorax. Top normal heart size is stable. " 831c37ed-2dd9c9a3-09efad98-17f92a93-ee960ee1.jpg,validate/p11/p11410945/s59653300/831c37ed-2dd9c9a3-09efad98-17f92a93-ee960ee1.jpg,validation," FINAL REPORT HISTORY: Latent TB. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Hyperexpansion of the lungs is again consistent with chronic changes. However, no evidence of old tuberculous disease or reactivation. " 01af706f-687dc4fe-12913e53-54368a18-ae12bfd2.jpg,validate/p11/p11137007/s50110635/01af706f-687dc4fe-12913e53-54368a18-ae12bfd2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with metasatic RCC with cough and low BP. // rule out pneumonia TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Multiple metastatic deposits have increased in the interim. Heart size and mediastinum are unchanged in position. There is interval development of bilateral pleural effusion, small, loculated. No focal consolidation to suggest pneumonia demonstrated. There is interval progression in the metastatic rib fracture with most likely presence of tissue component involving posterior lateral aspect of the left 8 rib. " 0dd0cbba-db7e8eca-137c362f-9e7b0a1d-f79167cd.jpg,validate/p13/p13648633/s58425023/0dd0cbba-db7e8eca-137c362f-9e7b0a1d-f79167cd.jpg,validation," FINAL REPORT HISTORY: PICC placement and possible worked up. TECHNIQUE: Portable frontal chest radiograph 3 views. COMPARISON: ___. FINDINGS: A right-sided PICC is in place terminating 2.3 cm caudal to the carina at the level of the lower SVC. A Dobbhoff tube is in place with the tip terminating at the mid portion of the ___ part of the duodenum. Other findings are not significantly changed with redemonstration of left basal atelectasis and unchanged right lung base opacities. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Right-sided PICC at the level of the low SVC. 2. Dobbhoff tube in the mid ___ portion of the duodenum. 3. Unchanged appearance of the lung parenchyma with a left base atelectasis and existing right lung base opacities which are likely to represent edema. " f9448f62-82b8cefe-9362c36d-cfc12ec2-583313b9.jpg,validate/p17/p17875843/s50996149/f9448f62-82b8cefe-9362c36d-cfc12ec2-583313b9.jpg,validation," 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. " ea51518b-f4ca5a5c-d82396e8-f0fc43fc-6d077961.jpg,validate/p17/p17875086/s51957231/ea51518b-f4ca5a5c-d82396e8-f0fc43fc-6d077961.jpg,validation," WET READ: ___ ___ ___ 8:42 AM The second of 2 films demonstrate tip of the NG-tube at the gastric body however the side port is likely above the GE junction and may be advanced for optimal positioning of the tube is use for feeding. Lungs are grossly clear. WET READ VERSION #1 ___ ___ 11:28 PM The second of 2 films demonstrate tip of the NG-tube at the gastric body however the side port is likely above the GE junction and may be advanced for optimal positioning of the tube is use for feeding. Lungs are grossly clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NG tube placement // NG tube position IMPRESSION: As compared to prior radiograph of 2 days earlier, nasogastric tube is been placed, with tip terminating in the upper stomach, and side port likely in close proximity to the GE junction. Exam is otherwise unchanged. " 91afc3e3-a250b8fe-8c0a4f25-82c520ab-117ed0f1.jpg,validate/p13/p13659261/s59673140/91afc3e3-a250b8fe-8c0a4f25-82c520ab-117ed0f1.jpg,validation," FINAL REPORT HISTORY: Pain over left chest and shoulder. TECHNIQUE: Upright AP view of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The lungs are clear. Pulmonary vascularity appears normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary process. " 3d57888b-2f354b82-a4205ccb-af5ff8d8-9a537688.jpg,validate/p19/p19931382/s52915650/3d57888b-2f354b82-a4205ccb-af5ff8d8-9a537688.jpg,validation," FINAL REPORT PORTABLE AP CHEST ON ___ AT 7:38 CLINICAL INDICATION: ___-year-old with alcohol abuse who now presents with chest pain and is diffusely wheezing. Comparison is made to the patient's prior study of ___ at 16:46. Portable semi-erect chest film dated ___ at 7:38 is submitted. IMPRESSION: 1. Lungs appear grossly clear and well inflated without evidence of pleural effusions, pulmonary edema or pneumothorax. Overall, cardiac and mediastinal contours are stable. No pneumothorax. Calcification of the aortic knob, consistent with atherosclerosis. " cd719c37-479b62a9-8e7c5b46-15f4c9c8-615ed3e0.jpg,validate/p13/p13894338/s58395531/cd719c37-479b62a9-8e7c5b46-15f4c9c8-615ed3e0.jpg,validation," FINAL REPORT EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old woman status post tracheobronchoplasty. Evaluate for interval change. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Bilateral silicone breast implants are noted. Right humeral hardware is partially imaged. Interval resolution of bilateral pleural effusions. Lung volumes are now normal. Cardiomediastinal and hilar contours are normal. There is no pneumothorax. Stable right apical pleural thickening. IMPRESSION: Interval resolution of small, bilateral pleural effusions. " 303c3ca1-d5d4dfde-5fcb3494-95447d38-5bd62785.jpg,validate/p13/p13718764/s56650654/303c3ca1-d5d4dfde-5fcb3494-95447d38-5bd62785.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with CHF, recent shortness of breath. Evaluate for pneumonia. TECHNIQUE: AP and lateral views of the chest were obtained. COMPARISON: Chest x-ray from ___ FINDINGS: The lungs are well inflated and clear. Moderate cardiomegaly is unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Moderate cardiomegaly. " 2671a3ff-5ed21716-5ca5f026-ce798c3f-8a251b44.jpg,validate/p16/p16743731/s58778955/2671a3ff-5ed21716-5ca5f026-ce798c3f-8a251b44.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with tachycardia and fever. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Left IJ central venous catheter is no longer seen. The lateral demonstrates small to moderate size bilateral effusions. The lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Small-moderate bilateral pleural effusions. " fd98d34d-f3575188-2644948c-507b371d-d5fa924c.jpg,validate/p19/p19623096/s53348954/fd98d34d-f3575188-2644948c-507b371d-d5fa924c.jpg,validation," FINAL REPORT FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Fever and tachycardia. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " 99ebc9e6-6601e401-885a2f13-097d626a-679e9e2d.jpg,validate/p11/p11087814/s56853223/99ebc9e6-6601e401-885a2f13-097d626a-679e9e2d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old female with increased frequency of seizures and sick contacts at daycare. 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. " 5fd082e8-55b5d2ad-f61bfd8d-9f6f7067-bccb5eb3.jpg,validate/p18/p18663902/s56536382/5fd082e8-55b5d2ad-f61bfd8d-9f6f7067-bccb5eb3.jpg,validation," FINAL REPORT HISTORY: New NG tube. COMPARISON: ___. FINDINGS: NG tube tip is at the gastroesophageal junction. This needs to be advanced. The ET tube and right-sided PICC line are unchanged. There is pulmonary vascular redistribution and ill definition of the vasculature with moderate pleural effusions left greater than right and dense retrocardiac opacity. IMPRESSION: 1. NG tube too high. 2. Worsened fluid status. " ee6f1fdb-1fd22b50-27087ecf-b4967b4d-5f0ed6f8.jpg,validate/p18/p18861496/s53468263/ee6f1fdb-1fd22b50-27087ecf-b4967b4d-5f0ed6f8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pna and volume overload starting cvvh, he possibly aspirated as well // improving or worsening lung findings? COMPARISON: Chest radiographs ___. IMPRESSION: Moderately severe pulmonary edema and a moderate cardiomegaly on ___ have improved gradually over the past 3 days. Also improved is previously severe left upper lobe consolidation, presumably resolving pneumonia. ET tube, left and right internal jugular line ends and an esophageal tube are in standard placements. No pneumothorax. " fede8ca8-5ed20569-69c07bd9-ad0cf7d7-2806248c.jpg,validate/p14/p14285126/s51365364/fede8ca8-5ed20569-69c07bd9-ad0cf7d7-2806248c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with failure to thrive, endorses paroxysmal dyspnea, history of lung/esophageal cancer TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest CT ___, chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The aorta demonstrates diffuse atherosclerotic calcifications and mild tortuosity. The patient is status post esophagectomy and gastric pull-through with similar appearance of the mediastinal and hilar contours. Fiducial marker is noted within a right apical lesion with surrounding opacity compatible with post treatment changes, better assessed on the prior CT and grossly unchanged. Lungs remain hyperinflated without new focal consolidation, pleural effusion or pneumothorax identified. Hypertrophic changes are noted in the thoracic spine. Post thoracotomy changes of the right rib cage are again noted along with remote left-sided rib fractures. IMPRESSION: No substantial interval change from recent chest CT. Opacity about a fiducial marker in the right apex likely reflects post treatment changes. Status post esophagectomy and gastric pull-through. No new focal consolidation. " 303619c3-e072a47f-56a88f0f-dc4c8be4-05042c29.jpg,validate/p14/p14948491/s57895527/303619c3-e072a47f-56a88f0f-dc4c8be4-05042c29.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of smoking, no respiratory symptoms, rule out mass. COMPARISON: No comparison available at the time of dictation. FINDINGS: Left pectoral pacemaker, correct single lead positioned in the right ventricle. The lung volumes are normal. No evidence of parenchymal abnormalities, in particular no evidence of nodules or masses. No pleural effusions. No pulmonary edema. No pneumonia. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. Normal hilar and mediastinal structures. " 26a801b5-2fe7553e-103d6714-505f29bd-49fff55a.jpg,validate/p11/p11303447/s51361702/26a801b5-2fe7553e-103d6714-505f29bd-49fff55a.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST PA AND LATERAL. INDICATION: ___-year-old male patient with left-sided chest pain, probably chest wall pain, nonsmoker, evaluate for lung lesion. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No configurational abnormality is present. Unremarkable appearance of thoracic aorta for age. No local contour abnormalities are present. 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. 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 cardiovascular or pulmonary abnormalities in this nonsmoker, atypical chest pain. " efadfffb-390eeca5-67bc68bf-7b9d012d-80ea3d07.jpg,validate/p14/p14186178/s55785168/efadfffb-390eeca5-67bc68bf-7b9d012d-80ea3d07.jpg,validation," WET READ: ___ ___ ___ 11:36 PM Right IJ tip is difficult to visualize on this exam. An exam with better inspiration is recommended. ______________________________________________________________________________ FINAL REPORT INDICATION: History of nausea and elevated lactate. Please evaluate for interval line placement. COMPARISONS: Multiple prior chest radiographs dated back to ___. TECHNIQUE: AP upright portable radiograph of the chest. FINDINGS: This is a very limited exam due to low lung volumes and obscuration of the apices by the patient's chin. There is a right-sided IJ whose tip is difficult to definitively visualize. Aside from bilateral atelectasis, the small visualized portion of the upper-to-mid lungs is unremarkable. No definite pneumothorax is identified. The visualized osseous structures are unremarkable. IMPRESSION: Right IJ tip is difficult to visualize on this exam. An exam with better inspiration is recommended. " 3a77e6e3-086984f1-4c01ff14-7f4289d0-86b675f2.jpg,validate/p18/p18325837/s55472341/3a77e6e3-086984f1-4c01ff14-7f4289d0-86b675f2.jpg,validation," FINAL REPORT HISTORY: COPD and new dyspnea on exertion with cough. Evaluate for pneumonia or a mass. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___ 122,010. FINDINGS: The lungs are hyperinflated, consistent with chronic obstructive pulmonary disease. There is streaky atelectasis seen at the left lung base. Otherwise, there is no focal consolidation concerning for pneumonia. There is no pleural effusion or pneumothorax. The pulmonary nodules seen on the CT abdomen and pelvis from ___ are too small to be seen on this study. There is a moderate size hiatal hernia. The cardiac and mediastinal contours are unchanged. A questionable subtle opacity is noted but appears unchanged from at least ___. IMPRESSION: 1. Changes from chronic lung disease without an acute cardiopulmonary process. 2. Questionable opacity seen in the right lung apex, best appreciated on the lateral view, is unchanged from at least ___. If needed, further evaluation can be performed with an apical lordotic view. These findings were discussed with Dr. ___ by Dr. ___ at ___ on ___ by telephone at the time of interpretation. " 91c3213e-ae7cafdf-2788b2af-48e404ba-df23415f.jpg,validate/p10/p10138917/s50300111/91c3213e-ae7cafdf-2788b2af-48e404ba-df23415f.jpg,validation," FINAL REPORT INDICATION: ___-year-old status post left lower lobectomy and shortness of breath, please evaluate for pneumonia. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___ and CT of the chest from ___. FINDINGS: Numerous large bilateral pulmonary metastases are seen from patient's known history of lung cancer, significantly progressed since ___. There is no definite evidence of pneumonia. No pneumothorax. Surgical clips are seen at the site of the left lower lobectomy. IMPRESSION: Extensive metastatic disease to the lungs. " 3a4af952-d0a243fe-fdc477a8-6ecaf7a9-7fe86fff.jpg,validate/p10/p10791554/s56805619/3a4af952-d0a243fe-fdc477a8-6ecaf7a9-7fe86fff.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman, status post fall with lesions concerning for metastases on head CT. Evaluate for infection or malignancy. COMPARISON: ___. FINDINGS: Frontal AP and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding and bibasilar atelectasis. There is no focal consolidation, pleural effusion, or pneumothorax. No nodule or mass is seen. Cardiac and mediastinal silhouettes and hilar contours with aortic knob calcifications are unchanged. No acute osseous abnormality is identified. IMPRESSION: No acute intrathoracic process. No nodule or mass seen. Bibasilar atelectasis. " 7375eb08-7b4a39e3-d7579260-b928fa62-ee1a0c08.jpg,validate/p11/p11465959/s56102683/7375eb08-7b4a39e3-d7579260-b928fa62-ee1a0c08.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with massive right lower extremity DVT and no pulmonary symptoms TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are hyperinflated. No focal consolidation, pleural effusion or pneumothorax is present. No pulmonary vascular congestion is present. Remote right-sided rib fractures are identified. IMPRESSION: No acute cardiopulmonary abnormality. " cafa3b9e-e5c38efa-0f8dc211-bbe8334e-248d797e.jpg,validate/p11/p11356821/s55092352/cafa3b9e-e5c38efa-0f8dc211-bbe8334e-248d797e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // r/o pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen peer No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Dual lead left-sided pacemaker is again seen with leads in the expected positions of the right atrium and right ventricle. IMPRESSION: No acute cardiopulmonary process. ___, MD ___=___ CC: DR. ___ " 95c1a8b1-72edbd40-967bb8f4-2de65758-a3871523.jpg,validate/p10/p10522132/s53836310/95c1a8b1-72edbd40-967bb8f4-2de65758-a3871523.jpg,validation," FINAL REPORT INDICATION: ___M with weeks of cough // r/o pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified IMPRESSION: No acute cardiopulmonary process. " a30ec8ce-61ab164e-305ff68a-a583ff23-dac663a4.jpg,validate/p12/p12990371/s57040987/a30ec8ce-61ab164e-305ff68a-a583ff23-dac663a4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old male with history of fever, assess pneumonia. FINDINGS: AP upright and lateral views of the chest were obtained. A dual-lead pacer is unchanged with proximal and distal leads positioned in the expected location of the right atrium and right ventricle. There is stable elevation of the left hemidiaphragm with mild left basilar plate-like atelectasis. No definite sign of pneumonia, CHF, pleural effusion. Heart size appears stable with an unfolded thoracic aorta noted. Bony structures are intact. IMPRESSION: No acute findings in the chest. " c26d94bc-baa20d12-1f1c411c-bd24af65-a67b2a95.jpg,validate/p13/p13225955/s54650130/c26d94bc-baa20d12-1f1c411c-bd24af65-a67b2a95.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with stage 5 CKD d/t HTN and DM, presented with worsening fatigue and urinary retention. // r/o pulmonary edema, signs of infection. r/o pulmonary edema, signs of infection. IMPRESSION: As compared to ___, there is unchanged evidence of bilateral small pleural effusions and subsequent areas of atelectasis. Moderate cardiomegaly persists. Very low lung volumes with mild fluid overload but no overt pulmonary edema. No evidence of pneumonia. " 59c0c8f9-60c5ba27-ac7560af-1a754c95-49bb5c13.jpg,validate/p17/p17933869/s50372466/59c0c8f9-60c5ba27-ac7560af-1a754c95-49bb5c13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with abnormal EKG // eval for pna or cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. Minimal atherosclerotic calcification is noted at the aortic knob. 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. " 5365b5de-9f08e128-ee4dffd4-6a849183-35bf1fc5.jpg,validate/p19/p19197903/s51197065/5365b5de-9f08e128-ee4dffd4-6a849183-35bf1fc5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of idiopathic lung fibrosis, new opacity seen on previous chest film. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a substantial decrease in extent of the pre-existing left lower lobe opacity. Remnant opacities are seen only in the peribronchial lung areas. No other changes. No progression of fibrosis. No newly appeared lung parenchymal changes. Unchanged size of the cardiac silhouette. " 631691ab-3e640fe5-7bf7dd36-21cc9eca-3c6a1ecf.jpg,validate/p11/p11607177/s57564278/631691ab-3e640fe5-7bf7dd36-21cc9eca-3c6a1ecf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiogenic shock // pulmonary edema, effusions IMPRESSION: Stable cardiomegaly accompanied by mild pulmonary vascular congestion without overt pulmonary edema. Swan-Ganz catheter remains in the distal position within the right lower lobe pulmonary vasculature and could be withdrawn approximately 6 cm for more optimal positioning in the more central pulmonary vasculature. " c3af66ca-1f200b42-00b88150-22ef7411-700ce445.jpg,validate/p14/p14226067/s56381827/c3af66ca-1f200b42-00b88150-22ef7411-700ce445.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chronic cough. Cardiomediastinal contours are normal. There are minimal bibasilar atelectasis, right greater than left; otherwise, the lungs are clear. There is no pleural effusion. Osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " e52e5e11-05beaf9d-fbd78621-290fa8e9-9015fded.jpg,validate/p17/p17217213/s58217551/e52e5e11-05beaf9d-fbd78621-290fa8e9-9015fded.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with fall and head strike and shortness of breath TECHNIQUE: UPRIGHT AP AND LATERAL VIEWS OF THE CHEST COMPARISON: ___ FINDINGS: Lung volumes are low. The cardiac, mediastinal and hilar contours remain unchanged. Bronchovascular structures are crowded without overt pulmonary edema. Streaky opacities in the left lung base likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. Multilevel degenerative changes are re- demonstrated in the imaged thoracic spine. IMPRESSION: Streaky opacity in the left lung base, likely atelectasis. Infection cannot be completely excluded in the correct clinical setting. " 16116c5c-e308dbac-db68f7a1-3a386859-d7835bcd.jpg,validate/p13/p13163471/s55147832/16116c5c-e308dbac-db68f7a1-3a386859-d7835bcd.jpg,validation," FINAL REPORT AP CHEST, 11:00 A.M., ___ HISTORY: ___-year-old man with hypoxemia, new white count. IMPRESSION: AP chest compared to ___ through ___: Pulmonary vascular congestion, moderate cardiomegaly, and mediastinal venous engorgement are all worse today than on ___, although there is no pulmonary edema. In the left mid lung, there is either a confluence of dilated vasculature or new small area of peribronchial infiltration, but this is the only finding of a possible pneumonia. Left subclavian line ends in the left brachiocephalic vein. No pneumothorax or appreciable pleural effusion. " 888dae1c-a65cf3cc-d5ea94e9-385b4980-c09d4141.jpg,validate/p13/p13956237/s57441459/888dae1c-a65cf3cc-d5ea94e9-385b4980-c09d4141.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain. COMPARISON: ___. FINDINGS: Single portable view of the chest. The lungs are clear of consolidation, right effusion or pulmonary edema. Cardiomediastinal silhouette is stable as are the osseous structures. IMPRESSION: No acute cardiopulmonary process. " cbbe357f-34a122c2-38ff3e0a-642ca12f-402273cb.jpg,validate/p15/p15680450/s58722816/cbbe357f-34a122c2-38ff3e0a-642ca12f-402273cb.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY COMPARISON: ___ chest x-ray. FINDINGS: Left lower lobe opacity has nearly resolved with only a small residual linear opacity remaining adjacent to the periphery of the left hemidiaphragm. Minimal area of linear atelectasis versus scarring is also present at the medial aspect of the right lung base with a similar appearance on older radiograph of ___. The heart is normal in size, and the aorta is mildly tortuous without change. No pleural effusion or concerning skeletal findings. IMPRESSION: Near resolution of left lower lobe opacity which may reflect response of clinically diagnosed pneumonia to antibiotic therapy. Small residual focus of atelectasis or scar. " 75e660e9-485bc0ab-0bfc1db7-c6a0f191-58c860d9.jpg,validate/p13/p13714286/s56661422/75e660e9-485bc0ab-0bfc1db7-c6a0f191-58c860d9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with likely alcoholic cirrhosis, cellulitis and MSSA bacteremia now with tachypenia // eval ? pna, effusion TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: The heart is moderately enlarged and there is pulmonary vascular redistribution and increased interstitial markings and hazy alveolar infiltrate in the lower lungs. There small bilateral effusions. There is dense retrocardiac opacity consistent volume loss/infiltrate/effusion. There is also increased opacity in the right lower lobe consistent with volume loss/infiltrate. IMPRESSION: Fluid overload. An underlying infectious infiltrate can't be excluded " 9645a6ff-dc16e95d-dc52b036-a68efba0-df3d654e.jpg,validate/p11/p11967908/s56241790/9645a6ff-dc16e95d-dc52b036-a68efba0-df3d654e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Bilateral pleural effusions after right chest tube placement. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained on ___ at 7:57 p.m. Since the prior study, there has been no substantial change in the appearance of the right pleural catheter. There is no definitive evidence of pneumothorax. Appearance of the lungs is unchanged as well as the right apical scarring and substantial sclerosis of the right clavicle. " c74758b8-e1cba60f-ac8ce8d1-b96e78c1-b73f4fac.jpg,validate/p12/p12049932/s59729878/c74758b8-e1cba60f-ac8ce8d1-b96e78c1-b73f4fac.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: IV drug use, MRSA bacteremia and dyspnea. COMPARISON: ___. FINDINGS: There has been interval removal of a right internal jugular central venous catheter, left PICC, endotracheal tube and enteric tube. There has been interval reduction in large area of opacification projecting over the right lung with scattered patchy opacities remaining on the right and to a lesser extent on the left. There is blunting of the right costophrenic angle and a small right pleural effusion is present. No definite overt pulmonary edema is seen. The cardiac and mediastinal silhouettes are unremarkable, although there is slight prominence of the hila which may be due to underlying adenopathy. IMPRESSION: Interval decrease in pulmonary opacities as compared to the prior study with persistent scattered patchy opacities in the lungs, right side greater than left, worrisome for multifocal infection. Small right pleural effusion. " e885fef0-59aa1128-ae33eff2-34bf7d29-e8366590.jpg,validate/p19/p19840128/s51396348/e885fef0-59aa1128-ae33eff2-34bf7d29-e8366590.jpg,validation," WET READ: ___ ___ ___ 8:36 PM Decreased small left pleural effusion compared to ___. Increased retrocardiac density with silhouetting of the left hemidiaphragm, which may represent atelectasis or consolidation. Right paratracheal opacity is small and non-specific; this could represent atelectasis, but attention on follow-up is recommended. This study is not sensitive for acute rib pathology. If there is high clinical suspicion, dedicated rib series or CT is recommended. Discussed with ___ by phone at 8:35 p.m. on ___ at time of initial review. ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with left-sided rib pain. Evaluate for rib fractures or new consolidation of the left lower lobe. FINDINGS: There is cardiomegaly. There is a left retrocadiac opacity. There is a left-sided pleural effusion which appears relatively stable. There is some coarsening of bronchovascular markings without overt pulmonary edema. Study is of limited sensitivity for evaluation of rib fractures; however, no definite rib fractures are seen. There is some demineralization. If there is high concern for rib fracture, dedicated rib series could be performed. " a7c49bee-9a33d58f-03d771d1-c0f06322-b4c27cef.jpg,validate/p18/p18649193/s52465133/a7c49bee-9a33d58f-03d771d1-c0f06322-b4c27cef.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Metastatic renal cancer with seizures, assess for infection. Cardiac size is normal. The aorta is tortuous. Opacity projecting in one of the lower lobes, seen in the lateral view, is worrisome for pneumonia given the clinical symptoms. Patient has known lung nodules, better seen in prior CT. Opacity anterior to the left major fissure, seen in the lateral view, could be due to atelectasis or other area of infection. There is no pneumothorax or pleural effusion. Moderate degenerative changes are in the thoracic spine. IMPRESSION: Pneumonia. Lung nodules are better seen in prior CT. " 80363dab-22d79e29-ffd49e75-f70b0091-6ac0c51f.jpg,validate/p17/p17995051/s59268016/80363dab-22d79e29-ffd49e75-f70b0091-6ac0c51f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx of EtOH abuse presents with left hemiparesis, found to have right MCA/ACA stroke. // please evaluate for pulmonary edema, tube positions, interval change . IMPRESSION: As compared to the previous image, the endotracheal tube has been slightly advanced. The tube now projects 6.5 cm above the carina. Retrocardiac atelectasis persists. No new focal parenchymal opacities. No larger pleural effusions. Borderline size of the cardiac silhouette. " 3bc75c1f-d95138a6-1cd514aa-8075b5fc-4425ef16.jpg,validate/p10/p10108435/s50530072/3bc75c1f-d95138a6-1cd514aa-8075b5fc-4425ef16.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with weight gain, leg swelling, DOE, CP // Eval for acute process, attn to CHF TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Battery pack overlies the left mid chest. Mild pulmonary vascular congestion appears slightly worse compared to the prior study. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Mild pulmonary vascular congestion, slightly worse compared to the prior study. " 60457a9f-50e47998-45c26be1-1c844e2f-09e4ec96.jpg,validate/p18/p18588429/s56955478/60457a9f-50e47998-45c26be1-1c844e2f-09e4ec96.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new BiVICD implant // evaluate for pneumothorax and lead placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received a triple lead pacemaker. All leads are in correct position. No evidence of pneumothorax or other complication. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. " 515c1d97-d045210f-0fe2f6a9-4a9777c7-15f39f71.jpg,validate/p17/p17575265/s54438154/515c1d97-d045210f-0fe2f6a9-4a9777c7-15f39f71.jpg,validation," FINAL REPORT AP CHEST, 5:32 A.M. ON ___ HISTORY: A ___-year-old man with pulmonary contusion. IMPRESSION: AP chest compared to ___: The upper lobe components of pulmonary contusion have improved minimally since ___, basal consolidation in the left lung is more pronounced. This could represent more active bleeding, atelectasis or pneumonia. Careful followup advised. Right lung is grossly clear. Heart size is normal. Gastric distension is probable explanation for a dilated viscus partially imaged in the upper abdomen. Dr. ___ was paged at 9:10 a.m. to discuss these findings. " a0a3836a-35d94e90-e07f18fa-da9dc669-b01907d1.jpg,validate/p18/p18062541/s52978247/a0a3836a-35d94e90-e07f18fa-da9dc669-b01907d1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with shortness of breath // pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: 2 lead left-sided pacer device is seen with leads in expected positions of the right atrium and right ventricle. The cardiac silhouette is mild to moderately enlarged. The aorta remains calcified. There may be minimal vascular congestion without overt pulmonary edema. Small left-sided Bochdalek hernia may be present. IMPRESSION: Persistent mild to moderate enlargement of the cardiac silhouette. Possible minimal vascular congestion without overt pulmonary edema. " 36089a05-f33b6f16-b5062f18-2e207cba-b220f605.jpg,validate/p19/p19650702/s55037828/36089a05-f33b6f16-b5062f18-2e207cba-b220f605.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tracheoplasty // perform at 5am on ___. r/o interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomegaly is stable. Widening of the mediastinum has improved. Bilateral multifocal atelectasis have improved. There is no pneumothorax. Right pleural effusion is small. There are low lung volumes. The aorta is tortuous IMPRESSION: Improved multifocal atelectasis. Small right effusion. " 27ff4127-362b6c5a-83ba349e-e55df613-0b90d74a.jpg,validate/p15/p15923118/s57573285/27ff4127-362b6c5a-83ba349e-e55df613-0b90d74a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with AML in remission. Now with cough and slight increase in WBC // h/o AML. Cough with slight increase in WBC h/o AML. Cough with slight increase in WBC IMPRESSION: Comparison to ___. New parenchymal opacity at the bases of the left lung, seen on both the frontal and the lateral radiograph. In the appropriate clinical setting, this opacity reflects pneumonia. Unchanged moderate cardiomegaly. No pulmonary edema. Unchanged normal alignment of the sternal wires. " b398fe42-6bafd613-9d75abcb-6fb50d54-e19d206b.jpg,validate/p16/p16883063/s53460397/b398fe42-6bafd613-9d75abcb-6fb50d54-e19d206b.jpg,validation," 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. " ea10bae8-fe6ea216-deaec37d-1d393d79-06035a98.jpg,validate/p17/p17776806/s52258474/ea10bae8-fe6ea216-deaec37d-1d393d79-06035a98.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is unchanged in size, mildly enlarged, and the mediastinal and hilar contours are also stable. IMPRESSION: No acute cardiopulmonary process. Mild enlargement of the cardiac silhouette. " 4f6524c8-e4ea1dbe-c3e73ee8-ebeba751-97bd7d41.jpg,validate/p11/p11268251/s58457970/4f6524c8-e4ea1dbe-c3e73ee8-ebeba751-97bd7d41.jpg,validation," 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. " ad69d7d7-fb1e6694-9eaefd84-a6e96336-1d7bca07.jpg,validate/p13/p13774492/s57190437/ad69d7d7-fb1e6694-9eaefd84-a6e96336-1d7bca07.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe COPD and asthma with acute worsening of respiratory status // Please eval for acute cause of dyspnea TECHNIQUE: Portable chest COMPARISON: ___ set. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. No new infiltrate " 39ef7879-f3d48548-5a502789-64ab2932-5ebc35fb.jpg,validate/p18/p18699523/s57053508/39ef7879-f3d48548-5a502789-64ab2932-5ebc35fb.jpg,validation," FINAL REPORT HISTORY: ___F with abdominal pain s/p endoscopy. Evaluate for mediastinal air. 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. No evidence of pneumomediastinum. IMPRESSION: Unremarkable chest radiographic examination. " 8b586388-33154a0e-1f4a6602-bbaacf06-d38cf9cf.jpg,validate/p18/p18708817/s54735856/8b586388-33154a0e-1f4a6602-bbaacf06-d38cf9cf.jpg,validation," FINAL REPORT HISTORY: New PE and possible pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. Again there is huge enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure, a discordancy that suggests cardiomyopathy or possibly even pericardial effusion. Left hemidiaphragm is not seen, consistent with substantial volume loss in the left lower lobe with a small pleural effusion. Area of asymmetric opacification in the left perihilar region could be related to areas of ischemia related to the subsegmental pulmonary emboli seen on the CT scan of ___, or aspiration or infectious pneumonia. " ac4649b9-5330eca3-85663e97-6d3824e1-790a4fb4.jpg,validate/p10/p10887773/s53149712/ac4649b9-5330eca3-85663e97-6d3824e1-790a4fb4.jpg,validation," FINAL REPORT INDICATION: ___F with altered mental status. // eval for acute process TECHNIQUE: AP and lateral views of the chest. COMPARISON: Exam performed at___ earlier the same day. FINDINGS: The lungs are grossly clear. Lateral view is limited due to the low lung volumes. No effusion is identified. There is moderate cardiomegaly and atherosclerotic calcifications of the aortic arch. No acute osseous abnormalities identified. IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process. " c1754751-2b1dca49-9a29ecb0-d33fb433-ec3bc28b.jpg,validate/p14/p14690687/s51287286/c1754751-2b1dca49-9a29ecb0-d33fb433-ec3bc28b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, shortness of breath. FINDINGS: PA and lateral views of the chest provided demonstrate midline sternotomy wires and mediastinal clips. There is a left chest wall AICD with lead tip extending to the level of the right ventricle. The heart is mildly enlarged. There is mild pulmonary edema. No large effusion. Stable scarring at the right lateral lung base. Bony structures are intact. IMPRESSION: Mild pulmonary edema. Mild cardiomegaly. " d7ab1507-7bcc29b5-087b00a7-94403aec-421a431c.jpg,validate/p15/p15193875/s57696114/d7ab1507-7bcc29b5-087b00a7-94403aec-421a431c.jpg,validation," FINAL REPORT INDICATION: Hypertension. Evaluate for acute pathology. TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: A right-sided Port-A-Cath is present with the tip in the low SVC. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Again noted are healing left rib fractures. IMPRESSION: No acute cardiopulmonary process. " 7dc6bdfe-caafe3b4-356245f7-a5111cb5-39b3e8fe.jpg,validate/p17/p17165725/s51625401/7dc6bdfe-caafe3b4-356245f7-a5111cb5-39b3e8fe.jpg,validation," FINAL REPORT HISTORY: CKD, empyema, chest tube on right. CHEST, SINGLE AP PORTABLE VIEW. The right-sided chest tube is in place, at the lung base, lying lateral to the vertical midline of the right lung. A small right effusion is present, similar, possibly slightly increased, compared with ___ at 3:27 a.m. Otherwise, no significant interval change is detected. Again seen is marked cardiomegaly. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF, likely accentuated by low lung volumes. Possible small left effusion. Patchy and somewhat alveolar opacity at both bases noted, consistent with lower lobe collapse and/or consolidation. The possibility of an associated pneumonic infiltrate cannot be excluded. Right dual-lumen catheter present, with both tips over right atrium. The appearance remains grossly similar to films dated ___ at 3:36 a.m. " a9c5cffc-6bade455-3bf76502-8428b378-ff360344.jpg,validate/p12/p12776606/s52849407/a9c5cffc-6bade455-3bf76502-8428b378-ff360344.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with trauma, left rib tenderness ___th ribs, bony tenderness to c-spine 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. In particular, there is no displaced rib fracture identified. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " f33f9009-dd55274d-0e345087-24285487-d0764e79.jpg,validate/p10/p10073646/s54852967/f33f9009-dd55274d-0e345087-24285487-d0764e79.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with influenza and HCAP. // eval for interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pre-existing left-sided opacity is minimally improved. The opacities at both the left and the right lung basis are constant in appearance. No new all rib fractures. Moderate cardiomegaly with minimal fluid overload persists. Unchanged minimal pleural effusions. . " fc7c0401-76793b97-8ca87fd3-bf73a15d-6fa2b793.jpg,validate/p10/p10705688/s52276875/fc7c0401-76793b97-8ca87fd3-bf73a15d-6fa2b793.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Cough x 3 days, assess pneumonia or nodule. FINDINGS: PA and lateral views of the chest were provided. Lungs are clear and well inflated. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: Normal chest radiograph. " 9fc2a56d-a676dcd9-83cff933-72e23af0-6113527a.jpg,validate/p17/p17569377/s53718743/9fc2a56d-a676dcd9-83cff933-72e23af0-6113527a.jpg,validation," FINAL REPORT HISTORY: Recent esophageal stent placed, now anorexic. Evaluate stent placement and position. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are unchanged from prior study. Again seen is an esophageal stent which appears unchanged in position from prior examination. Visualization is also made of a tracheo-bronchial stent which also appears patent and unchanged in position. Compared to prior study, there is new consolidation of the left lung base which may be atelectatic, however, infection in the correct clinical circumstance cannot be excluded. There is redemonstration of a roughly 3 cm mass in the right lung apex with apparent area of internal cavitation, unchanged from prior study. A left-sided infusion port remains unchanged in position. The osseous structures are grossly unremarkable. IMPRESSION: 1. New left lung base consolidation which is likely atelectatic, however, infection cannot be excluded given the correct clinical circumstance. 2. Esophageal stent and the tracheobronchial stent unchanged in position appearing grossly patent. 3. Unchanged appearance of likely a cavitary mass in the right lung apex. " 902b7ee8-7855df84-04c456db-192f3878-b0015421.jpg,validate/p16/p16156625/s51143847/902b7ee8-7855df84-04c456db-192f3878-b0015421.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with dyspnea on exertion, L leg swelling x3 days, evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: In comparison to the prior study, there is little interval change in markedly enlarged cardiac silhouette. No definite vascular congestion. There is no focal consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: Stable massively enlarged cardiac silhouette, concerning for cardiomyopathy. " 076278d1-0714e1dc-0fd5523f-1267c5db-63bea8aa.jpg,validate/p14/p14338126/s55649021/076278d1-0714e1dc-0fd5523f-1267c5db-63bea8aa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with history cardiomyopathy, presents with shortness of breath, leg swelling // eval for pulmonary edema TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size remains top normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Linear and patchy atelectasis is demonstrated in both lung bases. There is mild blunting of the left costophrenic angle, as seen on the previous examination, which likely reflects pleural thickening. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is seen. IMPRESSION: Bibasilar atelectasis. No evidence for pulmonary edema. " 794db0e5-4213d9ae-11033fda-7bba9ac5-870be8c9.jpg,validate/p17/p17963938/s58214063/794db0e5-4213d9ae-11033fda-7bba9ac5-870be8c9.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Chest radiograph: ___. FINDINGS: Indwelling support and monitoring devices remain in place, including a left chest tube and left pigtail pleural catheter. There has been apparent slight change in position of the left pigtail pleural catheter including the extrapleural component projecting lateral to the lower left ribs. A moderate left pneumothorax is present with both apical and basilar components. Although the apical component is unchanged, the basilar component appears more prominent than on the prior study. Cardiomediastinal contours are stable in appearance. Multifocal abnormalities throughout the right lung have slightly worsened, and a confluent opacity at the left base is also worse in the interval. These findings likely represent progressive multifocal pneumonia, although co-existing atelectasis is also evident in the right lower lobe. Right-sided loculated pleural fluid and/or thickening appears unchanged. Finally, note is made of a right PICC, terminating within the right subclavian vein just beyond the junction with the right axillary vein. IMPRESSION: Worsening multifocal pneumonia, with coexistent atelectasis in the right lower lobe. Moderate left pneumothorax, with increased prominence of basilar component. " e80035ef-3979590d-24d773b6-5c0ac412-c71196c6.jpg,validate/p17/p17119812/s53544167/e80035ef-3979590d-24d773b6-5c0ac412-c71196c6.jpg,validation," FINAL REPORT INDICATION: ___F with fever, cough, sputum, dyspnea 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. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are within normal limits. Osseous structures demonstrate no acute abnormality. IMPRESSION: No evidence of pneumonia. " 91a45e29-dec09d3b-67e76f7f-bc7db2da-2a8e4e9f.jpg,validate/p14/p14584470/s53373452/91a45e29-dec09d3b-67e76f7f-bc7db2da-2a8e4e9f.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Congestive heart failure. COMPARISONS: Prior radiographs from ___ and ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A right internal jugular venous catheter has been removed. The patient is status post apparently mitral valve replacement. The heart is moderately enlarged. The mediastinal and hilar contours are similar. There is persistent fluid in the minor fissure, but somewhat decreased. A small quantity of fluid is similar in the right major fissure. However, there is a new suspected small pleural effusion on the left with patchy associated basilar opacity and there is also increased opacification at the right lung base. There is no overt congestive heart failure. There is no pneumothorax. Bony structures are unremarkable. IMPRESSION: New bibasilar opacification with a small new left-sided pleural effusion. These findings are not specific and could be seen with atelectasis but developing pulmonary infection is not excluded. " f0ab25d8-6846a77e-25dfe18f-3ccd6e59-a2174e35.jpg,validate/p11/p11005665/s53613316/f0ab25d8-6846a77e-25dfe18f-3ccd6e59-a2174e35.jpg,validation," WET READ: ___ ___ 9:57 AM No evidence of pneumothorax. Opacification of the left hemi thorax is minimally improved from the most recent prior study done at 09:19 and closer appearing to the study done on ___ at 14:48. No other significant change. WET READ VERSION #___ ___ ___ ___ 10:17 PM No evidence of pneumothorax. Opacification of the left hemi thorax is minimally improved from the most recent prior study done at 09:19 and closer appearing to the study done on ___ at 14:48. No other significant change. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left lower lung collapse // eval after bronchoscopy COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the ventilation of the postsurgical left lung has improved. The appearance of the postsurgical left hemi thorax is constant. Constant appearance of the normal right lung and the right heart border. Unchanged position of the post surgical fixation devices. " 68e1074b-f8e27c19-fec8791d-7ffd4f7c-83c5f363.jpg,validate/p19/p19259960/s53487032/68e1074b-f8e27c19-fec8791d-7ffd4f7c-83c5f363.jpg,validation," 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. " 0ac423d8-7b681514-36c0fc55-03ed0313-3f5d6852.jpg,validate/p13/p13493515/s52902533/0ac423d8-7b681514-36c0fc55-03ed0313-3f5d6852.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain and right calf 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. " b6af227c-2669fe32-dc8244b3-6f2059bd-e8da7e8d.jpg,validate/p15/p15557153/s51651815/b6af227c-2669fe32-dc8244b3-6f2059bd-e8da7e8d.jpg,validation," FINAL REPORT INDICATION: ___F s/p colonoscopy and endoscopy with severe abd pain. Please evaluate for perforation 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 within normal limits. No acute osseous abnormalities. No free intraperitoneal air. IMPRESSION: No free intraperitoneal air. " 3201415b-ea715a2b-cdee955f-be503b45-05bc6a7e.jpg,validate/p16/p16387058/s56490530/3201415b-ea715a2b-cdee955f-be503b45-05bc6a7e.jpg,validation," WET READ: ___ ___ 9:21 AM 1. No acute cardiopulmonary process. 2. Cholelithiasis. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: Increased interstitial markings at bilateral lung bases are consistent with known history of bronchiectasis. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. Calcified right base granuloma and calcified granuloma posterior to the descending aorta are unchanged. The cardiomediastinal silhouette is stable. Gallstones are noted in the right upper quadrant. Note made of a mild scoliosis of the thoracic spine. IMPRESSION: 1. No acute pulmonary process. Calcified granulomas again noted. 2. Cholelithiasis. " 3a6813c3-3df59be8-f8cb2267-4a631c40-c5030b03.jpg,validate/p18/p18551287/s52131882/3a6813c3-3df59be8-f8cb2267-4a631c40-c5030b03.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESLD, NGT replaced with OGT // confirm OGT placement confirm OGT placement IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube is been removed and replaced with an orogastric tube with its tip in the mid to lower body of the stomach. The side-port is distal to the esophagogastric junction. Otherwise little change. " 989f3415-f733b13d-761c89cf-0e0ff9d7-720ba5b8.jpg,validate/p14/p14371035/s55091510/989f3415-f733b13d-761c89cf-0e0ff9d7-720ba5b8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with NGT // ?NGT placement TECHNIQUE: Portable AP view of the chest. COMPARISON: Multiple prior chest radiographs, most recently ___. FINDINGS: As compared to the most recent prior examination dated ___, there has been no significant interval change. Again, in a nasogastric tube is noted coiled within the stomach. Lung volumes remain low with crowding of the bronchovascular structures. The right hemidiaphragm remains chronically elevated with adjacent atelectasis. Streaky bibasilar opacities likely reflect atelectasis, and are improved. The heart size is appears top-normal. IMPRESSION: Nasogastric tube as described. Interval improvement in extent of bibasilar atelectasis and persistent elevation right hemidiaphragm " 953e6574-abfd4fcc-a4f126f9-6025e580-74d9681f.jpg,validate/p18/p18797174/s52684653/953e6574-abfd4fcc-a4f126f9-6025e580-74d9681f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with concern for worsening heart failure // Please evaluate for pulmonary edema Please evaluate for pulmonary edema COMPARISON: Prior chest radiographs ___ motor, most recently ___. IMPRESSION: Mild pulmonary edema has changed in distribution, not in overall severity. Small to moderate right pleural effusion stable. Small left pleural effusion and left basal atelectasis also unchanged. Moderate cardiomegaly stable. No pneumothorax. Left jugular line ends in the low SVC. Nasogastric feeding feeding tube passes into the stomach and out of view " 1e53e531-be0862f9-e4825782-92d2d3a1-aa2f1dd6.jpg,validate/p14/p14809300/s56421518/1e53e531-be0862f9-e4825782-92d2d3a1-aa2f1dd6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing pleural effusion on the right has completely resolved. There is no re-expansion edema or other parenchymal abnormality. The fiducial marker in the right apex is in constant position. Healing right basal lateral rib fracture. Normal appearance of the cardiac silhouette. Mild tortuosity of the descending aorta. " 0ec6e6a6-c3b620ac-9a86b4d3-a603d4fd-0c7a473d.jpg,validate/p19/p19933545/s51632069/0ec6e6a6-c3b620ac-9a86b4d3-a603d4fd-0c7a473d.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with cough, evaluate for pneumonia. COMPARISON: ___. FINDINGS: Heart is top normal size and cardiomediastinal silhouette is stable. A well-defined rounded retrocardiac opacity containing an air-fluid level is consistent with known hiatal hernia. There is mild bibasilar atelectasis. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " 503038d9-caee6fa5-92d1e252-8a45e69f-a0c363bc.jpg,validate/p14/p14575349/s53835921/503038d9-caee6fa5-92d1e252-8a45e69f-a0c363bc.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___-year-old woman with right ventricular systolic dysfunction. COMPARISON: Chest radiograph dated ___. FINDINGS: Right middle lobe opacity with volume loss causing shift of the minor fissure is more pronounced on today's exam and best appreciated on the lateral view. The lungs are otherwise clear except for unchanged appearance of asymmetrical biapical pleural and parenchymal scarring, right greater than left. No pulmonary edema or pleural effusion. No pneumothorax. Moderate cardiomegaly persists and is without change. The tortuous descending thoracic aorta is also overall unchanged. The pulmonary arteries are prominent but not enlarged. Moderate degenerative changes of thoracic spine with anterior osteophytes are unchanged. IMPRESSION: Interval increased prominence of right middle lobe opacity, suggesting possible chronic middle lobe syndrome with or potentially chronic MAC infection - follow-up with short-term radiographs or chest CT could be performed if warranted clinically. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 10:21 into the Department of Radiology critical communications system for direct communication to the referring provider. " a4e120cf-1bbc0cf5-e33dfcaf-2c7f23a6-e8e7d70a.jpg,validate/p16/p16453939/s52029736/a4e120cf-1bbc0cf5-e33dfcaf-2c7f23a6-e8e7d70a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F in ICU, question of early PNA, please eval for PNA, interval change // ___F in ICU, question of early PNA, please eval for PNA, interval change ___F in ICU, question of early PNA, please eval for PNA, interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are stable. Again, the side-port of the nasogastric tube is at the level of the esophagogastric junction. Cardiac silhouette remains within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 9363c867-36f7a94e-7eb798a4-c70821b2-59ac9e31.jpg,validate/p11/p11738518/s51192794/9363c867-36f7a94e-7eb798a4-c70821b2-59ac9e31.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ascending cholangitis s/p open cholecystectomy intubated, sedated // eval positioning of ETT eval positioning of ETT COMPARISON: Comparison to prior study dated ___ at 10:02 FINDINGS: Portable semi supine chest film dated ___ at 16 28 is submitted. IMPRESSION: The endotracheal tube now has its tip approximately 4.5-5 cm above the carina. Nasogastric tube is seen coursing below the diaphragm with the tip not identified. The left subclavian PICC line is unchanged in position with its tip in the proximal SVC. There is persistent total opacification at the left lung base with an associated effusion most likely reflecting partial lower lobe atelectasis, although pneumonia cannot be excluded. In addition, there is interval appearance of mild to moderate pulmonary and interstitial edema. There has also been interval appearance of a right lateral chest wall and neck subcutaneous emphysema. Subcutaneous emphysema is also seen in the left neck soft tissues as well as a inferiorly in the left lateral abdominal wall. Clinical correlation is advised as the subcutaneous emphysema is a new finding. There is no obvious pneumothorax or pneumomediastinum. A catheter is seen overlying the right upper quadrant. A portion of a biliary stent and aortic stent are again seen. The heart remains enlarged. NOTIFICATION: Results were communicated by phone to ___, the patient's nurse, on ___ at 17:45 at the time of discovery. " cf4321a5-d0c7732c-39dedd1f-bb89d7b9-ad55a0b7.jpg,validate/p12/p12406522/s52379508/cf4321a5-d0c7732c-39dedd1f-bb89d7b9-ad55a0b7.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with COPD and hypoxic respiratory failure with increased O2 requirement. Question interval change. Comparison is made to ___. Single portable view of the chest demonstrates a left-sided hemodialysis line terminating at cavoatrial junction. There is no overall gross change with no new focal consolidation worrisome for pneumonia. Previously noted slight increase in density in the left apex is likely related to bony changes rather than an infectious process. No evidence of pneumothorax or overt pulmonary edema. IMPRESSION: No overall change from the prior radiograph. " 9ceb5328-0fc687e0-3cc28188-5b2784ee-c3dcaa92.jpg,validate/p15/p15805011/s53345012/9ceb5328-0fc687e0-3cc28188-5b2784ee-c3dcaa92.jpg,validation," FINAL REPORT HISTORY: A ___-year-old male with chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are mildly underpenetrated due to patient body habitus. There is persistent elevation of the right hemidiaphragm. Slight blunting of the right costophrenic angle seen on the frontal view, not substantiated on the lateral view, is most likely due to overlying soft tissue. No large pleural effusion and pneumothorax is seen. There is no definite focal consolidation. The cardiac silhouette appears mildly enlarged, likely accentuated by AP technique. No overt pulmonary edema is seen. Slight prominence of the aortic knob is stable compared to scout radiograph from CT from ___. IMPRESSION: " 2e9502f0-28dc530c-367754f6-976bd130-261db41b.jpg,validate/p10/p10685822/s57223489/2e9502f0-28dc530c-367754f6-976bd130-261db41b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p bilateral thoacentesis. Pain in left hemithorax // r/o PTX left TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph obtained earlier on the same date. FINDINGS: There are persistent bilateral pleural effusions, decreased somewhat in size compared to the prior study. Persistent bibasilar atelectasis. Reticular opacities throughout the lungs likely reflect interstitial edema with alveolar edema evident at the lung bases. No pneumothorax seen. The visualized bony structures demonstrate increased sclerosis consistent with metastatic disease. No free air under the diaphragm. IMPRESSION: No pneumothorax seen. " d572fe3a-dc9d905a-66049278-fb77f398-70d5c68b.jpg,validate/p11/p11875773/s52792775/d572fe3a-dc9d905a-66049278-fb77f398-70d5c68b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) IN O.R. INDICATION: ___ year old man with sob, fever, sent in from dialysis pls eval for pna vs fluid COMPARISON: ___. FINDINGS: AP portable upright view of the chest. Overlying EKG leads noted. Lung volumes are low. Bronchovascular crowding is noted. Relative prominence of the hila may reflect hypoventilatory status. Mild hilar congestion is difficult to exclude. No large effusion. Mild left basal atelectasis. No large pneumothorax. Bony structures are intact. Cardiomediastinal silhouette unchanged. IMPRESSION: Probable mild congestion. No definite signs of pneumonia or edema. " 18837c52-8e4c08df-b0e0e086-0c96673c-6a47db4b.jpg,validate/p18/p18658996/s54840172/18837c52-8e4c08df-b0e0e086-0c96673c-6a47db4b.jpg,validation," FINAL REPORT INDICATION: NG tube position. COMPARISON: Chest radiograph on ___. FINDINGS: AP view of the chest. Enteric tube ends in the stomach in appropriate position. Left pigtail catheter is overlying the left lower hemithorax. Moderate bilateral pleural effusions are unchanged. The cardiomediastinal silhouette is stable. No pneumothorax. Dependent pulmonary edema is unchanged. Underlying pneumonia cannot be ruled out. IMPRESSION: Unchanged moderate bilateral pleural effusions and dependent pulmonary edema. Underlying pneumonia in the lower lobes cannot be ruled out. NG tube ends in the stomach in appropriate position. " a53f2071-502e43d5-5fd16724-731dbebd-056a0aa3.jpg,validate/p12/p12468629/s59750025/a53f2071-502e43d5-5fd16724-731dbebd-056a0aa3.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with shortness of breath, question pneumonia. COMPARISON: None. FINDINGS: Single portable view of the chest demonstrates a right-sided pleural effusion, small to moderate in size. The left appears clear. Cardiac size is enlarged. No pneumonia. Right-sided dialysis catheter terminates in the right atrium. This patient is status post median sternotomy with the upper sternotomy wire broken. IMPRESSION: Right-sided pleural effusion. Cardiomegaly. " 45c69c53-ea89ffbe-148e4918-4762e577-c0633cfe.jpg,validate/p16/p16962956/s51219630/45c69c53-ea89ffbe-148e4918-4762e577-c0633cfe.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Left pleural effusion, status post thoracocentesis. COMPARISON: No comparison available at the time of dictation. Minimal left pleural effusion limited to the costophrenic sinus. Plate-like atelectasis at the left lung bases. No evidence of left pneumothorax. Borderline size of the cardiac silhouette without pulmonary edema. No abnormalities in the right hemithorax. " 6693f45e-9aa017a0-fb2faa0f-8816f380-5e560855.jpg,validate/p17/p17382835/s59904663/6693f45e-9aa017a0-fb2faa0f-8816f380-5e560855.jpg,validation," WET READ: ___ ___ 12:24 PM Compared with ___ Lung volumes are low. There is left basilar atelectasis. Mild peribronchial thickening is noted. In the right infrahilar region, vague opacity is noted, which, in the appropriate clinical context may represent pneumonia or atelectasis. WET READ VERSION #1 ___ ___ 2:00 AM Compared with ___ Lung volumes are low. There is left basilar atelectasis. Mild peribronchial thickening is noted. In the right infrahilar region, vague opacity is noted, which, in the appropriate clinical context may represent pneumonia or atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man POD#1 from small bowel resection and revision of ileocolic anastomosis now with fever // r/o pulm. etiology TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: A linear opaque structure projects over the left hemi thorax. There is linear lateral left base atelectasis. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: Linear left lateral base opacity most likely represents atelectasis, much less likely pneumonia. " ee1e5220-de0641da-8269813a-a3016e8e-488d7801.jpg,validate/p11/p11879144/s55052839/ee1e5220-de0641da-8269813a-a3016e8e-488d7801.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with chronic cough (4 months) // r/o cause of chronic cough TECHNIQUE: Chest PA and lateral COMPARISON: Prior 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 effusions. IMPRESSION: No acute cardiopulmonary process. " eb1df789-77edf0fc-047de277-6fcfecc7-2d36f7d2.jpg,validate/p17/p17991156/s59800059/eb1df789-77edf0fc-047de277-6fcfecc7-2d36f7d2.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. INDICATION: ___-year-old with history of metastatic breast cancer with right-sided chest pain. FINDINGS: The heart size is normal. The aorta is mildly tortuous, but there is no local contour abnormality. There is no pulmonary edema. There is mild blunting of the right costophrenic sulcus, but no free pleural fluid. There is no pneumothorax. The lungs are clear. There is no obvious fracture or dislocation of the ribs. There is no hematoma. There is no vertebral compression fracture. IMPRESSION: 1. No pleural effusions. 2. No rib fracture. Stat read was called to Dr. ___, as requested, at 4:30 PM, at the time of discovery. " 716f9c1f-6c9c2e50-36d04741-6813cfbc-16d308cc.jpg,validate/p11/p11942558/s51944199/716f9c1f-6c9c2e50-36d04741-6813cfbc-16d308cc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cp COMPARISON: CT abdomen pelvis 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. " e91b1003-a8c28551-e5e8a4b9-5eb4b147-3de2e6ab.jpg,validate/p17/p17318449/s54809707/e91b1003-a8c28551-e5e8a4b9-5eb4b147-3de2e6ab.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of CHF, leg swelling. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The patient is status post median sternotomy. The cardiac and mediastinal silhouettes are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Evidence of DISH is seen along the thoracic spine. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 6e51a519-02d072b0-3ee6b621-e9e7311a-ef659852.jpg,validate/p18/p18230852/s52445953/6e51a519-02d072b0-3ee6b621-e9e7311a-ef659852.jpg,validation," FINAL REPORT EXAMINATION: The INDICATION: ___ year old man with hep c cirrhosis, known varices, and AMS now with psudo-hemoptysis // patient coughed up blood overnight. My suspicion is that it is from his known epistaxis, but we would like to rule out any pulmonary cause. Thank you IMPRESSION: In comparison to ___ chest radiograph, there has not been a relevant change in the appearance of chest. " 02eedc1a-f3c74da7-4c194fc1-dd4483d8-a61462bc.jpg,validate/p14/p14256999/s50592134/02eedc1a-f3c74da7-4c194fc1-dd4483d8-a61462bc.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // ?ptx . COMPARISON: None Available. TECHNIQUE Comparison is made to chest radiograph from ___. FINDINGS: There is no evidence of pneumothorax. There is no pleural effusion. The cardiomediastinal silhouette is normal. Again seen is a lingular opacity, not significantly changed from ___. There is no evidence of pneumonia. Views of the upper abdomen are unremarkable. IMPRESSION: No evidence of pneumothorax. Unchanged appearance of the chest. " 43da4108-f1680fc8-c7962167-942656c9-1472de5b.jpg,validate/p17/p17947399/s53144087/43da4108-f1680fc8-c7962167-942656c9-1472de5b.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // ? ptx 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. " e30d2cda-37d5270d-68c87b9a-3e3eed69-d9d6795b.jpg,validate/p17/p17451002/s58060413/e30d2cda-37d5270d-68c87b9a-3e3eed69-d9d6795b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with possibly lung cancer with increased somnolence, evacuate for pneumonia. TECHNIQUE: Portable frontal chest radiograph was obtained. COMPARISON: CT chest from ___ and multiple prior chest radiographs FINDINGS: There is a persistent opacity obscuring the right heart border which may represent a post obstructive process, better characterized on recent chest CT. Lobe peripherally at the right lung base, there is a semilunar opacity without CT correlate and may not be in intrathoracic process. The cardiac silhouette is mildly enlarged. There is no pneumothorax. There is thickening of the minor fissure with likely some pleural fluid. IMPRESSION: Focal opacity at the right middle lobe obscuring the right heart border which could represent a post obstructive process, better characterized on recent chest CT. " 8c812d9a-c540acc3-afd9bf1f-f939984b-29e65200.jpg,validate/p11/p11630519/s55549089/8c812d9a-c540acc3-afd9bf1f-f939984b-29e65200.jpg,validation," FINAL REPORT CLINICAL HISTORY: Intracranial bleed. Nasogastric tube placed, check position. CHEST AND UPPER ABDOMEN The tip of the nasogastric tube is somewhat difficult to identify but appears to lie at the level of the gastroesophageal junction and should therefore be advanced. Compared to the prior chest x-ray where the nasogastric tube is better seen, I think it has probably been withdrawn 1 or 2 cm. The lung fields are clear. The bowel gas pattern is normal. " 2514d8aa-45925ea3-2c65d3df-5ca5548a-b0f98fad.jpg,validate/p15/p15278197/s54341177/2514d8aa-45925ea3-2c65d3df-5ca5548a-b0f98fad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: AORTIC STENOSIS, VALVE REPLACEMENT IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. The cardiac silhouette remains at the upper limits of normal or mildly enlarged and there again is tortuosity of the aorta. No acute pneumonia, vascular congestion, or pleural effusion. " 10ae30cb-84e2834e-867cc18d-98e74eef-c148cc57.jpg,validate/p16/p16000868/s57874958/10ae30cb-84e2834e-867cc18d-98e74eef-c148cc57.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with brain mass. 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. " f213b978-fa25fd12-53d7eed3-bbee193b-50663f4b.jpg,validate/p19/p19243413/s50608653/f213b978-fa25fd12-53d7eed3-bbee193b-50663f4b.jpg,validation," FINAL REPORT HISTORY: Positive blood culture. FINDINGS: In comparison with study of ___, there is again increased opacification at the left base consistent with volume loss in the left lower lobe and pleural fluid. Some ill-defined opacification at the right base could also reflect developing atelectasis. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. " e891b00c-009b4dd7-069faa69-a2ab3a70-e934527f.jpg,validate/p13/p13480812/s57726042/e891b00c-009b4dd7-069faa69-a2ab3a70-e934527f.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY COMPARISON: ___. FINDINGS: Cardiomediastinal contours are within normal limits. No focal areas of consolidation are identified within the lungs, but standard PA and lateral views of the chest may be helpful for more complete assessment of the lung bases when the patient's condition allows. No pleural effusion or pneumothorax. " b3577fc0-2b0f250d-535dea04-d25b81a9-1e5c0c39.jpg,validate/p17/p17061225/s50916287/b3577fc0-2b0f250d-535dea04-d25b81a9-1e5c0c39.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F presents after torsades arrest, now with fatigue and crackles, and labored breathing // ? effusions, ?infection ? effusions, ?infection IMPRESSION: No comparison. Normal lung volumes. Moderate cardiomegaly with retrocardiac atelectasis. Mild fluid overload but no overt pulmonary edema. No larger pleural effusions. No pneumonia. No pneumothorax. " 8d6c45c2-e27c4a0f-f89c8636-e6e3b232-c73032a8.jpg,validate/p17/p17006872/s50392612/8d6c45c2-e27c4a0f-f89c8636-e6e3b232-c73032a8.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Possible pneumothorax. Evaluate with expiratory radiograph. IMPRESSION: PA inspiration and expiration and lateral chest radiograph compared to ___ through ___: There is no pneumothorax or pleural effusion. Postoperative atelectasis and residual hemorrhage along chain suture in the right upper lobe has not changed since ___, having improved over the preceding week. Expiratory view shows minimal change in lung volumes suggesting small airway obstruction. Heart size is normal. Hilar and mediastinal contours are unremarkable. " bf8ded31-af4d7940-0a1f1338-ab2b4aab-8e345305.jpg,validate/p10/p10852762/s56304760/bf8ded31-af4d7940-0a1f1338-ab2b4aab-8e345305.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with neutropenia. COMPARISON: Chest radiograph from ___ and chest CT from ___. CHEST, PA AND LATERAL: Lungs are clear. Cardiomediastinal and hilar contours are normal. Note is made of a moderate hiatal hernia, with internal air-fluid levels There are no pleural effusions or pneumothorax. New surgical clips project over the right chest wall. IMPRESSION: Moderate hiatal hernia. No acute process. " 7cd49c7e-4de451f1-91d968ae-81143d7e-0b2dd70f.jpg,validate/p15/p15541869/s50553646/7cd49c7e-4de451f1-91d968ae-81143d7e-0b2dd70f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CTA chest from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Sepsis unknown source, abdominal pain and altered mental status. FINDINGS: Portable AP semi-upright view of the chest was provided. Patient is quite rotated to the left which limits the evaluation. The heart is enlarged which could in part reflect leftward rotation. There is a left pleural effusion which is small in size. There is a small area of consolidation in the left upper lobe which could represent a small focus of pneumonia. Mild pulmonary edema is present. Atherosclerotic calcifications at the aortic knob noted. Bony structures are intact. IMPRESSION: Pulmonary edema, left upper lobe focal consolidation could represent pneumonia. Small left pleural effusion. Cardiomegaly. " b8f1ba56-b32c6c6b-9f6079bd-f56acefc-77dd0a86.jpg,validate/p17/p17980556/s56036487/b8f1ba56-b32c6c6b-9f6079bd-f56acefc-77dd0a86.jpg,validation," WET READ: ___ ___ ___ 11:01 PM NGT in the proximal stomch with sideholes just below GE junction. ______________________________________________________________________________ FINAL REPORT ABDOMEN, ___ 7:27 P.M. HISTORY: Intubated ___-year-old woman, evaluate NG tube placement. IMPRESSION: AP view of the abdomen centered at the L2 level shows a nasogastric tube ending in the upper stomach would need to be advanced at least 5 cm to move all the side ports beyond the gastroesophageal junction. The imaged portion of the intestinal tract is not distended. The widespread but variable abnormality at the lung bases may have improved, suggesting this was edema. " b1d835a3-0b1c621a-55cab2c6-15f4e047-43910d12.jpg,validate/p10/p10164277/s51379005/b1d835a3-0b1c621a-55cab2c6-15f4e047-43910d12.jpg,validation," FINAL REPORT INDICATION: Weakness. Evaluation for pneumonia. COMPARISONS: Chest radiograph ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " e15d6fc7-45be53f5-c87326ba-ccf05b96-d5d15aa2.jpg,validate/p18/p18614569/s51084396/e15d6fc7-45be53f5-c87326ba-ccf05b96-d5d15aa2.jpg,validation," FINAL REPORT INDICATION: Fever. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent radiographs dated ___. FINDINGS: No focal opacity to suggest pneumonia is seen. No pleural effusion, pulmonary edema, or pneumothorax is present. There is a small amount of atelectasis at the bases. A subtle interstitial abnormality seen at the bases has also previously been present. The heart size is normal. IMPRESSION: No evidence of acute cardiopulmonary process. " 48e1da71-cef40c0a-0861cb7c-9b9390e0-5548b2b4.jpg,validate/p18/p18605505/s55296010/48e1da71-cef40c0a-0861cb7c-9b9390e0-5548b2b4.jpg,validation," WET READ: ___ ___ ___ 11:26 AM 1. Persistent moderate left pleural effusion with retrocardiac opacity likely representing combination of pleural fluid and atelectasis however differential includes pneumonia in the appropriate clinical setting. 2. Persistent right lower lobe opacity with small right pleural effusion is most consistent with atelectasis however differential includes pneumonia or aspiration pneumonia in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Hypoxia. Assess for pneumonia or pleural effusions. COMPARISON: Chest radiograph ___, ___. FINDINGS: Frontal and lateral chest radiographdemonstrates persistent moderate left pleural effusion with retrocardiac opacity and decreased left lower lobe atelectasis. Persistent right lower lobe opacity with trace right pleural effusion. Mild vascular engorgement noted. Stable appearance of tracheostomy. Limited evaluation of heart size due to underlying lung abnormality.No pneumothorax. Mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. Degenerative changes of the thoracolumbar spine are noted. IMPRESSION: 1. Stable moderate left pleural effusion with retrocardiac opacity likely representing combination of pleural fluid and atelectasis however differential includes pneumonia in the appropriate clinical setting. 2. Decreased left lower lobe atelectasis. 3. Persistent right lower lobe opacity with small right pleural effusion is most consistent with atelectasis however differential includes pneumonia or aspiration pneumonia in the appropriate clinical setting. 4. Mild vascular engorgement. " 91fca33c-bdfa8c51-4cc546df-160867d6-94b92300.jpg,validate/p14/p14006922/s57090876/91fca33c-bdfa8c51-4cc546df-160867d6-94b92300.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: Positive PPD. COMPARISON: No prior chest radiographs available. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. " 28eaed15-4e1eed33-0947af2b-17c01e12-6767e10b.jpg,validate/p17/p17872693/s53716703/28eaed15-4e1eed33-0947af2b-17c01e12-6767e10b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with altered mental status, ? ingestion, tachycardia 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. " 08c725ea-77828503-7ffbfd7a-016b0c89-e6348752.jpg,validate/p14/p14003502/s52105248/08c725ea-77828503-7ffbfd7a-016b0c89-e6348752.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with cp // eval for pleural effusion TECHNIQUE: Single AP view of the chest was obtained. COMPARISON: CT chest from 3 hours prior FINDINGS: The cardiac silhouette is obscured by large, bilateral pleural effusions, greater on the left than on the right, with likely bilateral atelectasis. At least moderate pneumomediastinum is noted, as seen on recent CT of the chest. IMPRESSION: Bilateral pleural effusions and pneumomediastinum. " bb8b29e1-d35ef09c-af3dac3c-8dfe927c-1ea70c10.jpg,validate/p11/p11895636/s52114429/bb8b29e1-d35ef09c-af3dac3c-8dfe927c-1ea70c10.jpg,validation," FINAL REPORT INDICATION: Syncope. Assess for acute process. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate hyperexpanded lungs. There are prominent interstitial markings. No focal consolidation or pleural effusion. Hilar and mediastinal silhouettes are unchanged. The descending aorta is tortuous. Heart size is normal. Port-A-Cath tip projects over cavoatrial junction. Calcified granuloma in the left upper lung. IMPRESSION: No acute cardiopulmonary process. " e22afaa6-67c4dc35-6665f9be-216dd343-74f37b85.jpg,validate/p17/p17342389/s54665585/e22afaa6-67c4dc35-6665f9be-216dd343-74f37b85.jpg,validation," WET READ: ___ ___ ___ 11:16 PM No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with light headed, sob // PTX? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are slightly low, resulting in bronchovascular crowding. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumothorax. " 3c8a254c-d4f21514-95533fa2-36bb69fc-17d5114e.jpg,validate/p13/p13391297/s57961289/3c8a254c-d4f21514-95533fa2-36bb69fc-17d5114e.jpg,validation," FINAL REPORT HISTORY: Epistaxis, crackles bilaterally. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Low lung volumes are present. The cardiac, mediastinal and hilar contours are relatively unchanged with tortuosity of the thoracic aorta again noted. There is no pulmonary vascular congestion. Minimal linear opacities within both lower lobes likely reflect subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. Multiple clips are seen within the right upper quadrant of the abdomen. Partially imaged is hardware within the left proximal humerus. IMPRESSION: Bibasilar subsegmental atelectasis. " 6d2a0e10-dcf82443-13324d59-0603e995-5f29c7d7.jpg,validate/p10/p10240746/s56335639/6d2a0e10-dcf82443-13324d59-0603e995-5f29c7d7.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Productive cough and fever. PA and lateral upright chest radiographs were reviewed with comparison to ___. New right lower lobe opacity is noted concerning for right lower lobe pneumonia. Rest of the lungs are clear. Heart size and mediastinum are unremarkable. There is no pleural effusion or pneumothorax. Findings were discussed with Dr. ___ over the phone by Dr. ___ at 5 p.m. on ___. " a9a1586a-539dbd6d-225fca65-84e4af2c-a24ccf73.jpg,validate/p15/p15244289/s54168603/a9a1586a-539dbd6d-225fca65-84e4af2c-a24ccf73.jpg,validation," FINAL REPORT HISTORY: Hepatic hydrothorax, question pneumothorax. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___, again seen is increased opacity at the right base. Allowing for differences in positioning, this is likely similar to the earlier film. No new opacity is identified. The left lung remains grossly clear, without effusion. Mediastinum remains midline. Doubt CHF. No pneumothorax is detected at the lung apex and no fluid level is seen on the single view to suggest a hydropneumothorax. Correlation with additional clinical history may help for further characterization. " 98e91b8d-6ea5dcef-4001df22-1aa4bd29-e6f44463.jpg,validate/p14/p14168580/s53830377/98e91b8d-6ea5dcef-4001df22-1aa4bd29-e6f44463.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: New onset dizziness, chest process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. No acute parenchymal changes, no pulmonary nodules or masses. No pleural effusions. No pneumonia. No pulmonary edema. Moderate tortuosity of the thoracic aorta. " e9e0a14c-9e04f854-ba0463c6-ec48546a-901f2825.jpg,validate/p11/p11738518/s57500945/e9e0a14c-9e04f854-ba0463c6-ec48546a-901f2825.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea // eval pneumonia, pulm edema, effusions eval pneumonia, pulm edema, effusions IMPRESSION: In comparison with the study of ___, there is little change. Continued enlargement of the cardiac silhouette with elevated pulmonary venous pressure and left basilar opacification consistent with volume loss in the lower lobes and small pleural effusion. Central catheter tip extends to the mid portion the SVC. No evidence of free intraperitoneal gas, though again this is not a true upright image. " 1b366023-9bc7add6-20705a46-25fda5e5-c4ad60e9.jpg,validate/p19/p19324325/s54088705/1b366023-9bc7add6-20705a46-25fda5e5-c4ad60e9.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with pleuritic right upper quadrant flank pain. Evaluate for acute process. Wet read to ___ ___ at ___. 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. Lungs are clear. No pleural effusion or pneumothorax. No radiopaque foreign body. IMPRESSION: Normal chest radiographs. " 3994e298-9d89209a-d345188f-fc76d7af-6a10a1c3.jpg,validate/p11/p11423154/s53142969/3994e298-9d89209a-d345188f-fc76d7af-6a10a1c3.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with chest pain. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded and clear other than a small calcified granuloma in the right lung. No focal consolidation, edema, pneumothorax, or effusion. The heart is normal in size. The mediastinum is not widened. IMPRESSION: No pneumothorax. " a8af5899-73a2fccf-aea3622d-667757dc-c73f1e4e.jpg,validate/p12/p12156452/s52291002/a8af5899-73a2fccf-aea3622d-667757dc-c73f1e4e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with shortness of breath and weakness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is normal. The aorta is tortuous. The mediastinal and hilar contours are otherwise unchanged. Pulmonary vasculature is not engorged. Patchy opacities in the lung bases likely reflect atelectasis. No pleural effusion or pneumothorax is seen. There is no focal consolidation. No acute osseous abnormality is detected. IMPRESSION: Bibasilar atelectasis. " 00d0e450-f80b5323-eebd32f9-069031fc-7c486928.jpg,validate/p11/p11433898/s50901606/00d0e450-f80b5323-eebd32f9-069031fc-7c486928.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with new cough, wheeze, and diarrhea, question pneumonia or pulmonary congestion. IMPRESSION: AP chest compared to ___: Tiny left pleural effusion is new, but pulmonary vascular congestion, moderate cardiomegaly, and generalized enlargement of the pulmonary arteries is all stable. There is no clear pulmonary edema. Severe cardiomegaly is longstanding. Transvenous right atrial and right ventricular pacer leads are unchanged in their respective positions. " fcba363d-d1428f5c-9d12becd-fc38fe8c-f23a07b0.jpg,validate/p12/p12805811/s53279434/fcba363d-d1428f5c-9d12becd-fc38fe8c-f23a07b0.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: Chest x-ray of one day earlier. FINDINGS: Tip of intra-aortic balloon pump terminates 1.5 cm below the superior aspect of the aortic knob. Cardiomediastinal contours are stable. Diffuse alveolar opacities, presumably representing pulmonary edema have slightly improved in the interval and remain worse in the left than the right lung. Moderate layering bilateral pleural effusions are not appreciably changed. " 3ca8a2e2-edcc08eb-0996a0d3-8ef04f93-8ad3643f.jpg,validate/p13/p13899653/s50107708/3ca8a2e2-edcc08eb-0996a0d3-8ef04f93-8ad3643f.jpg,validation," FINAL REPORT INDICATION: ___M with decompensated cirrhosis presenting with failure to thrive // any acute cardiopulm 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. " 0d154ef9-96d37a1d-35f35f89-ec8991a7-e853055f.jpg,validate/p16/p16863033/s56463548/0d154ef9-96d37a1d-35f35f89-ec8991a7-e853055f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new onset of dyspnea/cough // r/o abnormality r/o abnormality IMPRESSION: In comparison with the study of ___, there again are low lung volumes. However, no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 18881616-ec7217c0-0b5c0d72-04ec430c-3744a3bf.jpg,validate/p14/p14237047/s59186584/18881616-ec7217c0-0b5c0d72-04ec430c-3744a3bf.jpg,validation," 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. " a9ce7154-5a79293a-ca4b09cb-194bdc33-69d2c2c8.jpg,validate/p13/p13757356/s51974105/a9ce7154-5a79293a-ca4b09cb-194bdc33-69d2c2c8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p CABG w/increased drainage from chest tube sites r/o effusion s/p CABG w/increased drainage from chest tube sites r/o effusion IMPRESSION: As compared to the previous radiograph from ___, the patient has developed bilateral small pleural effusions, blunting the costophrenic sinuses. In addition, areas of atelectasis at both the left and the right lung bases have newly appeared. No evidence of pneumonia. No pneumothorax. The alignment of the sternal wires continues to be normal. Moderate cardiomegaly without pulmonary edema. Unchanged position of the right internal jugular vein catheter. " be132c57-e9019a61-52637970-aee6fbe9-6458292f.jpg,validate/p17/p17772150/s50987854/be132c57-e9019a61-52637970-aee6fbe9-6458292f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleurisy and fever // r/o PNA r/o PNA IMPRESSION: No previous images. The heart is normal in size and there is no vascular congestion or pleural effusion. Specifically, no evidence of superimposed pneumonia. " 021776ea-32be89d5-1f3b018e-27a28a96-86881c6f.jpg,validate/p14/p14309697/s59124328/021776ea-32be89d5-1f3b018e-27a28a96-86881c6f.jpg,validation," FINAL REPORT INDICATION: ___F with weakness // infiltrate? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray FINDINGS: There are trace bilateral pleural effusions which have decreased in size since previous exam. The lungs are clear of consolidation or pulmonary edema. Cardiomediastinal silhouette is stable in atherosclerotic calcifications are noted at the aortic arch. Bold posterior right sixth rib fracture is noted. IMPRESSION: Interval decrease in size of the small bilateral effusions. No focal consolidation worrisome for pneumonia. " 1b4b11fe-2f4d30e2-7d7df7bc-80f9bbf4-6509a451.jpg,validate/p15/p15031695/s51220113/1b4b11fe-2f4d30e2-7d7df7bc-80f9bbf4-6509a451.jpg,validation," FINAL REPORT HISTORY: To exclude malignancy. FINDINGS: No previous images. There is hyperexpansion of the lungs with flattening of the hemidiaphragms and increased AP diameter, consistent with chronic pulmonary disease. However, no acute pneumonia or vascular congestion. There are bilateral pleural effusions with some compressive atelectasis at the bases. " f438f544-91a33f25-c7adb930-ffbf5099-ef4bbb0c.jpg,validate/p18/p18172619/s54158072/f438f544-91a33f25-c7adb930-ffbf5099-ef4bbb0c.jpg,validation," FINAL REPORT INDICATION: Cough for the past three weeks, 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. Mild generalized bronchial cuffing is chronic. The left costophrenic angle is blunted, as it has been on several prior studies, suggesting a very small pleural effusion. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are otherwise within normal limits and unchanged. Marked tortuosity of the descending thoracic aorta is noted. The trachea is midline. There is no evidence of free air beneath the right hemidiaphragm. IMPRESSION: No focal consolidation concerning for pneumonia. Bronchial cuffing, absent signs of heart failure suggests chronic bronchial inflammation. " 05672e3f-9f4636ed-b12bb77d-85293d59-69dd91ed.jpg,validate/p10/p10188275/s58645393/05672e3f-9f4636ed-b12bb77d-85293d59-69dd91ed.jpg,validation," FINAL REPORT INDICATION: History of tracheobronchomalacia, COPD on home 3 liters O2, who presents for evaluation of dyspnea. COMPARISONS: Multiple chest radiographs dated back to ___, most recently from ___. TECHNIQUE: PA and lateral radiograph of the chest. FINDINGS: There is mild cardiomegaly, stable compared to exams dated back to at least ___. The hilar and mediastinal contours are otherwise stable. There appears to be an interval increase in opacification at the retrocardiac region and left lung base which could be secondary to atelectasis; however, an infectious process cannot be excluded. There has been a slight interval increase in a chronic small right pleural effusion as well as mild right basilar atelectasis. There is no evidence of a pneumothorax. IMPRESSION: 1. Increased retrocardiac and left lung base opacification, likely secondary to atelectasis; however, an infectious process cannot be excluded. 2. Slight interval increase in a chronic small right pleural effusion and mild right basilar atelectasis. " a3e310b3-9c48dbf9-01e5492b-a7978001-a488841c.jpg,validate/p15/p15873528/s56241749/a3e310b3-9c48dbf9-01e5492b-a7978001-a488841c.jpg,validation," FINAL REPORT INDICATION: ___M with ett, evaluate tube placement. TECHNIQUE: Portable supine AP chest radiograph. COMPARISON: None available. FINDINGS: There is an endotracheal tube with tip terminating in the mid thoracic trachea in good position. An enteric tube is seen with distal tip projecting over the left upper quadrant, side-port seen distal to the GE junction. EKG leads overlie the chest. Lung volumes are low. The cardiomediastinal silhouette is likely accentuated in the setting of low lung volumes. The hila are within normal limits. Retrocardiac opacity may reflect atelectasis, however difficult to exclude superimposed infection in the appropriate clinical setting. There is no pulmonary edema. Elsewhere there is no evidence of focal lung consolidation. There is no pneumothorax or sizable pleural effusion. IMPRESSION: 1. ET tube terminating in the mid thoracic trachea. 2. Low lung volumes. Retrocardiac opacity may reflect atelectasis, however difficult to exclude superimposed infection or aspiration in the appropriate clinical setting. " 039c9875-7fc8fba6-40c021b9-3953dd13-4bd5c9ec.jpg,validate/p15/p15706391/s59860431/039c9875-7fc8fba6-40c021b9-3953dd13-4bd5c9ec.jpg,validation," FINAL REPORT HISTORY: Recurrent cough, rule out pneumonia or COPD. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: There is bilateral hyperexpansion of the lungs as well as bilateral upper lobe volume loss and associated apical scarring. A poorly-defined opacity is identified in the right middle lobe, partially obscuring the right heart border, and is associated with local bronchial wall thickening. There is no pleural effusion, pneumothorax, or pulmonary edema identified. The heart size is normal. No bony abnormality is detected. IMPRESSION: Right middle lobe opacity suggestive of pneumonia. A follow up chest x-ray is recommended in ___ weeks following completion of antibiotic therapy to document resolution. " 878b3890-03ed9d1b-7c0cbd0d-e7558d0b-979341d1.jpg,validate/p15/p15335912/s58863544/878b3890-03ed9d1b-7c0cbd0d-e7558d0b-979341d1.jpg,validation," 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. " f6f94214-c6aed6f0-40a111cc-23b8cdd2-d45cf136.jpg,validate/p18/p18423382/s58199427/f6f94214-c6aed6f0-40a111cc-23b8cdd2-d45cf136.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with as above // s/p thrombectomy of RLE w/elevated WBC r/o infiltrate COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the left PICC line has been removed. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Minimal retrocardiac atelectasis. No pleural effusions. No pulmonary edema. " 8cf93c7a-d1f2f12e-19e80fdc-12634487-e3dfdd9d.jpg,validate/p15/p15006805/s53558264/8cf93c7a-d1f2f12e-19e80fdc-12634487-e3dfdd9d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dyspnea // r/o CHF TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Moderate cardiomegaly is stable. The aorta is tortuous. Aortic stent is in unchanged position. There is minimal vascular congestion. There is no pneumothorax or pleural effusions. There are degenerative changes in the thoracic spine. There is pectus carinatum. IMPRESSION: Mild vascular congestion " 0ed35a93-f54f5ae8-bf4100fa-23c094fb-4a139b62.jpg,validate/p12/p12293866/s57226960/0ed35a93-f54f5ae8-bf4100fa-23c094fb-4a139b62.jpg,validation," FINAL REPORT INDICATION: ___F with cough and pain, 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. Lung volumes are slightly low. An area of opacification overlying the heart on lateral view may represent focal consolidation. The lungs are otherwise clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Possible opacity in the right middle lobe projecting over the heart may reflect developing pneumonia. No evidence of consolidation or other acute cardiopulmonary process elsewhere. " be58b0a3-d84dd717-8623fc66-35625352-57a8d9ff.jpg,validate/p11/p11661537/s56761136/be58b0a3-d84dd717-8623fc66-35625352-57a8d9ff.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with cough and low-grade fevers. Rule out fracture. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate clear lungs. There is no effusion or pneumothorax. The heart size is normal. The mediastinal contours are normal. Note is made of eventration of the right hemidiaphragm. There is no displaced rib fracture. IMPRESSION: No acute chest pathology. If there is concern for rib fracture, recommend repeat dedicated views with a BB marker to mark the site of pain. " 6a49c735-eefd1593-9a08ac09-71032215-0304851e.jpg,validate/p10/p10423466/s54166485/6a49c735-eefd1593-9a08ac09-71032215-0304851e.jpg,validation," FINAL REPORT HISTORY: Reports shortness-of-breath with normal examination. COMPARISON: ___. FINDINGS: 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. IMPRESSION: No acute intrathoracic process. " 4a3fcde4-f07774bf-4f18407d-3beb3bc7-63fd7342.jpg,validate/p16/p16390325/s54016592/4a3fcde4-f07774bf-4f18407d-3beb3bc7-63fd7342.jpg,validation," FINAL REPORT HISTORY: Dementia with urosepsis and increased oxygen demand. FINDINGS: In comparison with study of ___, the endotracheal tube has been removed. There is improved aeration in the retrocardiac region. Blunting of the costophrenic angles with mild atelectatic changes at the bases persist. " e5fdbc64-44d21bc1-2409305e-7070a123-04cc90ac.jpg,validate/p16/p16342554/s51188053/e5fdbc64-44d21bc1-2409305e-7070a123-04cc90ac.jpg,validation," 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. " 1dd80a81-f8162d69-c4e32e61-bbba48a9-323a90d4.jpg,validate/p11/p11018127/s53116776/1dd80a81-f8162d69-c4e32e61-bbba48a9-323a90d4.jpg,validation," FINAL REPORT INDICATION: Cough and neurologic changes. Evaluate for infection. COMPARISON: Chest radiographs from ___, ___, and ___ tear FINDINGS: Frontal and lateral chest radiographs again demonstrate sternal wires and a partially imaged cervical and lumbar fixation hardware. Lung volumes are low, with increased prominence of the cardiac silhouette and bronchovascular crowding. A retrocardiac opacity is unchanged and again may represent atelectasis. IMPRESSION: 1. Retrocardiac opacity may represent atelectasis, but superimposed infection cannot be excluded. 2. Low lung volumes with increased prominence of the cardiac silhouette and bronchovascular crowding. " 87101d4f-51209a8e-14576acd-1e2e4491-da8a2166.jpg,validate/p18/p18999116/s57126020/87101d4f-51209a8e-14576acd-1e2e4491-da8a2166.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with chronic dry cough since two months. No fever, mild shortness of breath, rule out infiltrate. COMPARISON: ___. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are normal. There is no pneumothorax or pleural effusion. CONCLUSION: There is no acute cardiopulmonary process. The exam is unchanged since ___. " 59dfe4c1-d020bcdf-0f4edb74-f525f9ba-04555c04.jpg,validate/p11/p11551769/s56871437/59dfe4c1-d020bcdf-0f4edb74-f525f9ba-04555c04.jpg,validation," FINAL REPORT INDICATION: AML, now with fever. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent dated ___. FINDINGS AND IMPRESSION: Overall, there is little change from the prior exam. There are bilateral opacities which were evaluated on a prior CT and were consistent with Aspergillus. There appears to be a mild amount of superimposed edema. No pneumothorax is present. The cardiomediastinal silhouette is unchanged. A right-sided PICC terminates in the mid SVC. " 6fb52078-358ba5ea-679d8195-aef95a4d-7516b93f.jpg,validate/p11/p11801344/s50398172/6fb52078-358ba5ea-679d8195-aef95a4d-7516b93f.jpg,validation," FINAL REPORT HISTORY: Cough and fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are within normal limits. The lungs are clear and the pulmonary vasculature normal. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities are demonstrated. IMPRESSION: No acute cardiopulmonary process. " abc9af35-c58a3564-7afd850a-9dc41fa9-4b8ade59.jpg,validate/p12/p12479159/s57789644/abc9af35-c58a3564-7afd850a-9dc41fa9-4b8ade59.jpg,validation," 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. " 42d21848-297127d4-371f5901-168175de-fd3e0b44.jpg,validate/p16/p16788522/s57580929/42d21848-297127d4-371f5901-168175de-fd3e0b44.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, GI bleed, s/p extubation // Et tube placement IMPRESSION: As compared to ___, the patient has been intubated with endotracheal tube in standard position. Heart is upper limits of normal in size and accompanied by mild pulmonary vascular congestion. " c622cf96-e8037b38-de44b3a0-fc19b36e-b7d7c711.jpg,validate/p18/p18977683/s51719485/c622cf96-e8037b38-de44b3a0-fc19b36e-b7d7c711.jpg,validation," FINAL REPORT HISTORY: Chronic lung disease with shortness of breath. FINDINGS: In comparison with study of ___, there is again prominence of coarse interstitial markings consistent with chronic pulmonary disease or possible interstitial fibrosis. A more focal area of increased opacification at the left base could represent a developing focus of consolidation. This information was telephoned to Dr. ___, who is covering for Dr. ___. " c713fac4-40255526-482bac9f-f7bcd18b-834ecfae.jpg,validate/p10/p10361825/s58370755/c713fac4-40255526-482bac9f-f7bcd18b-834ecfae.jpg,validation," FINAL REPORT INDICATION: Anterior chest wall crepitus. COMPARISON: Chest radiograph, ___. FINDINGS: There has been interval development of pneumoperitoneum with free air seen under both hemidiaphragms. The cardiomediastinal and hilar contours are stable. There is no pleural effusion, pneumothorax, or pneumomediastinum. There is no focal consolidation concerning for pneumonia. Again demonstrated are median sternotomy wires and aortic valve replacement. IMPRESSION: New pneumoperitoneum. In the absence of recent abdominal surgery, this finding is concerning for an acute abdominal process. CT abdomen and pelvis is recommended for further evaluation. Dr. ___ ___ these findings with Dr. ___ on ___ at 3 p.m., at the time of discovery, via telephone. " 3e9af386-d1f758dc-565fc916-cd19b9d5-ceb4829f.jpg,validate/p10/p10788120/s55149545/3e9af386-d1f758dc-565fc916-cd19b9d5-ceb4829f.jpg,validation," 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. " a358d9bf-df03cf6e-fc1bf1f2-40e97f32-1a5af7ae.jpg,validate/p13/p13961548/s58365882/a358d9bf-df03cf6e-fc1bf1f2-40e97f32-1a5af7ae.jpg,validation," FINAL REPORT HISTORY: Rib pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph and chest CT. FINDINGS: The heart size is top normal. The mediastinal contour is unchanged. Right hilar lymphadenopathy appears similar when compared to the prior studies. Pulmonary vascularity is not engorged. Previously noted right lower lobe ill-defined opacity has improved. No pneumothorax or pleural effusion is detected. There is no acute osseous abnormality including a displaced rib fracture identified. IMPRESSION: 1. No displaced rib fracture identified. If there is continued concern for a rib fracture, then a dedicated rib series is recommended. 2. Right hilar lymphadenopathy persists, and differential considerations remain broad including inflammatory, infectious, or neoplastic etiologies as noted on the prior chest CT. Continued clinical workup and followup is recommended if not already in progress. Previously seen right lower lobe patchy opacities have improved. " ec01d1b8-ea1326c1-112aad2c-1f27aee0-691f1016.jpg,validate/p11/p11509035/s51499135/ec01d1b8-ea1326c1-112aad2c-1f27aee0-691f1016.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with palpitations. 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. " 87e329ea-043a9153-f69bd94a-519cbaa9-c74e6304.jpg,validate/p16/p16389725/s53411522/87e329ea-043a9153-f69bd94a-519cbaa9-c74e6304.jpg,validation," FINAL REPORT INDICATION: ___ year old man with cough and rhonchi in the left upper lobe.. COMPARISON: None Available. TECHNIQUE PA 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. NOTIFICATION: The findings were discussed by Dr. ___ with ___ On the telephone on ___ at 11:51 AM, 10 minutes after discovery of the findings. " 25c6744c-1baf7a6c-b1f35c3c-2e80084a-200c89ac.jpg,validate/p15/p15713699/s54835765/25c6744c-1baf7a6c-b1f35c3c-2e80084a-200c89ac.jpg,validation," FINAL REPORT EXAMINATION:___ @ ___:15 PM: Chest: Frontal and lateral views INDICATION: ___ year old woman with ?ILD, here with cough, fever // please evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ Chest radiograph ___ FINDINGS: Bibasilar opacities improved since study from ___ likely represents improved pulmonary edema versus resolving multifocal pneumonia. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Improved noncardiac pulmonary edema, including drug related pulmonary reaction, or resolving multifocal pneumonia. " 5ba6276f-a60bd3e5-4a6f373d-7392a12c-3c2df733.jpg,validate/p19/p19270938/s50828715/5ba6276f-a60bd3e5-4a6f373d-7392a12c-3c2df733.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe MR // Assess for pneumonia, interval change in pulmonary edema Assess for pneumonia, interval change in pulmonary edema COMPARISON: Comparison to ___ at 10:55 FINDINGS: Portable semi-erect chest radiograph ___ at 02:48 is submitted. IMPRESSION: Overall, there is improving aeration throughout both lungs suggestive of resolving but persistent pulmonary and interstitial edema. The heart remains markedly enlarged. Mediastinal contours are stable. No pneumothorax. No developing airspace consolidation to suggest pneumonia at this time. " 0a4a860c-111f5ce6-d95ea41e-3193b22d-1e275d73.jpg,validate/p11/p11126801/s50442344/0a4a860c-111f5ce6-d95ea41e-3193b22d-1e275d73.jpg,validation," WET READ: ___ ___ 10:30 PM asymmetric pulmonary edema and layering pleural effusions. no penumothorax. supportive devices in appropriate position. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Low oxygen saturation, question pneumothorax. REFERENCE EXAM: ___ at ___. FINDINGS: Compared to the prior study, there has been interval increase in the amount of pulmonary edema with moderate bilateral pleural effusions, right greater than left. The ET tube and right central line are unchanged. " c347f952-86ca48b6-122cbac0-668659d4-a8c35b7c.jpg,validate/p14/p14709954/s55256484/c347f952-86ca48b6-122cbac0-668659d4-a8c35b7c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever and cough // eval for pneumonia eval for pneumonia IMPRESSION: Comparison to ___. Mild scoliosis, causing asymmetry of the ribcage. Normal size of the cardiac silhouette. No pneumonia, no pulmonary edema, no pleural effusions. " e65af6f0-3c721a4e-b8793765-094f9e04-98309766.jpg,validate/p14/p14689761/s58600132/e65af6f0-3c721a4e-b8793765-094f9e04-98309766.jpg,validation," 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. " 647f26bf-ec92ee29-bd2cd609-bf2d68c1-850f811e.jpg,validate/p13/p13439409/s55499972/647f26bf-ec92ee29-bd2cd609-bf2d68c1-850f811e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo F with history of systolic CHF (EF ___% per echo ___, reported non-ischemic), Afib on Coumadin, ICD in place for ?history of VT/VF in ___ who presents with likely acute on chronic systolic CHF exacerbation and hypoxic respiratory failure requiring bipap // pulmonary edema IMPRESSION: Allowing for differences in technique, there has been little change in the appearance of the chest since the recent study of 1 day earlier. " db4d85df-4b147333-cbdc8368-b2b7ebf7-3662cfec.jpg,validate/p16/p16428261/s50681446/db4d85df-4b147333-cbdc8368-b2b7ebf7-3662cfec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with anterior sub-sternal chest pain, s/p fall with headstrike // Eval for rib fracture or acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. 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. " 1397b48b-ec2a89bc-fc6b61a7-fc438540-956e8adf.jpg,validate/p18/p18773704/s55335076/1397b48b-ec2a89bc-fc6b61a7-fc438540-956e8adf.jpg,validation," 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. " 61c398f2-e59648b4-e35f2705-caeba089-13819de1.jpg,validate/p14/p14450610/s56517509/61c398f2-e59648b4-e35f2705-caeba089-13819de1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp failure // eval for interval change to explain hypoxemia TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 5.2 cm above the carinal. NG tube tip is in the stomach. Cardiomegaly is substantial, unchanged. Slight interval improvement in interstitial pulmonary edema is demonstrated although still present, mild. Small bilateral pleural effusions are noted, potentially slightly increased since the prior study. Right central venous line tip is at the level of mid SVC. There is no evidence of pneumothorax. " 2d6c4b32-e012b3fc-eb806495-36816877-e329ff19.jpg,validate/p16/p16997767/s55669589/2d6c4b32-e012b3fc-eb806495-36816877-e329ff19.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Pleuritic chest pain, bronchitis and tachycardia. Assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear bilaterally. No focal consolidation, effusion or pneumothorax is seen. The cardiomediastinal silhouette appears normal and stable. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 426c73a9-e5ab2927-c37169c9-87f0d570-d4b9ee05.jpg,validate/p18/p18865198/s56898104/426c73a9-e5ab2927-c37169c9-87f0d570-d4b9ee05.jpg,validation," 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. " 9e2aedd7-244a5234-8592e0d5-ced983d8-a445ae61.jpg,validate/p19/p19994730/s55355225/9e2aedd7-244a5234-8592e0d5-ced983d8-a445ae61.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fever, anemia, questionable adenopathy. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. The hilar and mediastinal contours are unremarkable. Normal lung structure without evidence of adenopathy, lung nodules, pulmonary edema, or pulmonary infection. Normal size of the cardiac silhouette. " 48033bc1-7fef24ac-7c1d5c10-5f8b87cf-f2ca23ce.jpg,validate/p14/p14754515/s59782153/48033bc1-7fef24ac-7c1d5c10-5f8b87cf-f2ca23ce.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with worsening SOB // eval pulm edema IMPRESSION: In comparison to prior radiograph of 2 days earlier, moderate right pleural effusion has increased in size and a small left pleural effusion is new. Note is also made of possible ascites in the upper abdomen with note made of trace ascites on recent ultrasound of ___. No other relevant change. " ea9d92a5-76facb65-60c04c7d-abbebe89-91122d90.jpg,validate/p14/p14743778/s57371941/ea9d92a5-76facb65-60c04c7d-abbebe89-91122d90.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. Evaluate for cardiopulmonary process. COMPARISONS: Multiple prior chest radiographs, most recently ___ ___. Multiple prior chest CTs, most recently ___ ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. A linear opacity is again seen in the right upper lobe, stable across multiple prior exams and compatible with scarring. There is no evidence of new focal or diffuse pulmonary abnormality. There is no focal consolidation, pneumothorax, or pleural effusion. Osseous structures are unremarkable. No radiopaque foreign bodies. IMPRESSION: No acute cardiopulmonary process. " 4c110a31-db38e239-ce71ff8f-88ae370a-af48465e.jpg,validate/p15/p15287471/s50857377/4c110a31-db38e239-ce71ff8f-88ae370a-af48465e.jpg,validation," WET READ: ___ ___ ___ 7:37 PM Increased opacification of bilateral bases greater on the left than the right may represent worsening fluid overload but superimposed infection cannot be excluded. Increased pulmonary edema/vascular congestion. Support lines unchanged. Wetread placed in CCC by ___. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: New cough, low-grade temperature, assess for aspiration. Comparison is made with prior study ___. There is stable mild interstitial pulmonary edema. Bibasilar opacities larger on the left side consistent with atelectasis and effusions have minimally increased on the right. There is no pneumothorax. NG tube tip is out of view below the diaphragm. " 241b0c01-ec196e0d-d3ef702f-bca6b1ec-f1715f55.jpg,validate/p15/p15221763/s55159945/241b0c01-ec196e0d-d3ef702f-bca6b1ec-f1715f55.jpg,validation," FINAL REPORT HISTORY: Fever after transplant. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Lungs clear. Cardiac silhouette is unremarkable. Hilar contours are normal. No pleural effusion, pneumothorax, pulmonary edema or pneumonia. IMPRESSION: Normal chest. No evidence of acute cardiopulmonary process. " 68cdebce-3f2edb32-af5c5c73-61c0e3dd-4482cf87.jpg,validate/p10/p10568523/s58303938/68cdebce-3f2edb32-af5c5c73-61c0e3dd-4482cf87.jpg,validation," 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. " 899ee331-fa21fd54-cdc621c2-cca3c0b3-f67ba9c2.jpg,validate/p15/p15227454/s54640482/899ee331-fa21fd54-cdc621c2-cca3c0b3-f67ba9c2.jpg,validation," 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. " 3cacedf7-0574a8d3-ba3d5fc3-8b02c127-270c10ff.jpg,validate/p11/p11776988/s53805266/3cacedf7-0574a8d3-ba3d5fc3-8b02c127-270c10ff.jpg,validation," FINAL REPORT INDICATION: ___F w/chest pain, please eval for PTX, other pathology // 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. " 353c6e41-ec4b513a-ff24f54b-c13c7491-94a35def.jpg,validate/p16/p16581134/s53415236/353c6e41-ec4b513a-ff24f54b-c13c7491-94a35def.jpg,validation," 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. // intubated, eval placement intubated, eval placement IMPRESSION: Compared to chest radiographs ___ and ___. New opacification in both sides of the lower chest is due to a likely combination of definite increasing moderate bilateral pleural effusion and some basal atelectasis or pneumonia. The upper lungs are clear. Mild cardiomegaly is stable. No pneumothorax. ET tube in standard placement. " 9f3670e1-610bc0ca-6f5ce065-39e1dee5-a643a4fe.jpg,validate/p17/p17396841/s54741948/9f3670e1-610bc0ca-6f5ce065-39e1dee5-a643a4fe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p NSTEMI, hx ILD progressively worse consolidations, s/p PEA arrest this morning, high airway pressures, ?ETT repositioning needed // eval for ETT position, interval change eval for ETT position, interval change IMPRESSION: In comparison with the earlier study of this date, the endotracheal tube is well seated with the tip approximately 5.5 cm above the carina. Little change in the diffuse bilateral pulmonary opacifications, much of which represents interstitial lung disease. On the recent CT, the findings were described as raising the suggestion of associated pulmonary hemorrhage. " 1a908677-c91f4227-84309a7b-74aa3582-e4e0fee6.jpg,validate/p15/p15015008/s59455009/1a908677-c91f4227-84309a7b-74aa3582-e4e0fee6.jpg,validation," FINAL REPORT INDICATION: Cardiac arrest, currently intubated. Evaluation of ET tube placement TECHNIQUE: Portable AP chest radiograph. COMPARISON: Multiple priors, most recently ___. FINDINGS: The ET tube terminates in the standard position. The right internal jugular catheter still terminates in the right atrium. The NG tube terminates near the diaphragm and the side hole is clearly above the diaphragm. There is no change in cardiomegaly and bilateral pleural effusions. IMPRESSION: 1. Right internal jugular catheter still terminates in the right atrium and withdrawing it 3 cm should place it in the low SVC. 2. Sidehole still terminates above the diaphragm. These findings were discussed with ___ by phone at 12:11 p.m. on ___. " 532b14a2-9aedef91-1cdf2575-dec2b7e6-2d5c4d41.jpg,validate/p14/p14073122/s57458940/532b14a2-9aedef91-1cdf2575-dec2b7e6-2d5c4d41.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dizziness TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is top normal. Mediastinal and hilar contours are normal. Lungs are hyperinflated with emphysematous changes again demonstrated. Lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax is present. There is no pulmonary vascular engorgement. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. Emphysema. " 0b3da9e5-a8f2a62e-f4b1a410-58560264-1689cea9.jpg,validate/p19/p19601036/s59897079/0b3da9e5-a8f2a62e-f4b1a410-58560264-1689cea9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with sob s/p cabg. Assess for pneumonia or heart failure. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph separate ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate hypoinflated lungs. Persistent small bilateral pleural effusions are noted. Bilateral lower lobe atelectasis again noted. Retrocardiac opacity is most consistent with combination of atelectasis and pleural fluid given elevated left hemidiaphragm however cannot exclude overlying infection in the appropriate clinical setting. No focal opacity. No pneumothorax. Heart size mediastinal contour are unremarkable. Multiple clips noted within mediastinum in a patient who is status post coronary artery bypass graft. Diffuse hyperdensity of bilateral lungs is likely artifactual due to over penetration given hypodensities over bilateral subcutaneous tissue. Sternotomy wires are intact and mitral valve replacement is again noted. Limited assessment of upper abdomen is unremarkable and osseous structures are within normal limits. IMPRESSION: Persistent retrocardiac opacity is most consistent with combination of atelectasis and pleural fluid however cannot exclude overlying infection in the appropriate clinical setting. No evidence of pulmonary edema. " aaf9a094-d7daea12-25a49e1b-07df7ef4-756a8248.jpg,validate/p19/p19601895/s55347009/aaf9a094-d7daea12-25a49e1b-07df7ef4-756a8248.jpg,validation," FINAL REPORT HISTORY: Recent gastric banding with vomiting and heartburn. Assess gastric band location. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ upper GI. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. There are mild degenerative changes in the thoracic spine. Appropriate positioning of the gastric band is identified in the left upper quadrant of the abdomen. IMPRESSION: Appropriate positioning of the gastric band in the left upper quadrant. No acute cardiopulmonary abnormality. " e1d5d9c2-5b667a10-0af4eff1-6f125780-86d2a2da.jpg,validate/p16/p16223641/s54468727/e1d5d9c2-5b667a10-0af4eff1-6f125780-86d2a2da.jpg,validation," FINAL REPORT HISTORY: Right upper quadrant pain. Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is mildly enlarged. The aorta is tortuous and calcified. Pulmonary vascularity is normal and the hilar contours are unremarkable. There is minimal blunting of the costophrenic angles bilaterally compatible with small effusions, decreased in size compared to the prior exam. No focal consolidation or pneumothorax is seen. Multilevel degenerative changes in the thoracic spine are present with anterior osteophyte formation. IMPRESSION: Small bilateral pleural effusions, decreased from the prior exam. No focal consolidation to suggest pneumonia. " 908f5cdf-dc02ea69-5ffc302a-7f06fb19-fb3089df.jpg,validate/p12/p12541979/s56167005/908f5cdf-dc02ea69-5ffc302a-7f06fb19-fb3089df.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Lymphoma and fevers, evaluation for infection. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right-sided PICC line has been removed. The lung volumes are normal. There is no evidence of pneumonia. No pleural effusions. No pulmonary edema. Normal size of the cardiac silhouette, moderate tortuosity of the thoracic aorta. " 76aa1420-332e5aec-a3034954-94811f6d-e6c8e16b.jpg,validate/p10/p10421678/s51376311/76aa1420-332e5aec-a3034954-94811f6d-e6c8e16b.jpg,validation," FINAL REPORT INDICATION: ___M w pleural effusion on CT scan at OSH today, pls evaluate for interval inc in size TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: Lung volumes are low. Bilateral perihilar and bibasilar opacities are identified. Mild blunting of the right lateral costophrenic angle could represent a pleural effusion. No definite left pleural effusion identified. Moderate cardiac enlargement, aortic valve prosthesis, and left chest wall dual lead pacing device are noted. Surgical clips in the right upper quadrant suggest prior cholecystectomy. IMPRESSION: Bibasilar opacities potentially due to combination of atelectasis or infection. Possible small right pleural effusion based on this portable exam. No large effusion. " ce7e571f-9768f9dd-ae27fde8-e3eefdf4-1a74bed3.jpg,validate/p14/p14887253/s58210669/ce7e571f-9768f9dd-ae27fde8-e3eefdf4-1a74bed3.jpg,validation," WET READ: ___ ___ ___ 9:22 PM NGT follows expected course with tip beyond edge of film. left lung opacity is new from ___ and may represent asymmetric edema, aspiration, or developing infection WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: ___. 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 projects over the middle parts of the stomach. No evidence of complications, notably no pneumothorax. However, in the left upper lung, there is a newly appeared zone of increased radiodensity with air bronchograms, potentially suggesting aspiration or pneumonia. Moreover, there is a new opacity at the left lung base, potentially related to aspiration. At the time of dictation and observation, 8:24 a.m., on the ___, the referring physician ___. ___ was paged for notification. " b22d4c91-898d8c77-f09ec375-216d9e7e-934804fe.jpg,validate/p16/p16259867/s58569771/b22d4c91-898d8c77-f09ec375-216d9e7e-934804fe.jpg,validation," FINAL REPORT STUDY: PA and lateral chest performed on ___. CLINICAL HISTORY: ___-year-old male with cirrhosis and ascites and worsening clinical status with hepatorenal syndrome. FINDINGS: Comparison is made to previous study from ___. There is a feeding tube whose distal tip is not included on the edge of the film. The heart size is within normal limits. Lungs are clear. There are no radiographic signs for aspiration. There is no consolidation, pleural effusions or pulmonary edema. No pneumothoraces are identified. " a7e8f14d-b931f9b8-33fc4b6c-50d0a083-4e35d4d9.jpg,validate/p13/p13961079/s55508892/a7e8f14d-b931f9b8-33fc4b6c-50d0a083-4e35d4d9.jpg,validation," FINAL REPORT HISTORY: Tube placement and pulmonary edema. FINDINGS: In comparison with study of ___, there are again diffuse bilateral pulmonary opacifications with differential as previously described. Endotracheal tube tip lies approximately 5 cm above the carina. Nasogastric tube extends well into a dilated stomach. Swan-Ganz catheter from the IVC has its tip in the left pulmonary artery. The aortic device introduced through the femoral artery as its tip extending to the standard position in the left ventricle. This information has been discussed with the resident covering for Dr. ___. " a1a26192-3d932996-df3d25d1-1c8b4d5c-1a69c78b.jpg,validate/p18/p18049473/s58810010/a1a26192-3d932996-df3d25d1-1c8b4d5c-1a69c78b.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and palpitations. Evaluate for infiltrate. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. There are diffuse hazy opacities, most consistent with mild interstitial pulmonary edema. No pleural effusion or pneumothorax. No focal consolidation. Cardiomediastinal and hilar contours are unchanged. IMPRESSION: Mild interstitial pulmonary edema. " 3df0e87c-aafa2fad-d8c4c9b9-a90321b1-4e4bc053.jpg,validate/p11/p11994822/s51307379/3df0e87c-aafa2fad-d8c4c9b9-a90321b1-4e4bc053.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with left upper quadrant pain status post trauma, assess pneumothorax or left rib fracture. COMPARISON: None. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. The imaged bony structures are intact. No displaced rib fracture is seen. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 28f2e5ee-01bb6d0e-ccd563fd-52118ad7-6ad3c45e.jpg,validate/p14/p14092601/s57133095/28f2e5ee-01bb6d0e-ccd563fd-52118ad7-6ad3c45e.jpg,validation," 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. " 62708f52-fb1de29c-99febc8a-a376a2ee-9236d93d.jpg,validate/p17/p17261065/s57077989/62708f52-fb1de29c-99febc8a-a376a2ee-9236d93d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p LVAD // eval atelectasis/hemothorax COMPARISON: ___, 00:27 IMPRESSION: No relevant change as compared to the previous image. The appearance of the lung parenchyma, the heart and the multiple monitoring and support devices are constant. " a69519cf-ad7fca3c-c54cc4c6-c1b1dad0-4e511f63.jpg,validate/p15/p15469243/s50808641/a69519cf-ad7fca3c-c54cc4c6-c1b1dad0-4e511f63.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F w/fevers and cough, please eval for occult PNA. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lungs are hyperinflated, consistent with COPD. There is no focal consolidation concerning for pneumonia. Biapical scarring is present. Surgical clips in right upper quadrant are noted. Mild anterior wedging of a mid thoracic vertebral body is present. IMPRESSION: No acute cardiopulmonary process. Mild anterior wedging of a mid thoracic vertebral body of indeterminate age. " f78d3e1a-88d9e18b-36d11d2e-536a9a75-fea494bd.jpg,validate/p15/p15614172/s53554673/f78d3e1a-88d9e18b-36d11d2e-536a9a75-fea494bd.jpg,validation," FINAL REPORT INDICATION: Altered mental status and lethargy. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. Chest radiograph from ___. PET-CT from ___. TECHNIQUE: AP and lateral views of the chest were obtained with a total of three exposures. FINDINGS: The lung volumes are low, and the patient is slightly rotated. There is a new retrocardiac opacity which obscures the left hemidiaphragm. No other focal opacities are identified. There is no pulmonary edema, pleural effusion, or pneumothorax. The aorta is tortuous and calcified, unchanged from prior exams. The heart size is mildly enlarged, and also unchanged from prior exams. IMPRESSION: Retrocardiac opacity. This may represent infection or atelectasis. " a2564ddf-ec06df38-8264f96f-1a2639f6-91e27f3e.jpg,validate/p12/p12537194/s57681260/a2564ddf-ec06df38-8264f96f-1a2639f6-91e27f3e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lung malignancy c/b pleural effusion now s/p PleurX // Please perform at 8 AM: Eval for interval change Please perform at 8 AM: Eval for interval change IMPRESSION: Compared to chest radiograph ___ through ___. Moderate right pleural effusion is reaccumulating, and right lung is still collapsed. Mild edema persists in the left lung. Heart is moderately enlarged, slightly leftward shifted. Right basal pleural drainage tube still in place. " d0d6b3f3-b1bda99a-07f5f7ca-6c420669-7d7c78fc.jpg,validate/p12/p12590117/s51624087/d0d6b3f3-b1bda99a-07f5f7ca-6c420669-7d7c78fc.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with new orogastric tube placement, confirm position. 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 six hours earlier during the same day. The patient remains intubated, the ETT in unchanged position. The same holds for the previously described right subclavian approach central venous line bilateral chest tubes. No pneumothorax has developed. Evidence of wall emphysema as before in this patient with multiple rib fractures documented on preceding chest CT. Referring physician, ___, was paged at 1:35 p.m. following mutual discussiont was felt that a faintly visible NG tube could be recognized. This pinding, however, existed already on the previous study obtained six hours earlier. The conclusion was that an NG tube had reached successfully the stomach. " 19716d65-146d3281-c5453c32-d84698dc-578ded61.jpg,validate/p11/p11735403/s51475220/19716d65-146d3281-c5453c32-d84698dc-578ded61.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old male with rash and shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. There are streaky bibasilar opacities, potentially atelectasis. Superiorly, the lungs are clear. There is no effusion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality. IMPRESSION: Bibasilar opacities potentially due to atelectasis. Otherwise, no acute cardiopulmonary process. " 40c298a8-13fbef35-d58ab12b-22f479a8-b5d0ebcc.jpg,validate/p17/p17702631/s52487079/40c298a8-13fbef35-d58ab12b-22f479a8-b5d0ebcc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NG placed // STAT to confirm placement of NG STAT to confirm placement of NG IMPRESSION: No comparison. The patient has received a nasogastric tube. The tube shows a normal course, the tip projects over the middle parts of the stomach. No complications, notably no pneumothorax. Small bilateral areas of atelectasis at the lung bases. No pulmonary edema, no pleural effusions. " fbd78207-3dad685d-af8f549e-03431093-fe1946aa.jpg,validate/p11/p11131026/s54014077/fbd78207-3dad685d-af8f549e-03431093-fe1946aa.jpg,validation," WET READ: ___ ___ ___ 9:40 PM Mild pulmonary edema. More focal opacity in the retrocardiac region may represent a combination of edema and atelectasis, however in the appropriate clinical setting pneumonia cannot be excluded. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with sob // PNA? TECHNIQUE: AP and lateral views. COMPARISON: Radiograph ___. FINDINGS: Lung volumes are low. Cardiomegaly is likely mild-to-moderate. There is mild pulmonary edema. There is a small left pleural effusion. More focal opacity in the retrocardiac region may be related to low volumes and atelectasis, however pneumonia cannot be excluded. IMPRESSION: Low lung volumes with suspected superimposed pulmonary edema. More focal opacity in the retrocardiac region may represent a combination of edema and atelectasis, however in the appropriate clinical setting pneumonia cannot be excluded. " 1c1c426e-7b76a5de-3a68f8ae-b06dccb8-b5a4e2c0.jpg,validate/p18/p18834582/s56105737/1c1c426e-7b76a5de-3a68f8ae-b06dccb8-b5a4e2c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma exacerbation with decreased breath sounds bilat // r/o consolidation COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung volumes are normal. No pulmonary edema. No pneumonia, no pleural effusions. Normal size of the cardiac silhouette. " 021674da-8e7d96d8-78246f0f-ef70d5d0-77a03a4d.jpg,validate/p13/p13303049/s53818597/021674da-8e7d96d8-78246f0f-ef70d5d0-77a03a4d.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess for fracture in the left side, the patient with left elbow fracture. There is mild-to-moderate cardiomegaly. The aorta is tortuous. There is no pneumothorax or pleural effusions. There is no evidence of rib fractures. Of note, this examination was not tailored for evaluation of osseous structures and with clinically persistent concern, dedicated rib series can be performed. There are mild degenerative changes in the thoracic spine. The lungs are hyperinflated. Partially evaluated hardware material in the left humerus . " 8fc71714-4069a19f-8c5c310e-cccac933-8c1064be.jpg,validate/p18/p18364018/s59778351/8fc71714-4069a19f-8c5c310e-cccac933-8c1064be.jpg,validation," FINAL REPORT INDICATION: ___F with chest tightness and dyspnea since ___ with associated productive cough. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT from ___ FINDINGS: The lungs are well inflated and clear. There is enlargement of the central pulmonary arteries suggestive of underlying pulmonary arterial hypertension. The aorta is tortuous. The cardiac silhouette is normal in size. There is no pleural effusion or pneumothorax. IMPRESSION: No focal consolidation. Enlargement of the central pulmonary arteries, suggesting the possibility of underlying pulmonary arterial hypertension. " e44a322b-16d20535-bfb6863e-9c8a4c3f-68b1dc84.jpg,validate/p14/p14958299/s57679343/e44a322b-16d20535-bfb6863e-9c8a4c3f-68b1dc84.jpg,validation," 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. " ce2f5f5f-db1eddb1-1f959c02-adc53e3e-203cef84.jpg,validate/p18/p18909627/s50459208/ce2f5f5f-db1eddb1-1f959c02-adc53e3e-203cef84.jpg,validation," FINAL ADDENDUM ADDENDUM Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state cough. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with see above. // Pneumoniain the carribean ___, please assess for resultion. Pneumoniain the carribean ___, please assess for resultion. IMPRESSION: In comparison with the study of ___, there is little change no evidence of acute cardiopulmonary disease. The study from ___ is not in the system at this time. " ebd448d0-12a1c8cc-74c9af44-d1efbe7b-8819a708.jpg,validate/p18/p18486197/s57691620/ebd448d0-12a1c8cc-74c9af44-d1efbe7b-8819a708.jpg,validation," 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. " a83c7ff9-2d42639c-6ddebd0e-6b67809b-38210026.jpg,validate/p10/p10001401/s57492692/a83c7ff9-2d42639c-6ddebd0e-6b67809b-38210026.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old woman with NGT re-placed // Assess for NGT placement, interval change TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph ___ 12:12 FINDINGS: NG tube is coiled in the stomach. Right PICC in lower SVC is unchanged in position. Cardiac size is normal. Mild bibasilar opacities consistent with atelectasis, unchanged compared to chest radiograph performed earlier in the same day. There is no pneumothorax or pleural effusion. IMPRESSION: NG tube in expected position with tip coiled in the stomach. No other interval change since chest radiograph performed earlier on the same day. " 2aa5fa97-b4348608-898dd3d5-060cad5d-9f2f0fe1.jpg,validate/p11/p11493670/s57972460/2aa5fa97-b4348608-898dd3d5-060cad5d-9f2f0fe1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new Dobhoff. // Evaluate Dobhoff placement. Evaluate Dobhoff placement. COMPARISON: Chest radiographs ___ through ___. IMPRESSION: 2 chest radiographs show successive advancement of the feeding tube, with the wire stylet in place from the lower esophagus to the mid stomach. Lungs are low in volume but essentially clear. Heart size is normal. There is no pleural abnormality. " 90e216c6-a0555132-f8b5c517-d3e61efa-433fd3da.jpg,validate/p15/p15249829/s55203224/90e216c6-a0555132-f8b5c517-d3e61efa-433fd3da.jpg,validation," FINAL REPORT HISTORY: Fatigue TECHNIQUE: PA and lateral chest radiograph, 2 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. " 26c247c7-39536030-ae3e53c6-e5fb2a84-38e106e8.jpg,validate/p14/p14832062/s51789425/26c247c7-39536030-ae3e53c6-e5fb2a84-38e106e8.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with pulmonary edema, interval change. COMPARISON: ___. FINDINGS: Moderate interstitial edema has worsened and is now moderate to severe. There is one focal area more confluent in right upper lobe. It could still be asymmetric edema, but close followup to this area is suggested to rule out developing pneumonia. Bilateral small pleural effusions with atelectasis have either worsened or are new. Cardiac contour is moderately enlarged. CONCLUSION: 1. Worsening of moderate to severe pulmonary edema. 2. Right upper lobe confluent opacification could still represent asymmetric pulmonary edema; however, close attention to this area in followup is suggested to rule out developing pneumonia. " 90277366-d95a7fa6-02e4412f-b274ff8c-e3787fd8.jpg,validate/p17/p17517983/s52490734/90277366-d95a7fa6-02e4412f-b274ff8c-e3787fd8.jpg,validation," FINAL ADDENDUM ADDENDUM Discussed with Dr. ___ ___ the phone by Dr. ___ at 11:50 a.m. on ___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with diabetes, CKD on dialysis with acute hypoxemia. // pulmonary edema, infection? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there has been interval development of interstitial pulmonary edema, mild to moderate. Cardiomegaly is substantial. No interval increase in pleural effusion or development of pneumothorax demonstrated " 107248df-2cb99f6a-65a0b8bf-271825ee-afb7683c.jpg,validate/p16/p16833802/s50240187/107248df-2cb99f6a-65a0b8bf-271825ee-afb7683c.jpg,validation," FINAL REPORT INDICATION: EKG changes and shortness of breath. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The aorta is mildly unfolded with some aortic knob calcifications. The pulmonary vascularity is normal, and the hilar contours are unremarkable. The lungs are clear. No pleural effusion or pneumothorax. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 7ddc973c-5b2d7918-06fde940-d6e2662e-639dcef4.jpg,validate/p16/p16773746/s59815613/7ddc973c-5b2d7918-06fde940-d6e2662e-639dcef4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p inferior MI // ?worsening pulmonary edema COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous image. Mild fluid overload but no overt pulmonary edema. Low lung volumes. Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta. No pleural effusions. No pneumonia. " 5e5c24d8-af4dcd5a-a91d5df8-e16f03ab-134107d7.jpg,validate/p15/p15248985/s50427363/5e5c24d8-af4dcd5a-a91d5df8-e16f03ab-134107d7.jpg,validation," 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. " 6048997d-c658744c-bba0860b-c608ed6d-67bfc6b1.jpg,validate/p15/p15549843/s56228698/6048997d-c658744c-bba0860b-c608ed6d-67bfc6b1.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with multiple myeloma, c/o persistent productive cough, increased sleepiness, O2 sat ___% // r/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest CTA ___, chest radiograph ___. FINDINGS: Tortuosity of the descending thoracic aorta is noted. The cardiomediastinal and hilar contours are otherwise within normal limits. There is no pleural effusion or pneumothorax. The lungs are well-expanded and without focal consolidation concerning for pneumonia. Bibasilar atelectasis is present. Small nodular opacities at the lung apices are noted, which may be projectional or represent pulmonary nodules. These were not clearly present on the prior exam. The upper abdomen is unremarkable in appearance. Multiple compression fractures of the lower thoracic spine are noted. IMPRESSION: 1. No pneumonia or other acute process. 2. Nodular opacities in both lung apices, which may be projectional. RECOMMENDATION(S): Lordotic views or chest CT is recommended for further evaluation of the nodular opacities in the lung apices. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 17:17 into the Department of Radiology critical communications system for direct communication to the referring provider. " ca9775a9-33c41329-04f02f75-346ab8ac-90bf1500.jpg,validate/p17/p17113540/s56858610/ca9775a9-33c41329-04f02f75-346ab8ac-90bf1500.jpg,validation," FINAL REPORT HISTORY: Pre-operative. FINDINGS: In comparison with study of ___, there are mildly lower lung volumes. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. " 43109698-6da12e6b-1841c766-d51976df-4a0a2c86.jpg,validate/p16/p16950272/s51562070/43109698-6da12e6b-1841c766-d51976df-4a0a2c86.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with small-bowel obstruction, recently treated for pneumonia. Evaluate for persistent pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Chest, portable. The right middle lobe opacity has resolved. The lungs are clear. An unfolded aortic configuration is again noted. The hilar and cardiac contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: The right middle lobe opacity has resolved and the lungs are now clear. " adca8add-98f6bf77-8a4fc11b-6a3404ea-50cff8f9.jpg,validate/p19/p19090986/s55074874/adca8add-98f6bf77-8a4fc11b-6a3404ea-50cff8f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with anxiety, depression presents with weakness after solumedrol // eval for intrapulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are low. The heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is present. IMPRESSION: No acute cardiopulmonary abnormality. " 0decaecd-2722f7a7-ca23d058-2e431a33-3d5c0163.jpg,validate/p14/p14156574/s53980084/0decaecd-2722f7a7-ca23d058-2e431a33-3d5c0163.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dysphagia. Question foreign body. 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. There is no evidence for radiodense foreign body. IMPRESSION: No evidence for mediastinal widening or air; no evidence for radiodense foreign body. " 81f5667d-2c827bb5-8425735a-6e15d570-dd96d50a.jpg,validate/p13/p13567471/s56768420/81f5667d-2c827bb5-8425735a-6e15d570-dd96d50a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with severe COPD and worsening respiratory distress. Assess for pneumonia. COMPARISON: Chest radiographs ___, ___, ___, ___. TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: Right PICC tip is in the mid SVC. Sternotomy wires are intact. Mild vascular engorgement with normal heart size, no pleural effusion, mediastinal vein dilatation, or pulmonary edema. No new focal opacity or pneumothorax. Prior hyperinflated lung volumes are now mildly decreased with new mild right lower lobe atelectasis. IMPRESSION: New mild right lower lobe atelectasis. No pneumonia. " 446f1825-98494079-aad2cbc1-822a837f-f1e8abb8.jpg,validate/p19/p19699616/s59246724/446f1825-98494079-aad2cbc1-822a837f-f1e8abb8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo F w/ T11/T12 osteomyelitis/discitis causing focal spinal canal narrowing and cord compression now s/p L thoracotomy, T11/T12 corpectomy + instrumentation of T12-L1 // eval for interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent of the known left pleural effusion. Otherwise, the radiograph is unchanged. Moderate cardiomegaly. Right PICC line in situ. Status post vertebral stabilization. No visible pulmonary abnormality. " d0fbfe59-b7c26e40-7a890079-93876917-df6c90b9.jpg,validate/p15/p15240073/s59040893/d0fbfe59-b7c26e40-7a890079-93876917-df6c90b9.jpg,validation," WET READ: ___ ___ ___ 7:58 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with persistent cough fevers and chills despite antibiodics // r/o infectious process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are low. The lungs are clear. Heart size and mediastinal contours are normal. There is no pleural effusion or pneumothorax. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 276fefd2-23bb1ce4-142381b2-809290ed-df644550.jpg,validate/p10/p10405915/s54645315/276fefd2-23bb1ce4-142381b2-809290ed-df644550.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tube post stab wounds. // r/o pneumonia post CT water seal TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes remain low, particularly on the right where there is blunting of the costophrenic angle consistent with a small pleural effusion. The right-sided chest tube is unchanged in position, post lateral chest wall. No pneumothorax seen. The cardiomediastinal contour is unchanged. No consolidation seen. IMPRESSION: No significant interval change when compared to the prior study. " cdc68b3b-aaa0f08d-93e8c16b-aa59e19d-1a6d9b31.jpg,validate/p16/p16660031/s55708873/cdc68b3b-aaa0f08d-93e8c16b-aa59e19d-1a6d9b31.jpg,validation," FINAL REPORT HISTORY: History of dyspnea, chest pain. Please evaluate for acute cardiopulmonary process. COMPARISON: Multiple prior chest radiographs dating back to ___, most recently from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are unremarkable. There is mild bibasilar atelectasis. No focal consolidations concerning for pneumonia are identified. There is no large pleural effusion or pneumothorax. Note is made of possible minimal thickening, less likely very trace fluid within the minor fissure. IMPRESSION: No acute intrathoracic abnormalities identified. " c917385d-628dc690-732c934d-e2cfbe05-73c0e0d1.jpg,validate/p11/p11581156/s57544312/c917385d-628dc690-732c934d-e2cfbe05-73c0e0d1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p left chest tube removal // ? interval change or left pnx COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the left chest tube has been pulled. A small left postprocedural pneumothorax persists. There is no evidence of tension. Air collection in the left soft tissues is constant. On the right, there is unchanged evidence of atelectatic changes at the lung bases. The appearance of the new esophagus is not substantially changed. Unchanged size of the cardiac silhouette. " 6e97f0cf-fe079635-c63d55bb-ce66d4d9-b0715b7d.jpg,validate/p12/p12521910/s58451104/6e97f0cf-fe079635-c63d55bb-ce66d4d9-b0715b7d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with possible calcific lymph nodes // ? calcific lymph nodes at edge of film not seen on ___ xray COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are fully expanded and essentially clear. Granulomatous calcifications are present in right hilar lymph nodes, and in the superior segment of one of the lower lobe seen on the lateral view. There is no evidence of active infection. Cardiomediastinal silhouettes and pleural surfaces are normal. " 441bde62-fd9cb0e7-d068c6e6-fc1bbb35-d819fb22.jpg,validate/p15/p15152711/s53630429/441bde62-fd9cb0e7-d068c6e6-fc1bbb35-d819fb22.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with etoh cirrhosis, s/p recent TIPS, cough and PND since the procedure // pls assess for volume overload or PNA pls assess for volume overload or PNA IMPRESSION: Compared to chest radiographs since ___, most recently ___. Small right pleural effusion is new. Pulmonary vasculature is more engorged, but there is no edema or mediastinal venous distention. Heart size normal. " 4acfbe6b-f198f033-6fc737cd-7caa42e8-ca329edd.jpg,validate/p12/p12759187/s55972134/4acfbe6b-f198f033-6fc737cd-7caa42e8-ca329edd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/new chest tube placement // evaluate for pneumothorax, interval changes TECHNIQUE: Single frontal view of the chest COMPARISON: Portable chest x-ray ___ FINDINGS: Right moderate pleural effusion is stable. Moderate cardiomegaly is stable. Pulmonary vascular congestion is increased. The left IJ dialysis catheter terminates within low SVC. The right IJ catheter with temporary pacer terminates within the right ventricle. The right pigtail catheter is in the right lower thorax. There is no pneumothorax. IMPRESSION: 1. Stable right moderate pleural effusion. 2. Increased pulmonary vascular congestion. 3. No pneumothorax. " d75b1748-1c4c5d79-4e36324d-93a97bd5-74970997.jpg,validate/p12/p12648465/s56601701/d75b1748-1c4c5d79-4e36324d-93a97bd5-74970997.jpg,validation," FINAL REPORT INDICATION: ___-year-old with shortness of breath and chest pain. COMPARISON: Chest radiograph ___. TECHNIQUE: AP and lateral views of the chest were obtained. FINDINGS: The cardiomediastinal contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded. Right perihilar and right base opacities are new and concerning for multifocal infectious process. The left lung is essentially clear. The upper abdomen is unremarkable. IMPRESSION: Multifocal opacities in the right lung concerning for infection. Dr. ___ ___ this result with Dr. ___ ___ telephone at 2:15 PM on ___. " 052e37d9-26bb1446-289bb4d0-44270ccb-489c9360.jpg,validate/p17/p17440770/s55644525/052e37d9-26bb1446-289bb4d0-44270ccb-489c9360.jpg,validation," FINAL REPORT EXAMINATION: Chest (PA and lateral) INDICATION: ___-year-old woman presenting left sided chest pain; evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unremarkable. Calcifications in the aortic knob and unchanged. Stable, mildly tortuous or ectatic descending aorta. No acute osseous abnormality. Postsurgical changes incidentally noted at the left humerus. IMPRESSION: No acute intrathoracic process. " 788417a6-da54ac33-061c6f93-483a5e59-8cae45de.jpg,validate/p12/p12459657/s58586941/788417a6-da54ac33-061c6f93-483a5e59-8cae45de.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear aside from minimal bibasilar atelectasis. Left ventricle is again enlarged. There is no pleural effusion or pneumothorax. Elevted right hemidiaphragm again noted. This patient is status post median sternotomy as well as mitral valve replacement. Aorta is tortuous with a calcified aortic knob. IMPRESSION: No evidence of acute cardiopulmonary process. No evidence of pneumothorax. " 8d63904b-08729784-bfd38f22-d12e6d36-aafdd12e.jpg,validate/p12/p12648465/s50263796/8d63904b-08729784-bfd38f22-d12e6d36-aafdd12e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with new central line // eval CVL placement TECHNIQUE: Frontal view of the chest COMPARISON: Multiple prior radiographs most recent on ___ FINDINGS: A right-sided internal jugular catheter terminates at the cavoatrial junction. 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-sided internal jugular catheter terminates at cavoatrial junction. No pneumothorax. " 425647fc-dae08bc2-af2fa926-c8755811-6250681c.jpg,validate/p16/p16934455/s58103985/425647fc-dae08bc2-af2fa926-c8755811-6250681c.jpg,validation," FINAL REPORT INDICATION: ___ year old man with improving dyspnea edema and pleyral egffusions // clinical chf improving no need to call covering if that is the reading COMPARISON: Radiographs from ___ IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are small bilateral effusions, left greater than right. No focal consolidation is seen. There are no pneumothoraces. " 764e7318-a99d8101-cf4a8121-ad68aab8-dc3c19f0.jpg,validate/p17/p17689868/s55421787/764e7318-a99d8101-cf4a8121-ad68aab8-dc3c19f0.jpg,validation," FINAL REPORT HISTORY: ___-year-old male pedestrian struck by car. STUDY: AP and lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. No displaced rib fracture is present. IMPRESSION: No evidence of thoracic injury. " d8fb6774-553ee5ee-bc7ccf8d-f9c8872d-14bd2a11.jpg,validate/p19/p19405755/s59052833/d8fb6774-553ee5ee-bc7ccf8d-f9c8872d-14bd2a11.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with UTI on antibiotics now with fever // ?PNA ?PNA IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs. Specifically, no evidence of acute pneumonia. " 3d91c13e-8540dce5-ae49ab93-d1d6e069-c72c3113.jpg,validate/p12/p12043836/s51213177/3d91c13e-8540dce5-ae49ab93-d1d6e069-c72c3113.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ongoing cough and poor air movement right lower/mid lung field. // rule out effusion or pneumonia COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. There is large right pleural effusion with compressive atelectasis. The left lung is clear. The heart is again seen to be severely enlarged. On lateral view, there may be a small fluid collection between the epicardial and pericardial fat pads. Pulmonary vasculature is normal. Median sternotomy wires and valvular repairs are seen. IMPRESSION: 1. New large right pleural effusion. 2. Massive cardiomegaly without pulmonary edema. Differential includes pericardial effusion versus cardiomyopathy. Echocardiogram is recommended for further assessment. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:32 PM, 15 minutes after the images were reviewed. " e682827b-ae5b5e5a-7d9c62b5-039bdc57-6371ee54.jpg,validate/p11/p11861017/s51061098/e682827b-ae5b5e5a-7d9c62b5-039bdc57-6371ee54.jpg,validation," FINAL REPORT INDICATION: ___ year old man with SDH and bilateral pleural effusions // chest tube placement COMPARISON: ___ IMPRESSION: Tracheostomy tube, left-sided PICC line, and right-sided chest tube are unchanged in position. There is a persistent left retrocardiac opacity. There is mild improved aeration of the opacity at the right base. There remains mild prominence of the pulmonary interstitial markings. Small bilateral effusions are unchanged. There are no pneumothoraces. " 94113888-0d63ee05-80b2e344-d3ce7efb-6bfb3a46.jpg,validate/p11/p11401718/s59578120/94113888-0d63ee05-80b2e344-d3ce7efb-6bfb3a46.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough, congestion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is mild right middle lobe atelectasis, without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " dc21ba19-a3016db1-4ee135c2-94b71e4d-5fa0499c.jpg,validate/p16/p16151261/s51591214/dc21ba19-a3016db1-4ee135c2-94b71e4d-5fa0499c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MCC w/ C5 fracture and quadriplegia s/p PEG on ___ with right sided free air noted on prior scans and partial left lower lung collapse. Assess for interval change of right sided free air, assess for interval change of left lower lung. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiographs of ___, ___. Trauma torso of ___ FINDINGS: Compared with the prior study, left basilar consolidation may be due to volume loss, however superimposed pneumonia is not excluded, especially given the absence of a lateral view. The left PICC line tip is at the cavoatrial junction. Cardiomediastinal and hilar silhouettes are similar in appearance. Tracheostomy appears in place. Incidental note is made of spinal hardware and a right clavicular fracture, as seen on the initial trauma torso from ___. IMPRESSION: 1. Left basilar consolidation may be due to volume loss, however superimposed pneumonia is not excluded, especially given the absence of a lateral view. 2. No evidence of free subdiaphragmatic air on this single view. " c0cb9ed0-956d1f04-7b503c9c-31746cbb-f4eba72f.jpg,validate/p14/p14508231/s59897080/c0cb9ed0-956d1f04-7b503c9c-31746cbb-f4eba72f.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post fall. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The AP view is lordotic. 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 aside from prior cervical fusion surgery. IMPRESSION: No evidence of acute disease. Status post incompletely characterized cervical fusion. " d2458600-6175ab77-67f83c34-1795f31b-ce67e3d7.jpg,validate/p16/p16395156/s54938307/d2458600-6175ab77-67f83c34-1795f31b-ce67e3d7.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with cough for one month. COMPARISON: ___ FINDINGS: Two PA and one 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. IMPRESSION: No acute cardiopulmonary process. " 46286f1b-78288046-80600ff4-f93c7b20-ebc44310.jpg,validate/p19/p19343087/s56768200/46286f1b-78288046-80600ff4-f93c7b20-ebc44310.jpg,validation," WET READ: ___ ___ ___ 7:21 AM Low lung volumes causing bronchovascular crowding. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with epigastric pain chest pain, evaluate for pneumonia or pneumothorax. TECHNIQUE: Portable AP upright view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: Low lung volumes cause bronchovascular crowding. Allowing for this, there is no significant pulmonary vascular congestion or pulmonary edema. There is no pleural effusion, focal consolidation, or pneumothorax. The cardiomediastinal silhouette is stable. A moderate hiatal hernia is unchanged from multiple prior studies. The osseous structures and upper abdomen are unremarkable. IMPRESSION: Low lung volumes causing bronchovascular crowding. No acute cardiopulmonary process. " 8cc1d9ba-41ac1008-78c3aa72-83bac233-d2710113.jpg,validate/p18/p18552050/s57795460/8cc1d9ba-41ac1008-78c3aa72-83bac233-d2710113.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F here with molar pregnancy, vaginal bleeding. // Any evidence of lung pathology? TECHNIQUE: Chest PA and Lateral COMPARISON: None 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. " b714c925-1fb4b61b-49d192fa-05831f59-62790803.jpg,validate/p18/p18971123/s57884521/b714c925-1fb4b61b-49d192fa-05831f59-62790803.jpg,validation," WET READ: ___ ___ ___ 7:10 PM Enteric tube remains in the stomach. Right PICC in unchanged position with tip at the cavoatrial junction. Otherwise unremarkable chest radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NG tube that was slightly pulled back - please eval if still in stomach // ___ year old woman with NG tube that was slightly pulled back - please eval if still in stomach ___ year old woman with NG tube that was slightly pulled back - please eval if still in stomach COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Feeding tube ends in the distal stomach. Lungs clear. Heart size normal. No pleural abnormality. " d56710de-055ecd10-f87ac412-ca09e555-22756436.jpg,validate/p13/p13335621/s53871058/d56710de-055ecd10-f87ac412-ca09e555-22756436.jpg,validation," WET READ: ___ ___ ___ 6:11 AM No evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with fever sob // pna? 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. IMPRESSION: No evidence of pneumonia. " 246db040-07707fd5-273db072-0b4f4bae-f0ca471c.jpg,validate/p18/p18971123/s52311815/246db040-07707fd5-273db072-0b4f4bae-f0ca471c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with need for feeding tube advancement // placement of feeding tube COMPARISON: None. FINDINGS: A Dobhoff type tube is present, with a radiopaque tip. The tip overlies the left upper quadrant of the abdomen, likely in the proximal stomach. It does not extend beyond the pylorus. No free air seen beneath the diaphragm. A right subclavian PICC line is again noted, tip over distal SVC. The heart is not enlarged. No CHF, focal consolidation or gross effusion is identified. Incidental note is made of mild sigmoid scoliosis of the thoracolumbar spine. IMPRESSION: As above. " 1e06dcd2-3fd27509-1271cf3e-f9216ac4-70b20372.jpg,validate/p10/p10963896/s59410765/1e06dcd2-3fd27509-1271cf3e-f9216ac4-70b20372.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Night sweats, prednisone, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No pulmonary infection, no pleural effusions. No pulmonary edema. Azygos lobe is anatomically normal variant. " 054fccce-d8a08ea2-f0b6a4d1-07c8b118-15f43e00.jpg,validate/p18/p18194315/s55893076/054fccce-d8a08ea2-f0b6a4d1-07c8b118-15f43e00.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with high blood pressure, limited history TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are low. Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Crowding of bronchovascular structures is present without overt pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. Mild loss of height of a vertebral body at the thoracolumbar junction appears similar to the previous radiograph. IMPRESSION: Low lung volumes. No acute cardiopulmonary abnormality. " 62bc6d27-1de30255-c01dfa7a-73389565-ef243bc4.jpg,validate/p18/p18084645/s55536485/62bc6d27-1de30255-c01dfa7a-73389565-ef243bc4.jpg,validation," FINAL REPORT AP CHEST, 6:05 A.M. ON ___ HISTORY: An ___-year-old woman with consolidation and effusion. IMPRESSION: AP chest compared to ___: Interstitial pulmonary edema, has changed in distribution, milder in the right lung, more pronounced in the left. Hyperinflation reflects COPD. Heart size normal. Small left pleural effusion is likely. Left subclavian line ends in the SVC. Upper enteric drainage tube ends in non-distended stomach. Leftward displacement of the trachea at the thoracic inlet reflects the large goiter documented by torso CT scanning on ___ " 2aa2b2cc-7286e672-8760cbc2-ba0e4cf0-86f4b410.jpg,validate/p11/p11723168/s56090974/2aa2b2cc-7286e672-8760cbc2-ba0e4cf0-86f4b410.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with multiple myeloma, fever, please evaluate for pneumonia. COMPARISON: None. FINDINGS: There is no pneumonia. Bibasilar atelectasis is minimal. There is no pleural effusion or pneumothorax. The cardiac contour is mildly enlarged, and the aorta is tortuous. Patient is known with severe compression fracture of T12 as shown in recent MRI. CONCLUSION: There is no radiologic evidence of pneumonia. " 12c2bce6-a865d3cb-1ebaffe2-7f355870-256e94b7.jpg,validate/p18/p18552808/s50307863/12c2bce6-a865d3cb-1ebaffe2-7f355870-256e94b7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ hx RHD and MR, ?paroxysmal Afib presented to BI-N afternoon ___ s/p 24hr of non-bloody clearish emesis x6, >5 loose brown stools with DOE and chest heaviness found to be in afib with RVR. // interval change in pleural effusions interval change in pleural effusions IMPRESSION: COMPARED TO CHEST RADIOGRAPHS ___. Previous mild to moderate pulmonary edema has cleared. Bibasilar atelectasis, mild on the right, moderate on the left is new, accompanied by small pleural effusions, left greater than right. Mild cardiomegaly unchanged. No pneumothorax. " c2a83db5-c124a313-6260a164-08576b79-ea12e73d.jpg,validate/p13/p13791874/s50345511/c2a83db5-c124a313-6260a164-08576b79-ea12e73d.jpg,validation," 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. " ff399a82-fd0b83ac-17daf24b-8de48801-ee6ef481.jpg,validate/p11/p11561883/s56943669/ff399a82-fd0b83ac-17daf24b-8de48801-ee6ef481.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Relatively low lung volumes are seen. There is no evidence of consolidation or effusion. The cardiomediastinal silhouette is within normal limits given this limitation. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 4ac7095b-038e7377-0506e2cf-a5046c6f-a950fc40.jpg,validate/p10/p10979480/s53950414/4ac7095b-038e7377-0506e2cf-a5046c6f-a950fc40.jpg,validation," FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Partially visualized are ___ rods in the thoracolumbar spine. A right-sided Port-A-Catheter ends at the right cavoatrial junction. Lungs are clear. The cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute cardiothoracic process. " 98c7aa1a-612906fe-ba3cb5f9-903d2612-462165c1.jpg,validate/p14/p14261116/s54912551/98c7aa1a-612906fe-ba3cb5f9-903d2612-462165c1.jpg,validation," FINAL REPORT INDICATION: ___-year-old male status post cardiac surgery after chest tube removal, assess for interval change. COMPARISONS: ___. Endotracheal tube, nasogastric tube and chest tubes have been removed. Right IJ central venous catheter terminates in the mid-to-distal SVC. Left basal atelectasis and effusion are slightly increased after extubation. No pneumothorax is seen. The heart remains moderately enlarged. IMPRESSION: Small left effusion and atelectasis without pneumothorax after chest tube removal. " 3de47e72-76e8b156-dbaf27e9-8382dd6d-ab6b5666.jpg,validate/p15/p15225349/s58327275/3de47e72-76e8b156-dbaf27e9-8382dd6d-ab6b5666.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left chest tube, s/p right chest tube, small apical right pneumo // interval change, please perform first thing in AM. TECHNIQUE: PA and lateral COMPARISON: ___ FINDINGS: The left-sided chest tube has been removed. A right-sided apical pneumothorax has increased in size, is now moderate. There is also a loculated anterior pneumothorax, which also has increased in size on the right. Multiple additional areas of loculated hydro pneumothorax are seen in the left lower lobe which are stable. There is a new right lower lobe opacity representing consolidation/atelectasis. The left retrocardiac opacity is unchanged. The cardiac silhouette remains enlarged. IMPRESSION: Interval increase in size of right apical pneumothorax and right anterior loculated hydropneumothorax, which are moderate in size. Similar very small left apical pneumothorax and small loculated basilar hydropneumothorax. Worsening atelectasis/consolidation in the right lower lobe NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:37 PM, 5 minutes after discovery of the findings. " b3ed2072-9114af74-dbee483a-f0e32a04-45491cfd.jpg,validate/p16/p16216201/s52242581/b3ed2072-9114af74-dbee483a-f0e32a04-45491cfd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with leukocytosis // infiltrate? COMPARISON: None FINDINGS: AP portable supine view of the chest. Left chest wall AICD is noted with leads extending to the region the right atrium and right ventricle. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process " 36a7477d-8a55ce4b-4859ccc0-a4cff224-c953b8ec.jpg,validate/p15/p15588831/s50895808/36a7477d-8a55ce4b-4859ccc0-a4cff224-c953b8ec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest tube s/p VATS // assess interval change IMPRESSION: As compared to previous study of 1 day earlier, a right pleural effusion has changed in position and is now predominantly subpulmonic. Slight improved aeration is noted at both lung bases. No other read relevant changes since the recent study. " cd189dd2-eb13fb42-03b528e4-65a1ccdc-5b8a2776.jpg,validate/p13/p13312176/s55702621/cd189dd2-eb13fb42-03b528e4-65a1ccdc-5b8a2776.jpg,validation," WET READ: ___ ___ 12:07 AM no evidence of pneumonia ______________________________________________________________________________ FINAL REPORT HISTORY: Lymphoma with recent pneumonia. FINDINGS: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. Specifically, no evidence of pneumonia. " c9e5f9f4-1dbb6cbf-df617019-0b01d806-68fe5813.jpg,validate/p14/p14553638/s56394051/c9e5f9f4-1dbb6cbf-df617019-0b01d806-68fe5813.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Dyspnea, hypoxia, hypertension. Comparison is made with prior study ___. Moderate cardiomegaly and tortuous aorta are unchanged. Left lower lobe opacity is grossly unchanged. As mentioned before, this could be pneumonia. There is a small left effusion. Cardiomediastinal contours are unchanged. Right lower lobe atelectasis has improved. There is no pneumothorax. " 101c7def-7cefb98a-f4edefef-3d846ffd-b8e5aa88.jpg,validate/p18/p18950783/s54690994/101c7def-7cefb98a-f4edefef-3d846ffd-b8e5aa88.jpg,validation," FINAL REPORT INDICATION: Cough. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiac, mediastinal, and hilar contours are within normal limits. There is no evidence for pulmonary consolidation, pulmonary edema, pleural effusion, or pneumothorax. Visualized bones appear unremarkable. IMPRESSION: No evidence for pneumonia. " 72f7b5b3-4ffc0542-c813dad5-56840677-414c5e57.jpg,validate/p17/p17246353/s57244300/72f7b5b3-4ffc0542-c813dad5-56840677-414c5e57.jpg,validation," 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. " 3deeb2c1-6878ebdc-d9bc2229-017e9fa3-56a2affe.jpg,validate/p11/p11089487/s54315457/3deeb2c1-6878ebdc-d9bc2229-017e9fa3-56a2affe.jpg,validation," FINAL REPORT INDICATION: History of intubation. Please evaluate for ET tube placement. COMPARISONS: CT from ___. TECHNIQUE: Single frontal portable radiograph of the chest. FINDINGS: ET tube terminates approximately 3.4-cm above the carina. There is an enteric tube which extends below the diaphragm, with the tip out of view of this film. There is a large distended, gas-filled loop of bowel traversing horizontally across the upper abdomen, better evaluated on the prior CT. The heart size is normal. There is mild dilatation of the esophagus. Opacities are seen at the right upper lung and bases of the lungs bilaterally. There is no large pleural effusion or pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. ET tube terminates approximately 3.4 cm above the carina. 2. Opacities at the lung bases may be secondary to aspiration/pneumonia. 3. Gas-filled distended loop of bowel traversing across the abdomen, is better evaluated on the dedicated CT of the abdomen. Enteric tube extends below the diaphragm with the tip out of view of this film. " 188c5f3a-3e69aa65-7fb5d66b-695a058e-e6afe429.jpg,validate/p19/p19359981/s54129748/188c5f3a-3e69aa65-7fb5d66b-695a058e-e6afe429.jpg,validation," FINAL REPORT INDICATION: History: ___F with CP // eval for infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6d90e6ac-e969b273-c3688526-e353c242-e947bcb4.jpg,validate/p16/p16936839/s51639313/6d90e6ac-e969b273-c3688526-e353c242-e947bcb4.jpg,validation," 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. " 001f47ed-b65bea40-5f8ca25c-d82cf022-9518c94b.jpg,validate/p17/p17419105/s57941247/001f47ed-b65bea40-5f8ca25c-d82cf022-9518c94b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NGT placement // evaluation of NGT placement TECHNIQUE: Chest single view COMPARISON: ___ 05:49 FINDINGS: Enteric tube tip in the mid stomach. Endotracheal tube tip in good position. Right lung has largely re-expanded since prior exam. Persistent right mid lung, right basilar patchy opacities. Right perihilar opacity, indeterminate, this area was obscured secondary to patient positioning on ___, and was normal on ___. Follow-up chest PA and lateral recommended to document resolution and exclude underlying mass or adenopathy. Trace right pleural effusion or thickening. Left lung is clear. Thoracolumbar degenerative changes, mild curve convex to the right. IMPRESSION: Right lung is largely re-expanded, persistent patchy right mid lung, basilar opacities. Persistent right perihilar opacity, recommend follow-up chest PA and lateral to document resolution, exclude adenopathy or mass. " 5c67b021-d6e686ce-7cb64908-2632c712-f1e0bd36.jpg,validate/p16/p16606885/s55475085/5c67b021-d6e686ce-7cb64908-2632c712-f1e0bd36.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with low grade fevers // Eval for interval change Eval for interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lungs are low in volume but clear, exaggerating mild cardiomegaly. There is no pulmonary edema, pneumonia, or pleural abnormality. Feeding tube passes into the duodenum and out of view. " 253f678f-3ec7d6b0-d5ba0d2f-740c2386-07c6b88c.jpg,validate/p16/p16156625/s51143847/253f678f-3ec7d6b0-d5ba0d2f-740c2386-07c6b88c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with dyspnea on exertion, L leg swelling x3 days, evaluate for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: In comparison to the prior study, there is little interval change in markedly enlarged cardiac silhouette. No definite vascular congestion. There is no focal consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: Stable massively enlarged cardiac silhouette, concerning for cardiomyopathy. " 6bf3eeda-e46aab7f-1075b8a1-5820c265-76e1d006.jpg,validate/p11/p11084812/s57769949/6bf3eeda-e46aab7f-1075b8a1-5820c265-76e1d006.jpg,validation," FINAL REPORT EXAM: Chest, AP upright portable view. CLINICAL INFORMATION: ___-year-old female with history of tachycardia, history of CHF. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. The previously seen left-sided PICC is no longer seen and likely removed in the interval. There are relatively low lung volumes. Haziness at the left lung base is likely due to overlying soft tissue. There is mild-to-moderate pulmonary vascular congestion. No large pleural effusion is seen. No definite focal consolidation is seen, although a retrocardiac consolidation would be difficult to exclude on this study. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Pulmonary vascular congestion. " 0eeed2ac-7c2c8b80-4a7de4c0-bf204a98-3f015f56.jpg,validate/p16/p16662264/s54193371/0eeed2ac-7c2c8b80-4a7de4c0-bf204a98-3f015f56.jpg,validation," FINAL REPORT AP AND LATERAL CHEST, ___ AT 16:55 HOURS. HISTORY: Hyperglycemia. COMPARISON: Multiple priors, the most recent dated ___. FINDINGS: The lungs are clear without consolidation or edema. An ill-defined density projecting adjacent to the cardiac apex is likely nipple shadow. 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: No acute pulmonary process. " a0ef8e0f-3b569b66-5b0d1f6b-0766e74d-c84bf34f.jpg,validate/p15/p15760171/s57498470/a0ef8e0f-3b569b66-5b0d1f6b-0766e74d-c84bf34f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with non productive cough after starting orencia infusion // ? pulmonary infiltrate ? pulmonary infiltrate COMPARISON: Prior chest radiographs are not available IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection, including tuberculosis, or cardiac decompensation. " 0a5e9efe-c60a9667-e235b63a-033d06bb-e9b9c101.jpg,validate/p12/p12224734/s59613125/0a5e9efe-c60a9667-e235b63a-033d06bb-e9b9c101.jpg,validation," 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. " df52222d-a75bc372-685c23b9-328ad0c5-8fa5da14.jpg,validate/p18/p18718102/s56582439/df52222d-a75bc372-685c23b9-328ad0c5-8fa5da14.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis, septic emboli, intubation // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, there are slightly lower lung volumes. Diffuse bilateral pulmonary opacifications with nodular component persists, again consistent with septic emboli in a patient with prior endocarditis. Monitoring and support devices are unchanged. " 957aabff-db3b7660-cfd1ffb0-1eee294e-2c83fa42.jpg,validate/p18/p18071110/s51509541/957aabff-db3b7660-cfd1ffb0-1eee294e-2c83fa42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with shortness of breath TECHNIQUE: Upright AP view of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Cardiac silhouette size is markedly enlarged. The aorta is tortuous. Enlargement of the hila bilaterally could suggest underlying lymphadenopathy. There is mild pulmonary vascular congestion without overt pulmonary edema. There appear to be small bilateral pleural effusions with bibasilar patchy opacities, potentially atelectasis. No pneumothorax is seen. No acute osseous abnormalities demonstrated. IMPRESSION: 1. Patchy bibasilar airspace opacities, potentially atelectasis, but infection or aspiration cannot be excluded. 2. Small bilateral pleural effusions. 3. Mild pulmonary vascular congestion. 4. Enlargement of the hila bilaterally, potentially suggestive of underlying lymphadenopathy. Comparison with previous radiographs or cross-sectional imaging is recommended, otherwise, further assessment with CT is recommended. " 3bb6cf70-fd70d161-97f537f3-79925973-f451064a.jpg,validate/p14/p14819550/s51998500/3bb6cf70-fd70d161-97f537f3-79925973-f451064a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever and cough for 4 weeks, increasing WBC. // PNA? Pleural Effusions? Pulmonary congestion PNA? Pleural Effusions? Pulmonary congestion IMPRESSION: In comparison with the study of ___, the patient has taken a slightly better inspiration. There may be some decrease in the width of the superior mediastinum on the right in this patient with known adenopathy. Continued enlargement of the cardiac silhouette with tortuosity of the aorta and bilateral pleural effusions with compressive basilar atelectasis. Little if any vascular congestion. " d36861fd-39733467-e014eccd-33e5feb0-ef693bdd.jpg,validate/p14/p14150988/s51477341/d36861fd-39733467-e014eccd-33e5feb0-ef693bdd.jpg,validation," FINAL REPORT INDICATION: ___ year old incarcerated male with 6 weeks of hemoptysis. // R/o tuberculosis TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: There is a new left lower lobe opacity which corresponds to an opacity projecting over the lower thoracic spine seen on lateral views suggesting a left lower lobe pneumonia. The right lung is clear. The lung volumes are normal. The cardiomediastinal and hilar contours are normal. Small bilateral pleural effusions best seen on lateral views. IMPRESSION: Left lower lobe pneumonia. Small bilateral pleural effusions. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 2:27 PM, 5 minutes after discovery of the findings. " 63ee646b-90cd747f-17f3b0cf-c8526cc8-31b48b08.jpg,validate/p11/p11753181/s52798894/63ee646b-90cd747f-17f3b0cf-c8526cc8-31b48b08.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with good health // patient with rhonchi diffusely in left lung. Right lung clear. no documented fevers. No URI s/s. ?infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to prior studies dating from ___ with the most recent dated ___. FINDINGS: The cardiomediastinal silhouette is normal. The pleura is unremarkable. The right lung is clear. There is a left perihilar opacification with associated left upper lobe linear atelectasis the could represent pneumonia but given lack of URI symptoms code represent a hilar mass causing obstruction. Recommend chest CT for further evaluation. IMPRESSION: Left perihilar opacification with associated left upper lobe linear atelectasis that could represent pneumonia or a left hilar obstructive mass. RECOMMENDATION(S): Recommend CT chest for further evaluation. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 17:09 into the Department of Radiology critical communications system for direct communication to the referring provider. " 29873b6a-f0d4adec-1f7a59c1-af860161-8821e6d9.jpg,validate/p16/p16741854/s54860383/29873b6a-f0d4adec-1f7a59c1-af860161-8821e6d9.jpg,validation," 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. " d6d3baef-18c3ea5e-12bf644c-fd20bcdc-5e8d2118.jpg,validate/p11/p11245254/s57311263/d6d3baef-18c3ea5e-12bf644c-fd20bcdc-5e8d2118.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The heart size is at the upper limits of normal but stable compared to prior exam. The mediastinal and hilar contours appear unremarkable. The lung volumes are slightly low, accentuating equivocal opacity in the retrocardiac space; this may reflect crowding of normal structures vs. atelectasis, and a superimposed pneumonia cannot be entirely excluded, although felt unlikely. There is no pleural effusion or pneumothorax. " 2eafeb78-a0b67b9e-40cf5916-5aa5f3fc-8bae2c65.jpg,validate/p19/p19389879/s54477209/2eafeb78-a0b67b9e-40cf5916-5aa5f3fc-8bae2c65.jpg,validation," FINAL REPORT CLINICAL INDICATION: Right upper quadrant pain and tenderness to palpation. COMPARISON: Multiple prior chest radiographs, the most recent of ___. 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 hemidiaphragms. There is no acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " 82f10d4f-2721100f-6b63f1e8-2d3fbad1-c33b03ac.jpg,validate/p11/p11845452/s51497254/82f10d4f-2721100f-6b63f1e8-2d3fbad1-c33b03ac.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain, dyspnea and cough // eval for PNA 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. " 71f359df-475052aa-3eae9b33-da798726-0ec5e873.jpg,validate/p17/p17629726/s53360586/71f359df-475052aa-3eae9b33-da798726-0ec5e873.jpg,validation," FINAL ADDENDUM ADDENDUM There was a transcription error in the previous study. The interpretation should read as follows: In comparison with the study of ___, the patient has taken a slightly better inspiration but otherwise there is little change. The cardiac silhouette remains within normal limits and there is mild tortuosity of the descending aorta. Apical pleural changes are again noted. No evidence of acute pneumonia, vascular congestion, or pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Stage IIIA melanoma ___ years ago // rule out metastatic disease rule out metastatic disease IMPRESSION: Stop " 54cf44da-a5163bf1-766ef2d1-100fce56-090b54a7.jpg,validate/p15/p15649651/s55598660/54cf44da-a5163bf1-766ef2d1-100fce56-090b54a7.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Worsening shortness of breath and chest pain. Comparison is made with prior study, ___. Cardiomediastinal contours are unchanged. Patient has known mediastinal and hilar lymphadenopathy, right perihilar and right upper lobe masses, and innumerable lung nodules consistent with metastatic disease. There is no pneumothorax. New opacity in the right lower lobe worrisome for pneumonia/aspiration. Findings were discussed with Dr. ___ by phone on ___ at the time of the discovery of the findings at 10:10 a.m. " 2195ff97-48e06ba8-0d4d21a0-b853b8b4-c8f32ece.jpg,validate/p18/p18369810/s51146837/2195ff97-48e06ba8-0d4d21a0-b853b8b4-c8f32ece.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old man s/p CABG with MVA 5 days ago, increased pain // rule out fracture or acute process TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: The patient has had median sternotomy and CABG. Normal postoperative cardiomediastinal silhouette seen and improved from ___ studies. A small left pleural effusion has decreased in size from previous studies. No focal consolidations, pulmonary edema, or pneumothorax is seen. The osseous structures are grossly unremarkable. IMPRESSION: No acute cardiopulmonary findings or fractures are with a small left pleural effusion that has decreased from the most recent study. " 36c5341c-9bbe9d41-5e1b067a-05c35b0a-79811e30.jpg,validate/p13/p13177514/s52237063/36c5341c-9bbe9d41-5e1b067a-05c35b0a-79811e30.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with daily phlegm // Eval for acute process COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is noted. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. No pneumonia, no pulmonary edema. Borderline size of the cardiac silhouette. Normal hilar and mediastinal structures. " 4beb6ac7-c8efae61-17d914a4-920122c9-6f5d66a7.jpg,validate/p18/p18232511/s50968663/4beb6ac7-c8efae61-17d914a4-920122c9-6f5d66a7.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Hypercarbic respiratory failure, followup. Compared to the study from the prior day there is no significant interval change. " 2e6cccb5-1b917ea8-81b4678c-17653c8f-8996282e.jpg,validate/p19/p19441625/s51519339/2e6cccb5-1b917ea8-81b4678c-17653c8f-8996282e.jpg,validation," FINAL REPORT CLINICAL HISTORY: Recurrent pneumonias, febrile and cough for several days. CHEST, PA AND LATERAL: When compared to the prior chest x-ray, there is a slight increase in lung markings to the right middle lobe on the PA chest, though this is not confirmed on the lateral. This may be due to overlying breast soft tissue, but in view of the patient's history, this could represent early evidence of a right middle lobe pneumonia. Elsewhere, the heart and mediastinum are normal and the lung fields are clear. " 70dbfe7d-77f0b576-15ee76d9-dd750bb4-8c8d4357.jpg,validate/p14/p14733367/s58033381/70dbfe7d-77f0b576-15ee76d9-dd750bb4-8c8d4357.jpg,validation," 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. " baafe7cb-474127df-e3251e9e-6341cd2a-e650e8da.jpg,validate/p18/p18855147/s59030328/baafe7cb-474127df-e3251e9e-6341cd2a-e650e8da.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old woman status post stents, evaluate for CHF or fluid overload. FINDINGS: Comparison is made to previous study from ___. Central venous catheter with distal lead tip in the mid SVC is again seen. Heart size is within normal limits. There is mild improved aeration of pulmonary edema. There remains blunting of bilateral CP angles, right side worse than left consistent with small pleural effusions. There is improved aeration at the left base as well. " 3b7c09d9-6a631092-82b9e390-d19bc4d8-f89aa3fa.jpg,validate/p19/p19405755/s50590591/3b7c09d9-6a631092-82b9e390-d19bc4d8-f89aa3fa.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough. 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 aorta is tortuous and the heart demonstrates left ventricular configuration. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " f9603e6b-82a982fa-6edea292-55af6f80-9004ab23.jpg,validate/p11/p11848123/s58093166/f9603e6b-82a982fa-6edea292-55af6f80-9004ab23.jpg,validation," FINAL REPORT INDICATION: Hypoxia, evaluate chest. COMPARISON: None available. FINDINGS: One portable supine AP view of the chest. An overlying pad obscures the left heart border and left lower lung. There are diffuse patchy opacifications in both lungs. The left upper lobe has a more dense opacification. Heart size appears slightly enlarged. No right pleural effusion is seen. The left hemidiaphragm is obscured by overlying pad. The endotracheal tube ends 2 cm from the carina. The enteric tube ends in the stomach. There is no evidence of free air. IMPRESSION: Diffuse bilateral opacities most consistent with pulmonary edema however hemorrhage or conosoidation cannot be entirely ruled out. " eb627deb-a4210001-9712737b-37b518c7-2d0dc6d4.jpg,validate/p18/p18462562/s59959648/eb627deb-a4210001-9712737b-37b518c7-2d0dc6d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: CT 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. Note is made of dense breast tissue. IMPRESSION: No acute intrathoracic process. " faee9a65-048e5b0a-a78f82e5-0351649d-66ebedca.jpg,validate/p15/p15836305/s59499370/faee9a65-048e5b0a-a78f82e5-0351649d-66ebedca.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with R PTX // R/O PTX post CT removal R/O PTX post CT removal IMPRESSION: Compared to prior chest radiographs ___ through ___. Since the removal of the right apical pigtail drainage catheter a tiny right apical pneumothorax is unchanged. There is no appreciable pleural effusion. Lungs are clear. " db400c7d-5b44edc1-5a5bfbcf-5bb41da4-40834dff.jpg,validate/p11/p11054411/s51153307/db400c7d-5b44edc1-5a5bfbcf-5bb41da4-40834dff.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Severe pancreatitis, rule out cholangitis, respiratory distress. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have slightly increased. However, there is unchanged evidence of mild pulmonary edema and bilateral pleural effusions. The effusions might have minimally, but not substantially decreased. Unchanged size of the cardiac silhouette. " 1856a008-4cdba47a-f110aea1-249daefa-65cbc942.jpg,validate/p17/p17799398/s51699946/1856a008-4cdba47a-f110aea1-249daefa-65cbc942.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and tachycardia. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: There has been interval removal of the right-sided PICC line. The lungs are well expanded and clear. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " e8042a15-0879fa60-853f4745-c09b8b57-c035e90b.jpg,validate/p11/p11686464/s50585267/e8042a15-0879fa60-853f4745-c09b8b57-c035e90b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from earlier today. CLINICAL HISTORY: Cough, fever, leukocytosis, assess 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. IMPRESSION: No signs of pneumonia. " 3a68b8c0-1f439705-6c3383c1-8976b2ce-0a45988b.jpg,validate/p18/p18762260/s57940363/3a68b8c0-1f439705-6c3383c1-8976b2ce-0a45988b.jpg,validation," FINAL REPORT INDICATION: ___ year old woman POD___ s/p L partial Nx, now with somnolence, evaluate for aspiration, PNA other acute pulm processes TECHNIQUE: Single semi-upright frontal view radiograph of the chest. COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: Very low lung volumes cause bronchovascular crowding. Opacities in the medial lungs bilaterally may represent collapsed lower lobes or consolidation. There is no definite pleural effusion, pneumothorax, or pulmonary edema. Allowing for patient positioning and low lung volumes the cardiomediastinal silhouette is likely unchanged. Evaluation for pneumoperitoneum is limited on these semi-upright views. IMPRESSION: Very low lung volumes with medial consolidative opacities bilaterally which may represent lower lobe collapse or consolidation, depending on the clinical circumstances. " bcdd29c0-81b339c5-ac9abdf9-c61cf52c-4e04dc88.jpg,validate/p17/p17677315/s59028679/bcdd29c0-81b339c5-ac9abdf9-c61cf52c-4e04dc88.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PE from OSH. Question of pneumonia on OSH imaging. // Pneumonia? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ available. IMPRESSION: Cardiac size is normal. The aorta is tortuous. Right pleural effusion is small. There is no evident pneumothorax. No pulmonary edema or lung consolidations. " 99879434-59b0a5c6-52334338-709941b7-5c01fda9.jpg,validate/p15/p15341255/s55458950/99879434-59b0a5c6-52334338-709941b7-5c01fda9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumothorax // eval for pneumothorax and chest tube placement TECHNIQUE: Upright portable. COMPARISON: Chest radiograph on ___ and 08:25 FINDINGS: Despite both an indwelling left pleural drain and a new drain, a small left pneumothorax, apical pleura at the level of the ___ posterior rib and veru small left pleural effusion, if any, are unchanged. The right lung is clear. Moderate cardiomegaly persists. A right internal jugular vein catheter ends just above the origin of the SVC. IMPRESSION: Small left pneumothorax persists despite second pleural tube. No other significant change from today at 08:25. " d790e819-19b0e255-2ac10910-f9887909-e9f27358.jpg,validate/p11/p11551927/s59480670/d790e819-19b0e255-2ac10910-f9887909-e9f27358.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute panc // interval progression interval progression IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are unchanged. There are slightly better lung volumes. The hazy opacification at the bases has decreased and the hemidiaphragms are more sharply seen. This is consistent with decreasing pleural effusions and compressive atelectasis, though some of this may be due to a more erect position of the patient. " 1db68f77-31b90cc5-7a1aea8f-142fe8f1-5d8f20c1.jpg,validate/p11/p11426796/s55030526/1db68f77-31b90cc5-7a1aea8f-142fe8f1-5d8f20c1.jpg,validation," FINAL REPORT HISTORY: Small-bowel obstruction, assess NG tube placement. CHEST, SINGLE AP PORTABLE VIEW, SEMISUPINE. COMPARISON: Chest dated ___. An NG tube is present, the tip extends beneath the diaphragm overlying the midline of the upper abdomen. The side port lies in region of the GE junction, likely just beyond it. There is mild cardiomegaly, with a left ventricular configuration and unfolded aorta. There is upper zone redistribution. No focal infiltrate or gross effusion. " f15103a5-8aa9fd13-8e5b89da-d28e6f90-ac509850.jpg,validate/p10/p10251182/s54141224/f15103a5-8aa9fd13-8e5b89da-d28e6f90-ac509850.jpg,validation," 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. " 59a29d79-4da027ba-77f5ec4f-f418bbde-497118a7.jpg,validate/p16/p16989439/s50575609/59a29d79-4da027ba-77f5ec4f-f418bbde-497118a7.jpg,validation," 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. " d378f204-40ef9e6e-a92790cf-e087c2a6-daed3092.jpg,validate/p11/p11521301/s59284826/d378f204-40ef9e6e-a92790cf-e087c2a6-daed3092.jpg,validation," 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. " bf35fe30-b84ee58a-dfc8f21f-38f29f24-df38ced9.jpg,validate/p16/p16833478/s56996090/bf35fe30-b84ee58a-dfc8f21f-38f29f24-df38ced9.jpg,validation," FINAL REPORT INDICATION: ___ year old man with L pleural effusion, s/p chest tube // eval for interval change FINDINGS: Ats come to radiograph from the day prior, left-sided pigtail catheter in similar position. Small apical left pneumothorax is unchanged. Left moderate pleural effusion is stable. Small right pleural effusion is also stable. Bibasal opacities have improved. IMPRESSION: Stable left apical pneumothorax. " b4bf15d6-ebd5b80d-4062e037-e7370ffb-ad3d19d7.jpg,validate/p17/p17784248/s50399798/b4bf15d6-ebd5b80d-4062e037-e7370ffb-ad3d19d7.jpg,validation," FINAL REPORT INDICATION: History: ___F with acute shortness of breath, left shoulder pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate mild cardiomegaly and hyperinflated lungs with severe emphysematous changes again noted. No focal consolidation, pleural effusion, or pneumothorax. Left apical radiation fibrosis is unchanged. There is no appreciable pulmonary edema. Surgical clips are noted projecting over the left mid upper lung and axilla, as before, with evidence of prior left mastectomy. IMPRESSION: No acute cardiopulmonary process. No pulmonary edema. Severe emphysema and unchanged radiation fibrosis in the left lung apex. " 17a424d4-c7199732-cdb1fbe4-3464f51d-e7abb88e.jpg,validate/p10/p10826816/s53221391/17a424d4-c7199732-cdb1fbe4-3464f51d-e7abb88e.jpg,validation," 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. " 082a29f1-3709b739-3413ee68-6cbefbbd-35482a46.jpg,validate/p16/p16033427/s58364627/082a29f1-3709b739-3413ee68-6cbefbbd-35482a46.jpg,validation," 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. " 88d94a05-0b46b996-b31e2ab4-39da5e0f-3c189b2b.jpg,validate/p16/p16326143/s57686816/88d94a05-0b46b996-b31e2ab4-39da5e0f-3c189b2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with HLD, obesity with chest discomfort and SOB, now resolved // r/o pna, pulm edema COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Eventration of the right hemidiaphragm again seen P 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. " 8b1b39a5-24d34d19-cf58a8f9-92e0e299-135ff69b.jpg,validate/p11/p11597221/s50052032/8b1b39a5-24d34d19-cf58a8f9-92e0e299-135ff69b.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with sudden onset chest pain and nonspecific EKG changes. COMPARISON: None. FINDINGS: PA and lateral views of the chest demonstrate well-expanded and clear lungs. Heart is larger than expected, but pulmonary vasculature are within normal limits. Mediastinal contour is unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: 1. No acute intrathoracic abnormality. 2. Heart is larger than expected, but no evidence of congestive failure. " b1f85530-de3b8069-d542450a-7d59a40c-480a5251.jpg,validate/p12/p12935888/s55625703/b1f85530-de3b8069-d542450a-7d59a40c-480a5251.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with rheumatoid arthritis, on immunosuppressants, new cough for three days, occasionally productive. Evaluate possible pneumonia. IMPRESSION: PA and lateral chest reviewed in the absence of available prior chest radiographs: Lungs are fully expanded and clear. Heart size top normal. Normal hilar and mediastinal and pleural contours. " 7f8503f6-272055e9-ffbc0b05-2736ec4d-8c16cfa9.jpg,validate/p13/p13069997/s58160771/7f8503f6-272055e9-ffbc0b05-2736ec4d-8c16cfa9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with atypical chest pain // eval for 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 acute intrathoracic process. " 89a6491c-12530200-88a4dba6-4db7a70c-eed4e8d6.jpg,validate/p12/p12637732/s56888703/89a6491c-12530200-88a4dba6-4db7a70c-eed4e8d6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with allergic reaction // concern for PNA vs other 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. " 970c83af-969aedd9-3a923b37-fc2c5279-3a296274.jpg,validate/p12/p12176298/s52502567/970c83af-969aedd9-3a923b37-fc2c5279-3a296274.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Hematoma evacuation, question interval change. REFERENCE EXAM: ___. FINDINGS: The ET tube is slightly low. It is pointed towards the right main stem bronchus and is probably 1 cm above the carina, although the exact location of the carina is difficult to tell on this study. Otherwise, the appearance of the lungs is unchanged. " ab905309-d27952ef-7c15989d-6a340968-cec52ae4.jpg,validate/p16/p16131849/s53074472/ab905309-d27952ef-7c15989d-6a340968-cec52ae4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w. L.spontaneous pneumo s/p CT placed OSH trasferred // worsening pneumothorax? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The position of the left chest tube is constant. The both apical and basal lateral pneumothorax is unchanged in extent. Also unchanged are retrocardiac atelectasis, as well as an elevation of the left hemidiaphragm. No abnormalities on the right. Unchanged size of the cardiac silhouette. " 42cfae54-426576a2-b5dda163-4001b253-b832fcf3.jpg,validate/p12/p12713218/s57584821/42cfae54-426576a2-b5dda163-4001b253-b832fcf3.jpg,validation," 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. " 382c3819-72bb1dfc-a5178f9b-3f649f82-5ad426fe.jpg,validate/p18/p18232489/s51132391/382c3819-72bb1dfc-a5178f9b-3f649f82-5ad426fe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p L VATS vagotomy // R/O PTX post CT removal R/O PTX post CT removal COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Heart size is normal. Compared to ___ previous mild vascular engorgement in the lungs and mediastinum has resolved. There is no edema or pneumothorax. Lateral view shows small pleural effusions collected posteriorly, probably unchanged. Left subclavian infusion port ends in the mid SVC. " 3b0a3d21-c74b30a5-e846ddff-d7c2738e-4f16059f.jpg,validate/p11/p11820695/s56016420/3b0a3d21-c74b30a5-e846ddff-d7c2738e-4f16059f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph dated ___. CLINICAL HISTORY: Subacute cough, pain at the right inferior costal margin, tenderness in the abdomen, question of pneumonia or free air. FINDINGS: PA and lateral views of the chest are provided. A Port-A-Cath resides over the right chest wall with catheter tip extending to the low SVC. The lungs are clear bilaterally. No focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Clips are noted in the right upper abdomen. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 4da82081-49afcb8c-72e8c123-88d99480-3e817f11.jpg,validate/p18/p18647453/s52400099/4da82081-49afcb8c-72e8c123-88d99480-3e817f11.jpg,validation," FINAL REPORT AP CHEST, 6:23 A.M. ON ___ HISTORY: ___-year-old man intubated. Evaluate for changes. IMPRESSION: AP chest compared to ___: Apparent increase in volume of postoperative pneumoperitoneum may be due to change in patient position, now more erect. ET tube and left subclavian line in standard placements respectively. No pneumothorax. Opacification at both lung bases is probably a combination of worsening atelectasis and small pleural effusions. There is no pneumothorax. Heart size is larger due in part to lower lung volumes, but probably greater intravascular volume as well. " a3e3c95d-9268095c-181107ae-b150cab7-f32faa43.jpg,validate/p14/p14637100/s53757588/a3e3c95d-9268095c-181107ae-b150cab7-f32faa43.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with congestive heart failure and COPD exacerbation. Portable AP radiograph of the chest was reviewed in comparison to ___. Cardiomegaly is severe. Patient continues to be in pulmonary edema, although it is slightly improved since the prior study. Left consolidation and bilateral pleural effusions are noted. " b4d71150-85a36a26-9ca18ca7-69201c07-605b0f04.jpg,validate/p10/p10337260/s55898744/b4d71150-85a36a26-9ca18ca7-69201c07-605b0f04.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fever and cough. 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. " 2ce7b1ab-68a694ef-5ea56368-d4185f26-689554c8.jpg,validate/p13/p13021036/s51420746/2ce7b1ab-68a694ef-5ea56368-d4185f26-689554c8.jpg,validation," FINAL REPORT HISTORY: Elevated lactate question pneumonia. COMPARISON: Outside hospital chest radiograph dated ___. FINDINGS: Portable frontal radiograph of the chest demonstrates normal heart size and mediastinal contours. No focal consolidation, pleural effusion or pneumothorax. On the prior study a faint ovoid density projected over the right second anterior rib. It is not visualized on our study but could be masked by the difference in projection. IMPRESSION: 1. No pneumonia. 2. Ovoid density projection over right upper chest seen on prior study, not seen today, but could be masked by difference in projection. Recommend repeat PA and lateral. Telephone notification regarding change in wet read and recommednation to Dr ___ by Dr ___ at 8:45 on ___ " 32224a6f-0628ae66-c1b32dcc-086846f6-24cc7aa6.jpg,validate/p11/p11845452/s52615651/32224a6f-0628ae66-c1b32dcc-086846f6-24cc7aa6.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with recent cath and substernal chest pain. Please evaluate for acute process. COMPARISON: Multiple chest radiographs, the latest 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. " 22349545-ec3400f7-16dc2a6b-9bfcf988-a812fa36.jpg,validate/p14/p14779022/s55616053/22349545-ec3400f7-16dc2a6b-9bfcf988-a812fa36.jpg,validation," FINAL REPORT INDICATION: History of diabetes and right-sided chest pain. Now with cough and bibasilar crackles. COMPARISONS: CT chest, ___. CT torso, ___. Chest radiograph, ___. Chest radiograph, ___. Chest radiograph, ___. FINDINGS: PA and lateral images of the chest show bibasilar coarse reticular opacities which were seen previously in the prior CT from ___. These opacities are intermittently present in prior studies, and most likely represent an atypical appearance of pulmonary edema. Also on the differential is intermittent environmental or medication exposures causing intersitial reaction. There is no consolidations. There is no pleural effusion or pneumothorax. The hila and the cardiomediastinal silhouette are normal in shape and contour. There are mild degenerative changes with flowing anterior osteophytes in the lower thoracic spine. IMPRESSION: Diffuse bibasilar reticular opacities which have been present sporadically on previous radiographs likely represent atypical pulmonary edema, alternative reaction to periodic environmental or medication exposure. Results were communicated with Dr. ___ at 1:30 p.m. on ___ via telephone by Dr. ___. " 88231d3a-166c286f-786780b6-062ee3ed-10864d91.jpg,validate/p17/p17684961/s56903819/88231d3a-166c286f-786780b6-062ee3ed-10864d91.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F chest pain for the past two days // ___F chest pain for the past two days TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The pulmonary hilar vessels may be slightly prominent without overt pulmonary edema. IMPRESSION: Possible mild central pulmonary vascular engorgement without overt pulmonary edema. No definite focal consolidation. " e17cac43-d068e746-351e3b9a-a78d5fb0-33fd096f.jpg,validate/p18/p18391757/s58957429/e17cac43-d068e746-351e3b9a-a78d5fb0-33fd096f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with L rib pain s/p basketball injury // ? 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. IMPRESSION: No acute cardiopulmonary process. " 161727bc-247cc0f3-fc713973-372d24c7-cc014024.jpg,validate/p15/p15848257/s56954715/161727bc-247cc0f3-fc713973-372d24c7-cc014024.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cp // eval for ptx COMPARISON: Prior exam from ___. FINDINGS: PA and lateral views of the chest provided. Dialysis catheter projects over the right chest with right IJ access and tip in the lower SVC. A left chest wall Port-A-Cath is unchanged with tip also in the lower SVC as on prior. The heart is top-normal in size. Lung volumes are low. No convincing evidence for pneumonia or edema. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 8715e33c-bf10ab2a-35293168-caf43be8-dea50342.jpg,validate/p13/p13191788/s59861831/8715e33c-bf10ab2a-35293168-caf43be8-dea50342.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with crackles on examination. Evaluate for acute process. FINDINGS: Comparison is made to previous study from ___. Heart size is upper limits of normal. There is some prominence of the pulmonary interstitial markings; however, there are no signs for overt pulmonary edema or focal consolidation. There is no pleural effusion. There are no pneumothoraces. There is some thickening and calcifications of the lung apex, on the left side. Bony structures are intact. " 658fdb03-8947455d-1f95b924-cc8129ad-703b9743.jpg,validate/p10/p10577647/s56660652/658fdb03-8947455d-1f95b924-cc8129ad-703b9743.jpg,validation," 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. " 9422c835-ed29458f-05415654-78fd943b-5b16a666.jpg,validate/p18/p18970086/s59013830/9422c835-ed29458f-05415654-78fd943b-5b16a666.jpg,validation," WET READ: ___ ___ ___ 11:19 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with history of pancreatitis p/w epigastric pain and nausea, vomiting // eval for pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest radiograph ___, CT ___ FINDINGS: The heart size is within normal limits. Calcified mediastinal and hilar lymph nodes are unchanged from CT ___. The lungs are clear except for unchanged mild biapical pleural and parenchymal scarring. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary abnormality. " cb639dc9-6f9fb207-b4aab149-9c3e5370-4cdead60.jpg,validate/p11/p11123733/s52279091/cb639dc9-6f9fb207-b4aab149-9c3e5370-4cdead60.jpg,validation," WET READ: ___ ___ ___ 6:41 PM No change in large bilateral pleural effusions and cardiomegaly ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, evaluation for volume overload. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change. Small bilateral pleural effusions, subsequent areas of atelectasis at both lung bases. Mild cardiomegaly without overt pulmonary edema. No evidence of pneumonia or other parenchymal changes in the interval. " ffd4aacb-dfa1cca2-7e6c2510-b11c7a79-eb312292.jpg,validate/p18/p18049473/s56267277/ffd4aacb-dfa1cca2-7e6c2510-b11c7a79-eb312292.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p L VATS lung Bx // check interval change FINDINGS: The previously reported potentially concerning left mediastinal abnormality has resolved. The appearance is now similar to the ___ radiograph. A small left apical pneumothorax is also similar to that radiograph. Diffuse pulmonary opacities are again demonstrated, and show interval improvement with residual opacities most prominent in the left mid and both lower lungs. Small pleural effusions have also apparently improved. COMPARISON: ___ AND ___ RADIOGRAPH. " 67cc4148-0f04a7ff-81b15d54-1738eb0c-d4cc8e3b.jpg,validate/p12/p12953693/s53856971/67cc4148-0f04a7ff-81b15d54-1738eb0c-d4cc8e3b.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with anxiety, atrial fibrillation, and increasing coughing, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " 73cf6b26-0089cac3-46c36021-ee416386-c88e238a.jpg,validate/p15/p15208372/s51644641/73cf6b26-0089cac3-46c36021-ee416386-c88e238a.jpg,validation," FINAL REPORT INDICATION: Ataxia. COMPARISON: None available. FINDINGS: Chest, AP and lateral. The lungs are hyperinflated, suggestive of COPD. There is a diffuse increase in interstitial markings bilaterally. There is no air space consolidation. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: 1. Diffusely increased interstitial markings likely due to a chronic process. 2. Hyperinflation of the lungs suggestive of COPD. 3. No acute cardiopulmonary process. " 2ae392b6-82c50c38-f0e61059-a30e5928-9f573bcb.jpg,validate/p16/p16164648/s53583713/2ae392b6-82c50c38-f0e61059-a30e5928-9f573bcb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: New atrial fibrillation. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is at the upper limits of normal size. A calcified lymph node again projects over the prevascular region of the mediastinum. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute disease. " 0d65db8b-d7ad29ec-bf7c1bb8-85a0e757-92678bd0.jpg,validate/p11/p11842879/s58748631/0d65db8b-d7ad29ec-bf7c1bb8-85a0e757-92678bd0.jpg,validation," FINAL REPORT AP CHEST, 9:27 A.M., ___ HISTORY: ___-year-old intubated woman. Concern for pneumonia. IMPRESSION: AP chest compared to ___ through ___: Extensive consolidation in the left lung is improving. Less severe pneumonia right lower lobe looks a little smaller but this may be a function of better lung volumes today than on ___. ET tube is in standard placement, NG tube ends in the upper portion of a non-distended stomach and feeding tube passes into the distal stomach and out of view. Left jugular line ends low in the SVC. Small bilateral pleural effusions are presumed left greater than right but not increasing nor substantial. Moderate cardiomegaly with particular contour abnormality suggesting enlargement of the main pulmonary artery displacing the left atrial appendage, is longstanding. " b235b924-dcdb9820-cf273bb2-a78b634d-750c4c4a.jpg,validate/p14/p14542695/s55940567/b235b924-dcdb9820-cf273bb2-a78b634d-750c4c4a.jpg,validation," FINAL REPORT HISTORY: Cough, nausea and diarrhea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ FINDINGS: The cardiac silhouette size is top normal. Mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " f81a519e-734afad4-3d6c87f8-6434f949-a7676b82.jpg,validate/p10/p10569231/s53678530/f81a519e-734afad4-3d6c87f8-6434f949-a7676b82.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with altered mental status // r/o ICH, pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Underpenetration of the lower chest, particularly on the left, is felt to be due to overlying soft tissue. No focal consolidation is seen on the lateral view. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable with persistent enlargement of the cardiac silhouette. IMPRESSION: No acute cardiopulmonary process. " c55c15dc-7df2a63e-0e05ba7c-f51265bd-3c1d58c9.jpg,validate/p19/p19010426/s58080020/c55c15dc-7df2a63e-0e05ba7c-f51265bd-3c1d58c9.jpg,validation," FINAL REPORT INDICATION: ___F with + blood cultures. now presenting with abdominal and left flank pain. // ? psoas abscess ? pyelonephritis 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. No free intraperitoneal air. IMPRESSION: No acute cardiopulmonary process. " 79d6cb7a-39f9326c-d2e871f6-cd58331c-614a6474.jpg,validate/p17/p17832035/s57856701/79d6cb7a-39f9326c-d2e871f6-cd58331c-614a6474.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with substernal chest pain // r/o CHF/Pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Fibrotic changes seen at lung apices. No definite new focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Left sided pacer device is stable. IMPRESSION: No acute cardiopulmonary process. " a60c3d80-43716110-e921cf41-6e0ba518-287ba55f.jpg,validate/p13/p13688556/s54659107/a60c3d80-43716110-e921cf41-6e0ba518-287ba55f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with several episodes syncope, palpitations over prior month COMPARISON: Prior study from ___ FINDINGS: PA and lateral views of the chest provided. Spinal hardware projects over the lower T-spine and upper lumbar spine and is only partially 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. IMPRESSION: No acute intrathoracic process. " e9b7356b-cf970c41-6f0769eb-f0ac1b3e-c8f3643f.jpg,validate/p19/p19699616/s59829352/e9b7356b-cf970c41-6f0769eb-f0ac1b3e-c8f3643f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with presumed osteomyelitis. Must wear TSLO brace while ambulatory and during procedure. // ? Infectious workup given likely osteomyelitis. Quantiferon pending. COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Mild cardiomegaly. Minimal left pleural effusion. No pulmonary edema. Atelectasis in the retrocardiac lung regions. Mild elongation of the descending aorta. " b64a9b84-9b88dd97-f1e31116-bf0eb987-7903f566.jpg,validate/p12/p12761308/s51139685/b64a9b84-9b88dd97-f1e31116-bf0eb987-7903f566.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough for 10 days // Eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead left-sided pacemaker stable in position. The lungs remain hyperinflated, consistent with chronic obstructive pulmonary disease.No focal consolidation is seen. Mild biapical pleural thickening is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Anchor screw noted overlying the right humeral head. IMPRESSION: COPD. No definite focal consolidation. " ac6b2ce6-686e80a6-d8eda5ab-4deeddb2-56b4f4dc.jpg,validate/p15/p15614172/s53627449/ac6b2ce6-686e80a6-d8eda5ab-4deeddb2-56b4f4dc.jpg,validation," WET READ: ___ ___ 9:37 PM Previously noted retrocardiac opacity appears slightly improved, suggestive of improving infection or atelectasis. No new foci of infection identified. If clinical suspicion for an atypical infection is high, CT is the more sensitive study. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old immunosupressed man with chills c/f pneumonia // eval for pneumonia COMPARISON: ___ THROUGH ___. IMPRESSION: PREVIOUS VASCULAR CONGESTION AND BORDERLINE INTERSTITIAL EDEMA HAVE RESOLVED, MILD CARDIOMEGALY HAS IMPROVED AND MEDIASTINAL VASCULAR ENGORGEMENT IS NO LONGER PRESENT. THERE COULD BE A NEW ELLIPTICAL OPACITY IN THE LEFT LUNG PROJECTING LATERAL TO THE BORDER OR COULD BE CALCIFICATION IN COSTAL. SHALLOW OBLIQUE VIEWS MIGHT BE HELPFUL TO DETERMINE IF THIS IS GENUINE AND A POSSIBLE FOCUS OF INFECTION. " ae0eb63f-7b36bc4e-e5058f39-b3767ec6-88940710.jpg,validate/p17/p17652927/s54988924/ae0eb63f-7b36bc4e-e5058f39-b3767ec6-88940710.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, cardiomyopathy. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Cardiomegaly with no pulmonary edema. Left pectoral pacemaker. No pleural effusions. No pneumonia. No other relevant changes. " e10435f1-2465bbb6-620cd5d3-86667283-58b6af36.jpg,validate/p13/p13535349/s50529223/e10435f1-2465bbb6-620cd5d3-86667283-58b6af36.jpg,validation," FINAL REPORT INDICATION: Trauma. COMPARISON: ___. FINDINGS: AP portable view of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. No free air. IMPRESSION: No acute cardiopulmonary process. No free air. Conventional radiographs are not useful for evaluation of subtle trauma. " b30f9bbc-c0e25d21-66ca1a4e-fe24350e-969be47e.jpg,validate/p17/p17182744/s52376027/b30f9bbc-c0e25d21-66ca1a4e-fe24350e-969be47e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with frontal lobe lesion // ETT and NGT placement COMPARISON: ___, 06:39 IMPRESSION: As compared to the previous radiograph, the tip of the endotracheal tube is unchanged, projecting approximately 2-3 cm above the carinal. In the interval, the patient has received a nasogastric tube, the course of the tube is unremarkable, the tip projects over the middle parts of the stomach. Platelike atelectasis at the right lung bases. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. No pneumonia. " 967215eb-e211ed56-ed96cf9c-75e37474-0ab00676.jpg,validate/p11/p11057136/s52906214/967215eb-e211ed56-ed96cf9c-75e37474-0ab00676.jpg,validation," FINAL REPORT INDICATION: ___ year old man with right apical PTX and air leak. // assess interval change COMPARISON: Radiographs from ___. IMPRESSION: There is a right-sided chest tube which is unchanged in position. There has been reappearance of a small right apical pneumothorax whose pleural line projects over the third posterior rib. There is atelectasis versus early infiltrate at the lung bases, stable. Heart size is normal. There is no overt pulmonary edema. There is again seen subcutaneous emphysema throughout the chest wall. A stent is seen along the right lower neck. " a9799e51-020f47b4-acc64130-b57aa721-6d9375af.jpg,validate/p12/p12385889/s58803774/a9799e51-020f47b4-acc64130-b57aa721-6d9375af.jpg,validation," 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 ___. " 9f8f1ce7-310e9623-cfc8336c-9ebd7853-4cd12a19.jpg,validate/p13/p13259221/s59913349/9f8f1ce7-310e9623-cfc8336c-9ebd7853-4cd12a19.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with history of necrotising pancreatitis complicated by pseudocysts, presenting with signs of sepsis, abdominal pain, and shortness of breath // ? pneumonia ? pneumonia COMPARISON: Chest radiographs since ___, most recently ___. . IMPRESSION: New interstitial abnormality in the setting of increased pulmonary vascular caliber and venous engorgement in the mediastinum is probably early edema in the heart is normal size unchanged. Pleural effusion small if any. No pneumothorax " e019aa28-37328a34-d7c1aa22-20308100-b1e53898.jpg,validate/p13/p13257606/s56350572/e019aa28-37328a34-d7c1aa22-20308100-b1e53898.jpg,validation," FINAL REPORT HISTORY: Hyperglycemia. 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 silhouette is top-normal. The mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " eac36e36-5cf6929c-da38e8d4-c6c188ef-3d25c6bd.jpg,validate/p19/p19802326/s54609476/eac36e36-5cf6929c-da38e8d4-c6c188ef-3d25c6bd.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with cirrhosis, altered mental status, status post nasogastric tube placement. Evaluate tube placement. PORTABLE AP CHEST RADIOGRAPH: Nasogastric tube passes below the diaphragm to the expected region of the stomach, although the tip is outside the field of view provided. There is cardiomegaly. Bilateral basal opacities are similar to the x-ray obtained earlier today and may represent atelectasis versus aspiration/pneumonia. There is no pneumothorax. A small left pleural effusion is noted. " a9147847-21db2efb-21ce7a53-4ff913f3-eea29349.jpg,validate/p15/p15263212/s59134146/a9147847-21db2efb-21ce7a53-4ff913f3-eea29349.jpg,validation," FINAL REPORT HISTORY: Right pleuritic chest pain with decreased breath sounds on the right. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. Small opacity in the lower left lung corresponds to opacity projecting over the lower thoracic spine on the lateral view. Blunting of the right costophrenic angle is consistent with pleural thickening or a small right pleural effusion. No pneumothorax. IMPRESSION: Small left lower lobe opacity may represent pneumonia in the appropriate clinical context. Small right pleural effusion or pleural thickening. Findings were communicated via phone call by Dr. ___ to Dr. ___ ___ on ___ at ___ PM. " 24ed6d8d-86fad438-5329d8f5-042118c7-a2cfb80b.jpg,validate/p11/p11490478/s56101935/24ed6d8d-86fad438-5329d8f5-042118c7-a2cfb80b.jpg,validation," FINAL REPORT HISTORY: Productive cough. COMPARISON: Chest radiograph from ___ and rib series from ___. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fractures are identified with evidence of healed right posterior rib fractures. IMPRESSION: No acute cardiopulmonary process. " d63c35da-8d9bd420-0f4ed005-2ce18918-c9c9c2a9.jpg,validate/p19/p19481280/s55156136/d63c35da-8d9bd420-0f4ed005-2ce18918-c9c9c2a9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Crohns on vedalizimuab // Evaluation of lesions suspicious for TB Evaluation of lesions suspicious for TB IMPRESSION: There to prior chest radiographs ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " c139552c-e26782d9-eb66cc42-44e38485-ea03d5ab.jpg,validate/p19/p19818481/s56275516/c139552c-e26782d9-eb66cc42-44e38485-ea03d5ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated // eval for ETT placement, interval change COMPARISON: ___. IMPRESSION: The patient is intubated. The tip of the endotracheal tube projects 4.8 cm above the carinal. The nasogastric tube is unchanged in course and position. Also unchanged is the course of the left internal jugular vein catheter. The pre described multifocal parenchymal opacities, likely reflecting pneumonia out or aspiration, are stable on the left and minimally increased on the right. Unchanged is the moderate cardiomegaly. Minimal increase in diameter of the perihilar vascular structures, likely reflecting mild fluid overload. No larger effusions are present. " 64da0ae0-8fe19214-3b5534d7-27fa8d50-c7c78b82.jpg,validate/p10/p10900387/s58898454/64da0ae0-8fe19214-3b5534d7-27fa8d50-c7c78b82.jpg,validation," FINAL REPORT HISTORY: End-stage renal disease, on hemodialysis status post flash pulmonary edema. CHEST, SINGLE AP VIEW. Compared with ___, the ET tube and NG tube has been removed. Again seen is marked cardiomegaly involving both right and left ventricles, with unfolding of the aorta. There is upper zone re-distribution and mild vascular blurring, consistent with CHF, improved compared with the prior film. No gross pleural effusion is now visible, consistent with interval clearing of the effusions. There has also been re-expansion of the left lower lobe and resolution of the increased retrocardiac density. Some patchy opacity overlying the right lung base medially is again noted. Increased density in the right paratracheal soft tissue density again noted, similar to the ___ chest CT scout film, where it appeared to represent mediastinal soft tissue. IMPRESSION: 1) Marked cardiomegaly again seen. 2) Interval improvement in previously seen CHF, LLL collapse, and pleural effusion. 3) Right paratracheal soft tissue density, unchanged. " 8ee73004-eae89b70-db29bf15-37ce69f7-cbc0f18f.jpg,validate/p16/p16223998/s58912733/8ee73004-eae89b70-db29bf15-37ce69f7-cbc0f18f.jpg,validation," WET READ: ___ ___ 3:39 PM 14 mm faint rounded opacity within the left lung apex, new from prior exams. This finding is nonspecific and may reflect an inflammatory or infectious process, and a follow up radiograph after treatment is recommended to ensure resolution of this finding. If this finding persists, a chest CT is recommended. ______________________________________________________________________________ FINAL REPORT HISTORY: Right brain adenocarcinoma with new headaches, chills and subjective fevers. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Within the left lung apex, there is a 14 mm faint rounded opacity not clearly seen on the prior exam. Remainder the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: 14 mm faint rounded opacity within the left lung apex, new from prior exams. This finding is nonspecific and may reflect an inflammatory or infectious process, and a follow up radiograph after treatment is recommended to ensure resolution of this finding. If this finding persists, a chest CT is recommended. " 1adef28c-76407684-936c1c1e-e51da752-8103b21c.jpg,validate/p19/p19032166/s51622021/1adef28c-76407684-936c1c1e-e51da752-8103b21c.jpg,validation," FINAL REPORT INDICATION: ___-year-old male status post assault. Evaluate for injury. COMPARISON: None available. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: Lungs are normally expanded and clear. The heart is not enlarged. The mediastinal contours are normal. There is no pleural effusion or pneumothorax. Within the limitations of routine radiography the included osseous structures are grossly intact. IMPRESSION: No acute cardiopulmonary abnormality. " ec7696de-b02a751a-43748ef0-7c5c62ea-9180c8d4.jpg,validate/p11/p11344751/s51489459/ec7696de-b02a751a-43748ef0-7c5c62ea-9180c8d4.jpg,validation," FINAL REPORT INDICATION: ___ year old feamle with history of HIV on HAART with CD4 count of 877, undetectable viral load, seronegative rheumatoid arthritis on Prednisone and Methotrexate here with leukocytosis and found to be hypoxic with likely dCHF exacerbation on admission and being transferred to the ICU for altered mental status. // interval change COMPARISON: Radiographs from ___. IMPRESSION: Support lines and tubes are unchanged in position. Cardiac silhouette is enlarged and stable. There is again seen pulmonary edema, unchanged. There is mild improved aeration at the left base. There are no pneumothoraces. " b348848b-4e1fc225-ad9d66c7-c29c5f4f-5ad6d4ea.jpg,validate/p15/p15442180/s53196744/b348848b-4e1fc225-ad9d66c7-c29c5f4f-5ad6d4ea.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with flu and concern for aspiration. Evaluate for aspiration versus infection. TECHNIQUE: Portable AP frontal chest radiograph was obtained. COMPARISON: Chest radiograph from ___, ___, ___ and ___. FINDINGS: There has been interval worsening of bilateral parenchymal opacities, right greater the left, concerning for worsening edema, though superimposed infection is not excluded. The cardiac silhouette is obscured. A left internal jugular central venous line terminates at the cavoatrial junction, and there has been interval removal of an enteric tube and endotracheal tube. IMPRESSION: Interval worsening of bilateral parenchymal opacities concerning for worsening edema, though superimposed infection is not excluded. " d5be85d6-51866f03-59571d49-c8b69e31-9a3abbdd.jpg,validate/p16/p16901956/s53884024/d5be85d6-51866f03-59571d49-c8b69e31-9a3abbdd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with HIV AIDS, hepatitis-C and persistent right upper quadrant pain. Decreased breath sounds on the right. Suspect pleural effusion. COMPARISON: Chest radiographs ___ IMPRESSION: Moderate right pleural effusion is responsible for elevation of the apparent right hemidiaphragm. In addition there is a large to region of consolidation in the right lower lung, localized to the middle lobe on the lateral view. Small left pleural effusion is unchanged. A large region of atelectasis at the left lung base, is unchanged since ___. The widespread pneumonia present in ___ which it cleared by ___ has not returned. Heart size is normal. Mediastinal contours reflect substantial central adenopathy. " 3c5a2430-31c298c7-833fa123-ecfd0ce1-eb9d6596.jpg,validate/p19/p19960115/s57573988/3c5a2430-31c298c7-833fa123-ecfd0ce1-eb9d6596.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RLL collapse // evaluate for interval change evaluate for interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Substantial right pleural effusion, moderate left pleural effusion, and lower lobe atelectasis have not changed appreciably over the past several days. Previous pulmonary edema has largely cleared and now pulmonary vascular congestion may be improving. Very large cardiac silhouette and mediastinal venous engorgement are unchanged. No pneumothorax. Right PIC line ends in the low SVC, left subclavian line in the mid SVC. " 4cbf9cf8-659e399f-f1204a47-14f17504-0446f625.jpg,validate/p10/p10462639/s55304155/4cbf9cf8-659e399f-f1204a47-14f17504-0446f625.jpg,validation," FINAL REPORT INDICATION: Fever. 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. A linear opacity at the left lower lobe is most compatible with mild scarring, unchanged since ___. IMPRESSION: No acute intrathoracic process. " 9c5c4339-616b8cb7-55f354f3-9f649961-34b28a2e.jpg,validate/p17/p17865089/s54488346/9c5c4339-616b8cb7-55f354f3-9f649961-34b28a2e.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Check NG tube. The NG tube goes down into the distal esophagus and then curves such that the tip is pointing upwards. Finding was called to Dr. ___ at the time of dictating this report on ___ at 4:30 p.m. by Dr. ___. Right IJ and left subclavian lines are unchanged. There are bilateral pleural effusions left greater than right with continued dense retrocardiac opacity consistent with volume loss/effusion/infiltrate. IMPRESSION: NG tube curved within the esophagus with the tip at the thoracic inlet. This will need to be removed and replaced. " 841c13b7-61d595b1-2547a071-84961857-b15de31c.jpg,validate/p19/p19993776/s56679343/841c13b7-61d595b1-2547a071-84961857-b15de31c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left ___ toe ulcer preop angio // cardiopulmonary process Surg: ___ (___ angiogram) COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung volumes have decreased. Moderate cardiomegaly. Unchanged alignment of the sternal wires of the CABG. The pacemaker leads are in constant position. Mild fluid overload but no overt pulmonary edema. No larger pleural effusions. No pneumonia. " 4124f4f0-9989b0d4-123bfff7-d384a66b-5dabb8fe.jpg,validate/p14/p14628457/s56444207/4124f4f0-9989b0d4-123bfff7-d384a66b-5dabb8fe.jpg,validation," WET READ: ___ ___ ___ 9:21 AM There has been interval decrease in the bilateral pleural effusions with increased aeration of the lungs. Mild central vascular congestion and interstitial edema are again noted. Multiple support lines in devices are in stable position. WET READ VERSION #1 ___ ___ 8:08 PM There has been interval decrease in the bilateral pleural effusions with increased aeration of the lungs. Mild central vascular congestion and interstitial edema are again noted. Multiple support lines in devices are in stable position. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG/AVR // interval change in effusion, volume change interval change in effusion, volume change COMPARISON: Comparison to ___ at 11:09 FINDINGS: Portable semi-erect chest radiograph ___ at 19:42 is submitted. IMPRESSION: Left-sided pacer and right internal jugular Swan-Ganz catheter unchanged in position in this patient status post median sternotomy with mitral annular ring and CABG and stable expected postoperative appearance to the cardiac and mediastinal contours. Layering bilateral effusions with patchy bibasilar airspace opacities likely reflecting atelectasis. Interval improvement in mild pulmonary edema with crowding of the perihilar vasculature due to diminished lung volumes. No pneumothorax. " 69b7f62f-924e0959-e63a424a-374f7dd5-3a8b51eb.jpg,validate/p10/p10420279/s55722151/69b7f62f-924e0959-e63a424a-374f7dd5-3a8b51eb.jpg,validation," FINAL REPORT HISTORY: Chest pain x. 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 and unremarkable. No pulmonary edema is seen. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 559a61f9-7964b81d-923794e7-8f2036ae-921ed53f.jpg,validate/p17/p17451713/s55043558/559a61f9-7964b81d-923794e7-8f2036ae-921ed53f.jpg,validation," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old female with epigastric pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are hyperinflated. Biapical scarring is again noted. There is no consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Mid thoracic dextroscoliosis is again noted. No free air is seen below the diaphragm. Surgical clips project over the right breast. IMPRESSION: Hyperinflation but no acute cardiopulmonary process. " c78f9519-2911eee7-42c77629-b34cc154-b93dd1f7.jpg,validate/p18/p18171555/s55488152/c78f9519-2911eee7-42c77629-b34cc154-b93dd1f7.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with left chest pain. Dyspnea status post fall. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates low lung volumes. There is a non displaced fractures are identified within the posterior ___ left rib. Linear lucency within the posterior fifth rib is thought to be artifactual. There is no focal consolidation. Heart size is within upper limits of normal. Mediastinal and hilar contours are unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: Nondisplaced fracture through the posterior fourth rib. No pneumothorax. NOTIFICATION: Findings discussed with doctor ___ by Dr. ___ at 13:19 on ___. " bff4751e-cbf24b25-ba3757a6-cd151c6e-83c4c20c.jpg,validate/p10/p10646211/s55711015/bff4751e-cbf24b25-ba3757a6-cd151c6e-83c4c20c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain, nausea, hematemesis TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is top normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. The lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary abnormality. " e2d3ae92-4b429020-45997544-7808e4cc-cd9dc6aa.jpg,validate/p16/p16088589/s52600851/e2d3ae92-4b429020-45997544-7808e4cc-cd9dc6aa.jpg,validation," WET READ: ___ ___ ___ 11:35 AM Right-sided pneumothorax status post right-sided chest tube placement. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with chest tube, pls eval interval change on right TECHNIQUE: Single portable AP view of the chest was obtained COMPARISON: Portable AP view of the chest from 1 hour prior. FINDINGS: There is been interval placement of a right-sided chest tube. There is significant improvement in the right-sided pleural effusion. There is a small pneumothorax, measuring 7.3 mm. The cardiac silhouette and pulmonary vasculature are unremarkable. No definite consolidation is noted. IMPRESSION: Small right-sided pneumothorax status post right-sided chest tube placement with significant decrease in size of pleural effusion. " b1cf33ff-6f744ea2-7779ec30-81842599-a4625e58.jpg,validate/p16/p16508811/s53708518/b1cf33ff-6f744ea2-7779ec30-81842599-a4625e58.jpg,validation," FINAL REPORT INDICATION: Fever and cough, status post renal transplant. History of smoking. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There are new opacities in the superior segment of the left lower lobe and in the right lower lobe, most consistent with multifocal pneumonia. No pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are normal. IMPRESSION: New multifocal pneumonia in the right and left lower lobes. These findings were discussed with Dr. ___ by Dr. ___ at 1:45 p.m. on ___ by telephone at the time of discovery. " 8a6cb030-29ac9498-0b4d25f7-b41836eb-048e9db9.jpg,validate/p15/p15872837/s59560569/8a6cb030-29ac9498-0b4d25f7-b41836eb-048e9db9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with CP // evidence of pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: ___ 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. " f1db073d-2f4e31da-2a492b80-88ae18be-9552f26a.jpg,validate/p19/p19398915/s54195213/f1db073d-2f4e31da-2a492b80-88ae18be-9552f26a.jpg,validation," FINAL REPORT PORTABLE CHEST, ___. COMPARISON: Radiograph of one day earlier. FINDINGS: Slight increase in size of moderate to large right pleural effusion and persistent adjacent atelectasis and/or consolidation in the right mid and lower lung region. Diffuse left-sided airspace opacities have slightly worsened in the interval. Otherwise, no relevant short-interval change. " d117e730-3cff0d3b-d5cfdaa4-3021811d-adc0d61c.jpg,validate/p19/p19404187/s51734751/d117e730-3cff0d3b-d5cfdaa4-3021811d-adc0d61c.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Fever, in a patient with gastrointestinal bleeding and recent endoscopy. Portable AP radiograph of the chest was compared to ___, and ___. Extensive opacification of left mid and lower lobe with frank consolidation in the left lower lobe and partial atelectasis as well as right lower lobe opacity are new since ___ and have substantially progressed since ___. These findings might be consistent with multifocal aspiration or pneumonia with at least partial atelectasis of the left lower lobe. Bilateral pleural effusion is most likely present. There is no evidence of pneumothorax, or pneumomediastinum. " 016e0eba-ccb7d262-a6b8ef01-8ecd5c9a-ec4c6673.jpg,validate/p11/p11123584/s52416103/016e0eba-ccb7d262-a6b8ef01-8ecd5c9a-ec4c6673.jpg,validation," WET READ: ___ ___ ___ 9:50 PM Normal chest radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Chest pain. Assess for cause of chest pain. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographdemonstrates well expanded and clear lungs.No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. Mild degenerative disease of the thoracic spine is noted. IMPRESSION: Normal chest radiograph. " e7f1a2b3-afbbf7b3-b517a10b-9311cc9a-8508eff2.jpg,validate/p18/p18692222/s51299913/e7f1a2b3-afbbf7b3-b517a10b-9311cc9a-8508eff2.jpg,validation," WET READ: ___ ___ 2:27 AM possible early CHF, not florid. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with shortness of breath. COMPARISON: PA and lateral chest radiograph ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: There has been interval increase in cardiomegaly with increased prominence of mediastinal veins and prominence of peripheral interstitium consistent with pulmonary edema. There is a homogeneous opacity seen in the left lower lobe concerning for infection. Seen again is left pectoral implant pacer device with leads in unchanged position terminating within the right ventricle and atrium. There is no pleural effusion or pneumothorax. The patient has significant pectus excavatum, otherwise, the osseous structures are unremarkable. IMPRESSION: 1. Increased cardiomegaly and pulmonary edema consistent with CHF. 2. Left lower lobe pneumonia. " 468d32a5-0db4dcdf-e2cd85d3-892182de-8d78229b.jpg,validate/p17/p17288913/s56807730/468d32a5-0db4dcdf-e2cd85d3-892182de-8d78229b.jpg,validation," 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. " 4e581cf6-e5cb8f91-7de52bcb-5b7ae695-819d6079.jpg,validate/p12/p12392072/s57459530/4e581cf6-e5cb8f91-7de52bcb-5b7ae695-819d6079.jpg,validation," 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. " 813d04bc-3c6368a9-224c2cbb-3b4dcd10-4b96cd85.jpg,validate/p16/p16898765/s54547599/813d04bc-3c6368a9-224c2cbb-3b4dcd10-4b96cd85.jpg,validation," FINAL REPORT INDICATION: History: ___ with altered mental status TECHNIQUE: Semi-upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged with a left ventricular predominance. The aorta is tortuous and diffusely calcified. The mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Small bilateral pleural effusions are similar in size compared to the prior study. There is associated atelectasis in the lung bases. No new focal consolidation or pneumothorax is present. Lungs remain hyperinflated suggestive of COPD. Multiple compression deformities are again seen within the imaged thoracolumbar spine, some of which have undergone vertebroplasty. IMPRESSION: Small bilateral pleural effusions with bibasilar atelectasis. Unchanged compression deformities within the thoracolumbar spine. " c2216264-7645d751-e230fbb3-5abf31c9-8fb82d0c.jpg,validate/p17/p17237809/s58047927/c2216264-7645d751-e230fbb3-5abf31c9-8fb82d0c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF and stroke. // Pulmonary edema COMPARISON: Chest x-ray from ___ at 14:40 FINDINGS: An ET tube is present. The tip lies approximately 4.4 cm above the carina. A left-sided PICC line is present, tip overlies the mid/ distal SVC. The patient is status post sternotomy, with the enlarged cardiomediastinal silhouette, similar to ___. There is upper zone redistribution and mild vascular plethora, consistent with CHF -- this is similar, possibly slightly improved. Again seen is increased retrocardiac density consistent with left lower lobe collapse and/or consolidation and a small to moderate left effusion. Left hemidiaphragm is obscured. The right base, there is minimal atelectasis and possible minimal blunting the right costophrenic angle. IMPRESSION: Left lower lobe collapse and/or consolidation and small to moderate left effusion, similar to the prior film. Upper zone redistribution and mild vascular plethora, consistent with CHF, is similar, possibly slightly improved. " beae0005-b77e7704-aa91a723-de3e1663-b7ae3522.jpg,validate/p19/p19809073/s52025780/beae0005-b77e7704-aa91a723-de3e1663-b7ae3522.jpg,validation," FINAL REPORT HISTORY: Leukemia status post allogeneic transplant. Now with 2 weeks of cough and shortness of breath, evaluate for infection. TECHNIQUE: Frontal and lateral views of the chest (3 exposures). COMPARISON: Chest radiographs ___ and ___. CTA chest ___. FINDINGS: There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac silhouette is normal in size. There is unchanged appearance of the mediastinum with no new prominence of the ascending aorta. The hilar contours are unremarkable. Nipple shadows are seen bilaterally. IMPRESSION: No acute cardiopulmonary process. Dr. ___ was unable to be paged. " 7ec39a19-469e1354-bf196f84-f37e4661-cf49b95e.jpg,validate/p15/p15597371/s53240935/7ec39a19-469e1354-bf196f84-f37e4661-cf49b95e.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with left hip fracture. Concern for altered mental status. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal AP and lateral views of the chest were obtained. Opacity in the medial right lower lobe and medial left lower lobe are new from ___. There is a small right, and possibly left, pleural effusion. Linear atelectasis at the left lung base is unchanged. The upper lung zones are clear. There is no pneumothorax. Cardiac and mediastinal silhouettes and hilar contours are stable. No acute osseous abnormality is identified. Pulmonary vasculature is slightly indistinct, which may be due to pulmonary vascular congesion. IMPRESSION: 1. New lateral opacities are likely atelectasis, but infection or aspiration cannot be excluded. Small right and possibly left, pleural effusions. 2. Possible pulmonary vascular congestion. Preliminary findings discussed with Dr. ___ by phone at 7:20 p.m., ___. " 3a268f62-5e2bc2ec-284be096-aa4e6b4e-27407fde.jpg,validate/p10/p10423466/s55702195/3a268f62-5e2bc2ec-284be096-aa4e6b4e-27407fde.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: New brain lesion, question infiltrate. 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. Please note that CT is more sensitive in detecting small pulmonary nodules. " 20b73510-7c4a3646-e475969d-8e94927f-86affc14.jpg,validate/p11/p11731363/s53815391/20b73510-7c4a3646-e475969d-8e94927f-86affc14.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old woman with COPD, dyspnea and shortness of breath. Evaluate for pneumonia. IMPRESSION: PA and lateral chest compared to ___: Hyperinflation suggests emphysema and/or small airway obstruction. Lungs are clear of any focal abnormality. Heart is not enlarged and there is no edema or substantial pleural effusion. " aa940956-32f04b14-a60ee96a-e8955cf1-9e58a9ce.jpg,validate/p13/p13174810/s55306661/aa940956-32f04b14-a60ee96a-e8955cf1-9e58a9ce.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man after bronchoscopy with desaturation increased ventilation requirements. FINDINGS: Comparison is made to prior study from ___. A right-sided PICC line, bilateral chest tubes, endotracheal tube and feeding tube which are all unchanged in position. The feeding tube tip is pointing cranially and there is a single loop and the distal tip in the fundus of the stomach. There is persistent consolidation and increased density at the right mid lung field consistent with loculated fluid. Underlying consolidation is not excluded. Small basilar bilateral pleural effusions are identified. No pneumothoraces are seen. " a289f45a-e26eab1f-e81fc154-9f38fc31-ff0deb1c.jpg,validate/p10/p10351360/s52609740/a289f45a-e26eab1f-e81fc154-9f38fc31-ff0deb1c.jpg,validation," FINAL REPORT HISTORY: Weakness, intermittent dyspnea. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: PA and lateral images of the chest. The right PICC terminates in the low SVC. 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 low SVC. 2. No acute cardiopulmonary process. " b0dbaf26-4d04f82f-c9f12ce8-92a7bbdd-6b42f743.jpg,validate/p16/p16454295/s58902143/b0dbaf26-4d04f82f-c9f12ce8-92a7bbdd-6b42f743.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with recent kidney/pancreas transplant, fever, cough // evaluate for pneumonia COMPARISON: Chest radiographs ___ through ___ aligned non in ___. IMPRESSION: Chest radiographs over the preceding 4 months show chronic recurrent pulmonary edema, most recently ___. The edema present at that time might obscure some but probably not all of the heterogeneous peribronchial infiltration and consolidation seen in both the right mid and right lower and left suprahilar wall lungs. Given the clinical history, pneumonia should be the fi normal size. There is no pleural effusion. Consideration, but if there is failure to resolve with antibiotics PTLD should be considered. Heart is normal size. There is no pleural effusion. NOTIFICATION: Dr. ___ reported the findings to DR. ___ By telephone on ___ at 10:29 AM, 10 minutes after discovery of the findings. " b37a0f58-0efb5675-9524c891-b9028b56-e48fc08d.jpg,validate/p12/p12907891/s58456875/b37a0f58-0efb5675-9524c891-b9028b56-e48fc08d.jpg,validation," 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. " dda2e9e0-6976b91b-e1676b2b-06ab2c46-0a06560c.jpg,validate/p10/p10055694/s55007777/dda2e9e0-6976b91b-e1676b2b-06ab2c46-0a06560c.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Shortness of breath, CHF. Comparison is made with prior study, ___. Moderate cardiomegaly is stable. Widened mediastinum, enlarged right pleural effusion, mild pulmonary edema, and bibasilar atelectasis larger on the right side are all unchanged. " 8e191e09-9553caef-bfbfd242-4b26138e-4716644d.jpg,validate/p18/p18905861/s52036529/8e191e09-9553caef-bfbfd242-4b26138e-4716644d.jpg,validation," FINAL REPORT INDICATION: ___M with fever/weakness // ?PNA TECHNIQUE: Front and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are essentially clear besides streaky left basilar opacity which is likely atelectasis. There is no effusion or edema. Mild cardiomegaly is noted. Sternal wires are again noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " cd71fcdf-e03df34c-31dc6dab-f089f65b-32b023fc.jpg,validate/p14/p14654937/s52371114/cd71fcdf-e03df34c-31dc6dab-f089f65b-32b023fc.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CAD, HTN presents with progressive dyspnea // evaluate for evidence of pneumonia or pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: CT torso from ___ FINDINGS: Diffuse bilateral peribronchial ground-glass opacities are relatively unchanged and better evaluated on recent CT examination. Small bilateral effusions persist. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax. IMPRESSION: Persistent diffuse bilateral peribronchial ground-glass opacities, better evaluated on recent CT, overall unchanged. " 88ef5546-b941229b-79bdc7dd-58c4a3a8-b4f150f3.jpg,validate/p12/p12842991/s55659035/88ef5546-b941229b-79bdc7dd-58c4a3a8-b4f150f3.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with shortness of breath after exposure, evaluate for pulmonary edema. FINDINGS: PA and lateral views of the chest were obtained. Heart is normal size, and cardiomediastinal silhouette is unremarkable. Lung volumes are low limiting assessment for edema. There is no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Low volume lungs limit assessment for mild edema. Repeat radiographs with full inspiration would be helpful if indicated. " 7a602a2a-9cc991dd-3a66e479-1d8c2713-7122d5f6.jpg,validate/p16/p16012048/s57520956/7a602a2a-9cc991dd-3a66e479-1d8c2713-7122d5f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH, IVH // NGT placement, please assess placement NGT placement, please assess placement IMPRESSION: Comparison to ___. The patient has received the new nasogastric tube. Per course of the tube is unremarkable, the tip of the tube projects over the proximal parts of the stomach. No complications, notably no pneumothorax. " c07ae63b-333e5f50-52d497cd-02621f58-36ba8fb8.jpg,validate/p17/p17626903/s51388838/c07ae63b-333e5f50-52d497cd-02621f58-36ba8fb8.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old with cough and congestion and rhonchi at the right base. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. " 5273d8f7-21ba6b4d-663d22b0-f5e6bc6c-b602437e.jpg,validate/p19/p19026714/s56864303/5273d8f7-21ba6b4d-663d22b0-f5e6bc6c-b602437e.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman status post right thoracotomy and diaphragm plication, evaluate for pneumothorax. COMPARISON: ___. TECHNIQUE: Single portable view of the chest. FINDINGS: There is no evidence of pneumothorax. Left lower lobe atelectatic changes are certainly present as well as elevation of the left hemidiaphragm compared to the prior study. No pleural effusion or pneumothorax and no evidence of infection. Epidural cathetars and a chest tube are in place. A small amount of subcutaneous air in the right neck and a possible tiny apical pneumothorax are also present. " c1130977-004ff562-cc50920b-e59bd16b-3b828256.jpg,validate/p15/p15852020/s58370440/c1130977-004ff562-cc50920b-e59bd16b-3b828256.jpg,validation," FINAL REPORT INDICATION: History: ___M with cough, fever // eval for PNA COMPARISON: None. FINDINGS: 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. " 7b39ae4c-2884987c-8d1a615a-8e6f95f7-b6c0f227.jpg,validate/p13/p13084683/s57033971/7b39ae4c-2884987c-8d1a615a-8e6f95f7-b6c0f227.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Acute drop in oxygenation. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 6 cm above the carina. The Swan-Ganz catheter tip is at the level of the right ventricle outflow tract. The left chest tube is in place. The NG tube tip is in the stomach. There is interval unchanged appearance of widespread parenchymal opacities concerning for extensive pulmonary edema. Bilateral pleural effusions are present. No pneumothorax is seen. " 8ab9a11c-d4f151ae-7516c140-a7f2a7b0-5b71af20.jpg,validate/p11/p11900721/s57006058/8ab9a11c-d4f151ae-7516c140-a7f2a7b0-5b71af20.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB, crackles // pul edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the severity of the signs indicative of pulmonary fluid overload have decreased. No pneumonia. Unchanged retrocardiac atelectasis. No new focal parenchymal opacities. Unchanged size of the cardiac silhouette. " 2b0baee9-70f243a3-137356ec-915a0ab8-1f319f18.jpg,validate/p14/p14993899/s53211477/2b0baee9-70f243a3-137356ec-915a0ab8-1f319f18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness // infiltrate? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___. FINDINGS: The patient's chin partially obscures the medial lung apices. The patient is status post median sternotomy and aortic valve replacement. The heart is top normal in size. The cardiomediastinal silhouette and hilar contours are within normal limits. Subtle bibasilar opacities are most consistent with atelectasis. There is no evidence of focal consolidation. There is no large pleural effusion. IMPRESSION: No evidence of frank pulmonary edema. Bibasilar atelectasis. " a14b172e-2ccb2bed-2f867cae-bc196a06-e2717ad7.jpg,validate/p17/p17454111/s54004076/a14b172e-2ccb2bed-2f867cae-bc196a06-e2717ad7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with co2 retention, edema // edema ? atelectasis TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Vascular congestion has improved. Bibasilar atelectasis have improved, more so in the right. Bilateral effusions have decreased. There is no pneumothorax. Cardiomegaly is stable " 474a27f9-73d5156c-4f2b1ff2-fb9c3dc3-76806b51.jpg,validate/p15/p15432819/s52889656/474a27f9-73d5156c-4f2b1ff2-fb9c3dc3-76806b51.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with recent pneumonia, basilar crackles on the right. Rule out CHF. COMPARISONS: Chest radiograph from ___. FINDINGS: PA and lateral chest radiographs were provided. Compared to the most recent prior study, there has been no significant change. There is no focal consolidation, pleural effusion or pneumothorax. There is no overt pulmonary edema. Moderate cardiomegaly and elevation of the right hemidiaphragm persists. The imaged upper abdomen is unremarkable. There are degenerative changes in the thoracic spine. IMPRESSION: No significant change since the prior study with no evidence of pneumonia or CHF. " 28c19750-69aa25c4-602c6790-32a08df7-abaf8545.jpg,validate/p12/p12995479/s58296423/28c19750-69aa25c4-602c6790-32a08df7-abaf8545.jpg,validation," FINAL REPORT INDICATION: History: ___M with chest pain, shortness of breath // r/o infiltrate, effusion TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 20:15. FINDINGS: Cardiomediastinal silhouette is within normal limits. There is mild bibasilar atelectasis. Lungs are otherwise clear. There is no pleural effusion or pneumothorax. Bones and the upper abdomen are grossly unremarkable. IMPRESSION: No evidence of pneumonia. " 6a1cbbf7-c86a47ab-7b6abdb0-32797e79-66bc0b92.jpg,validate/p14/p14120635/s50561126/6a1cbbf7-c86a47ab-7b6abdb0-32797e79-66bc0b92.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain, edema // eval heart and lungs TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Small bilateral pleural effusions are again seen, with overlying atelectasis. Mild to moderate pulmonary edema is similar to prior. No definite focal consolidation is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. Small radiopaque density projecting over the left hilar region is stable. IMPRESSION: Pulmonary edema and small pleural effusions without significant interval change. " ecec1c6b-064198f5-3d7655fb-225483ff-53917c94.jpg,validate/p19/p19095721/s55103597/ecec1c6b-064198f5-3d7655fb-225483ff-53917c94.jpg,validation," WET READ: ___ ___ 5:22 AM 1. Right lower lobe opacity could reflect pneumonia in the appropriate clinical situation. Close interval follow-up after treatment is recommended. This patient could benefit from a non-emergent Chest CT if he has not had any before. 2. Background emphysema. 3. Possible 5 mm right peripheral mid lung nodule versus a vascular marking. Correlate with any prior imaging. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting with hypoxia. Evaluate for pneumonia. TECHNIQUE: Portable upright AP radiograph view of the chest. COMPARISON: No prior relevant imaging is available. FINDINGS: The lungs are hyperinflated. Increased right infrahilar opacity could reflect aspiration and pneumonia. There appears to be mild peribronchiolar thickening. The minor fissure with is depressed, suggesting some degree of atelectasis in the right lung. Streaky opacities in the left lower lung may reflect atelectasis. No pleural effusion or pneumothorax. Background hyperlucency of the lungs suggests emphysema. An approximately 5 mm the opacity in this periphery of the right midlung could be a vessel on and, however pulmonary nodule cannot be excluded. Probable 4-mm calcified granuloma in the left periphery of the lung. IMPRESSION: 1. Right lower lobe opacity could reflect pneumonia in the appropriate clinical situation. Close interval follow-up after treatment is recommended. This patient could benefit from a non-emergent Chest CT if he has not had any before. 2. Background emphysema. 3. Possible 5 mm right peripheral mid lung nodule versus a vascular marking. Correlate with any prior imaging. " 53c85aab-457fe95e-71227abf-f1124b71-b4119e9c.jpg,validate/p17/p17517983/s51528516/53c85aab-457fe95e-71227abf-f1124b71-b4119e9c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: CVL placement, assess position. FINDINGS: PA and lateral views of the chest were provided demonstrating a new right IJ central venous catheter in place with its tip in the mid SVC region. The heart is stable in size, mildly enlarged. Biateral lower lung consolidation seen on prior radiograph appears significantly improved with minimal residual streaky opacities which could represent a component of scarring. No large effusion or pneumothorax is seen. " 0b94eaf6-f1be610a-e29b203e-7f0ef405-9bdaf1f4.jpg,validate/p15/p15584013/s58220744/0b94eaf6-f1be610a-e29b203e-7f0ef405-9bdaf1f4.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with SOB // ? PNA TECHNIQUE: Chest PA and lateral COMPARISON: Since ___, significant improvement in right upper lobe pneumonia. FINDINGS: Since ___, significant improvement in right upper lobe pneumonia. Diminished vascularity in left upper lung fields consistent with probable emphysema. Port-a-cath ends at the level of the cavoatrial junction. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions. No pneumothorax. IMPRESSION: Since ___, significantly improvement and resolved right upper lobe pneumonia. Probable emphysematous changes in left lung. " 43511d56-3db7fc24-fcd9d99b-0d2247e2-165dd539.jpg,validate/p10/p10835660/s58110752/43511d56-3db7fc24-fcd9d99b-0d2247e2-165dd539.jpg,validation," FINAL REPORT INDICATION: Fever. COMPARISON: Chest radiograph from ___. FINDINGS: Lung volumes are low, exaggerating pulmonary vascular markings. Otherwise, the cardiomediastinal silhouette is within normal limits. Mild bibasilar atelectasis is accompanied by small pleural effusions. There is no pneumothorax. No acute fractures are identified. Air and contrast material is visualized throughout the colon. The ascending aorta is tortuous or dilated but probably unchanged since ___. IMPRESSION: 1. Low lung volumes with bibasilar atelectasis and small effusions. 2. The ascending aorta is tortuous or dilated but probably unchanged since ___. " 0862ff7c-02b95005-96c4f87c-71dca836-fc3287da.jpg,validate/p11/p11494099/s58125155/0862ff7c-02b95005-96c4f87c-71dca836-fc3287da.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with fall // please evaluate for acute cp process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs: ___. FINDINGS: The lungs are hyperinflated. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation concerning for pneumonia. Small calcified granulomas are noted in the right apex. Focal linear scar or atelectasis persists in the periphery of the right lung base. Tortuous thoracic aorta with extensive atherosclerotic calcification is unchanged. Right upper quadrant cholecystectomy clips are noted. IMPRESSION: No acute cardiopulmonary process. " c883735d-dfec34ce-0319e12d-06bbffb3-654accd8.jpg,validate/p18/p18273833/s56043544/c883735d-dfec34ce-0319e12d-06bbffb3-654accd8.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with history of liver disease with worsening shortness of breath. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Exam is extremely limited secondary to extremely low lung volumes. That said, there has been significant interval change since prior with indistinct pulmonary vascular markings and possible more confluent consolidation at the right lung base. Osseous structures are unremarkable. Rounded calcific density in the right upper quadrant compatible with calcified gallstones. IMPRESSION: Extremely low lung volumes. Increased interstitial markings in lungs bilaterally right greater than left when compared to prior suggestive of edema. More confluent opacity of the right lung base raising possibility of superimposed infection. " 4b183b5d-bfb1ebee-c42a4227-b8441388-5cacdf4d.jpg,validate/p12/p12452998/s55324460/4b183b5d-bfb1ebee-c42a4227-b8441388-5cacdf4d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 60 pack year smoking history night sweats and leukocytosis // please evaluate for evidence of malignancy please evaluate for evidence of malignancy IMPRESSION: Comparison to ___. Severe overinflation. Apical pulmonary emphysema. No pneumonia, no pleural effusions. No pulmonary edema. Normal size of the cardiac silhouette. Mild elongation of the descending aorta. " 592622f6-6da059ac-eac53d50-d181829d-c60c6350.jpg,validate/p16/p16581134/s59579277/592622f6-6da059ac-eac53d50-d181829d-c60c6350.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated, w/prior RLL mucus plugging (improved on ___ am CXR), but now with worsening hypoxia in past ___ min // please assess for mucus plugging COMPARISON: Chest x-ray from ___ at 05:33 FINDINGS: Rotated positioning. Allowing for this, no definite change is detected. Again seen are patchy opacities at both lung bases, possibly minimally worse at the left lung with base laterally. Allowing for this, no new areas of opacity are identified. Mild vascular plethora appears slightly improved. Possible small pleural effusions, not significantly changed. Right IJ line, tip over distal SVC , again noted. No pneumothorax detected. IMPRESSION: 1. Slight improvement in vascular plethora. 2. Possible minimal increased opacity at the lateral edge of the previously seen left base patchy opacity. 3. Otherwise, I doubt significant interval change. 4. Right base patchy opacity remains present. " 9a8286b4-13ea3fd9-34b401ad-7dc5c075-121a37c4.jpg,validate/p10/p10291112/s56611129/9a8286b4-13ea3fd9-34b401ad-7dc5c075-121a37c4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F intubated in icu // ___F intubated in icu ___F intubated in icu IMPRESSION: Comparison to ___. No relevant change is seen. The tip of the endotracheal tube projects 4 cm above the carina. The course of the feeding tube is stable. Stable correct position of the right internal jugular vein catheter. Minimal increase in extent of the pre-existing pleural effusion on the left. Otherwise the appearance of the lung parenchyma and the pleura is unchanged. " bc272d9b-b56dff53-d933d27a-e0b58965-fe261fb7.jpg,validate/p15/p15239201/s53504261/bc272d9b-b56dff53-d933d27a-e0b58965-fe261fb7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old gentleman with Child C (recent meld ___ ___) alcoholic cirrhosis, nonbleeding esophageal varices and hepatic encephalopathy, recently admitted for hepatic encephalopathy hepatic hydrothorax, transferred from OSH with altered mental status intubated for airway protection found to have recurrent L sided pleural effusion. // eval for interval changes COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Low lung volumes. Moderate cardiomegaly. Left lower lobe atelectasis. Small left pleural effusion. Unchanged monitoring and support devices. Normal appearance of the right lung. " c1e143ba-5d288fcb-91fd4bb7-0f83d84a-b9669586.jpg,validate/p15/p15490401/s56662889/c1e143ba-5d288fcb-91fd4bb7-0f83d84a-b9669586.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain // ? acute cardipulm process TECHNIQUE: PA 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 acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6ba0c6df-69ac9945-d7a17137-8d55a51c-235a9cc9.jpg,validate/p12/p12429688/s55719537/6ba0c6df-69ac9945-d7a17137-8d55a51c-235a9cc9.jpg,validation," FINAL REPORT HISTORY: Seizure. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: There is persistent tenting of the left hemidiaphragm, chronic. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " bfa575ed-66f35164-62660c7a-a1b282b9-8bf495b0.jpg,validate/p18/p18793292/s50806810/bfa575ed-66f35164-62660c7a-a1b282b9-8bf495b0.jpg,validation," FINAL REPORT INDICATION: Cough. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: There is minimal bibasilar atelectasis. The lungs are otherwise clear. There is no evidence of pneumonia, pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. In a mid thoracic vertebral body, there is a compression deformity. Since the prior exam, in ___, the loss of height appears to have worsened. In an upper lumbar vertebral body, there is mild compression deformity, which is stable from ___. IMPRESSION: 1. No acute cardiopulmonary process; specifically, no evidence of pneumonia. 2. Worsened compression deformity in a mid thoracic vertebral body. 3. Stable mild compression deformity in a upper lumbar vertebral body. " 13d4ecd9-d3bb9143-b7f9c5e7-a4258de5-3d9f0521.jpg,validate/p11/p11595140/s52466283/13d4ecd9-d3bb9143-b7f9c5e7-a4258de5-3d9f0521.jpg,validation," 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. " c6fe489d-e88f0ce7-e6b7bb77-2c394b30-fb67b460.jpg,validate/p18/p18171919/s58043900/c6fe489d-e88f0ce7-e6b7bb77-2c394b30-fb67b460.jpg,validation," FINAL REPORT HISTORY: Abdominal surgery with fever. FINDINGS: No previous images. There is a thin streak of gas beneath the hemidiaphragmatic contour, consistent with pneumoperitoneum related to recent surgery. However, there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. " b17d5c12-3ca3423b-9de67768-fdb6705b-1d216b5f.jpg,validate/p10/p10905789/s55015813/b17d5c12-3ca3423b-9de67768-fdb6705b-1d216b5f.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Intracranial hemorrhage and fever. Question. TECHNIQUE: Chest, portable AP view. COMPARISON: Earlier outside film from the same day. FINDINGS: The heart appears mild to moderately enlarged with a left ventricular configuration. The lung volumes are low. Streaky opacities at the right lung base suggests minor atelectasis. There is suspected vague new retrocardiac opacity, with low lung volumes, probably due to atelectasis. IMPRESSION: Patchy suspected retrocardiac opacity, not specific and probably compatible with atelectasis; etiologies such as developing pneumonia or aspiration pneumonitis are not excluded, however. The opacity does not appear extensive. Evaluation with short-term follow-up radiographs could be considered. " 67ab1feb-da9d8ec8-e34deca3-3873cdba-89b1ae90.jpg,validate/p15/p15239201/s58168585/67ab1feb-da9d8ec8-e34deca3-3873cdba-89b1ae90.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, intubated // effusion versus pna, compare with previous effusion versus pna, compare with previous IMPRESSION: Comparison to ___, 03:29. No relevant change is noted. The monitoring and support devices are constant. Large left pleural effusion. Persists. Mild to moderate pulmonary edema is unchanged. " 37aa81a2-ade53b05-4d4066f7-12d6c58d-24682dd6.jpg,validate/p10/p10621303/s53635828/37aa81a2-ade53b05-4d4066f7-12d6c58d-24682dd6.jpg,validation," 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. " 481f8dd1-7f703ffa-4bd7e1cf-e86754bd-2db4b32e.jpg,validate/p19/p19145056/s50246212/481f8dd1-7f703ffa-4bd7e1cf-e86754bd-2db4b32e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stroke and leukocyte sits. // Eval for PNA Eval for PNA COMPARISON: The only prior chest radiograph available, ___. IMPRESSION: Moderate cardiomegaly, pulmonary vascular engorgement persist, and mild pulmonary edema is new. Pleural effusions are small if any. No pneumothorax. " 60e0b042-a65d66bf-85334cdb-51123de8-de13be7b.jpg,validate/p11/p11451979/s58022852/60e0b042-a65d66bf-85334cdb-51123de8-de13be7b.jpg,validation," FINAL REPORT INDICATION: Patient with worsening shortness of breath. Assess for worsening pneumonia or edema. COMPARISONS: Chest radiographs of the same date, ___ and ___. FINDINGS: Semi-upright portable view of the chest demonstrates interval removal of an endotracheal tube. Swan-Ganz catheter is in unchanged position. Sternotomy wires appear intact. Extensive diffuse bilateral heterogeneous opacities are significantly progressed from prior exam, compatible. Small pleural effusions cannot be excluded. There is no pneumothorax. The hilar and mediastinal silhouettes are unchanged. Cardiomegaly is mild to moderate. IMPRESSION: In comparison to study obtained 12 hours prior, there is significant interval progression of pulmonary edema, which is now severe. " 5531ca5d-ffce3017-4c23bfff-9f049fd2-2f4f710d.jpg,validate/p11/p11185907/s53332517/5531ca5d-ffce3017-4c23bfff-9f049fd2-2f4f710d.jpg,validation," WET READ: ___ ___ 1:25 AM Partially loculated moderate left pleural effusion appears slightly larger since the study earlier this morning at 09:06 although this may be positioned. Small apical left pneumothorax is slightly larger. Heart size is normal. There is no pulmonary edema. The lungs are hyperexpanded as before. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with copd, new O2 requirement. // ?pna, effusion, pulmonary edema ?pna, effusion, pulmonary edema IMPRESSION: Comparison to ___. Slight increase in extent of a pre-existing left and probably loculated pleural effusion. Subsequent increase of the resulting basilar atelectasis. Stable size of the small left apical pneumothorax, no evidence of tension. Stable appearance of the right hemi thorax. " 38a7feb6-5b2de32b-a66be1ea-a662ca3b-c1987621.jpg,validate/p13/p13329429/s56232087/38a7feb6-5b2de32b-a66be1ea-a662ca3b-c1987621.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Chest x-ray ___. FINDINGS: Tip of endotracheal tube terminates approximately 2 cm above the carina with the neck in a flexed position. Slight withdrawal by 1-2 cm may be helpful for standard positioning. Widening of right mediastinal contours consistent with known lymph node enlargement on recent cross-sectional studies. Known right lung nodules are not well demonstrated on this portable radiograph, but have been shown to better detail on recent cross-sectional imaging studies. Lungs are otherwise clear, and no definite pleural effusions or pneumothoraces are visible. " 4d99cd9f-e40d80e5-f38eb039-cc686399-2cd1be75.jpg,validate/p17/p17473651/s53878655/4d99cd9f-e40d80e5-f38eb039-cc686399-2cd1be75.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Status post fall after alcohol use presenting with headache and crackles on physical exam. TECHNIQUE: Chest PA and lateral COMPARISON: ___ through ___. Chest CT ___. FINDINGS: Heart size is normal with mild unfolding of the aorta. Mediastinal silhouette and hilar contours are normal. Lungs are clear. Spiculated right apical nodule identified on prior CT is not visualized on radiography. Pleural surfaces are clear without effusion or pneumothorax. No overt traumatic findings. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. No overt traumatic findings. 3. Previously identified right apical spiculated nodule is not detected on radiography. " 88fd1087-deb6c94a-c859f2d9-3cafa27b-b6622323.jpg,validate/p13/p13224377/s50961833/88fd1087-deb6c94a-c859f2d9-3cafa27b-b6622323.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: ET tube placement. COMPARISON: ___, 8:28 a.m. FINDINGS: As compared to the previous radiograph, there is ongoing very high position of the endotracheal tube, with its tip projecting over 7 cm above the carina. The tube could be advanced by 3 to 4 cm. The low lung volumes, the enlarged cardiac silhouette and the known parenchymal changes are constant. " 7bad64b2-2cd114bf-2fdedd2d-f4f8a251-e7b2d49a.jpg,validate/p19/p19143018/s52641913/7bad64b2-2cd114bf-2fdedd2d-f4f8a251-e7b2d49a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic cirrhosis, hematemesis intubated for EGD. Stat CXR for ETT placement. // ETT placement ETT placement IMPRESSION: Comparison to ___. Increasing retrocardiac opacity, suggestive of pneumonia or aspiration. Stable right basal atelectasis. Moderate cardiomegaly persists. In the interval, the patient has been intubated the tip of the endotracheal tube projects approximately 6 cm above the carinal. " f269af4c-96dad030-b6cdc3b8-13e47d00-db8ad2dd.jpg,validate/p13/p13396234/s58696706/f269af4c-96dad030-b6cdc3b8-13e47d00-db8ad2dd.jpg,validation," 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. " d287519a-6c01c73f-961a64d2-7f8848bc-7c02db7b.jpg,validate/p12/p12906270/s53551698/d287519a-6c01c73f-961a64d2-7f8848bc-7c02db7b.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with hypoxia, shortness of breath, pneumonia and lung collapse. 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 preceding day ___. The AP portable single view again demonstrates the previously described density on the right lung base, previously identified as atelectasis with infiltrates in the right lower lobe. On the left side, one can again identify a nodular density superimposed on the anterior portion of the first rib apparently in unchanged position and representing the on CT identified nodular lesion in the left upper lobe. No evidence of new pulmonary or cardiovascular abnormalities in comparison with the next previous portable chest examination of ___ " af7f27ff-348e58c6-94d69711-27788fb0-b5f8d15e.jpg,validate/p17/p17339556/s54540485/af7f27ff-348e58c6-94d69711-27788fb0-b5f8d15e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with epigastric pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are hyperinflated but clear without focal consolidation. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormalities are detected. Clips from prior cholecystectomy are noted in the right upper quadrant of the abdomen. Dextroscoliosis of the thoracolumbar spine is again noted. No subdiaphragmatic free air is present. IMPRESSION: No acute cardiopulmonary abnormality. No subdiaphragmatic free air. " e6b98138-4ae2dd7c-736a62ea-61665dca-3cbd714d.jpg,validate/p19/p19616273/s58414233/e6b98138-4ae2dd7c-736a62ea-61665dca-3cbd714d.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male 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. Cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 0bd740d3-92733d07-8c271abc-d97485b5-ab2a5032.jpg,validate/p10/p10943603/s52056748/0bd740d3-92733d07-8c271abc-d97485b5-ab2a5032.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Single supine portable view was compared with prior chest radiographs from ___ to ___. Chest CT from ___ was also concurrently reviewed. FINDINGS: Tip of the endotracheal tube terminates approximately 5.5 cm above the carina. OGT is seen to course below the diaphragm into the stomach; however, the distal end is beyond the field of view. Internal jugular line ends at right mid atrium. Bilateral, veil-like opacities, right side more than left, reflecting moderate right and mild left pleural effusions are unchanged since ___. AN ill-defined and more discrete opacity in the right mid lung corresponds to the opacity in the lateral segment of the right middle lobe, demomsrated on chest CT from ___, is most likely atelectasis. However, requires attention on followup radiograph to rule out an evolving pneumonia. Presumed small left Pleural effusion and increased retrocardiac opacity suggesting left lower lung atelectasis is similar. Moderate-to-large heart and hilar contours are unchanged in appearance. " 4ecc90e1-aa7cd7b0-6bf8924d-a8cca127-b8ab552b.jpg,validate/p15/p15570344/s50297298/4ecc90e1-aa7cd7b0-6bf8924d-a8cca127-b8ab552b.jpg,validation," FINAL REPORT CHEST, 2 VIEWS: ___ HISTORY: ___-year-old female with recent hospitalization and confusion. COMPARISON: ___. FINDINGS: AP and lateral views of the chest again demonstrate elevation of the left hemidiaphragm. Relatively low lung volumes are seen with crowding of the bronchovascular markings, noting that mild pulmonary vascular congestion is possible. Possible left effusion seen posteriorly on the lateral view. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Possible mild pulmonary vascular congestion and left effusion. " 87f3f293-fccceded-226bee5d-dbc03d30-7a028014.jpg,validate/p16/p16755216/s54819923/87f3f293-fccceded-226bee5d-dbc03d30-7a028014.jpg,validation," 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. " 34fceff7-36e15eae-f79902a1-435b89d6-f27e85cf.jpg,validate/p11/p11570536/s57081293/34fceff7-36e15eae-f79902a1-435b89d6-f27e85cf.jpg,validation," FINAL REPORT INDICATION: ___F with failure to thrive, unstead gait, on steroids // r/o pNA TECHNIQUE: AP and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: AP upright and lateral chest radiograph demonstrate low lung volumes. Heart is upper limits of normal in size, likely exaggerated by low lung volumes. There is bronchovascular crowding and bibasilar atelectasis. There is no evidence of pulmonary edema, pleural effusion, or pneumothorax. No focal consolidation convincing for pneumonia is seen. IMPRESSION: No acute intrathoracic abnormality. " 327a3563-fa1e9a45-4ae057b2-990e03c5-d543a948.jpg,validate/p19/p19244907/s58261170/327a3563-fa1e9a45-4ae057b2-990e03c5-d543a948.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PNA w/effusion // Assess for interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomediastinal contours are unchanged. Large left effusion has minimally increased. Left perihilar and retrocardiac opacities are unchanged. The right lung is grossly clear. There is no pneumothorax. Tracheostomy tube is in standard position. Right PICC tip is in the lower SVC " 6fcb7f78-b0f6af4d-bb1a1f9d-c834d144-f38465b9.jpg,validate/p14/p14800808/s54062027/6fcb7f78-b0f6af4d-bb1a1f9d-c834d144-f38465b9.jpg,validation," FINAL REPORT INDICATION: ___M with chest trauma // acute process? TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. Nipple shadows project over the lungs bilaterally. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Hiatal hernia is again noted. No acute osseous abnormalities, multiple old anterior right rib fractures are noted. IMPRESSION: No acute cardiopulmonary process. " cb04f1d4-e1a055ed-ececaeea-e188364f-398d26b0.jpg,validate/p16/p16617005/s52463586/cb04f1d4-e1a055ed-ececaeea-e188364f-398d26b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ICH, intubated // serial exam TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Increasing opacities in the left lower lobe is due to increasing atelectasis and effusion. Multifocal opacities throughout the right lung are stable. Cardiomegaly is unchanged. Lines and tubes are in place standard position. " 9ed35ca7-7304fa34-21e596cc-00af9934-196cd151.jpg,validate/p10/p10229323/s58937992/9ed35ca7-7304fa34-21e596cc-00af9934-196cd151.jpg,validation," FINAL REPORT CLINICAL HISTORY: Self-extubated, now endotracheal tube replaced, check position. CHEST The endotracheal tube lies 4.8 cm from the carinal angle. Extensive opacities are again noted, and these are considerably improved on the chest x-rays from ___. IMPRESSION: Improving lung infiltrates, endotracheal satisfactory positioned. " 8d3cd720-af91db15-fe889860-498b3d22-fc58a6d3.jpg,validate/p15/p15324563/s54168063/8d3cd720-af91db15-fe889860-498b3d22-fc58a6d3.jpg,validation," FINAL REPORT INDICATION: ___M with acute onset left sided chest pain while walking to study. any acute intrathoracic process? // left sided chest pain. any acute intrathoracic 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. " 4eee35db-d8f49ec6-089b493a-1465e823-bc7388a0.jpg,validate/p16/p16069646/s59605552/4eee35db-d8f49ec6-089b493a-1465e823-bc7388a0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fevers Afib RVR, unclear source, new L pleural effusion // ? LLL infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 03:30 FINDINGS: This radiograph demonstrates markedly improved aeration compared to the study from 6 hr previously. While the right hemidiaphragm continues to be elevated, there is improved aeration in the retrocardiac region with only minimal volume loss in the left lower lobe. There is a new small area of atelectasis/ infiltrate in the right mid lung laterally. IMPRESSION: Improved aeration of the left lower lobe without left lower lobe infiltrate. New area of increased opacity in the right mid lung laterally. " 2b154137-f6baf32a-64e819e7-2bafb282-6379eeaf.jpg,validate/p14/p14653207/s50674518/2b154137-f6baf32a-64e819e7-2bafb282-6379eeaf.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY DATED ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are stable in appearance, with persistent leftward deviation of the trachea. Lungs and pleural surfaces are clear, with no focal areas of consolidation to suggest the presence of pneumonia. Persistent mild elevation of right hemidiaphragm. Note is made of previous mastectomy. " a112fece-f37b5121-0db23792-9de75b23-65f1bcea.jpg,validate/p18/p18859129/s50797983/a112fece-f37b5121-0db23792-9de75b23-65f1bcea.jpg,validation," FINAL REPORT EXAMINATION: Portable semi-upright chest x-ray INDICATION: ___ year old woman with SAH, intubated // ? ETT placement TECHNIQUE: Single semi-upright chest x-ray COMPARISON: Comparison is made to prior chest x-rays dating from ___ through ___. FINDINGS: The cardiomediastinal silhouette is stable with moderate cardiomegaly. Mild to moderate pulmonary edema is seen. Left subclavian central venous catheter is seen with tip projecting at the mid SVC and unchanged in position. An ETT is seen with the tip projecting approximately 2.2 cm superior to the carina. Pulmonary vascular prominence is seen without evidence of pulmonary edema. No focal consolidations, pneumothorax, or pleural effusions are seen. IMPRESSION: 1. Mild to moderate pulmonary edema. 2. ETT projects approximately 2.2 cm superior to the carina. 3. Left subclavian CVC projects at the level of the mid SVC. " b6a2d9eb-46ec2ce8-1d5ea0ac-25d7c2b1-b880d778.jpg,validate/p10/p10871867/s54336487/b6a2d9eb-46ec2ce8-1d5ea0ac-25d7c2b1-b880d778.jpg,validation," WET READ: ___ ___ 5:53 AM 1. Heterogeneous bibasilar opacities may represent atelectasis or pneumonia in the appropriate clinical setting. 2. Mild vascular congestion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with pleuritic chest pain . Assess for acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are moderately well-expanded with mild vascular congestion. Heterogeneous bibasilar opacities are noted. No pleural effusion or pneumothorax. The heart is mildly enlarged which has increased since prior examination. Mediastinal contour and hila are unremarkable. IMPRESSION: 1. Heterogeneous bibasilar opacities may represent atelectasis or pneumonia in the appropriate clinical setting. 2. Mild vascular congestion. " dcd5b326-9a41d10e-3a03cb13-1eab3769-a928d107.jpg,validate/p18/p18590682/s50165678/dcd5b326-9a41d10e-3a03cb13-1eab3769-a928d107.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with sob, cough, fever // ? infiltrate COMPARISON: ___ FINDINGS: Lung volumes are lower than on the prior study, accentuating the cardiac silhouette and bronchovascular structures. New patchy bibasilar opacities have developed, right greater than left as well as minimal basilar interstitial opacities. Pulmonary vascularity is within normal limits allowing for accentuation by lower lung volumes. There are no pleural effusions. Note is made of previous median sternotomy and aortic valve surgery. IMPRESSION: New combined alveolar and interstitial basilar lung opacities, concerning for an atypical pneumonia in the setting of cough and fever. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 16:33 into the Department of Radiology critical communications system for direct communication to the referring provider. " f967d3cf-1cd0204e-dbe11a85-485e8162-6bf2589f.jpg,validate/p14/p14358282/s54452621/f967d3cf-1cd0204e-dbe11a85-485e8162-6bf2589f.jpg,validation," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. Dual-lead left-sided pacemaker is again seen with leads extending to the expected position of the right atrium and right ventricle, although the very inferior aspect of the right ventricular lead is not fully included on the image. Moderate cardiac silhouette enlargement persists. Mild central pulmonary vascular engorgement is again seen. No focal consolidation, pleural effusion, or pneumothorax is seen. Mediastinal contours are stable. IMPRESSION: Persistent moderate cardiomegaly and mild pulmonary vascular engorgement. " dfbc2b78-ce289714-c7a891fd-e09c3175-fbc07745.jpg,validate/p13/p13085886/s51115981/dfbc2b78-ce289714-c7a891fd-e09c3175-fbc07745.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo AML s/p MEC salvage tx, pending HSCT, prior CXR showed ""irregular thickening right lateral costal pleura"". No h/o trauma, reproducible chest pain, cough, desaturation // please have patient disrobe to waist for study; prior artifact vs right pleural thickening? need for f/up CT? TECHNIQUE: Chest two views COMPARISON: ___ 14:16 FINDINGS: Previously seen-stated pleural thickening is no longer present, wall is most likely superimposition of overlying structures external to the patient. No new abnormality. Otherwise stable. IMPRESSION: No pleural abnormality or effusion. " 0ccd29a3-284e82aa-57239d3b-bbd211ab-63d2b4f8.jpg,validate/p12/p12960142/s52656496/0ccd29a3-284e82aa-57239d3b-bbd211ab-63d2b4f8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with MDS on ___ presents with fever 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. " 7e98368d-77e5c77e-6a38aad4-fb2a359f-3245911a.jpg,validate/p12/p12136629/s59148925/7e98368d-77e5c77e-6a38aad4-fb2a359f-3245911a.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with tingling and sweats. COMPARISON: ___. 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. No radiopaque foreign body. IMPRESSION: No evidence for acute cardiopulmonary process. " 529a780c-e9424f56-a01a4651-4fb5966d-b4a6e741.jpg,validate/p13/p13138475/s58162740/529a780c-e9424f56-a01a4651-4fb5966d-b4a6e741.jpg,validation," WET READ: ___ ___ ___ 6:44 PM ETT now terminates 4.5 cm above the carina. Otherwise, no appreciable change since radiograph of 14:07pm with widespread opacities compatible with infection or vasculitis. - ___ p_________________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with Wegener, respiratory failure, ET tube. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: ET tube ends 4.7 cm above carina. Left jugular line is in mid SVC. Bilateral widespread opacities are unchanged with left lower lobe collapse. Small bilateral pleural effusions are also stable. There is no pneumothorax. NG tube is in the stomach. Cardiac contour is not enlarged. CONCLUSION: 1. Tube and lines are in adequate position. 2. The remainder of the exam is unchanged. " 89cb1b42-ec5ed141-00caba48-de20502e-2d49b4b0.jpg,validate/p19/p19215144/s55211593/89cb1b42-ec5ed141-00caba48-de20502e-2d49b4b0.jpg,validation," FINAL REPORT INDICATION: Chest pain, evaluate for pneumonia. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate stable cardiomegaly. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax evident. No osseous abnormality identified. IMPRESSION: Stable moderate cardiomegaly. No findings concerning for pneumonia. " a86b2fd0-9c32adcb-c6d5fcd6-2238da55-da0e7036.jpg,validate/p19/p19758701/s53935044/a86b2fd0-9c32adcb-c6d5fcd6-2238da55-da0e7036.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new onset afib RVR // is central line too deep is central line too deep COMPARISON: Chest radiographs since ___ most recently ___ through ___. IMPRESSION: Cardiomegaly and moderately severe pulmonary edema developed on ___. Edema and the cardiomegaly have improved subsequently. Heart is top-normal size. Mediastinal veins are still dilated suggesting either biventricular decompensation or continued volume overload. Right jugular line ends at the superior cavoatrial junction. Pleural effusions are small. No pneumothorax. " c40c757d-5011e762-3b7f2ec0-23fd12be-96d9fe50.jpg,validate/p11/p11104877/s52013365/c40c757d-5011e762-3b7f2ec0-23fd12be-96d9fe50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p NG tube // eval NG placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained 09:23 IMPRESSION: The final position of the Dobbhoff tube is in the stomach. ET tube tip is 4 cm above the Carina. Low lung volumes and perihilar opacities are unchanged. " df172623-26fa77c3-debe99c4-099093ae-0c769969.jpg,validate/p19/p19827553/s58102843/df172623-26fa77c3-debe99c4-099093ae-0c769969.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with elevate wbc and prior pos ppd // pna 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 evidence of acute cardiopulmonary process. No specific radiographic evidence of active TB. " 32eef97c-a99d29af-b2d51125-d7cee65a-07a664d5.jpg,validate/p19/p19220361/s53078178/32eef97c-a99d29af-b2d51125-d7cee65a-07a664d5.jpg,validation," 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. " dffe492c-c7d8db3e-e6c96f17-f74cd11c-4e2353e6.jpg,validate/p12/p12180682/s59714052/dffe492c-c7d8db3e-e6c96f17-f74cd11c-4e2353e6.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Left subclavian line placement. FINDINGS: There is a new left subclavian line with tip in the SVC. There is no pneumothorax. The ET tube tip is 4.2 cm above the carina. The NG tube is coiled in the stomach. The right hemidiaphragm is mildly elevated. There is right lower lobe volume loss with some plate-like atelectasis medially. " f74ba0cf-011bcd3e-c0846449-e2d9e368-ab2250e7.jpg,validate/p15/p15341255/s57337253/f74ba0cf-011bcd3e-c0846449-e2d9e368-ab2250e7.jpg,validation," FINAL REPORT INDICATION: Apical pneumothorax, followup pneumothorax on suction at 40 cm of H2O. COMPARISON: ___ 8:38. FINDINGS: Portable frontal radiograph of the chest demonstrates a right IJ central venous catheter and 2 left pleural catheters in unchanged position. The left apical pneumothorax is slightly increased compared to prior now measuring 21 mm, previously 17 mm. Otherwise, there is stable appearance of the chest with unchanged enlargement of the cardiac silhouette and bilateral pleural effusions with pulmonary vascular congestion. " fa7938bb-c5db683a-2b8effc7-7083c65e-de0771d3.jpg,validate/p17/p17051420/s55924810/fa7938bb-c5db683a-2b8effc7-7083c65e-de0771d3.jpg,validation," 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. " d8a9524e-000c04f7-b24787c0-541db30d-f0d7dff3.jpg,validate/p11/p11321986/s53417098/d8a9524e-000c04f7-b24787c0-541db30d-f0d7dff3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NSIP // concern for interval worsening COMPARISON: ___. IMPRESSION: As compared to the previous image, no relevant change is seen. Status post sternotomy. Known extensive right and basal left parenchymal opacities. The alignment of the sternal wires is constant. No new parenchymal opacities. The right PICC line is unchanged. " 7dac7194-d669e81d-a160be80-92e34190-9ef02297.jpg,validate/p11/p11775739/s57885753/7dac7194-d669e81d-a160be80-92e34190-9ef02297.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old man s/p RUL/RML wedge // check interval change post CT removal TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ at 05:17 FINDINGS: Since the prior CXR performed earlier this morning, the right chest tube has been removed. Right Port-A-Cath is unchanged in position. The known right apical pneumothorax has decreased in size since yesterday afternoon, but has remained stable since the most recent CXR performed this morning. Within the right hemithorax, there are two new air-fuid levels, compatible with hydropneumothorax. There are likely tiny bilateral pleural effusions. Stable cardiomediastinal silhouette. Elevation of the right hemidiaphragm suggest volume loss. IMPRESSION: 1. Interval removal of the right chest tube. Stable right apical pneumothorax. 2. Two new air-fluid levels in the right lung, compatible with hydropneumothorax. " 9e69b30a-c3398ed6-5aa8c63a-e3757597-43e57d6a.jpg,validate/p14/p14371035/s53587472/9e69b30a-c3398ed6-5aa8c63a-e3757597-43e57d6a.jpg,validation," FINAL REPORT PORTABLE CHEST ___ ___ AT 11:02 A.M. COMPARISON: Chest x-___ ___ ___ at 9:37 a.m. FINDINGS: Tip of the endotracheal tube terminates at the level of the carina, as communicated by telephone to Dr. ___ at 12:45 p.m., the same time of discovery of this finding on ___. A new nasogastric tube has been placed and terminates below the diaphragm, with tip outside of the field of view. Allowing for differences in technique and projection, the exam is otherwise not appreciably changed since the recent study performed less than two hours earlier. " c8401075-8ac2b216-6f13bc92-d30a4bb0-519eb659.jpg,validate/p11/p11084812/s58820371/c8401075-8ac2b216-6f13bc92-d30a4bb0-519eb659.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with polymyositis, congestive heart failure, presenting with productive cough, edema, weakness. Evaluate for infiltrate or fluid overload. COMPARISON: ___. TECHNIQUE: AP and lateral chest radiographs. FINDINGS: Lung volumes are low. There is bilateral hilar prominence with upper vascular re-distribution and diffuse interstitial thickening, but no focal opacities. Heart size is mildly enlarged although AP views are not tailored for accurate assessment of cardiac size. There is no pleural effusion or pneumothorax. IMPRESSION: Findings compatible with mild pulmonary edema. " c508ccc9-7b95ea6f-b58996ab-c39c99bc-56c0fcab.jpg,validate/p19/p19231238/s54158425/c508ccc9-7b95ea6f-b58996ab-c39c99bc-56c0fcab.jpg,validation," FINAL REPORT INDICATION: ___F with confusion // CXR: Eval for pnaCT head: eval for ICH TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: When compared to prior, there has been no significant interval change. There is persistent pulmonary edema. More confluent infrahilar opacity on the right could represent superimposed infection. There is no large effusion. Degree of cardiomegaly is unchanged. No acute osseous abnormalities. IMPRESSION: Pulmonary edema with more confluent opacity in the right infrahilar region which could represent edema versus superimposed infection. " fecb6272-c9cadfef-487377ec-91934c45-0f99bc68.jpg,validate/p17/p17975678/s59024975/fecb6272-c9cadfef-487377ec-91934c45-0f99bc68.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ET tube placement // ET tube placement Surg: ___ (organ harvest) IMPRESSION: In comparison to ___ radiograph, an endotracheal tube has been it advanced, with tip now terminating 5.7 cm above the carina. Lung volumes are increased compared to the prior study. Appearance of the chest is otherwise similar to the recent exam except for slight worsening of left retrocardiac opacification. " 44b11553-6d70765e-86b95eba-f6a38269-307dd317.jpg,validate/p14/p14470386/s55418837/44b11553-6d70765e-86b95eba-f6a38269-307dd317.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 2 EXAMS INDICATION: ___ year old male with history polysubstance abuse and Hepatitis C, admitted to ___ after trauma of unclear etiology s/p r craniotomy for large epidural hematoma with midline shift. Now with R PCA infarct, ventilator-associated pneumonia. // NJ tube placement NJ tube placement IMPRESSION: In comparison with the earlier study of this date, this and placement of a Dobhoff tube that extends to the upper stomach with the opaque tip well below the esophagogastric junction. Other monitoring and support devices are unchanged. Areas of increased opacification are again seen the bilaterally, though less prominent. Some of this probably represents improved pulmonary vascular status. Again, bilateral aspiration pneumonia should be seriously considered. " bb79745c-ce8c302d-34a7e235-302838a7-c07aaad1.jpg,validate/p11/p11533574/s56650790/bb79745c-ce8c302d-34a7e235-302838a7-c07aaad1.jpg,validation," FINAL REPORT INDICATION: Exertional chest pain with clean coronary artery catheterization. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Chest PA and lateral radiographs demonstrate unremarkable mediastinal, hilar, and cardiac contours. The lungs are clear. No pleural effusion or pneumothorax evident. IMPRESSION: No acute cardiopulmonary process. " 21bc5013-e1517808-915ba7c5-d549d09a-89df694a.jpg,validate/p13/p13747362/s56513601/21bc5013-e1517808-915ba7c5-d549d09a-89df694a.jpg,validation," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient status post ascending aortic replacement, chest tubes on water seal. No air leak. 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 obtained four hours earlier during the same day. The position of the ETT is unchanged and symmetrical within the lumen of the trachea. The tube terminates just above the previously described left-sided impression on the trachea caused by the now operated aneurysm. Postoperative widening of the superior mediastinum is unchanged during the latest four hours. The Swan-Ganz catheter has been withdrawn but the right internal jugular sheath remains in position. There is now a small right-sided apical pneumothorax measuring up to 2 cm in width. When reviewing the same area on the preceding examination four hours ago, such pneumothorax was not present. On the other hand, evidence of bilateral air inclusion in Bibasilar hazy densities and obliteration of the diaphragmatic the pectoralis muscle structures is again noted as before. contours is suggestive of bilateral pleural effusion. The latter finding appears to be stable. IMPRESSION: Development of small right apical pneumothorax possibly related to Swan-Ganz removal and the remaining sheath. ___ was informed by telephone. " a6f1ea4d-e5438f26-0e359d05-98e19d8f-22d7768c.jpg,validate/p13/p13451992/s50736000/a6f1ea4d-e5438f26-0e359d05-98e19d8f-22d7768c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC partially pulled out. // ?PICC placement TECHNIQUE: Chest single view COMPARISON: ___ 15:37 FINDINGS: Right PICC line tip in the upper SVC, 8 cm from cavoatrial junction. Heart size is stable. Pulmonary vascularity has decreased. Hyperinflation. Mildly improved right basilar opacity. Mildly improved left basilar consolidation. Small pleural effusions, stable. IMPRESSION: Decreased pulmonary vascularity. Mildly improved basilar opacities. " 47d85ff7-f704fe76-df491f25-b5b86b66-f77909b5.jpg,validate/p11/p11151938/s57389232/47d85ff7-f704fe76-df491f25-b5b86b66-f77909b5.jpg,validation," 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. " 184551fe-bb131951-0b437d7f-d000a750-da1307f0.jpg,validate/p13/p13428362/s57275174/184551fe-bb131951-0b437d7f-d000a750-da1307f0.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion. COMPARISON: None. FINDINGS: Portable AP upright chest radiograph was obtained. The lungs are reasonably well expanded with elevation left hemidiaphragm resulting in left basilar atelectasis. There is no pulmonary edema. No pneumothorax or pleural effusion seen. The heart is moderately enlarged with prominent ascending aortic contour. IMPRESSION: Left basilar atelectasis likely relating to elevated left hemidiaphragm without acute intrathoracic process. If patient is able, a conventional 2 view radiograph including a lateral view would be useful to assess for left pleural effusion accounting for the basal opacity. " bd637101-69498d14-7bdd91f6-596dc782-fa30f48e.jpg,validate/p17/p17959674/s58692872/bd637101-69498d14-7bdd91f6-596dc782-fa30f48e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hairy cell leukemia and hypoxia // ?pulm edema ?pulm edema IMPRESSION: Comparison to ___. Stable appearance of the heart and the lung parenchyma. Mild to moderate pulmonary edema. No pleural effusions. No pneumonia. Borderline size of the heart. No pneumothorax. The right PICC line is in stable correct position. " 657c2747-d25f6177-2f4662bf-94bde918-a6ef4499.jpg,validate/p11/p11534871/s51751434/657c2747-d25f6177-2f4662bf-94bde918-a6ef4499.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___, AT 18:23 HOURS. HISTORY: History of chest pain. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The osseous structures are unremarkable. IMPRESSION: No acute pulmonary process. In particular, no pneumothorax seen. " 6dd396eb-df18079e-8c4a2e87-3565ecc9-c6632464.jpg,validate/p15/p15207910/s56486369/6dd396eb-df18079e-8c4a2e87-3565ecc9-c6632464.jpg,validation," FINAL REPORT TECHNIQUE: A single AP upright chest view was read in comparison with prior chest radiograph from ___. FINDINGS: Lungs are adequately expanded. Bilateral lower lung consolidations have worsened since ___. Presumed small left pleural effusion is unchanged. Bilateral lungs demonstrate mild opacities with ill-defined vascular margins likely mild pulmonary edema. Heart size, mediastinal and hilar contours are stable. IMPRESSION : Mild pulmonary edema Worsening bilateral lower lung consolidation and stable small left pleural effusion. " 83077118-2440abc0-2e491401-6c1b1818-530a1a95.jpg,validate/p11/p11828962/s51493118/83077118-2440abc0-2e491401-6c1b1818-530a1a95.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___. COMPARISON: ___ radiograph. FINDINGS: Interval extubation. Low lung volumes accentuate cardiac silhouette and bronchovascular structures. Perihilar and basilar opacities are relatively similar allowing for differences in lung volumes, and may reflect multifocal aspiration pneumonia given clinical history of aspiration event. Small right pleural effusion is also noted. " 6bf2a0c5-0f77f6b9-6c8c7040-c8adebb4-e514c667.jpg,validate/p15/p15518947/s53861615/6bf2a0c5-0f77f6b9-6c8c7040-c8adebb4-e514c667.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with toxic congestions. Question pneumonitis. IMPRESSION: AP chest compared to ___: Heart size top normal, decreased since prior studies. No pulmonary vascular congestion. No consolidation, appreciable atelectasis or evidence of airtrapping. Mediastinal and hilar silhouettes and pleural surfaces are normal. " 6b7decbc-bd36510b-a97baf19-11d69b72-42943557.jpg,validate/p15/p15103276/s52261216/6b7decbc-bd36510b-a97baf19-11d69b72-42943557.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with left-sided chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pulmonary vascular congestion. The cardiac silhouette are unchanged. No acute osseous abnormality is identified, hypertrophic changes seen in the spine. IMPRESSION: No acute cardiopulmonary process. " afdb20bc-5cc6a2fa-56d6547b-d9e84aa6-8190397b.jpg,validate/p14/p14018555/s53031920/afdb20bc-5cc6a2fa-56d6547b-d9e84aa6-8190397b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MVC // Cardiopulm process TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 4.4 cm above the carinal. . Heart size and mediastinum are similar to previous examination. Large bilateral pleural effusions and bibasal consolidations are noted, minimally progressed since the prior study. No pneumothorax is seen. " 924354a4-cb556cb9-3d762df6-a36601e5-ebb4b6bc.jpg,validate/p15/p15229604/s51209326/924354a4-cb556cb9-3d762df6-a36601e5-ebb4b6bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man POD 5 from combined kidney pancreas transplant with increasing confusion, delayed graft function of the kidney // Assess for effusion, exudate, atelectasis, any infectious source for confusion COMPARISON: Chest radiograph ___ FINDINGS: AP and lateral views of the chest provided. Left hemodialysis catheter terminates at the right atrium. Lung volumes are low. Asymmetry at lung bases concerning for consolidation at left lung base. Mild indistinctness of pulmonary vessels could be related to elevated venous pressure or low lung volumes. No pneumothorax. Small, bilateral pleural effusions are new. Hilar and cardiomediastinal contours are normal. IMPRESSION: 1. New left lung base infiltrate is concerning for pneumonia. 2. Small, bilateral pleural effusions are new. " 3d3401b2-dba1bc61-4973f4f1-b21e12d6-9f99cfe5.jpg,validate/p18/p18123982/s52875735/3d3401b2-dba1bc61-4973f4f1-b21e12d6-9f99cfe5.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with pancreatic CA, dyspnea on exertion // ? effusions, CHF TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Blunting of the costophrenic angles, right greater than left, suggest small pleural effusions. No definite focal consolidation is seen. There is no pulmonary edema. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Left-sided Port-A-Cath terminates in the mid SVC. IMPRESSION: Small pleural effusions. No pulmonary edema. Left Port-A-Cath terminates in the mid SVC. " b9c323a3-11953687-1580710e-6c7cefda-dafa7e6d.jpg,validate/p17/p17591410/s51918193/b9c323a3-11953687-1580710e-6c7cefda-dafa7e6d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusion s/p drainage; c/b PTX, now with trapped lung, ongoing O2 requirement // worsening pleural effusion vs pulmonary edema vs worsening PTX given ongoing O2 requirement IMPRESSION: In comparison to ___ chest radiograph, a large left hydropneumothorax with associated trapped lung has a increased slightly in size. No other relevant change. " 1be9fc96-eabd4e8f-953b6ed1-3981eec6-b55700d9.jpg,validate/p12/p12183689/s57793194/1be9fc96-eabd4e8f-953b6ed1-3981eec6-b55700d9.jpg,validation," FINAL REPORT INDICATION: Evaluate trach placement, evaluate for pneumothorax. Patient also s/p PEG placement by surgery today. COMPARISON: ___ at 9:47 a.m. FINDINGS: AP view of the chest. A right IJ and central venous catheter ends in the mid SVC. Tracheostomy ends 2.2 cm from the carina. There is bibasilar opacities likely representing atelectasis. There is new small amount of free peritoneal air under the diaphragms. No pneumothorax. Mediastinal and hilar contours are normal. IMPRESSION: New free air under the diaphragms, likely postoperative given PEG placement. Attention on follow up. Tracheostomy ends 2.2 cm from the carina. Bibasilar atelectasis. These findings were discussed with Dr. ___ by Dr. ___ at 415pm on ___ by phone at time of discovery. " f3a43768-8863df2a-7d295bed-a43e4a98-8cbe51c7.jpg,validate/p19/p19229277/s53376589/f3a43768-8863df2a-7d295bed-a43e4a98-8cbe51c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SOB, fever. // PNA? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. However, in the retrocardiac lung region, at the level of the left lower lobe, and atelectasis persists. The atelectasis contains air bronchograms. No evidence of pneumonia or pulmonary edema. Unchanged appearance of the cardiac silhouette. " 2d59f932-26577b07-3a0c3233-341d8ca8-c3990a8f.jpg,validate/p14/p14289467/s57759528/2d59f932-26577b07-3a0c3233-341d8ca8-c3990a8f.jpg,validation," FINAL REPORT INDICATION: Failure to thrive. Assess for pneumonia. COMPARISON: Chest radiograph from ___. Chest CT from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. There is redemonstration of prior midline sternotomy and CABG as well as a prosthetic aortic valve. There has been interval removal of the previously seen left PICC. Blunting of the left costophrenic angle is not significantly changed, likely secondary to scarring and a small pleural effusion. There is no focal consolidation. The heart size is upper limits of normal. Mitral annular calcifications are noted. There is no right pleural effusion. No pneumothorax is seen. The mediastinal contours are normal. IMPRESSION: Unchanged blunting of the left costophrenic angle suggestive of a small pleural effusion with scarring or atelectasis. No acute cardiac or pulmonary process otherwise noted. " 48fc84a5-f5c0a088-d44922f1-dd5eee8d-f894ed64.jpg,validate/p17/p17980556/s58991378/48fc84a5-f5c0a088-d44922f1-dd5eee8d-f894ed64.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Recent pneumonia and increasing white count. IMPRESSION: PA and lateral chest compared to ___: Previous heterogeneous opacification in the right lung which improved from ___ through ___ has not improved subsequently, consistent with persistent multifocal pneumonia. Additionally, mild pulmonary edema most readily detected in the left lung, continues to improve. Heart is top normal size, decreased. Small right pleural effusion remains. No pneumothorax. Left PICC line ends alongside a dual-channel right supraclavicular central venous catheter in the mid-to-low SVC. No pneumothorax. " caa05548-8e9847e8-8edab3da-094169b7-661646ec.jpg,validate/p18/p18204836/s58028685/caa05548-8e9847e8-8edab3da-094169b7-661646ec.jpg,validation," FINAL REPORT PORTABLE AP CHEST ON ___ AT ___ CLINICAL INDICATION: Dobbhoff tube placement, check position. Comparison is made to the patient's prior study of ___ at 543. A portable semi-erect chest film ___ at ___ is submitted. IMPRESSION: 1. Interval removal of the nasogastric tube with placement of the Dobbhoff feeding tube which has its tip within the stomach. Endotracheal tube remains in place with its tip 4.5 cm above the carina. Right subclavian PICC line has its tip in the distal SVC unchanged. Spinal fusion hardware overlies the mid to lower thoracic spine. Heart remains enlarged and the mediastinum appears widened but unchanged likely related to relatively low lung volumes and portable technique. There is diffuse bilateral airspace process with more consolidative component at the left base essentially unchanged but may reflect moderate pulmonary edema or diffuse pneumonia. Clinical correlation is advised. No pneumothorax is seen. " 8e42a8fd-f790e96b-ee77be2a-7651aab6-da4c5769.jpg,validate/p12/p12106204/s56797900/8e42a8fd-f790e96b-ee77be2a-7651aab6-da4c5769.jpg,validation," FINAL REPORT INDICATION: ___-year-old man status post AVR with new Dobbhoff. COMPARISONS: ___ to ___. FINDINGS: An endotracheal tube remains in the upper airway. A right-sided PICC line terminates in the low SVC. A Dobbhoff tube projects over the stomach. Median sternotomy wires are intact. Thickening of the right minor fissure, small left effusion and basal atelectasis are similar. Retrocardiac opacity is also unchanged. IMPRESSION: Dobbhoff tube projects over the stomach. Stable appearance of bibasilar atelectasis and left effusion. " 949f1e65-0f4289c9-c2634cdf-68c7c8ef-4f682115.jpg,validate/p19/p19822093/s57868788/949f1e65-0f4289c9-c2634cdf-68c7c8ef-4f682115.jpg,validation," FINAL REPORT CHEST, TWO VIEWS. HISTORY: ___-year-old male with chills and subjective fever. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Right PICC is no longer seen. The lungs are clear of consolidation or effusion. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 934899b5-2caaaef5-d3142110-d3fca3c7-f46800b2.jpg,validate/p15/p15837443/s58315602/934899b5-2caaaef5-d3142110-d3fca3c7-f46800b2.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with fever, altered mental status, and hypertension; question pneumonia. COMPARISON: ___. SINGLE PORTABLE AP VIEW OF THE CHEST: Lung volumes are again low. A generalized increase in the radiodensity in the lower lungs could be due to edema, less likely to pneumonia, although this is still conceivable if the patient's clinical picture fits. Bibasilar streaky atelectasis remains. Patient is status post median sternotomy. Cardiomediastinal silhouette and hilar contours are normal. IMPRESSION: Generalized increase in the radiodensity in the lower lungs could be due to edema, less likely pneumonia. " 0eea414e-caa5d90c-41a1bedf-0316ab46-c4f4e9ce.jpg,validate/p11/p11834717/s58928130/0eea414e-caa5d90c-41a1bedf-0316ab46-c4f4e9ce.jpg,validation," WET READ: ___ ___ ___ 11:43 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // Eval for structural process TECHNIQUE: Chest PA and lateral COMPARISON: None available per. FINDINGS: The lungs are hyperinflated and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 281d6f8d-b23aaa93-55282b4a-bff85e03-f72e7040.jpg,validate/p14/p14191651/s57863185/281d6f8d-b23aaa93-55282b4a-bff85e03-f72e7040.jpg,validation," FINAL REPORT HISTORY: Shortness breath, headache, AIDS. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. 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 acute cardiopulmonary process. " d2a2ec3a-a8510eba-fc2522e2-2fb2e96b-902eadab.jpg,validate/p10/p10602633/s57117705/d2a2ec3a-a8510eba-fc2522e2-2fb2e96b-902eadab.jpg,validation," FINAL REPORT INDICATION: Dyspnea for further evaluation. History of hypertension. TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. FINDINGS: Both lungs are well expanded and clear. There are no lung opacities concerning for pneumonia or edema. There is no pleural abnormality. Heart size, mediastinal and hilar contours are normal. IMPRESSION: Normal chest. " 3c01df1d-1687e225-8bbb7932-8cea586e-53576f7a.jpg,validate/p15/p15467950/s51074007/3c01df1d-1687e225-8bbb7932-8cea586e-53576f7a.jpg,validation," 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. " 8ff5b549-b143dd8f-526fc486-46b98e7f-bf08a19a.jpg,validate/p14/p14325285/s56779275/8ff5b549-b143dd8f-526fc486-46b98e7f-bf08a19a.jpg,validation," FINAL REPORT HISTORY: Metastatic lung CA, question interval change in pulmonary edema. CHEST, SINGLE AP PORTABLE VIEW Compared with ___ at 3:17 a.m., and allowing for technical differences, I doubt significant interval change. Again seen are opacities in the right upper zone and left mid and lower zones and faint opacity throughout the left upper zone which is slightly more apparent -- ? due to technical differences. Minimal increased interstitial markings at the right base are also slightly more apparent, but similar to ___ at 19:45 p.m. IMPRESSION: Minimal, if any, interval change. " 2da72631-67cd9082-2ab41794-0bdc833c-4e9fc270.jpg,validate/p10/p10179857/s53421656/2da72631-67cd9082-2ab41794-0bdc833c-4e9fc270.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new onset wheezing episode without clear precipitant. No known history of asthma. 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. " 74b6e10c-8fe50157-0a9c4f25-9f30987a-810b94e2.jpg,validate/p17/p17561108/s57273849/74b6e10c-8fe50157-0a9c4f25-9f30987a-810b94e2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with prior lymphoma and pneumonitis, increased shortness of breath // eval for change/infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: CT chest from ___ IMPRESSION: Heart size is enlarged, unchanged. Mediastinum is stable. Port-A-Cath catheter tip is at the level of superior to mid SVC. No new consolidations or masses to suggest interval development of infectious process demonstrated. Chronic changes in the right lung with subsequent partial volume loss are unchanged " 8fe0ecce-698805e1-97b86023-dc5b62b7-47a876c4.jpg,validate/p12/p12327475/s51236851/8fe0ecce-698805e1-97b86023-dc5b62b7-47a876c4.jpg,validation," 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. " 806f24ec-0d99b021-f57d2ce7-38b26edb-d1e43d78.jpg,validate/p19/p19336651/s54032647/806f24ec-0d99b021-f57d2ce7-38b26edb-d1e43d78.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: metastatic panc Ca, with prior effusion, now w/ pleuritic left sided chest pain // effusion, PNA effusion, PNA COMPARISON: Prior chest radiographs ___. IMPRESSION: Small left pleural effusion still present. Mild cardiomegaly unchanged. No pulmonary edema. Probable mild left lower lobe atelectasis. " 170490c7-fe3a447e-0d07221c-da6a27c8-cdae867d.jpg,validate/p18/p18776647/s52940368/170490c7-fe3a447e-0d07221c-da6a27c8-cdae867d.jpg,validation," FINAL REPORT HISTORY: Fall, head trauma, question bleed or fracture. CHEST, TWO VIEWS. No previous chest x-rays on PACS record for comparison. No localizing history is available. Allowing for this, the heart is not enlarged. The aorta is minimally unfolded. The mediastinal silhouette is otherwise within normal limits. There is no CHF, focal infiltrate or effusion. No pneumothorax is detected. There are mild degenerative changes in the thoracic spine. In the visualized levels, no vertebral body compression is identified. No rib fracture is detected on these lung-technique films. IMPRESSION: 1) No acute pulmonary process and no pneumothorax identified. 2) No displaced rib fracture identified on these lung technique films. " 0f1a9976-016a68f9-c188dd7a-6ba98b95-33e0535f.jpg,validate/p16/p16033728/s58534188/0f1a9976-016a68f9-c188dd7a-6ba98b95-33e0535f.jpg,validation," FINAL REPORT INDICATION: ___M with fever, cough, sob recetnpna dx // pna? TECHNIQUE: AP and lateral views of the chest COMPARISON: ___ FINDINGS: Relative elevation of left hemidiaphragm is again none. Left basilar opacity may be secondary to atelectasis. Elsewhere the lungs are grossly clear. The cardiac silhouette is stable in configuration. There is no large effusion. No acute osseous abnormalities identified. IMPRESSION: Persistent elevation of left hemidiaphragm with left basilar opacity likely atelectasis although infection is not entirely excluded. " 5fec8149-687589f1-7170f967-3ea3bc64-40a1dd75.jpg,validate/p19/p19244907/s54676569/5fec8149-687589f1-7170f967-3ea3bc64-40a1dd75.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH, fever, leukocytosis // Please evaluate for interval change Please evaluate for interval change COMPARISON: Comparison to prior study dated ___ at 04:06 FINDINGS: Portable supine chest film ___ at 506 is submitted. IMPRESSION: There is a layering right effusion with associated patchy airspace disease in the right mid and lower lung which would be concerning for pneumonia given its focality. Endotracheal tube, nasogastric tube and left subclavian central line are unchanged in position. Overall cardiac and mediastinal contours are stable. No evidence of pulmonary edema. Left lung is grossly clear. " 7e1f2fda-2262524f-f498ecda-249dd319-ea98a4d5.jpg,validate/p10/p10532853/s55927417/7e1f2fda-2262524f-f498ecda-249dd319-ea98a4d5.jpg,validation," WET READ: ___ ___ ___ 8:16 AM A right-sided effusion may be minimally decreased in size from ___. A small left-sided effusion is still present. Lung volumes are low. Opacity at the right base may be related to compressive atelectasis however infection should be considered in the appropriate clinical setting. WET READ VERSION #___ ___ ___ ___ 10:19 PM A right-sided effusion may be minimally decreased in size from ___. A small left-sided effusion is still present. Lung volumes are low. Opacity at the right base may be related to compressive atelectasis however infection should be considered in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CHF (EF ___%), cirrhosis complicated by ascites with worsening liver function labs. // PNA? COMPARISON: ___. IMPRESSION: Minimal decrease in effusion on the left. Massive cardiomegaly persists. No other changes are noted. " 7064364c-bb204ce2-88fbb4dc-35eeaadc-f249043d.jpg,validate/p15/p15225349/s53370025/7064364c-bb204ce2-88fbb4dc-35eeaadc-f249043d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with liver/colon ca, hx of perihep fluid, now with n/v, pls eval for receurrence of fluid vs obstruct COMPARISON: CT torso from earlier today. FINDINGS: PA and lateral views of the chest provided. Again noted, are bilateral pleural effusions, left greater than right. Cardiomegaly reflects known pericardial effusion. Compressive lower lobe atelectasis is also noted. No pneumothorax. Mediastinal contour is normal. No convincing evidence for pulmonary congestion or edema. Bony structures are intact. IMPRESSION: Bilateral pleural effusions, left greater than right with compressive lower lobe atelectasis better assessed on same-day CT torso. Cardiomegaly reflect known pericardial effusion. " 9114148a-73b37305-5d6b3221-53245715-243cdd1d.jpg,validate/p13/p13913890/s58379433/9114148a-73b37305-5d6b3221-53245715-243cdd1d.jpg,validation," FINAL REPORT INDICATION: History: ___F with fever and cough // eval for pna TECHNIQUE: Portable AP upright view of the chest. COMPARISON: ___ at 19:05 FINDINGS: In comparison to the study of several hours prior, lung volumes remain extremely low. Cardiomediastinal silhouette is within normal limits. Multiple bilateral rounded opacities have progressed compared to the prior study. There is no large effusion or pneumothorax. IMPRESSION: Progression of multiple bilateral rounded opacities raises concern for multifocal pneumonia or septic emboli. RECOMMENDATION(S): An echocardiogram should be obtained to rule out endocarditis. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 8:54 AM, 5 minutes after discovery of the findings. " fd1ff2a7-5cab563c-0dfa943e-2ecbb114-3cdd904a.jpg,validate/p11/p11293962/s57655198/fd1ff2a7-5cab563c-0dfa943e-2ecbb114-3cdd904a.jpg,validation," WET READ: ___ ___ ___ 7:51 PM IMPRESSION: Findings compatible with right middle lobe pneumonia. ______________________________________________________________________________ FINAL REPORT HISTORY: Recent pneumonia with new fever and white blood cell count. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: In the right middle lobe, best seen on the lateral view, there is an increased opacity. A corresponding area of subtly increased opacity obscuring the right heart border in the right middle lobe is also seen on the frontal view, worrisome for pneumonia. The left lung is clear. Cardiac size is normal. There is no pleural effusion or pneumothorax or pulmonary edema. IMPRESSION: Findings compatible with right middle lobe pneumonia. " 68b69cb7-81707529-1b69b46a-f106de85-317bd8d3.jpg,validate/p16/p16401890/s51950829/68b69cb7-81707529-1b69b46a-f106de85-317bd8d3.jpg,validation," 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 pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 394f4791-5f4264ee-3f870086-98d76455-e6f4b4cc.jpg,validate/p14/p14065514/s57427120/394f4791-5f4264ee-3f870086-98d76455-e6f4b4cc.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever, chills, shortness of breath and cough. COMPARISONS: Recent prior radiographs from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is again mild-to-moderate relative elevation of the right hemidiaphragm. The only change is a streaky right mid lung opacity, suggesting minor atelectasis. A central venous catheter terminates in the lower superior vena cava. IMPRESSION: No evidence of acute disease. " a7529d02-90ef1155-04e71ca3-44e72964-f33b06d6.jpg,validate/p11/p11000183/s53970869/a7529d02-90ef1155-04e71ca3-44e72964-f33b06d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with DLBCL on RCHOP // eval for pna IMPRESSION: In comparison to ___ chest radiograph, pulmonary vascular congestion and minimal edema persist. Previously reported right basilar opacity has partially resolved with associated decrease in adjacent right pleural effusion. Patchy and linear opacity at left lung base is new and favors atelectasis over infectious pneumonia. " ad598ba4-b4e63ff0-913f49c1-d1652592-3698478b.jpg,validate/p13/p13680126/s53272600/ad598ba4-b4e63ff0-913f49c1-d1652592-3698478b.jpg,validation," FINAL REPORT INDICATION: Cough and shortness of breath, persistent despite antibiotics and inhalers. COMPARISON: Chest radiograph ___, ___. FINDINGS: The cardiomediastinal and hilar contours are stable with geographic marginated fibrotic changes in the paramediastinal areas consistent with radiation changes. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. Signs of volume loss are again seen in both upper lobes. Surgical clips are redemonstrated in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " b23a1106-adb8ed29-61a182c5-9f411973-69dcfd62.jpg,validate/p13/p13990571/s56239386/b23a1106-adb8ed29-61a182c5-9f411973-69dcfd62.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Please evaluate for right-sided pneumonia. COMPARISON: ___ to ___. FINDINGS: There is no evidence of new consolidation. Minimal interstitial lung markings are unchanged since ___. On previous abdominal CT, there was possibly minimal reticulation in subpleural area. Cardiac contour is mildly enlarged. There is no pleural effusion or pneumothorax. CONCLUSION: 1. There is no evidence of pneumonia. 2. Possible interstitial lung disease, unchanged since ___. " 90e137ab-d354be58-67352549-276dcce7-27145915.jpg,validate/p19/p19132043/s50044191/90e137ab-d354be58-67352549-276dcce7-27145915.jpg,validation," FINAL REPORT INDICATION: History of tachypnea, evaluate for possible intrapulmonary process. COMPARISON: Chest radiograph ___. FINDINGS: A left internal jugular central line terminates at the cavoatrial junction. A right subclavian line terminates in the right atrium. Severe cardiomegaly is stable. There is no focal consolidation or pneumothorax. There has been improvement in the right pleural effusion and a small left pleural effusion is stable. IMPRESSION: Improvement in right pleural effusion. Probable small left pleural effusion. " 399e1910-93e79739-b4ac3076-46754197-0d705c08.jpg,validate/p16/p16826765/s56599880/399e1910-93e79739-b4ac3076-46754197-0d705c08.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stroke, increased respiratory rate and work of breathing // edema? pneumonia? edema? pneumonia? IMPRESSION: In comparison with the study ___ ___, the nasogastric tube is been removed. There is again enlargement of the cardiac silhouette with pulmonary edema, which may be slightly improved. Of incidental note is residual contrast material in the colon. " 198f9bb2-9ec368b3-944ec485-fdaab1a2-a2b08148.jpg,validate/p14/p14778296/s59390558/198f9bb2-9ec368b3-944ec485-fdaab1a2-a2b08148.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with new tachycardia, no symptoms, pls eval for cardiopulmonary change // ___F with new tachycardia, no symptoms, pls eval for cardiopulmonary change TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: The lungs are hyperinflated. Bibasilar atelectasis/scarring is seen. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable. No overt pulmonary edema is seen. IMPRESSION: Hyperinflated lungs suggest chronic obstructive pulmonary disease. Bibasilar atelectasis/scarring. " 647beb66-0415dedb-fe5a4fc6-66b7e7ec-cf2d7f9f.jpg,validate/p11/p11958303/s58561936/647beb66-0415dedb-fe5a4fc6-66b7e7ec-cf2d7f9f.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with endobronchial tumor obstruction, evaluate interval change status post bronchoscopy. FINDINGS: Comparison is made to previous study from ___. There has been improved aeration of the right upper lobe since the prior study. There is again seen a right-sided Port-A-Cath with the distal tip in the mid SVC. There is prominence of the pulmonary interstitial markings, which is unchanged. Oral contrast is seen in the transverse colon. There are no pneumothoraces. " f4bd02b0-ef9a0c03-ba279432-d51d64ef-a870d730.jpg,validate/p16/p16417985/s55463235/f4bd02b0-ef9a0c03-ba279432-d51d64ef-a870d730.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Abdominal surgery, baseline imaging. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The patient has received a nasogastric tube. The tube is in correct position. Normal size of the cardiac silhouette. No acute pulmonary edema. Minimal atelectasis at the right and left lung bases. No pneumonia. No pleural effusion. No pneumothorax. " 9464bd56-882ec6c5-e9e3ed57-9f2df130-5efc6ebd.jpg,validate/p13/p13103745/s58070486/9464bd56-882ec6c5-e9e3ed57-9f2df130-5efc6ebd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ HCC, HCV now s/p liver txp from healthy donor w/ arterial reconstruction (donor w/ replaced hepatics) and jump graft from SMV to portal vein via donor iliac vein // serial exam COMPARISON: Chest radiographs ___ IMPRESSION: Pulmonary and mediastinal vascular engorgement which developed between ___ and ___ have not improved. Heart size is top normal, unchanged. Opacification in the right lower hemi thorax has increased, could be explained entirely by a pleural effusion, despite the presence of a drainage tube at the level of the right hemidiaphragm, whether intrathoracic or subdiaphragmatic, one cannot tell from this single frontal radiograph:. Mild interstitial edema at the base of the left lung is new. Left lower lobe atelectasis is presumed. No pneumothorax. " d9dd7675-80e65bf9-369b8857-9cda016a-ea2b8336.jpg,validate/p18/p18616499/s52425461/d9dd7675-80e65bf9-369b8857-9cda016a-ea2b8336.jpg,validation," 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. " 74e965bd-b4b135f9-81a741ec-1210c72b-ba2fd9cc.jpg,validate/p16/p16743731/s57856808/74e965bd-b4b135f9-81a741ec-1210c72b-ba2fd9cc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Gastrointestinal bleed, assessment for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes remain low. Borderline size of the cardiac silhouette. Mild fluid overload. Mild right pleural effusion. Newly appeared parenchymal opacities. The pre-existing areas of atelectasis at both lung bases are constant. " 00852f7e-8ee6afeb-7a8b7936-7519630d-5635f907.jpg,validate/p12/p12346738/s50690375/00852f7e-8ee6afeb-7a8b7936-7519630d-5635f907.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with chest pain. Assess for pleural effusion or consolidation. 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. There is persistent disruption of the first and second sternotomy wires consistent with fracture. Additional sternotomy wires are intact. Left upper quadrant clips are noted. IMPRESSION: 1. No acute cardiopulmonary process. Specifically no pleural effusion or pneumonia. 2. No interval change in fractured first and second sternotomy wires. " 318dcd3d-93d60dc4-ce899500-d85bde6a-2dfbb880.jpg,validate/p14/p14887088/s56054199/318dcd3d-93d60dc4-ce899500-d85bde6a-2dfbb880.jpg,validation," FINAL REPORT HISTORY: Lung contusion status post motor vehicle accident. Evaluate progress. COMPARISON: ___. FINDINGS: Single AP portable radiograph of the chest. There is no consolidation, pleural effusion, or pneumothorax. The cardiac silhouette is unchanged compared to the prior radiograph. No rib fractures are identified. The soft tissues are unremarkable. IMPRESSION: No change since the prior radiograph. " af4d40ca-eb1f8e4a-bd296eeb-706ed958-96451106.jpg,validate/p12/p12462675/s51541411/af4d40ca-eb1f8e4a-bd296eeb-706ed958-96451106.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: The patient with intraparenchymal SAH. Aspiration pneumonia. Comparison is made with prior study, ___. There are low lung volumes. Aeration of the right lower lobe has markedly improved. Cardiomegaly is unchanged. The patient's chain obscures the apices of the lungs. Endotracheal tube is in standard position. Right peripheral catheter tip is in the right axillary veins as before. There is no evident pneumothorax. Left lower lobe atelectasis has markedly improved. Presumed bilateral pleural effusions have decreased. Mild vascular congestion has improved. " 7eb81cb8-2b450eb4-02877190-98d5669b-47d4bdc7.jpg,validate/p15/p15705977/s52164031/7eb81cb8-2b450eb4-02877190-98d5669b-47d4bdc7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain, h/o PE low Well's probability // Eval for cardiopulmonary 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 " fe266fd3-d77b5853-549eed31-a505f518-11d738e4.jpg,validate/p12/p12639585/s57916440/fe266fd3-d77b5853-549eed31-a505f518-11d738e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis/___ and continued dyspnea // ?Change in pulmonary vascular congestion or pulmonary edema IMPRESSION: Compared to ___ radiograph, the right hemidiaphragm remains elevated, but there has been slight improvement in extent of adjacent right middle and lower lobe atelectasis. Small right pleural effusion persists. No other relevant changes since recent exam. " 9948b846-c480c09f-a4dd4b35-12d0638c-f2a6b3eb.jpg,validate/p11/p11887722/s53937541/9948b846-c480c09f-a4dd4b35-12d0638c-f2a6b3eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and CT chest ___ FINDINGS: Lung volumes are low which accentuates the size of the cardiac silhouette which appears mildly enlarged. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Atelectasis is noted in both lung bases without focal consolidation. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is detected. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 6b84cd12-b0bb9a01-fc534476-698b5a4b-e0d084a5.jpg,validate/p17/p17212019/s53444591/6b84cd12-b0bb9a01-fc534476-698b5a4b-e0d084a5.jpg,validation," FINAL REPORT INDICATION: ___-year-old with left-sided chest pressure. 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. " 76d4bbf4-0ad59a69-de1a1983-90cbe6cf-6ea08f3d.jpg,validate/p14/p14215082/s57896001/76d4bbf4-0ad59a69-de1a1983-90cbe6cf-6ea08f3d.jpg,validation," FINAL REPORT CLINICAL HISTORY: Status post ___'s reversal, now intubated and sedated. CHEST: Since the prior chest x-ray, the endotracheal has been removed. The tip of the subclavian line lies in the mid-to-lower SVC. Lung fields appear clear, no evidence of pneumonia or failure is seen. " 8e678ae7-8e4bd0e0-9e42ef0d-1f494b86-b67d3ac2.jpg,validate/p19/p19099761/s51878189/8e678ae7-8e4bd0e0-9e42ef0d-1f494b86-b67d3ac2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p temp wire removal. // assess for PTX TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to___. FINDINGS: The temporary pacemaker wire has been removed. There is no pneumothorax. A right apical density could be an elongated calcified right brachiocephalic trunk, more prominently seen due to positioning. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. The aorta is tortuous. There has been a total shoulder arthroplasty of the left, and severe degenerative changes are noted at the right glenohumeral joint. IMPRESSION: 1. No pneumothorax. 2. No evidence of acute cardiopulmonary process. " 2029931f-824d49a0-e70d00b2-6fd4d76f-ff3c457b.jpg,validate/p12/p12448098/s51157387/2029931f-824d49a0-e70d00b2-6fd4d76f-ff3c457b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with cough // ?pneumonia, progression of known lung CA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest PA and lateral ___ FINDINGS: Patient is status post right lower lobe wedge resection with postsurgical changes again noted. There are no focal consolidations. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No evidence of pneumonia. No evidence of progression of known lung cancer. No acute cardiopulmonary process. " 333a81c0-8dcbc97c-7d3361c9-e3eb8616-9f964275.jpg,validate/p18/p18270562/s51187660/333a81c0-8dcbc97c-7d3361c9-e3eb8616-9f964275.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with stroke, questionable pneumonia. FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. The heart size is normal. No configurational abnormality is seen. Thoracic aorta 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 seen and the lateral pleural sinuses are free. No evidence of pneumothorax in the apical area. Skeletal structures grossly unremarkable. Our records do not include a previous chest examination available for comparison. IMPRESSION: AP single view chest examination without evidence of cardiac enlargement, pulmonary congestion or pneumonic infiltrates. " 5f8bcf62-ffe67ea2-5d9b4938-9b55fbea-585acf31.jpg,validate/p13/p13984946/s58329458/5f8bcf62-ffe67ea2-5d9b4938-9b55fbea-585acf31.jpg,validation," FINAL REPORT INDICATION: History: ___M with chest pain // Evaluation of PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes remain low with minimal bibasilar atelectasis. Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 79dd9c87-f1bfc22e-cf7ec4b4-dfe7bbce-1a213b0c.jpg,validate/p16/p16254772/s58760422/79dd9c87-f1bfc22e-cf7ec4b4-dfe7bbce-1a213b0c.jpg,validation," WET READ: ___ ___ 2:47 AM Increased opacity in the left lower lobe concerning for pneumonia given the clinical history. Free intraperitoneal air under the right hemidiaphragm consistent with recent postoperative state (patient is postop T1 from open hernia repair). The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:46 AM, 2 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pancreatic cancer s/p Whipple now admit for incisional hernia repair w/ mesh, febrile ___F. // Assess for atelecatasis vs. pneumonia Assess for atelecatasis vs. pneumonia IMPRESSION: Compare to prior chest radiographs, most recently ___. Recent abdominal surgery is responsible for pneumoperitoneum. Lungs clear. Heart size normal. Normal mediastinal and hilar silhouettes. No pleural abnormality. " b5b99754-4146b283-1a00da91-9ae057bb-ab93f488.jpg,validate/p15/p15259308/s50074862/b5b99754-4146b283-1a00da91-9ae057bb-ab93f488.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post fall from bicycle with pain and tenderness to palpation over the left scapula. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without effusion, consolidation or pneumothorax. Please note that the posterior costophrenic angles are excluded from the field of view. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. Consider left shoulder or scapular films for better evaluation of this area given history. " 7f2ae21b-17edb543-f0142783-68d8814b-f6a635eb.jpg,validate/p11/p11733756/s57260121/7f2ae21b-17edb543-f0142783-68d8814b-f6a635eb.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Right shoulder and right 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 are no pleural effusions or pneumothorax. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 33039521-07f5047b-be8d844d-c199eb85-5cc2a03a.jpg,validate/p15/p15508423/s57429692/33039521-07f5047b-be8d844d-c199eb85-5cc2a03a.jpg,validation," FINAL REPORT HISTORY: Cough. Assess for pneumonia. COMPARISON: Chest radiographs, ___, ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded and clear. Pleural surfaces are normal without pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are normal. Limited assessment of the osseous structures demonstrates mid thoracic scoliosis, convex to the right. IMPRESSION: No acute cardiopulmonary process. Specifically, no evidence for pneumonia. " 4a222102-ae58f2a9-59723590-b0f79ec7-1d6fa387.jpg,validate/p14/p14948491/s57895527/4a222102-ae58f2a9-59723590-b0f79ec7-1d6fa387.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of smoking, no respiratory symptoms, rule out mass. COMPARISON: No comparison available at the time of dictation. FINDINGS: Left pectoral pacemaker, correct single lead positioned in the right ventricle. The lung volumes are normal. No evidence of parenchymal abnormalities, in particular no evidence of nodules or masses. No pleural effusions. No pulmonary edema. No pneumonia. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. Normal hilar and mediastinal structures. " 6a7df93c-0a95d33a-a30bd328-fd422e6d-dfe5d7e1.jpg,validate/p13/p13714231/s55024778/6a7df93c-0a95d33a-a30bd328-fd422e6d-dfe5d7e1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chronic bronchiectasis, fever, increased sputum // ?acute exaccerbation of bronchiectasis TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ and multiple prior studies going to ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Bibasal bronchiectasis are extensive and associated with extensive bronchial wall thickening and surrounding consolidation that appear to be more pronounced than on the remote radiographs and the radiographs dating back to ___, does consistent with bibasal infectious process. Upper lungs are clear. No pleural effusion or pneumothorax is seen. " 8d6c2346-e4857b42-de728730-84a2e18a-7d1ef5a5.jpg,validate/p16/p16843799/s58541717/8d6c2346-e4857b42-de728730-84a2e18a-7d1ef5a5.jpg,validation," FINAL REPORT HISTORY: Status post CABG, ?hemothorax CHEST, SINGLE AP PORTABLE VIEW. Right IJ central line is present, tip over upper/mid right atrium. There are low inspiratory volumes. The patient is status post sternotomy, with prominence of the cardiomediastinal silhouette. There are two left-sided chest tubes, possibly withan additional drain over the mediastinum. There is patchy retrocardiac opacity, consistent with left lower lobe collapse and/or consolidation, similar but slightly improved compared with ___ at 12:30 p.m. There is minimal atelectasis at the right lung base. No CHF. Small bilateral effusions cannot be entirely excluded. IMPRESSION: Overall similar to one day earlier, but with improving left lower lobe and right perihilar patchy opacities. No CHF. No gross effusion. " 4355e57e-6c59f458-76d64c8e-b52ef23c-882fb091.jpg,validate/p19/p19946917/s50058033/4355e57e-6c59f458-76d64c8e-b52ef23c-882fb091.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with history of positive PPD with night sweats. FINDINGS: PA 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 radiographic evidence of active tuberculosis. " a51102a9-72f2249e-8826f500-86e35dd6-442e37d2.jpg,validate/p12/p12040649/s58738831/a51102a9-72f2249e-8826f500-86e35dd6-442e37d2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Pain, 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. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " cfa914dc-bd923c33-1622126c-38234de0-ab5ae0f7.jpg,validate/p14/p14034311/s50263158/cfa914dc-bd923c33-1622126c-38234de0-ab5ae0f7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough for several weeks, green sputum, on immumosuppresants // pneumonia? pneumonia? IMPRESSION: In comparison with the study of ___, there again are relatively low lung volumes that accentuate the transverse diameter of the heart in this patient with previous CABG procedure and intact midline sternal wires. No evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 450ca62e-017ee1c6-0d4a4c7a-774eaef0-7972e0c6.jpg,validate/p10/p10993373/s57253767/450ca62e-017ee1c6-0d4a4c7a-774eaef0-7972e0c6.jpg,validation," 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. Lungs are clear. Minimal chronic blunting of the left costophrenic angle posteriorly is likely due to scarring. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 386edae1-3e6139a3-522180b5-20748a24-89e443ad.jpg,validate/p17/p17175679/s58889934/386edae1-3e6139a3-522180b5-20748a24-89e443ad.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Persistent cough, questionable lesion. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette without pulmonary edema. No lung nodules or masses. No focal parenchymal opacity suggesting pneumonia. Unchanged focal pleural thickening at the right lung apex, constant since ___. " e7266394-d120266b-e5e8cba5-4ea81056-9cc8daa0.jpg,validate/p17/p17199551/s56979612/e7266394-d120266b-e5e8cba5-4ea81056-9cc8daa0.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. Mild hyperinflation is suspected. Moderate degenerative changes are similar along the thoracic spine. There has been no significant change. IMPRESSION: No evidence of acute disease. Mild hyperinflation. " f9dc8191-73f800d0-b1f820b7-1a1f6a9f-fd619611.jpg,validate/p18/p18774799/s55976507/f9dc8191-73f800d0-b1f820b7-1a1f6a9f-fd619611.jpg,validation," FINAL REPORT INDICATION: Seizure. COMPARISON: None. FINDINGS: AP and lateral views of the chest were obtained. The lung fields are clear bilaterally without evidence of focal consolidation or pulmonary edema. No pneumothorax or pleural effusion. Cardiomediastinal silhouette is normal. Old right ribe deformity appears chronic. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " a70fe0f7-a3e8ba24-e3a2dd24-6e33352c-d63184f5.jpg,validate/p19/p19231238/s56136629/a70fe0f7-a3e8ba24-e3a2dd24-6e33352c-d63184f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with cough productive of sputum 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 with a small hiatal hernia again noted. There is mild pulmonary vascular congestion. There are small bilateral pleural effusions, not changed from the prior study. Retrocardiac patchy opacity may reflect atelectasis though infection is difficult to exclude. Hypertrophic changes are again noted within the thoracic spine. No subdiaphragmatic free air is identified. IMPRESSION: Mild pulmonary vascular congestion and small bilateral pleural effusions. Retrocardiac atelectasis, though infection cannot be completely excluded. " 34c378b4-859ba750-a7008806-f762cac8-59ac0b25.jpg,validate/p13/p13391297/s50160007/34c378b4-859ba750-a7008806-f762cac8-59ac0b25.jpg,validation," FINAL REPORT INDICATION: COPD. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Multiple priors, most recently, ___. FINDINGS: Lungs are low in volume but otherwise clear aside from left basal atelectasis. There is no pleural effusion or pneumothorax. The heart is normal in size with tortuous aorta. IMPRESSION: No acute intrathoracic process. " 00342f4d-07740358-ef43955f-2cecd5ce-bede1533.jpg,validate/p17/p17424385/s56898693/00342f4d-07740358-ef43955f-2cecd5ce-bede1533.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with asthma presents with cough and wheeze and SOB // is there pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. CT of the chest from ___. FINDINGS: Lungs are well-expanded and clear. Stable chronic right mediastinal shift and right lower lobe volume loss. Mild cardiomegaly is unchanged. The aorta is tortuous. The hila and cardiac borders are stable. IMPRESSION: 1. No evidence of pneumonia. 2. Mild stable cardiomegaly. " d228ee1e-9c7f613a-075289df-7b075244-ac90f552.jpg,validate/p15/p15886512/s59958733/d228ee1e-9c7f613a-075289df-7b075244-ac90f552.jpg,validation," 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. " f32eefbc-d2c57623-14e3b0f5-690a6f8d-00b4f77f.jpg,validate/p11/p11776988/s53805266/f32eefbc-d2c57623-14e3b0f5-690a6f8d-00b4f77f.jpg,validation," FINAL REPORT INDICATION: ___F w/chest pain, please eval for PTX, other pathology // 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. " 1949864c-667ced25-c9c0546c-a2e3be2f-191dbb47.jpg,validate/p17/p17463370/s53908060/1949864c-667ced25-c9c0546c-a2e3be2f-191dbb47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ Y/O M s/p L4-___ fx and L CT, removed ___ // interval change from post-pull film this AM, ? increase in PTX or pleural effusion- Please obtain film at 13:00. interval change from post-pull film this AM, ? increase in P IMPRESSION: In comparison with the earlier study of this date, there is probably little change in the tiny left apical pneumothorax as well as the possible loculated pneumothorax at the left base. Subcutaneous gas is again along the lower chest wall and upper abdomen. Fixation device is again seen about previous left clavicle fracture. There is the vague suggestion of some asymmetric opacification in the right mid zone. In the appropriate clinical setting, this could represent a developing consolidation. " f08a2069-4f744567-24ed9e97-11b67a30-d9862688.jpg,validate/p18/p18454049/s58528442/f08a2069-4f744567-24ed9e97-11b67a30-d9862688.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with weakness, DOE // eval for PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Left base opacity is re- demonstrated and there may be a trace left pleural effusion. No large pleural effusion is seen. Subtle right base opacity is re- demonstrated. Overall, there is no significant interval change and findings may represent chronic aspiration. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Relatively stable bibasilar opacities may relate to chronic aspiration. " 2645e117-1cefbca5-7ba7c6ed-fa9a60b8-d11e0f07.jpg,validate/p12/p12402651/s58286240/2645e117-1cefbca5-7ba7c6ed-fa9a60b8-d11e0f07.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female status post fall with chest pain. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Lower lung volumes seen on the current exam with secondary crowding of the bronchovascular markings. Lateral view is limited secondary to motion. Cardiomediastinal silhouette is stable, noting mild cardiomegaly. Atherosclerotic calcifications seen at the arch. Right-sided rib deformities are suggestive of chronic fractures. Partially visualized density in the proximal left humerus may be from prior infarct or enchondroma. Mid thoracic vertebral body height loss with better seen on prior, noting that the bones are not well assessed on the lateral view on the current exam. Surgical clips project over the right axilla. IMPRESSION: No definite acute cardiopulmonary process. " d2393bdf-9cbfb947-82bdffd5-88199d64-cf255ec9.jpg,validate/p13/p13299285/s54158133/d2393bdf-9cbfb947-82bdffd5-88199d64-cf255ec9.jpg,validation," 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. ___. " 78df9155-94efd4d8-d36ecbb4-87722c4f-15ee80bb.jpg,validate/p15/p15289901/s50170208/78df9155-94efd4d8-d36ecbb4-87722c4f-15ee80bb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cabg // eval for effusion eval for effusion IMPRESSION: Compared to chest radiographs ___ through ___. Moderate pulmonary edema has worsened again and a small bilateral pleural effusions have increased. Widening of the upper mediastinum reflects pulmonary venous engorgement due to elevated central venous pressure or volume. Moderate to severe cardiomegaly is stable. " 5e91984e-e1fbb641-00bef08c-70752170-3cb12177.jpg,validate/p15/p15227491/s58388319/5e91984e-e1fbb641-00bef08c-70752170-3cb12177.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ?free air/perf // eval for free air COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there are massive amounts of free intra-abdominal air, with compression of the intra thoracic structures, including the heart. Immediately upon review of the findings, 427 p.m., on the ___, the referring physician ___. ___ was paged for notification. Findings were discussed over the telephone ___ min later. " fbe89a14-acd55e7d-c5f7fd28-31ed21cd-6a27b19c.jpg,validate/p14/p14362183/s56388201/fbe89a14-acd55e7d-c5f7fd28-31ed21cd-6a27b19c.jpg,validation," FINAL REPORT HISTORY: Elevated blood sugar. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. Heart size is moderately enlarged and is accentuated due to low lung volumes. The mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures, but no overt pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is seen. Minimal atelectasis is noted in the lung bases. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes. Mild bibasilar atelectasis. " 8f90ebfe-92f8b0b5-daf1f1e8-cde19f77-7f71783e.jpg,validate/p18/p18683014/s55816304/8f90ebfe-92f8b0b5-daf1f1e8-cde19f77-7f71783e.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with seizures. Evaluate for evidence of mass or pneumonia. COMPARISONS: None available. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The right lung demonstrates a band of opacity across the lower lung field that extends to the right heart border, without obscuring it. The left lung is clear without focal opacities. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Right lower lobe opacity likely represents aspiration/pneumonia in the clinical setting of seizures. " f1825bf3-040e73c4-1039f74b-3fc7b5c8-4b2eef77.jpg,validate/p15/p15863098/s53291785/f1825bf3-040e73c4-1039f74b-3fc7b5c8-4b2eef77.jpg,validation," WET READ: ___ ___ ___ 2:06 PM Large ___ tension pneumothorax. ______________________________________________________________________________ FINAL REPORT HISTORY: ___ chest pain and report from PCP of ___ pneumothorax. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: None. FINDINGS: A large ___ tension pneumothorax is present with rightward shift of mediastinal structures, and collapse of the left lung. There is widening of the intercostal spaces on the left compared to the right. The right lung is clear. No pleural effusion is present. No acute osseous abnormalities detected. IMPRESSION: Large left tension pneumothorax. A pigtail catheter has already been placed at the time of discovery of this finding at 1:39 PM, ___. " 49b1584f-ca9b722f-c6744891-e8cfc082-cf3f3668.jpg,validate/p11/p11620743/s51749002/49b1584f-ca9b722f-c6744891-e8cfc082-cf3f3668.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of wheezing. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is mild bibasilar atelectasis. Patchy left base retrocardiac opacity could be due to atelectasis than early pneumonia. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. IMPRESSION: Bibasilar atelectasis. Left retrocardiac opacity more likely to be atelectasis versus less likely pneumonia. " 76b9b99d-83cec5bf-7b9d2621-4bfcccf0-f8282888.jpg,validate/p17/p17653729/s58763887/76b9b99d-83cec5bf-7b9d2621-4bfcccf0-f8282888.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hyoxia, leukocytosis // pls eval for interval change, concern for PNA COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous examination. Left retrocardiac atelectasis, left small pleural effusion. Borderline size of the cardiac silhouette. No new focal parenchymal opacity indicative of pneumonia. Normal and unchanged position of the right-sided central venous access line. " 16c85947-b965c7f1-ad2186ac-19a5fff4-1e664369.jpg,validate/p14/p14601638/s52495699/16c85947-b965c7f1-ad2186ac-19a5fff4-1e664369.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with COPD and increasing cough. Evaluate for pneumonia. COMPARISON: Radiograph of the chest dated ___. FINDINGS: Frontal lateral radiographs of the chest demonstrate hyperexpansion of the lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax or consolidation. IMPRESSION: Hyperexpanded lungs without evidence of pneumonia. " 1594928a-fb37bfe3-572c270e-69250381-eef8769f.jpg,validate/p18/p18867536/s53456991/1594928a-fb37bfe3-572c270e-69250381-eef8769f.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hemoptysis, on ASA and clopidogrel. // Any changes? EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There is new opacity in the retrocardiac region of left lower lobe. There is no pleural effusion or pneumothorax. Cardiac silhouette is within normal size. IMPRESSION: New opacity in left lower lobe is suspicious for pneumonia, possibly from aspiration. " 25783498-42f1e2c3-97d4793d-46181afb-2e3d4c7a.jpg,validate/p14/p14318651/s54214176/25783498-42f1e2c3-97d4793d-46181afb-2e3d4c7a.jpg,validation," WET READ: ___ ___ ___ 2:56 PM No focal consolidation. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old female with cough. 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. IMPRESSION: No acute intrathoracic process. " 3535cd9c-ec33cf1c-58eafc60-6fcfe516-50e5f53c.jpg,validate/p16/p16729683/s55955123/3535cd9c-ec33cf1c-58eafc60-6fcfe516-50e5f53c.jpg,validation," FINAL REPORT HISTORY: Chest pain, evaluate for pneumonia COMPARISON: ___ FINDINGS: Frontal and lateral radiographs of the chest demonstrate a stable mildly cardiomegaly. The mediastinal silhouette and hilar contours are normal. Clear lungs. No pleural effusion or pneumothorax. IMPRESSION: No pneumonia " 032ae723-37ab5eec-2a9198a9-7c86d313-eeceb6fb.jpg,validate/p17/p17982586/s57001744/032ae723-37ab5eec-2a9198a9-7c86d313-eeceb6fb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with prior pneumothorax assess for change // Change from prior Change from prior IMPRESSION: In comparison with the study of ___, there is mild improvement in the appearance of the right apical pneumothorax. Otherwise, little overall change. Hyperexpansion of the lungs is again seen. Left lung is essentially clear. Biventricular pacer remains in place. " 5055b734-26ad71a6-9c91f0e7-680b740d-e6c779ce.jpg,validate/p15/p15235135/s56471580/5055b734-26ad71a6-9c91f0e7-680b740d-e6c779ce.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest radiograph. INDICATION: ___ year old man with poor swallow s/p dobhoff // placement of dobhoff. Staged approach. COMPARISON: Chest radiograph dated ___. FINDINGS: Initial image history foot placement of the duct cough tube. Subsequent image cysts the double of tube ends study left with its tip projecting over the left mediastinum proximal to the gastroesophageal junction. Yet another subsequent radiograph shows the Dobhoff tube tip in the approximate region of the GE junction or just slightly distal. The final image shows the Dobhoff tube tip in the stomach just distal to the GE junction. Otherwise, no significant change. Bibasilar atelectasis, greater on the left is slightly worse. The lungs are otherwise clear. No focal consolidation, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is overall unchanged with prominence of the thoracic aorta. No significant change in small left pleural effusion. IMPRESSION: 1. Dobhoff tube and stylet in stomach just past GE junction. Could advance a few more centimeters. 2. Otherwise, no significant interval change. " e055dba7-fdf8e970-55066511-b6cfb084-b9ce15da.jpg,validate/p16/p16788522/s56574516/e055dba7-fdf8e970-55066511-b6cfb084-b9ce15da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o F w PMH of cirrhosis ___ autoimmune hepatitis with recent (___) xlap for non-occlusive SMV thrombus and bowel necrosis left w open abdomen treated w vac now p/w drainage from wound // please rule out acute lesions please rule out acute lesions IMPRESSION: Comparison to ___. All monitoring and support devices have been removed. There is mild pulmonary edema and mild cardiomegaly. No pleural effusions. No interstitial thickening. No pneumonia. " 041bf172-76419a07-f1f43672-17bf41a2-6de2e2ca.jpg,validate/p13/p13613806/s54243232/041bf172-76419a07-f1f43672-17bf41a2-6de2e2ca.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old female status post median sternotomy. Now with right-sided pain. COMPARISON: ___ x-ray as well as CT from outside hospital from ___. SINGLE AP ERECT PORTABLE VIEW OF THE CHEST: The patient is status post median sternotomy. There is elevation of the right hemidiaphragm with a right basilar opacity compatible with known pleural mass and adjacent atelectasis with a small pleural effusion. Right-sided Port-A-Cath terminates in the lower SVC. Left lung is essentially clear with no pleural effusion. No pneumothorax is noted. Bones are intact. IMPRESSION: Right basilar opacification compatible with the patient's known pleural based mass with adjacent atelectasis and small pleural effusion. " 4fb48cfc-d536ea2d-654f8a10-41109bd0-e21a4310.jpg,validate/p13/p13948093/s56957606/4fb48cfc-d536ea2d-654f8a10-41109bd0-e21a4310.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recently MDS ___/p allogeneic cord blood transplant now with recurrent fevers and hypoxia s/p bilateral thoracentesis. // Chest tube placement, compare to prior TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to___. FINDINGS: Compared with the immediate prior radiograph of ___, the right pleural effusion has decreased, now small, if present at all. There is probably a small to moderate residual left pleural effusion. Bibasilar chest tubes and a right hemodialysis catheter are in unchanged position. Trace biapical pneumothoraces are unchanged. Widespread bilateral parenchymal opacities are unchanged. IMPRESSION: 1. Interval decrease in right pleural effusion, now small, if present at all. 2. Probable small to moderate residual left pleural effusion. 3. No change in position of tubes and lines, no change in widespread parenchymal opacities. " 867c41d3-211415e0-1a935e38-b594600c-7e30a1bb.jpg,validate/p14/p14997223/s56818030/867c41d3-211415e0-1a935e38-b594600c-7e30a1bb.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 2:05 PM PFI: 1. Dobbhoff tube tip projecting over the gastric bubble. 2. Small-to-moderate right pleural effusion with associated atelectasis. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with new Dobbhoff tube placed. STUDY: Portable AP upright chest radiograph. COMPARISON: ___. FINDINGS: The left-sided PICC tip still remains at the lower SVC. The Dobbhoff tube tip projects over the gastric bubble. The heart size is at the upper limits of normal and the mediastinal contours are unchanged. The lungs show decreased volume in the right base with probable right pleural effusion patent. The left costophrenic angle is excluded from the study. There is no pneumothorax. IMPRESSION: 1. Dobbhoff tube tip projecting over the gastric bubble. 2. Small-to-moderate right pleural effusion with associated atelectasis. " 68b8f891-414346c2-c6b632fa-5d125f2b-aea360d9.jpg,validate/p10/p10135376/s52610464/68b8f891-414346c2-c6b632fa-5d125f2b-aea360d9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old male with history of coronary artery disease s/p CABG, Aortic stenosis s/p AVR, severe MR, HFpEF (EF ___%) OSA, pulmonary HTN, DM, gout, and CVA w/right hemiparesis presenting with abdominal pain found to be volume overloaded on exam with elevated BNP, JVP, and new ___ concerning for acute heart failure exacerbation in the setting of progressive mitral valve disease. Here for right and left heart cath with possible ___-___ evaluation. // PICC line placement PICC line placement IMPRESSION: Comparison to ___. The lateral radiograph shows that the line is coiled in the brachiocephalic vein and crosses the midline, with the tip directed upward. The line needs to be repositioned. . Decrease in severity of the pre-existing pulmonary edema, the edema is still mild to moderate. Better seen on the lateral than on the frontal radiograph are small bilateral pleural effusions and fluid marking of the fissures. " 6e067a17-f7706851-f529f276-fe53598a-6f2b1987.jpg,validate/p11/p11339006/s50097312/6e067a17-f7706851-f529f276-fe53598a-6f2b1987.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with TFs for nutrition, Dobbhoff placed // please check Dobbhoff placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a Dobbhoff catheter. The previously placed nasogastric tube was removed. The tip of the Dobbhoff catheter is projecting over the gastroesophageal junction. The device needs to be advanced by approximately 5 cm. . The previously placed right hemodialysis catheter was removed. The other monitoring and support devices are in unchanged position. Unchanged low lung volumes without parenchymal abnormalities. Unchanged borderline size of the cardiac silhouette. " 70395f34-912db3d4-fcba270b-54102f0c-010e7248.jpg,validate/p15/p15287471/s55307572/70395f34-912db3d4-fcba270b-54102f0c-010e7248.jpg,validation," FINAL REPORT AP CHEST, 3:03 A.M., ___ HISTORY: ___-year-old woman with endocarditis. Preop for tracheostomy and PEG placement. IMPRESSION: AP chest compared to ___: Chin is probably in neutral position, which means the tip of the endotracheal tube 2.5 cm from the carina is probably ___-20 mm lower than optimal. Since tracheostomy is imminent, repositioning might not be indicated. Pulmonary edema continues to clear. Heart size is normal and mediastinal veins are not dilated. Small bilateral pleural effusions are presumed. The texture of the lungs is heterogeneous and there may well be small lung nodules, because of overlying appliances, rib fractures, and asymmetric resolution of edema. When the patient's clinical situation permits, conventional chest radiograph should be performed. Dialysis catheter ends in the right atrium and a feeding tube passes into the stomach and out of view. No pneumothorax. " 217071e1-cfcfee14-1460dfc9-1f0587be-41537421.jpg,validate/p10/p10356845/s57560221/217071e1-cfcfee14-1460dfc9-1f0587be-41537421.jpg,validation," FINAL REPORT HISTORY: NG tube pulled. FINDINGS: In comparison with the study of ___, the NG tube is no longer seen. Continued low lung volumes may account for some of the prominence of the transverse diameter of the heart. No definite vascular congestion or acute focal pneumonia. Prominent skin folds are seen bilaterally. Mild atelectatic changes are seen in the retrocardiac area and the left subclavian catheter again extends to the junction with the SVC. " 9ec0cfcc-56c60789-9ba97090-78a9c166-1429115f.jpg,validate/p17/p17270742/s59121133/9ec0cfcc-56c60789-9ba97090-78a9c166-1429115f.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with HIV/AIDS, on PCP prophylaxis with known aspergilloma. With cough and productive sputum and hypoxia. Evaluate for pneumonia. COMPARISON: Multiple priors, most recent chest radiograph, ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: A dominant right cavitary lesion is stable in size but demonstrates slightly less fluid and more gas than on the ___ study. The smaller cavitary lesion at the right lung apex is stable in appearance. The left upper lobe consolidation has slightly decreased in size although the small area of central lucency is stable in size. Bilateral areas of ground-glass and patchy opacities appear overall stable in appearance and distribution. Observed findings are consistent with widespread pulmonary infection. There are no new areas of consolidation. There is no pleural effusion or pneumothorax. " 4028b350-1f31feaf-d7feb586-6cdf0f0f-81ece15e.jpg,validate/p13/p13841691/s56847857/4028b350-1f31feaf-d7feb586-6cdf0f0f-81ece15e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with sob wheezing past few days // r/o infiltrate chf TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ and ___ FINDINGS: There is diffuse interstitial abnormality bilaterally which may be due to chronic pulmonary disease and/or pulmonary edema. Atypical infection not excluded. No large pleural effusion is seen. There is no pneumothorax.The aorta is tortuous. The cardiac silhouette is mildly enlarged. IMPRESSION: Diffuse increased interstitial markings bilaterally with differential diagnosis including pulmonary edema and/or chronic lung disease. " 6044cec1-cbbd0e9e-3864774f-64e010e8-54e51b12.jpg,validate/p17/p17062932/s54093159/6044cec1-cbbd0e9e-3864774f-64e010e8-54e51b12.jpg,validation," WET READ: ___ ___ ___ 8:58 PM Dobbhoff tube ends within the stomach, unchanged. Right PICC ends near the superior cavoatrial junction, unchanged. Ovoid lucency projecting over the medial right lung base is thought to correspond to a tongue of aerated right lower lobe parenchyma, as seen on the recent CT from ___. There is no pneumothorax. A moderate right pleural effusion is not significantly changed. Moderate right and mild left lower lung atelectasis is unchanged. WET READ VERSION #1 ___ ___ ___ 8:56 PM Dobbhoff tube ends within the stomach, unchanged. Right PICC ends near the superior cavoatrial junction, unchanged. Ovoid lucency projecting over the medial right lung base is thought to correspond to a tongue of aerated left lower lobe parenchyma, as seen on the recent CT from ___. There is no pneumothorax. A moderate right pleural effusion is not significantly changed. Moderate right and mild left lower lung atelectasis is unchanged. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:40 P.M. ON ___ HISTORY: Pseudoaneurysm. Recent Dobbhoff placement. Rule out pneumothorax. IMPRESSION: There is no pneumothorax. A moderate right pleural effusion has changed in distribution, probably larger as well. Extent of right lower lobe atelectasis is hard to assess, could be considerable. Left upper lung is clear. Heterogeneous opacification at the base of the left lung has been present since ___, presumably atelectasis but raising question of chronic aspiration. Heart is normal size. Feeding tube with a wire stylet in place ends in the upper stomach. Right PIC line ends in the low SVC. Small left pleural effusion may be present. No pneumothorax. " 86b07e68-cce3b4f2-c6bce772-4c77dc2b-0733fe5a.jpg,validate/p17/p17832035/s57856701/86b07e68-cce3b4f2-c6bce772-4c77dc2b-0733fe5a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with substernal chest pain // r/o CHF/Pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Fibrotic changes seen at lung apices. No definite new focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Left sided pacer device is stable. IMPRESSION: No acute cardiopulmonary process. " 1dfeffa2-97850b45-7f5eba7f-fc95dc64-4d3d2380.jpg,validate/p18/p18577013/s54713392/1dfeffa2-97850b45-7f5eba7f-fc95dc64-4d3d2380.jpg,validation," FINAL REPORT INDICATION: Patient with history of breast cancer, now with weight loss. 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 unchanged. Aortic arch calcifications are again noted. There is no pulmonary edema. Heart size is normal. A single-lead pacemaker device lead is unchanged in position. IMPRESSION: No evidence of acute cardiopulmonary process. " 98484282-3c884bd3-7d77847a-0efe8ad2-8b35246b.jpg,validate/p10/p10236621/s58602726/98484282-3c884bd3-7d77847a-0efe8ad2-8b35246b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CAD, occasional wheezing, longterm MJ use // r/o CHF TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___. FINDINGS: The lungs are hyperexpanded with flattened diaphragms and increased retrosternal and retrocardiac lucency. Lungs are clear. Normal postoperative mediastinum and heart borders. Coronary stent and mitral valve repair are unchanged. No pleural effusion. IMPRESSION: 1. No evidence of congestive heart failure. 2. Chronic obstructive pulmonary disease. " eaae9122-31f79963-30bf5106-0d545178-db951a15.jpg,validate/p13/p13648633/s56210371/eaae9122-31f79963-30bf5106-0d545178-db951a15.jpg,validation," FINAL REPORT HISTORY: Hypoxia. TECHNIQUE: Single chest radiograph. COMPARISON: Multiple chest radiographs dating back to ___. FINDINGS: The cardiomediastinal silhouette and hilar contour is stable. Again appreciated is a right central venous catheter unchanged in position with the tip terminating at the cavoatrial junction. Again noted are bibasilar and retrocardiac opacities greater on the right versus the left. There is no effusion or pneumothorax. No acute bony changes are identified. IMPRESSION: Right greater than left bibasilar opacities worrisome for infection. " a97874f1-aba06fbc-b2a85e8b-fe9e8f63-8e2f0eba.jpg,validate/p19/p19338803/s55977413/a97874f1-aba06fbc-b2a85e8b-fe9e8f63-8e2f0eba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pigtail placement. FINDINGS: Status post insertion of a left pigtail catheter into the pleural space. The pneumothorax has decreased in extent, it is however, still considerable, with the average width of approximately 4 cm. However, the signs of tension, indicated by a rightward shift of the mediastinum and depression of the left hemidiaphragm have completely disappeared. Minimal atelectasis at the left lung base. " 406783b8-13705b49-66a99d8a-e497fec7-f05174d8.jpg,validate/p19/p19291199/s51750569/406783b8-13705b49-66a99d8a-e497fec7-f05174d8.jpg,validation," FINAL REPORT HISTORY: Pleural effusion. FINDINGS: In comparison with the study of ___, there is again large right pleural effusion, with a changed appearance that most likely reflects different position of the patient. There are extensive atelectatic changes involving the lower right lung. Little change in the bilateral hilar adenopathy. In the appropriate clinical setting, supervening pneumonia would have to be considered. " fe27d23b-ee27ba32-0182e088-c952724d-1a573fb3.jpg,validate/p17/p17697134/s51596771/fe27d23b-ee27ba32-0182e088-c952724d-1a573fb3.jpg,validation," WET READ: ___ ___ ___ 12:08 AM Normal chest radiograph. Specifically no pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fevers // evaluate for consolidation evaluate for consolidation IMPRESSION: Comparison to ___. Complete resolution of the pre-existing right basal opacity. No new opacities. Normal size of the heart. No pleural effusions. " 7df3be2a-352027c4-25c70004-f4fc920c-5ac6ab0f.jpg,validate/p17/p17505019/s57209448/7df3be2a-352027c4-25c70004-f4fc920c-5ac6ab0f.jpg,validation," WET READ: ___ ___ ___ 11:45 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fall and 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. IMPRESSION: No acute intrathoracic process. " 3fbb0526-e415f9c6-26cb34a9-be12ac18-d44a2f55.jpg,validate/p17/p17114171/s59052266/3fbb0526-e415f9c6-26cb34a9-be12ac18-d44a2f55.jpg,validation," 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. " cf8b8afb-ea04ce0f-da3988b8-902a623e-c4523db3.jpg,validate/p18/p18120578/s59036255/cf8b8afb-ea04ce0f-da3988b8-902a623e-c4523db3.jpg,validation," FINAL REPORT INDICATION: ___F with fever, abdominal pain, diarrhea s/p transplant patient // ?pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, large effusion or edema. The cardiac silhouette is mildly enlarged. No acute osseous abnormalities. No free intraperitoneal air. IMPRESSION: No definite acute cardiopulmonary process. " 474d0554-ea1bd58d-7cdeae76-baf207d6-e4e03541.jpg,validate/p14/p14336348/s50263724/474d0554-ea1bd58d-7cdeae76-baf207d6-e4e03541.jpg,validation," WET READ: ___ ___ 9:51 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with altered mental status. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: PA and lateral views the chest provided demonstrate clear well expanded lungs without focal consolidation, large effusion or pneumothorax. There is a C-shaped calcification projecting over the heart, as on prior, compatible with mitral annular calcification. The heart is not enlarged. The mediastinal contour is normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " c8032ee2-4e8e5324-0195a21c-2e8cb2a5-c041a9cc.jpg,validate/p17/p17650672/s53870330/c8032ee2-4e8e5324-0195a21c-2e8cb2a5-c041a9cc.jpg,validation," FINAL REPORT HISTORY: Shortness of breath on exertion for six months. COMPARISON: None available. 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 intrathoracic process. " 228ff5a9-d3b1c929-20911797-d086b9c7-14dfde49.jpg,validate/p19/p19978087/s57734458/228ff5a9-d3b1c929-20911797-d086b9c7-14dfde49.jpg,validation," FINAL REPORT INDICATION: ___F with L flank pain // eval for ptx, pleural effusion TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 98dbc422-c1b61925-a86a9e48-73d58606-bcab2370.jpg,validate/p12/p12221629/s58878574/98dbc422-c1b61925-a86a9e48-73d58606-bcab2370.jpg,validation," 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. " 41780e35-5fc35be8-ee979677-6a208ef9-e52ce44d.jpg,validate/p18/p18688402/s57189099/41780e35-5fc35be8-ee979677-6a208ef9-e52ce44d.jpg,validation," FINAL REPORT AP CHEST, 7:59 A.M. ON ___ HISTORY: A ___-year-old woman with a new nasogastric tube. IMPRESSION: AP chest compared to ___ through ___ at 4:14 a.m.: Large left pleural effusion, moderate right pleural effusion have increased increase. Severe cardiomegaly and pulmonary vascular congestion are still present. Feeding tube with a wire stylet in place ends in the upper stomach. No pneumothorax. " 49637d7a-eec8c071-a66b96b8-97480e79-27106d83.jpg,validate/p18/p18266518/s52452279/49637d7a-eec8c071-a66b96b8-97480e79-27106d83.jpg,validation," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: ___ chest x-ray. FINDINGS: Cardiac silhouette is mildly enlarged and has minimally increased in size since the previous study. Additionally, there has been slight increase in caliber of the pulmonary vessels which appear indistinct and are accompanied by peribronchial cuffing and a bilateral interstitial pattern with a basilar predominance. Upper lobe predominant emphysema is again demonstrated as well as an area of linear scarring in the left upper lobe. In addition to bilateral interstitial opacities, heterogeneous, more confluent areas of opacity have developed at the bases, greater than right. No definite pleural effusion, but there is slight thickening of the fissures bilaterally. IMPRESSION: New radiographic findings which could reflect an asymmetrical pattern of congestive heart failure superimposed upon chronic emphysema. Coexisting pneumonia should be considered, especially particularly in the left lower lobe. Followup chest radiograph after diuresis may be helpful for initial further evaluation. " 33a569d3-8e5eca5d-58015b0f-b33f6843-e3845e92.jpg,validate/p12/p12613218/s57624489/33a569d3-8e5eca5d-58015b0f-b33f6843-e3845e92.jpg,validation," FINAL REPORT EXAMINATION: Chest two-views. INDICATION: ___ year old woman ___ post-partum now with fever of unknown origin // Is there e/o PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart and great vessels are normal. The lungs are clear of an active process and well-expanded. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest " 8cc1bcd7-ec068862-22c89ab3-7ffdecd4-4e335d90.jpg,validate/p12/p12938515/s55707639/8cc1bcd7-ec068862-22c89ab3-7ffdecd4-4e335d90.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with alcoholic hepatitis, renal failure, and new oxygen requirement. Evaluate for pneumonia or pulmonary edema. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is persistent bilateral diffuse interstitial abnormality, which is not significantly changed from the prior study, and likely represents moderate pulmonary edema. The cardiomediastinal and hilar contours are unchanged. A nasogastric tube courses into the stomach and out of the field of view. A right-sided internal jugular central venous line ends in the mid SVC. Left-sided wide bore central venous line ends at the cavoatrial junction. IMPRESSION: Moderate pulmonary edema without relevant change. " fbdf3148-d7efd67f-9a3e1693-78d837d5-ad518d2f.jpg,validate/p12/p12759378/s53493598/fbdf3148-d7efd67f-9a3e1693-78d837d5-ad518d2f.jpg,validation," WET READ: ___ ___ ___ 9:29 PM 1. Right internal jugular line terminates in the lower SVC. Multiple opacities within the right lung consistent with multiple masses seen on the recent CT. Improved aeration of the right lung. Elevation of left hemidiaphragm. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:56 P.M. ON ___ HISTORY: Abdominal pain. Pelvic mass with pulmonary metastases. IMPRESSION: AP chest compared to ___: Previous edema has improved. Large lung nodules barely visible. Heart moderately enlarged. No pneumothorax or appreciable pleural effusion. Right jugular line ends low in the SVC. " 4bc38fb1-fdbea90d-cf0a5ec6-881d1184-675bbef5.jpg,validate/p11/p11098660/s57595015/4bc38fb1-fdbea90d-cf0a5ec6-881d1184-675bbef5.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with A/V endocarditis, story of paravalvular leak, closure today for AV dehiscence. New clinical symptoms with HTN and desaturation. Pulmonary edema? TECHNIQUE: Chest x-ray in 2 projections. COMPARISON: exam is compared with ___. FINDINGS: Endotracheal tube and Swan ganz were placed, the latter has the tip in the outflow tract The alignment of the sternotomy wires is unchanged. Heart appears bigger, with increased perihilar vascular drawings for vascular congestion. There is pleural effusion on the left side. No signs of pneumothorax IMPRESSION IMPRESSION: There is an increased vascular congestion along with pleural effusion on the left side. Positioning of monitoring device " 1ac8dc62-0f260b0d-32fb9580-63156c85-f02ab49e.jpg,validate/p15/p15390338/s57478332/1ac8dc62-0f260b0d-32fb9580-63156c85-f02ab49e.jpg,validation," FINAL REPORT HISTORY: Congestive failure versus pneumonia. FINDINGS: In comparison with study of ___, there is little interval change. Again there is enlargement of the cardiac silhouette with tortuosity of the aorta. No evidence of vascular congestion. This discordancy raises the possibility of cardiomyopathy. No evidence of acute focal pneumonia or pleural effusion. " 06f87508-f2421ecd-00607181-e31d5d7a-7e04e586.jpg,validate/p18/p18454049/s59049002/06f87508-f2421ecd-00607181-e31d5d7a-7e04e586.jpg,validation," WET READ: ___ ___ ___ 5:28 AM Left lower lobe pneumonia or aspiration pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with cough. Assess for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest and rib radiograph ___. FINDINGS: The lungs are well-expanded. There are bilateral heterogeneous bibasilar opacities, right more prominent than left. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: Bibasilar pneumonia or aspiration pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:32 AM, 5 minutes after discovery of the updated findings. " 66a4bdcb-d2183b0a-1dab65ca-e16464d5-4d14a48b.jpg,validate/p16/p16428261/s59669749/66a4bdcb-d2183b0a-1dab65ca-e16464d5-4d14a48b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman recovering from DKA, recently intubated with increasing cough and low grade fevers. // r/o PNA r/o PNA IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. New heterogeneous opacification, right lung base could be atelectasis or alone, or atelectasis mixed with a small region of new consolidation. Small bilateral pleural effusions are new since ___. Heart size is top-normal. Bilateral prominent nipple shadow should not be mistaken " b7417ec3-9717e0e8-d1e82863-dd1d6a55-c36ca6b6.jpg,validate/p13/p13405151/s56331436/b7417ec3-9717e0e8-d1e82863-dd1d6a55-c36ca6b6.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion for several weeks. COMPARISON: ___ chest radiograph, ___. TECHNIQUE: AP and lateral chest radiograph, three views. FINDINGS: Heart size is difficult to evaluate due to a large right-sided pleural effusion with adjacent right middle and lower lobe collapse without mediastinal shift. Dense pericardial calcification is best visualized on lateral view. A left-sided single-lead ICD is unchanged in position. Compared to earlier examination, there has been worsening of central vascular congestion and interstitial edema. The lungs are otherwise clear. There is no pneumothorax. IMPRESSION: Mild-to-moderate pulmonary edema intervally worsened with unchanged probably chronic large right pleural effusion with right middle/lower lobe collapse. " 2dc3bcf0-af942043-bbeebb02-b867fee9-4bd849bf.jpg,validate/p16/p16160008/s57156217/2dc3bcf0-af942043-bbeebb02-b867fee9-4bd849bf.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. COMPARISON: Chest x-ray and CT chest from ___. FINDINGS: Frontal and lateral views of the chest again demonstrate increased opacity projecting over the right middle lobe. There is obscuration of the right heart border and increased interstitial markings, slightly more peripherally. These findings appear slightly more conspicuous on the current exam with more dense consolidative component potentially due to progression of disease. Elsewhere, the lungs are clear. Surgical clips are seen in the region of the AP window. Cardiomediastinal silhouette is unchanged. No acute osseous abnormality is identified. IMPRESSION: Slight increased opacity projecting in the region of the right middle lobe, worrisome for progression of disease although superimposed infection is also possible. " 8ddf91e4-72e1b05a-a8948f81-6aa2ba74-10bab131.jpg,validate/p10/p10594556/s57116398/8ddf91e4-72e1b05a-a8948f81-6aa2ba74-10bab131.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with CT showing pneumothorax. FINDINGS: Single portable view of the chest was compared to CT scan from earlier the same day. Dense left basilar opacity is compatible with combination of left lower lobe collapse and parenchymal opacities in the left upper lobe. Left pneumothorax is demonstrated, both superiorly and at the lung base and along the mediastinum. Right lung is grossly clear. Cardiomediastinal silhouette is grossly unremarkable, although shifted to the left. Osseous and soft tissue structures are unremarkable. IMPRESSION: Left-sided pneumothorax as seen on prior CT scan. Dense left basilar opacity compatible with left lower lobe collapse and opacity in the left upper lobe as well. " 8c595db7-e116a6ee-83e0f6d9-9be8626a-26e6c240.jpg,validate/p14/p14938318/s51338617/8c595db7-e116a6ee-83e0f6d9-9be8626a-26e6c240.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: Multiple chest radiographs the most recent from ___. FINDINGS: There is increased retrocardiac opacity which may be representative of pneumonia in the proper clinical setting. Otherwise, the remainder of the lungs are clear. The heart is moderately enlarged but stable. Atherosclerotic calcifications are noted at the aortic arch. Pacer wires appear appropriately placed. No acute fractures are identified. IMPRESSION: There is increased retrocardiac opacity which may be representative of a developing pneumonia in the proper clinical setting. Two view may help furhter characterize. Followup to resolution is recommended. " 18a6655b-190d1257-f5bc2d6e-6a747c2a-229fb0aa.jpg,validate/p16/p16934035/s59088283/18a6655b-190d1257-f5bc2d6e-6a747c2a-229fb0aa.jpg,validation," FINAL REPORT INDICATION: ___M with abd pain s/p fall // evidence of infection or bleed TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right chest wall port is seen in stable position. The lungs are clear without focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 6a303a68-7933bd99-20ba4513-360f9a69-830a6a17.jpg,validate/p16/p16743731/s54439797/6a303a68-7933bd99-20ba4513-360f9a69-830a6a17.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Massive gastrointestinal bleed, evaluation. COMPARISON: ___:58 p.m. FINDINGS: As compared to the previous radiograph, there is a massive progression. The patient has developed generalized consolidation of the lung parenchyma, with only a few strongly opacified areas showing air bronchograms. These are located in the left lung periphery, in the right upper lobe base and in the right lower lobe apex. The size of the cardiac silhouette cannot be determined with safety. Moreover, the costophrenic sinuses are blunted, suggesting the presence of pulmonary edema. The endotracheal tube tip now projects 7 cm above the carina. No evidence of pneumothorax. " 6d0fdf2f-8b154527-af60c9d4-877f529f-d06e1ed3.jpg,validate/p18/p18369810/s59855757/6d0fdf2f-8b154527-af60c9d4-877f529f-d06e1ed3.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p cabg and line change // check line placement TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the right internal jugular central venous catheter projects over the superior cavoatrial junction. The patient is status post prior median sternotomy. Low bilateral lung volumes with persisting bibasilar and left mid lung atelectasis. No pleural effusion or pneumothorax identified. The size and appearance of the cardiomediastinal silhouette is unchanged. IMPRESSION: Interval placement of a right internal jugular central venous catheter, the tip projecting over the superior cavoatrial junction. No other significant interval change. " e5f0d15a-fed73f4c-b1889c60-b25e399f-dc0bb67f.jpg,validate/p10/p10535897/s55753733/e5f0d15a-fed73f4c-b1889c60-b25e399f-dc0bb67f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with persistent tachycardia // eval for pulm edema eval for pulm edema COMPARISON: Comparison to ___ at 06:07 FINDINGS: Portable semi-erect chest radiograph ___ at 19:42 is submitted. IMPRESSION: Right internal jugular central line is unchanged in position. A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the stomach. It appears that the endotracheal tube has been removed. Hardware is seen overlying the lower cervical and lower thoracic/upper lumbar spine. Interval appearance of a linear opacity at the left base likely reflecting subsegmental atelectasis. There is decreased but persistent mild pulmonary and interstitial edema. Probable small layering effusions, right greater than left. " e6e68dfe-69a82407-f21e6f85-cb7897e9-ccf3ee0c.jpg,validate/p15/p15914421/s59176008/e6e68dfe-69a82407-f21e6f85-cb7897e9-ccf3ee0c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chf and basilar infiltrates at end of ___.? ILD // Have infiltrates cleared/improved FINDINGS: Heart is enlarged but decreased in size compared to ___ chest radiograph. Mild pulmonary vascular congestion is present without overt pulmonary edema or pleural effusion. Bibasilar areas of atelectasis have nearly resolved in the interval. Right hemidiaphragm remains moderately elevated. IMPRESSION: Resolving bibasilar opacities are most likely due to atelectasis. If there is strong clinical suspicion for interstitial lung disease, a high-resolution chest CT may be considered. " 00f6cd20-435e281c-f2f899d0-82151518-ff5615f6.jpg,validate/p11/p11948874/s51602926/00f6cd20-435e281c-f2f899d0-82151518-ff5615f6.jpg,validation," FINAL REPORT HISTORY: Pneumonia and ARDS. FINDINGS: In comparison with study of ___, there is continued bibasilar opacification consistent with extensive atelectatic changes and pleural effusions. Monitoring and support devices remain in place. Continued low lung volumes. " b03a53cd-939d8e84-9bc8ae86-6a6efd94-e95e110f.jpg,validate/p15/p15586571/s52668145/b03a53cd-939d8e84-9bc8ae86-6a6efd94-e95e110f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R frontal IPH with increased WOB // ?infectin TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiac size is top-normal. Left lower lobe opacities likely atelectasis and effusion are grossly unchanged. Right lower lobe opacities have increased these could be atelectasis or pneumonia. NG tube tip is in the stomach. Patient's chin obscures the apices of the lungs. " 04bd144f-7f64bfba-6dca52e0-d3f9862b-d6925b9f.jpg,validate/p10/p10803096/s51208293/04bd144f-7f64bfba-6dca52e0-d3f9862b-d6925b9f.jpg,validation," FINAL REPORT INDICATION: ___ year old man with fever, rigors // pneumonia TECHNIQUE: AP view of the chest. COMPARISON: ___ at 09:02. FINDINGS: Prior right-sided central venous catheter is no longer visualized. No large effusion identified noting resolution of prior moderate left-sided pleural effusion. Streaky retrocardiac opacity is most likely atelectasis. Superiorly, lungs are clear. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires are intact. No acute osseous abnormalities. IMPRESSION: Left basilar opacity most likely atelectasis although infection is not entirely excluded. Consider PA and lateral if patient is amenable. Otherwise, no acute cardiopulmonary process. " 3c8bd3e7-9d7c1cca-66bebc42-e4f9ea9b-c3a1bf7e.jpg,validate/p12/p12388290/s58954650/3c8bd3e7-9d7c1cca-66bebc42-e4f9ea9b-c3a1bf7e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___ year old man with cough, chest pain COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are somewhat low though allowing for this, there is no focal consolidation, large effusion or pneumothorax. The cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " c4507366-c5d08e80-e0f13b4d-fc3d084f-bece4b72.jpg,validate/p19/p19989783/s55663444/c4507366-c5d08e80-e0f13b4d-fc3d084f-bece4b72.jpg,validation," FINAL REPORT INDICATION: History: ___M with weakness, ekg changes // eval for consolidation TECHNIQUE: Single portable upright chest radiograph COMPARISON: Chest radiograph dated ___ FINDINGS: Single portable AP upright chest radiograph demonstrate cardiomegaly, the size of the heart which appears decreased in size relative to prior study performed ___. There is no evidence of pulmonary edema. There is no pleural effusion or pneumothorax. Lungs are clear without a focal consolidation convincing for pneumonia. IMPRESSION: Cardiomegaly without evidence of pulmonary edema. No evidence of pneumonia. " 139e8993-2891664b-12d4d5f0-c681b0b1-deabddb5.jpg,validate/p17/p17762094/s53854644/139e8993-2891664b-12d4d5f0-c681b0b1-deabddb5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with septic shock with RIJ CVL pulled back 2 cm // interval change interval change COMPARISON: Chest radiographs ___ since ___ most recently ___ 01:05. IMPRESSION: Previous moderate pulmonary edema has improved since ___:00. Small region of now more focal consolidation in the right lower lobe is concerning for pneumonia. Left infrahilar consolidation could be pneumonia or atelectasis. Small left pleural effusion unchanged. Heart size normal. ET tube, right internal jugular line are in standard placements. Nasogastric tube ends in the mid to low the esophagus at least 7 cm above the GE junction. No pneumothorax. New left upper quadrant drainage catheter. " 0709ced2-8f5fa9b1-73d07835-a3f0d352-6c226494.jpg,validate/p19/p19368870/s51461519/0709ced2-8f5fa9b1-73d07835-a3f0d352-6c226494.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea/ cough // r/o pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Subtle linear density in the right lower lung is likely indicative of scarring. A retrocardiac bulbous opacity is most compatible with a small hiatal hernia. Lungs are clear without 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: Small retrocardiac density is compatible with hiatal hernia. No signs of pneumonia or edema. " d1d04391-e3bd47a7-9a6b03e1-8e8bfc5d-5338c775.jpg,validate/p14/p14743875/s58276037/d1d04391-e3bd47a7-9a6b03e1-8e8bfc5d-5338c775.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with COPD, assess for lung lesions. Cardiac size is normal. The aorta is tortuous. Deviation of the trachea towards the left is unchanged due to enlarged thyroid. Loss of volume and scarring in the right upper lobe is minimally increased from prior. Minimal interstitial peripheral abnormality in the lower lobes bilaterally is nonspecific, minimally increased from prior study. There are no lung masses, pneumothorax, or pleural effusion. Surgical clips project in the right upper hemithorax. " dede41a5-52c34518-9f8838db-156d54ff-507f5949.jpg,validate/p17/p17397284/s51613638/dede41a5-52c34518-9f8838db-156d54ff-507f5949.jpg,validation," WET READ: ___ ___ ___ 8:24 PM New left pigtail tube coiled at the left lung base with resultant improved aeration at the left base. No pneumothorax. At least a small amount of pleural fluid remains. Streaky opacities at the right lung base are also improved. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Loculated effusion after pigtail placement. Portable AP radiograph of the chest was reviewed in comparison to ___. The left pigtail catheter has been placed with interval decrease in the loculated left pleural effusion. The right PICC line tip terminates at the cavoatrial junction. There is improved aeration of the right lower lung. Cardiomediastinal silhouette is overall unchanged. No pneumothorax demonstrated. " 51095b2e-90fcdaaa-eb86ed90-a8959f64-3daf74cd.jpg,validate/p19/p19321265/s51176548/51095b2e-90fcdaaa-eb86ed90-a8959f64-3daf74cd.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP // r/o acute process 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 unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " d6d3e40e-9f828a5b-69b28715-7c23bc20-dbb36c9f.jpg,validate/p14/p14053930/s54412709/d6d3e40e-9f828a5b-69b28715-7c23bc20-dbb36c9f.jpg,validation," FINAL REPORT INDICATION: ___-year-old with seizure. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: There are no prior studies for comparison available. 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. " 37f754fc-368d5339-5d767d2d-190b9075-009bcc29.jpg,validate/p18/p18450763/s52319370/37f754fc-368d5339-5d767d2d-190b9075-009bcc29.jpg,validation," 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. " 499fc0ae-79a24115-93616b50-e421037e-103fca98.jpg,validate/p12/p12297145/s53914547/499fc0ae-79a24115-93616b50-e421037e-103fca98.jpg,validation," FINAL REPORT HISTORY: Shortness of breath fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Increased interstitial markings are demonstrated the lung bases, moreso than on the prior exam, with more focal opacity within the left lower lobe. No pleural effusion or pneumothorax is present. There is scarring within the lung apices. No acute osseous abnormalities detected. IMPRESSION: Increased interstitial markings within the lung bases with more focal opacity in the left lower lobe. Findings may reflect pneumonia with mild pulmonary vascular congestion, but atypical infection should also be considered. " ded25309-2ca56822-6b1d9c22-f92059e2-c1822dea.jpg,validate/p13/p13346482/s50964516/ded25309-2ca56822-6b1d9c22-f92059e2-c1822dea.jpg,validation," FINAL REPORT INDICATION: ___F with weakness, DOE, dry cough // Evidence of acute pulmonary process TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear noting that the left costophrenic angle is excluded from the field of view. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " b0b9ccdf-741b173a-3b0aafb4-62d41ab6-be01c206.jpg,validate/p16/p16347969/s54591296/b0b9ccdf-741b173a-3b0aafb4-62d41ab6-be01c206.jpg,validation," FINAL REPORT INDICATION: ___M with malaise, generalized weakness // ? pna COMPARISON: ___. 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: No acute cardiopulmonary process. " 21e9b7c1-3928db01-6586f939-d888bc7e-8083c3f6.jpg,validate/p11/p11522912/s55210159/21e9b7c1-3928db01-6586f939-d888bc7e-8083c3f6.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with seizure, evaluate for pneumonia. TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiograph from ___ and ___ FINDINGS: The heart is moderately enlarged, and there is no overt pulmonary edema, focal consolidation or pleural effusion. There is bibasilar atelectasis. IMPRESSION: No acute cardiopulmonary process. " a3b7e369-9b7588cc-5e54b56f-659d7727-52c6629d.jpg,validate/p13/p13874942/s58970384/a3b7e369-9b7588cc-5e54b56f-659d7727-52c6629d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with h/o of Alports, on immunosup, BK, elevated Cr, worsened dry cough overnight. // immunosup, eval acute process EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There is a new small left pleural effusion. There is a new irregular opacity at the left lung base laterally, which could be an infectious process or atelectasis. A calcified granuloma in the left mid to upper lung is unchanged. Cardiomediastinal silhouette is normal size. IMPRESSION: New small left pleural effusion and left lung base opacity could be an infectious process or atelectasis. If clinically indicated, CT is recommended for further evaluation. " d8213a7e-34ed86c1-033e64b3-0b66cac7-e8b2e23b.jpg,validate/p11/p11541295/s59546593/d8213a7e-34ed86c1-033e64b3-0b66cac7-e8b2e23b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chronic cough x 3 months, LAD // masses, pneumonia, masses, pneumonia, IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion. There is no pneumothorax " 84cbe4a2-2e4ed6f2-609ced32-1deeffe9-67dca64a.jpg,validate/p10/p10551194/s56020916/84cbe4a2-2e4ed6f2-609ced32-1deeffe9-67dca64a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Chest pain. Question pneumothorax. COMPARISON: ___. 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. Surgical clips project over the left axilla. The thoracic spine again curves slightly to the right side. IMPRESSION: No evidence of acute cardiopulmonary disease. " d1a8523b-6effcba1-8bcc1335-04df7505-6ab40a43.jpg,validate/p13/p13858896/s50293765/d1a8523b-6effcba1-8bcc1335-04df7505-6ab40a43.jpg,validation," FINAL REPORT INDICATION: Dizziness. Evaluate for pneumonia. COMPARISON: None. TECHNIQUE: Upright PA and lateral radiograph of the chest. FINDINGS: The lungs are normally expanded and clear. The cardiomediastinal silhouette and hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 2300c83a-6ab2f984-a6979fe6-ed61e99d-11722457.jpg,validate/p17/p17512499/s54870684/2300c83a-6ab2f984-a6979fe6-ed61e99d-11722457.jpg,validation," FINAL REPORT HISTORY: Chest pain, rule out infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest. Normal heart size. Clear lungs. Normal hilar and mediastinal contours. No pleural effusion or pneumothorax. No displaced rib fracture. IMPRESSION: No pneumonia. " 979910c5-40560fc2-892793d9-91c9e45f-23bd54e7.jpg,validate/p14/p14085712/s53320221/979910c5-40560fc2-892793d9-91c9e45f-23bd54e7.jpg,validation," 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. " e49d369c-9b5e5654-d39bf20f-e3a8b172-a137d9cb.jpg,validate/p18/p18056761/s52360316/e49d369c-9b5e5654-d39bf20f-e3a8b172-a137d9cb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with ?seizure // ? ich. pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Bibasilar opacities may be due to atelectasis and overlying vascular structures however, underlying aspiration or subtle infection is not excluded in the appropriate clinical setting. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Subtle bibasilar opacities may be due to atelectasis however, infection or aspiration not excluded in the appropriate clinical setting. " 63cd2119-ac4e603c-fd79868e-c6296770-cb3beb05.jpg,validate/p15/p15376482/s55682662/63cd2119-ac4e603c-fd79868e-c6296770-cb3beb05.jpg,validation," FINAL REPORT INDICATION: Patient with fever, please assess for infiltrate. COMPARISON: Comparison is made to chest CT and radiograph performed ___. FINDINGS: Redemonstration of a larger retrocardiac opacification, characterized as a large diaphragmatic hernia on the ___ CT. Adjacent opacification likely reflects atelectasis, though cannot exclude infectious process in the appropriate clinical setting. Left costophrenic angle is blunted, reflecting atelectasis or a small pleural effusion. Linear right middle lobe opacification is similar to prior radiograph and correlated with area of atelectasis on concurrent CT. Stable mild enlargement of the cardiac silhouette. Mediastinal and hilar contours are unremarkable. No lytic or blastic lesion identified. There is stable mild vertebral body height loss of mid thoracic vertebrae, unchanged compared to ___ CT. IMPRESSION: Large retrocardiac opacity likely represents combination of large hiatal hernia and adjacent atelectasis, though cannot exclude infectious process in the correct clinical setting. Possible left pleural effusion. Stable mild mid thoracic vertebral body height loss. " f177afd0-6f78a226-9b1c954e-01e213c3-50cfcd66.jpg,validate/p19/p19005323/s50928197/f177afd0-6f78a226-9b1c954e-01e213c3-50cfcd66.jpg,validation," FINAL REPORT INDICATION: ___M with elev wbc, and cirrhosis // eval pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Streaky right basilar opacities are identified particularly in the right middle lobe. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Streaky right middle lobe opacities most suggestive of atelectasis. " 869a41f2-5fe55887-15acd23d-5e39b1e4-fa38c533.jpg,validate/p19/p19598034/s50665908/869a41f2-5fe55887-15acd23d-5e39b1e4-fa38c533.jpg,validation," 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. " f45ec0ac-68bd33e5-b4059b27-9985eb63-40040ae0.jpg,validate/p12/p12671607/s52470535/f45ec0ac-68bd33e5-b4059b27-9985eb63-40040ae0.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Productive cough and shortness of breath. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size and mediastinum are unremarkable. Questionable opacity adjacent to the left cardiac border is noted, approximately 2 cm in diameter. It might reflect infectious process, but pulmonary nodule cannot be excluded. In addition, there is relative density projecting over the right clavicle at the mid aspect, 12 mm in diameter. Evaluation of the patient in four weeks after completion of antibiotic therapy is required for assessment of resolution. If no typical history of pneumonia is present, assessment with chest CT would be appropriate for precise characterization of the right upper and left pericardiac areas. " 7dae13b3-ae81b011-64d806ca-8c069e1d-2f63ae01.jpg,validate/p19/p19620779/s56625935/7dae13b3-ae81b011-64d806ca-8c069e1d-2f63ae01.jpg,validation," FINAL REPORT INDICATION: History: ___F with ams // ams TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Left pectoral pacemaker leads terminate in right atrium and right ventricle. No consolidation, pneumothorax, or pleural effusion is identified. Cardiomediastinal silhouette is normal size. Severe dextroscoliosis of the thoracic spine is noted. IMPRESSION: No acute cardiopulmonary process. " 0bd66051-2e77eac4-a5b4cf8a-931cc3cd-4733e048.jpg,validate/p16/p16914658/s54096461/0bd66051-2e77eac4-a5b4cf8a-931cc3cd-4733e048.jpg,validation," FINAL REPORT HISTORY: Worsening dyspnea on exertion. FINDINGS: No previous images. There is some enlargement of the cardiac silhouette with marked tortuosity of the aorta. No vascular congestion, pleural effusion, or acute focal pneumonia. Suggestion of several healed or healing rib fractures laterally in the mid zone on the right. " fa86c7a7-938cd826-e15f7e64-3879fd3a-80dc6f99.jpg,validate/p19/p19359981/s54129748/fa86c7a7-938cd826-e15f7e64-3879fd3a-80dc6f99.jpg,validation," FINAL REPORT INDICATION: History: ___F with CP // eval for infiltrate TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ac1d0cd7-221f42f5-2b2e63fc-38fae1fb-e82a61b9.jpg,validate/p13/p13875890/s52932177/ac1d0cd7-221f42f5-2b2e63fc-38fae1fb-e82a61b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PICC that is no longer drawing back // confirm placement of PICC TECHNIQUE: Chest single view COMPARISON: ___ 13:55 FINDINGS: Left PICC line tip is either in the upper SVC or possibly in the azygos vein. Lateral radiograph may be helpful. Tracheostomy. Enteric tube tip is well below diaphragm, not included on the radiograph. Very shallow inspiration. Stable cardiopulmonary findings, aside for mildly worsened left basilar atelectasis. Mildly distended loop of bowel left upper quadrant, likely splenic flexure of the colon. IMPRESSION: Left PICC line tip is in the upper SVC or azygos vein, lateral radiograph may be helpful. " 2040a5f9-74297367-e3dacc1b-c78adaa0-12fc87d3.jpg,validate/p15/p15284020/s50450175/2040a5f9-74297367-e3dacc1b-c78adaa0-12fc87d3.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: The patient is status post AVR and CABG, followup effusions. Comparison is made with the prior study, ___. Large right pleural effusion is grossly unchanged. Moderate left pleural effusion has increased. Cardiomediastinal contours are unchanged. Pacer leads are in standard position. There is no pneumothorax. " 2393922e-cab92b20-65e468d2-9689ca45-9fdc5bd4.jpg,validate/p15/p15597371/s53240935/2393922e-cab92b20-65e468d2-9689ca45-9fdc5bd4.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with left hip fracture. Concern for altered mental status. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal AP and lateral views of the chest were obtained. Opacity in the medial right lower lobe and medial left lower lobe are new from ___. There is a small right, and possibly left, pleural effusion. Linear atelectasis at the left lung base is unchanged. The upper lung zones are clear. There is no pneumothorax. Cardiac and mediastinal silhouettes and hilar contours are stable. No acute osseous abnormality is identified. Pulmonary vasculature is slightly indistinct, which may be due to pulmonary vascular congesion. IMPRESSION: 1. New lateral opacities are likely atelectasis, but infection or aspiration cannot be excluded. Small right and possibly left, pleural effusions. 2. Possible pulmonary vascular congestion. Preliminary findings discussed with Dr. ___ by phone at 7:20 p.m., ___. " 94a65859-1d570e3d-91a0ec57-9d9a1d84-27502058.jpg,validate/p18/p18550032/s53986079/94a65859-1d570e3d-91a0ec57-9d9a1d84-27502058.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // ett ett IMPRESSION: Compared to prior chest radiographs, ___ through ___ at 03:25. Indwelling ET tube in standard placement. Right internal jugular line ends in the upper SVC. Esophageal drainage tube passes into the stomach and out of view. Moderate bilateral pleural effusions have improved. Left lower lobe is still collapsed. Moderate enlarged of the cardiac silhouette may have improved as well. No pneumothorax. " 6366f148-fdb5986a-6a40e4d1-3591bb35-0757afcf.jpg,validate/p18/p18193242/s55799499/6366f148-fdb5986a-6a40e4d1-3591bb35-0757afcf.jpg,validation," 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. " 6e8318d4-9ca5ef2c-ed7426c1-dc854ac3-525b9db2.jpg,validate/p10/p10380616/s51638923/6e8318d4-9ca5ef2c-ed7426c1-dc854ac3-525b9db2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p tracheobronchoplasty // interval change TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs the most recent on ___ FINDINGS: Mild cardiomegaly is stable. The hilar and mediastinal contours are stable and within normal limits. New from the prior examination is right lower lobe and right middle lobe opacity which reflects a combination of pleural effusion and collapse. . There is a minimal atelectasis at the left base. There is no pulmonary edema. Pneumothorax. IMPRESSION: Opacity involving the right middle lobe and right lower lobe represents a combination of volume loss and layering pleural effusion. Minimal left basal atelectasis. Right lower lobe pneumonia should be considered in the appropriate clinical setting. " 69beb083-ab4f59e3-2a2fb661-15900e48-d201765d.jpg,validate/p13/p13749608/s50234983/69beb083-ab4f59e3-2a2fb661-15900e48-d201765d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent outside film showing left upper lobe lesion, evaluation. COMPARISON: No comparison is available at the time of dictation. FINDINGS: The lung volumes are normal. Moderate scoliosis. Normal size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pleural effusions. The only abnormality seen in the left lung apex is a semicircular 3-4 mm structure projecting over the upper margin of the fourth rib. The lesion is seen on the frontal view only. The overall conspicuity of the structure is a small, it could represent a little granuloma or a calcified structure associated to the rib. For evaluation of stability and potential growth, a comparison with outside hospital films would be helpful. We will be happy to reevaluate the case once these prior images are provided. An according E-mail was sent to the referring physician, ___. ___. " 73435534-4de324e3-6ca5ea43-073de04b-a1a099db.jpg,validate/p17/p17517983/s57072116/73435534-4de324e3-6ca5ea43-073de04b-a1a099db.jpg,validation," FINAL REPORT INDICATION: History: ___F with hypoglycemia // ? pna TECHNIQUE: Single portable upright AP image of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded. There are increased interstitial markings as on prior exam and vascular indistinctness, consistent with increased mild pulmonary edema, most prominent in the lung bases, right greater than left. Trace bilateral pleural effusions are likely present. No pneumothorax is seen. Cardiomegaly is again noted. IMPRESSION: Increased mild pulmonary edema, most prominent lung bases, right greater than left. " e08cd1fa-4d61332b-382d9dd1-8a4045f9-63552cf4.jpg,validate/p12/p12948450/s52442153/e08cd1fa-4d61332b-382d9dd1-8a4045f9-63552cf4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff placed // ? re: dobhoff placement ? re: dobhoff placement IMPRESSION: In comparison with the study of ___, a series of images shows the Dobbhoff tube eventually within the fundus of the stomach. Otherwise, there may be slight decrease in pulmonary vascularity and right hilar opacification, flow the left hilum is more prominent. This could represent some obliquity of the patient. " 6bbf6873-87c16183-dc3c6113-6bd004d6-20f0eba9.jpg,validate/p16/p16863449/s55928046/6bbf6873-87c16183-dc3c6113-6bd004d6-20f0eba9.jpg,validation," WET READ: ___ ___ ___ 2:47 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F epigastric pain. Assess for cardiopulmonary change. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CTA chest ___. FINDINGS: The lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No acute cardiopulmonary process. " d97475a4-c01d5492-11ed6956-e207390d-bca480bd.jpg,validate/p13/p13747454/s59422224/d97475a4-c01d5492-11ed6956-e207390d-bca480bd.jpg,validation," FINAL REPORT INDICATION: Poly trauma s/p ex-lap, chest tubes and ETT assess for change. TECHNIQUE: Supine portable chest radiograph COMPARISONS: Trauma chest radiograph ___ FINDINGS: As compared with the prior study, the endotracheal tube is located 3 cm above the carina in satisfactory position. There has been interval placement of two chest tubes, without appreciable pneumothorax. There is elevation of the right hemidiaphragm, which is more pronounced than on the prior study. Lung volumes are low, without focal consolidation. Right basal atelectasis is appreciated. Bilateral rib fractures are again demonstrated, though poorly assessed due to rotation. What appears to be a left subclavian venous catheter terminates as before at the level of the confluence of brachiocephalic veins. What appears to be a left PICC or other small caliber catheter terminates at the level of the axilla. Calcified and unfolded tortuous aorta is noted. The heart is mildly enlarged. IMPRESSION: 1. Interval placement of bilateral chest tubes without appreciable pneumothorax. 2. Left subclavian catheter terminating in the left brachiocephalic vein just proximal to the confluence. Small bore catheter terminating at the level of the left axilla. These findings were discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. " db71b8fd-1b9d13e2-356921db-fc3ad0b9-b6572037.jpg,validate/p15/p15239201/s55708398/db71b8fd-1b9d13e2-356921db-fc3ad0b9-b6572037.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with liver failure, hepatorenal // interval change interval change IMPRESSION: In comparison with the earlier study of this date, the monitoring support devices are unchanged, as are the extensive pulmonary and pleural changes involving both lungs. " 96fb59c4-d18718d7-3202d325-8bfc9b23-38653a11.jpg,validate/p12/p12358216/s58367863/96fb59c4-d18718d7-3202d325-8bfc9b23-38653a11.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with right-sided pleural effusion, evaluate for interval change. 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 right-sided basal density has improved and the right-sided diaphragmatic contour is now visible again indicating marked reduction of the previously identified right-sided basal pleural effusion. It is assumed that a right-sided thoracocentesis has been performed during the latest examination interval. The lung remains well aerated and there is no evidence of significant pneumothorax in the right apical area. Basal right sided density persists, raising suspicion of pulmonary parenchymal process in this area. In the left hemithorax, no evidence of new acute parenchymal infiltrates. " b6e98cdc-6c132195-0a74c392-b6b9cc38-bffa8d77.jpg,validate/p13/p13119476/s50605320/b6e98cdc-6c132195-0a74c392-b6b9cc38-bffa8d77.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with malaise, DOE // Pneumonia vs. CHF exacerbation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead left-sided pacer device is seen, stable in position. There is persistent moderate to severe enlargement of the cardiac silhouette. Mediastinal contours are stable. Neo esophagus is again seen, with large air-fluid level distally. There is slight blunting of the costophrenic angles could be due to pleural thickening or trace of pleural effusions. No evidence of pneumothorax is seen. No definite new focal consolidation is seen. Several old right-sided rib deformities are re- demonstrated. Gaseous distention of multiple loops of bowel is incompletely evaluated on this study. . IMPRESSION: Medial esophagus with large air-fluid level distally. Slight blunting of the costophrenic angles could be due to pleural thickening and/ or trace pleural effusions. Cardiomegaly. Gaseous distention of multiple loops of bowel, incompletely evaluated on this study. " 29696004-45b8559c-604f3446-841e1770-b896c830.jpg,validate/p14/p14997223/s57542587/29696004-45b8559c-604f3446-841e1770-b896c830.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with pleural effusion, status post right pigtail catheter placement. Evaluate for pneumothorax. FINDINGS: Comparison is made to the previous study from ___. There has been placement of a right basilar pigtail catheter. There has been interval reduction in the size of the right-sided pleural effusion since the prior study. There are no pneumothoraces. There is also a left-sided pleural effusion, which is moderate. There is a left retrocardiac opacity. There are no signs for overt pulmonary edema. " 3fabc89f-3e8cd044-ca044929-30893fea-94111db6.jpg,validate/p16/p16033728/s51650840/3fabc89f-3e8cd044-ca044929-30893fea-94111db6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic respiratory failure, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have substantially decreased, likely caused by decreased inspiration. The left hemidiaphragm remains elevated. Patient shows bilateral areas of atelectasis, left more than right. The ventilated lung parenchyma shows no evidence of pathological changes, no evidence of pneumonia or pulmonary edema. No pneumothorax. Borderline size of the cardiac silhouette. " c3b347b3-1c19b411-d5f5297b-6975b29e-3b1c098a.jpg,validate/p11/p11938332/s59688805/c3b347b3-1c19b411-d5f5297b-6975b29e-3b1c098a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with NGT in place POD#___ total pelvic exenteration with end colostomy and colonic urostomy now with fever POD#___ // r/o PNA r/o PNA IMPRESSION: Compared to chest radiographs ___. New right PIC line ends in the mid SVC. Nasogastric tube ends in the upper stomach. Lungs fully expanded and clear. Small pleural effusion blunting of one of the posterior sulci on the lateral view is probably but not definitely on the right side. There is no pneumothorax. " d587011f-95d4fd0b-35f15bf6-19cb2ee0-e7bc8af8.jpg,validate/p19/p19034608/s58700666/d587011f-95d4fd0b-35f15bf6-19cb2ee0-e7bc8af8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // eval for acute process TECHNIQUE: Chest PA 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. " 44465522-a70b891a-a395c0a8-ecec7950-80e4fa89.jpg,validate/p10/p10401281/s57978852/44465522-a70b891a-a395c0a8-ecec7950-80e4fa89.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hypoglycemic episode // Eval PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. Nipple jewelry is incidentally noted. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9fd70cde-e8d74fed-e6a1d237-88fba966-d24860e7.jpg,validate/p17/p17963938/s58740904/9fd70cde-e8d74fed-e6a1d237-88fba966-d24860e7.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with history of MVA, tension pneumothorax, tube on waterseal, assess for pneumothorax. Comparison is made to the patient's prior study of ___ at 457. Single portable semi-erect chest film ___ at ___ is submitted. IMPRESSION: 1. Right internal jugular central line, endotracheal tube and nasogastric tube are unchanged in position. The left chest tube remains in position. There is a small left apical pneumothorax which probably is not significantly changed given differences in positioning between studies. Overall cardiac and mediastinal contours are unchanged. There is interval improvement in aeration of the left base with persistent focal patchy opacity at the right base. No evidence of pulmonary edema. There is some lateral right-sided pleural thickening as well as focal left apical pleural thickening unchanged. " a263fc98-8785fa0f-674628ca-00834d9c-7dcbb51f.jpg,validate/p17/p17634840/s53511513/a263fc98-8785fa0f-674628ca-00834d9c-7dcbb51f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with history NSIP, now with worsening dyspnea, productive cough and slightly worsened PFTs. Evaluate for pneumonia or worsening NSIP. IMPRESSION: PA and lateral chest compared to ___: Mild, but widespread infiltrative pulmonary abnormality has worsened since ___. Moderate cardiomegaly has also progressed, so there is a possibility of a component of cardiac decompensation, but there is no pleural effusion or vascular plethora in the peripheral lungs. There are no focal abnormalities to suggest pneumonia. Interval enlargement of the hila could be explained by worsening pulmonary arterial hypertension, in turn the explanation for enlarging heart size. " 35e707f0-e1cbb5b7-bedb822a-52248d1c-28d917d7.jpg,validate/p18/p18325012/s54318096/35e707f0-e1cbb5b7-bedb822a-52248d1c-28d917d7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o TBI and epilepsy with new O2 requirement over last 24h // ? aspiration pna ? aspiration pna IMPRESSION: In comparison with study of ___, there is little overall change. Again there are low lung volumes, but no evidence of pneumonia, vascular congestion, or pleural effusion. " 6bc3d192-a0613443-7525c30a-d4f5b2e9-3e620855.jpg,validate/p13/p13933090/s56083778/6bc3d192-a0613443-7525c30a-d4f5b2e9-3e620855.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dyspnea on exertion. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The patient is status post sternotomy. A dual-lead pacemaker/ICD device appears unchanged with leads terminating in the right atrium and ventricle, respectively, without change. The heart appears mildly enlarged. The aorta shows unfolding and mural calcification. Hemidiaphragms are flattened. There is probably a small pleural effusion on the right and a slightly larger one on the left, as well as increased thickening along the minor fissure. Although this finding suggests a component of fluid overload, focal opacities projecting over the right lower and left upper lungs are most suggestive of pneumonia with areas of spared lung elsewhere. Biapical pleural thickening is unchanged. Bony structures are unremarkable. IMPRESSION: Findings most suggestive of multifocal pneumonia. Small pleural effusions. " 0fd991aa-e7519b67-6a26fd00-bfc05197-5099cb7c.jpg,validate/p15/p15177630/s58059379/0fd991aa-e7519b67-6a26fd00-bfc05197-5099cb7c.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with left-sided chest pain for 5 days. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Lungs are mildly hyperinflated. Heart and mediastinal contours are within normal limits. IMPRESSION: Mildly hyperinflated lungs without radiographic evidence for acute cardiopulmonary process. " 29a9ca2f-50292418-e78e2999-12755e18-3103a476.jpg,validate/p16/p16508811/s50382515/29a9ca2f-50292418-e78e2999-12755e18-3103a476.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CAP // ___ year old man with CAP TECHNIQUE: Single portable AP view of the chest was obtained. COMPARISON: ___ FINDINGS: In comparison with the most recent examination, lung volumes slightly lower. The cardiac silhouette is stably enlarged. Again noted is a mild indistinctness of the pulmonary vasculature with superimposed opacities bilaterally, more confluent on the left than previously noted, consistent with superimposed pneumonia. IMPRESSION: Possible mild edema with superimposed pneumonia. " 327625fe-e06704b4-994b179b-9847b0cf-60f230f4.jpg,validate/p10/p10494089/s51908520/327625fe-e06704b4-994b179b-9847b0cf-60f230f4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD on HD, severe sepsis with large volume requirement // Assessment of pulmonary vascular congestion TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 00:06 IMPRESSION: Cardiomegaly is substantial, unchanged. Mediastinal silhouette is unchanged. Vascular hilar enlargement is re- demonstrated most likely consistent with pulmonary artery enlargement. The central venous line has been removed in the interim. There is no pneumothorax. There is no interval increase in pleural effusion. There is mild vascular congestion but no pulmonary edema and no substantial change since the prior study seen " 8ec39485-e5df57ad-e6fa8c10-5feeaab5-1f87eba5.jpg,validate/p17/p17522005/s59085622/8ec39485-e5df57ad-e6fa8c10-5feeaab5-1f87eba5.jpg,validation," FINAL REPORT HISTORY: CHF. FINDINGS: In comparison with study of ___, there is again substantial enlargement of the cardiac silhouette in a patient with a triple-channel pacer device with leads in position. No appreciable pulmonary vascular congestion or acute focal pneumonia. " 15ee4dd4-ef01a858-5eff0382-7006afa3-b9c78209.jpg,validate/p19/p19231238/s53648000/15ee4dd4-ef01a858-5eff0382-7006afa3-b9c78209.jpg,validation," FINAL REPORT INDICATION: ___F with ab pain. h/o SBOs // rule out acute process COMPARISON: ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Mild cardiomegaly and mediastinal contours are stable. Minimal blunting of the posterior costophrenic angles is consistent with trace pleural effusions. There is slight interstitial prominence consistent with mild pulmonary edema, but no focal consolidation or pneumothorax. A vascular stent is present in the upper abdomen. IMPRESSION: Stable mild cardiomegaly with increased interstitial prominence consistent with mild pulmonary edema. Trace bilateral pleural effusions. No focal consolidation. " 62619c9e-ac54be26-89ac1ca3-f1727f31-c66157c6.jpg,validate/p17/p17070596/s53585078/62619c9e-ac54be26-89ac1ca3-f1727f31-c66157c6.jpg,validation," 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. ___. " bf99c9ca-52cb81ea-002dadab-153be2ee-3661bd47.jpg,validate/p10/p10037432/s52374866/bf99c9ca-52cb81ea-002dadab-153be2ee-3661bd47.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of left-sided thoracic pain and increases with deep inspiration with upper respiratory infection symptoms. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been interval removal of a right-sided PICC. 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 identified. IMPRESSION: No acute cardiopulmonary process. " feb4c1e6-ed4a056d-7099bf9b-11771dd7-54ff4af4.jpg,validate/p10/p10432096/s56969662/feb4c1e6-ed4a056d-7099bf9b-11771dd7-54ff4af4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ AT 11:23 FINDINGS: Heart size is mildly enlarged. The aortic knob is calcified. Hilar contours are normal. There is no pulmonary vascular congestion. Moderate to large right pleural effusion is present, perhaps slightly increased in size compared to the previous study. There is adjacent right basilar atelectasis. Left lung is clear. No pneumothorax is identified. Mild loss of height of 2 adjacent vertebral bodies in the lower thoracic spine are age indeterminate. IMPRESSION: Moderate to large right pleural effusion with right basilar atelectasis. 2 mild lower thoracic compression deformities, of indeterminate age. " 8a0579a3-035a39ca-84095d79-1c7cc166-63fbca42.jpg,validate/p16/p16377954/s57313441/8a0579a3-035a39ca-84095d79-1c7cc166-63fbca42.jpg,validation," 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. " 9f377011-8d5f4819-c0f09d7c-74e0af50-b6246863.jpg,validate/p13/p13080456/s52300200/9f377011-8d5f4819-c0f09d7c-74e0af50-b6246863.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with gastric cancer, hematemisis, respiratory distress , now intubated with bilateral ronchi throughout: ? ET tube placement, ? new infiltrates concerning for aspiration // ? ET tube placement ? ET tube placement IMPRESSION: In comparison with the study ___ ___, there has been placement of an endotracheal tube with its tip approximately 2.6 cm above the carina. Hazy opacification of the bases with silhouetting the hemidiaphragms is consistent with layering effusion and atelectatic changes. No vascular congestion is appreciated. " bcb7da07-ab488c87-f3e2033b-c238be6a-d00623f2.jpg,validate/p16/p16815189/s59770043/bcb7da07-ab488c87-f3e2033b-c238be6a-d00623f2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with altered mental status // acute cardiopulm disease COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Chronic right rib deformities are again noted. No acute bony injury. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process " 30655655-88aa073e-08309708-7ae24860-2a2aad90.jpg,validate/p12/p12979215/s51208852/30655655-88aa073e-08309708-7ae24860-2a2aad90.jpg,validation," FINAL REPORT INDICATION: History of sarcoidosis and chest pain. COMPARISONS: Chest radiograph, ___. CTA chest, ___. FINDINGS: There is stable prominence of the bilateral hilar regions, more so on the left than the right, and consistent with the patient's known hilar lymphadenopathy. This is not significantly changed from the prior chest radiograph. There is no consolidation, edema, pleural effusion, or pneumothorax. An irregularity of the right posterior sixth rib likely reflects a prior healed fracture. This is unchanged in appearance from the prior exam. IMPRESSION: 1. Stable bilateral mild hilar lymphadenopathy which is compatible with the patient's history of sarcoidosis. 2. Stable appearance of an old right sixth rib fracture. 3. No acute cardiopulmonary process. " c09969ea-fa76b30b-afe5524d-c528d310-c58b0a4c.jpg,validate/p10/p10279030/s57130476/c09969ea-fa76b30b-afe5524d-c528d310-c58b0a4c.jpg,validation," 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. " 6b732f29-70e4922f-a9367b8e-2fb415bc-94cc016f.jpg,validate/p16/p16907073/s54462184/6b732f29-70e4922f-a9367b8e-2fb415bc-94cc016f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with acute onset R sided chest and back pain // any PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is somewhat rotated to the right. Patient is status post median sternotomy.Right lower lobe opacity with blunting of the posterior costophrenic angle is worrisome for pneumonia and pleural effusion. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Right lower lobe opacity worrisome for pneumonia and small pleural effusion. Subtle left base opacity may be due to atelectasis. " 64b0366f-bdd4d677-5ad9de6d-ed03b96a-144395d6.jpg,validate/p18/p18829575/s54099630/64b0366f-bdd4d677-5ad9de6d-ed03b96a-144395d6.jpg,validation," FINAL REPORT CHEST TWO VIEWS ON ___ HISTORY: Bike accident, small apical pneumothorax, followup. FINDINGS: There are no old films available for comparison. There is comminuted left posterior third rib fracture. There is increased pleural opacity in that region, which may represent a small amount of blood. There is subsegmental atelectasis in the left lower lobe. " 3703f13d-a140160b-f1a6382e-c7ba4965-2ddf3d73.jpg,validate/p15/p15225349/s57620523/3703f13d-a140160b-f1a6382e-c7ba4965-2ddf3d73.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with a left pneumothorax and pigtail in place, evaluate for interval change. TECHNIQUE: PA and lateral chest x-ray. COMPARISON: Chest x-ray ___ at 17:59. FINDINGS: There has been interval improvement in the overall size of left pneumothorax. There has been interval decrease in size of the left apical component -- a small residual left apical component remains visible. The left costophrenic angle component is re-demonstrated, compatible with small residual pneumothorax. The retrosternal/medial component adjacent to the mediastinum is much smaller and less conspicuous, nearly resolved. Hydro pneumothoraces are again seen both anteriorly and posteriorly on the lateral view . There is no evidence of shift of mediastinal structures. A left pigtail catheter is in unchanged position along the left chest wall. Small foci of subcutaneous gas along catheter tract are unchanged. The aerated portions of the left lung and the right lung are grossly clear. There is no pulmonary vascular congestion. Small bilateral pleural effusions are unchanged. There is no right pneumothorax. IMPRESSION: 1. Interval near-complete resolution of the apical and retrosternal components of the left pneumothorax. Residual left costophrenic angle small hydropneumothorax, possibly loculated. On the lateral view, components are seen both anteriorly and posteriorly. Left pigtail catheter along the left chest wall is in unchanged, grossly appropriate position. 2. Stable small right pleural effusion. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:08 PM, 5 minutes after discovery of the findings. " c9b8d089-b0437373-64c373c1-c28f412e-870e3452.jpg,validate/p17/p17374016/s54344407/c9b8d089-b0437373-64c373c1-c28f412e-870e3452.jpg,validation," 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 " 9283348a-a0b21725-08d9ff60-45e536f2-49d9de50.jpg,validate/p19/p19860832/s52785472/9283348a-a0b21725-08d9ff60-45e536f2-49d9de50.jpg,validation," FINAL REPORT INDICATION: NG tube placement. COMPARISON: 13:16 earlier today. FINDINGS: A single portable AP chest radiograph was obtained. A nasogastric tube loops in the mid esophagus. Moderate pulmonary edema is unchanged. Left basilar opacity and small effusion are unchanged. A right sided PICC line tip terminates in the mid SVC. IMPRESSION: Persistent coiling of the NG tube in the mid esophagus. Findings were discussed with Dr. ___ ___ telephone at approximately ___ on ___. " d68860c0-d3c91a17-128027fa-369c4618-3fc8c304.jpg,validate/p18/p18221111/s51230316/d68860c0-d3c91a17-128027fa-369c4618-3fc8c304.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, cough, evaluation. COMPARISON: No comparison available at the time of dictation. 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. " 6b2fff84-3329c582-25dd75a4-4b068469-020931f9.jpg,validate/p15/p15233042/s55546456/6b2fff84-3329c582-25dd75a4-4b068469-020931f9.jpg,validation," WET READ: ___ ___ 12:08 PM 1. Mild pulmonary edema. No focal consolidation or mass is seen. Severe cardiomegaly. 2. Fracture median sternotomy wires, with some fragments migrating to the soft tissues from prior exams. WET READ VERSION #___ ___ ___ 11:29 AM Mild to moderate pulmonary edema. No focal consolidation or mass is seen. Moderate cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs with INDICATION: History: ___F with COPD on home O2 now with cough. // pneumonia? TECHNIQUE: AP and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___ FINDINGS: The lungs are well expanded. There is mild pulmonary edema, increased from baseline. No focal consolidation or mass is seen. There is no pleural effusion or pneumothorax. Severe cardiomegaly is seen. Median sternotomy wires are noted, several of which are fractured. Some of the sternal wire fragments are migrating through the soft tissues from prior exams. Mediastinal clips are noted. Hardware is noted in the right proximal humerus. IMPRESSION: 1. Mild pulmonary edema. No focal consolidation or mass is seen. Severe cardiomegaly. 2. Fractured median sternotomy wires, with some fragments migrating to the soft tissues from prior exams. " 4b9a7fd1-0974d454-36fae605-59101ea3-ca309ab8.jpg,validate/p14/p14120635/s52133903/4b9a7fd1-0974d454-36fae605-59101ea3-ca309ab8.jpg,validation," FINAL REPORT INDICATION: ___M with ams // pna? TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: Endotracheal tube tip is 5.5 cm from the carina. Enteric tube passes below the field of view, side-port just past the GE junction. Metallic density projects over the left hilum. Additional bead like metallic density projects over the mid abdomen. Increased interstitial markings are seen throughout the lungs. More dense opacity seen at the left lung base obscuring the descending thoracic aorta. Hazy right basilar opacity is also noted. The cardiac silhouette is enlarged but likely accentuated by technique. No displaced fractures identified. IMPRESSION: Findings suggest pulmonary vascular congestion and cardiomegaly. Left greater than right basilar opacities could be atelectasis although infection or aspiration are not excluded. Metallic densities, projecting over the left hilum, location indeterminate. Apparent jewelry projects over the upper abdomen to be correlated clinically. " b2b836ef-8f9d4035-a63b4f98-9ef819f0-0007b687.jpg,validate/p12/p12190636/s52068645/b2b836ef-8f9d4035-a63b4f98-9ef819f0-0007b687.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with presyncope. COMPARISON: Chest radiograph from ___. FINDINGS: A two-lead pacemaker is noted with wires in appropriate position. Again noted is scarring in the left lower lobe. Otherwise, the lungs are clear with no evidence of consolidation, effusion, or pneumothorax. An ovoid density is again noted projecting over the right anterior fourth rib and stable dating back to ___. Cardiomediastinal silhouette is normal. Multiple compression deformities are again noted throughout the upper and mid thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 3c9ee41e-48121574-d586e370-ceaec873-e46e3cdc.jpg,validate/p12/p12040402/s57965421/3c9ee41e-48121574-d586e370-ceaec873-e46e3cdc.jpg,validation," FINAL REPORT INDICATION: History: ___M with leg swelling // eval for pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ through ___ and CT of the chest dated ___.. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. There is persistent elevation of the right hemidiaphragm. Right hilar opacity and consistent with known lesion in the superior segment of the right lower lobe. Radiation changes are present within the mediastinum. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 45280321-6f1f5b78-5b067bc9-8b4033f5-27697a6d.jpg,validate/p14/p14117743/s57044009/45280321-6f1f5b78-5b067bc9-8b4033f5-27697a6d.jpg,validation," FINAL REPORT Comparison. EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis, pneumonia, new tachypnea s/p extubation // assses for edema/infiltrate assses for edema/infiltrate COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lung volumes have improved since ___, despite interval extubation, explaining some, but probably not all of the apparent improvement in diffuse infiltrative pulmonary abnormality, now relatively mild. Heart size is normal. Pleural effusions are presumed, but not large. Right jugular line ends in the upper SVC. There is no pneumothorax. " bc7ef520-43416f61-637ca5fb-49563249-1274559f.jpg,validate/p10/p10654063/s55653668/bc7ef520-43416f61-637ca5fb-49563249-1274559f.jpg,validation," 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. " 2c184419-b32e0023-d92200f2-744d6429-fd751658.jpg,validate/p16/p16258153/s56346315/2c184419-b32e0023-d92200f2-744d6429-fd751658.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Emergent MVR/CABG. Please ___ ___ at ___ with abnormalities. // FAST TRACK EXTUBATION CARDIAC SURGERY, ?line placement, r/o PTX/Effusion IMPRESSION: As compared to previous radiograph of earlier the same date, tip of intra-aortic balloon pump remains relatively low, terminating 6 cm below the carina. Tip of endotracheal tube is also low, currently terminates of within 1.5 cm of the carina. Pulmonary edema has substantially improved compared to the preoperative radiograph. Right pleural effusion is no longer evident. Hyperlucency along the right hemidiaphragm contour could be projectional or may reflect a small basilar pneumothorax with indwelling chest tube. " 8caaf09d-bce4c5b2-5c7ea1ba-cc63c05a-d50c3119.jpg,validate/p18/p18991067/s51787434/8caaf09d-bce4c5b2-5c7ea1ba-cc63c05a-d50c3119.jpg,validation," FINAL REPORT INDICATION: Cough. Positive PPD. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: A right PICC ends in the low superior vena cava. The lungs are clear without focal opacities, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal IMPRESSION: No acute cardiopulmonary abnormality. Right PICC ends in the low SVC. " dce1792a-16ca24f4-06158b77-ed2631bd-8b36e252.jpg,validate/p14/p14981236/s58430522/dce1792a-16ca24f4-06158b77-ed2631bd-8b36e252.jpg,validation," FINAL REPORT HISTORY: Aortic dissection with repair, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change in the postoperative appearance. Sternal wires are intact and there is again extensive tortuosity of the aorta. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. " 48469c28-c0488416-b6943367-3a1c1285-991f69c4.jpg,validate/p11/p11658675/s54795944/48469c28-c0488416-b6943367-3a1c1285-991f69c4.jpg,validation," FINAL ADDENDUM Left upper extremity PICC line is again noted though the distal tip is poorly seen. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old man with history of COPD with dyspnea. COMPARISON: Prior exam dated ___. FINDINGS: AP upright portable chest radiograph was provided. Increasing bibasilar consolidation is concerning for worsening pneumonia. Underlying emphysema is evident in the upper lobe lucency. The heart size cannot be assessed. IMPRESSION: Worsening opacities in the lower lungs remain concerning for pneumonia. " 33ce9a1d-420a03f5-9c097b48-7ac9d94d-3b4b3357.jpg,validate/p16/p16108772/s55914920/33ce9a1d-420a03f5-9c097b48-7ac9d94d-3b4b3357.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Nausea, vomiting and diarrhea with fever. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral views. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is patchy new left basilar opacity slightly silhouetting the hemidiaphragm on the left; the lateral view in particular depicts a more widespread patchy opacity in the left lower lobe, however, for which atelectasis or pneumonia could be considered. There is no definite effusion or pneumothorax. Moderate-to-severe rightward convex curvature centered along the upper thoracic spine with associated deformities among the chest wall appears similar. IMPRESSION: Increased left lower lobe opacification, but potentially due to atelectasis. Pneumonia or inflammatory process of lower airways could also be considered, however, as potential etiologies. " 82d1cd52-3dd72a31-7d0ec62d-11223ac1-696257a6.jpg,validate/p15/p15127972/s52144627/82d1cd52-3dd72a31-7d0ec62d-11223ac1-696257a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with blodd-tinnued saliva // r/o TB r/o TB IMPRESSION: In comparison with the study ___ ___, the cardiac silhouette remains within normal limits and there is no definite vascular congestion, pleural effusion, or acute focal pneumonia. " 071d4271-11b0e8c5-3a8b59a9-a722b05b-d1ad7d92.jpg,validate/p11/p11098660/s53709780/071d4271-11b0e8c5-3a8b59a9-a722b05b-d1ad7d92.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: AVR and recent history of shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and aortic valve replacement. There is very minimal interstitial edema. No focal consolidation or pleural effusion is seen. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette mildly enlarged. Mediastinal contours are stable. IMPRESSION: Minimal interstitial edema. Persistent mild cardiomegaly. " 54f5530c-e8a3e74a-cb409e0d-550950a3-c9e4c249.jpg,validate/p10/p10535715/s59332684/54f5530c-e8a3e74a-cb409e0d-550950a3-c9e4c249.jpg,validation," WET READ: ___ ___ ___ 8:15 AM Lung volumes are slightly low. Heart size is likely top-normal exaggerated by portable technique. There is bibasilar atelectasis similar to chest CT yesterday. There is no new opacity to suggest pneumonia and no pulmonary edema. WET READ VERSION #___ ___ ___ ___ 10:32 PM Lung volumes are slightly low. Heart size is likely top-normal exaggerated by portable technique. There is bibasilar atelectasis similar to chest CT yesterday. There is no new opacity to suggest pneumonia and no pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulm htn, worsening hypoxia // interval change COMPARISON: Scout radiograph from CT chest 1 day earlier. IMPRESSION: Stable cardiomegaly and tortuosity of the thoracic aorta. Worsening patchy and linear bibasilar opacities which may reflect atelectasis with or without accompanying aspiration. " 0865c4bc-3388b40a-5402f6c7-13f754e3-6df80ce2.jpg,validate/p13/p13834043/s55714655/0865c4bc-3388b40a-5402f6c7-13f754e3-6df80ce2.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with ILI // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low leading to crowding of the bronchovascular structures. Probable left retrocardiac airspace opacity is noted. Left basilar atelectasis is present. No large pneumothorax or pleural effusion. Mild pulmonary edema may be present, though difficult to evaluate given the patient body habitus. Moderate cardiomegaly is present. IMPRESSION: 1. Low lung volumes and limited examination secondary to patient body habitus. Within this limitation, a left retrocardiac airspace opacity may represent pneumonia in the appropriate clinical setting. 2. Moderate cardiomegaly and likely mild pulmonary vascular congestion/edema. " 4acdffa3-3f74bd99-ce491e6e-1de68ad6-51c688e4.jpg,validate/p13/p13907527/s50164156/4acdffa3-3f74bd99-ce491e6e-1de68ad6-51c688e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with SCC of the lung and prior left lung collapse s/p stenting, with more diminished left lung sounds // please assess for lung collapse. COMPARISON: chest radiographs ___ through ___ IMPRESSION: Moderate to large left pleural effusion displacing the mediastinum slightly to the right an obscuring the cardiac borders is no larger today than was on ___. A region of atelectasis obscuring the aortic knob is stable. Right lung is clear. PIC line ends close to the superior cavoatrial junction. No pneumothorax. " 8e17d15b-b8e228d8-65740c5a-49a8e6d7-61a498a4.jpg,validate/p16/p16544972/s56953512/8e17d15b-b8e228d8-65740c5a-49a8e6d7-61a498a4.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain, recent EGD. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is within normal limits. There is no pneumomediastinum. No acute osseous abnormality is detected. No free air seen below the diaphragm. IMPRESSION: Normal chest x-ray. " 39ea14d8-6ff5ad2c-3a1f0b90-e991f589-59661624.jpg,validate/p16/p16565780/s53264944/39ea14d8-6ff5ad2c-3a1f0b90-e991f589-59661624.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough SOB and possible LLL opacity on portable plain film evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___ and outside hospital chest CT dated ___. FINDINGS: Compared with the immediate prior chest radiograph, pulmonary vascular congestion and mild pulmonary edema have improved. Moderate cardiomegaly is unchanged. There is crowding of the infrahilar vessels, compatible with atelectasis, improved compared with a ___. A left hemidiaphragm is not distinctly visible. Blunting of the posterior costophrenic angle is consistent with a small amount of pleural fluid and/or thickening. There is no gross pleural effusion and no pneumothorax, or focal consolidation. Background COPD again noted. The cardiomediastinal contour is stable including cardiomegaly and mild prominence of the pulmonary arteries suggesting pulmonary arterial hypertension. Biapical pleural-parenchymal scarring is similar to the recent prior chest CT. IMPRESSION: 1. Interval improvement in pulmonary vascular congestion and mild pulmonary edema. 2. Small residual pleural fluid and/or thickening and left infrahilar atelectasis again noted. 3. Hyperexpansion suggesting COPD. 4. No focal consolidation NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 10:50 AM, 1 minutes after discovery of the findings. " 95c23dee-ece4c219-8b979e5e-8f0caef5-558198f7.jpg,validate/p11/p11096044/s52910674/95c23dee-ece4c219-8b979e5e-8f0caef5-558198f7.jpg,validation," 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. " c35ef600-57cff8c5-793de140-89b51b5a-dd6b1b7b.jpg,validate/p11/p11403312/s58196800/c35ef600-57cff8c5-793de140-89b51b5a-dd6b1b7b.jpg,validation," FINAL REPORT INDICATION: History: ___F with calcaneal fracture // preop TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Opacity in the left lower lobe appears chronic. There is no pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: Opacity in the left lower lobe appears chronic. " 5f3a7d3a-216a0968-8b6b8fd6-33071c5e-69cb8bf4.jpg,validate/p12/p12449468/s54435944/5f3a7d3a-216a0968-8b6b8fd6-33071c5e-69cb8bf4.jpg,validation," FINAL REPORT HISTORY: Abdominal aortic aneurysm, preoperative assessment. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph, ___ chest CT. FINDINGS: Right-sided Port-A-Cath tip terminates in the upper SVC. The heart size is normal. Mediastinal and hilar contours are unremarkable. 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. " 08555220-baed4c9a-157ce685-dd40d2ef-485db0df.jpg,validate/p16/p16252973/s52412556/08555220-baed4c9a-157ce685-dd40d2ef-485db0df.jpg,validation," FINAL REPORT INDICATION: ___F with CP s/o airbag deployment in MVC // eval acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 3686dc10-b6153f78-837c934e-bedc9109-f5553b12.jpg,validate/p18/p18264198/s52091977/3686dc10-b6153f78-837c934e-bedc9109-f5553b12.jpg,validation," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Multiple prior chest radiographs with the most recent from ___. FINDINGS: Evaluation is limited due to patient body habitus. Lung volumes are low and exaggerate the pulmonary vascular markings. There is mild right basilar and left retrocardiac atelectasis; otherwise, the lungs are clear and without a focal consolidation, effusion, or pneumothorax. A tracheostomy button is noted in the upper trachea. Cardiac silhouette is exaggerated. IMPRESSION: Limited study due to patient body habitus and low lung volumes demonstrates mild bibasilar atelectasis. " 484cc254-62360db0-03cba3cc-f9003cd9-341f0c50.jpg,validate/p11/p11708854/s58186311/484cc254-62360db0-03cba3cc-f9003cd9-341f0c50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chest tube right sided // r/o PTX TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There has been interval placement of right-sided chest tube with marked decrease in the amount of right pleural effusion. There has been partial re-expansion of the right lower lung but there still a substantial amount of volume loss in the right lower lobe and right middle lobe. There is hazy alveolar infiltrate involving the left lower lobe which also has some volume loss. There is no pneumothorax " 0ec377c4-c85637f7-61ae3575-2fec0bd2-b34e73fb.jpg,validate/p14/p14913896/s54353659/0ec377c4-c85637f7-61ae3575-2fec0bd2-b34e73fb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough // ? pna COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Lungs appear hyperinflated with upper lobe lucency suggesting underlying emphysema. Cardiomediastinal silhouette is stable. There is subtle opacity in the lateral right lung base which in the correct clinical setting may represent a very early/mild pneumonia. No large effusion or pneumothorax seen. IMPRESSION: Subtle opacity in the right lateral lung base is concerning for an early pneumonia. " ff156b82-524a2570-530fc9c6-6c2a8693-9278bf0a.jpg,validate/p14/p14019847/s56506986/ff156b82-524a2570-530fc9c6-6c2a8693-9278bf0a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CVA, now intubated post-angio // ? ETT placement ? ETT placement IMPRESSION: No previous images. The tip of the endotracheal tube is approximately 3.5 cm above the carina. Nasogastric tube extends to the upper stomach, where it passes the lower margin of the image. There are low lung volumes that accentuate the enlargement of the transverse diameter of the heart. Mild engorgement of pulmonary vessels is consistent with elevated pulmonary venous pressure. No definite acute focal pneumonia, though this would be difficult to exclude in the appropriate clinical setting, especially in the absence of a lateral view. " ef34a0a6-6fb8db73-8cf93dd4-57d78cd6-dd79332d.jpg,validate/p13/p13551252/s50874073/ef34a0a6-6fb8db73-8cf93dd4-57d78cd6-dd79332d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP) INDICATION: History: ___F with distended abdomen, nausea, vomiting , no bowel movement, history of aspiration pneumonia TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ at 14:07 FINDINGS: Assessment is limited by patient positioning and the patient's head and chin obscuring assessment of the lung apices, more so on the right. Heart size appears unchanged, and top-normal. Elevation of the right hemidiaphragm is chronic with streaky opacity in the right lung base compatible with atelectasis. No gross focal consolidation, pleural effusion or large pneumothorax is identified, but assessment again is limited. There is no pulmonary edema. Percutaneous gastrostomy catheter is seen in the left upper abdomen. Diffuse gaseous distension of bowel loops are seen in the upper abdomen. No acute osseous abnormalities detected. IMPRESSION: Limited assessment due to patient positioning, particularly of the lung apices, more so on the right. Right basilar atelectasis with chronic right hemidiaphragmatic elevation. No other acute cardiopulmonary abnormality grossly identified. Diffuse gaseous distention of bowel loops in the upper abdomen. " aa3812de-99238462-2d6fcce6-806f1d4a-8eddc8de.jpg,validate/p18/p18550032/s51927772/aa3812de-99238462-2d6fcce6-806f1d4a-8eddc8de.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // ett IMPRESSION: IN COMPARISON TO PREVIOUS RADIOGRAPH FROM 1 DAY EARLIER, THERE HAS NOT BEEN A SUBSTANTIAL CHANGE IN THE APPEARANCE OF THE CHEST EXCEPT FOR ADVANCEMENT OF ENDOTRACHEAL TUBE, NOW TERMINATING 5 CM ABOVE THE CARINA. " fb0f616d-fc4fadf6-5bb9f3d7-f6f41725-257493d6.jpg,validate/p19/p19185965/s57788775/fb0f616d-fc4fadf6-5bb9f3d7-f6f41725-257493d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Mr. ___ is a ___ year old man with newly diagnosed metastatic urothelial cancer and innumerable pulmonary metastases on imaging who was admitted with dyspnea and hemoptysis stabilized in___ transferred to OMED for further management, underwent bronch yesterday spiked fever 101 this AM // ?acute interval changes ?PNA COMPARISON: Chest x-ray from ___ at 358 FINDINGS: There are innumerable nodular opacities throughout both lungs, consistent with known metastatic pulmonary nodules. Overall, the appearance is grossly unchanged compared with ___. No obvious new infiltrate is identified. However, the extent of the abnormality makes it difficult to identify a subtle superimposed pneumonic infiltrate or other subtle superimposed opacity. IMPRESSION: As above. " 7965165c-c6a43c99-d66c94e9-c43e0f88-41ca6d58.jpg,validate/p13/p13748721/s55857875/7965165c-c6a43c99-d66c94e9-c43e0f88-41ca6d58.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cough and chest tightness. Cardiac size is top normal. The lungs are clear. There is no pneumothorax or pleural effusion. Mild degenerative changes are in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " f03d490f-0d691445-af7472b0-c2fa1331-3700648f.jpg,validate/p11/p11244468/s50564610/f03d490f-0d691445-af7472b0-c2fa1331-3700648f.jpg,validation," WET READ: ___ ___ 6:51 PM Retracted endotracheal tube now terminates approximately 1.5 cm from the carina. Right IJ central line is unchanged. No pneumothorax or pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent surgery intubated with ETT too deep now pulled back // Eval ETT placement Eval ETT placement IMPRESSION: The patient is intubated. The tip projects approximately 1.5 cm above the carina. The right internal jugular vein catheter is unchanged. Low lung volumes. Mild retrocardiac atelectasis. No pulmonary edema. No pleural effusions. " 2760049e-616df67f-eed54c0d-0df9a77e-ae2677b3.jpg,validate/p17/p17155997/s50544055/2760049e-616df67f-eed54c0d-0df9a77e-ae2677b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ woman with chronic mesenteric ischemia and recent Ao-SMA revision surgery, with chronic bilateral pleural effusions and hospital acquired pneumonia // What is the status of the bilateral pleural effusions? What is the status of the bilateral pleural effusions? IMPRESSION: Comparison to ___. Improvement with decrease in extent and severity of a pre-existing right parenchymal opacity with air bronchograms. Unchanged extensive left retrocardiac atelectasis. Mild fluid overload but no overt pulmonary edema. The right effusion has almost completely resolved. The left effusion is stable. Unchanged position of the left PICC line. " e1da4a14-0f2239c8-2d6bd34b-15652b6a-e36eaf5a.jpg,validate/p15/p15118021/s57464325/e1da4a14-0f2239c8-2d6bd34b-15652b6a-e36eaf5a.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with motor vehicle collision, question fracture or pneumothorax. COMPARISON: Chest radiograph 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. Vertebral body heights are well preserved. No definite rib fractures are noted. IMPRESSION: No acute intrathoracic process. " cf6cde53-8507de9f-260385fc-3b76bc95-8ab47337.jpg,validate/p11/p11718842/s56079607/cf6cde53-8507de9f-260385fc-3b76bc95-8ab47337.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with GI bleed, now status post intubation, check position. FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained seven hours earlier during the same day. The patient has now been intubated, the ETT terminating in the trachea 4 cm above the level of carina. The position is acceptable. Otherwise, no significant interval changes since the next preceding study 5 hours earlier on the same day. No pneumothorax can be identified. Right internal jugular central venous line catheter is in unchanged position. " d2d53563-7e55ae95-826394ee-f1efae1f-53f32984.jpg,validate/p14/p14004013/s51505000/d2d53563-7e55ae95-826394ee-f1efae1f-53f32984.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with recurrent cough. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal lateral chest radiograph demonstrates well expanded and clear lungs. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Visualized osseous structures are unremarkable. IMPRESSION: No findings to explain recurrent cough. " 19afcbb2-27678d76-320e4a44-27e8e75c-8bcdb6c0.jpg,validate/p16/p16447390/s50227519/19afcbb2-27678d76-320e4a44-27e8e75c-8bcdb6c0.jpg,validation," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with right-sided chest pain and cough, assess for infiltrate. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is at the upper limit of normal variation. No typical configurational abnormality is identified. Thoracic aorta of ordinary ___ without evidence of local contour abnormality. The pulmonary vasculature is not congested. On both lung bases there exists some linear densities slightly more on the right than on the left side. These appear to be peripheral atelectasis occurring in a patient with shallow inspiratory activity. Acute parenchymal infiltrates cannot be identified and the lateral and posterior pleural sinuses are free from any major fluid accumulation. No pneumothorax in the apical area. Skeletal structures of the thorax grossly unremarkable. Comparison is made with the next available previous chest examination dated ___; findings are grossly identical. Thus, no evidence of new acute pulmonary processes. " a232ec4a-c9a3be41-9f5fa674-29f922c2-9dedb1c1.jpg,validate/p19/p19914039/s51846636/a232ec4a-c9a3be41-9f5fa674-29f922c2-9dedb1c1.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with shortness of breath. Rule out lung water. IMPRESSION: PA and lateral chest compared to the only prior chest radiograph, ___: Previous mild pulmonary edema has improved. Still dense consolidation in the right mid lung, probably displaced middle lobe. I do know if it is recurrent or chronic pneumonia or a region of chronic scarring. Lesser degree of the same problem is present in the lingula, both of which obscure respective borders of a very large cardiac silhouette. Mediastinal vasculature is not dilated, but both hila are very large. A 23 mm wide nodular opacity projecting over the lower pole of the left hilus could be a tortuous vessel or a small lung mass, and there is a suggestion of small lung nodules elsewhere, such as the mid lungs projecting over the fifth anterior ribs and fourth anterior interspace. Cardiac configuration indicates dominant left atrial enlargement suggesting mitral valve pathology. Pleural effusions are minimal. Dr. ___ ___ was telephoned as requested and I discussed the findings with her. " 28591625-3853c628-c79bab6d-d257fed0-9b6e055f.jpg,validate/p13/p13350579/s55143589/28591625-3853c628-c79bab6d-d257fed0-9b6e055f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with stage I adenocarcinoma after bronchoscopy and stent placement. Evaluate right middle and lower lobe. IMPRESSION: PA and lateral chest compared to chest radiographs since ___, most recently ___ and ___: A bronchial stent is not apparent on conventional chest radiographs. Extent of consolidation in the right lung base has not improved appreciably since ___. Small right pleural effusion is still present. Left upper lung is clear aside from region of new opacification in the lingula, partially obscuring left heart border which could be atelectasis or consolidation. Right PIC line ends in the mid SVC. Heart size is normal. " a2efadce-2c3a89d6-60e3e83d-c259d65a-a4dffece.jpg,validate/p10/p10336855/s50704296/a2efadce-2c3a89d6-60e3e83d-c259d65a-a4dffece.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right MCA stroke // interval changes interval changes IMPRESSION: Comparison to ___. No relevant change. Monitoring and support devices are stable. Minimally increasing areas of atelectasis at the left and right lung bases. No new parenchymal opacities. Moderate cardiomegaly persists. " a7f28322-d106fce6-8ac2a7ce-b8f453da-1c76665c.jpg,validate/p11/p11124675/s51739989/a7f28322-d106fce6-8ac2a7ce-b8f453da-1c76665c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Bilateral opacities, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. There is evidence of widespread bilateral severe parenchymal opacities with diffuse distribution. The opacities are unchanged in severity and extent since several previous radiographs, part of which come from outside hospitals. Unchanged moderate cardiomegaly and retrocardiac atelectasis. " c88a9fd3-92280cb9-b9f2603e-38c5b1d1-58ef3324.jpg,validate/p12/p12729668/s54746015/c88a9fd3-92280cb9-b9f2603e-38c5b1d1-58ef3324.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Desaturation, tachycardia, history of pneumonia. Rule out infectious process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the opacities, diffusely distributed in both lungs, have minimally increased in extent and severity. No interval appearance of new opacities or pleural effusions. Unchanged size of the cardiac silhouette. Unchanged lack of pneumothorax. " 0610ed68-ba948f21-68fdd906-44bea712-3c7064fa.jpg,validate/p11/p11724294/s54538618/0610ed68-ba948f21-68fdd906-44bea712-3c7064fa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with STEMI. S/p balloon pump placement. // Assess IABP placement. IMPRESSION: Since the prior radiograph of a few hours earlier, and intra-aortic balloon pump has been placed, terminating 2.8 cm below the superior aspect of the aortic knob. Endotracheal tube has been placed, terminating 6.9 cm above the Carina, and a nasogastric tube courses below the diaphragm outside of the field of view of the radiograph. Interval worsening of asymmetrical pulmonary edema pattern accompanied by moderate left and small right pleural effusions. " f5d6f41e-af7df608-b8e5e60e-98153117-86de8567.jpg,validate/p16/p16560053/s55871378/f5d6f41e-af7df608-b8e5e60e-98153117-86de8567.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post CABG, evaluation for pneumothorax. FINDINGS: The pneumothorax in the right apex, suspected on the previous radiograph, is now confirmed. The pneumothorax has a diameter of 3.8 cm. There is flattening of the right hemidiaphragm that could be attributed to early tension. Otherwise, unchanged radiograph. At the time of dictation and observation, 4:40 p.m., on ___, the referring physician, ___. ___, was paged for notification. " 0f8bdaf1-149a64dd-3a692bad-ab833a84-d51a2d5b.jpg,validate/p12/p12963966/s53595288/0f8bdaf1-149a64dd-3a692bad-ab833a84-d51a2d5b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with sudden SOB, likely pericarditis, but pls r/p ptx // History: ___M with sudden SOB, likely pericarditis, but pls r/p ptx 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. " c4d1dfc7-b98af940-e2a96706-2dfff20e-ba1a6796.jpg,validate/p17/p17081205/s54518208/c4d1dfc7-b98af940-e2a96706-2dfff20e-ba1a6796.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with upper GI bleeding TECHNIQUE: Upright AP view 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. " 53c81cc4-c384e751-9bf020b9-931034d0-f4ba0d9f.jpg,validate/p12/p12878814/s50167459/53c81cc4-c384e751-9bf020b9-931034d0-f4ba0d9f.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with lymphoma, presenting with fever. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a dialysis catheter with the tip terminating in the low SVC, unchanged compared to ___. The lungs are mildly hyperinflated. The cardiomediastinal silhouette is within normal limits. There is no focal consolidation or pneumothorax. Bilateral small pleural effusions with associated bibasilar subsegmental atelectasis are noted. The visualized upper abdomen is unremarkable. Degenerative changes of the thoracic spine noted. IMPRESSION: 1. Bilateral small pleural effusions with associated bibasilar subsegmental atelectasis. 2. No focal consolidation or pneumothorax. Mildly hyperinflated lungs. " 087ddcca-4589e1f6-bea09283-fe60e618-475b2a23.jpg,validate/p14/p14809018/s51361242/087ddcca-4589e1f6-bea09283-fe60e618-475b2a23.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man s/p AVR/lead placement // eval for effusions TECHNIQUE: Chest: PA Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: New moderate right hydro pneumothorax. Previous pneumomediastinum and pneumopericardium continues to improve. Interval improvement and near resolution of pulmonary edema and vascular congestion. Mild improvement in left base atelectasis. Moderate cardiomegaly unchanged. Median sternotomy wires and epicardial pacer leads unchanged. Interval removal of right IJ sheath. IMPRESSION: Interval removal right IJ sheath. New moderate right hydropneumothorax with small hydro component. Improved pneumomediastinum and bilateral vascular congestion. No pulmonary edema. Mild improvement in left base atelectasis. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 4:05 PM, 10 minutes after discovery of the findings. " 461672b1-db71805f-4ac56ef9-a9afc131-da3beded.jpg,validate/p13/p13903940/s59023791/461672b1-db71805f-4ac56ef9-a9afc131-da3beded.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p extension EVAR now with pleural edema // interval cxr TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal shadow unchanged. Unfolding of the thoracic aorta with associated atherosclerotic changes. Mild increase in pulmonary vascular and peripheral interstitial markings. Left basal atelectasis. Nonspecific soft tissue density seen in the right superior mediastinum. IMPRESSION: Mild interval progression of the pulmonary edema. Left basal atelectasis is unchanged. RECOMMENDATION(S): Nonspecific soft tissue density seen in the right superior mediastinum and correlation with PA radiograph is advised, and if this soft tissue density persists a CT of the chest may be performed. " 46d202b0-4e474ed4-3f77f3ae-abd5708d-6cfcf82a.jpg,validate/p17/p17584398/s50483299/46d202b0-4e474ed4-3f77f3ae-abd5708d-6cfcf82a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with GI bleed, intubated. // ?ET tube placement, ?aspiration PNA ?ET tube placement, ?aspiration PNA IMPRESSION: ET tube tip is 6 cm above the carinal. Heart size and mediastinum are stable. Right PICC line tip is at the level of lower SVC. Left retrocardiac consolidation is unchanged. Mild vascular congestion is unchanged. " e58e6780-d560be2a-e888ba22-3cab30b6-d2ce36a4.jpg,validate/p16/p16742247/s53747478/e58e6780-d560be2a-e888ba22-3cab30b6-d2ce36a4.jpg,validation," 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. " 4d9acf8a-5c929a23-2d727a1f-8080c6d6-46ea1c4e.jpg,validate/p13/p13473848/s51587885/4d9acf8a-5c929a23-2d727a1f-8080c6d6-46ea1c4e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with EtOH intoxication, fell from standing onto R side with +headstrike and +LOC, reporting R rib pain, neck and head pain COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Acute rib fractures involve the right eighth and ninth lateral arch, minimally displaced. There is no pneumothorax or pleural effusion. Lungs are clear. A retrocardiac opacity on the lateral projection may reflect the presence of a hiatal hernia. Cardiomediastinal silhouette appears normal. Clips in the upper abdomen noted. IMPRESSION: Right eighth and ninth rib fractures. Possible hiatal hernia. " 81519ba6-8d7cb2e1-1711d24c-0d43f539-d2181628.jpg,validate/p16/p16508811/s56381590/81519ba6-8d7cb2e1-1711d24c-0d43f539-d2181628.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Right-sided double lumen central venous catheter tip terminates in the proximal right atrium. Heart size is mildly enlarged. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Aeration of the lungs has markedly improved compared to the previous radiograph, with patchy opacities demonstrated in the lung bases, potentially infectious or atelectasis. No pleural effusion or focal consolidation is present. No acute osseous abnormalities detected. IMPRESSION: Patchy opacities in the lung bases may reflect atelectasis however infection is not excluded. " d62b9a1b-5d930604-3a1cbb33-2c9cadb5-d3121603.jpg,validate/p16/p16347969/s50730523/d62b9a1b-5d930604-3a1cbb33-2c9cadb5-d3121603.jpg,validation," 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. " 0e33d461-e1b94dcc-e48ba446-ec878784-62e42467.jpg,validate/p14/p14835908/s53293470/0e33d461-e1b94dcc-e48ba446-ec878784-62e42467.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with flank pain // ? infectious process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Low lung volumes with bibasilar atelectasis. Small opacification at the left base, which is concerning for pneumonia, appreciated on both frontal and lateral radiographs. Moderate enlargement of the cardiac silhouette is new since ___, with cardiomegaly and/or pericardial effusion. No pulmonary edema. No pleural effusion. No pneumothorax. Configuration of the mediastinum at the thoracic inlet with undulation of the trachea could be due to tortuous vessels alone or possible contribution of enlarged right thyroid lobe. IMPRESSION: Likely left lower lobe pneumonia. Suggest repeat chest radiograph electively to document clearing. The region may need to be clarified with chest CT. Note: Abdomen CT performed 3 hr after this examination confirmed enlargement of probable pneumonia, left lower lobe, alternatively very large pulmonary infarct. There is no pericardial effusion. " 041240ae-1271c0bb-83b69eb3-71071c4f-66128b43.jpg,validate/p18/p18930214/s55754264/041240ae-1271c0bb-83b69eb3-71071c4f-66128b43.jpg,validation," FINAL REPORT EXAM: Chest, AP upright portable view. CLINICAL INFORMATION: Dropping hematocrit, status post CABG. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. A right-sided IJ central venous catheter is seen terminating in the mid SVC. There are low lung volumes and bibasilar atelectasis. No overt pulmonary edema is seen. There is no definite focal consolidation or large pleural effusion. " 8e362e4d-d2b42f80-791eb9b2-5620585d-c308a7f3.jpg,validate/p17/p17592232/s54960545/8e362e4d-d2b42f80-791eb9b2-5620585d-c308a7f3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo M with an undefined chronic inflammatory demyelinating polyneuropathy previously on IVIG who presented to ICU with worsening respiratory distress and RLL pneumonia with w/u for weakness. Workup negative to date s/p trach and PEG // interval change, placement of new tubes interval change, placement of new tubes IMPRESSION: In comparison with the study of ___, the endotracheal tube is been removed and a tracheostomy tube is now in place. No evidence of pneumothorax or pneumomediastinum. The enteric tube is been removed. Continued hyperexpansion of the lungs with bibasilar opacifications, more prominent on the left. Although these could reflect atelectasis and pleural fluid, it would be difficult to exclude the possibility of superimposed pneumonia (primarily on the left), especially in the absence of a lateral view. " fb40f6fe-d550ab64-75b06ff1-b3451f7d-d91a5fa9.jpg,validate/p13/p13312184/s56509504/fb40f6fe-d550ab64-75b06ff1-b3451f7d-d91a5fa9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F s/p treatment for ADEM p/w new-onset neuro deficits // ?infection 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. " d04cd36a-8d71589a-9fedef5b-e3dfd309-ac8b6df4.jpg,validate/p13/p13791874/s51511304/d04cd36a-8d71589a-9fedef5b-e3dfd309-ac8b6df4.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough and fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Battery pack overlies the left mid hemithorax. There is blunting of the posterior costophrenic angles which may be due to trace pleural effusion. Mild prominence of the central pulmonary vasculature is stable, suggesting small pulmonary edema. No new focal consolidation is seen. Hilar contours are stable. Cardiac and mediastinal silhouettes are stable. No pneumothorax is seen. IMPRESSION: Trace bilateral pleural effusions and mild pulmonary vascular congestion. " d161df63-47008e05-bbdf173d-258fcf72-37cd6ab5.jpg,validate/p14/p14244279/s54605364/d161df63-47008e05-bbdf173d-258fcf72-37cd6ab5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with chest pain TECHNIQUE: Upright AP view of the chest COMPARISON: ___ FINDINGS: Moderate cardiomegaly is unchanged. The mediastinal and hilar contours are similar. Mild atherosclerotic calcifications are noted at the aortic knob. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is identified. Minimal streaky and linear opacities in the right lung base likely reflect areas of atelectasis. Blunting of the right costophrenic angle likely reflects a small amount of pleural thickening, not changed in the interval. No pneumothorax is seen. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: Patchy right basilar opacity likely reflects atelectasis. Blunting of the right costophrenic angle likely reflects chronic pleural thickening, not changed in the interval. " 7d8c3878-3ae79446-88ef3d4b-8d845ba5-36d8dcd3.jpg,validate/p12/p12462675/s50912324/7d8c3878-3ae79446-88ef3d4b-8d845ba5-36d8dcd3.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with subarachnoid hemorrhage with increasing oxygen requirement. AP radiograph of the chest was compared to ___. The ET tube tip is 5 cm above the carina. The right internal jugular line tip is at the level of mid SVC. Heart size and mediastinum are stable, but there is gradual progression of bibasal opacities concerning for infectious process. No definitive edema demonstrated. " 334a6583-7d369e24-45dc3432-f7147e61-1b04153d.jpg,validate/p11/p11190372/s51201686/334a6583-7d369e24-45dc3432-f7147e61-1b04153d.jpg,validation," FINAL REPORT HISTORY: Cough and pleurisy. COMPARISON: Multiple prior chest radiographs, most recently of ___. 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. " 3ea0cd5d-b6ef4a9d-bd053deb-a611067c-284e4144.jpg,validate/p15/p15000170/s54385701/3ea0cd5d-b6ef4a9d-bd053deb-a611067c-284e4144.jpg,validation," FINAL REPORT INDICATION: History: ___M with epigastric pain // evaluate for pleural effusion or pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ dating back to ___ FINDINGS: Unchanged heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. A 5 mm dense nodule in the left lower lung is unchanged dating back to ___ compatible with a benign nodule. IMPRESSION: No acute process. " 31afabb5-1bab1f87-ced724a1-8ae227f6-6bca4f42.jpg,validate/p11/p11287042/s50657073/31afabb5-1bab1f87-ced724a1-8ae227f6-6bca4f42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with right pleural effusion seen on CT cervical spine, assess for interval change. COMPARISON: PET-CT dated ___. FINDINGS: PA and lateral views of the chest provided. A small right pleural effusion is noted not significantly changed from the prior PET-CT allowing for differences in modality. Otherwise, lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Small right pleural effusion, not significantly changed from prior PET-CT. " bf6c2b82-e6ef8a9a-84e34086-96e9e240-9a32ef2b.jpg,validate/p11/p11344751/s54446367/bf6c2b82-e6ef8a9a-84e34086-96e9e240-9a32ef2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with SOB // ?acute intrapulmonary process ?pulmonary edema TECHNIQUE: Chest single view COMPARISON: 327 IMPRESSION: There has been interval increase in the cardiac silhouette with hazy bilateral vasculature and alveolar edema. There are not bilateral effusions layering posteriorly. The overall impression is that of worsened fluid overload. An underlying infectious infiltrate cannot be excluded. " 89b35132-0d3deba1-3a74036b-cd08ee05-9e89ce2a.jpg,validate/p12/p12393609/s53838014/89b35132-0d3deba1-3a74036b-cd08ee05-9e89ce2a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Monitoring and support devices are constant. Moderate cardiomegaly with mild pulmonary edema. Areas of bilateral atelectasis, left more than right. Minimal bilateral pleural effusions. No newly appeared focal parenchymal opacities suggesting pneumonia. " 3a2619c2-c81db01a-cc6563cb-967b75f6-398a2b34.jpg,validate/p13/p13229615/s59684454/3a2619c2-c81db01a-cc6563cb-967b75f6-398a2b34.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with sob, leukocytosis // eval for pna COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Since the prior exam, there is improved aeration in the lower lungs. Lungs remain hyperinflated and lucent suggesting underlying emphysema. Heart size is suboptimally assessed but appears grossly stable. The mediastinal and hilar configuration is unchanged. There is no pneumothorax or large effusion. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: COPD without superimposed pneumonia. Improved aeration in the lower lungs compared with prior. " ddc9b8f7-beba141d-2b1035b6-ab22777b-5314959d.jpg,validate/p12/p12414328/s50910196/ddc9b8f7-beba141d-2b1035b6-ab22777b-5314959d.jpg,validation," WET READ: ___ ___ 5:41 PM No significant change from prior with LLL consolidation and left pleural effusion in the setting of severe cardiomegaly. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: A ___-year-old woman with left lower lobe consolidation or effusion after asystolic arrest. Evaluate left chest. IMPRESSION: AP and lateral chest compared to ___: Predominant abnormalities in the lower lungs are pleural effusions, small on the left, small to moderate on the right. Left basal atelectasis is secondary. Heart is moderately to severely enlarged chronically. Pulmonary arteries and mediastinal veins are larger caliber today than ___. There is no pulmonary edema and no pneumothorax. " a3aa18f5-c2bc9fb2-0e38b9fb-bbb38554-ccdd9cf7.jpg,validate/p17/p17182076/s53547123/a3aa18f5-c2bc9fb2-0e38b9fb-bbb38554-ccdd9cf7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o throat cancer s/p XRT ___ years ago with chronic stricture J tube dependent with T = 100.9 // Please evaluate for PNA. Please evaluate for PNA. COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lung severely hyperinflated but clear of focal abnormalities. No pneumonia or pulmonary edema, and no pleural effusion. Heart is normal size. Lateral view shows heavy atherosclerotic coronary calcification and calcification at the origin of the head and neck vessels and descending thoracic aorta. Possible aortic valvular calcification is partially obscured. Left upper quadrant tubing is probably a gastric feeding tube, tip at the level of the gastric fundus, but not definitively localized in the absence of a gastric air bubble. " c7a58b90-3712a9dc-eca110b8-5a36006e-74e19ea0.jpg,validate/p18/p18715014/s55520760/c7a58b90-3712a9dc-eca110b8-5a36006e-74e19ea0.jpg,validation," WET READ: ___ ___ ___ 4:53 PM The known metastatic lesion in the right upper lobe is increased, now measuring 4.6 cm compared to 3.4 cm on prior CT. Other known subcentimeter metastatic pulmonary lesions are not well seen on this radiograph. No evidence of pneumonia, pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with fevers on steroids with metatstatic melanoma TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT on ___. FINDINGS: The known dominant metastatic lesion in the right upper lobe is increased, now measuring 4.6 cm compared to 3.4 cm on prior CT. Other known subcentimeter metastatic pulmonary lesions are not well seen on this radiograph. No evidence of pneumonia. No pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: The known dominant metastatic lesion in the right upper lobe is increased, now measuring 4.6 cm compared to 3.4 cm on prior CT. Other known subcentimeter metastatic pulmonary lesions are not well seen on this radiograph. No evidence of pneumonia, pleural effusion or pneumothorax. " d426418a-4645b869-19439276-02bcc6bc-8a1029a4.jpg,validate/p18/p18634175/s51261016/d426418a-4645b869-19439276-02bcc6bc-8a1029a4.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with right rib pain // r/o ptx 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. " a3d994d3-e7792e5f-0228b8f6-4aa3a976-3c06133d.jpg,validate/p16/p16912984/s58422096/a3d994d3-e7792e5f-0228b8f6-4aa3a976-3c06133d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p CABG 5 weeks ago, with cough, wheezing, DOE // Assess for effusion, infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. FINDINGS: Small bilateral left greater than right pleural effusions are new from prior examination. Linear retrocardiac opacity and volume loss are consistent with atelectasis. Postsurgical changes including intact sternotomy wires, surgical clips, and radiopaque device overlying the middle mediastinum are consistent with prior CABG. The right lung is clear. Cardiac borders and mediastinal contours are within normal limits. IMPRESSION: Small bilateral left greater than right pleural effusions are new from prior examination. " 828d54b7-db743bd4-1da06367-bb9a7879-289ca131.jpg,validate/p18/p18590682/s56421003/828d54b7-db743bd4-1da06367-bb9a7879-289ca131.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with chronic obstructive asthma, chronic cough // any change in left lower lobe opacity TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ FINDINGS: There is minimal bibasilar atelectasis. Otherwise, the lungs are free of focal consolidations, pleural effusions or pneumothorax. No evidence of pulmonary edema. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires are unremarkable. A prosthetic aortic valve is re-demonstrated. IMPRESSION: Minimal bibasilar atelectasis. Otherwise, no acute cardiopulmonary process. " 4b48d368-9c817abb-ff521303-d174930a-dcb02481.jpg,validate/p12/p12106204/s54317849/4b48d368-9c817abb-ff521303-d174930a-dcb02481.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with 5-point drop in hematocrit. Evaluate for fluid in the chest cavities. FINDINGS: Comparison is made to previous study from ___. There is a right IJ Cordis, there is a right-sided PICC line. There is endotracheal tube, there is a Dobbhoff tube and a nasogastric tube. These devices are all unchanged in position. There is again seen cardiomegaly, bilateral pleural effusions left greater than right and left retrocardiac opacity. Persistent atelectasis at the right mid and lower lung fields are seen. Overall, there has been no interval change. There are no pneumothoraces. " decdc463-6f228ca4-8bdbb0b4-6221f361-a50531bb.jpg,validate/p19/p19358609/s56123546/decdc463-6f228ca4-8bdbb0b4-6221f361-a50531bb.jpg,validation," 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. " a7e10174-5046b0a5-622618ad-3f7b44a8-8e0492a6.jpg,validate/p16/p16897590/s52450800/a7e10174-5046b0a5-622618ad-3f7b44a8-8e0492a6.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // acute process? TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 56dda552-f30b9731-71e8661e-2bb93e8b-c2f99cca.jpg,validate/p10/p10670085/s58641154/56dda552-f30b9731-71e8661e-2bb93e8b-c2f99cca.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with multiple co-morbidities, recurrent UTIs and recent admission for E. coli bacteremia presenting with choledocholithiasis and mild pancreatitis c/b by anemia and NSTEMI. // evidence of pulmonary edema evidence of pulmonary edema COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Severe cardiomegaly, thickening of the pleural margins, and pulmonary vascular congestion are chronic. There is probably no pulmonary edema or new pleural effusion. " 069f7227-3e4ed340-d251951f-35a2693e-8eb5d55c.jpg,validate/p10/p10104732/s56033097/069f7227-3e4ed340-d251951f-35a2693e-8eb5d55c.jpg,validation," FINAL REPORT HISTORY: HIV, elevated white count, feeling well. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormality seen. IMPRESSION: No acute cardiopulmonary process. " e52687d6-89f8c8fd-3003ff6d-ba481a73-a95ef7a8.jpg,validate/p15/p15619921/s53482439/e52687d6-89f8c8fd-3003ff6d-ba481a73-a95ef7a8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever, and hypotension // eval for infiltrate IMPRESSION: As compared to ___, cardiomediastinal contours are stable. Pulmonary vascular congestion is accompanied by mild to moderate edema. Moderate layering right pleural effusion has apparently increased in size, but positional differences limit comparison. Small left pleural effusion is similar. Persistent left lower lobe and worsening right lower lobe atelectasis and or consolidation, as well as a persistent rounded opacity in the periphery of the left upper lung. " 82a19bfb-6fcb42a8-3dcfa296-d130c783-7517ea54.jpg,validate/p13/p13622559/s54376040/82a19bfb-6fcb42a8-3dcfa296-d130c783-7517ea54.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with AIDS, Dobhoff feeding tube, correct placement. COMPARISON: ___. FINDINGS: Dobhoff tube is curving in the stomach. Right-sided PICC line is at the cavoatrial junction. Bibasilar atelectasis has completely resolved. The lungs are now clear. Mediastinal and cardiac contours are unremarkable. There is no pleural effusion or pneumothorax. CONCLUSION: Dobhoff tube is in the stomach. " 268d235c-885ea9e6-0a9c3c3c-4c733808-4f269655.jpg,validate/p18/p18269439/s57525495/268d235c-885ea9e6-0a9c3c3c-4c733808-4f269655.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Several weeks of cough, shortness of breath, question pneumonia. FINDINGS: PA and lateral views of the chest provided. There is slight elevation of the right hemidiaphragm which is unchanged. Vague linear density at the left lung base is most compatible with atelectasis or scarring. There is no definite sign of pneumonia or CHF. No pleural effusion or pneumothorax. The heart size is grossly stable. Mediastinal contour is unremarkable. The bony structures are intact. IMPRESSION: No definite signs of pneumonia. " aab11394-d901cde3-3e887808-beed1b78-136debd7.jpg,validate/p14/p14258645/s50409115/aab11394-d901cde3-3e887808-beed1b78-136debd7.jpg,validation," FINAL REPORT PATIENT HISTORY: ___-year-old man with pleural effusion, please evaluation. COMPARISON: Exam is compared to chest exam of ___. IMPRESSION: PA and lateral views of the chest show stable extensive bilateral pleural calcification which partially obscures lung parenchyma. No large pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged and mildly enlarged. " 873713d8-ea999a08-b314ad4b-4bcc9ad3-b2fdd487.jpg,validate/p11/p11814438/s57223284/873713d8-ea999a08-b314ad4b-4bcc9ad3-b2fdd487.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and fever. COMPARISON: None available in the ___ system. PA AND LATERAL CHEST RADIOGRAPH: 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. No pneumonia. " 22f62102-b56b5ed5-e3533a24-906acd70-9159487b.jpg,validate/p15/p15967773/s57930556/22f62102-b56b5ed5-e3533a24-906acd70-9159487b.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Status post assault, stab to left back, presenting with shortness of breath. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. There is a moderate-to-large left pneumothorax without definite tension. Left basilar opacities may be due to atelectasis/collapsed lung, although underlying consolidation due to pulmonary hemorrhage is not excluded in this clinical context. Right lung demonstrates low lung volumes without focal consolidation. No large pleural effusion is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is identified. IMPRESSION: Moderate-to-large left pneumothorax without definite signs of tension. The emergency department is aware at 4 p.m. on ___ including Dr. ___. " e5ff93d6-e8a12211-0cf57b57-e32fc039-15f80012.jpg,validate/p17/p17233116/s50588298/e5ff93d6-e8a12211-0cf57b57-e32fc039-15f80012.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain and dysphagia, history of sickle cell. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion or evidence of pneumothorax is seen. There is minimal right base atelectasis. The cardiac and mediastinal silhouettes are unremarkable. The cardiac silhouette is within normal limits. IMPRESSION: Mild basilar atelectasis. No acute cardiopulmonary process. " 9ade5295-a9c731ff-f9883f23-a18cf921-4132c65f.jpg,validate/p18/p18651563/s59122167/9ade5295-a9c731ff-f9883f23-a18cf921-4132c65f.jpg,validation," 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. " bd999c42-d5d26a40-75a3f76b-3a969757-1142665e.jpg,validate/p13/p13138475/s57963331/bd999c42-d5d26a40-75a3f76b-3a969757-1142665e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with Wegeners granulomatosis, intubated. AP radiograph of the chest was reviewed, with a focus on the lower lungs and upper abdomen. The NG tube tip is in the stomach. There is interval improvement of the mediastinal position, consistent with more central position of the heart and mediastinum as well as improvement of the left lung atelectasis, partially imaged. " 6ede3638-7d64c211-2bd8feac-bf09ac63-0c43a07b.jpg,validate/p11/p11566151/s50232549/6ede3638-7d64c211-2bd8feac-bf09ac63-0c43a07b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man with cough x 1 month TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___. FINDINGS: The lungs are hyperinflated and emphysematous. There is no focal lung consolidation. There is large pleural effusion. There is no pneumothorax. A well-circumscribed density projecting over the right cardiophrenic angle demonstrates stability since ___ and is most consistent with a pericardial cyst. There are multiple healed rib fractures on the left. IMPRESSION: 1. Hyperinflated lungs. No focal consolidation. 2. Unchanged right cardiophrenic density, most consistent with a pericardial cyst peer " 9a8ed39d-86149403-685c1082-a6f134d1-11b8e4b8.jpg,validate/p15/p15139909/s52853951/9a8ed39d-86149403-685c1082-a6f134d1-11b8e4b8.jpg,validation," FINAL REPORT INDICATION: History of stage II melanoma. Evaluation of disease status. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: There is a new nodular opacity in the right upper lung. This lesion was not present in ___. The lungs are otherwise clear. The heart size is normal, and the cardiac, hilar, and mediastinal contours are within normal limits. There is mild elevation of the right hemidiaphragm, unchanged. IMPRESSION: New pulmonary nodular opacity. Given this patient's history of melanoma, this is concerning for metastatic disease and CT-Chest is recommended. Findings were added to the critical results dashboard by ___ at 3:27 p.m. on ___. " 70ecd4c6-f76bee83-00e33416-7bce2ca0-95211525.jpg,validate/p10/p10062617/s55170181/70ecd4c6-f76bee83-00e33416-7bce2ca0-95211525.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with confusion per family TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Assessment of the lung apices is somewhat limited by the patient's neck and chin projecting over these areas. A left-sided pacer device is noted with leads terminating in the right atrium and right ventricle. Moderate cardiomegaly is re- demonstrated with a left ventricular predominance. The aorta is diffusely calcified and tortuous. Mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Patchy opacities are demonstrated within the right lung base, along with streaky retrocardiac opacity. No pleural effusion or pneumothorax is clearly noted. Moderate to severe degenerative changes of the thoracic spine are present along with chronic compression deformity of a mid thoracic vertebral body. IMPRESSION: Limited assessment of the lung apices. Patchy opacities in the right lung base may reflect infection or aspiration in the correct clinical setting. Streaky retrocardiac atelectasis. " 744969c5-ffb740ce-041a6439-166b82e6-5d3bd99f.jpg,validate/p11/p11541295/s59546593/744969c5-ffb740ce-041a6439-166b82e6-5d3bd99f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chronic cough x 3 months, LAD // masses, pneumonia, masses, pneumonia, IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion. There is no pneumothorax " ae7e219a-cd765c73-55af754b-44333479-5d15c35b.jpg,validate/p11/p11064674/s52991042/ae7e219a-cd765c73-55af754b-44333479-5d15c35b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Questionable infection. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. There is mild overinflation and non-characteristic scarring, predominantly in both lower lobes and the bases of the right upper lobe. However, no acute changes are seen, in particular there is no evidence of pneumonia or larger pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " 140a19ff-75f04c05-ed208039-99748e4c-bd6d2d4f.jpg,validate/p10/p10078480/s55492778/140a19ff-75f04c05-ed208039-99748e4c-bd6d2d4f.jpg,validation," WET READ: ___ ___ ___ 7:49 PM No acute cardiopulmonary process. Mild to moderate anterior wedging of a lower thoracic vertebral body new since ___, of indeterminate age, but likely present on MRI from ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with ruq pain // ?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. There is stable right paratracheal opacity without indentation on the trachea which may be due to vascular structures. There is mild-to-moderate anterior wedging of a vertebral body at the thoracolumbar junction, new since ___, but of otherwise indeterminate age, however likely present on MRI of from ___. IMPRESSION: No acute cardiopulmonary process. Mild to moderate anterior wedging of a lower thoracic vertebral body new since ___, of indeterminate age, but likely present on MRI from ___. " f8d55772-2b247d07-bd2a4091-cd9603ea-f3acc97b.jpg,validate/p17/p17800072/s57421045/f8d55772-2b247d07-bd2a4091-cd9603ea-f3acc97b.jpg,validation," WET READ: ___ ___ ___ 8:12 PM The NG tube is in the stomach although the proximal weighted portion is near the GE junction and could be advanced 5-6 cm to place the entire portion in the stomach if desired. Bibasilar interstitial opacities persist particularly at the bases and could reflect atelectasis. There is no cardiomegaly. There is no pleural effusion or pneumothorax. ______________________________________________________________________________ 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. The side port is at the GE junction and should be advanced at least 6 cm for more standard position. Cardiac size is normal. Bibasilar opacities are consistent with atelectasis. There is no pneumothorax or pleural effusion. " f834a63d-bdcd3d6a-6a87cf3f-a7a890c2-5cda7d0e.jpg,validate/p14/p14319319/s59650920/f834a63d-bdcd3d6a-6a87cf3f-a7a890c2-5cda7d0e.jpg,validation," FINAL REPORT INDICATION: ___M with AMS // bleed? infiltrate? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. No displaced rib fracture. IMPRESSION: No acute process. " ba9c8531-a7ed450e-a779809a-361a6cfd-2bf2fba2.jpg,validate/p17/p17561108/s58241593/ba9c8531-a7ed450e-a779809a-361a6cfd-2bf2fba2.jpg,validation," FINAL REPORT PORTABLE CHEST FROM ___ AT 8:19am CLINICAL INDICATION: ___ year old with questionable chemo-pneumonitis with ground-glass opacities, postop day 1 status post VATS of right upper lobe wedge biopsy, assess for interval change. Comparison is made to the patient's prior study of ___ at 14:14. A portable upright chest film ___ at 8:19am is submitted. IMPRESSION: 1. Right-sided Port-A-Cath and right chest tube are unchanged in position, although the side port projects over the lateral thoracic ribcage. No pneumothorax is seen. There has been interval improvement with residual mild interstitial edema. Postoperative changes in the right upper lung are again seen. Heart remains enlarged status post median sternotomy with aortic valve replacement. " f9a02507-8822e941-d8441c25-2326f7c8-26418a7a.jpg,validate/p17/p17537809/s51456096/f9a02507-8822e941-d8441c25-2326f7c8-26418a7a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. There is new focal consolidation identified in the left upper lobe compatible with pneumonia. The lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Left upper lobe consolidation compatible with pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. " d3a7c41a-4c4fef2d-9ecb8966-57c0f186-d503c6ec.jpg,validate/p15/p15395644/s53215700/d3a7c41a-4c4fef2d-9ecb8966-57c0f186-d503c6ec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p tvring/ AVR/ CABG // eval for effusion eval for effusion IMPRESSION: In comparison with the study of ___, the widening of the mediastinum is much less prominent. The monitoring and support devices are unchanged and there is no evidence of pneumothorax. The increased opacification in the right mid zone, which could reflect loculated fluid and a fissure, is less prominent on the current study. " 5a0a8d72-9f5cdb38-bf55ceaf-04f44d6b-fd64a78b.jpg,validate/p16/p16385283/s52706189/5a0a8d72-9f5cdb38-bf55ceaf-04f44d6b-fd64a78b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PNA, s/p intubation // eval for infiltrates eval for infiltrates IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. An the degree of pulmonary edema appears to have decreased. There has been some improvement in the bibasilar opacifications consistent with pleural effusion and underlying compressive atelectasis. " 72401497-84347d43-19d2eedb-e0dce07d-21592581.jpg,validate/p11/p11184688/s59518051/72401497-84347d43-19d2eedb-e0dce07d-21592581.jpg,validation," FINAL REPORT INDICATION: Low oxygen saturations. Evaluate for edema. TECHNIQUE: Single upright AP view of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Since the prior exam, there has been development of new moderate pulmonary edema. A retrocardiac opacity likely represents atelectasis. There is no definite pleural effusion, though a small left one cannot be excluded due to obscuration of the left costophrenic angle by the heart. There is no pneumothorax. The mediastinal contours are normal. The heart is severely enlarged, and unchanged from the prior exam. A left-sided pacemaker is unchanged. IMPRESSION: Moderate pulmonary edema and severe cardiomegaly. " cc6f25bc-2bcad5e4-332dcbc7-4b1c83d0-b65d10f8.jpg,validate/p14/p14146097/s59488820/cc6f25bc-2bcad5e4-332dcbc7-4b1c83d0-b65d10f8.jpg,validation," FINAL REPORT INDICATION: ___ year old woman preop for debridement // Please assess for acute pathology Surg: ___ (debridement) TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph from ___, ___. FINDINGS: The lungs are well-expanded. Persistent elevation of the left hemidiaphragm with adjacent atelectasis is unchanged. Mediastinal contours and cardiac borders are normal. Right hilar scarring is stable. Serpiginous opacities in the right upper lung and left axilla appear unchanged, likely representing soft tissue calcifications. No pleural effusion. IMPRESSION: No acute cardiopulmonary process. " ebd92479-b98bf205-e071e85e-b212b2d3-3deb0827.jpg,validate/p17/p17784248/s50684465/ebd92479-b98bf205-e071e85e-b212b2d3-3deb0827.jpg,validation," WET READ: ___ ___ ___ 4:10 AM 1. Moderate interstitial pulmonary edema. 2. Probable small bilateral pleural effusions. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with sob, cough // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Surgical clips are seen within the left axilla. There is stable scarring at the left apex. Lungs are hyperinflated. There is vascular engorgement and moderate interstitial pulmonary edema, which is new. Probable small bilateral pleural effusions. Stable cardiomegaly. No pneumothorax. There are no acute osseous abnormalities. IMPRESSION: 1. Moderate interstitial pulmonary edema. 2. Probable small bilateral pleural effusions. " 5b96d924-59acd345-2210561a-7b7059d6-bf2f7121.jpg,validate/p19/p19822093/s50892056/5b96d924-59acd345-2210561a-7b7059d6-bf2f7121.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with altered mental status, left foot ulcers TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. A coronary artery stent is noted. Mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 4e525bff-6a9ad0f2-f2336837-d7ad1a28-bb0df19f.jpg,validate/p13/p13379136/s51097867/4e525bff-6a9ad0f2-f2336837-d7ad1a28-bb0df19f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Chest pain, shortness of breath and cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Cardiac silhouette size is normal. The aorta is tortuous. Mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Streaky opacities in the lung bases likely reflect atelectasis. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Streaky bibasilar opacities, most reflective of atelectasis. " 7dd07ab4-67761ab5-45ed10d4-f47154e8-366c5e50.jpg,validate/p13/p13992060/s58991215/7dd07ab4-67761ab5-45ed10d4-f47154e8-366c5e50.jpg,validation," FINAL REPORT INDICATION: ___ year old man with kidney transplant // interval change TECHNIQUE: Single portable semi upright view of the chest. COMPARISON: Prior radiographs, most recently ___ FINDINGS: Right IJ central venous catheter is at the cavoatrial junction. Lung volumes remain low. There is no focal consolidation or pleural effusion. No pneumothorax. IMPRESSION: No relevant change compared to the prior examination. Persistent low lung volumes and mild basal atelectasis. " c9653d34-6c277e9f-c5db654b-4aaf0b9c-b77e8c33.jpg,validate/p19/p19497735/s55352183/c9653d34-6c277e9f-c5db654b-4aaf0b9c-b77e8c33.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cholangiocarcinoma, now w/ fever // evaluate for interval change, infiltrate TECHNIQUE: Single frontal view of the chest COMPARISON: Portable chest x-ray ___ FINDINGS: There is a persistent opacity at the right lung base likely a combination a pleural effusion atelectasis however, in the absence of a lateral view, pneumonia cannot be excluded in the appropriate clinical setting. There is a small left pleural effusion. Stable moderate pulmonary vascular congestion. Mild cardiomegaly is stable. Mediastinal widening is stable. Right Port-A-Cath terminates in the low SVC. There is no pneumothorax. IMPRESSION: Persistent opacity at the right lung base likely combination pleural effusion and atelectasis however, in the absence of a lateral view, pneumonia cannot be excluded in the appropriate clinical setting. " 7523c896-4c24c853-f6cd4760-ad4e6009-fcae1ab1.jpg,validate/p10/p10550621/s59880459/7523c896-4c24c853-f6cd4760-ad4e6009-fcae1ab1.jpg,validation," 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. " b4ac7e0b-19dfecf8-f5f3f99f-166ce6f0-45c2fcb5.jpg,validate/p16/p16635089/s59096505/b4ac7e0b-19dfecf8-f5f3f99f-166ce6f0-45c2fcb5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with ___, leukocytosis TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Heart size is mildly enlarged, unchanged. Mediastinal and hilar contours are within normal limits. There is minimal upper zone vascular redistribution, but the previously noted pattern of pulmonary edema has resolved. Minimal atelectasis is noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is present. Multiple calcified vessels are seen within the supraclavicular regions. No acute osseous abnormality is detected. IMPRESSION: No radiographic evidence for pneumonia. " 5c65dac4-4186f068-e8428ecc-a1a66895-8f34d77c.jpg,validate/p13/p13648633/s52615316/5c65dac4-4186f068-e8428ecc-a1a66895-8f34d77c.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Fever. Cardiac size is top normal. Irregular consolidation in the left lower lobe is consistent with pneumonia. right central catheter tip is in the cavoatrial junction. There is no pneumothorax or pleural effusion. Enlargement of the hila bilaterally is due to lymphadenopathy. IMPRESSION: Left lower lobe pneumonia and hilar lymphadenopathy. Findings were discussed with Dr. ___ by phone on ___ at 11:21 a.m., 5 minutes after the discovery of the findings. " 3d64b397-8d33879d-b3873e1d-4d40dc54-36704d18.jpg,validate/p14/p14828203/s50809428/3d64b397-8d33879d-b3873e1d-4d40dc54-36704d18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, fever. Evaluate for pneumonia. COMPARISON: Chest radiographs from ___. FINDINGS: Support Devices: None. There are multifocal bilateral airspace opacities. There is no pneumothorax or pleural effusion. The hilar and cardiomediastinal contours are normal. Pulmonary vascularity is normal. There has been minimal interval progression of an upper thoracic vertebra compression fracture. IMPRESSION: Bilateral airspace opacities concerning for multifocal pneumonia. Posttreatment radiographs to complete resolution is recommended. " edaf8747-295977eb-587dea6e-a801f3e7-e0daa27e.jpg,validate/p19/p19699616/s52768856/edaf8747-295977eb-587dea6e-a801f3e7-e0daa27e.jpg,validation," FINAL REPORT HISTORY: Chest tube removal with pneumothorax. FINDINGS: In comparison with the study of ___, there again is a small left apical pneumothorax. The retrocardiac opacification may be more prominent, though some of this could be due to the relatively low lung volumes rather than worsening atelectasis and effusion. Mild atelectatic changes are seen at the right base. " 32ded0b9-1c7dc4d9-43e55354-5c5fe99d-81793718.jpg,validate/p14/p14311395/s53780745/32ded0b9-1c7dc4d9-43e55354-5c5fe99d-81793718.jpg,validation," FINAL REPORT INDICATION: Fall with right knee swelling, dyspnea and cough. TECHNIQUE: Two views of the chest. COMPARISON: None available. FINDINGS AND IMPRESSION: No focal opacity to suggest pneumonia is seen. No pleural effusion, pulmonary edema or pneumothorax is present. Incidental note is made of an azygos fissure. The heart size is top normal. There is some tortuosity of the aorta. " 65ce22f2-6bd4b309-c527e374-4642ac74-3234b3cf.jpg,validate/p19/p19143018/s54611795/65ce22f2-6bd4b309-c527e374-4642ac74-3234b3cf.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with shortness of breath and chest pain. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: A portable supine frontal chest radiograph demonstrates an endotracheal tube terminating in the mid thoracic trachea. The cardiomediastinal silhouette is normal, allowing for a exaggeration of the cardiac silhouette related to low lung volumes. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 243b6ab6-852df397-f5ff5767-eae65280-59287e37.jpg,validate/p11/p11014799/s58220507/243b6ab6-852df397-f5ff5767-eae65280-59287e37.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ___ years of DOE // ?lung disease ?lung disease IMPRESSION: No previous images. The cardiac silhouette is at the upper limits of normal in size. There is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Of incidental note are several old healed rib " 5354cade-fac600a7-b81abd8b-d3e838cb-8e819ad4.jpg,validate/p10/p10216097/s50082130/5354cade-fac600a7-b81abd8b-d3e838cb-8e819ad4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with large right pleural effusion s/p ___fr pigtail placement // ? PTX ? PTX IMPRESSION: In comparison with the study of ___, there has been placement of a pigtail catheter at the right base with removal of some of pleural fluid. No evidence of pneumothorax. Some residual opacification is consistent with pleural fluid and volume loss in the lower lungs. Cardiac silhouette is prominent and there is some indistinctness of pulmonary vessels suggesting some underlying vascular congestion. " 85be6b1a-0fc7eceb-30850bd4-571c49d5-18db480b.jpg,validate/p10/p10576601/s54587673/85be6b1a-0fc7eceb-30850bd4-571c49d5-18db480b.jpg,validation," 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. " a4164d91-9011ef07-204898b8-4d6ef895-a51e18af.jpg,validate/p11/p11690442/s52400358/a4164d91-9011ef07-204898b8-4d6ef895-a51e18af.jpg,validation," FINAL REPORT AP CHEST, 10:35 A.M., ___ HISTORY: ___-year-old man with past medical history of pericarditis and asthma transferred with three days of chest pain and elevated troponins. EKG suggests pericarditis. Evaluate for effusions. IMPRESSION: Normal heart, lungs, hila, mediastinum and pleural surfaces. No radiographic change since ___. No evidence of elevated central venous, pulmonary venous or pulmonary arterial pressure. " 918baac2-05f8e33c-0da9f2ee-f4872c31-eb0badd7.jpg,validate/p10/p10233307/s53705691/918baac2-05f8e33c-0da9f2ee-f4872c31-eb0badd7.jpg,validation," WET READ: ___ ___ ___ 7:59 AM Endotracheal tube terminates in the mid thoracic trachea. Nasogastric tube terminates in the left upper quadrant. Lungs are underinflated but clear. Heart size is mildly enlarged. No pleural effusion or pneumothorax. WET READ VERSION #1 ___ ___ ___ 8:50 PM Endotracheal tube terminates in the mid thoracic trachea. Nasogastric tube terminates in the left upper quadrant. Lungs are underinflated but clear. Heart size is mildly enlarged. No pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT - please eval for placement // ETT placement ETT placement IMPRESSION: In comparison with the study of ___, there again are low lung volumes with enlargement of the cardiac silhouette but no vascular congestion or acute focal pneumonia. Endotracheal tube tip lies approximately 3.5 cm above the carina. Nasogastric tube extends to at least the upper stomach, where it crosses the lower margin of the image. " 61c1fdf1-188c24e0-3d07d8eb-a40e6d49-db8a51f0.jpg,validate/p14/p14325448/s57180216/61c1fdf1-188c24e0-3d07d8eb-a40e6d49-db8a51f0.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with femur fracture. Preoperative evaluation. COMPARISON: Multiple prior chest radiographs, most recent on ___. TECHNIQUE: Frontal upright chest radiograph. FINDINGS: The lungs are well expanded. There has been a significant interval improvement of bilateral alveolar opacities present on ___. There are some residual streaky opacities in the retrocardiac space which are likely from atelectasis. No pleural effusions are identified. Previous blunting of the right cardiophrenic angle has completely resolved. There is no pneumothorax. Of note, there is an unusual curvilinear opacity tracking along the right margin of the mediastinum of unclear significance. There might be mild cardiomegaly, although assessment is limited in this AP exam. An old posterior rib fracture of the left sixth rib is present. IMPRESSION: 1. Unusual curvilinear opacity tracking along the right margin of the mediastinum of unclear significance. Dedicated PA and lateral radiographs are recommended for better assessment. 2. Mild left basilar atelectasis. Otherwise, no evidence of acute cardiopulmonary process. The recommendation in item 1 of the Impression was communicated by Dr ___ to Dr ___ ___ phone on ___ at 8:50 am after review of the results with the attending. " ca532b4d-54add08d-c3c5f2bc-f3d2d47f-9b023541.jpg,validate/p14/p14495609/s55607621/ca532b4d-54add08d-c3c5f2bc-f3d2d47f-9b023541.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been no significant interval change. Minimal basilar atelectasis is seen. Left nipple shadows are incidentally noted. There is no new focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No significant interval change. No acute cardiopulmonary process. " 8e67971a-c7fc2bd5-1a938aca-a768ee9c-6e9e86b2.jpg,validate/p10/p10459005/s53624559/8e67971a-c7fc2bd5-1a938aca-a768ee9c-6e9e86b2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CHF, shortness of breath, weight gain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy, CABG, and left-sided AICD placement with leads terminating in the regions of the right atrium and right ventricle. Moderate cardiomegaly is unchanged. There is mild pulmonary vascular congestion, new in the interval. No focal consolidation, pleural effusion or pneumothorax is present. Mild atelectasis is noted in the lung bases. There are moderate multilevel degenerative changes in the thoracic spine. IMPRESSION: Moderate cardiomegaly with mild pulmonary vascular congestion. " 907eba60-324b06f4-5b1f7cf3-577c64a8-efb407cf.jpg,validate/p18/p18809552/s54414086/907eba60-324b06f4-5b1f7cf3-577c64a8-efb407cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p CABG // f/u effusions, atx TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest radiographs ___ FINDINGS: Lung volumes remain low. There are bilateral small pleural effusions with associated atelectasis. Superimposed infection cannot be excluded. Even allowing for the projection, the heart is enlarged. There is prominence of pulmonary vasculature consistent with mild pulmonary vascular congestion but no frank pulmonary edema. Left lower lobe atelectasis. No pneumothorax seen. IMPRESSION: Small bilateral pleural effusions are similar in degree when compared to the prior study. " d41e7f3d-fc99fa03-f2c72996-3421464a-0a2ea4a8.jpg,validate/p12/p12210632/s56592428/d41e7f3d-fc99fa03-f2c72996-3421464a-0a2ea4a8.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. STUDY: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 4ea161d6-2c2a5719-98015d69-6e1b97a1-384b615e.jpg,validate/p13/p13312176/s58913216/4ea161d6-2c2a5719-98015d69-6e1b97a1-384b615e.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with confusion and tachycardia. Evaluate for cardiopulmonary process. 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 intrathoracic process. " 182cef3d-e6bed28d-da791113-badd001e-3335f081.jpg,validate/p17/p17571919/s50059627/182cef3d-e6bed28d-da791113-badd001e-3335f081.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with perforated appendicitis // please check lines/tubes TECHNIQUE: Single frontal view of the chest COMPARISON: ___ abdomen CT FINDINGS: Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. ET tube is in standard position. NG tube tip is in the stomach IMPRESSION: No acute cardiopulmonary abnormality " 17afcfba-dedab343-935103f5-6256e0a9-2bc7bd58.jpg,validate/p17/p17316172/s50655133/17afcfba-dedab343-935103f5-6256e0a9-2bc7bd58.jpg,validation," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH OF ___. COMPARISON: ___, ___, ___ chest radiographs. FINDINGS: New bilateral, relatively symmetrical perihilar and basilar ground-glass and reticular opacities are present, with some apparent associated bronchial wall thickening. Lung volumes are increased, in keeping with history of COPD. Heart size and mediastinal contours are within normal limits and without change. Bilateral hilar prominence persists, left greater than right, similar to baseline CXR of ___. There are no acute skeletal abnormalities. IMPRESSION: New perihilar and basilar ground-glass and reticular opacities with associated bronchial wall thickening. In the setting of significant immunosuppression, pneumocystis pneumonia should be strongly considered. However, a community-acquired, atypical pneumonia could produce a similar imaging pattern. Followup chest radiographs are recommended in ___ weeks to document resolution. Findings discussed with Dr. ___ by telephone at 2 p.m. on ___. " 24567192-42002ef8-9952ca7c-18042fb5-527cbe19.jpg,validate/p10/p10165672/s51586829/24567192-42002ef8-9952ca7c-18042fb5-527cbe19.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with chest pain // evaluate for pneumonia, pulmonary edema, acute process COMPARISON: ___ FINDINGS: Upright views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Heart size is top-normal. Imaged osseous structures are intact. IMPRESSION: No acute intrathoracic process. " 8c42bab0-af6b6352-75da4f7d-2abc3376-be66eeac.jpg,validate/p11/p11846160/s51470484/8c42bab0-af6b6352-75da4f7d-2abc3376-be66eeac.jpg,validation," 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 ___. " 26a1b0b6-ba0b0c35-783973f7-f590bc29-37428115.jpg,validate/p18/p18044793/s59215603/26a1b0b6-ba0b0c35-783973f7-f590bc29-37428115.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p fall with polytrauma // ? interval change, please do on AM ICU rounds ? interval change, please do on AM ICU rounds COMPARISON: Comparison to ___ at 16:17 FINDINGS: Portable semi-erect chest film ___ at 05:38 is submitted. IMPRESSION: Right subclavian central line, endotracheal tube, nasogastric tube, and right chest tube are unchanged in position. Lung volumes remain low with streaky opacities at both bases likely reflecting atelectasis. There is been decrease in the amount of right lateral chest wall subcutaneous emphysema, although there is now lucency within the right paratracheal region which may reflect pneumomediastinum or possibly a loculated medial pneumothorax. This can be better assessed on followup imaging. No pulmonary edema. " 71f3dc28-571dec68-67ce10b6-eed48aff-89ee2969.jpg,validate/p19/p19398915/s55684761/71f3dc28-571dec68-67ce10b6-eed48aff-89ee2969.jpg,validation," FINAL REPORT HISTORY: Cirrhosis and hepatic hydrothorax. Evaluate for interval change. COMPARISON: Multiple chest radiographs dating back to ___, the most recent on ___. FINDINGS: A portable frontal chest radiograph was obtained, demonstrating low lung volumes. Allowing for apical lordotic projection and lower lung volumes, there is likely no change in the moderate to large right pleural effusion and left lower lung opacities. The remainder of the exam is unchanged. IMPRESSION: Allowing for apical lordotic projection and lower lung volumes, there is likely no change in the moderate to large right pleural effusion and left lower lung opacities. " 7114583a-2117bb02-9b0e3806-486f7a90-71dae542.jpg,validate/p14/p14740322/s54962855/7114583a-2117bb02-9b0e3806-486f7a90-71dae542.jpg,validation," FINAL REPORT 5 images are provided. On the fifth image, the nasogastric tube is securely positioned in the stomach, with the tip projecting over the middle parts of the stomach. No complications. " bc5c7c33-1986ffdf-5c3318b0-6ca5ef23-482462a7.jpg,validate/p13/p13397741/s55956085/bc5c7c33-1986ffdf-5c3318b0-6ca5ef23-482462a7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Resolved complete heart block, assess pneumonia or fluid overload. FINDINGS: PA and lateral views of the chest were provided. There are small bilateral pleural effusions. Mild interstitial edema is noted. The heart is normal in size. Mediastinal contour is normal. Upper lobe lucency within the lungs may indicate underlying emphysema. Bony structures intact. IMPRESSION: Tiny effusions, probable mild pulmonary edema. Emphysema. " 63efbf97-29cf479b-2cae809f-626084cf-1ae41883.jpg,validate/p12/p12509843/s59323074/63efbf97-29cf479b-2cae809f-626084cf-1ae41883.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: The patient is status post massive volume resuscitation. Comparison is made with prior study, ___. Moderate-to-severe cardiomegaly is stable. ET tube is in standard position. NG tube tip is out of view below the diaphragm. Right PICC tip is in the mid SVC. Vascular congestion has improved. Left lower lobe opacities are a combination of small effusion and atelectasis, unchanged from prior study. " 1c73ce22-bfb48b29-d50a7f8d-eab1ada8-1c7c1681.jpg,validate/p14/p14189406/s52242143/1c73ce22-bfb48b29-d50a7f8d-eab1ada8-1c7c1681.jpg,validation," FINAL REPORT HISTORY: Chills. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: ___. FINDINGS: Elevation of the right hemidiaphragm is unchanged, with adjacent linear opacity in the right lung base compatible subsegmental atelectasis. The heart size is normal. Mild atherosclerotic calcification of the aortic arch is re- demonstrated. The mediastinal and hilar contours are unremarkable. Previously noted right PICC has been removed. Left lung is clear, and there is no pulmonary vascular congestion. No pneumothorax or pleural effusion is identified. No acute osseous abnormalities demonstrated. IMPRESSION: No radiographic evidence for pneumonia. Chronic elevation of the right hemidiaphragm with adjacent right basilar linear atelectasis. " 096a33e8-cefd73b7-2c5a54d2-8ecb9ad4-a51425a8.jpg,validate/p19/p19209268/s57935248/096a33e8-cefd73b7-2c5a54d2-8ecb9ad4-a51425a8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with stage IV pancreatic adenocarcinoma presenting with worsening abd pain, weakness, loss of appetite // Eval port-a-cath placement TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: A right Port-A-Cath is seen, terminating in the low SVC/ cavoatrial junction. There is mild elevation of the right hemidiaphragm. The cardiac silhouette is not enlarged. Mediastinal contours are unremarkable. There are perihilar opacities which may be due to pulmonary edema, infection not excluded in the appropriate clinical setting. No pleural effusion or pneumothorax. IMPRESSION: Right Port-A-Cath terminates in the low SVC/ cavoatrial junction. Elevated right hemidiaphragm. Perihilar opacities could be due to pulmonary edema and/ or infection. " 6f218afd-cc50daaf-14f05ab9-97083bbb-42a2862b.jpg,validate/p16/p16441183/s50577475/6f218afd-cc50daaf-14f05ab9-97083bbb-42a2862b.jpg,validation," FINAL REPORT INDICATION: Evaluate adjusted right subclavian and endotracheal tubes. COMPARISON: Study performed earlier the same day. SEMI-UPRIGHT PORTABLE CHEST: The endotracheal tube has been withdrawn, now terminating approximately 2.5 cm from the carina. Right subclavian line has also been slightly withdrawn, now in the region of the upper right atrium/cavoatrial junction. Nasogastric tube again passes into the stomach, but a persistent coil of tubing is seen projecting over the neck, suggesting that it is coiled in the hypopharynx. Lung volumes are low. Basilar atelectasis persists. No new focal opacity, and no effusion or pneumothorax. Findings discussed with Dr. ___ at noon on ___ by Dr. ___ ___ phone. " a3d8204c-0527a58a-96bb6cd9-32a9a114-5348a08c.jpg,validate/p14/p14470386/s59972183/a3d8204c-0527a58a-96bb6cd9-32a9a114-5348a08c.jpg,validation," FINAL REPORT HISTORY: Seizure, evaluation for aspiration. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hypoinflated and exaggerated pulmonary vascular markings. There are new increased left basilar opacities which may represent atelectasis or aspiration in this clinical setting. The lungs are otherwise clear. The cardiac and mediastinal contours are normal. There is no pleural effusion or pneumothorax. No acute fractures are identified. IMPRESSION: New left basilar opacities which are suggestive of atelectasis or aspiration in this clinical setting. " ded8cc76-44b099be-37d6454e-c22c6225-4799d3b1.jpg,validate/p16/p16590876/s55616920/ded8cc76-44b099be-37d6454e-c22c6225-4799d3b1.jpg,validation," WET READ: ___ ___ ___ 3:01 PM Bibasilar opacities, left greater than right, are concerning for pneumonia. There is a small left pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, SOB, fever // eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Bibasilar opacities, left greater than right, are concerning for pneumonia. There is a small left pleural effusion. Multiple calcified granulomas appear similar to the prior study. The heart remains enlarged. The aorta is tortuous and diffusely calcified. Old healed right-sided rib fractures are again seen. No pneumothorax. IMPRESSION: Bibasilar opacities, left greater than right, are concerning for pneumonia. There is a small left pleural effusion. " 247d6722-c9edd24c-4566f541-3c51a14b-421ddb93.jpg,validate/p10/p10021487/s50316375/247d6722-c9edd24c-4566f541-3c51a14b-421ddb93.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with rib fracture, evaluate for rib fractures. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate healing right-sided rib fractures. There is increase in the air component within a large air-fluid collection under an elevated right hemidiaphragm consistent with known necrotic right lobe of the liver. The lungs are otherwise clear with right more than left basilar atelectasis, and a large right pleural effusion. The cardiac silhouette and mediastinal contours are normal. IMPRESSION: 1. Poor visualization of right-sided rib fractures. If there is further question regarding these, repeat dedicated views are recommended. 2. Large air-fluid level within the necrotic right lobe of the liver, and elevation of the right hemidiaphragm with right base atelectasis and small pleural effusion. " 90f1438d-60656f39-afb3fd55-f13a5070-32411d0c.jpg,validate/p15/p15403852/s51973977/90f1438d-60656f39-afb3fd55-f13a5070-32411d0c.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p avr/mvr now desatting // interval change FINDINGS: As compared to chest radiograph from the same day, endotracheal tube, and nasogastric tube have been removed. Interval decrease in lung volumes with increasing bibasilar opacities. Mild pulmonary vascular congestion. No pneumothorax. Probable small to moderate left effusion. IMPRESSION: Interval decrease in lung volumes with increasing bibasilar opacities. Mild pulmonary vascular congestion. " e408fff3-e6e48e8a-cd47b091-f75bea34-b2f42373.jpg,validate/p17/p17542660/s51294388/e408fff3-e6e48e8a-cd47b091-f75bea34-b2f42373.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with worsening liver function. COMPARISON: None. PA & LATERAL VIEWS CHEST: Lung volumes are low which may accentuate lung markings, however they are still somewhat more prominent than expected. Cardiomediastinal silhouette and hilar contours appear grossly unremarkable. There is a trace right pleural effusion. No pneumothorax. IMPRESSION: Low lung volumes with prominent interstitial markings; there may be a component of chronic interstitial disease underlying interstitial edema. No focal consolidation. " 23485570-04f92519-945763d2-56d3fa91-1e6da609.jpg,validate/p17/p17869727/s53309546/23485570-04f92519-945763d2-56d3fa91-1e6da609.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Patient is status post recent median sternotomy and mitral valve surgery. Right apical pneumothorax has nearly resolved with only a tiny residual pneumothorax remaining. Cardiomediastinal contours are stable in the post-operative period. Bibasilar areas of atelectasis are similar on the right and slightly improved on the left. Small bilateral pleural effusions persist, left greater than right. " 61e696dc-5e2d72d0-0cffde03-3991a8d5-3ba37651.jpg,validate/p15/p15347696/s55530248/61e696dc-5e2d72d0-0cffde03-3991a8d5-3ba37651.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and COPD. FINDINGS: In comparison with the study of ___, there is little interval change. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " fe633cf5-3cadad40-a2f013e6-5d9772c0-55479656.jpg,validate/p18/p18567227/s51936179/fe633cf5-3cadad40-a2f013e6-5d9772c0-55479656.jpg,validation," 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. " dd2b91de-25405ee8-8690b2a3-581f12b5-a87f3e72.jpg,validate/p19/p19885929/s53728849/dd2b91de-25405ee8-8690b2a3-581f12b5-a87f3e72.jpg,validation," 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. " e4c72457-0865a1bd-32361dfc-94a143e0-424e5fc5.jpg,validate/p16/p16868368/s50057325/e4c72457-0865a1bd-32361dfc-94a143e0-424e5fc5.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. Question pneumonia or 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. " c414707b-30aec959-be6b17a2-0ce85a47-3b7a0847.jpg,validate/p19/p19171679/s51780560/c414707b-30aec959-be6b17a2-0ce85a47-3b7a0847.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o ETOH, low grade temps now lethargic. // Please evalute for infection. TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size is normal. Widening of the mediastinum is most likely related to the very expiratory nature of the radiograph. No discrete consolidations demonstrated. No appreciable pleural effusion or pneumothorax seen. Repeated radiograph with emphasis on full inspiration is recommended " 8aef8176-62776dcc-9ecbeb7f-8088c0fe-74feba1a.jpg,validate/p17/p17090453/s56503359/8aef8176-62776dcc-9ecbeb7f-8088c0fe-74feba1a.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. FINDINGS: Frontal and lateral views of the chest compared to previous exam from ___. The lungs remain clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are notable for hypertrophic changes in spine. IMPRESSION: No acute cardiopulmonary process. " 73802487-99087b42-07dfbfa5-0014f1b3-185103dc.jpg,validate/p16/p16441183/s57199533/73802487-99087b42-07dfbfa5-0014f1b3-185103dc.jpg,validation," WET READ: ___ ___ ___ 5:10 PM NASOGASTRIC TUBE IN THE STOMACH WITH THE TIP OUT OF THE FIELD OF VIEW. BIBASILAR ATELECTASIS. RIGHT SUBCLAVIAN PICC. ___ AT 17:10 ON ___. ______________________________________________________________________________ FINAL REPORT HISTORY: NG tube placement. FINDINGS: Nasogastric tube extends at least to the distal stomach and possibly into the duodenum. Central catheter tip remains in the lower portion of the SVC. There are low lung volumes with minimal atelectasis at the right base. However, no evidence of vascular congestion or pleural effusion. " 0a6c7e4f-c71f6a22-c3be22c9-10446479-a4d5630b.jpg,validate/p12/p12990623/s53643851/0a6c7e4f-c71f6a22-c3be22c9-10446479-a4d5630b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with mid thoracic back pain // eval for CHF/pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There relatively low lung volumes but no focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Evidence of DISH is seen along the thoracic spine. IMPRESSION: No acute cardiopulmonary process. Thoracic spine DISH. " 4505585e-359d4475-fa6ecf08-50afd216-96553684.jpg,validate/p15/p15785689/s58340841/4505585e-359d4475-fa6ecf08-50afd216-96553684.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ?RUL lung nodule on prior CXR, recommended repeat CXR (?needs oblique view as well) // eval for RUL nodule (?artifact vs. true nodule) 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: Previously described nodular opacity in the right hemi thorax is not longer visualized " 44032b2e-c817e5bc-14450984-bb871963-934f0911.jpg,validate/p13/p13750116/s54382694/44032b2e-c817e5bc-14450984-bb871963-934f0911.jpg,validation," 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. " 1923feae-0ea61141-83c6f273-f50e1490-800724fd.jpg,validate/p18/p18551287/s59214680/1923feae-0ea61141-83c6f273-f50e1490-800724fd.jpg,validation," WET READ: ___ ___ ___ 8:58 PM A right chest tube is new since the prior study, with interval improvement in right lung aeration. Low lung volumes and right pleural effusion persist. Embolization coils projecting over the upper abdomen are also new since the prior chest radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RFA ablation, hemothorax s/p intubation/chest tube placement // eval tubes; please do upon arrival to ICU eval tubes; please do upon arrival to ICU IMPRESSION: Comparison to ___. The patient has received a right-sided chest tube. The previous extensive right pleural effusion has substantially drained. The heart and the left lung are stable in appearance. Stability of the correctly positioned. Monitoring and support devices. No pneumothorax. " 1e064e0b-702c22e7-caf1a02a-878e0fa7-ac8428c1.jpg,validate/p17/p17477764/s58139279/1e064e0b-702c22e7-caf1a02a-878e0fa7-ac8428c1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // r/o pneumothorax 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. " cd5a181b-27bbb2db-8facee05-474c4ae6-0079ffc2.jpg,validate/p11/p11186434/s56960324/cd5a181b-27bbb2db-8facee05-474c4ae6-0079ffc2.jpg,validation," FINAL REPORT INDICATION: History: ___M with chest pain/shoulder pain // evidence of rib or shoulder fracture TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart size is normal. The hilar mediastinal contours are normal. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion, or pneumothorax. Posterior to the xiphoid process of the sternum, there may be a possible area of soft tissue swelling on the lateral view. IMPRESSION: No acute intrathoracic abnormalities identified. Posterior to the xiphoid process, on the lateral view, there may be a possible area of soft tissue swelling. Please correlate with clinical physical exam. No definite sternal fracture is identified. Please note that radiographs are insensitive for bony trauma, and if there is further clinical concern, a CT or dedicated rib series may be helpful for further evaluation. " 72642c65-978cdeeb-0455f39e-b1d4c458-b7244a16.jpg,validate/p17/p17850184/s51664302/72642c65-978cdeeb-0455f39e-b1d4c458-b7244a16.jpg,validation," FINAL REPORT INDICATION: History: ___M with palps // eval for cardiomegaly TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lung volumes are slightly low, but there is no focal consolidation concerning for pneumonia. Right basilar atelectasis is present. Mild interstitial edema is present. IMPRESSION: Mild interstitial edema. No pneumonia. " 468163b7-22438bca-eaf48afd-283767ae-18b4cc9d.jpg,validate/p15/p15265248/s58782499/468163b7-22438bca-eaf48afd-283767ae-18b4cc9d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough,fevers // infiltrate 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. " 079e6674-b5735af2-caac4b0d-8f991898-e22b2b51.jpg,validate/p12/p12872646/s50413242/079e6674-b5735af2-caac4b0d-8f991898-e22b2b51.jpg,validation," 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. " bdc27aab-8fd7e29f-8d8d7967-0c456217-c67af8bd.jpg,validate/p14/p14881010/s54125185/bdc27aab-8fd7e29f-8d8d7967-0c456217-c67af8bd.jpg,validation," WET READ: ___ ___ 8:21 AM New right basilar opacity is of equivocal significance. For more certainty, oblique radiographic views could be obtained. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with fever and right upper quadrant pain. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___. FINDINGS: The cardiomediastinal and hilar silhouettes and pleural surfaces are normal. A right basilar opacity is new, but of equivocal significance. No pleural effusion or pneumothorax. IMPRESSION: New right basilar opacity is of equivocal significance. For more certainty, oblique radiographic views could be obtained. NOTIFICATION: The updated findings and recommendation were communicated via telephone by Dr. ___ to Dr. ___ in the ___ at 08:00 on ___, 5 min after discovery. " 809287bd-c3c5a8a9-6a07b789-6480bda5-0cf5ce65.jpg,validate/p13/p13433858/s56903760/809287bd-c3c5a8a9-6a07b789-6480bda5-0cf5ce65.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right lower lobe crackles // ? focal consolidation ? focal consolidation IMPRESSION: No previous images. Low lung volumes, but no evidence of acute pneumonia, vascular congestion, or pleural effusion. There is mild blunting of the left costophrenic angle. " 7e0a2581-2aa75085-0af4c3a6-5c65dd7f-55086727.jpg,validate/p13/p13553079/s51758787/7e0a2581-2aa75085-0af4c3a6-5c65dd7f-55086727.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Linear opacity in the left mid lung likely represents a small focus of atelectasis. Heart and mediastinal contours are stable. Left upper quadrant clips are noted. IMPRESSION: No acute cardiopulmonary process. " 5cbdfdef-f0bb910d-df5ef769-9cc8d05a-f2e3b88f.jpg,validate/p11/p11899569/s58615992/5cbdfdef-f0bb910d-df5ef769-9cc8d05a-f2e3b88f.jpg,validation," FINAL REPORT INDICATION: ___ year year old male, s/p fall, r. ___ rib fracture, PTX, placement of chest tube // please check status of PTX ( standing-end expiratory film) TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right apicolateral pneumothorax measures 9 mm in diameter. Extensive subcutaneous emphysema. Pneumomediastinum also noted. Right-sided chest drain in situ. Right tenth rib fracture again visualized. Spondylotic changes of the thoracic spine. Minimal free air seen in the right retroperitoneum. IMPRESSION: As above " 8bb3cfe0-509951be-fd07992e-ad04fd49-cbc8db49.jpg,validate/p18/p18882650/s51762200/8bb3cfe0-509951be-fd07992e-ad04fd49-cbc8db49.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with small R-sided PTX after chest tube placement // Please assess interval change in PTX Please assess interval change in PTX IMPRESSION: Right pigtail catheter is in place with interval decrease in both pleural effusion and pneumothorax. There is progression of the left upper lung consolidation and persistence of bibasal opacities, concerning for multifocal infection in particular in the left upper lobe. There is no interval increase in pleural effusion. Cardiomediastinal silhouette is unchanged. " c9f39e47-7cf05f75-855998e2-94c32eae-468c8c7d.jpg,validate/p12/p12489152/s53623799/c9f39e47-7cf05f75-855998e2-94c32eae-468c8c7d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain under right breast and sternum. Postop hysterectomy. COMPARISON: ___. FINDINGS: Frontal 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. No free air detected below the hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " bf446aaa-b50194cd-aa0a486e-da796280-cd3b6c16.jpg,validate/p13/p13762124/s59072888/bf446aaa-b50194cd-aa0a486e-da796280-cd3b6c16.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Fever, leukocytosis, AFib. Patient with history of pulmonary fibrosis. Comparison is made with prior study ___. Cardiomediastinal silhouette cannot be evaluated. It is obscured by the lung abnormalities. Mid and lower extensive lung opacities have markedly increased from ___. Differential diagnosis is broad including diffuse multifocal pneumonia, ARDS. This could be superimposed to a more chronic interstitial lung abnormality. There are small bilateral pleural effusions. " 9a571416-6dee4120-82e7a8f3-3596f39d-b8725743.jpg,validate/p13/p13090958/s54474319/9a571416-6dee4120-82e7a8f3-3596f39d-b8725743.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cocaine use, 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. " 372e9abe-bdb180cb-2ba7b412-5e84dfaa-30d023a4.jpg,validate/p16/p16548129/s56729564/372e9abe-bdb180cb-2ba7b412-5e84dfaa-30d023a4.jpg,validation," 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. " 0e497561-bd121dc8-7c5df080-4b6e98a9-e8d58ce8.jpg,validate/p13/p13031024/s51286949/0e497561-bd121dc8-7c5df080-4b6e98a9-e8d58ce8.jpg,validation," FINAL REPORT INDICATION: ___ yo F with PMHx HFpEF p/w CP 1 week duration radiating to her l Arm // eval for pulm edema, PNA TECHNIQUE: Frontal lateral views the chest. COMPARISON: ___. FINDINGS: There is mild cardiomegaly as seen on prior. There is no focal consolidation or effusion. There is pulmonary vascular congestion without overt edema. No acute osseous abnormality. IMPRESSION: Cardiomegaly with vascular congestion, no overt edema. " dcb17bb7-91232a1f-69e058c3-8f2cde75-ed53fec5.jpg,validate/p11/p11352876/s51026799/dcb17bb7-91232a1f-69e058c3-8f2cde75-ed53fec5.jpg,validation," FINAL REPORT INDICATION: COPD and fevers and shortness of breath. COMPARISON: Chest radiograph on ___. FINDINGS: AP 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. " e20f0124-5ee3e3e3-02064fea-9f4ebea8-84d289ec.jpg,validate/p12/p12284185/s51785498/e20f0124-5ee3e3e3-02064fea-9f4ebea8-84d289ec.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // eval for PTX TECHNIQUE: PA and lateral views 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. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 724c282f-24353e04-9334a817-181bdf0c-37f5e94c.jpg,validate/p13/p13294497/s50679608/724c282f-24353e04-9334a817-181bdf0c-37f5e94c.jpg,validation," 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. " 957c1bc1-ae661db7-25f1a942-0dc11329-49991e2c.jpg,validate/p18/p18851192/s55299476/957c1bc1-ae661db7-25f1a942-0dc11329-49991e2c.jpg,validation," FINAL REPORT HISTORY: Altered mental status and confusion. COMPARISON: None available. FINDINGS: AP and lateral views of the chest demonstrate increase in density at the left lung base, which may represent atelectasis or developing infection in the appropriate clinical setting. The cardiac, mediastinal, and hilar contours are normal. No pleural abnormality is seen. IMPRESSION: Increased density at the left lung base may represent atelectasis or infection in the appropriate clinical setting. " bd96e396-42cadec8-8d7b85a4-6ac0f280-4ba33e17.jpg,validate/p10/p10855190/s52124732/bd96e396-42cadec8-8d7b85a4-6ac0f280-4ba33e17.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with left lower lobe crackles // PNA? COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Stable elevation of the left hemidiaphragm noted. There is mild interstitial pulmonary edema. No large effusion or pneumothorax. No convincing signs of pneumonia. Heart size appears grossly stable. Mediastinal contour appears normal. No acute bony abnormality. Acute kyphotic angulation at the thoracolumbar junction with a chronic compression deformity at T12 again noted. Right shoulder prosthesis again noted. IMPRESSION: Mild interstitial pulmonary edema. Stable elevation of the left hemidiaphragm. " ac459d63-80c2115b-58830867-62a1334e-4cd688a7.jpg,validate/p18/p18443326/s56131092/ac459d63-80c2115b-58830867-62a1334e-4cd688a7.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Likely right-sided ischemic stroke. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. Cardiomediastinal silhouette is unremarkable. There is a central pulmonary vascular engorgement with moderate interstitial pulmonary edema. A right subclavian approach Port-A-Cath tip terminates in the right atrium. There is a small right-sided pleural effusion with increased density at the right base. There is no pneumothorax. Bones are diffusely demineralized. IMPRESSION: Pulmonary vascular congestion with moderate interstitial pulmonary edema and small right-sided pleural effusion. A confluent opacity at the right lung base may be secondary asymmetrical edema, though infection should also be considered in the appropriate clinical setting. Short-term followup radiographs after diuresis may be helpful in this regard, if warranted clinically. . " c556396f-3265bdbe-88f0cd6e-500e7d80-75dfe9e4.jpg,validate/p13/p13219116/s53289375/c556396f-3265bdbe-88f0cd6e-500e7d80-75dfe9e4.jpg,validation," FINAL REPORT INDICATION: Productive cough. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: On the frontal view, there is a subtle opacity overlying the right sixth rib. This is more prominent than on the prior exam. The lungs are otherwise clear without a focal opacity or pulmonary edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Subtle opacity overlying the right sixth rib. This is uncertain if it is within the pulmonary parenchyma or a deformity of the rib. Recommend a repeat PA view of the chest and shallow obliques for further characterization. Results were discussed with Dr. ___ at 3:30 p.m. on ___ via telephone by Dr. ___ at the time the findings were discovered. " 9d13eabb-75e560f3-1ac5c512-7002105c-b46845d9.jpg,validate/p14/p14912272/s57562756/9d13eabb-75e560f3-1ac5c512-7002105c-b46845d9.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with pleural effusion eval. COMPARISONS: Multiple prior radiographs, most recently from ___, CTA of the chest from ___. TECHNIQUE: PA and lateral chest radiographs are provided. Since the recent prior radiograph after thoracentesis on ___, there has been some re-accumulation of right pleural effusion as well as persistent moderate left pleural effusion. Again seen is the large right upper lobe mass with multiple nodules at the bases consistent with metastatic disease. Cardiomediastinal silhouette is stable with dense calcifications along the aorta. Bony structures are intact. IMPRESSION: Interval increase in moderate right pleural effusion after thoracentesis on ___. Stable moderate left pleural effusion. " 06d4e358-8dc9a649-22636760-952ad5b5-d082e322.jpg,validate/p14/p14558435/s55151789/06d4e358-8dc9a649-22636760-952ad5b5-d082e322.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: The patient with bile leak rule out pneumonia or atelectasis. COMPARISON: ___ abdominal CT. No prior chest x-ray. FINDINGS: Lung volumes are low. Bilateral pleural effusions are minimal. There is no evidence of consolidation. Mediastinal and cardiac contours are normal. There is no pneumothorax. CONCLUSION: There is no evidence of pneumonia. " ddd48533-e44b93bb-4975ceb2-4405506d-3552f0c5.jpg,validate/p17/p17428853/s57840405/ddd48533-e44b93bb-4975ceb2-4405506d-3552f0c5.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of new-onset second-degree heart block, known interstitial lung disease. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. In the periphery of the right upper lobe as well as the right lung base, there are increased interstitial markings, which may relate to patient's interstitial lung disease, although there is no prior for comparison to assess for interval change and to exclude underlying infection. The hila are slightly prominent, which may be due to underlying pulmonary engorgement. No pleural effusion or pneumothorax is seen. The cardiac silhouette is not enlarged. The patient is rotated to the right. IMPRESSION: Findings which may be due to patient's known interstitial lung disease as above, although given lack of priors for comparison, unable to assess for interval change and to exclude infection. Probable pulmonary vascular engorgement. " 6ff56a64-9702c717-8c9a5b2a-c8b7bbaa-1aab2c4e.jpg,validate/p14/p14744387/s54634418/6ff56a64-9702c717-8c9a5b2a-c8b7bbaa-1aab2c4e.jpg,validation," FINAL REPORT CLINICAL HISTORY: Hepatitis C cirrhosis, now febrile. CHEST: The cardiac size is within the limits of normal. No evidence of failure is seen. A nasogastric tube is present, curled up within the stomach. There are increased opacities in the right mid lobe extending from the hilus. This may represent early pneumonia. IMPRESSION: Possible early pneumonia, right middle lobe. " 8ac3e407-348c5bf7-7f1b7417-3ec77b35-bb423f9b.jpg,validate/p10/p10989799/s53136675/8ac3e407-348c5bf7-7f1b7417-3ec77b35-bb423f9b.jpg,validation," 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. " 47beba5e-4944800d-f11b52b7-de56aa6c-e4b29b05.jpg,validate/p14/p14875942/s56673529/47beba5e-4944800d-f11b52b7-de56aa6c-e4b29b05.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with dyspnea, cough, and fever concerning for pneumonia. Admission radiograph demonstrated pulmonary edema, and patient was diuresed overnight. COMPARISON: ___. CHEST, PA AND LATERAL: Right ventricular pacemaker again courses in expected position, with discarded leads in the left chest wall. Following diuresis, there has been interval decrease in mild interstitial edema. Continued moderate cardiomegaly and central venous congestion. No pleural effusions. Persistent right lower lobe streaky opacities with adjacent pleural thickening, suggesting prior pneumonia. IMPRESSION: 1. Decreased pulmonary edema. 2. Sequelae of prior right lower lobe pneumonia. " 8ae1586e-e25b695d-804eab46-aa474630-d438cdf8.jpg,validate/p16/p16454913/s59349004/8ae1586e-e25b695d-804eab46-aa474630-d438cdf8.jpg,validation," FINAL REPORT INDICATION: Patient with bilateral pleural effusions, thoracocentesis on the left side with 400 cc out, rule out pneumothorax or residual effusion. COMPARISON: ___ at 4:03 a.m., CT scan ___. FINDINGS : There is no pneumothorax. Stability of the bilateral mild pleural effusions. There is still mild sign of volume overload that is possibly slightly better on the left side. Stability of the bibasilar atelectasis. The right-sided PICC line is unchanged in the lower vena cava and the left subclavian line is also unchanged. Tracheostomy in good position. CONCLUSION: 1. The mild bilateral pleural effusion are stable. There is no visible pneumothorax. 2. Residual mild volume overload possibly better on the left side. " 6676b821-4a5a5ebb-42a9faed-1b2fbe7f-af6de151.jpg,validate/p10/p10264902/s55041187/6676b821-4a5a5ebb-42a9faed-1b2fbe7f-af6de151.jpg,validation," FINAL REPORT INDICATION: ___F with cough prep, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Ill-defined airspace opacity in the infrahilar right lung may represent atelectasis or pneumonia, depending upon the clinical circumstances. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Ill-defined airspace opacity in the right infrahilar region may represent atelectasis or early pneumonia . NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 10:07 AM, 1 minutes after discovery of the findings. " 088900a4-6323b0a7-59a4df1d-3dbfc3ab-6023aeaa.jpg,validate/p13/p13840464/s58401774/088900a4-6323b0a7-59a4df1d-3dbfc3ab-6023aeaa.jpg,validation," FINAL REPORT HISTORY: ___-year-old male tricuspid regurgitation with crackles on exam. Question volume overload. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of consolidation, effusion, or vascular congestion. Cardiomediastinal silhouette enlarged similar compared to prior epicardial pacing wires are again seen. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. Unchanged cardiomegaly. " 39351ec6-89183e1d-6f755d26-00b4eb26-a10af1c8.jpg,validate/p14/p14185546/s57407188/39351ec6-89183e1d-6f755d26-00b4eb26-a10af1c8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a new nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. There is no evidence of complications, notably no pneumothorax. The lung volumes have increased, likely reflecting improved ventilation. However, signs of mild fluid overload, bilateral small pleural effusions and basal areas of atelectasis are constant. " 8b9f9ae0-d15ef6fa-d74146b3-c72840df-bb9b5451.jpg,validate/p19/p19189928/s50941535/8b9f9ae0-d15ef6fa-d74146b3-c72840df-bb9b5451.jpg,validation," FINAL REPORT HISTORY: Cardiac arrest. TECHNIQUE: Portable semi-upright AP view of the chest. COMPARISON: ___. FINDINGS: Left-sided AICD / pacemaker device is noted with single lead terminating in the right ventricle. Dual lumen central venous catheter tip terminates in the proximal right atrium. Moderate to severe enlargement of cardiac silhouette is unchanged. Lung volumes are low. Mediastinal and hilar contours are stable. There is crowding of the pulmonary vascular markings, with probable mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Minimal atelectasis is seen in the lung bases. IMPRESSION: Low lung volumes with mild bibasilar atelectasis and probable mild pulmonary vascular congestion. " 6f8eb23b-44c6ccb9-d84673dd-4a6c08f5-1896f5e1.jpg,validate/p15/p15785689/s58934306/6f8eb23b-44c6ccb9-d84673dd-4a6c08f5-1896f5e1.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are normal. An incompletely marginated round 1.2 cm diameter opacity is present in the periphery of the right upper lung, at the level of the intersection of the right fourth anterior and seventh posterior ribs. Lungs are otherwise clear, and there are no pleural effusions or acute skeletal findings. IMPRESSION: 1. No CT findings to suggest the presence of pneumonia. 2. 1.2 cm opacity in right upper lung as described, possibly representing a skin lesion or a structure external to the patient. Recommend initial further evaluation with repeat chest radiograph. If the patient has a skin lesion on the right chest wall, a marker could be placed on this region at the time of followup radiograph to assist in localization. Findings entered into radiology communications dashboard on date of study. " d8355aa8-e2d6c792-78708f3e-8fd8fbf7-8ca20ded.jpg,validate/p11/p11967908/s51649994/d8355aa8-e2d6c792-78708f3e-8fd8fbf7-8ca20ded.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with fevers/chills TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest CT ___ and chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Calcifications projecting over the right mid and upper lung fields are similar compared to the previous exam, reflecting a combination of pleural calcifications and chest wall calcifications. Scarring with bronchiectasis is again noted in the right apex. No new focal consolidation, pleural effusion or pneumothorax is visualized. Multiple clips are again seen in the right axillary region as well as overlying the right hemidiaphragm. No acute osseous abnormality is identified. Remote right proximal humeral fracture is again noted. IMPRESSION: Similar scarring and bronchiectasis within the right apex and calcifications projecting over the right upper and mid lung fields. No focal consolidation. " 6d9961e2-00da6362-41713688-73a710e3-43136107.jpg,validate/p18/p18068984/s53240310/6d9961e2-00da6362-41713688-73a710e3-43136107.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Fever x 3 days. Assess for pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral chest radiographdemonstrates well expanded lungs. No CHF or focal infiltrate is identified.No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are within normal limits. Note is made of mild anterior wedging of a lower thoracic vertebral body question T12, with loss of height of approximately ___%. IMPRESSION: Chest x-ray examination within normal limits allowing for mild wedging of a lower thoracic vertebral body. No acute pulmonary process identified. " 0d13c56d-c7477d49-925fb8a2-26172891-096d5437.jpg,validate/p18/p18737826/s54468213/0d13c56d-c7477d49-925fb8a2-26172891-096d5437.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SDH and IPH s/p fall now with new delirium and AMS // please assess for pnemonia vs. aspiration pneumonitis vs. other evidence of consolidation please assess for pnemonia vs. aspiration pneumonitis vs. ot COMPARISON: Prior chest radiographs most recently ___. IMPRESSION: A large opacity in the left lower chest has increased in size since ___. How much of this is pleural or extrapleural fluid, possibly blood given the history provided, and how much is left lower lobe collapse is radiographically indeterminate. Lateral view would be helpful, but CT scanning may ultimately be necessary. Right lung is clear. The heart is normal size. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 12:55 PM, minutes after discovery of the findings. " 40ceb463-00971983-563246be-27a5e114-2a336433.jpg,validate/p14/p14832062/s58103863/40ceb463-00971983-563246be-27a5e114-2a336433.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient status post flash pulmonary edema, CHF after diuresis. Study requested for interval evaluation. COMPARISON: Prior chest radiographs from ___ through ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiographs from ___, there has been interval improvement of a right upper lobe opacity. However, there is slight worsening of pulmonary edema. There are small bilateral pleural effusions. There are no new focal consolidations. Mild cardiomegaly is stable. IMPRESSION: 1. Improving opacity in right upper lobe, likely related to asymmetrical edema. 2. Slight worsening of pulmonary edema with bilateral small pleural effusions. " 48e234f9-d6652c12-49d80891-9b9d339e-c43f92b1.jpg,validate/p16/p16298181/s50920521/48e234f9-d6652c12-49d80891-9b9d339e-c43f92b1.jpg,validation," 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. " 22daae6e-7e7eb816-374ccd26-3e47cf7b-fff5e9fa.jpg,validate/p18/p18162379/s57338020/22daae6e-7e7eb816-374ccd26-3e47cf7b-fff5e9fa.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral chest radiograph 3 views. COMPARISON: Chest radiograph ___ at. FINDINGS: The heart size is normal. The cardiomediastinal silhouette and hilar contour is stable and unremarkable. The lungs are clear without focal consolidation, effusion or pneumothorax. No acute bony abnormality is identified. IMPRESSION: No acute intrathoracic process. " e18e38de-7a3e5d3b-05469312-5362b3e6-17b83d85.jpg,validate/p11/p11535886/s50635928/e18e38de-7a3e5d3b-05469312-5362b3e6-17b83d85.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with altered mental status // acute process? COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Previously noted lines and tubes have been removed. The heart remains mildly enlarged. There is mild interstitial pulmonary edema. Hilar engorgement is also present. No large pleural effusions. No pneumothorax. No signs of pneumonia. Aortic atherosclerotic calcifications noted. Bony structures are intact. High riding right humeral head may reflect chronic rotator cuff disease. A calcified/bony structure projects inferior to the right coracoid, unchanged. IMPRESSION: Mild pulmonary edema, stable mild cardiomegaly. " aa8c794b-8571da20-fc366bc9-020aaee5-14e9ab50.jpg,validate/p18/p18722129/s50917382/aa8c794b-8571da20-fc366bc9-020aaee5-14e9ab50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o positive ppd // r/o tb (routine for work) r/o tb (routine for work) IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. There is no evidence of acute cardiopulmonary disease or old tuberculous disease. " b077741b-616144a1-5b5177d8-6aa28404-1a944d5a.jpg,validate/p10/p10407143/s58460251/b077741b-616144a1-5b5177d8-6aa28404-1a944d5a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bilateral ___ claudication // cardiopulmonary process COMPARISON: None avail FINDINGS: ICD in dual lead pacing device is in place, with leads terminating in the right atrium (1), right ventricle (2) and for biventricular pacing (1). Cardiomediastinal contours are within normal limits. Mild pulmonary vascular congestion is present without overt pulmonary edema. No confluent areas of consolidation are present, and no pleural effusion or pneumothorax is identified. Left costophrenic angle has been excluded from the field of view. IMPRESSION: Mild pulmonary vascular congestion. " 4b68d122-5d935b1c-53aeaa03-e0ca53eb-1b927b04.jpg,validate/p10/p10740309/s56246607/4b68d122-5d935b1c-53aeaa03-e0ca53eb-1b927b04.jpg,validation," WET READ: ___ ___ 2:08 PM Focal ill-defined opacity at the right lung base, seen best on frontal view, is concerning for an infectious process in the appropriate clinical setting. Short interval followup after treatment is recommended to document resolution. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest pain. Evaluate for pneumonia. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Ill-defined increased opacity at the right lung base seen best on frontal view projecting over the cardiac silhouette on the lateral is concerning for an infectious process. Lungs are otherwise clear. There is no large pleural effusion or pneumothorax. IMPRESSION: Focal ill-defined opacity in the right middle lobe compatible with pneumonia in the appropriate clinical setting. " 770eff48-73023fb6-b28cfc7f-32858d5e-1371da59.jpg,validate/p18/p18092465/s52709368/770eff48-73023fb6-b28cfc7f-32858d5e-1371da59.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with intubation TECHNIQUE: Frontal chest radiographs were obtained with the patient in the semi-upright position. COMPARISON: Chest CT from ___ and chest radiograph from ___. FINDINGS: A endotracheal tube terminates within the right mainstem bronchus on the initial chest radiograph. On follow-up imaging, the endotracheal tube terminates in appropriate position. A nasogastric terminates in appropriate position. Lung volumes are low, and there are very severe diffuse bilateral pulmonary consolidations. IMPRESSION: Appropriate positioning of the endotracheal tube and nasogastric tube. Severe diffuse pulmonary consolidation. " 2f9650fc-7f24936b-d0a9143e-9f0414ff-caca3656.jpg,validate/p19/p19233138/s54864793/2f9650fc-7f24936b-d0a9143e-9f0414ff-caca3656.jpg,validation," WET READ: ___ ___ ___ 5:28 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with history of CAD, pulmonary hypertension p/w chest pain // eval for pneumonia, CHF TECHNIQUE: Upright PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: Lungs are well expanded. There is mild hilar fullness suggestive of mild pulmonary vascular congestion. No edema is seen. There is no pleural effusion or pneumothorax. Cardiac silhouette appears mildly enlarged. The aorta is tortuous. IMPRESSION: No acute cardiopulmonary process. " bbb2b942-4e6a552a-63d8277d-7a5a521c-d74c7848.jpg,validate/p17/p17708517/s54937910/bbb2b942-4e6a552a-63d8277d-7a5a521c-d74c7848.jpg,validation," FINAL REPORT HISTORY: Cough, confusion. TECHNIQUE: Single frontal view of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " e06fb933-202f192f-82296e81-47272c87-1a581999.jpg,validate/p11/p11199765/s56299465/e06fb933-202f192f-82296e81-47272c87-1a581999.jpg,validation," WET READ: ___ ___ 8:40 AM IMPRESSION: No radiographic findings to explain chest pain. Suggest 6 weeks followup chest radiographs for right apical lesion to exclude reactivation tuberculosis or early lung cancer, unless prior radiographs can be obtained that demonstrate it is inert. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest pain, prior MI. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is normal with mild tortuosity of the thoracic aorta. Hilar contours are unremarkable. Small stellate, subpleural opacity in the apex of the right lung (level of first anterior interspace) at the end of linear scarring or atelectasis is likely a tuberculous scar, but would need documentation of ___ years' stability before it can be considered inert. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No radiographic findings to explain chest pain. Suggest 6 week followup chest radiographs for right apical lesion to exclude reactivation tuberculosis or early lung cancer, unless prior radiographs can be obtained that demonstrate it is inert. Dr ___ ___ findings with ___ resident by telephone ___AM. " 42d3bdf8-47935465-be4b3cde-53d32916-7fcc3494.jpg,validate/p16/p16435316/s51734362/42d3bdf8-47935465-be4b3cde-53d32916-7fcc3494.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with bronchiectasis // s/p bronch COMPARISON: ___. IMPRESSION: Of the right bronchoscopy there is no evidence of pneumothorax. The extensive parenchymal opacities on the right are unchanged as compared to previous radiographs. " fbed2763-32e1610b-cb445bc1-49e2d2d9-404f7105.jpg,validate/p14/p14255450/s52612877/fbed2763-32e1610b-cb445bc1-49e2d2d9-404f7105.jpg,validation," 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. " ffacbfb9-685e8c85-b60c1e1a-483cd78c-7729685b.jpg,validate/p16/p16904987/s53735530/ffacbfb9-685e8c85-b60c1e1a-483cd78c-7729685b.jpg,validation," FINAL REPORT HISTORY: Polytrauma. FINDINGS: In comparison with the study of ___, the left chest tube and subclavian catheters remain in place. No evidence of pneumothorax. Cardiac silhouette is at the upper limits of normal in size. There is evidence of elevated pulmonary venous pressure. Mild haziness of the lower zones is consistent with small bilateral pleural effusions and compressive atelectasis at the bases. " a4f8553d-4dff2fb7-1cd2b9ed-2de624a5-9cba226a.jpg,validate/p18/p18001762/s59728339/a4f8553d-4dff2fb7-1cd2b9ed-2de624a5-9cba226a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, orthopnea TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size remains mildly enlarged. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 7e80a66e-963144ae-315256e9-ce0f1b34-aad0815a.jpg,validate/p19/p19758044/s57209022/7e80a66e-963144ae-315256e9-ce0f1b34-aad0815a.jpg,validation," WET READ: ___ ___ ___ 4:23 PM A vague opacity in the right lung base is new since prior study, nonspecific and potentially atelectasis, in the appropriate clinical setting may represent early infectious process. WET READ VERSION #1 ___ ___ ___ 3:27 PM A nodular opacity in the right lung base is new since prior study, nonspecific, in the appropriate clinical setting may represent early infectious process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with sob, cough, fever // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrates opacity which is subtle at the right lung base medially, new since prior examination. Remaining lungs appear clear. There is been interval removal of a right PICC. There is no pneumothorax or pleural effusion. Cardiomediastinal and hilar contours are within normal limits. There is no evidence of pulmonary edema. There is no air under the right hemidiaphragm. IMPRESSION: A vague opacity in the right lung base is new since prior study, nonspecific and potentially atelectasis, in the appropriate clinical setting may represent early infectious process. " e794b1d7-913bc414-3cc1e485-d11f6118-2a55cd4a.jpg,validate/p13/p13310560/s56812581/e794b1d7-913bc414-3cc1e485-d11f6118-2a55cd4a.jpg,validation," FINAL REPORT INDICATION: ___M with new dyspnea on exertion // Eval for acute CP process TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT from ___. Chest x-ray from ___. FINDINGS: Focal somewhat linear opacity at the right costophrenic angle is likely atelectasis. Elsewhere, the lungs are clear. Cardiomediastinal silhouette is stable. Left chest wall dual lead pacing device is again noted. Chronic left lateral rib fractures are noted. Median sternotomy wires are intact. Partially visualized stent seen in the abdomen. IMPRESSION: No acute cardiopulmonary process. " f65479c5-c16537d4-1ecf3af1-72270d64-f1b1ccdd.jpg,validate/p18/p18377937/s59964962/f65479c5-c16537d4-1ecf3af1-72270d64-f1b1ccdd.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, leukocytosis // ?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. " a6eb2d9c-cdd9eff4-87da3196-39a85146-7730ad65.jpg,validate/p17/p17501651/s59399124/a6eb2d9c-cdd9eff4-87da3196-39a85146-7730ad65.jpg,validation," 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. " 6c409164-5b95ca6f-dc6a7510-959225c3-2aa9f7df.jpg,validate/p12/p12471550/s50457980/6c409164-5b95ca6f-dc6a7510-959225c3-2aa9f7df.jpg,validation," FINAL REPORT CHEST TWO VIEWS, ___. HISTORY: ___-year-old with decreased breath sounds at the bases. Question pleural effusion. FINDINS: PA and lateral views of the chest are compared to prior dated ___. There is stable elevation of the left hemidiaphragm compared to prior. There is no visualized pleural effusion. There is suggestion of atelectasis versus scarring abutting the left hemidiaphragm, similar to prior. The lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits, as are the osseous and soft tissue structures. IMPRESSION: Elevation of left hemidiaphragm with adjacent atelectasis versus scarring. No evidence of effusion, no change from prior. " de157854-797ec909-187c74bd-56a9e71c-437ee52d.jpg,validate/p13/p13634485/s56822394/de157854-797ec909-187c74bd-56a9e71c-437ee52d.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with aspiration event, assess for progression. COMPARISONS: None. Portable semi-upright radiograph of the chest was obtained. Tracheostomy tube is noted. The patient is rotated. Left basal opacity is seen, which could reflect an early aspiration event. No priors are available for comparison. There is no pleural effusion or pneumothorax. Heart is moderately enlarged. IMPRESSION: Left basilar opacity could reflect atelectasis or aspiration. " 47da8016-81f76897-e1c5637f-113172b9-7b9f6061.jpg,validate/p15/p15676084/s57703929/47da8016-81f76897-e1c5637f-113172b9-7b9f6061.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Esophageal dilatation, evaluation for pneumomediastinum. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette. Normal contour of the neoesophagus projecting over the right mediastinum and right heart border. No pleural effusions. Normal size of the heart. No pulmonary edema. " 91cfd5c5-51d8c67c-2a6da84b-63e1253c-86fd7231.jpg,validate/p13/p13031383/s57510320/91cfd5c5-51d8c67c-2a6da84b-63e1253c-86fd7231.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea on exertion, hx chf // pneumonia vs chf COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. The pulmonary hila appear mildly congested. There is minimal interstitial pulmonary edema. No large effusion or pneumothorax. No convincing evidence for pneumonia. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Congestion with mild interstitial edema. " 291e215e-fecc4beb-5b01af35-5fff67f7-2156ad1c.jpg,validate/p12/p12875284/s54573012/291e215e-fecc4beb-5b01af35-5fff67f7-2156ad1c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M w/worse respiratory exam than baseline TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " 49116445-6433a16d-0ec42e0c-a5c14964-519e5fbf.jpg,validate/p17/p17155697/s57497649/49116445-6433a16d-0ec42e0c-a5c14964-519e5fbf.jpg,validation," FINAL REPORT HISTORY: Left thoracotomy. FINDINGS: In comparison with the study of ___, with the left chest tube removed, there is no definite pneumothorax, though a small pneumothorax could possibly be hidden due to superimposition of bony structures overlying the left apex. The lungs are free of acute pneumonia or vascular congestion. Continued opacification at the right base. " baa35aa8-6745fe08-1b493240-7848fc02-50aec7ec.jpg,validate/p13/p13103184/s56736794/baa35aa8-6745fe08-1b493240-7848fc02-50aec7ec.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fatigue, anemia, and decreased exercise tolerance. COMPARISONS: None. TECHNIQUE: Chest, AP and lateral. FINDINGS: The heart is at the upper limits of normal size. The aortic arch is calcified. There is mild unfolding of the thoracic aorta. Patchy medial right basilar opacity suggests minor atelectasis. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. Mild degenerative changes are similar along the mid-to-lower thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. Suspected minor right basilar atelectasis. " f669facc-fc276c3a-9aa2f7e4-c288385e-1542b957.jpg,validate/p19/p19850525/s59616328/f669facc-fc276c3a-9aa2f7e4-c288385e-1542b957.jpg,validation," FINAL REPORT INDICATION: ___M with shortness of breath // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: Left axillary dual lead pacemaker is present with tip terminating in the right atrium and right ventricle as expected. Moderate cardiomegaly is again noted. The mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are well-expanded without focal consolidation concerning for pneumonia. Mild vascular congestion is present. Multiple healed rib fractures in the right posterior ribcage are noted. IMPRESSION: 1. Mild vascular congestion. 2. Stable moderate cardiomegaly. " bf1866e2-59c19773-4cd55b47-dc5a1774-5422c66c.jpg,validate/p19/p19236527/s58707814/bf1866e2-59c19773-4cd55b47-dc5a1774-5422c66c.jpg,validation," FINAL ADDENDUM ADDENDUM: There is suggestion of some sclerotic change in the humeral head on the right. This could be a manifestation of metastatic disease. ______________________________________________________________________________ FINAL REPORT HISTORY: Metastatic breast cancer with lung crackles. FINDINGS: No previous images. The cardiac silhouette is within normal limits and there is no definite vascular congestion. There is a moderate left pleural effusion. Minimal atelectatic changes seen at the right base. " 92c32c82-12a62f9c-f28ef1de-aa6bdc04-c6946e9e.jpg,validate/p18/p18767957/s55238104/92c32c82-12a62f9c-f28ef1de-aa6bdc04-c6946e9e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chronic nonhealiong wound here for below knee amputation. // preop CXR Surg: ___ (below knee amputation) COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a further improvement in extent and severity of the pre-existing pulmonary edema. Edema is now mild. Moderate cardiomegaly persists. No pleural effusions. No pneumonia, no pneumothorax. " f12984f4-b293b9c9-1689b99b-5486e0b4-24884da5.jpg,validate/p14/p14043925/s52987496/f12984f4-b293b9c9-1689b99b-5486e0b4-24884da5.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs are clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 012a4d42-726b7c21-8f7e074b-ad0e633b-76b3715c.jpg,validate/p14/p14217885/s57613064/012a4d42-726b7c21-8f7e074b-ad0e633b-76b3715c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with chest pain. 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 and clear without focal consolidation concerning for pneumonia. IMPRESSION: No acute cardiopulmonary process. " 8dcd5ea3-ee438639-17e9549b-e27f22e1-54695510.jpg,validate/p18/p18039147/s51501678/8dcd5ea3-ee438639-17e9549b-e27f22e1-54695510.jpg,validation," FINAL REPORT HISTORY: Right lower lobe VATS with CT removal, to assess for pneumothorax. FINDINGS: In comparison with the study of ___, there is no evidence of pneumothorax following removal of the chest tube. Subcutaneous gas continues to decrease. Bibasilar opacifications persist, consistent with atelectasis and small pleural effusion on the right. No vascular congestion. " 11807f41-2c83be3a-525c65a9-53044082-01d4d8c9.jpg,validate/p13/p13999026/s52534070/11807f41-2c83be3a-525c65a9-53044082-01d4d8c9.jpg,validation," FINAL REPORT INDICATION: ___M with cirrhosis presents with volume overload and ascites // Pulmonary edema TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Blunting of a posterior costophrenic angle is compatible with small pleural effusion, likely on the left. Lungs are otherwise clear besides mild right basilar atelectasis. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Persistent small left pleural effusion. No superimposed acute cardiopulmonary process. " aca79ec8-fda4540f-1162d85d-6a2e80f1-0a6e7935.jpg,validate/p17/p17036580/s53198593/aca79ec8-fda4540f-1162d85d-6a2e80f1-0a6e7935.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: New fever, hypertension, on chronic ventilation. Comparison is made with prior study, ___. Cardiomediastinal contours are normal. Large bilateral pleural effusions with adjacent atelectasis are unchanged. There is no pneumothorax. Left PICC tip is in the mid-to-lower SVC. There are no new lung abnormalities. " f116e5b1-8b4f4a90-d48336c7-9291610f-7506581e.jpg,validate/p12/p12385857/s54931292/f116e5b1-8b4f4a90-d48336c7-9291610f-7506581e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ and chest CT on ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Subtle opacity involving the right middle lobe may represent an area of infection. No pleural effusion or pneumothorax is seen. A nodular density is seen in the mid, left lower lobe is consistent with known mass, better characterized on prior PET-CT. As before there are streaks of fibrosis seen in the bilateral lungs consistent with posttreatment changes. IMPRESSION: Subtle opacity involving the right middle lobe may represent an early focus of infection. Short-term followup radiographs may be helpful in this regard. . " 3100e550-9a75c674-69529c87-2f7aef2f-44fc9446.jpg,validate/p15/p15998296/s59116062/3100e550-9a75c674-69529c87-2f7aef2f-44fc9446.jpg,validation," FINAL REPORT HISTORY: Pneumonia. FINDINGS: In comparison with the study of ___, there may be some increasing opacification at the right base in addition to the diffuse bilateral opacifications seen previously. Findings are consistent with multifocal pneumonia, though some element of elevated pulmonary venous pressure should be considered. " 00d3c93c-f256e5e4-6e972c13-dc8c6cc8-71f63527.jpg,validate/p14/p14755254/s52382833/00d3c93c-f256e5e4-6e972c13-dc8c6cc8-71f63527.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent fevers and increased secretions // eval for PNA eval for PNA IMPRESSION: Comparison to ___. Decrease in severity of the pre-existing pulmonary edema that is now mild. Moderate cardiomegaly persists. Mild retrocardiac atelectasis. No pleural effusions. No pneumonia. " a93ba05c-cb6b0964-37674de0-5723ea4e-cc69fbee.jpg,validate/p14/p14330727/s58257129/a93ba05c-cb6b0964-37674de0-5723ea4e-cc69fbee.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " e3ffbba4-4081d1fb-118d999f-7c5a674f-bf24462f.jpg,validate/p18/p18869008/s51149109/e3ffbba4-4081d1fb-118d999f-7c5a674f-bf24462f.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with profound weight loss. Question mass or infection. 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. No mass or consolidation is evident. IMPRESSION: No evidence of acute cardiopulmonary process. No evidence for mass or infection. " d6e82d0d-129863c8-d21f5e8d-28c3b4b0-1f11cf2b.jpg,validate/p15/p15938402/s51353897/d6e82d0d-129863c8-d21f5e8d-28c3b4b0-1f11cf2b.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with MVA and now with mid thoracic and posterior chest wall pain on the right side. COMPARISON: None. FINDINGS: PA and lateral views of the chest were provided. Lung volumes are somewhat low, though there is no focal consolidation, large effusion or pneumothorax. Faint linear density in the left lower lung likely represents mild subsegmental atelectasis. There is retrocardiac air containing structure likely representing a small hiatal hernia. No large effusion or pneumothorax is seen. No definite displaced rib fracture is seen. Anchors are partially noted visualized at the level of the right shoulder. A chronic compression deformity of T12 is partially visualized on the lateral view. IMPRESSION: No acute findings. Small hiatal hernia. " ffe8eceb-171fd746-f20dacba-025f28cd-54ebb423.jpg,validate/p15/p15355458/s52348670/ffe8eceb-171fd746-f20dacba-025f28cd-54ebb423.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with bandemia and shortness of breath. No identified source. COMPARISON: Outside chest x-ray and CT abdomen from earlier the same day. FINDINGS: AP and lateral views of the chest. There is no confluent consolidation. Streaky bibasilar opacities are seen with increased interstitial markings compatible with atelectasis and bronchiectasis seen on CT scan. There is no effusion. The cardiomediastinal silhouette appears slightly enlarged but this is likely due to a relatively lower lung volumes on the current exam. No acute osseous abnormality identified. IMPRESSION: Bibasilar atelectasis and bronchiectasis in without definite acute cardiopulmonary process. " 7bca26e1-3daa6945-90d14f91-15e4611f-d03f2d22.jpg,validate/p18/p18360443/s52847698/7bca26e1-3daa6945-90d14f91-15e4611f-d03f2d22.jpg,validation," WET READ: ___ ___ 9:22 PM bibasilar atelectasis. no evidence of pneumonia. free air after surgery ___ d/w ___ Glass by phone at 9:22pm ___. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old woman with increased temperature. COMPARISONS: Abdomen CT, ___ and ___. FINDINGS: Portable AP chest radiograph was obtained. Small amount of pneumoperitoneum is expected status post abdominal surgery. Bibasilar atelectasis is mild. Bilateral pleural effusions are small. There is no consolidation or pneumothorax. Cardiac and mediastinal contours are normal. Aortic arch calcification is trace. IMPRESSION: Small pneumoperitoneum expected after abdominal surgery. Bibasilar atelectasis. " a86af117-3d1dc714-0dfd03b1-ee7b5e1d-ddcde5cf.jpg,validate/p19/p19543748/s52133203/a86af117-3d1dc714-0dfd03b1-ee7b5e1d-ddcde5cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with right pleural effusion status post catheter placement. PLEASE PERFORM AT 5:30PM ON ___ TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 15:31 and 10:32 FINDINGS: Right basilar chest tube remains in unchanged position. Small right hydropneumothorax is unchanged. There is increased patchy opacification within the right lung base. This could reflect asymmetric pulmonary edema given its rapid development over the course of a few hours. Multiple scattered ill-defined nodular opacities are compatible with known metastatic disease. The cardiac and mediastinal contours are unchanged. Streaky left basilar atelectasis is re- demonstrated. IMPRESSION: Unchanged appearance of small right hydropneumothorax. Interval development of patchy opacification in the right lung base which given its rapid development may reflect asymmetric pulmonary edema, but is nonspecific, and hemorrhage or infection can have a similar appearance. Continued followup is recommended. " da108d06-79743550-e9523833-3e984460-185dbad5.jpg,validate/p12/p12132246/s58564507/da108d06-79743550-e9523833-3e984460-185dbad5.jpg,validation," FINAL REPORT HISTORY: Recent aortic root repair and right lower extremity DVT now with persistent fevers. COMPARISON: Chest radiograph ___ and ___. FINDINGS: Frontal and lateral views of the chest were performed. The heart has decreased in size from the prior study but remains mildly enlarged. There is prominence of the central vasculature without overt signs of pulmonary edema. Bibasilar atelectasis is noted. There is no pleural effusion or pneumothorax. A tortuous and a dilated aorta is again noted. Sternotomy wires and mediastinal clips are unchanged. IMPRESSION: Decrease in heart size which remains mildly enlarged without an acute cardiopulmonary process. " 873f3695-d6b7c594-dbcb3d51-63e1dc5a-ba501cf3.jpg,validate/p10/p10768869/s59518314/873f3695-d6b7c594-dbcb3d51-63e1dc5a-ba501cf3.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Sinus tachycardia, cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated with flattening of the diaphragms and increased AP diameter, suggesting chronic obstructive pulmonary disease. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Degenerative changes are seen in the upper-to-mid thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 47e4f696-a1269f40-d8a27208-213cd936-e5fb6a11.jpg,validate/p12/p12731439/s57469787/47e4f696-a1269f40-d8a27208-213cd936-e5fb6a11.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with met BC, known pulmonary nodules // restaging in late ___ TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___. PET-CT from ___ CT chest with contrast from ___ FINDINGS: Since ___, bilateral interstitial fibrosis, predominantly in the upper and lower lobes, with honeycombing is unchanged and compatible with known patient history. A small right pleural effusion is noted. No evidence of superimposed pneumonia. Right pectoral pacemaker is seen with transvenous leads in the right atrium and right ventricle. Heart size is top normal. No pneumothorax or pulmonary edema. At least one pulmonary nodule measuring 0.4 cm is seen in the left mid lung, better assessed on prior CT Chest. IMPRESSION: 1. Unchanged small right pleural effusion and known bilateral interstitial fibrosis with honeycombing since ___. 2. At least one subcentimeter pulmonary nodule is seen in the left midlung but is better assessed on prior CT Chest. " 7866da6a-ae4e0ce6-c3505e89-b3e84d9c-16c1a131.jpg,validate/p11/p11630519/s57082510/7866da6a-ae4e0ce6-c3505e89-b3e84d9c-16c1a131.jpg,validation," FINAL REPORT PORTABLE CHEST ___, ___ COMPARISON: ___. FINDINGS: Interval removal of nasogastric tube. Cardiomediastinal contours are stable. No new focal areas of consolidation in the lungs to suggest the presence of an acute aspiration event. " d15b8003-0d96626b-5415925e-75df3429-b2a2974f.jpg,validate/p10/p10670085/s54685497/d15b8003-0d96626b-5415925e-75df3429-b2a2974f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea on Lasix drip for CHF. // Evaluate for pulmonary edema and pneumonia Evaluate for pulmonary edema and pneumonia COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Moderate pulmonary edema and moderate bilateral pleural effusions have increased since ___. Severe cardiomegaly is also worsened. No pneumothorax. " dbce8b1e-745e56a2-681a1956-056ee77a-a9037b00.jpg,validate/p13/p13406208/s53078634/dbce8b1e-745e56a2-681a1956-056ee77a-a9037b00.jpg,validation," WET READ: ___ ___ ___ 7:35 PM Findings concerning for right lower lobe pneumonia. Followup radiographs to resolution are recommended after treatment. ______________________________________________________________________________ FINAL REPORT HISTORY: Weakness. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ chest radiograph. Chest CT ___. FINDINGS: The cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. There is no pulmonary vascular congestion. Right lower lobe ill-defined opacity is concerning for pneumonia. No pneumothorax or pleural effusion is seen. Emphysematous changes are re- demonstrated as well as hyperinflation of the lungs, and scarring within the left upper lobe is similar compared to the prior exam. Oral contrast material is seen within colonic loops of bowel in the left upper quadrant of the abdomen. No acute osseous abnormalities are detected. IMPRESSION: Findings concerning for right lower lobe pneumonia. Followup radiographs to resolution are recommended after treatment. " b4e49a08-11ac1789-0da7b9a7-8fd64f76-3dd4da5f.jpg,validate/p18/p18673042/s54019809/b4e49a08-11ac1789-0da7b9a7-8fd64f76-3dd4da5f.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with history of congestive heart failure. Patient now presenting with acute shortness of breath. COMPARISON: Chest radiograph from ___ at 17:38 at outside hospital and chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: There are increasing interstitial opacities with peripheral septal thickening, findings consistent with mild interstitial pulmonary edema. An opacity overlying the lower thoracic spine on the lateral view likely reflects a tortuous aorta. No definite confluent opacity is identified to suggest pneumonia. No pneumothorax is evident. The calcified aortic arch is unchanged from prior. Moderate-to-severe cardiomegaly, particularly right atrial enlargement, appears unchanged. IMPRESSION: 1. Increasing interstitial opacities consistent with mild pulmonary edema. 2. Unchanged moderate cardiomegaly. 3. Calcified tortuous aorta, unchanged from prior. " 5e6eec00-11b0401d-93282716-cc1c6b34-6cec069a.jpg,validate/p12/p12913304/s51923783/5e6eec00-11b0401d-93282716-cc1c6b34-6cec069a.jpg,validation," 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. " 6c7d3d3c-b6aa95cb-e8510b46-188430d0-544e7594.jpg,validate/p14/p14045219/s54021080/6c7d3d3c-b6aa95cb-e8510b46-188430d0-544e7594.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Epigastric and 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 are no pleural effusions or pneumothorax. Mild reverse S-shaped curvature to the thoracic spine appears unchanged. IMPRESSION: No evidence of acute cardiopulmonary disease. " f931eabb-9b1fe528-dd2ad596-034c7da9-4feb20d4.jpg,validate/p17/p17137598/s56527243/f931eabb-9b1fe528-dd2ad596-034c7da9-4feb20d4.jpg,validation," 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. " 7b0934ce-51d45672-39c6d9f4-f06cdb7f-58a1cea9.jpg,validate/p15/p15490195/s57614987/7b0934ce-51d45672-39c6d9f4-f06cdb7f-58a1cea9.jpg,validation," 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. " 577c0273-5b704760-e193ed07-4656a1a8-3ad260fd.jpg,validate/p14/p14912272/s56173786/577c0273-5b704760-e193ed07-4656a1a8-3ad260fd.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with newly diagnosed metastatic lung cancer with right-sided pleural effusion status post thoracentesis. COMPARISONS: PA and lateral chest radiograph from ___, CT chest from ___, PA and lateral radiograph from ___. FINDINGS: Since the most recent prior radiograph, there has been a decrease in right-sided pleural effusion. Small left-sided pleural effusion persists. Again seen are large masses within the right upper lobe and multiple nodular densities within the lower lobes, all of which are better characterized on the recent CT from ___. There is no definite focal consolidation or pneumothorax. Cardiomediastinal silhouette is stable. IMPRESSION: 1. Slight decrease in right pleural effusion, small persistent left pleural effusion. No pneumothorax 2. Right upper lobe masses and multiple nodules, better characterized on a recent CT. " 53cfa3c7-67bb2668-32d67739-2eb1107c-ab6aee36.jpg,validate/p14/p14721325/s52140957/53cfa3c7-67bb2668-32d67739-2eb1107c-ab6aee36.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with sob // ? infectious process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Mild cardiomegaly is stable. Aorta is unfolded and tortuous. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " d2bca4d6-e498e5cb-1b51337b-d1268405-7e224b1b.jpg,validate/p10/p10146602/s54990601/d2bca4d6-e498e5cb-1b51337b-d1268405-7e224b1b.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT 19:14 CLINICAL INDICATION: Evaluate for pneumothorax and subcutaneous emphysema status post wedge resection. Comparison to prior study of ___. PA and lateral views of the chest and ___ at 9:14 are submitted. IMPRESSION: 1. There continues to be extensive subcutaneous emphysema involving the right chest wall soft tissues and extending up to both sides of the neck with some more air now seen tracking in the left neck soft tissues when compared to the prior studies. This could just represent additional air tracking, although an ongoing air leak cannot be entirely excluded. Clinical correlation is advised. No definite pneumothorax is appreciated. Overall cardiac and mediastinal contours are stable. Multiple surgical clips in right paratracheal region as well as surgical chain sutures in the right upper and mid lung are again seen in this patient status post recent wedge resection. No focal airspace consolidation is seen to suggest pneumonia. No large effusions, although there is minimal blunting of the right costophrenic angle which may represent a tiny effusion and/or pleural thickening. No evidence of pulmonary edema. " 09c53ce5-16ccf3c0-65441b71-e767c292-e7d55406.jpg,validate/p15/p15353701/s56235768/09c53ce5-16ccf3c0-65441b71-e767c292-e7d55406.jpg,validation," WET READ: ___ ___ ___ 8:24 AM Pleural catheter projects over the right lower lung, similar to the prior examination. Right pleural effusion has decreased in size, revealing heterogeneous right lower lung airspace opacities. WET READ VERSION #1 ___ ___ ___ 12:43 AM Pleural catheter projects over the right lower lung, similar to the prior examination. Right pleural effusion has decreased in size, revealing heterogeneous right lower lung airspace opacities. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent R chest tube placement, new pain // please eval chest tube placement, pneumothorax please eval chest tube placement, pneumothorax IMPRESSION: In comparison with the earlier study of this date, there appears to be little change in the appearance of the pigtail catheter at the right base with substantial reduction in size of the pleural effusion. No evidence of pneumothorax. Left effusion with substantial volume loss in the lower lobe is unchanged. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. " 2c27614d-df5d18b9-d93249b6-10178a5f-05a69b81.jpg,validate/p14/p14429763/s56968110/2c27614d-df5d18b9-d93249b6-10178a5f-05a69b81.jpg,validation," FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of an enteric catheter. Although the tip is not well seen, it appears to extend at least to the lower stomach. Remainder of the study is essentially unchanged with some retrocardiac opacification consistent with volume loss in the left lower lobe. " 9d0b9000-77cfb82d-11f487c8-f6f99faf-96a980ce.jpg,validate/p18/p18709681/s57903614/9d0b9000-77cfb82d-11f487c8-f6f99faf-96a980ce.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of fall, 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 silhouette is mildly enlarged. The aorta is tortuous. Kyphoplasty/vertebroplasty of a mid thoracic vertebral body is incidentally noted. No displaced fracture is identified. IMPRESSION: Enlarged cardiac silhouette. No focal consolidation. " 4d0a7278-7ab4221a-5a88440f-b1df5c84-9d260c6c.jpg,validate/p19/p19343878/s53183554/4d0a7278-7ab4221a-5a88440f-b1df5c84-9d260c6c.jpg,validation," WET READ: ___ ___ ___ 6:07 PM Mild improvement of interstitial pulmonary edema. No other significant interval change. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Pulmonary edema with fever. FINDINGS: There is some mild improvement with decreased central vascular engorgement and slight decrease in cardiac silhouette. There is a small left pleural effusion and mild pulmonary vascular redistribution. IMPRESSION: Changing appearance of mild CHF. " 8d62252c-86215a33-d6dd3145-f70531b6-a3c4c2d9.jpg,validate/p12/p12590117/s58587071/8d62252c-86215a33-d6dd3145-f70531b6-a3c4c2d9.jpg,validation," FINAL ADDENDUM ADDENDUM: Findings were discussed with Dr. ___ over the phone by Dr. ___ at 10:15 a.m. and the findings were made approximately 30 minutes prior to that. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after intubation and respiratory failure. Portable AP radiograph of the chest was reviewed in comparison to ___. Tracheostomy is in place. Heart size and mediastinum are unchanged including cardiomegaly. There is interval progression of interstitial pulmonary edema in conjunction with increase in bilateral pleural effusions. Multiple rib fractures are noted, in particular involving upper right ribs laterally. No pneumothorax is seen. " 445935c8-ccd4a773-0f021caa-e1a7cf7e-ec21303d.jpg,validate/p16/p16773288/s56771559/445935c8-ccd4a773-0f021caa-e1a7cf7e-ec21303d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation of left pleural effusion. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. There is unchanged substantial left mediastinal widening after aortic repair. Left lower lobe atelectasis and blunting of the left costophrenic sinus suggest the presence of a left pleural effusion. This finding shows no relevant change in severity as compared to the previous image. Unremarkable appearance of the right lung, the right chest tube is in unchanged position. Overall, constant size and appearance of the cardiac silhouette. " 1eb49498-3c11a73c-acd15aa1-f395bc97-8f753818.jpg,validate/p11/p11888596/s53819235/1eb49498-3c11a73c-acd15aa1-f395bc97-8f753818.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumonia // eval for resolution of pneumonia, right lower lobe, now on last day of levofloxacin TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Compared to ___, the retrocardiac opacification, probably in the right lower lobe, has resolved. There is no pleural effusion or pneumothorax. No pulmonary edema. Heart size is normal. Mediastinal and hilar contours are normal. IMPRESSION: Resolved retrocardiac, probably right lower lobe, opacification. " ef8262b4-2c2b8549-39e5be2d-f56bb223-27dcea59.jpg,validate/p15/p15069333/s52247160/ef8262b4-2c2b8549-39e5be2d-f56bb223-27dcea59.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pericardial drain with SOB // ?pna, acute change, ptx ?pna, acute change, ptx COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Left lower lobe is chronically airless. Small left pleural effusion stable since ___. Moderate to severe cardiac enlargement also stable, despite the new pericardial drainage catheter. Left perihilar ground-glass opacification could be early edema. New peribronchial opacification in the right lower lobe concerning for aspiration. No pneumothorax. Left trans subclavian right atrial and ventricular pacer leads follow their expected courses from the left pectoral generator. " 9e46d723-ec08d3b9-e7b767ba-c6b774e3-05a9d1ed.jpg,validate/p16/p16939016/s53276344/9e46d723-ec08d3b9-e7b767ba-c6b774e3-05a9d1ed.jpg,validation," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumothorax or pneumonia. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a heart which is again top normal in size and well-aerated lungs which are clear. No focal consolidation, pleural effusion, or pneumothorax is seen. There is again pleural thickening at the bilateral apices, as well as a nodular opacity projecting over the left upper lung, unchanged dating back to at least ___. Old fractures of the right fifth and sixth ribs are also unchanged. IMPRESSION: No acute cardiopulmonary abnormality. " 8bb7b832-eba17799-52e31225-8c33a84b-cfd288c7.jpg,validate/p14/p14542380/s54776879/8bb7b832-eba17799-52e31225-8c33a84b-cfd288c7.jpg,validation," FINAL REPORT INDICATION: ___F with pericardial effusion // eval for pleural effusions 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 identified. Mild mid thoracic dextroscoliosis is noted. IMPRESSION: No acute cardiopulmonary process. " 6e250aab-ab256b89-25b2c9c3-b0ff80ac-2fed8903.jpg,validate/p16/p16887109/s55194703/6e250aab-ab256b89-25b2c9c3-b0ff80ac-2fed8903.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pneumonia 5 weeks ago // ?resolution of pneumonia ?resolution of pneumonia IMPRESSION: In comparison with the study of ___, there is no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " f9fcfda6-a1c09400-e9bbf87c-034ba2ba-03c37215.jpg,validate/p16/p16142166/s51705556/f9fcfda6-a1c09400-e9bbf87c-034ba2ba-03c37215.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. Hyperinflation of the lung likely reflects COPD. The heart is normal in size. The patient is status post median sternotomy, and a prosthetic aortic valve is also noted. IMPRESSION: No acute cardiopulmonary process. " 3e60abd3-9a99af38-06ce97ce-320093f3-54795c55.jpg,validate/p18/p18646710/s52567268/3e60abd3-9a99af38-06ce97ce-320093f3-54795c55.jpg,validation," FINAL REPORT EXAMINATION: CXR INDICATION: ___F with fever, cough // r/o pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, 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. " 0c0e1cd7-02fd9e50-6068aa5e-f00a2bdb-e5105c69.jpg,validate/p18/p18178435/s53039992/0c0e1cd7-02fd9e50-6068aa5e-f00a2bdb-e5105c69.jpg,validation," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: HIV, cough, chills, and right-sided rhonchi. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. On the lateral view, patchy posterior basilar opacity is seen, which could be due to pneumonia, not appreciated on the frontal view. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. " 93be51d0-5a124e30-5f57e43b-67ed4331-b176a482.jpg,validate/p17/p17593711/s50673015/93be51d0-5a124e30-5f57e43b-67ed4331-b176a482.jpg,validation," FINAL REPORT HISTORY: Hypoxia and cough, to assess for pulmonary edema. FINDINGS: In comparison with the study of ___, there is little change in the substantial pulmonary edema with bilateral pleural effusions and compressive atelectasis at the bases. In the appropriate clinical setting, superimposed pneumonia would have to be considered. " eac813c6-91db2470-386b77d7-24a7ba0b-c4b5133b.jpg,validate/p14/p14997616/s58756174/eac813c6-91db2470-386b77d7-24a7ba0b-c4b5133b.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cough and SIADH. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The lungs are mildly hyperinflated. The patient is status post CABG. Sternal wires are aligned. Moderate degenerative changes are in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 896bc1d1-0ff0d70d-3ff1fe01-ada2d980-7b9c445a.jpg,validate/p11/p11107643/s58530489/896bc1d1-0ff0d70d-3ff1fe01-ada2d980-7b9c445a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with c/o cough and SOB, question pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. CTA chest dated ___. FINDINGS: PA and lateral views the chest provided. Left chest wall pacer device and dual leads extent is the region of the right atrium and right ventricle. Cardiomediastinal silhouette is unchanged in overall size. No focal consolidation, large effusion or pneumothorax is seen. No edema or congestion. Bony structures are intact. IMPRESSION: No acute findings. " a96e22d8-02f407d8-19b67f65-9c73fe7d-d51e83c6.jpg,validate/p12/p12835242/s50065993/a96e22d8-02f407d8-19b67f65-9c73fe7d-d51e83c6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SOB, chills, lightheadness // pneumonia TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: Slight increase in opacity over the inferior spine on the lateral view, not substantiated on the frontal view, felt to unlikely represent consolidation, possibly atelectasis. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Subtle increase in opacity over the inferior spine on the lateral view, not substantiated on the frontal view, felt to unlikely represent consolidation, possibly atelectasis vs artifact. " c0ce69dd-a7d91322-59a4dbc9-62d23b49-5c239902.jpg,validate/p11/p11648387/s50116355/c0ce69dd-a7d91322-59a4dbc9-62d23b49-5c239902.jpg,validation," FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: A right basilar opacities unchanged common due to underlying calcified granulomas in bronchiectasis. Fat pad noted at the right cardiophrenic angle. No new focal opacity concerning for pneumonia. No pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: Unchanged right basilar opacity. No new opacity concerning for pneumonia. " 99bf3255-36369c20-c45f4fa6-e45eccea-44b77b0e.jpg,validate/p12/p12881468/s58663489/99bf3255-36369c20-c45f4fa6-e45eccea-44b77b0e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post VATS left lung surgery. COMPARISON: ___, 11:49. FINDINGS: As compared to the previous radiograph, the left chest tube has been removed. There is no pneumothorax. The lung volumes remain relatively low with areas of atelectatic opacities at the right lung base. Clips projecting over the mediastinum. Normal size of the cardiac silhouette. " 77bd9c2b-533a704b-ff4088b3-66e761c4-d1441b1f.jpg,validate/p15/p15995969/s56260808/77bd9c2b-533a704b-ff4088b3-66e761c4-d1441b1f.jpg,validation," FINAL REPORT INDICATION: Altered mental status. Evaluate for pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The lung volumes are low. There is noconsolidation, pulmonary edema, pleural effusion or pneumothorax. There is a possible 9 mm nodule in the right upper lung zone. The mediastinal silhouette is normal. The heart size is at the upper limits of normal. IMPRESSION: 1. No acute cardiopulmonary process. 2. Possible right upper lobe pulmonary nodule; recommend further evaluation with a non-emergent CT of the chest if clinically indicated. Results were discussed with Dr. ___ at 10:20 AM on ___ via telephone by Dr. ___. " 3bafbec4-2d64c2ed-ebe577a9-8567f1f2-eea63d0d.jpg,validate/p14/p14068639/s59868269/3bafbec4-2d64c2ed-ebe577a9-8567f1f2-eea63d0d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with CHF // ?worsening CHF COMPARISON: Compared to prior radiograph from ___. IMPRESSION: AICD is unchanged. There is mild improved aeration of the right upper lobe. There remains a left retrocardiac opacity and moderate pulmonary edema. Small bilateral effusions are seen. There are low lung volumes " d044284a-abe87241-6ac3b57b-71c3fdad-757a1da4.jpg,validate/p14/p14886127/s51491172/d044284a-abe87241-6ac3b57b-71c3fdad-757a1da4.jpg,validation," WET READ: ___ ___ ___ 9:48 PM 1. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ALL on high dose steroids with worsening cough // interval change, r/o PNA interval change, r/o PNA IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE IS LITTLE CHANGE. CARDIAC SILHOUETTE IS WITHIN NORMAL LIMITS AND THERE IS NO VASCULAR CONGESTION, PLEURAL EFFUSION, OR ACUTE FOCAL PNEUMONIA. THE TIP OF THE LEFT PICC LINE IS IN THE MID SVC. " e7873ac5-c2821cc5-4a9dfdbc-5548d795-fd924571.jpg,validate/p13/p13305035/s56432625/e7873ac5-c2821cc5-4a9dfdbc-5548d795-fd924571.jpg,validation," FINAL REPORT HISTORY: Aspiration pneumonia with coarse breath sounds. FINDINGS: In comparison with the study of ___, there is again diffuse bilateral pulmonary opacifications, which in a patient with cardiac enlargement and prior surgery suggests pulmonary edema. Hazy opacification at the bases suggestive of bilateral pleural effusions, more prominent on the left. In view of the extensive pulmonary opacification, it would be difficult to exclude a superimposed pneumonia. " c9d8db39-ef7af737-2ff25c9e-ab9336ba-8f99022a.jpg,validate/p10/p10038999/s53087507/c9d8db39-ef7af737-2ff25c9e-ab9336ba-8f99022a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with drained pericardial effusion, bilateral pleural effusions // eval for interval changes COMPARISON: ___ FINDINGS: ET and NG tube have been removed. Right-sided PICC line overlies proximal/mid SVC.No pneumothorax is detected. There are low inspiratory volumes. Cardiomediastinal silhouette is similar to prior. There is patchy opacity at the left lung base and increased retrocardiac density, slightly more pronounced. Some vascular crowding is present at the right lung base. Small effusions would be difficult to exclude. IMPRESSION: Low inspiratory volumes. Slight increase in opacities at the left lung base. " 763f73ee-5fb52a8c-bb831141-4cbeb360-7d4873c1.jpg,validate/p18/p18296202/s58561335/763f73ee-5fb52a8c-bb831141-4cbeb360-7d4873c1.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever and hypoxia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes and elevation of the right hemidiaphragm. Bibasilar opacities are seen which could in part relate to atelectasis, although underlying consolidation is not excluded. No large pleural effusion is seen, although small is difficult to exclude. The cardiac silhouette is difficult to assess due to bibasilar opacities. The bibasilar opacities could also relate to chronic aspiration. " ca9f087f-99d1bd46-fbaf2fe6-95a2fe70-d198de97.jpg,validate/p13/p13679494/s53309802/ca9f087f-99d1bd46-fbaf2fe6-95a2fe70-d198de97.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of psychiatric, presents with hallucinations, cough and strange breathing, question pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is subtle small area of left base opacity which could be due to artifact, although an underlying early consolidation cannot be entirely excluded. The right lung is clear. No pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: Small very subtle focus of increased density at the left lung base may be artifactual, but in the appropriate clinical setting, early/mild consolidation cannot be excluded. Remainder of the lung fields is clear. " 9d6a779c-5a6e509c-ee6b5365-5f796193-1d71ce48.jpg,validate/p14/p14474735/s53967116/9d6a779c-5a6e509c-ee6b5365-5f796193-1d71ce48.jpg,validation," FINAL REPORT HISTORY: Postoperative tracheal reconstruction. FINDINGS: In comparison with the study of ___, there again are low lung volumes, which accentuate the size of the cardiac silhouette. Suture drain overlying the upper mediastinum has been removed. No evidence of acute focal pneumonia or vascular congestion. " 3d2d85bd-c9a59fba-153a4bf7-ead48b9f-32dad243.jpg,validate/p19/p19129105/s57788904/3d2d85bd-c9a59fba-153a4bf7-ead48b9f-32dad243.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman who is being worked up to be a allogeneic transplant donor. // r/o pulmonary/cardiac concerns r/o pulmonary/cardiac concerns COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: The lungs are hyperinflated. Emphysema, largely paraseptal was demonstrated by a chest CTA in ___, and bullae are probably responsible for the constellation of ring shadows seen in the right upper lobe at the level of the third anterior rib. Lungs are otherwise clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 5266b42d-a48ecb2d-f3613ac2-71778b48-164f9afc.jpg,validate/p19/p19758044/s53922935/5266b42d-a48ecb2d-f3613ac2-71778b48-164f9afc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with RUL abscess on vanc and empyema s/p chest tube. // interval change with chest tube TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Right lower lobe opacities have markedly improved. Right upper lobe opacity is unchanged. Right base pigtail catheter remains in place. There are low lung volumes. Cardiac size is normal. There is no evident pneumothorax. Right PICC tip is in the cavoatrial junction. " 2ae82330-8aa965f5-a811c7b7-73cf5c80-f2006ab9.jpg,validate/p14/p14319319/s54489741/2ae82330-8aa965f5-a811c7b7-73cf5c80-f2006ab9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Fever, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is vague opacity in the left perihilar region, which is concerning for pneumonia. In addition, there is subtle increased opacity in the right lower lobe, which also may represent a focus of pneumonia. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. A screw is partially imaged in the right humeral head. IMPRESSION: Left perihilar and right lower lobe opacities concerning for pneumonia. " b849d55c-38f107c1-04a44347-c6125a75-24f3ec53.jpg,validate/p15/p15814270/s52344256/b849d55c-38f107c1-04a44347-c6125a75-24f3ec53.jpg,validation," FINAL REPORT INDICATION: History leukocytosis. Please evaluate. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart is mildly enlarged. The hilar and mediastinal contours are unremarkable. No focal consolidations concerning for pneumonia are identified. Note is made of mild bibasilar atelectasis. There is no pleural effusion or pneumothorax. Compression deformities of the mid thoracic spine are of indeterminate chronicity. IMPRESSION: 1. No focal consolidations concerning for pneumonia are identified. 2. Compression deformities of the mid thoracic spine are of indeterminate chronicity. Please correlate clinically, or with prior exams. " b9687254-0a602535-453430f4-9c9bee17-0acd9fbf.jpg,validate/p10/p10911067/s56908688/b9687254-0a602535-453430f4-9c9bee17-0acd9fbf.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Tachypnea, evaluation for pneumonia, effusion or pneumothorax. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette, normal hilar and mediastinal structures. There is no evidence of pleural effusions or pneumothorax. No pulmonary edema. No pneumonia, no other parenchymal changes. No evidence of rib fractures. " 0ba34ab5-13b979cd-27714912-8182f72b-3da45de2.jpg,validate/p11/p11483216/s50831392/0ba34ab5-13b979cd-27714912-8182f72b-3da45de2.jpg,validation," FINAL REPORT INDICATION: Fever, on chemotherapy. COMPARISON: ___. TECHNIQUE: Upright AP and lateral views of the chest. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unchanged. Right PICC has been removed. Lungs remain hyperinflated with emphysematous changes again noted. Small left pleural effusion is similar compared to the prior study. There is no focal consolidation or pneumothorax. Minimal left basilar atelectasis is present. There are mild degenerative changes in the thoracic spine. IMPRESSION: Small left pleural effusion. Persistently hyperinflated lungs with emphysema. " 6ad7ddf4-e82cd3cb-f799e675-ef851817-b99fcafa.jpg,validate/p17/p17957742/s58211736/6ad7ddf4-e82cd3cb-f799e675-ef851817-b99fcafa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NSTEMI going for CABG // pre-op pre-op COMPARISON: Chest radiograph ___ 19:18 IMPRESSION: Tip of the new intra-aortic pump balloon is less than a cm from the aortic apex and should be withdrawn 3.5 cm for standard placement. Patient has at least mild to moderate pulmonary fibrosis predominantly basilar and asbestos related, calcified pleural plaques, suggesting a specific diagnosis of asbestosis. Since ___ one greater opacification at the right lung base and suggests either early edema or developing pneumonia in that location. Heart is not enlarged. Pleural effusion is small, on the right, if any. No pneumothorax. Irregular thickening of the right apical pleural margin suggests prior tuberculosis. There is no good evidence of reactivation infection. NOTIFICATION: Dr. ___ reported the findings to Dr. ___ by telephone on ___ at 3:08 PM, 1 minutes after discovery of the findings. " 0db938e1-690dc984-ba844f21-de21580a-832ae129.jpg,validate/p11/p11296936/s54190246/0db938e1-690dc984-ba844f21-de21580a-832ae129.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath and hypoxia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Prominence of the interstitium and vasculature is worrisome for moderate pulmonary edema. There are trace bilateral pleural effusions. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Findings worrisome for moderate pulmonary edema, superimposed infectious process is not included in the appropriate clinical setting. Trace pleural effusions. " a9004af3-9f2d2ed9-4612ce69-a67697b3-b11aa51b.jpg,validate/p17/p17671146/s56963490/a9004af3-9f2d2ed9-4612ce69-a67697b3-b11aa51b.jpg,validation," 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. " 3830214d-e8203cb9-f36b961b-82bc2542-fb44a797.jpg,validate/p10/p10425278/s51089363/3830214d-e8203cb9-f36b961b-82bc2542-fb44a797.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough/fever. hx carcinoid resection // ? pneumonia ? pneumonia IMPRESSION: Heart size and mediastinum are stable. Bi apical scarring, right mediastinal shift and cystic opacities in the it SS are stable. Pleural thickening in the right costophrenic angle is unchanged. No new focal consolidations or masses seen. " 05e29441-5a07f26f-413bde84-0f6e1fca-dda36a5b.jpg,validate/p12/p12010209/s58354398/05e29441-5a07f26f-413bde84-0f6e1fca-dda36a5b.jpg,validation," 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. " 0bf3dfa1-2e5685ef-3cd83214-a984335d-25d11060.jpg,validate/p10/p10759461/s52865651/0bf3dfa1-2e5685ef-3cd83214-a984335d-25d11060.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with tachypnea. COMPARISON: None available PORTABLE FRONTAL CHEST RADIOGRAPH: The patient is rotated to the right, which results in limited evaluation of the mediastinal structures, though the mild cardiomegaly is likely. There is blunting of bilateral costophrenic angles, which may be secondary to small effusions. Bilateral atelectasis is also likely. No overt interstitial pulmonary edema is identified. There is no pneumothorax. IMPRESSION: Probable small bibasilar pleural effusions and atelectasis. No overt interstitial edema. " 7fc36c17-cccea873-061260bf-7decdbd5-41020f86.jpg,validate/p11/p11250458/s51093508/7fc36c17-cccea873-061260bf-7decdbd5-41020f86.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with rash. COMPARISON: Prior exam from ___. FINDINGS: PA and lateral views of the chest were provided. No focal consolidation, effusion or pneumothorax is seen. Calcified granuloma in the left mid lung as well as calcified mediastinal lymph nodes noted. No signs of congestive heart failure. The heart and mediastinal contours normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " aa330111-f0ec14b1-40399ec9-69a91d67-1dcbf137.jpg,validate/p19/p19887372/s54728288/aa330111-f0ec14b1-40399ec9-69a91d67-1dcbf137.jpg,validation," FINAL REPORT HISTORY: Fever. Evaluate for pneumonia. COMPARISON: None available. FINDINGS: Frontal and lateral views of 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. " 4602276e-79603c01-92f5c894-a5f71e1d-bdb6f536.jpg,validate/p10/p10091873/s51220649/4602276e-79603c01-92f5c894-a5f71e1d-bdb6f536.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with neck carcinoma recently completed chemoradiation therapy with cisplatin. Now with nausea and vomiting. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: CT abdomen and pelvis ___ 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 some mid thoracic vertebral bodies. IMPRESSION: No acute cardiopulmonary abnormality. " d7bca336-014aa129-499a2167-0fb1f141-a39a138a.jpg,validate/p19/p19188435/s56773817/d7bca336-014aa129-499a2167-0fb1f141-a39a138a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea // etiology IMPRESSION: As compared to previous study of 1 day earlier, the patient has been intubated, with tip of tube abutting the lower right lateral wall of the trachea approximately 1.3 cm above the carina. Withdrawal by a few cm is suggested for optimal positioning. Exam is otherwise remarkable for a very large hiatal hernia, adjacent left lower lobe atelectasis or consolidation, and a moderate layering left pleural effusion. New right upper lobe opacities could reflect aspiration or evolving pneumonia in the appropriate clinical setting. Previously present free intraperitoneal air is less apparent, probably are due to supine positioning. " dee868e2-c0a1b8dc-8fd18431-fb1ef21f-b6cd3421.jpg,validate/p17/p17767787/s55517212/dee868e2-c0a1b8dc-8fd18431-fb1ef21f-b6cd3421.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new onset productive cough, crackles, finished recent course for cap // r/o pna vs pulm edema IMPRESSION: As compared to previous radiograph of 3 days earlier, pulmonary edema has decreased in severity with residual interstitial edema remaining. The small to moderate bilateral pleural effusions appear similar with adjacent bibasilar opacities. A focus of consolidation medially at the right lung base could potentially represent a site of infectious pneumonia in the appropriate clinical setting. " 49dee88a-4697fc46-1a601a33-416ae31c-d0db121a.jpg,validate/p12/p12762984/s59745116/49dee88a-4697fc46-1a601a33-416ae31c-d0db121a.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with fever and cough. COMPARISONS: None at this institution. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well inflated and clear. No focal consolidation, effusion, or pneumothorax is present. The heart is mildly enlarged. Otherwise, the cardiac and mediastinal contours are normal. IMPRESSION: Mild cardiomegaly. No acute cardiopulmonary process. This finding was discussed with ___ at the office of Dr. ___ at approximately 1:15 on ___. " 053ea6ed-cf648615-20b8a3e9-7d1c7c4e-56c5636f.jpg,validate/p18/p18140285/s51905533/053ea6ed-cf648615-20b8a3e9-7d1c7c4e-56c5636f.jpg,validation," FINAL REPORT INDICATION: ___M with weakness, syncope, evaluate for pneumonia. TECHNIQUE: AP and lateral chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: There are low lung volumes. Allowing for changes due to this, the cardiomediastinal silhouettes are stable and within normal limits, with a mildly tortuous thoracic aorta. Mild prominence of the cardiac silhouette likely relates to low lung volumes and AP technique. There is no focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Low lung volumes. No acute cardiopulmonary process. " 0e6a09f1-8eafda4a-a6090374-918dcaa0-dc94a810.jpg,validate/p13/p13050559/s59121624/0e6a09f1-8eafda4a-a6090374-918dcaa0-dc94a810.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old male with large paratracheal hilar mass status post mediastinoscopy and bronchoscopy, now with neck swelling, fever, and congestion. Evaluate for pneumothorax or pneumomediastinum. FINDINGS: Comparison is made to previous study from ___. There is again seen right upper lobe collapse and increased density which is stable. However, the inferior margin is less sharp. The heart size is within normal limits. No definite pneumomediastinum is seen. There are no pleural effusions. There is some soft tissue swelling about the lower neck. " 049133c3-8857901b-0ab65750-ad294207-f2d2671d.jpg,validate/p16/p16278732/s59824687/049133c3-8857901b-0ab65750-ad294207-f2d2671d.jpg,validation," FINAL REPORT INDICATION: Chest pain, pulmonary edema, pleural effusion, question pneumonia. COMPARISONS: PA and lateral chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Lung volumes are slightly low. The cardiomediastinal silhouette is unremarkable. Osseous structures are unremarkable. IMPRESSION: Low lung volumes, no overt pathology. " ae18a928-e4fccd5f-2c6db829-6ebf958f-ce6e5aa7.jpg,validate/p15/p15810543/s59479813/ae18a928-e4fccd5f-2c6db829-6ebf958f-ce6e5aa7.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with left-sided chest pain. FINDINGS: Frontal and lateral views of the chest. No prior. Low lung volumes are noted. Lungs are clear without consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 97998f75-6f212855-364a3948-606d2eb0-2deabce5.jpg,validate/p15/p15863098/s54958852/97998f75-6f212855-364a3948-606d2eb0-2deabce5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after left VATS lobectomy and pleurodesis. Portable AP radiograph of the chest was compared to ___. The two left chest tubes have been placed after surgery. Left basal opacities representing atelectasis. There is substantial interval decrease in pneumothorax. Right basal opacity might reflect atelectasis due to low lung volume. Distended stomach is noted on the left that most likely contributes to elevated left hemidiaphragm and left basal atelectasis. " 01a777e6-406cf311-34b35752-ef74d8e0-a623dad4.jpg,validate/p14/p14661688/s51447903/01a777e6-406cf311-34b35752-ef74d8e0-a623dad4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SIADH // r/o lung lesions r/o lung lesions IMPRESSION: In comparison with the study of ___, there is little overall change. No evidence of acute focal pneumonia or vascular congestion. " 807c83cd-c7e0a3a3-7074ac47-e37361b1-e7fac003.jpg,validate/p11/p11658675/s55310365/807c83cd-c7e0a3a3-7074ac47-e37361b1-e7fac003.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain and shortness of breath. Recently admitted for aspiration pneumonia. COMPARISON: ___. FINDINGS: There are low lung volumes, with improvement in bibasilar airspace opacity. Bilateral lower lung streaky opacities are slightly improved from prior study suggesting slight interval improvement in aeration. The cardiac silhouette is stable, and normal in size. The mediastinal contours are notable for calcification of the aortic arch. Vertebroplasty cement is noted at two vertebral body levels. " 7bacd385-deb39d6d-05035e43-70e38ef9-6a3f4a62.jpg,validate/p10/p10188472/s50107474/7bacd385-deb39d6d-05035e43-70e38ef9-6a3f4a62.jpg,validation," FINAL REPORT HISTORY: Worsening palpitations. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is mildly enlarged. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is not engorged. No focal consolidation, pleural effusion or pneumothorax is seen. Minimal atelectatic changes are noted in the right lung base. Multilevel degenerative changes are re- demonstrated in the thoracic spine. Clips are noted within the left upper quadrant of the abdomen. IMPRESSION: Minimal right basilar atelectasis. " d99eff97-ac537a27-a7f681fe-08cbe418-ebace2a3.jpg,validate/p11/p11129702/s55622670/d99eff97-ac537a27-a7f681fe-08cbe418-ebace2a3.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Linear left basilar opacities that is unchanged from prior and may represent atelectasis or scarring. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. Surgical clips seen in the upper abdomen. IMPRESSION: No acute cardiopulmonary process, no evidence of pneumonia. " 27c1bef8-848e3717-e509b5c0-b76ae902-884a6eb3.jpg,validate/p18/p18019452/s53248506/27c1bef8-848e3717-e509b5c0-b76ae902-884a6eb3.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with right-sided pneumothorax, left lower lobe pneumonia. FINDINGS: Comparison is made to previous study from ___. There is a very tiny right apical pneumothorax near the tip of the right-sided chest tube. No pneumothorax on the left side is seen. There is again seen unchanged diffuse consolidation throughout both lung fields, more confluent in the left mid and lower lung fields. The lines and tubes appear stable in position and appropriately sited. " dd3c74f3-1d9d0066-b3b8179a-aee8c1b5-6e6cf66a.jpg,validate/p14/p14627594/s54045342/dd3c74f3-1d9d0066-b3b8179a-aee8c1b5-6e6cf66a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with coughing // ? aspiration COMPARISON: Chest x-ray from ___ at 15:22 FINDINGS: There are low inspiratory volumes. Heart size is at the upper limits of normal. The aorta is calcified and slightly tortuous. No CHF, effusion, or pneumothorax is detected. Streaky bibasilar opacities are again noted, consistent with bibasilar atelectasis. On the lateral view, there is considerable overlap posteriorly, limiting assessment of the lower lobes. No definite focal infiltrate and no definite change compared with ___ is detected. No frank consolidation is identified. IMPRESSION: Bibasilar atelectasis, similar to the film from 2 days earlier. No definite new focal infiltrate. Please see comment above. " b16f59b3-ad2da05e-1be38a33-6afa0ab1-561a11f8.jpg,validate/p18/p18527379/s55709470/b16f59b3-ad2da05e-1be38a33-6afa0ab1-561a11f8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain x 1 month with gallop on exam // evaluate for cardiomegaly TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Patchy right base opacity could be due to overlap of structures versus small consolidation. No pleural effusion is seen. There is no pneumothorax. The cardiac silhouette is enlarged, with apparent enlargement of the left atrium. No overt pulmonary edema is seen. Mediastinal contours unremarkable. IMPRESSION: Enlarged cardiac silhouette. No overt pulmonary edema is seen. Patchy right base opacity could relate to overlap of structures although consolidation due to pneumonia is not excluded in the appropriate clinical setting. " 65b70c09-cbf347ef-be511699-363b71a0-3606f4c6.jpg,validate/p14/p14344189/s59619073/65b70c09-cbf347ef-be511699-363b71a0-3606f4c6.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:48 AM 1. Lines and tubes in place. 2. Diffuse interstitial and airspace opacities the differential for which includes pulmonary edema, pulmonary hemorrhage, interstitial lung disease, or components of each; subtly increased in left upper lung. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with respiratory failure status post intubation. STUDY: Portable AP semi-upright chest radiograph. COMPARISON: ___. FINDINGS: There has been interval placement of an endotracheal tube whose tip sits ___ cm above the carina. Endogastric tube courses inferiorly with its side port well below the GE junction. A right-sided PICC tip terminates at the lower SVC. The cardiomediastinal contours are within normal limits. Diffuse airspace opacities are present, as well as an underlying interstitial process; these opcacities are subtly increased in the left upper lung. There is no large pleural effusion or pneumothorax. IMPRESSION: 1. Lines and tubes in place. 2. Diffuse interstitial and airspace opacities the differential for which includes pulmonary edema, pulmonary hemorrhage, interstitial lung disease, or components of each; subtly increased in left upper lung. " 163a13a1-0472ac1a-cd446073-013928f2-96d81409.jpg,validate/p18/p18704423/s54134001/163a13a1-0472ac1a-cd446073-013928f2-96d81409.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Dob huff advanced // Dob huff placement TECHNIQUE: Single frontal view of the chest COMPARISON: Portable chest x-ray ___ FINDINGS: Dobhoff remains positioned appropriately in the upper stomach. Study remains unchanged from prior. IMPRESSION: Dobhoff is appropriately positioned in the upper stomach. No changes since prior. " aab67c04-14a8c112-88035878-d1543e69-05ea3a6e.jpg,validate/p15/p15403852/s51020579/aab67c04-14a8c112-88035878-d1543e69-05ea3a6e.jpg,validation," 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 ___, the monitoring and support devices are essentially unchanged. There are again relatively low lung volumes with worsening retrocardiac opacification consistent with pleural fluid and substantial volume loss in the left lower lobe. Minimal atelectatic changes are seen on the right. " fbce215b-ffda5a5c-35f85a98-99ae6f6e-9f5ebb30.jpg,validate/p13/p13510413/s59674841/fbce215b-ffda5a5c-35f85a98-99ae6f6e-9f5ebb30.jpg,validation," FINAL REPORT INDICATION: Vomiting, evaluate for free air. COMPARISON: Chest radiograph on ___. FINDINGS: One portable AP upright view of the chest. There is no evidence of free air. The lungs are clear. The cardiac, mediastinal, and hilar contours are normal. No pleural effusion or pneumothorax. IMPRESSION: No evidence of free air. " 8abf3c5a-e011ed63-788b3697-41327379-3075bce8.jpg,validate/p14/p14772351/s58867295/8abf3c5a-e011ed63-788b3697-41327379-3075bce8.jpg,validation," 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 again are low lung volumes. However, the heart remains within normal limits in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " e2bf1d09-d36ab273-469cf62e-9e93f0b6-f5d934ca.jpg,validate/p19/p19381076/s57907904/e2bf1d09-d36ab273-469cf62e-9e93f0b6-f5d934ca.jpg,validation," FINAL REPORT HISTORY: Cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change and no evidence of discrete focal pneumonia. No vascular congestion or pleural effusion. " c02b126a-ba3083be-132678f1-f4d49a2f-b6bc5244.jpg,validate/p18/p18212113/s52496786/c02b126a-ba3083be-132678f1-f4d49a2f-b6bc5244.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p CABG // eval ptx TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Large bilateral pleural effusions right greater than left have increased. Bilateral adjacent atelectasis have also increased. There is no pneumothorax. Right IJ catheter tip is in the IVC as before. Cardiomediastinal contours are unchanged. Sternal wires are aligned. Moderate pulmonary edema has worsened " f34bc293-8770ea02-bbf20219-d9613f47-5f9ebee3.jpg,validate/p15/p15878234/s50070953/f34bc293-8770ea02-bbf20219-d9613f47-5f9ebee3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with hx of oleural and pericardial effusions presented with worsening SOB. Evaluate for changes // Evaluate for changes COMPARISON: Chest radiographs since ___, most recently ___ II ___. IMPRESSION: Previous pulmonary vascular engorgement has improved. The small right pleural effusion is slightly smaller, and the even smaller left pleural effusion is substantially smaller today than on ___. Mild cardiomegaly unchanged. No pulmonary edema. A region of atelectasis in the right lower lobe that developed after ___ has yet to clear. Presence of pericardial effusion is not diagnosable on conventional chest radiographs. Transvenous right atrial right ventricular pacer leads of the expected courses from the left pectoral pacemaker. No pneumothorax. Patient has had right mastectomy. " 3010989e-eb7b4f9d-44a757b0-be56e1d9-f634b83e.jpg,validate/p17/p17698189/s52648266/3010989e-eb7b4f9d-44a757b0-be56e1d9-f634b83e.jpg,validation," FINAL REPORT INDICATION: Patient with tachypnea and chills. Assess for pneumonia. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate diffuse right upper lobe opacity abutting minor fissure. No pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. Visualized osseous structures are intact. IMPRESSION: Right upper lobe opacity is new from ___ exam, and is compatible with pneumonia in the appropriate clinical setting. " 2666b32d-07fc1036-ca32af85-a035cd11-cbecdc7a.jpg,validate/p11/p11600855/s56548462/2666b32d-07fc1036-ca32af85-a035cd11-cbecdc7a.jpg,validation," WET READ: ___ ___ 7:48 PM No acute cardiopulmonary process. Nodular opacity over the left lung apex. This could potentially be within the bone or in the parenchyma from pulmonary nodule or scarring. Nonurgent followup chest CT is suggested. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with afib with rvr // Eval for infiltrate TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is no focal consolidation, effusion, or edema. Streaky suprahilar right opacity is seen. This could be due to atelectasis. There is biapical scarring. Nodular opacity projecting over the left fourth rib at the lung apex cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. Nodular opacity over the left lung apex. This could potentially be within the bone or in the parenchyma from pulmonary nodule or scarring. RECOMMENDATIONS: Nonurgent followup chest CT is suggested. " 5707f13f-3ae7f8b1-e1d44d37-165d5282-a4bf609c.jpg,validate/p10/p10804034/s59980587/5707f13f-3ae7f8b1-e1d44d37-165d5282-a4bf609c.jpg,validation," WET READ: ___ ___:___ AM No radiographic evidence of pneumonia. The findings were discussed with Dr. ___, ___D. by ___, ___D. on the telephone on ___ at 5:___ PM, 5 minutes after discovery of the findings. WET READ VERSION #1 ___ ___:___ PM No radiographic evidence of pneumonia. The findings were discussed with Dr. ___, ___D. by ___, ___D. on the telephone on ___ at 5:___ PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old ___ woman with 2 months of productive cough, night sweats // infiltrate? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable, the cardiac size is normal. hilum bilaterally are enlarged as before. The lungs are clear. There are low lung volumes. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable IMPRESSION: No evidence of pneumonia. Enlargement of the hilum bilaterally is again noted, due to lymphadenopathy, minimally increased from prior study. CT is recommended for further evaluation NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at ___:___ into the Department of Radiology critical communications system for direct communication to the referring provider. " 9cee4d12-047a8345-4565ff38-157fdfd0-5f942ada.jpg,validate/p16/p16514111/s53311031/9cee4d12-047a8345-4565ff38-157fdfd0-5f942ada.jpg,validation," 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. " a70b1c23-4930c918-d6878fc2-99ee14d2-22a7c38c.jpg,validate/p17/p17131451/s54926034/a70b1c23-4930c918-d6878fc2-99ee14d2-22a7c38c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with new fever, leukocytosis // r/o PNA TECHNIQUE: Chest upright AP and lateral COMPARISON: Chest radiograph from ___, ___. FINDINGS: Increased opacity in the right mid lung likely localizes to the right upper lobe on lateral view. Mild cardiomegaly is stable. The lungs are hyperexpanded, unchanged. Chronic diffuse interstitial lung changes may be related to age and are similar to prior examination. Mediastinal contour, hilar, and cardiac borders are stable. No pneumothorax or pleural effusion. IMPRESSION: 1. Increased opacity in right upper lobe concerning for early pneumonia. 2. Stable mild cardiomegaly and chronic interstitial changes. RECOMMENDATION(S): Repeat radiograph is recommended 6 weeks after treatment to ensure resolution. NOTIFICATION: The findings were discussed with Dr. ___, M.D. by ___, M.D. on the telephone on ___ at 4:34 PM, 10 minutes after discovery of the findings. " a58977fc-b8f31e9a-aeea6305-5672896a-929ae340.jpg,validate/p14/p14268088/s59014359/a58977fc-b8f31e9a-aeea6305-5672896a-929ae340.jpg,validation," FINAL REPORT INDICATION: Pt with critical AS/ ? pulmonary edema ?pneumonia EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: Moderate to large bilateral pleural effusions with bilateral lower lobe collapse are stable. Previous moderate pulmonary edema has improved since ___. There is heavy calcification in the mitral valve annulus and aortic valve. Moderate cardiomegaly is unchanged. IMPRESSION: Stable moderate to large bilateral pleural effusions with bilateral lower lobe collapse. Overall lung volume and mild pulmonary edema is slightly improved compared to ___ " dc9a6908-8024a7c6-b82e6db7-c2387016-0944129d.jpg,validate/p19/p19633644/s55673066/dc9a6908-8024a7c6-b82e6db7-c2387016-0944129d.jpg,validation," 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. " 8d36947d-8fec52ec-87ca49e6-f3bff0cf-defb8ce8.jpg,validate/p17/p17561108/s51844066/8d36947d-8fec52ec-87ca49e6-f3bff0cf-defb8ce8.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with history of lymphoma who developed pneumonitis s/p chemotherapy, who presents for evaluation of interval change. COMPARISON: Chest radiograph from ___, ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There has been an interval increase in the right pulmonary vascular congestion and pulmonary edema. There has been a slight increase in opacity over the right lower lobe compared to the prior exam. The left lung is clear. There is a background of chronic interstitial abnormality. There are no significant pleural effusions. There is no pneumothorax. There is moderate enlargement of the cardiac silhouette, unchanged compared to multiple prior exams dating back to ___. The hilar and mediastinal contours are otherwise unremarkable. Median sternotomy wires are stable, and patient is s/p AVR. Widening of the left acromioclavicular joint is chronic. There is a right-sided Port-A-Cath with the tip terminating in the mid SVC. IMPRESSION: 1. Interval increase in the right lower lobe opacification compared to the prior exam. This could be secondary to progression of pneumonitis, or if the patient is clinically presenting with cough/fever, could be secondary to an infectious etiology. 2. Slight interval increase in right-sided pulmonary edema and pulmonary vascular congestion compared to the prior study. " 9b4fe14c-14a2b9ce-497bcfcb-12117e2a-457222f8.jpg,validate/p14/p14566045/s51601373/9b4fe14c-14a2b9ce-497bcfcb-12117e2a-457222f8.jpg,validation," FINAL REPORT INDICATION: History: ___M with NG tube // eval for new NGT placement //History: ___M with NG tube TECHNIQUE: SINGLE PORTABLE VIEW OF THE CHEST COMPARISON: Radiograph from 4 hr prior FINDINGS: In the interval since the prior radiograph there is an NG tube that has been placed which terminates in the region of the pylorus. The remainder of the exam remains relatively stable the top-normal heart size. Streaky opacities at the right lung base are compatible with atelectasis. There is no large pleural effusion. There is no pneumothorax. IMPRESSION: NG tube within the stomach. " 605237b8-60bf0682-257cfbc2-0634e8e1-ff0d1966.jpg,validate/p17/p17651554/s50769151/605237b8-60bf0682-257cfbc2-0634e8e1-ff0d1966.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man with known systolic heart failure, sepsis of pulmonary versus urinary source // R/o worsening pulmonary edema COMPARISON: Chest radiographs ___. IMPRESSION: The prior chest radiographs suggest a dilated ascending thoracic aorta. This region is obscured on the current examination. There is clearly mediastinal venous distention, accompanied by pulmonary vascular redistribution in the upper lungs and mild edema in the lower. There is substantial atelectasis in the right lower lung, less severe on the left. Pleural effusion is probably moderate on the right and smaller on the left. The extent of cardiomegaly is difficult to assess. A oval opacity in the right mid lung could be either pulmonary or fissural pleural fluid. I would recommend chest CT scanning in order to discriminate the pulmonary from the pleural abnormalities. There is no pneumothorax. " cfbfab8f-d2c2df88-1a39e589-c8713e53-93ec146a.jpg,validate/p17/p17446597/s58705101/cfbfab8f-d2c2df88-1a39e589-c8713e53-93ec146a.jpg,validation," FINAL REPORT AP CHEST, 4:35 A.M., ___ HISTORY: ___-year-old man with history of CHF and coronary artery disease. Recent mechanical fall, subdural hematoma. Fever and hypoxia. IMPRESSION: AP chest compared to ___ at 12:15 p.m.: Moderately severe pulmonary edema has minimally improved, while moderate-to-large right pleural effusion has worsened. Moderate cardiomegaly is stable. It would be difficult to recognize early pneumonia given the other pulmonary and pleural abnormality. No pneumothorax. " 94c0ab39-109dd710-bf107a70-8dc8738a-773dfb5a.jpg,validate/p15/p15334868/s52808854/94c0ab39-109dd710-bf107a70-8dc8738a-773dfb5a.jpg,validation," FINAL REPORT INDICATION: ___F with acute onset left facial heaviness and left arm heaviness concerning for TIA vs cardiac cause, evaluate for any cardiac abnormalities . COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No acute cardiopulmonary process. " c3a4d90e-f9146395-9160a398-89f504b3-5c40fb79.jpg,validate/p16/p16455067/s54313948/c3a4d90e-f9146395-9160a398-89f504b3-5c40fb79.jpg,validation," FINAL REPORT HISTORY: Severe shortness of breath. COMPARISON: Chest radiograph ___, every ___. FINDINGS: Two AP views of the chest were obtained. Cardiomediastinal and hilar contours are stable. Again seen is a left lower lobe and lingula opacity in which is stable to slightly increased since the prior study. There may be a small left pleural effusion. There is no right pleural effusion, and the right lung is clear. There is no pneumothorax. IMPRESSION: Stable to slight worsening of left lower lobe and lingular opacity with possible small left pleural effusion. " 67bc1b63-7c66aed7-39bb526e-9961b108-61bb77b2.jpg,validate/p14/p14065959/s54775284/67bc1b63-7c66aed7-39bb526e-9961b108-61bb77b2.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p pea arrest // endotracheal tube placement TECHNIQUE: Single portable radiograph of the chest COMPARISON: ___ FINDINGS: Low lung volumes. No pulmonary edema or lobar consolidation. No pleural effusions. Marked cardiomegaly as before. Endotracheal tube tip terminates 3.6 cm above the carina, right-sided central venous catheter terminates at the cavoatrial junction, temperature probe terminates in the mid esophagus and enteric tube tip terminates in the expected location of the stomach. EKG leads overlie the chest wall. Visualized bones are unremarkable IMPRESSION: Severe cardiomegaly with no pulmonary edema or lobar consolidation. Lines and tubes as above. " 25d44b65-9043beb5-55332063-491c7274-f9f205e0.jpg,validate/p19/p19962126/s53880756/25d44b65-9043beb5-55332063-491c7274-f9f205e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M status post arrest TECHNIQUE: Supine AP view of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Heart size is normal. Mediastinal contours are unremarkable. Hilar contours are prominent suggestive of underlying pulmonary arterial enlargement. Relative paucity of pulmonary vascular markings towards the apices indicates underlying emphysema. Streaky and patchy opacities are seen within the right mid lung field of both lung bases, potentially areas of atelectasis and/or infection. No large pneumothorax or pleural effusion is detected on this supine exam. Multiple bilateral rib fractures are noted, potentially related to recent resuscitation. IMPRESSION: Emphysema and probable underlying pulmonary arterial hypertension. Patchy opacities within the right mid lung and both lung bases, potentially atelectasis and/or infection. Multiple bilateral rib fractures which may be related to recent resuscitation, without large pneumothorax identified. " 64ac2f2c-c5a720f0-5d75df99-71ecdb4c-3fe31f09.jpg,validate/p15/p15849075/s53517161/64ac2f2c-c5a720f0-5d75df99-71ecdb4c-3fe31f09.jpg,validation," FINAL REPORT INDICATION: Cough for the past three to four days, here to evaluate for pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The patient is status post median sternotomy with multiple mediastinal surgical clips suggesting prior CABG surgery. The lungs are hyperinflated with flattened hemidiaphragms consistent with COPD/emphysema. Ill-defined opacities projecting over the right upper to mid lung are new from ___. Trace pleural fluid is noted in the left posterior sulcus on the lateral view. No pneumothorax is seen. The pulmonary vasculature is not engorged, and there is no overt pulmonary edema. The cardiomediastinal and hilar contours are within normal limits. There is moderate tortuosity of the thoracic aorta. IMPRESSION: New ill-defined opacities in the right upper to mid lung compatible with infection. A followup chest radiograph is recommended in ___ weeks after an appropriate course of therapy to confirm resolution. NOTIFICATION: Findings and recommendations were communicated by Dr. ___ to Dr. ___ ___ telephone at 4:00 p.m. on ___. " 60ede958-24a84386-0f3e269a-6cdfd7c7-ee40bf04.jpg,validate/p11/p11451979/s58359613/60ede958-24a84386-0f3e269a-6cdfd7c7-ee40bf04.jpg,validation," 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. " bbdde900-27889a24-1853e6ad-0dcbb074-a6605b49.jpg,validate/p15/p15158152/s53221335/bbdde900-27889a24-1853e6ad-0dcbb074-a6605b49.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with liver disease, report of effusion from OSH previously // ? effusion or other acute cardiopulmonary process TECHNIQUE: Upright AP view of the chest COMPARISON: None. FINDINGS: A large right pleural effusion is present with compressive right basilar atelectasis. There is mild shift of the mediastinal structures towards the left. Heart size is difficult to assess given the presence of the large pleural effusion. No pulmonary vascular engorgement is present. Patchy opacity in the left lung base may reflect atelectasis, though infection is not excluded in the correct clinical setting. No left-sided pleural effusion or pneumothorax is present. IMPRESSION: 1. Large right pleural effusion with compressive right basilar atelectasis. 2. Patchy opacity in the left lung base may reflect atelectasis, but infection is not excluded in the correct clinical setting. " 7cb1867d-c42d2418-cf8b5ab1-86ba097a-7f9c3f3e.jpg,validate/p19/p19524729/s56197509/7cb1867d-c42d2418-cf8b5ab1-86ba097a-7f9c3f3e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with concern for TIA, hx of AS // acute process COMPARISON: Prior exam from ___ FINDINGS: PA and lateral views of the chest provided. ___ is again noted with leads extending to the region the right atrium right ventricle. Midline sternotomy wires and mediastinal clips again noted. Lung volumes are low limiting assessment. There is mild cardiomegaly with hilar congestion and probable mild interstitial edema. No large effusion or pneumothorax. No convincing signs of pneumonia. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild cardiomegaly with congestion and mild edema. " fa48ce3c-2ae8840a-d0f9c2d5-b4cd06b7-9199235e.jpg,validate/p10/p10467237/s54877911/fa48ce3c-2ae8840a-d0f9c2d5-b4cd06b7-9199235e.jpg,validation," 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. " 1fca9b63-cbbdc018-de0a418d-cf4bf9a2-0d45bab7.jpg,validate/p13/p13680126/s50930593/1fca9b63-cbbdc018-de0a418d-cf4bf9a2-0d45bab7.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p left thoracotomy and upper division segmentectomy. ___ with new incisional pain // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Since ___, resolved left pleural effusion and basilar atelectasis. New loculated pleural effusion in the lateral aspect of the left mid lung and increased displacement of posterior rib fracture. Postsurgical changes with unchanged upward retraction of the right minor fissure and elevation of the right hilum. 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: New loculated pleural effusion in the lateral aspect of the left lung with increased displacement of the left posterior rib fracture. Resolved left pleural effusion and atelectasis. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 17:40 into the Department of Radiology critical communications system for direct communication to the referring provider. " 2c83eacf-98256e43-ec6868ac-5dea6ec3-c26be2d2.jpg,validate/p14/p14546769/s55834391/2c83eacf-98256e43-ec6868ac-5dea6ec3-c26be2d2.jpg,validation," 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. " 3d231a10-058dbcec-06e17659-cbc8ea2b-c6523c1e.jpg,validate/p18/p18616499/s50314789/3d231a10-058dbcec-06e17659-cbc8ea2b-c6523c1e.jpg,validation," FINAL REPORT AP CHEST, 4:27 A.M., ___ HISTORY: ___-year-old man with hepatic and renal failure. IMPRESSION: AP chest compared to ___. The patient has been extubated. Large areas of consolidation in the right upper and right lower lung have not improved, due to infection or infarction. There may be new small nodules in the left lower lobe partially obscured by the cardiac silhouette. Heart size normal. No pulmonary edema or vascular congestion. Right jugular line ends in the mid SVC and a feeding tube in the stomach, transvenous right atrial and right ventricular pacer leads follow their expected courses. No pneumothorax. Heart size normal. " ca4d01d6-cb179a37-bbc43659-89760352-ceaf403c.jpg,validate/p19/p19849930/s50740958/ca4d01d6-cb179a37-bbc43659-89760352-ceaf403c.jpg,validation," FINAL REPORT HISTORY: History of mitral valve replacement, coronary artery disease, and pacemaker, now with shortness of breath and lower extremity swelling. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate sternotomy wires and a pacemaker with leads terminating in the region of the left atrium and ventricle. A left lower lobe opacity is unchanged compared to multiple radiographs from ___ and ___ and may represent persistent atelectasis or recurrent pneumonia. A small left pleural effusion is unchanged. There is a new small right pleural effusion. Mild to moderate cardiomegaly is slightly worse compared to prior radiographs. No pneumothorax or bony abnormality is seen. IMPRESSION: 1. A left lower lobe opacity, also seen on multiple prior radiographs, likely represents persistent atelectasis or possibly recurrent pneumonia. 2. Small right pleural effusion, new since ___. Unchanged small left pleural effusion. 3. Mild-to-moderate cardiomegaly is slightly worse since ___. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___. " 2cc8bb7e-a819d140-034e9b91-3afaf4ad-35ab49b8.jpg,validate/p19/p19092287/s58760140/2cc8bb7e-a819d140-034e9b91-3afaf4ad-35ab49b8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with r sided rib pain after fx // rib fx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Basilar atelectasis without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture identified. IMPRESSION: No displaced rib fracture seen. No large pleural effusion or evidence of pneumothorax. " 6cc1b0c5-de1ce3d1-859710fa-c4ffd181-f43436ce.jpg,validate/p13/p13590729/s54026718/6cc1b0c5-de1ce3d1-859710fa-c4ffd181-f43436ce.jpg,validation," FINAL REPORT HISTORY: Left pneumothorax status post pigtail removal. COMPARISON: ___ FINDINGS: This study still shows a pigtail catheter a small pneumothorax seen superolaterally. There is a left pleural effusion. There is a small right effusion. There is volume loss at the left base. Multiple displaced rib fractures are again seen on the left. " 1f760c2e-e1fcef38-27192b41-e5977488-df3352a4.jpg,validate/p11/p11245558/s54920705/1f760c2e-e1fcef38-27192b41-e5977488-df3352a4.jpg,validation," WET READ: ___ ___ ___ 9:22 PM Low lung volumes without radiographic evidence for acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: Evaluation for transplantation. FINDINGS: No previous images. The heart is normal in size and the lungs are clear without vascular congestion or pleural effusion. " 31ab98c3-7d0cc849-a119c0e7-f2624bd7-e05bb360.jpg,validate/p16/p16901707/s59060598/31ab98c3-7d0cc849-a119c0e7-f2624bd7-e05bb360.jpg,validation," FINAL REPORT HISTORY: For Dobbhoff placement. FINDINGS: In comparison with study of ___, there has been placement of the Dobbhoff tube with the opaque portion straddling the gastroesophageal junction. Diffuse bilateral pulmonary opacifications persist. " 1d634c44-c1c2b8d0-4173414c-02879f57-e8814362.jpg,validate/p18/p18719314/s56988696/1d634c44-c1c2b8d0-4173414c-02879f57-e8814362.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sub massive PE // ? ilfiltrates ? ilfiltrates IMPRESSION: In comparison with the study of ___, there is little overall change. Again there are low lung volumes with the cardiac silhouette at the upper limits of normal in size. No vascular congestion, pleural effusion, or acute focal pneumonia. Right subclavian PICC line again extends to the lower SVC. " 6fc24510-675e4103-a84dfe42-9f8c2fb4-fa38787c.jpg,validate/p10/p10439570/s54186542/6fc24510-675e4103-a84dfe42-9f8c2fb4-fa38787c.jpg,validation," FINAL REPORT HISTORY: Syncopal episode. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The patient is status post median sternotomy as well as extensive cardiac surgery. There does not appear to be any evidence of pneumonia, pulmonary edema, pleural effusion or pneumothorax. Cardiac size is slightly enlarged. IMPRESSION: No evidence of acute cardiopulmonary process. " ca49e039-31ad9310-8d1b22c1-01a2d158-9afa6f05.jpg,validate/p17/p17653647/s59259684/ca49e039-31ad9310-8d1b22c1-01a2d158-9afa6f05.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man, smoker with persistent cough. // Please evalute. Please evalute. IMPRESSION: In comparison with the study of ___, there is little change. Hyperexpansion of the lungs is consistent with the history of smoking. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " cc970469-84af3bd8-63076e1d-0f938f7c-9f65917d.jpg,validate/p10/p10843878/s52729511/cc970469-84af3bd8-63076e1d-0f938f7c-9f65917d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with mild SOB, tachycardia // eval for pulmonary edema 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 " 6ec21819-9ca2bfd9-26e11fdc-e2312148-51553fd3.jpg,validate/p11/p11585485/s53471308/6ec21819-9ca2bfd9-26e11fdc-e2312148-51553fd3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo old man with lymphoma in remission, known right pleural effusion s/p pleurodesis. Now with increased SOB/DOE and fever. Evaluate for PNA. evaluate pleural effusion COMPARISON: Prior exam from ___ and PET-CT from ___. FINDINGS: PA and lateral views of the chest provided. Cardiomegaly is again noted unchanged. There is a small right pleural effusion with blunted CP angle on the right. Otherwise the lungs are clear. Dextroscoliosis T-spine again noted. IMPRESSION: Mild cardiomegaly and small right pleural effusion, unchanged. " 63d974ca-5674a2e4-a4138d31-9535d977-e357cd2f.jpg,validate/p13/p13824839/s53258426/63d974ca-5674a2e4-a4138d31-9535d977-e357cd2f.jpg,validation," FINAL REPORT INDICATION: ___M with cp pls eval pna // History: ___M with cp pls eval 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 identified. IMPRESSION: No acute cardiopulmonary process. " bed765dd-a1fe2c41-192f993b-79badb54-7aca80c3.jpg,validate/p11/p11123733/s58880816/bed765dd-a1fe2c41-192f993b-79badb54-7aca80c3.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph on ___. FINDINGS: AP and lateral views of the chest. There is a large pleural effusion on the left which has increased in size and a moderate right pleural effusion which is also increased in size. There is likely mild pulmonary edema as well. Heart size is difficult to assess. Sternotomy wires are seen. No pneumothorax. The left PICC is in appropriate position. IMPRESSION: Large left and moderate right pleural effusions have increased in size compared to ___. Mild pulmonary edema, " 08e66ed8-fa1e828a-25078967-9bda532e-1e0cbb4f.jpg,validate/p15/p15225349/s59329148/08e66ed8-fa1e828a-25078967-9bda532e-1e0cbb4f.jpg,validation," WET READ: ___ ___ ___ 8:31 AM Increase in size of left apical pneumothorax in comparison to study performed 8 hours prior. Persistent bilateral pleural effusions. D/w Dr. ___ on ___ at 10:10PM at time of observation of findings WET READ VERSION #1 ___ ___ ___ 10:11 PM Increase in size of left apical pneumothorax in comparison to study performed 8 hours prior. Persistent bilateral pleural effusions. D/w Dr. ___ on ___ at 10:10PM at time of observation of findings ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pneumothorax after port placement. // PLEASE PERFORM EXAM @ 5:00pm - F/U status of pneumothorax after chest tube clamped. PLEASE PERFORM EXAM @ 5:00pm - F/U status of pneumothorax af IMPRESSION: In comparison with the earlier study of this date, there is mild increase in the size of the left apical pneumothorax after clamping of the chest tube. Otherwise little change. " 646f2600-a02ddb4b-8a17345d-364f9d1e-1b5027a1.jpg,validate/p13/p13058213/s55676902/646f2600-a02ddb4b-8a17345d-364f9d1e-1b5027a1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever and SOB // ? Pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Right lower lobe opacity is worrisome for pneumonia. The left lung is clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Thoracic scoliosis is again noted. Partially imaged cervical spine hardware is also noted. IMPRESSION: Right mid to lower lung opacity, worrisome for pneumonia. " b4871917-965339b5-2aedd8e8-c0dd628d-63ea9b51.jpg,validate/p19/p19022644/s53361756/b4871917-965339b5-2aedd8e8-c0dd628d-63ea9b51.jpg,validation," FINAL REPORT HISTORY: Postoperative fever. 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 radiographs of the chest. " 9468ca30-b176da17-894a177e-e26f0715-6ba7d037.jpg,validate/p17/p17030279/s50579328/9468ca30-b176da17-894a177e-e26f0715-6ba7d037.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with hypotension. FINDINGS: PA and lateral views of the chest. No prior. Lungs are clear of focal consolidation. Cardiomediastinal silhouette is top normal in size. Median sternotomy wires are noted. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " a4458648-b83063e2-c42b0c9d-c03e8c93-2041233b.jpg,validate/p12/p12907739/s59702095/a4458648-b83063e2-c42b0c9d-c03e8c93-2041233b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PMH alcohol abuse, recent fall. Now hypotensive with systolic BP of 70. // please evaluate for consolidation, pulmonary edema please evaluate for consolidation, pulmonary edema IMPRESSION: In comparison with the study of ___ from an outside facility, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, pleural effusion, or pneumothorax. " 7291db53-308879d7-2d7da363-3b1f5b55-416ae42b.jpg,validate/p11/p11549602/s51313806/7291db53-308879d7-2d7da363-3b1f5b55-416ae42b.jpg,validation," WET READ: ___ ___ 10:31 PM Left picc with tip in the mid svc. Little change otherwise compared to the prior study from the same day. ______________________________________________________________________________ FINAL REPORT AP CHEST, 9:04 P.M. ON ___ HISTORY: Thoracic spinal osteomyelitis. Confirm left PICC placement. IMPRESSION: AP chest compared to ___, 4:24 p.m. The tip of the left PIC line is at the level of the superior cavoatrial junction. The line cannot be traced continuously through the mediastinum. If there is any reason to be concerned for fracture of the line, then additional imaging would be required. Elevation of the right hemidiaphragm, present without appreciable change since ___ was documented as due to an elevated hemidiaphragm with minimal right pleural effusion on a thoracic spine CT on ___, and has not changed subsequently. The heart is moderately enlarged, exaggerated by low lung volumes. Thoracic aorta is extremely tortuous. Dr. ___ was paged at 10:30 a.m., 2 minutes after recognition of the findings. " 48144220-a4eb0e31-4c77fe10-0ad96207-52e17e22.jpg,validate/p17/p17876274/s51437923/48144220-a4eb0e31-4c77fe10-0ad96207-52e17e22.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with mediastinal hematoma. f/u elevated left hemidiaphragm TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs the most recent on ___. FINDINGS: The heart is normal in size. The aorta is minimally tortuous as before. The left hemidiaphragm is minimally elevated, but not significantly changed in extent from ___. A left suprahilar opacity is stable. No new focal consolidation, pleural effusion or pneumothorax. There is likely an ingested hyperdense object in the area of the hepatic flexure. IMPRESSION: No acute cardiopulmonary process. " 96dbd136-5f497dfc-c948de46-a5f3c322-95eeabee.jpg,validate/p17/p17018837/s51210150/96dbd136-5f497dfc-c948de46-a5f3c322-95eeabee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung cancer // hypoxia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Status post left upper lobectomy. Low left hemithoracic volume. No evidence of recurrence. Normal appearance of the right lung. Status post right shoulder surgery. " 5ec7d199-5f0f1d86-396fa10d-e1d2dbdb-a6b5b3ff.jpg,validate/p14/p14947107/s52015077/5ec7d199-5f0f1d86-396fa10d-e1d2dbdb-a6b5b3ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cardiac surgery // evaluate for pneumothorax TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: There has been interval removal of the chest tubes. Lung volumes remain low with bilateral lower lobe atelectasis and small bilateral pleural effusions. A Swan-Ganz catheter is unchanged in appearance. No pneumothorax seen. IMPRESSION: No significant interval change following removal of the bilateral chest tubes. " cf35f551-e2077c94-049a57b0-2f8978e7-6162a102.jpg,validate/p12/p12974096/s58147295/cf35f551-e2077c94-049a57b0-2f8978e7-6162a102.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SLE and hepatic hydrothorax with desat and diminished L lung sounds. // c/f re-accumulated hydrothorax vs PTX c/f re-accumulated hydrothorax vs PTX COMPARISON: Prior chest radiographs ___ and ___. IMPRESSION: Large right pleural effusion is bigger, displacing the mediastinum to the left, and collapsing nearly all of the right lung. Left lung is clear. " 4ae33810-73ae625a-fab32d4d-6bd67f84-fc002d4d.jpg,validate/p13/p13031383/s54415549/4ae33810-73ae625a-fab32d4d-6bd67f84-fc002d4d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with ___, worsening edema/weight gain COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Hilar congestion is new from prior and there is mild interstitial pulmonary edema. There is a small right pleural effusion. The heart and mediastinal contours remain within normal limits of size. Bony structures are intact. IMPRESSION: Mild pulmonary interstitial edema with small right pleural effusion. " 6523b834-d6fa67db-e908316d-13f76e10-e259c791.jpg,validate/p18/p18576755/s53751116/6523b834-d6fa67db-e908316d-13f76e10-e259c791.jpg,validation," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with well controlled HIV, nonsmoker with recent presumed influenza c/b persistent cough and CXR ___ with ?RML infiltrate, ? of some volume loss now s/p antibitiotic therapy; needs f/u CXR to help assess need for CT raised to assess for ""post obstructive"" pna. F/u RML pna/volume loss. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, and ___. FINDINGS: The previously described right middle/lower lobe opacity has improved, suggesting that it is a pneumonia or atelectasis. The cardiomediastinal and hilar contours are normal. No pleural effusion or pneumothorax. IMPRESSION: Improvement in the previously described right middle/ lower lobe opacity, suggesting it is an pneumonia or atelectasis. A CT is not recommended at this time. However, if symptoms persist, then followup in 8 weeks could be obtained. " 3d67c4e4-4eabf03c-f37398b4-c8fbd091-c6304aef.jpg,validate/p15/p15968244/s56339437/3d67c4e4-4eabf03c-f37398b4-c8fbd091-c6304aef.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with s/p CABG // eval postop changes TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Left anterior chest wall dual lead pacer, median sternotomy wires and surgical clips are unchanged. Heart size is mildly enlarged. Mediastinal and hilar contours are unremarkable. Lungs are clear with improved aeration of the left lung base. There are tiny bilateral pleural effusions. There is no pneumothorax. IMPRESSION: Unremarkable postoperative examination with improved aeration of the left lung base and tiny residual bilateral pleural effusions. " b754601d-cd96b032-7c53e513-f79ba56e-fd979627.jpg,validate/p18/p18624005/s59139905/b754601d-cd96b032-7c53e513-f79ba56e-fd979627.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o CAD s/p CABG, CHF, AF and chronic R sided lung opacity who presents with weight gain, dyspnea and intermittent CP. Last CXR showed pleural effusion of left lung, with new nasal congestion and worsening cough. // Interval change in CXR? Especially left lower lobe. COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Patient is status post median sternotomy. Pacemaker is noted overlying the left chest with leads terminating in the right ventricle. Mild cardiomegaly is unchanged. Moderate volume loss on the right is unchanged. A moderate pleural effusion on the right and a small pleural effusion on the left are unchanged. Focal consolidations are seen in the left retrocardiac area, the right upper, middle and lower lobes, which appear unchanged. Imaged osseous structures are intact. IMPRESSION: 1. Focal consolidations in the left retrocardiac area, the right upper, middle and lower lobes appear unchanged. 2. A moderate pleural effusion on the right and a small pleural effusion on the left are unchanged. 3. Mild cardiomegaly is unchanged. " bccbc8ee-56b61166-7c7c3ec4-51aa5f0d-5a0d5f86.jpg,validate/p14/p14287925/s55550419/bccbc8ee-56b61166-7c7c3ec4-51aa5f0d-5a0d5f86.jpg,validation," FINAL REPORT HISTORY: History of Crohn's disease about began Remicade. Evaluate for prior tuberculosis. 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 contours are normal. Incidentally noted is mild scoliosis with rightward convexity of the mid thoracic spine. IMPRESSION: No radiographic evidence for acute cardiopulmonary or chronic granulomatous disease. " 02479b5c-c703b346-f8b60a33-23afc7ec-4237aff2.jpg,validate/p13/p13417577/s53575102/02479b5c-c703b346-f8b60a33-23afc7ec-4237aff2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea // eval for acute process COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Airspace consolidation within the left lower lobe is concerning for pneumonia. The previously noted right pleural effusion has resolved. A cavitary structure in the left lung apex measures 2.6 x 2.6 cm with peripheral/apical opacity could reflect prior infection or malignancy. A retrocardiac opacity better assessed on previous imaging is consistent with a known hiatal hernia. Please correlate clinically. Cardiomediastinal silhouette is stable. Bony structures appear intact. IMPRESSION: 1. Left lower lobe pneumonia. 2. Cavitary lesion in the left apex with apical opacity, question sequelae of old infection/malignancy. Consider CT to further assess once the acute symptoms resolve. 3. Hiatal hernia. " 5e8b4e5a-42c9d772-709e13fc-bebe8d48-49ca6653.jpg,validate/p19/p19045562/s54336442/5e8b4e5a-42c9d772-709e13fc-bebe8d48-49ca6653.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___ year old woman with acute renal failure and nephropathy now on hemodialysis // TB screen for dialysis placement TECHNIQUE: Chest PA and lateral COMPARISON: X-ray from ___ FINDINGS: There is interval placement of a right sided hemodialysis catheter with its tip at the caval atrial junction. The lungs are clear. Remainder of the exam is not significantly changed compared to ___. IMPRESSION: Placement of a right-sided hemodialysis catheter in appropriate position. Reviewed with Dr. ___. " 5c596455-0ec27b54-83b2ebf3-4debce3b-b0cb2f0e.jpg,validate/p13/p13639259/s57948904/5c596455-0ec27b54-83b2ebf3-4debce3b-b0cb2f0e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: PA and lateral chest views were read in comparison with multiple prior chest radiographs through ___ with the most recent from ___. The most recent radiograph from ___ was in the mid inspiratory phase, better inspiration on prior radiograph from ___. As compared to ___ radiograph, there is mild increased in peribronchial opacities associated with, some architectural distortion, bronchiectasis and diffuse bronchial wall thickening reflecting bronchitis. No evidence of an acute lobar pneumonia. The lungs are hyperinflated though consistent with COPD changes. No pleural effusion or pneumothorax. Cardiac, hilar and mediastinal contours are unchanged. " 4f7c9830-4e2ad5a3-6e23591f-19267bd3-cd4eba16.jpg,validate/p11/p11865423/s58922940/4f7c9830-4e2ad5a3-6e23591f-19267bd3-cd4eba16.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with CP // r/o pneumothorax TECHNIQUE: Single, AP, portable view of the chest. COMPARISON: ___. 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 frank pulmonary edema. The borderline enlarged cardiac silhouette is stable IMPRESSION: No evidence of acute cardiopulmonary process. " 5785d852-95522ecc-47857bb0-7203c70e-631675d3.jpg,validate/p13/p13604162/s51019764/5785d852-95522ecc-47857bb0-7203c70e-631675d3.jpg,validation," FINAL REPORT PORTABLE CHEST ___, ___ No prior studies for comparison. FINDINGS: Tip of endotracheal tube terminates approximately 4.1 cm above the carina, and nasogastric tube terminates within the stomach. Cardiac silhouette is enlarged, and mild pulmonary vascular congestion is accompanied by minimal interstitial edema. Multifocal patchy and linear areas of atelectasis are present in the right apex, juxtahilar and basilar regions, and there is also a probable small left pleural effusion. No pneumothorax is evident. " c33a79f8-6647af0a-bd7cbf9d-410a5c0f-6301c015.jpg,validate/p10/p10956814/s56015713/c33a79f8-6647af0a-bd7cbf9d-410a5c0f-6301c015.jpg,validation," WET READ: ___ ___ ___ 3:42 PM 1. Small interval increase in degree of now small effusions. 2. Improved aeration of the left lower lobe. No additional focal consolidation is identified. 3. Stable, mild cardiomegaly. WET READ VERSION #1 ___ ___ ___ 3:36 PM 1. Small interval increase in degree of now small effusions. 2. Persistent left lower lobe collapse. No additional focal consolidation is identified. 3. Stable, mild cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with chest pain // Acute cardiopulmonary disease TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiographs dated ___. FINDINGS: Improved aeration of the left lower lobe as compared to prior. The remainder of the lungs are hyperexpanded bilaterally, and without additional focal consolidation. Bibasilar scarring is noted. Small-moderate, bilateral pleural effusions are slightly increased as compared to the prior examination. The cardiomediastinal silhouette remains mildly enlarged without overt pulmonary vascular congestion. Unchanged compression deformity of an upper thoracic vertebral body. IMPRESSION: 1. Small interval increase in degree of now small effusions. 2. Improved aeration of the left lower lobe. No additional focal consolidation is identified. 3. Stable, mild cardiomegaly. " 99852536-138d0264-baa309a0-61994db6-666cd740.jpg,validate/p14/p14875942/s57463257/99852536-138d0264-baa309a0-61994db6-666cd740.jpg,validation," 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. " b22c90ae-3dc42059-d9ce62cb-7608317b-c974a0f6.jpg,validate/p16/p16989180/s52010590/b22c90ae-3dc42059-d9ce62cb-7608317b-c974a0f6.jpg,validation," WET READ: ___ ___ ___ 4:58 PM Large right tension hydropneumothorax with collapse of the left lung. WET READ VERSION #1 ___ ___ ___ 2:28 PM Large tension right hydropneumothorax with collapse of the left lung. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with right chest pain/dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is a large right tension hydropneumothorax with collapse of the right lung and leftward shift of mediastinal structures. Left lung is grossly clear. Heart size is normal. No left pleural effusion is present. The pulmonary vasculature is normal. There are no acute osseous abnormalities. IMPRESSION: Large right tension hydropneumothorax with collapse of the left lung. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:25 PM, 1 minute after discovery of the findings. " cd187f4d-a7cba8f7-bcd11a9d-213168d0-fba3e59f.jpg,validate/p14/p14377190/s55382810/cd187f4d-a7cba8f7-bcd11a9d-213168d0-fba3e59f.jpg,validation," 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. " 9c54f4dd-7fbe535e-c4fc8874-10848afe-b7793903.jpg,validate/p12/p12783356/s54811074/9c54f4dd-7fbe535e-c4fc8874-10848afe-b7793903.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with nausea and vomiting. Evaluate for acute process. COMPARISON: Multiple prior chest radiographs, most recent on ___. TECHNIQUE: Frontal and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear, without focal opacities. There is an unfolded aorta, but otherwise the cardiomediastinal and hilar contours are unremarkable. There is no cardiomegaly. There is no pleural effusion or pneumothorax. The visualized osseous structures are notable for a right cervical rib. IMPRESSION: No evidence of acute cardiopulmonary process. " 49a68a6b-34f52c36-3240884e-a905f0d5-d8e626d2.jpg,validate/p12/p12316202/s50376013/49a68a6b-34f52c36-3240884e-a905f0d5-d8e626d2.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: PA and lateral chest x-ray ___, ___. INDICATION: ___-year-old with pneumothorax. FINDINGS: There is a possible residual pleural line in the right apex. The lungs are otherwise clear. There is no pulmonary edema or pleural effusion. The cardiomediastinal and hilar contours are normal. IMPRESSION: Possible residual right apical pneumothorax. No further study is needed to document resolution. " 748a7197-50ddf4a3-a1824c98-c5e2eb75-3a6ce00d.jpg,validate/p19/p19729398/s55967140/748a7197-50ddf4a3-a1824c98-c5e2eb75-3a6ce00d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with pulmonary edema // interval change TECHNIQUE: Portable AP upright view of the chest COMPARISON: ___ FINDINGS: Right PICC terminates in the mid to lower SVC. A Prosthetic mitral valve is again noted. There is no pneumothorax. There is persistent right upper lobe collapse with hyperinflation of the right middle lobe. Moderate right pleural effusion has increased in size. Small to moderate left pleural effusion is stable. The left mid lung zone consolidation is unchanged. No pneumothorax. IMPRESSION: 1. Enlarging moderate right pleural effusion, stable small left effusion. 2. Persistent consolidation in the left mid lung and collapse of the right upper lobe. " cfcf8bf9-7bfabae5-7b583060-4668d91f-5426409b.jpg,validate/p16/p16200793/s58930891/cfcf8bf9-7bfabae5-7b583060-4668d91f-5426409b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG with ct removal // eval for ptx eval for ptx COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is interval improvement in pulmonary edema but there is still present bibasal atelectasis and pleural effusion and the opacities in the lung bases are in part represent resolving edema. Right internal jugular line tip is at the level of superior SVC. " 2911c545-86e94149-8047dddb-4b15c839-0063e823.jpg,validate/p17/p17600522/s50972636/2911c545-86e94149-8047dddb-4b15c839-0063e823.jpg,validation," FINAL REPORT HISTORY: Hyperventilation and shortness of breath. COMPARISON: None available. 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. " 980503ac-02d14f80-e6aa55f9-dd350bd1-b7e1cccf.jpg,validate/p13/p13235049/s50159848/980503ac-02d14f80-e6aa55f9-dd350bd1-b7e1cccf.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with liver disease and altered mental status. Question pneumonia. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate low lung volumes and patient to be lordotic in position. The cardiac silhouette is prominent, but likely accentuated by AP technique. The mediastinal and hilar contours are otherwise within normal limits. The lungs are clear. Previously seen left basilar opacity has improved with better visualization of the left hemidiaphragm. There is no pneumothorax, vascular congestion, or pleural effusion. Right humeral deformity is noted, compatible with remote injury. IMPRESSION: Interval improvement of left basal opacity previously seen on ___. No new findings to suggest definite pneumonia. " 227466ba-840bfb46-08eddfe0-e8d2c24a-e4f53664.jpg,validate/p13/p13917127/s55100327/227466ba-840bfb46-08eddfe0-e8d2c24a-e4f53664.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with disseminated zoster with continued hypoxia // Please evaluate for evidence of pulmonary edema or pneumonia TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Multifocal opacities appear to be slightly progressed as compared to the previous study, concerning for progression of disseminated zoster or superimposed bacterial infection. Bilateral pleural effusions are noted, small. For pre size details please review CT chest obtained the same day and the corresponding report. " a51c7721-8271f574-61ddc361-11193681-b9fac165.jpg,validate/p13/p13402588/s50871118/a51c7721-8271f574-61ddc361-11193681-b9fac165.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with increased white blood count, nausea and vomiting, evaluate for pneumonia. FINDINGS: Patient's condition required examination in sitting semi-upright position using AP frontal and left lateral views. On the frontal view, the heart appears to be borderline in size without typical configurational abnormality. Unremarkable 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 and the lateral and posterior pleural sinuses are free. No pneumothorax is identified in apical area. In the right shoulder area, exists evidence of previous surgical intervention with several metallic plugs. No other gross skeletal abnormalities within the thoracic area. Our records do not include a previous chest examination available for comparison. IMPRESSION: No evidence of acute pneumonia. " 00b99883-7b6b7270-5b467cc2-ebb9b59c-ddab03e5.jpg,validate/p12/p12092683/s59641001/00b99883-7b6b7270-5b467cc2-ebb9b59c-ddab03e5.jpg,validation," FINAL REPORT INDICATION: ___F with fall, some mild left pelvic tenderness. Able to ambulate. // fracture? TECHNIQUE: PA and lateral views of the chest. COMPARISON: None available time of dictation. FINDINGS: Linear left basilar opacities are likely due to scarring. The lungs are clear without consolidation worrisome for pneumonia. No large pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. No displaced fractures identified. Surgical clips project over the thoracic inlet. IMPRESSION: No acute cardiopulmonary process. " cd1d3900-6a3a830a-b608d389-eafb4c65-9d337dd9.jpg,validate/p10/p10684181/s55277180/cd1d3900-6a3a830a-b608d389-eafb4c65-9d337dd9.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. No pulmonary edema is seen. The cardiac and mediastinal silhouettes are stable. Thoracolumbar scoliosis is again noted. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 01c36eab-0bd8e050-aa990f05-22c87046-b666ac8a.jpg,validate/p14/p14218694/s58704034/01c36eab-0bd8e050-aa990f05-22c87046-b666ac8a.jpg,validation," 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. " 3753525d-57b710b0-e6cda421-3d194051-2359945a.jpg,validate/p13/p13723259/s58557612/3753525d-57b710b0-e6cda421-3d194051-2359945a.jpg,validation," FINAL REPORT INDICATION: Acute kidney injury, on hemodialysis with severe aortic stenosis with increasing dyspnea on exertion. COMPARISON: Chest radiographs ___, ___. FINDINGS: The heart size remains normal. There has been reaccumulation of small bilateral pleural effusions with associated compressive atelectasis. Slight vascular congestion is present. There is no focal consolidation concerning for pneumonia. IMPRESSION: New small bilateral pleural effusions with mild vascular congestion. " 39071524-2d574895-1744219e-4e4ec6eb-0cc375ab.jpg,validate/p18/p18874187/s54253046/39071524-2d574895-1744219e-4e4ec6eb-0cc375ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with report of dyspnea x2 weeks // dyspnea 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. Fiducial seeds in the posterior lower chest are stable IMPRESSION: No acute cardiopulmonary abnormalities " 979f410a-e68ec1aa-89a90f56-d53d6ab2-d23e37f5.jpg,validate/p17/p17963938/s59009146/979f410a-e68ec1aa-89a90f56-d53d6ab2-d23e37f5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post tracheostomy and PEG tube, evaluation of interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices, including the left-sided chest tube, are in constant position. Also unchanged is the small left basal PICC line. The separation of the pleural layers is unchanged as compared to the previous examination, the change is indicative of a left pneumothorax. An additional, newly appeared linear structure paralleling the left lateral chest wall corresponds to a skinfold. No evidence of tension. Normal size of the cardiac silhouette. No newly appeared focal parenchymal opacities. No pulmonary edema. Unchanged minimal right pleural effusion. " ac5ab733-e57ba15a-4604db7a-604f4fe2-7fc037ca.jpg,validate/p16/p16944227/s57975074/ac5ab733-e57ba15a-4604db7a-604f4fe2-7fc037ca.jpg,validation," FINAL REPORT INDICATION: Status post thoracentesis. COMPARISON: ___ at 19:15. PORTABLE UPRIGHT AP VIEW OF THE CHEST: There has been little interval change from the prior exam with continued near total opacification of the left hemithorax. No pneumothorax is identified. The right lung is grossly clear. Patient is status post median sternotomy and CABG. IMPRESSION: Little interval change from prior with continued opacification of the left hemithorax. No pneumothorax. " b182f297-17b4eb15-879792ba-1858b505-96f29a47.jpg,validate/p10/p10204908/s52119910/b182f297-17b4eb15-879792ba-1858b505-96f29a47.jpg,validation," 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. " ccffb09e-ad8c580d-9e417faa-785c30d9-765154ce.jpg,validate/p12/p12793357/s54053950/ccffb09e-ad8c580d-9e417faa-785c30d9-765154ce.jpg,validation," FINAL REPORT INDICATION: ___F with chest and shoulder pain post mvc // ? fx TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no pneumothorax or effusion. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: Normal chest x-ray. " 30cf897d-6ee29161-aa0059fb-45827b96-60d26ab0.jpg,validate/p10/p10361930/s51585632/30cf897d-6ee29161-aa0059fb-45827b96-60d26ab0.jpg,validation," FINAL REPORT HISTORY: ET tube position. FINDINGS: In comparison with the study of earlier in this date, there is little change in the appearance of the endotracheal tube, which appears to be well positioned. Other monitoring and support devices remain in place. Again there is diffuse bilateral pulmonary opacification, though it has decreased on both sides. Again, this could reflect some improving pulmonary vascular congestion and substantial airspace consolidation, especially on the left. " c52606fa-26ef8675-9cc64c23-05d4d5db-697751cf.jpg,validate/p16/p16519016/s51030836/c52606fa-26ef8675-9cc64c23-05d4d5db-697751cf.jpg,validation," WET READ: ___ ___ 2:30 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with patient endorsing chest pain and SOB r/o PNA or other intrathoracic process // Patient endorsing chest pain and SOB r/o PNA or other intrathoracic process TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are slightly low, resulting in bronchovascular crowding. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures identified. IMPRESSION: No acute cardiopulmonary process. " 4514370b-c0387193-1bc31b13-6cb39512-266f215d.jpg,validate/p16/p16931484/s51942429/4514370b-c0387193-1bc31b13-6cb39512-266f215d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with persistent cough. // Any changes? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Post CABG changes stable. Slight interruption of the second from superior sternal wire. Heart size normal. Normal hila. Atherosclerotic changes of the aortic arch. No airspace consolidation. No pleural effusions. No pneumothorax. No pleural thickening. Spondylotic changes of the thoracic spine. IMPRESSION: No features of pneumonia. " 48776391-a3ef691d-ef138e53-21900748-e67d273b.jpg,validate/p13/p13723259/s55754113/48776391-a3ef691d-ef138e53-21900748-e67d273b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p cabg // eval for effusion COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the extent of the bilateral pleural effusions is not substantially changed. Unchanged appearance of the cardiac silhouette. No overt pulmonary edema but mild fluid overload persists. Unchanged course of the right internal jugular vein catheter. Unchanged bilateral areas of atelectasis. " 1903d49e-4d6b5d26-c10dc3a9-7573587a-f2626498.jpg,validate/p14/p14130631/s56265847/1903d49e-4d6b5d26-c10dc3a9-7573587a-f2626498.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ M MCA stroke, w/ PNA, increased work of breathing // ? interval change, fuid overload ? interval change, fuid overload COMPARISON: Chest radiographs ___ through ___ at 4:22 a.m. IMPRESSION: Severe multi focal pulmonary consolidation has not improved over the past several days, accompanied by mild pulmonary edema which is worsened since ___, stable mild cardiomegaly and moderate right pleural effusion, increased since ___, subsequently stable. No pneumothorax. Most likely explanation is severe pneumonia. Concurrent morbidity such as pulmonary hemorrhage or infarction should be considered from a clinical standpoint. " bef53378-3831afb4-6c88efff-d87c1857-40ad7f8c.jpg,validate/p11/p11231396/s58357672/bef53378-3831afb4-6c88efff-d87c1857-40ad7f8c.jpg,validation," WET READ: ___ ___ ___ 9:28 AM Right upper extremity PICC ends in the upper SVC. WET READ VERSION #1 ___ ___ ___ 8:41 PM Right upper extremity PICC ends in the upper SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC placed at OSH. // Confirm PICC line location. Confirm PICC line location. IMPRESSION: In comparison with the study of ___, the right subclavian PICC line extends to the upper SVC. There is hyperexpansion of the lungs consistent with chronic pulmonary disease, though no vascular congestion or acute focal pneumonia. " 869d2a4d-4d90e8a5-0bb3dd8a-6dd479c4-bfb47617.jpg,validate/p12/p12706699/s51602851/869d2a4d-4d90e8a5-0bb3dd8a-6dd479c4-bfb47617.jpg,validation," WET READ: ___ ___ ___ 2:10 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with cough // cough TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. 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. " e175995d-d618fd88-679aef07-591cc8c3-abed5dd3.jpg,validate/p16/p16881403/s51404196/e175995d-d618fd88-679aef07-591cc8c3-abed5dd3.jpg,validation," 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. " 01e42998-da340d32-9064679d-d19957c9-78187d89.jpg,validate/p11/p11123733/s59057185/01e42998-da340d32-9064679d-d19957c9-78187d89.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after pulling out of the chest tube. COMPARISON: ___ obtained at 09:49 a.m. Three AP views of the chest were reviewed. Heart size and mediastinum are unchanged. Swan-Ganz catheter tip is at the level of the right ventricular outflow tract. There is bilateral pleural effusion demonstrated. After removal of the left chest tube, no definitive pneumothorax is demonstrated. Mild vascular engorgement is noted, overall unchanged since prior examination. " 63df2749-3a1c7bae-7a2c739d-373feba4-1aad234c.jpg,validate/p12/p12521910/s58451104/63df2749-3a1c7bae-7a2c739d-373feba4-1aad234c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with possible calcific lymph nodes // ? calcific lymph nodes at edge of film not seen on ___ xray COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are fully expanded and essentially clear. Granulomatous calcifications are present in right hilar lymph nodes, and in the superior segment of one of the lower lobe seen on the lateral view. There is no evidence of active infection. Cardiomediastinal silhouettes and pleural surfaces are normal. " 546e0612-e323130d-8d6c1dc4-2e087f0a-d9a36715.jpg,validate/p18/p18908795/s58252457/546e0612-e323130d-8d6c1dc4-2e087f0a-d9a36715.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with post-pull pneumothorax // residual pneumothorax residual pneumothorax COMPARISON: Comparison to prior study dated ___ 07:47 FINDINGS: PA and lateral views of the chest ___ at 14 19 are submitted. IMPRESSION: Interval removal of the right apical pigtail catheter with appearance of a small right apical pneumothorax. Streaky linear opacity at the right costophrenic angle likely reflects subsegmental atelectasis or scarring. There is some blunting of the right costophrenic angle as well suggesting a component of pleural fluid. Overall cardiac and mediastinal contours are unchanged. Left lung remains clear. No pulmonary edema. NOTIFICATION: Results were communicated to the patient's nurse, ___, by phone on ___ at 14:26 at the time of discovery. " 521a7891-aac30eb1-1574beec-2ae8cfdb-e1eff242.jpg,validate/p11/p11154338/s51808709/521a7891-aac30eb1-1574beec-2ae8cfdb-e1eff242.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with hypertension and diabetes and tobacco history with recent pneumonia treated ___; for assessment of resolution. COMPARISONS: Chest CT and radiographs from ___. TECHNIQUE: Two views of the chest were obtained. FINDINGS: The lungs are well expanded with mild residual juxtahilar right-sided pulmonary opacity. No pleural effusion or pneumothorax is seen. Cardiac size and mediastinal contours are unchanged. IMPRESSION: Mild residual juxtahilar opacity. Re-evaluation in ___ weeks is recommended to assess for radiographic resolution, with need for further antimicrobial treatment to be determined by clinical circumstance. Findings were entered into the radiology department's online record for notification of critical results on ___. " d3faf986-90312809-c85559cc-993bc235-4c5e148c.jpg,validate/p12/p12505527/s53303478/d3faf986-90312809-c85559cc-993bc235-4c5e148c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sinusitis, chest congestion, shortness of breath // r/o pneumonia r/o pneumonia IMPRESSION: Heart size and mediastinum are normal in appearance. Lungs are clear except for bilateral linear opacities that might potentially represent areas of atelectasis versus recurrent aspirations. There is no pleural effusion. There is no pneumothorax. " 4c026f5a-2facd35b-6fe56869-069c1d2b-f9a7ccf2.jpg,validate/p12/p12092329/s54096329/4c026f5a-2facd35b-6fe56869-069c1d2b-f9a7ccf2.jpg,validation," FINAL REPORT INDICATION: Cough and fever for the past ___ weeks. Evaluate for pneumonia. COMPARISON: None. 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: Normal chest radiograph. " f483fb3a-8beb69b4-71d7b82c-a8982d3b-c11c948e.jpg,validate/p14/p14733367/s54788039/f483fb3a-8beb69b4-71d7b82c-a8982d3b-c11c948e.jpg,validation," FINAL REPORT INDICATION: Recent admission to outside hospital for pneumonia. Symptoms improved with treatment, but has persistent hallucinations. Evaluate for worsening or new infiltrate on chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: A single AP radiograph of the chest was obtained. Moderate-to-severe enlargement of the cardiac silhouette is not significantly changed. There is pulmonary venous congestion with predominantly perihilar and right lower lung heterogeneous opacities as well as Kerley B lines, most consistent with mild interstitial pulmonary edema. Given the slight asymmetry of the opacities at the right lung base, a superimposed infectious process cannot be excluded. There may be a small right pleural effusion. No pneumothorax is seen. The mediastinal contours are grossly unchanged. IMPRESSION: 1. Mild interstitial pulmonary edema, likely cardiogenic in nature given moderate cardiomegaly. 2. Possible small right pleural effusion. 3. Heterogeneous opacities at the right lung base could be atelectasis, although an infectious process cannot be excluded. Short-term follow-up radiographs may be helpful to evaluate further if clinically indicated. " 5bea5214-38810eea-e69188b3-b0ef75ef-8e6486af.jpg,validate/p13/p13194001/s59200003/5bea5214-38810eea-e69188b3-b0ef75ef-8e6486af.jpg,validation," 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. " 04db7aef-616fda25-bc152f88-79327d44-523c13d8.jpg,validate/p10/p10456513/s52210635/04db7aef-616fda25-bc152f88-79327d44-523c13d8.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with esophageal cancer and status post minimally invasive esophagectomy. FINDINGS: Endotracheal tube is unchanged in position. There is an enteric tube whose side port is near the GE junction, within the neoesophagus. Heart size is enlarged. There is left retrocardiac opacity. There are no signs for overt pulmonary edema. Overall, these findings are stable. " ef54b3e5-f5812bd3-934094b8-2a02e856-f3183504.jpg,validate/p17/p17137598/s55347097/ef54b3e5-f5812bd3-934094b8-2a02e856-f3183504.jpg,validation," 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. " 94af971a-8488416f-a03f6c8d-0c3edbd0-096494f2.jpg,validate/p15/p15308477/s54387970/94af971a-8488416f-a03f6c8d-0c3edbd0-096494f2.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with dyspnea. Question pneumonia. History of recently biopsied left lung base mass compatible with metastatic melanoma. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___ and ___. Left lower lobe lung mass is again noted. Margins on the current exam are less clearly delineated when compared to pre-biopsy exam, however, appear similar to prior portable exam from ___. There is increased opacity more posteriorly in the left lower lobe, potentially due to consolidation, post-biopsy changes and possible underlying small effusion. Elsewhere, the lungs are clear. Cardiomediastinal silhouette is stable. Left shoulder arthroplasty again noted. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No significant interval change since prior. " 4d880eb2-777a1443-8dcf4081-a8a2eb63-89d75442.jpg,validate/p19/p19773753/s58060880/4d880eb2-777a1443-8dcf4081-a8a2eb63-89d75442.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pressure, obesity, anxiety. Please evaluate for evidence of CHF or pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well inflated. The right lung is clear while the left lung demonstrates a retrocardiac opacity that is confirmed in the lateral view. The cardiomediastinal and hilar contours are unremarkable. There is no evidence of pleural effusion or pneumothorax. IMPRESSION: Retrocardiac opacity might represent atelectasis versus consolidation secondary to infectious/inflammatory process. " e1469d38-133e31a2-52868765-bc0be4fc-b11666dd.jpg,validate/p15/p15839900/s54396721/e1469d38-133e31a2-52868765-bc0be4fc-b11666dd.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with dyspnea. Evaluation for pneumonia. COMPARISON: None available. FINDINGS: PA and lateral views of the chest demonstrate an ill-defined right hilar opacity, projecting as a double density on the lateral view, as well as scattered nodularity in the right upper and lower lobes. The heart size is normal. There is no pleural effusion, pulmonary edema, or pneumothorax. IMPRESSION: Right hilar opacity and right lung nodularity could represent multifocal pneumonia in the appropriate clinical setting. Follow-up radiographs should be obtained after treatment to ensure resolution, and if still present, a dedicated chest CT is recommended. NOTIFICATION: The above findings were posted to the online critical results radiology dashboard by Dr. ___ at 8:40pm on ___ for provider ___. " b7d910ac-b931cfd9-3563cc32-566c1f45-80b91de8.jpg,validate/p19/p19650702/s51918043/b7d910ac-b931cfd9-3563cc32-566c1f45-80b91de8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman s/p R thoracotomy and tracheobronchoplasty with persistent rib pain and swelling // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiograph from ___, ___, ___. FINDINGS: Postsurgical changes following right thoracotomy and tracheobronchoplasty are noted. The lungs are otherwise clear. The heart size is unchanged. There is no pulmonary edema, pneumothorax, or pleural effusion. IMPRESSION: Postsurgical changes following right thoracotomy and tracheobronchoplasty without evidence of acute cardiopulmonary process. " b79e57ca-f08d0994-435cecdd-a8711070-b2eb8240.jpg,validate/p11/p11410807/s55222420/b79e57ca-f08d0994-435cecdd-a8711070-b2eb8240.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man presenting after fall with pain on deep inspiration. Rule out pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. No focal consolidation, edema, effusion, or pneumothorax. Heart size is normal. Mediastinum is not widened. No acute osseous abnormality on this nondedicated exam. IMPRESSION: No pneumothorax. No obvious fracture. Dedicated rib films is recommended corresponding to the area of focal exam findings if there is concern of fracture. RECOMMENDATION(S): Dedicated rib films is recommended corresponding to the area of focal exam findings if there is concern of fracture. " b3ff298c-a3ff2b4d-b9cd28ee-726f9409-c98f7f57.jpg,validate/p18/p18309272/s53515609/b3ff298c-a3ff2b4d-b9cd28ee-726f9409-c98f7f57.jpg,validation," FINAL REPORT INDICATION: ___F with acute onset pleuritic CP and SOB // c/f enlarged mediastinum, PNA TECHNIQUE: PA and lateral views of 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. " 1da1c9c4-7c53ea63-d965eb76-7b71a41f-de182498.jpg,validate/p18/p18754895/s55503748/1da1c9c4-7c53ea63-d965eb76-7b71a41f-de182498.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Elevation of the right hemidiaphragm is stable. Bibasilar atelectasis is similar to prior. No focal consolidation, pleural effusion, or pneumothorax. Heart size and cardiomediastinal contours are stable. IMPRESSION: No acute cardiopulmonary process. " 87615e99-18cd17f4-a5279717-477a6816-bdac09d0.jpg,validate/p14/p14317457/s53703676/87615e99-18cd17f4-a5279717-477a6816-bdac09d0.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with cough. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No focal consolidation, edema, effusion, or pneumothorax. The heart is normal size. The mediastinum is not widened. The descending thoracic aorta is slightly tortuous, unchanged. Right shoulder prosthesis is only partially imaged. No acute osseous abnormality. Multilevel degenerative changes of thoracic spine are moderate, unchanged. IMPRESSION: No pneumonia. " 2900c764-4383fd33-819827a7-299b6a71-1db4e6c8.jpg,validate/p11/p11321986/s51462660/2900c764-4383fd33-819827a7-299b6a71-1db4e6c8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with history of CHF, hypoxia TECHNIQUE: Portable upright AP view of the chest COMPARISON: CT chest ___, chest radiograph ___. FINDINGS: Patient is status post median sternotomy and CABG. Moderate to severe enlargement of the heart size is re- demonstrated, unchanged. Mediastinal contour is similar with central venous congestion again noted. Hazy opacities are noted involving the perihilar regions and lung bases bilaterally in a relatively symmetric fashion, perhaps slightly worse in the left mid lung field compared to the previous radiograph. No pneumothorax is present. No large pleural effusion is identified. There are no acute osseous abnormalities. IMPRESSION: Bilateral hazy opacity involving the perihilar regions and lung bases, perhaps slightly worse in the left mid lung field compared to the prior study. Findings may reflect mild pulmonary edema superimposed on a background of chronic interstitial lung disease which was better assessed on the prior CT chest. No large pleural effusion. " 03f2cf00-0ee80f78-e42f48b0-83bf2803-ca9af356.jpg,validate/p11/p11152196/s53351326/03f2cf00-0ee80f78-e42f48b0-83bf2803-ca9af356.jpg,validation," FINAL REPORT HISTORY: Shaking and cough. COMPARISON: Chest radiograph ___. FINDINGS: PA and lateral views of the chest were obtained. The heart size is normal. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Increased lung markings in the left upper lobe are concerning for pneumonia in the correct clinical setting. IMPRESSION: Increased lung markings in the left upper lobe concerning for pneumonia. " 5eb70b16-eb65dcda-b8fff928-66a91177-b8284cb2.jpg,validate/p18/p18026603/s53135248/5eb70b16-eb65dcda-b8fff928-66a91177-b8284cb2.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient with bright red blood per rectum and hematocrit drop. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and fairly well-aerated lungs without definite focal consolidation, pleural effusion, or pneumothorax. There is mild vascular congestion. The visualized upper abdomen is unremarkable. An apparent device projects in the left mid chest IMPRESSION: No definite focal consolidation. Mild vascular congestion. " c503c2f6-c792f1e4-800ae6c4-db631887-a88e05de.jpg,validate/p14/p14821385/s58746298/c503c2f6-c792f1e4-800ae6c4-db631887-a88e05de.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with recurrent cough. COPD // r/o pna 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 acute cardiopulmonary abnormalities. " db1c4e24-acd97bc7-d5e97d65-04ffb3e5-9c036419.jpg,validate/p11/p11413236/s55972946/db1c4e24-acd97bc7-d5e97d65-04ffb3e5-9c036419.jpg,validation," FINAL REPORT HISTORY: Wheezing, mast cell crisis. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy. Right-sided Port-A-Cath tip terminates in the right atrium. Lung volumes are low. This accentuates the cardiac silhouette size which is likely mildly enlarged. Calcified mediastinal nodes are re- demonstrated reflective of prior granulomatous disease. Mediastinal and hilar contours are otherwise unremarkable. There is no pulmonary vascular congestion. Patchy bibasilar airspace opacities most likely reflect atelectasis. There is no pleural effusion or pneumothorax. No acute osseous abnormalities detected. IMPRESSION: Low lung volumes with probable bibasilar atelectasis. " 60959337-13746839-3c677454-05cae6a5-4c7da6da.jpg,validate/p11/p11164650/s50519500/60959337-13746839-3c677454-05cae6a5-4c7da6da.jpg,validation," FINAL REPORT INDICATION: ___ year old man with chronic cough // r/o infiltrate or mass TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear, no acute consolidation or pulmonary edema. Heart size is top normal. No pleural effusions or pneumothorax. Bilateral pleural effusions have resolved. Prior median sternotomy and CABG. IMPRESSION: No acute cardiopulmonary process. " 65f89ac1-0b8e514f-edfa599b-cf095b48-88d18f27.jpg,validate/p17/p17612000/s51202445/65f89ac1-0b8e514f-edfa599b-cf095b48-88d18f27.jpg,validation," FINAL REPORT HISTORY: Multiple surgeries, now with fever. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Cardiac and mediastinal contours are stable. Substantial pulmonary edema with layering effusions and areas of compressive atelectasis at the bases. In the appropriate clinical setting, supervening pneumonia would have to be considered. " 05a25a6b-72aabad4-e05336e9-68aaf4ab-c71f9782.jpg,validate/p14/p14331699/s57518964/05a25a6b-72aabad4-e05336e9-68aaf4ab-c71f9782.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain, evaluate for pneumonia. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: There are bilateral hazy pulmonary opacities and cardiomegaly consistent with congestive heart failure. No focal opacities concerning for infection are seen. There may be small bilateral pleural effusions. Bones are intact. IMPRESSION: Mild congestive heart failure with small bilateral pleural effusions. " 8db8b452-2bfd696e-ac0b4cbb-0c8564ca-12cd2cf8.jpg,validate/p13/p13560848/s52804200/8db8b452-2bfd696e-ac0b4cbb-0c8564ca-12cd2cf8.jpg,validation," FINAL REPORT INDICATION: ___ year old man with sCHF with ___. Evaluate for pulmonary edema. TECHNIQUE: Single AP view of the chest. COMPARISON: Chest x-ray from ___. FINDINGS: Cardiac silhouette is severely enlarged. Areas of atelectasis at the right lung base are stable. No focal consolidation or pulmonary edema. The thoracic aorta is tortuous. There is no pleural effusion or pneumothorax. A left chest single lead AICD is unchanged in position. Patient is status post median sternotomy with aortic valve replacement. IMPRESSION: No pulmonary edema or consolidation. Right lower lobe atelectasis. Severe cardiomegaly. " c72eb864-0c84357d-d319308b-2beea539-71e0dd66.jpg,validate/p16/p16672237/s51767638/c72eb864-0c84357d-d319308b-2beea539-71e0dd66.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough // rule out pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is unchanged persistent elevation of the left hemidiaphragm. There is left basilar atelectasis, but no focal consolidations. The pulmonary vasculature is normal. The cardio mediastinal silhouette is stable. There is no pleural effusion. There is no pneumothorax. IMPRESSION: Persistent elevation of the left hemidiaphragm, but no evidence of pneumonia. " b740f79e-73da2f17-0d2dac03-2e639b9e-4e01c770.jpg,validate/p13/p13473495/s53351384/b740f79e-73da2f17-0d2dac03-2e639b9e-4e01c770.jpg,validation," FINAL REPORT INDICATION: History of Gram-negative rod bacteremia, intubated, please evaluate for interval change. COMPARISONS: Multiple chest radiographs dated back to ___ and CT from ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The ET tube terminates 3.9 cm above the carina. There is an enteric tube which extends well below the diaphragm. Again seen is severe cardiomegaly, stable since at least ___. The lung volumes continued to be low with evidence of elevated pulmonary venous pressure and moderate bilateral pleural effusions, left greater than right. There appears to be slight interval worsening of the bibasilar atelectasis. There is no evidence of a pneumothorax. Note is again made of stable elevation of the right hemidiaphragmatic contour. IMPRESSION: Slight interval worsening of atelectasis at the left lung base. Stable moderate bilateral pleural effusions, left greater than right. " 226b6ec8-10b8c413-ec7a8f87-72d87578-7f727362.jpg,validate/p15/p15169108/s59252078/226b6ec8-10b8c413-ec7a8f87-72d87578-7f727362.jpg,validation," WET READ: ___ ___ 3:28 PM displaced, comminuted right clavicle fx. possible nondisplaced posterior right 2nd rib fracture. WET READ VERSION #1 WET READ VERSION #2 ___ ___ 3:26 PM displaced right clavicle fx ______________________________________________________________________________ FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Bicycle injury, possible clavicle injury. COMPARISON: None. FINDINGS: There are relatively low lung volumes that accentuate the bronchovascular markings. Basilar atelectasis is seen without definite focal consolidation. There is no large pleural effusion or pneumothorax. The cardiac silhouette is top normal. The mediastinal contours are unremarkable. There is a displaced mid right clavicular fracture with approximately 1.3 cm of bony overriding and with inferior displacement of the distal fracture fragment by approximately one shaft width. Partially imaged hardware in the mid to distal left clavicle is noted. IMPRESSION: Displaced right midclavicular fracture. " c8954bdc-3cd32e28-2792d8e2-95acb301-17eac0ac.jpg,validate/p17/p17125981/s57501484/c8954bdc-3cd32e28-2792d8e2-95acb301-17eac0ac.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: ET tube placement in a patient with pulmonary edema. COMPARISON: ___. The ET tube tip is 4.3 cm above the carina. The right internal jugular line tip is at the level of mid SVC. The NG tube tip is in the stomach. The patient continues to be in pulmonary edema that appears to be even progressed since the prior examination, currently moderate to severe. Bilateral pleural effusions and bibasal atelectasis are unchanged. " c9a668d0-ba49c40b-d50d1a37-c7d21131-0453ad10.jpg,validate/p17/p17841596/s54118833/c9a668d0-ba49c40b-d50d1a37-c7d21131-0453ad10.jpg,validation," FINAL REPORT HISTORY: Coughing in a smoker. FINDINGS: No previous images. There is substantial elevation of the right hemidiaphragmatic contour of uncertain etiology. Mild atelectatic or fibrotic changes are seen at the right base. The left lung is essentially clear and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 1bfd3398-6cc9e2f1-1f769a6b-b110226d-0663841c.jpg,validate/p10/p10583673/s51435289/1bfd3398-6cc9e2f1-1f769a6b-b110226d-0663841c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with AMS // ? 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. THE AORTA IS SOMEWHAT TORTUOUS. IMPRESSION: No acute cardiopulmonary process. " 4e9f32f0-ba4ca161-6703f1ad-e34d0200-1b13c6d5.jpg,validate/p12/p12414328/s50067297/4e9f32f0-ba4ca161-6703f1ad-e34d0200-1b13c6d5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Acute chest pain. Portable AP radiograph of the chest was reviewed in comparison to ___. Post-sternotomy wires are unremarkable. Heart size is enlarged with the pacemaker leads terminating in the expected location of right atrium, right ventricle and left periventricular leads. There is new opacity running parallel to the aorta in the left lung, new since the prior study and might reflect area of atelectasis. Small amount of pleural effusion cannot be excluded. If clinically warranted and giving the history of upcoming surgery, assessment with chest CT to exclude the possibility of acute pathology may be considered. " fab322a0-b20a26e8-e98b0a36-406d8aae-1698b603.jpg,validate/p16/p16620451/s58235509/fab322a0-b20a26e8-e98b0a36-406d8aae-1698b603.jpg,validation," FINAL REPORT INDICATION: ___ year old woman // eval for pneumo COMPARISON: Radiograph dated ___. FINDINGS: Portable AP upright radiograph through the chest demonstrates a right-sided internal jugular vein which terminates at the low a SVC. This appears in unchanged position when compared to most recent radiograph. Patient is status post extubation and enteric tube removal. Patient is status post sternotomy with median sternotomy wires intact. Surgical clips are noted projecting over the left hemithorax. Chest tubes have been removed. New since prior examination, there is increased opacification at the left lung base with obscuration of the left costophrenic angle concerning for pleural effusion and most likely atelectatic changes. There is mild shift of the trachea rightward which may reflect projectional differences. There is improved aeration and increased lung volume within the right hemithorax. No pneumothorax is visualized. IMPRESSION: 1. Status post extubation and enteric tube removal. 2. Status post left chest tube removal with increased opacification at left lung base and obscuration of left hemidiaphragm concerning for pleural effusion. These findings discussed with Dr. ___ by Dr. ___ ___ telephone at 15:30 on ___ at the time radiograph was reviewed. " bb67460d-da9888ac-9dbe043b-04347c78-740742ee.jpg,validate/p19/p19181318/s50242241/bb67460d-da9888ac-9dbe043b-04347c78-740742ee.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: AP upright portable view. COMPARISON: ___. FINDINGS: The patient is rotated to the left. Right-sided large-bore central venous catheter likely terminates in the right atrium. The patient is status post median sternotomy. There is obscuration of the left hemidiaphragm and left base opacity seen which may be due to atelectasis however, underlying consolidation or small pleural effusion is difficult to entirely excluded. There is mild left mid lung atelectasis/scarring. No pneumothorax is seen. The cardiac silhouette is top-normal. No overt pulmonary edema. IMPRESSION: The patient is rotated to the left. Left base opacity and obscuration of the hemidiaphragm may be due to atelectasis and small pleural effusion, consolidation is difficult to exclude. There is evidence of bowel signature over the inferior left hemithorax, superior to the level of the right hemidiaphragm and the left hemidiaphragm may be elevated or there may be a hiatal hernia. " 3b4a6d48-7714e83a-d97598c8-4449135b-5485db21.jpg,validate/p16/p16127725/s51131962/3b4a6d48-7714e83a-d97598c8-4449135b-5485db21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with blood tinged sputum // Assess for intrapulm bleeding Assess for intrapulm bleeding IMPRESSION: In comparison with the study ___ ___, the cardiac silhouette remains at the upper limits of normal. Mild indistinctness of pulmonary vessels again suggest some elevated pulmonary venous pressure. No evidence of acute pneumonia or widespread pulmonary hemorrhage. No widening of the superior mediastinum is identified. " 4e7718f3-7c217cc9-62b176dd-22178cc7-c207cc4b.jpg,validate/p13/p13021440/s57802852/4e7718f3-7c217cc9-62b176dd-22178cc7-c207cc4b.jpg,validation," FINAL REPORT HISTORY: Chronic trach, multifactorial narrowing and worsening respiratory status. Evaluate for mucous plugging or increasing pneumonia. COMPARISON: ___ at 3:07. FINDINGS: Compared with most recent prior radiographs, there has been no significant change. There is no change in position of trach tube and left dialysis line which is pointing horizontally rather than down into the SVC. There is no significant change in moderate cardiomegaly, and bilateral pleural effusions with associated atelectasis. No new focal opacities are present. There is no evidence of pneumothorax. IMPRESSION: No significant interval change. " 7ed34499-4aa70705-0c7b9642-030c0790-e1e420a8.jpg,validate/p16/p16580009/s58029707/7ed34499-4aa70705-0c7b9642-030c0790-e1e420a8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Unresponsiveness. 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 no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " 16054f91-3545538a-00f495dc-b9ecde2d-d229f180.jpg,validate/p17/p17620982/s53020173/16054f91-3545538a-00f495dc-b9ecde2d-d229f180.jpg,validation," FINAL REPORT INDICATION: ___-year-old female patient with hepatorenal syndrome, worsening respiratory status. Study requested for evaluation of pulmonary edema. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: As compared to prior chest radiograph from ___, the degree of pulmonary edema has improved. There is moderate pulmonary congestion with an interstitial component. Moderate right pleural effusion, may be smaller when compared to prior. There is a small left pleural effusion. Cardiomegaly is stable. IMPRESSION: 1. Interval improvement of moderate pulmonary edema. 2. Moderate right pleural effusion and small left pleural effusion. " 5880c137-f9905b7b-9ab032f9-eeb07666-22eece93.jpg,validate/p14/p14536823/s59593543/5880c137-f9905b7b-9ab032f9-eeb07666-22eece93.jpg,validation," 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. " 6330ae75-4b4b98a8-f30103e2-b63a9851-0c9291d3.jpg,validate/p10/p10952156/s55366672/6330ae75-4b4b98a8-f30103e2-b63a9851-0c9291d3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypoxia and left arm pain TECHNIQUE: Portable upright chest radiograph COMPARISON: 3 hr prior FINDINGS: As seen on the radiograph from 3 hr prior, there is mild vascular congestion, moderate cardiomegaly, calcified aortic arch, and left basilar atelectasis. IMPRESSION: No change from 3 hr prior. " 80a09a3c-77a747a7-aa9bfa8b-d09eb5dd-5b367dba.jpg,validate/p19/p19027210/s59867726/80a09a3c-77a747a7-aa9bfa8b-d09eb5dd-5b367dba.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and fever // evaluate for pneumonia evaluate for pneumonia IMPRESSION: In comparison with the study of ___, there is little overall change. Again the cardiac silhouette is at the upper limits of normal in size and there is tortuosity of the descending thoracic aorta. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. Of incidental note is partial eventration of the right hemidiaphragm. " 6eb90215-8ba4b024-b326c41b-9e832fd5-d678690f.jpg,validate/p19/p19499595/s57088454/6eb90215-8ba4b024-b326c41b-9e832fd5-d678690f.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Confusion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The patient is status post median sternotomy with multiple fractured sternal wires including the third superior most and additional more inferior as also seen previously. Cardiac silhouette is mildly enlarged. There may be slight prominence of the main pulmonary artery, which may be in part related to patient positioning, however, underlying pulmonary hypertension is not excluded. " 6fd489d7-5e5215b0-0c11771f-df299acc-efcccef8.jpg,validate/p13/p13224377/s55874073/6fd489d7-5e5215b0-0c11771f-df299acc-efcccef8.jpg,validation," FINAL REPORT HISTORY: MRSA pneumonia, interval imaging. CHEST, SINGLE AP PORTABLE VIEW. The tracheostomy and nasoenteric tube are again noted. Also again noted is the dual-lumen catheter with tip in the region of the SVC/RA junction. Patchy opacities seen throughout the right greater than left lungs quite similar to the chest x-ray from ___. Possible minimal blunting of the right costophrenic angle, but no gross effusion is seen on either side. No pneumothorax is identified. Incidental note made of possible subchondral cyst along the right superior glenoid, at the shoulder. " ecb10724-e085cad9-73c8b3a2-dc33763c-c5461fb1.jpg,validate/p11/p11749570/s54410917/ecb10724-e085cad9-73c8b3a2-dc33763c-c5461fb1.jpg,validation," WET READ: ___ ___ ___ 7:32 PM Right hilar opacity -- ?? mass - rec CT. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Shoulder pain radiating to the chest, assess acute intrathoracic process. FINDINGS: PA and lateral views of the chest were obtained. On the first of three images, there is poorly defined opacity at the right hilum/infrahilar level which has no corresponding abnormality on the lateral view. Findings are concerning for a mass. No pleural effusion or pneumothorax is seen. Heart size is normal. Mediastinal contour is normal. No bony abnormalities are seen. IMPRESSION: Right hilar opacity concerning for mass. CT advised. Posted/flagged to ED dashboard at time of this dictation. " 10e7654f-19b2fecb-fc557451-57ee77b0-791f491b.jpg,validate/p13/p13161178/s50012063/10e7654f-19b2fecb-fc557451-57ee77b0-791f491b.jpg,validation," WET READ: ___ ___ 8:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___F with 1 day constant substernal cp, // eval for cardiomegaly TECHNIQUE: Upright PA and lateral images of the chest. COMPARISON: Comparison 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. IMPRESSION: No acute cardiopulmonary process. " 1e185312-0ba7692e-5b17e713-b7ddcaab-1a05b36b.jpg,validate/p14/p14614404/s58339888/1e185312-0ba7692e-5b17e713-b7ddcaab-1a05b36b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with left pneumothorax after left pigtail placement. AP radiograph of the chest demonstrates substantial interval decrease of left pneumothorax with only minimal apical pneumothorax seen. Rib fractures on the left are redemonstrated as well as substantial scapular fracture, although partially imaged on the current examination. Left basal opacity is still persistent, consistent with re-expanding lung. Right basal opacity is redemonstrated. " 8ebd00ee-33021440-03fe3ce0-6f719f92-81bccf7c.jpg,validate/p18/p18863944/s52547930/8ebd00ee-33021440-03fe3ce0-6f719f92-81bccf7c.jpg,validation," FINAL REPORT INDICATION: Stage III breast cancer status post chemo and radiation, pain in the right anterior tenth rib, worse with deep breath or cough, question of any bony lesion over lower anterior ribs on the right. COMPARISON: Rib films on ___. FINDINGS: PA and Lateral views of the chest. The lungs are clear without consolidation, pleural effusion, or pneumothorax. The cardiac, mediastinal, and hilar contours are normal. No definite rib lesions identified however these views are not optimized for assessing for rib lesions. IMPRESSION: On these routine PA and lateral views of the chest, there are no rib lesions identified, however these views are no optimized for assessing rib lesions, recommend ordering dedicated rib views for better examination of the ribs. " 740710ec-2d649326-29df1a5d-dacb1c4c-ebbd7481.jpg,validate/p11/p11522912/s52953287/740710ec-2d649326-29df1a5d-dacb1c4c-ebbd7481.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with seizure, quadriplegia. TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiograph from ___, ___, ___ and ___. FINDINGS: Lung volumes are low, and there is no focal consolidation, pleural effusion or pulmonary edema. The heart continues to be moderately enlarged. IMPRESSION: No acute cardiopulmonary process. " 91c2886e-89154224-41890fed-b45b03f3-edae3734.jpg,validate/p19/p19228066/s50852232/91c2886e-89154224-41890fed-b45b03f3-edae3734.jpg,validation," FINAL REPORT INDICATION: Postoperative hypotension with thoracic aneurysm on Lovenox. Evaluate for mediastinal changes. COMPARISONS: Chest radiograph ___. Chest radiograph ___. FINDINGS: The mediastinum is widened secondary to known ascending aortic aneurysm, but is unchanged from prior exams. There is no new mediastinal widening. The cardiac silhouette is stably enlarged. Bilateral moderate pleural effusions are unchanged with associated bibasilar atelectasis. There are no new consolidations. There is no pneumothorax. IMPRESSION: 1. Unchanged appearance of the mediastinum. 2. Bilateral moderate pleural effusions. 3. Bibasilar atelectasis. " b242c53d-fb5c53c0-85e3ae82-081e55e4-ec518710.jpg,validate/p19/p19580035/s58801048/b242c53d-fb5c53c0-85e3ae82-081e55e4-ec518710.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman postop day 7 from ankle surgery, with fever // ?pneumonia ?pneumonia IMPRESSION: In comparison with the study of ___, there is again some hyperexpansion of the lungs with extensive reticular changes in the right upper zone. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. " f0939e9b-6646417a-5ddc2d8c-2d010216-b7e8d20c.jpg,validate/p19/p19188435/s58108441/f0939e9b-6646417a-5ddc2d8c-2d010216-b7e8d20c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp failure // Is there interval change? Is there interval change? IMPRESSION: Comparison to ___. The patient has been extubated and the nasogastric tube was removed. The large hiatal hernia persists. Right central venous access line is stable. The right lung bases is minimally better ventilated than before but the large parenchymal opacity in the right lung apex persists. " 6a6812fe-e8392c89-3c23a059-b2129a2a-61175315.jpg,validate/p19/p19119135/s52580075/6a6812fe-e8392c89-3c23a059-b2129a2a-61175315.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Shortness of breath and chest pain. Status post CABG. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The patient is status post coronary artery bypass graft surgery and mitral valve repair. There is still marked enlargement of the right hemidiaphragm but atelectasis at the right lung base has decreased and appears minimal. The left lung appears clear. There is no pleural effusion or pneumothorax. IMPRESSION: Elevation of the right hemidiaphragm. No evidence of acute disease. " e016ec8f-ec5f0d32-9ce7d0ef-94374c52-8aa0ecbf.jpg,validate/p11/p11821055/s55525648/e016ec8f-ec5f0d32-9ce7d0ef-94374c52-8aa0ecbf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever // r/o PNA r/o PNA COMPARISON: Chest radiographs ___. IMPRESSION: Lung volumes are appreciably lower than on ___ exaggerating heart size which is borderline enlarged. It also produces crowding and partial obscuration of pulmonary vasculature which is probably normal. The lungs are grossly clear, but subtle pulmonary abnormalities would not be appreciated. RECOMMENDATION(S): Consider conventional PA and lateral chest radiographs performed at full inspiration, to see if there is still a question about the pulmonary parenchyma which would warrant chest CT. " bcdf55bd-4e8a89e8-30437c40-6f2f45e6-4a326a0e.jpg,validate/p12/p12241303/s55400819/bcdf55bd-4e8a89e8-30437c40-6f2f45e6-4a326a0e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Abdominal distention, intermittent chest pain and dyspnea, assess for fluid overload or pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion or evidence of overt CHF. Cardiomediastinal silhouette is stable. Atherosclerotic calcification along the aortic knob noted. Bony structures appear intact. IMPRESSION: No evidence of pneumonia or overt CHF. " cd4894a7-8b364711-e20059b6-f4728990-5e941990.jpg,validate/p18/p18051152/s59798332/cd4894a7-8b364711-e20059b6-f4728990-5e941990.jpg,validation," FINAL REPORT INDICATION: History: ___M with abd pain // eval for free air TECHNIQUE: AP view of the chest COMPARISON: Multiple prior chest radiographs the most recent on ___ FINDINGS: An enteric tube terminates in the region of the stomach. A right-sided PICC terminates in the mid SVC. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are within normal limits. No intraperitoneal free air is identified. IMPRESSION: No acute cardiopulmonary process. No intraperitoneal free air identified " b47c5cee-e6456752-2b6e5b0b-dd75bf6c-1f10727c.jpg,validate/p17/p17477807/s54826550/b47c5cee-e6456752-2b6e5b0b-dd75bf6c-1f10727c.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain and shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is a small right pleural effusion with overlying atelectasis. A trace left pleural effusion is difficult to exclude. There is bibasilar atelectasis. The cardiac silhouette is mildly enlarged. Mediastinal contours are stable. No overt pulmonary edema is seen. IMPRESSION: Small bilateral pleural effusions with overlying atelectasis. " d8fd737a-25c12bd2-f12e0690-0214454f-0956402a.jpg,validate/p16/p16755216/s51398298/d8fd737a-25c12bd2-f12e0690-0214454f-0956402a.jpg,validation," WET READ: ___ ___ ___ 10:29 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fall // evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The cardiomediastinal silhouette is unchanged. The lungs are clear. There is no pleural effusion or pneumothorax. Mild to moderate multilevel degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " a6961b56-0e1df637-71f99268-71d2919e-2b64c3b4.jpg,validate/p12/p12488897/s59044729/a6961b56-0e1df637-71f99268-71d2919e-2b64c3b4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, shortness of breath, evaluation for infection. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, lung volumes are still low. The size of the cardiac silhouette is at the upper range of normal. Newly occurred mildly widened pulmonary vessels, potentially suggesting mild fluid overload. Pleural effusions, no evidence of pneumonia. At the time of observation and dictation, 11:16 a.m., on ___, the referring physician, ___. ___, was paged for notification. The finding was subsequently discussed over the telephone. " ff9a31a9-9a3a70fb-56206f6b-de003b88-423ab37d.jpg,validate/p13/p13648633/s58425023/ff9a31a9-9a3a70fb-56206f6b-de003b88-423ab37d.jpg,validation," FINAL REPORT HISTORY: PICC placement and possible worked up. TECHNIQUE: Portable frontal chest radiograph 3 views. COMPARISON: ___. FINDINGS: A right-sided PICC is in place terminating 2.3 cm caudal to the carina at the level of the lower SVC. A Dobbhoff tube is in place with the tip terminating at the mid portion of the ___ part of the duodenum. Other findings are not significantly changed with redemonstration of left basal atelectasis and unchanged right lung base opacities. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Right-sided PICC at the level of the low SVC. 2. Dobbhoff tube in the mid ___ portion of the duodenum. 3. Unchanged appearance of the lung parenchyma with a left base atelectasis and existing right lung base opacities which are likely to represent edema. " 1c46a32d-5f8b994a-9edd0fdf-552c10ca-d96afac5.jpg,validate/p11/p11234592/s56327117/1c46a32d-5f8b994a-9edd0fdf-552c10ca-d96afac5.jpg,validation," WET READ: ___ ___ ___ 12:16 AM Left PICC terminates in right atrium. Mechanical heart valves are in unchanged positions. Sternotomy wires are intact. Bibasilar atelectasis is mild. Pulmonary vascular congestion is mild. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p Bentall w/mech AVR // predischarge eval predischarge eval IMPRESSION: Left PICC terminates in right atrium. Mechanical heart valves are in unchanged positions. Sternotomy wires are intact. Bibasilar atelectasis is mild. Pulmonary vascular congestion is mild, with resolution of pulmonary edema. " 90aa33f2-25c62c99-cddd1778-3ba19066-50213e41.jpg,validate/p13/p13279382/s58558287/90aa33f2-25c62c99-cddd1778-3ba19066-50213e41.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Weakness and hyponatremia. Portable AP radiograph of the chest was reviewed with no prior studies available for comparison. The patient is after median sternotomy and CABG. Heart size and mediastinum are normal in size. Lung volumes are preserved. No definitive focal consolidations are demonstrated, but multiple rib fractures may obscure on the right presence of parenchymal abnormalities. Left lung is essentially clear and there is no appreciable pleural effusion or pneumothorax. " cc88eb04-70d61af4-b8f1e71b-b35df294-7112e063.jpg,validate/p15/p15297415/s59736456/cc88eb04-70d61af4-b8f1e71b-b35df294-7112e063.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with dyspnea and effusion on ultrasound. COMPARISON: Radiograph dated ___. FINDINGS: Single AP portable chest radiograph is compared to radiograph dated ___. Relative to prior examination, a right pleural effusion has increased as well as a likely small left pleural effusion. Heart size is enlarged though similar in appearance to prior examination. No overt pulmonary edema is present. A right large bore central venous catheter is identified, its tip which terminates within the expected location of the right atrium. Patient is status post median sternotomy, wires which appear intact. No acute osseous abnormality is detected. IMPRESSION: Large right pleural and likely small left pleural effusion with bibasilar atelectasis, increased since prior examination dated ___. Cardiomegaly without overt pulmonary edema. " f782ba18-9069f1a2-9c249826-1403bbb2-5d16a1bd.jpg,validate/p19/p19442084/s51362206/f782ba18-9069f1a2-9c249826-1403bbb2-5d16a1bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p trach resection // evidence of PNA evidence of PNA COMPARISON: Chest radiographs since ___, most recently ___ through ___. IMPRESSION: Previous mild bibasilar atelectasis and interstitial edema have nearly resolved. Moderate cardiomegaly persists. Mediastinum has a normal postoperative appearance. There is no pneumothorax. Tiny right pleural effusion is probably not clinically significant. " 6b487d73-90ad91d5-01a3eac5-4fb233af-e8ffb94a.jpg,validate/p17/p17055354/s53997079/6b487d73-90ad91d5-01a3eac5-4fb233af-e8ffb94a.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with increased respiratory failure. Question pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: There are low lung volumes which accentuates bibasilar atelectasis. Cardiomediastinal silhouette and hilar contours are unremarkable. A battery pack with pacemaker leads terminating in the right atrium and right ventricle are in unchanged position. A slight increase in the retrocardiac density may be due to low lung volumes versus early infectious process. IMPRESSION: Bibasilar atelectasis and low lung volumes. While ther is no overt evidence of pneumonia, a retrocardiac opacity in the appropriate clinical setting may be an early infectious process. " ec57a729-de112a33-7ff41f7c-16cc208f-0ccfb4e3.jpg,validate/p13/p13907527/s50164156/ec57a729-de112a33-7ff41f7c-16cc208f-0ccfb4e3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with SCC of the lung and prior left lung collapse s/p stenting, with more diminished left lung sounds // please assess for lung collapse. COMPARISON: chest radiographs ___ through ___ IMPRESSION: Moderate to large left pleural effusion displacing the mediastinum slightly to the right an obscuring the cardiac borders is no larger today than was on ___. A region of atelectasis obscuring the aortic knob is stable. Right lung is clear. PIC line ends close to the superior cavoatrial junction. No pneumothorax. " 9001cb07-38aabfc8-d802d558-636b130a-3d1cc2cc.jpg,validate/p16/p16826765/s58355436/9001cb07-38aabfc8-d802d558-636b130a-3d1cc2cc.jpg,validation," FINAL REPORT EXAMINATION: Chest, supine portable. INDICATION: Evaluate for interval changes in a patient status post CVA treated with tPA with likely aspiration event on the morning of ___. COMPARISON: Chest radiograph from ___. FINDINGS: There is no airspace consolidation. Mild pulmonary edema is unchanged from the prior. There is no pneumothorax or pleural effusion. Cardiomediastinal contours are normal. IMPRESSION: Unchanged mild pulmonary edema. " 271e12b7-d6797a6c-5edb9204-fffdf36d-a95aecdc.jpg,validate/p12/p12542274/s50247390/271e12b7-d6797a6c-5edb9204-fffdf36d-a95aecdc.jpg,validation," FINAL REPORT INDICATION: Productive cough, evaluate for pneumonia. COMPARISON: CT chest, ___. FINDINGS: There is no focal consolidation to suggest pneumonia. Paucity of vasculature at the apices and flattened diaphragms is compatible with chronic obstructive lung disease. Heart size is normal. There is no pleural effusion or pneumothorax. There is bibasilar streaky atelectasis. Degenerative changes of the right acromioclavicular joint are marked by mild spurring. IMPRESSION: Bibasilar atelectasis. " 99917e54-4c9f2add-9fe9153f-ae807d54-4c9588c5.jpg,validate/p11/p11111102/s56850215/99917e54-4c9f2add-9fe9153f-ae807d54-4c9588c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dementia decrease PO intake x 1 day. Per daughter has altered mental status. COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Patient is rotated to the left. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. And eventration of the right hemidiaphragm is incidentally noted. IMPRESSION: No acute intrathoracic process " 0d8f1a17-c0110a9e-f1079ed0-d3fe6dde-1be0a235.jpg,validate/p14/p14464902/s57615684/0d8f1a17-c0110a9e-f1079ed0-d3fe6dde-1be0a235.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is improved transparency of the lung parenchyma, likely reflecting improved ventilation. Minimal fluid overload remains present but is certainly less severe than on the previous image. Moderate cardiomegaly, left pectoral pacemaker. " f8902cf4-94b993fe-a1694618-0969df66-3fd9b6d7.jpg,validate/p12/p12793572/s58794854/f8902cf4-94b993fe-a1694618-0969df66-3fd9b6d7.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The patient is status post coronary artery bypass graft surgery. The heart is at the upper limits of normal size. The mediastinal and hilar contours are otherwise unremarkable. There is no pleural effusion or pneumothorax. The lungs appear clear. Mild degenerative changes are noted along the mid through lower thoracic spine. The bones appear probably demineralized. IMPRESSION: No evidence of acute cardiopulmonary disease. " 547480f7-b55db98c-8f7a283a-5786d9fa-7bfbb9e5.jpg,validate/p14/p14957416/s52421451/547480f7-b55db98c-8f7a283a-5786d9fa-7bfbb9e5.jpg,validation," WET READ: ___ ___ ___ 9:05 AM Normal chest radiograph. Specifically no free intraperitoneal air. WET READ VERSION #1 ___ ___ ___ 5:35 AM No acute cardiopulmonary process. Specifically no free intraperitoneal air. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man with epigastric pain, nausea, and vomiting. Assess for free air under the diaphragm TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: Lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart is top-normal in size. Mediastinal contour and hila are unremarkable. Limited assessment of the upper abdomen is unremarkable. No free intraperitoneal air. IMPRESSION: Normal chest radiograph. Specifically no free intraperitoneal air. " a94fcca0-3ae54059-e4698a0b-ab3b5a7c-96405895.jpg,validate/p16/p16830759/s57667173/a94fcca0-3ae54059-e4698a0b-ab3b5a7c-96405895.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with HCV cirrhosis with altered mental status, evaluation for interval changes, infectious causes. COMPARISON: ___ to ___. FINDINGS: The patient has been extubated. Dobbhoff tube still curves in the stomach. Minimal cardiac congestion is unchanged. Small new left lung base opacity is nonspecific, could either be small pleural effusion or atelectasis, but superimposed infection or aspiration cannot be excluded. Known hiatal hernia. CONCLUSION: 1. Unchanged mild cardiac congestion. 2. New very small opacification of the left lung base is nonspecific, could reflect atelectasis and small pleural effusion. Aspiration or infection cannot be excluded in appropriate clinical setting. " 564c70ed-f26a6156-98d5e728-c2d4e293-e881a134.jpg,validate/p12/p12514721/s51953434/564c70ed-f26a6156-98d5e728-c2d4e293-e881a134.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Dyspnea, worsening shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Evidence of patient's known large hiatal hernia is seen. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No definite new focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: Known large hiatal hernia. No focal consolidation or pulmonary edema. " 45bf9bb5-ed3145ad-37ff2205-005c554a-68726b3b.jpg,validate/p18/p18748813/s55589462/45bf9bb5-ed3145ad-37ff2205-005c554a-68726b3b.jpg,validation," WET READ: ___ ___ ___ 12:10 PM No acute cardiopulmonary process. Specifically, no evidence of pulmonary edema or frank pneumonitis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with alkali exposure via aerosol bottle with cough and sore throat. Assess for pneumonitis. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No acute cardiopulmonary process. Specifically, no evidence of pulmonary edema or frank pneumonitis. " a0dbe271-e98e6a3b-c2874636-022c82b1-61dd470f.jpg,validate/p17/p17980556/s58991378/a0dbe271-e98e6a3b-c2874636-022c82b1-61dd470f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Recent pneumonia and increasing white count. IMPRESSION: PA and lateral chest compared to ___: Previous heterogeneous opacification in the right lung which improved from ___ through ___ has not improved subsequently, consistent with persistent multifocal pneumonia. Additionally, mild pulmonary edema most readily detected in the left lung, continues to improve. Heart is top normal size, decreased. Small right pleural effusion remains. No pneumothorax. Left PICC line ends alongside a dual-channel right supraclavicular central venous catheter in the mid-to-low SVC. No pneumothorax. " 37fd1c3b-f1cbb49a-9853cf02-cccfd56e-4f0a9929.jpg,validate/p14/p14068639/s56128416/37fd1c3b-f1cbb49a-9853cf02-cccfd56e-4f0a9929.jpg,validation," FINAL REPORT INDICATION: History of shortness of breath. Evaluate for COPD/infiltrate. COMPARISONS: Chest radiographs from ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Left-sided AICD device is again noted with the lead terminating in the right ventricle, unchanged in position compared to the prior exam. The lung volumes are low. There is stable mild cardiomegaly. The aorta is tortuous. However, the mediastinal contours are otherwise unremarkable. The lungs demonstrate a new right lower lobe opacity, concerning for infection. There is also a streaky opacity along the mid-right lung, likely secondary to fluid along the fissures. No pneumothoraces or pleural effusions are identified. Numerous clips are again seen in the left upper quadrant. Multilevel degenerative changes are seen within the thoracic spine, mild-to-moderate in degree, overall stable compared to the prior exam. IMPRESSION: New right lower lobe opacity concerning for infection. ___ d/w Dr. ___ by Dr. ___ by telephone at 3:___p on the day of the exam. " ba1908f6-fbcad715-8b96b35b-026f5a4c-bb922530.jpg,validate/p15/p15287471/s50532560/ba1908f6-fbcad715-8b96b35b-026f5a4c-bb922530.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Endocarditis, persistent depressed level of consciousness, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is slightly increased bilateral lung volume, likely reflecting either improved ventilation or increased respiratory pressure. The signs suggesting pulmonary edema are improved, but mild edema is still present. No pneumothorax. Unchanged size of the cardiac silhouette. Unchanged bilateral pleural effusions. " b9a801ec-69016535-12646cb4-198faee3-4cfa96f3.jpg,validate/p17/p17198431/s57924547/b9a801ec-69016535-12646cb4-198faee3-4cfa96f3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Congestive heart failure, hypoxia TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Moderate enlargement of the cardiac silhouette is re- demonstrated, unchanged. Mediastinal contour is stable. There is mild pulmonary edema, relatively unchanged compared to the previous study. No pleural effusion, focal consolidation or pneumothorax is demonstrated. Patchy bibasilar airspace opacities likely reflect atelectasis. Degenerative changes of the right glenohumeral joint are present. IMPRESSION: Moderate cardiomegaly with mild pulmonary edema, not substantially changed in the interval. " 1a8a4872-9984e8e5-7f87eeb0-ff368f00-8aa03334.jpg,validate/p15/p15957987/s52869932/1a8a4872-9984e8e5-7f87eeb0-ff368f00-8aa03334.jpg,validation," FINAL REPORT HISTORY: Pneumothorax. FINDINGS: In comparison with the study of ___, the degree of left apical pneumothorax has not appreciably changed. There appears to be some improved aeration at the left base. Otherwise, little overall ]change. " dae88f4d-e36f4aba-25a68bab-db1743b6-c7beb470.jpg,validate/p19/p19840960/s57305872/dae88f4d-e36f4aba-25a68bab-db1743b6-c7beb470.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Chest pain, assess acute process. FINDINGS: AP portable upright chest radiograph obtained. Midline sternotomy wires and mediastinal clips are unchanged. The lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears grossly stable. Bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. Post-CABG changes. " 06615393-d7c10f61-06fedf82-106a06e2-1d77c07c.jpg,validate/p15/p15366293/s56509084/06615393-d7c10f61-06fedf82-106a06e2-1d77c07c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp distress s/p tracheal dilation // ? mediastinal air TECHNIQUE: Single portable frontal view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. No evidence of pneumomediastinum. IMPRESSION: No acute cardiopulmonary abnormality. No definite pneumomediastinum or pneumothorax. " e33236c2-e0c0bade-8c90d3e3-ba0ab648-a5b26891.jpg,validate/p12/p12462675/s58619940/e33236c2-e0c0bade-8c90d3e3-ba0ab648-a5b26891.jpg,validation," FINAL REPORT HISTORY: Status post clipping of ACom aneurysm, now with desaturation on vent. Evaluate for interval change. COMPARISON: ___ at 6:48 a.m. FINDINGS: Frontal radiograph of the chest shows unchanged appearance of endotracheal tube, right internal jugular central venous line, and enteric tube. The lung volumes are similar. There is again mild bibasilar atelectasis with no focal consolidations concerning for pneumonia. No pneumothorax is seen. Pleural effusions are appreciated. The cardiac and mediastinal contour is unchanged. IMPRESSION: Minimal interval change in the lungs, mediastinum, and monitoring and support devices. " 86cd0e4a-23243499-939764a4-8af15248-21ce3f4a.jpg,validate/p16/p16546662/s54721523/86cd0e4a-23243499-939764a4-8af15248-21ce3f4a.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough and fever for 5 days. // Please rule out pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. FINDINGS: The lungs are well-expanded and clear. A small left pleural effusion is slightly larger than on ___. Linear opacity overlying the spine is similar to the prior studies, consistent with scarring. The heart is normal in size. IMPRESSION: No evidence pneumonia. Small left pleural effusion slightly larger than ___. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 2:27 PM, 5 minutes after discovery of the findings. " 4689b65b-11a60b91-bc81e6dd-f12d0926-330fcecf.jpg,validate/p19/p19550773/s50363408/4689b65b-11a60b91-bc81e6dd-f12d0926-330fcecf.jpg,validation," FINAL REPORT INDICATION: ___ year old man with right pleural effusion and pneumothorax s/p chest tube // ?chest tube placement and improvement in pneumothorax/pleural effusion TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier today FINDINGS: There are right pleural catheter is present unchanged. There is a persisting trace right pneumothorax. A small right pleural effusion with adjacent atelectasis is present. Unchanged right hilar prominence. The left lung is clear. The size the cardiac silhouette is unchanged. IMPRESSION: Persisting trace right pneumothorax with a right pleural pigtail catheter present. " e4f57835-2371c0ec-48861b0c-4de90689-6bd2f892.jpg,validate/p10/p10917695/s57814103/e4f57835-2371c0ec-48861b0c-4de90689-6bd2f892.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with palpitations. ? acute cardiopulm process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___ and ___. FINDINGS: The lungs are clear and well expanded, without pleural effusion, pneumothorax, or focal consolidation. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No acute cardiopulmonary process. " 2905a219-0044b483-8315fff6-2258fe9f-a288ed45.jpg,validate/p16/p16508811/s52670967/2905a219-0044b483-8315fff6-2258fe9f-a288ed45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man h/o renal transplant (___) with chronic non healing L foot ulcers, osteomyelitis, LLL Pneumonia // interval change in pneumonia IMPRESSION: As compared to ___, bilateral lower lobe predominant airspace opacities have worsened, and may reflect evolving infectious pneumonia. Peripheral interstitial opacities likely reflect coexisting interstitial edema. Small left pleural effusion has increased in size, and a small right pleural effusion is new. " 4a1e8bce-317dbe8d-2ff833e2-65437cc9-aa841d0c.jpg,validate/p14/p14420248/s59141862/4a1e8bce-317dbe8d-2ff833e2-65437cc9-aa841d0c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Nausea and cough. FINDINGS: AP upright and lateral views of the chest provided. Dialysis catheter is unchanged in position with tip in the low SVC. The heart size is top normal. There is no overt edema or pneumonia. No effusion or pneumothorax seen. The mediastinal contour is stable. Bony structures are intact, though an all deformity of the left mid shaft clavicle is again noted. IMPRESSION: Top normal heart size. Otherwise, unremarkable. " 86f6e762-11146a95-e6aca7cf-0f351bec-95c2197d.jpg,validate/p12/p12514721/s50028985/86f6e762-11146a95-e6aca7cf-0f351bec-95c2197d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD exacerbation // ?pulm edema, PNA TECHNIQUE: Single frontal view of the chest COMPARISON: CT ___ FINDINGS: Cardiac size is normal. Moderate hiatal hernia is again noted. The lungs are hyperinflated. Patient has known emphysema. Small lung nodules, and lingular atelectasis are better seen in prior CT. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary abnormality " 19f8d2e6-a3ac904f-93c6ce35-76071fe1-f6e08733.jpg,validate/p14/p14295340/s58205345/19f8d2e6-a3ac904f-93c6ce35-76071fe1-f6e08733.jpg,validation," FINAL REPORT INDICATION: History of chest pain, question pneumonia. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs were provided. 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: No acute cardiopulmonary process. " 6b48aa15-0e2326f3-bc7c38df-625c3181-f19bb25f.jpg,validate/p10/p10763729/s58551987/6b48aa15-0e2326f3-bc7c38df-625c3181-f19bb25f.jpg,validation," FINAL REPORT INDICATION: Hypotensive. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: A right PICC is present with the tip in the mid SVC, not significantly changed from the prior exam. Patchy bibasilar opacities appear new from the prior exam, and are likely due to bibasilar atelectasis. There is no focal consolidation. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Patchy bibasilar opacities, likely atelectasis. No focal consolidation. " 9f8a8b71-027f4aae-8b93e26b-ab3a665f-5995f330.jpg,validate/p15/p15805011/s57826074/9f8a8b71-027f4aae-8b93e26b-ab3a665f-5995f330.jpg,validation," WET READ: ___ ___ 12:05 AM No acute process. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with chest pain. TECHNIQUE: Frontal and lateral radiographs of the chest. COMPARISON: Chest radiograph from ___. CTA of the chest from ___. FINDINGS: Lung volumes are low with secondary widening of the cardiomediastinal silhouette. Bibasilar atelectasis. No focal lung consolidation. No pulmonary edema, no pleural effusions. " 8237ece3-02894bd6-87de19ea-d38f3ebb-2c759b4b.jpg,validate/p18/p18265318/s55538528/8237ece3-02894bd6-87de19ea-d38f3ebb-2c759b4b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chf. Worsening SOB // ?pulmonary edema ?pulmonary edema IMPRESSION: Compared to chest radiographs ___ and ___. Right upper lobe is more severely affected by worsening mild pulmonary edema, accompanied by increasing mediastinal venous engorgement. This pattern is often seen with acute mitral regurgitation, sometimes seen with this degree of mitral annulus calcification. Pleural effusion is small if any. No pneumothorax. Moderate cardiomegaly is stable. ___, MD " e8b45ac4-02ff5144-36d3c7ad-8c8c1863-adcdc01a.jpg,validate/p11/p11047388/s53981702/e8b45ac4-02ff5144-36d3c7ad-8c8c1863-adcdc01a.jpg,validation," WET READ: ___ ___ ___ 11:38 PM 1. Minimally displaced fracture of the lateral aspect of the right clavicle. 2. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with syncope // acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There are low lung volumes. Cardiomediastinal silhouette is within normal limits. Lungs are clear and there is no pleural effusion or pneumothorax. Possible minimally displaced fracture of the lateral aspect of the right clavicle. Remaining osseous structures appear intact. IMPRESSION: 1. Possible minimally displaced fracture of the lateral aspect of the right clavicle. This could be clarified with dedicated shoulder radiographs. 2. No acute cardiopulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 11:36 PM, 2 minutes after discovery of the findings. " 320688c9-825f43ac-46b22d7e-897c076c-76f296f6.jpg,validate/p15/p15199994/s58258074/320688c9-825f43ac-46b22d7e-897c076c-76f296f6.jpg,validation," FINAL REPORT INDICATION: ___-year-old, please assess for pneumonia. 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. Old rib fractures are seen bilaterally. IMPRESSION: No acute cardiothoracic process. " adce4937-4ed8fe7e-3ef7617b-4c090afe-94a29055.jpg,validate/p17/p17684961/s56903819/adce4937-4ed8fe7e-3ef7617b-4c090afe-94a29055.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F chest pain for the past two days // ___F chest pain for the past two days TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. The pulmonary hilar vessels may be slightly prominent without overt pulmonary edema. IMPRESSION: Possible mild central pulmonary vascular engorgement without overt pulmonary edema. No definite focal consolidation. " b739bf7d-56512f68-31b63815-012c4558-951556ce.jpg,validate/p17/p17613334/s54505190/b739bf7d-56512f68-31b63815-012c4558-951556ce.jpg,validation," FINAL REPORT INDICATION: Patient with cough, fever and wheezing. Evaluate for infiltrate. 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: Normal chest radiographic examination. " 19fa7ba9-199f3e6f-159db998-6df01dff-4e7f705f.jpg,validate/p13/p13561687/s57180419/19fa7ba9-199f3e6f-159db998-6df01dff-4e7f705f.jpg,validation," FINAL REPORT HISTORY: Fever of 104 on chemotherapy, concerning for pneumonia COMPARISON: Comparison is made with chest radiograph from ___ and ___. FINDINGS: PA and lateral views of the chest. The lungs are well expanded and clear. A granuloma is seen in the right lateral lung, unchanged to prior exam. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8972f7fa-ccee26f0-1ebd0fef-693cd7b4-fb5d9722.jpg,validate/p12/p12902262/s52061559/8972f7fa-ccee26f0-1ebd0fef-693cd7b4-fb5d9722.jpg,validation," FINAL REPORT INDICATION: History: ___F with multiple falls // R/O CHF, pneumonia TECHNIQUE: Chest PA and lateral views. The lateral view is suboptimal due to overlying motion artifact. COMPARISON: None. Please note that comparison to old films can be helpful to detect subtle interval change. FINDINGS: There is moderate cardiac enlargement which may reflect cardiomegaly or a pericardial effusion. There is pulmonary vascular congestion with no overt pulmonary edema. Thehilar and mediastinal contours difficult to assess given marked patient rotation on the current study. There is likely a hiatal hernia. There may be a focal opacity in the retrocardiac region; however evaluation is limited due to patient rotation and motion artifact. Followup imaging may be prudent. No large effusions are seen. No pneumothorax is appreciated. No acute bony abnormality. IMPRESSION: 1. Limited examination due to marked patient rotation and overlying motion artifact on the lateral view. Cardiac enlargement which may reflect cardiomegaly or pericardial effusion. Probable hiatal hernia. No definite pneumonia or pulmonary edema. Followup imaging would be prudent. . NOTIFICATION: ___ d/w Dr. ___ by Dr. ___ at 5:___p on the day of the exam by phone. " a28a20ea-b2b29ec5-eecd8cb1-732aad47-296ae31d.jpg,validate/p16/p16217465/s51880679/a28a20ea-b2b29ec5-eecd8cb1-732aad47-296ae31d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, smoker, increased SOB // eval for resolution of opacity noted in ___ TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are hyperexpanded and clear. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities hyperexpanded lungs. " ccb98fd2-2e891ee4-a91f2f25-75290fab-5a131e5b.jpg,validate/p11/p11543398/s51599750/ccb98fd2-2e891ee4-a91f2f25-75290fab-5a131e5b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intubation s/p diuresis with continued hypoxia // acute interval changes TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Large bilateral pleural effusions have minimally increased with increasing adjacent atelectasis. Cardiac size cannot be evaluated. Widening of the mediastinum with tortuous aorta is unchanged. The pulmonary arteries are enlarged as before. Mild pulmonary edema is minimally worsened. ET tube is in standard position. Left IJ is in unchanged standard position. NG tube tip is out of view below the diaphragm. No other interval changes " 72f41c21-7faa72d8-e7372ecc-f47620f7-73df8710.jpg,validate/p11/p11287191/s57727428/72f41c21-7faa72d8-e7372ecc-f47620f7-73df8710.jpg,validation," WET READ: ___ ___ ___ 5:25 PM There has been interval retraction of a left PICC since the prior study from ___, now terminating in the SVC. Right midlung scarring and associated pleural thickening is unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R axillo-bi-femoral bypass on ___ with T ___.7 and rising leukocytosis // any pneumonia or consolidation to explain rising temp CBC? any pneumonia or consolidation to explain rising temp CBC? IMPRESSION: Left PICC line tip is at the level of mid - superior SVC. Heart size and mediastinum are stable. Interstitial changes gist and opacities in the upper lungs are unchanged. No new pleural effusion or pneumothorax is seen. " 0cefe1d6-4006acd1-c5f4bbf1-68dbe24e-05ce7299.jpg,validate/p18/p18953695/s57564870/0cefe1d6-4006acd1-c5f4bbf1-68dbe24e-05ce7299.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___M with traumatic R CP // ? PTx or lung contusion ? PTx or lung contusion COMPARISON: ___ FINDINGS: The lungs remain clear. The heart and mediastinal structures are unremarkable. The bony thorax is grossly intact. There is no acute change. IMPRESSION: No active disease. " eebbdf5c-7dc8e2df-ced26646-9c16776a-6257230f.jpg,validate/p15/p15717787/s59282553/eebbdf5c-7dc8e2df-ced26646-9c16776a-6257230f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old woman with a cough and chest pain. Rule out pneumonia. IMPRESSION: Normal heart, lungs, hila, mediastinum and pleural surfaces. No evidence of intrathoracic malignancy or infection. " e168f502-ca9d1e5e-4588c329-542d7b81-21cbd9db.jpg,validate/p12/p12431768/s58957737/e168f502-ca9d1e5e-4588c329-542d7b81-21cbd9db.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Diffuse wheezing, rhonchi, new cough and subjective fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. There is slight increase in interstitial markings bilaterally, which could be due to mild edema versus atypical infection. IMPRESSION: No focal consolidation. Mild increased interstitial markings bilaterally may relate to mild edema and appear decreased compared to the prior study; however, atypical infection is not entirely excluded in the appropriate clinical setting. " aa5ac4b6-86309910-19a1b029-1af525eb-bd9afd80.jpg,validate/p16/p16701040/s50482963/aa5ac4b6-86309910-19a1b029-1af525eb-bd9afd80.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with HIV, cough // eval pneumonia- change from prior CXR last week. ? was atelectasis, vs true pneumonia eval pneumonia- change from prior CXR last week. ? was atelectasis, vs true pneumonia IMPRESSION: Comparison to ___. No abnormality at the left lung bases is seen on today's radiograph. Stable right-sided pleural adhesion that ___ the right heart border. No cardiac abnormalities. " 21d308f4-9dc66f69-095c50d1-560283dd-6dff18f7.jpg,validate/p10/p10577647/s55939063/21d308f4-9dc66f69-095c50d1-560283dd-6dff18f7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with abdominal pain // eval port placement COMPARISON: ___ IMPRESSION: Left subclavian porta catheter terminates in the body of the right atrium with no evidence of pneumothorax. Lung volumes are low. Mild cardiac enlargement without evidence of congestive heart failure. No focal areas of consolidation or pleural effusions. " 73fe7b13-dcad5e49-c8eea785-57231066-7c69672a.jpg,validate/p15/p15394622/s59698529/73fe7b13-dcad5e49-c8eea785-57231066-7c69672a.jpg,validation," 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. " 481ace90-fa02fb00-bbc80661-8c50a312-ac57d84a.jpg,validate/p12/p12251785/s57977513/481ace90-fa02fb00-bbc80661-8c50a312-ac57d84a.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath. Question pneumonia. COMPARISON: ___. FINDINGS: Single portable view of the chest. The lungs are clear of consolidation or large effusion. Relatively low lung volumes seen with probable right basilar atelectasis, unchanged. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. Surgical clips again noted in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " b52fd23d-ff70988c-c1f02c90-5ba6cae6-91177d2e.jpg,validate/p12/p12229726/s55774131/b52fd23d-ff70988c-c1f02c90-5ba6cae6-91177d2e.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: Study of earlier the same date. FINDINGS: Recently placed right internal jugular central venous catheter terminates in the lower superior vena cava, with no visible pneumothorax, and otherwise no relevant short interval changes in the appearance of the chest since the recent study. " 3c6791a8-22c1bacd-f685eae8-d6ad1516-db551dcb.jpg,validate/p12/p12670557/s57775567/3c6791a8-22c1bacd-f685eae8-d6ad1516-db551dcb.jpg,validation," FINAL REPORT STUDY: AP CHEST, ___. CLINICAL HISTORY: ___-year-old woman with bacteremia. Persistently hypotensive. Evaluate for pneumonia. FINDINGS: Comparison is made to previous study from ___. There is a right IJ central line with distal lead tip in the proximal right atrium. The heart size is within normal limits. There is some atelectasis at the lung bases. There is mild improved aeration since the previous study. No pneumothoraces are identified. " ccb04640-0a9766ad-54b78401-bfaf1bb2-0d715dbc.jpg,validate/p11/p11558814/s55950047/ccb04640-0a9766ad-54b78401-bfaf1bb2-0d715dbc.jpg,validation," 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. " 2b4bc3ec-d76598af-e916895a-f0edcce2-da469953.jpg,validate/p12/p12916556/s50368081/2b4bc3ec-d76598af-e916895a-f0edcce2-da469953.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx ptx // ? residual ptx ? residual ptx IMPRESSION: Comparison to ___. There is no evidence for the presence of a residual right apical pneumothorax. Mild overinflation continues to be present. Pre-existing opacities on the right have almost completely resolved. Normal size of the heart. " 9589ba0e-e6663629-12f25816-e71f0347-da2a1c45.jpg,validate/p14/p14562303/s59286628/9589ba0e-e6663629-12f25816-e71f0347-da2a1c45.jpg,validation," FINAL REPORT HISTORY: ___F with SOB COMPARISON: None. FINDINGS: Portable AP upright chest radiograph was provided. The lungs are clear bilaterally. The cardiomediastinal silhouette appears grossly unremarkable. No large effusion or pneumothorax. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " 53442010-f866f477-1127edf1-c417d903-361460dd.jpg,validate/p19/p19791131/s59954702/53442010-f866f477-1127edf1-c417d903-361460dd.jpg,validation," WET READ: ___ ___ ___ 7:10 PM Normal chest radiographs ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with mild SOB and cough // eval pneumonia, other acute process TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are clear. Heart size and mediastinal contours are normal. There is no pleural effusion or pneumothorax. Osseous structures are intact. IMPRESSION: Normal chest radiographs " 80ab9ace-142cf18a-99cf3357-a18e101e-668e9574.jpg,validate/p17/p17413521/s55132023/80ab9ace-142cf18a-99cf3357-a18e101e-668e9574.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with DHT // ?DHT in right spot COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the tip of the Dobbhoff catheter is now well visualized. The tip projects over the pre-pyloric region of the stomach. The stomach is marked by contrast material. The course of the tube is unremarkable. Unremarkable appearance of the basal lung parenchyma and the cardiac silhouette. " baca61f7-6eb27c71-0431da4a-d889a5dd-0f88e62d.jpg,validate/p12/p12457907/s55473698/baca61f7-6eb27c71-0431da4a-d889a5dd-0f88e62d.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after right upper lobectomy and mediastinal lymph node dissection, assessment of pleural effusion. PA and lateral upright chest radiographs were reviewed in comparison to ___. As compared to the prior study there is interval resolution of subcutaneous air. Lungs are well expanded. There is no evidence of pleural effusion on current examination neither on the right nor on the left. No pneumothorax is seen. Expected right mediastinal shift is noted. " ef580200-28aac8ea-eff39a3d-6ef831f9-93065fa7.jpg,validate/p16/p16421524/s59592339/ef580200-28aac8ea-eff39a3d-6ef831f9-93065fa7.jpg,validation," 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. " 57126820-16d7f683-6c8c0cd5-d999f3cf-b77dcfe3.jpg,validate/p18/p18627179/s54242406/57126820-16d7f683-6c8c0cd5-d999f3cf-b77dcfe3.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: new respiratory distress after extubation. Comparison is made with prior study ___. New left perihilar opacities are worrisome for aspiration. Left lower lobe retrocardiac opacities are unchanged, combination of atelectasis and pleural effusion. Cardiac size is obscured by the lung abnormalities. Mild vascular congestion has minimally increased. There are low lung volumes. Bilateral stimulators are again noted. Findings were discussed by phone with Dr. ___, at 11.___ am ___ at the time of interpretation of study. " d1c5a188-8058ee20-ebc98b4c-7db97b24-e3e0dcb3.jpg,validate/p17/p17935897/s51875638/d1c5a188-8058ee20-ebc98b4c-7db97b24-e3e0dcb3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with 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 with new fever // please evaluate for pneumonia please evaluate for pneumonia IMPRESSION: In comparison with the study of ___ for, there is again substantial enlargement of the cardiac silhouette with moderate pulmonary edema and bilateral pleural effusions with compressive volume loss in the lower lobes. Given the extensive pulmonary changes, it is impossible to exclude the possibility of superimposed pneumonia in the appropriate clinical setting, especially in the absence of a lateral view. " f1ca7491-f663de39-56d4d835-0421c672-5102a34b.jpg,validate/p10/p10345528/s57915303/f1ca7491-f663de39-56d4d835-0421c672-5102a34b.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Anginal chest pain. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest radiographs: Lungs are low in volume but clear. Heart size is normal. There is no pleural effusion or evidence of central adenopathy. The large and small bowel are at least moderately distended. Clinical correlation advised. No free subdiaphragmatic gas. " d91351ef-5f9cc31a-34f8e36e-f9860832-69855b11.jpg,validate/p19/p19172342/s56781383/d91351ef-5f9cc31a-34f8e36e-f9860832-69855b11.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with productive cough x5 weeks. COMPARISON: PA and lateral chest radiograph, ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: Lungs are well expanded bilaterally and clear. No lesions, pleural effusion, or pneumothorax are identified. There is mild tortuosity of the thoracic aorta. Otherwise, cardiomediastinal silhouette is within normal limits and unchanged. Pleural surfaces are unremarkable. IMPRESSION: No evidence of pneumonia. These findings were reported to Dr. ___ ___ phone at 8:45 p.m. by ___ ___. " 716aca46-42456a63-4e9cb645-cf802867-3ad377a4.jpg,validate/p15/p15712408/s55786355/716aca46-42456a63-4e9cb645-cf802867-3ad377a4.jpg,validation," FINAL REPORT INDICATION: Complains of cough and bibasilar crackles. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous examination, the lung volumes have decreased. At both lung bases, band-like consolidations are seen. Their extent is better visualized on the lateral than on the frontal radiograph, they predominate in the lower lobes. Overall, the size of the cardiac silhouette is within normal limits. The patient has no pleural effusions. The hilar and mediastinal contours are unremarkable. IMPRESSION: In the appropriate clinical setting, the bilateral parenchymal opacities are likely to reflect pneumonia. At the time of observation and dictation, 2:23 p.m., the referring physician, ___. ___, was paged for notification, on ___, and the findings were subsequently discussed over the telephone. " 9b087f28-7a87da12-d5c9a4e7-aeebcc35-f19a9cc0.jpg,validate/p11/p11961710/s52496616/9b087f28-7a87da12-d5c9a4e7-aeebcc35-f19a9cc0.jpg,validation," 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. " d96c7ca1-1cf13793-e4e035b7-0d5a11df-14102aed.jpg,validate/p14/p14235312/s52077357/d96c7ca1-1cf13793-e4e035b7-0d5a11df-14102aed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with purulent sputum via ETT, fever, rising WBC. // eval for PNA TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 4 cm above the carinal. Left subclavian line tip is at the level of superior SVC. NG tube tip is in the stomach. Heart size and mediastinum are stable. Lungs are essentially clear. No interval progression or development of infectious process is seen on the current radiograph " d6e27d4d-cba76470-703cfb85-21b0a6f3-46e93726.jpg,validate/p11/p11504637/s55266525/d6e27d4d-cba76470-703cfb85-21b0a6f3-46e93726.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pleuritic L sided chest pain, Hx PE 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. " 52663b70-de520dde-303646bc-0b24d588-736c2cc4.jpg,validate/p15/p15454331/s55821648/52663b70-de520dde-303646bc-0b24d588-736c2cc4.jpg,validation," 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. " 97ca44fc-576deb40-bb285955-4228ff57-aefd1e30.jpg,validate/p14/p14318651/s57903686/97ca44fc-576deb40-bb285955-4228ff57-aefd1e30.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with chest pain radiating to back, neck, L arm // s/p assault, chest pain radiating ot back and neck and L-arm x1d TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are normal, without consolidation. Pleural surfaces are smooth, without pleural effusion or pneumothorax. Cardiomediastinal contours are normal. Imaged osseous structures are grossly intact. IMPRESSION: No evidence of acute cardiopulmonary process. " 8cee6d18-09c2b1e5-3a66a7f3-0678b42d-e0fa5658.jpg,validate/p19/p19108974/s56664872/8cee6d18-09c2b1e5-3a66a7f3-0678b42d-e0fa5658.jpg,validation," FINAL REPORT INDICATION: ___ year old man with persisting cough and coarse breath sounds at left base // pls eval for pulm pathology TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: The lung volumes are normal. Normal size of cardiac silhouette. No pleural effusions. No focal parenchymal opacity suggesting pneumonia. No pulmonary edema. No pneumothorax. Normal hilar and mediastinal contours. The osseous structures are stable. IMPRESSION: No acute cardiopulmonary process. " a62a4648-3bbafcb9-f4e6fd22-13aebeb4-35445137.jpg,validate/p15/p15233042/s51001236/a62a4648-3bbafcb9-f4e6fd22-13aebeb4-35445137.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with falls, question rib fracture or pneumonia. COMPARISON: Multiple chest radiographs, the latest from ___. ONE VIEW OF THE CHEST: There are with bilateral interstitial opacities, with atelectasis or scarring at the right base, unchanged. The cardiac silhouette is top normal or slightly enlarged. The left hilum is prominent. No pleural effusion or pneumothorax is detected. There are fractured sternal wires superiorly -- these appear diffrent compared with ___ CXR, which also showed fractured wires -- ? due to differences in positioning (most likely), change in wire fragment position, or interval wire fracture -- attention to this area on follow-up films is recommended. The adjoining mediastinal contour is unchanged. Assessment of rib fxs is limited on this lung-technique films. Focal opacity along right inferior chest wall is noted, but may relate to rib fxs and hematoma seen on the ___ CT. No displaced rib fracture is identified. IMPRESSION: 1) Mild unchanged pulmonary edema. 2) No displaced rib fracture detected. Opacity adjacent to right inferior chest wall. If this corresponds to a site of focal tenderness, it could indicate an acute fracture, but it also corresponds to a prior site of rib fracture and hematoma and may very well be an old injury. 3) Change in configuration of fractured superior sternal wires. Please see comment above. " a60fe3bb-8a208723-0eb133af-01853665-59e376f4.jpg,validate/p14/p14014950/s52083797/a60fe3bb-8a208723-0eb133af-01853665-59e376f4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p cabg with new complaints of sob // eval for effusion TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Small right pneumothorax is a stable. Large bilateral effusions larger on the left are grossly unchanged. Vascular congestion mildly increased. Cardiac size cannot be evaluated. Pacer leads are in standard position. " 8ec60612-25640f5d-3e20710d-1c0fff08-761d5479.jpg,validate/p14/p14670441/s51422515/8ec60612-25640f5d-3e20710d-1c0fff08-761d5479.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Tip of endotracheal tube is in standard position terminating about 5 cm above the carina, but the cuff appears slightly overdistended. Cardiomediastinal contours are stable in appearance, and are reflective of previous esophagectomy and gastric pull-up procedure. Diffuse heterogeneity of the lungs is predominantly due to known upper lobe predominant emphysema and bibasilar scarring/fibrosis. A subtle superimposed interstitial process is likely, and probably represents mild interstitial edema. Unchanged small left pleural effusion. No visible pneumothorax. " 3c440c62-333ef203-258510af-5c9eb098-3225e607.jpg,validate/p19/p19597426/s57065620/3c440c62-333ef203-258510af-5c9eb098-3225e607.jpg,validation," WET READ: ___ ___ ___ 11:49 PM 1. Left base opacity silhouetting the hemidiaphragm likely due to a combination of consolidation in the setting of infection with superimposed effusion. 2. Streaky right basilar opacities, may reflect pneumonia or atelectasis. WET READ VERSION #1 ___ ___ 7:52 PM 1. Left lower lobe and lingular pneumonia. 2. Small-moderate left pleural effusion. 3. Streaky right basilar opacities, likely reflecting atelectasis. WET READ VERSION #2 ___ ___ 8:26 PM 1. Left lower lobe and lingular pneumonia. 2. Small-moderate left pleural effusion. 3. Streaky right basilar opacities, may reflect pneumonia or atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with pna // eval pna TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Airspace opacities within the left lower lobe and lingula obscuring the left hemidiaphragm and left heart border, respectively. There is a probable superimposed small-moderate left pleural effusion. Streaky right basilar opacities likely reflect atelectasis. The cardiomediastinal silhouette is within normal limits. Possible calcified left hilar node is noted. No acute osseous abnormalities are detected. IMPRESSION: 1. Left base opacity silhouetting the hemidiaphragm likely due to a combination of consolidation in the setting of infection with superimposed effusion. 2. Streaky right basilar opacities, may reflect pneumonia or atelectasis. " a7da7c66-70e7dd3e-202ab9e8-d2afb506-6877dfc9.jpg,validate/p14/p14130631/s55141442/a7da7c66-70e7dd3e-202ab9e8-d2afb506-6877dfc9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated with pneumonia and fluid overload // interval change? interval change? TECHNIQUE: Portable AP semi erect radiograph of the chest was obtained. COMPARISON: Frontal chest radiograph ___. FINDINGS: There is an endotracheal tube with tip terminating 4.8 cm cephalad to the carina. An orogastric tube extends below the field of view, below the diaphragm. There is an unchanged right pleural effusion tracking into the minor fissure and along the right apex. Accounting for decreased inspiratory volume in current study, bilateral airspace opacities are unchanged, right greater than left. There is unchanged blunting of the left costophrenic angle consistent with effusion. There is no pneumothorax. IMPRESSION: Unchanged bilateral pleural effusions and bilateral airspace opacities, right greater than left. " 49ce9eee-1b587928-ded208b1-22931601-cfb9d30e.jpg,validate/p18/p18194653/s56875492/49ce9eee-1b587928-ded208b1-22931601-cfb9d30e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cardiogenic shock, on ECMO, assessment of ET tube placement. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 5.3 cm above the carina. There is suspicion for coiled NG tube in the oropharynx/proximal esophagus with the distal tip being at the stomach. The ECMO tube terminates at the proximal right atrium. The patient continues to be in pulmonary edema with bilateral pleural effusions. " a38b109b-917551b1-a382d226-52fdc045-75e4a282.jpg,validate/p12/p12584492/s54915866/a38b109b-917551b1-a382d226-52fdc045-75e4a282.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with cabg // check L pleural effusion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiographs since ___ through ___. FINDINGS: Again seen is the moderate left pleural effusion, unchanged since most recent radiograph from 1 day prior, with stable small right pleural effusion. Left lower lobe atelectasis stable. Right upper lobe opacity mildly improved from yesterday but now new opacity in the right lower lung concerning for multi-focal pneumonia secondary to aspiration. The cardiac and mediastinal silhouettes are unchanged. Median sternotomy wires again seen. IMPRESSION: No interval change in left pleural effusion. Right upper lobe and right lower lobe opacities concerning for multi-focal pneumonia could be due to aspiration in the right decubitus position. " 10202aef-28b8601d-8fb62d86-7e4cdbe7-bc09a3a8.jpg,validate/p13/p13762124/s56532186/10202aef-28b8601d-8fb62d86-7e4cdbe7-bc09a3a8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypoxia and shortness of breath, question pneumonia. FINDINGS: Portable AP upright chest radiograph was provided. There is extensive bilateral pulmonary airspace consolidation which is most compatible with multifocal pneumonia. Bilateral small pleural effusions are seen, left greater than right. No pneumothorax. Multiple coronary stents project over the heart. The heart size is difficult to assess though appears grossly unchanged. Aortic atherosclerotic calcification noted. Bony structures appear intact. IMPRESSION: Extensive bilateral pulmonary airspace consolidations concerning for multifocal pneumonia with bilateral pleural effusions, left greater than right. " 0086b873-c1ed351d-70ce97ef-e0a39434-74200e97.jpg,validate/p10/p10765644/s56638404/0086b873-c1ed351d-70ce97ef-e0a39434-74200e97.jpg,validation," WET READ: ___ ___ ___ 9:10 PM Interval reduction of the right pleural effusion, which is now moderate. No pneumothorax. Small left effusion. Cardiomegaly. No edema ______________________________________________________________________________ FINAL REPORT HISTORY: Right-sided pleural effusion after thoracentesis, to assess for pneumothorax. FINDINGS: In comparison with the earlier study of this date, there has been substantial decrease in the degree of right pleural effusion, though some fluid in the pleural space remains. Specifically, there is no evidence of pneumothorax. The remainder of the study is unchanged from the previous examination. " 012b655a-8dcd0050-0e476d49-54a263d7-58fe77fa.jpg,validate/p14/p14720356/s50758521/012b655a-8dcd0050-0e476d49-54a263d7-58fe77fa.jpg,validation," FINAL REPORT HISTORY: Metastatic cancer with blood products resuscitation. FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. The cardiac silhouette remains mildly enlarged. The pulmonary vascularity has reverted to essentially normal appearance. Left basilar opacification is consistent with a small effusion and atelectatic changes in the left lower lung. " cfe52d4b-edc892d1-112512db-ec50d922-65085299.jpg,validate/p10/p10364180/s54235873/cfe52d4b-edc892d1-112512db-ec50d922-65085299.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Dyspnea, assess for pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. Interstitial edema persists with interval development of moderate right and tiny left pleural effusion. Associated compressive lower lobe atelectasis is likely present. No pneumothorax. The heart remains mildly enlarged. The mediastinal contour is stable with aortic atherosclerotic calcification noted. The bony structures are intact. IMPRESSION: Pulmonary interstitial edema with bilateral effusions, right greater than left. " c2004639-cea73cf0-3682dce0-f9f840d7-9a8f0ae9.jpg,validate/p18/p18064435/s52054421/c2004639-cea73cf0-3682dce0-f9f840d7-9a8f0ae9.jpg,validation," 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. " beefbef0-9756c454-71938ec6-e9e22464-7f0bcd19.jpg,validate/p13/p13175081/s58295227/beefbef0-9756c454-71938ec6-e9e22464-7f0bcd19.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever, cough, IGG def // ? pna TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs from ___ and ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Median sternotomy wires and mediastinal clips in unchanged positions are incidentally noted. IMPRESSION: No evidence of acute cardiopulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:30 PM, 2 minutes after the discovery of the findings. " f4b25098-975c5fc7-83578156-869222f9-a1909453.jpg,validate/p14/p14846288/s54101798/f4b25098-975c5fc7-83578156-869222f9-a1909453.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with shortness of breath. Please evaluate for pneumonia or pulmonary edema. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: The heart is mildly enlarged, and bilateral basilar hazy opacities like reflect combination of bilateral pleural effusions and edema. Superimposed infection cannot be excluded. No pneumothorax is seen. A cardiac pacing device and its leads are in stable and appropriate position. IMPRESSION: Cardiomegaly with bibasilar opacities likely reflecting congestive heart failure with a combination of pleural effusions, atelectasis and edema. A superimposed pneumonia is not excluded. " b5223eb9-681ad5bf-b2a86688-639d2d08-952426d1.jpg,validate/p15/p15511456/s57262072/b5223eb9-681ad5bf-b2a86688-639d2d08-952426d1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo F s/p tracheobronchoplasty // check interval change check interval change IMPRESSION: Compared to prior chest radiographs ___ through ___. Right pleural thickening at the site of rib resection has improved. Very small subpulmonic pleural effusion may still be present. No pneumothorax. Mild right infrahilar atelectasis unchanged. Left lung and right upper lungs are clear. Normal postoperative cardiomediastinal silhouette. " e992d929-e66a5334-34408f3d-e2b0a3f6-62e08217.jpg,validate/p14/p14717248/s51419663/e992d929-e66a5334-34408f3d-e2b0a3f6-62e08217.jpg,validation," FINAL REPORT INDICATION: Chest pain and shortness of breath; evaluate for acute process. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. The lungs, heart, mediastinal, hilar, and pleural surfaces are normal. No pleural effusion or pneumothorax. No evidence of pneumonia. IMPRESSION: No radiographic evidence of acute cardiopulmonary process. " 004e7310-ab4efa89-79e591b8-a8e16c01-39b77e9e.jpg,validate/p12/p12301792/s58516780/004e7310-ab4efa89-79e591b8-a8e16c01-39b77e9e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // Eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No focal consolidation is seen. There is minimal left mid lung linear atelectasis/ scarring. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " fe9b6b79-059303bd-89732334-238c8114-186153ed.jpg,validate/p13/p13415352/s58627185/fe9b6b79-059303bd-89732334-238c8114-186153ed.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. The lung volumes are low, though allowing for this, there is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 6b93047b-40ded033-729203d3-598c2b67-2c4c9b7e.jpg,validate/p12/p12151569/s59674506/6b93047b-40ded033-729203d3-598c2b67-2c4c9b7e.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient status post left first rib resection, evaluate for pneumothorax. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. The single exposure covers well the area of interest which is the left-sided apical chest area where resection of the first left-sided rib has been performed. Row of external metallic surgical clips indicates the surgical entrance at the anterior frontal chest wall in subclavicular area. Mid third portion of the first rib appears to have been removed. Pulmonary vascular structures extend well into the apical area and thus there is no evidence of pneumothorax. No new pulmonary abnormalities are seen. " 7c8ffbc2-24391f32-2beb14ba-409ab980-ee8b2b2b.jpg,validate/p11/p11632236/s54908166/7c8ffbc2-24391f32-2beb14ba-409ab980-ee8b2b2b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Respiratory failure, here to evaluate ET tube position. COMPARISON: ___. TECHNIQUE: Portable semi-erect frontal radiograph of the chest. FINDINGS: The endotracheal tube has been advanced, the tip now terminating 2.5-cm above the carina, which may be related to position of the head and neck. An enteric tube has been pulled back from ___, with the tip now terminating at the diaphragm in the left upper quadrant, likely in the proximal stomach. A left internal jugular central venous catheter and right supraclavicular approach dual-chamber dialysis catheter are unchanged in position. The appearance of the chest is otherwise similar to the prior exam with diffuse infiltrative parenchymal opacities throughout the left lung and consolidated right lower lung. Small pleural effusions are likely present. No pneumothorax is seen. The cardiac silhouette is normal in size. The mediastinal contours are within normal limits. IMPRESSION: 1. ET tube tip 2.5 cm above the carina, which may be related to position of the head and neck. 2. Enteric tube retracted with the tip in the proximal stomach. 3. Otherwise, similar appearance of the chest. " 00edbfed-30e29ed1-8808ef7f-bba4be19-ed7fc29d.jpg,validate/p15/p15345462/s50239093/00edbfed-30e29ed1-8808ef7f-bba4be19-ed7fc29d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with c/o CP // ? PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ 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 intrathoracic process. " 52f0a258-92e3ecb7-030b5ed9-67994dcd-41924e4d.jpg,validate/p13/p13473268/s56949420/52f0a258-92e3ecb7-030b5ed9-67994dcd-41924e4d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/ silicosis s/p recent RUL TBBx. Productive cough. // e/o PNA COMPARISON: Multiple chest radiographs, most recent ___ FINDINGS: PA and lateral views of the chest provided. Right upper lobe consolidation seen on ___ has since resolved. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal appearance and position is unchanged. Radiopaque objects projecting over the chest are consistent with known post gunshot injury. IMPRESSION: Resolved right upper lobe consolidation. No evidence of pneumonia. " 8d6bd966-9b17437b-5f9dca5b-6c4981c5-cd92f02e.jpg,validate/p11/p11730422/s56994142/8d6bd966-9b17437b-5f9dca5b-6c4981c5-cd92f02e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of new AFib, shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette is enlarged. Retrocardiac lucency with air-fluid level is seen, consistent with a likely large hiatal hernia which may also be accentuating the cardiac silhouette size in part. The aorta is calcified and tortuous. There is prominence of the pulmonary vasculature consistent with moderate pulmonary edema. No large pleural effusion or pneumothorax is seen. IMPRESSION: 1. Large hiatal hernia which may in part be accentuating the cardiac silhouette, which appears larger in size as compared to the prior study, mild to moderately enlarged. 2. Moderate pulmonary edema. No large pleural effusion. " fe438508-76987f0a-9473a7a6-dff624b7-88d217f2.jpg,validate/p12/p12226373/s58128569/fe438508-76987f0a-9473a7a6-dff624b7-88d217f2.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with recent history of eosinophilic pneumonia, now has recurrent fever, cough, sweats despite antibiotics. Comparison to previous chest x-ray. COMPARISON: Multiple chest x-rays from ___ to ___ and chest CT of ___. FINDINGS : Right upper lobe opacities have improved, but right lower lobe and left upper lobe opacities have worsened. There is no pneumothorax or pleural effusion. Mediastinal and cardiac contours are normal. CONCLUSION: 1. Right upper lobe opacities have improved and could be related to an infectious process in a patient who receiveD antibiotics. 2. The patient has already been investigated with multiple CT and chest x-rays for bilateral subpleural consolidation that are coming and going. Right upper lobe consolidation and left upper lobe opacities have increased since ___. The evolution and characteristics are more consistent with COP than eosinophilic pneumonia. " c6daa86b-28de832b-4cdd7e0d-51eca585-d7dad6ce.jpg,validate/p16/p16553329/s58737609/c6daa86b-28de832b-4cdd7e0d-51eca585-d7dad6ce.jpg,validation," FINAL REPORT HISTORY: recent acute CHF exacerbation, now with cough and sputum production. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: The examination is somewhat limited by low lung volumes. Redemonstrated are moderate to large bilateral pleural effusions. As compared to the prior examination, there has been resolution of the pulmonary edema. No focal consolidation or pneumothorax is seen. The heart size is not well assessed, but appears to be at least mildly enlarged. Mediastinal contours are stable. IMPRESSION: Interval resolution of the prior pulmonary edema, with stable moderate to large bilateral pleural effusions. No evidence of focal consolidation within the visualized upper lobes. " 09bced07-cf54f369-6f52477d-312a8b21-dac82b06.jpg,validate/p19/p19644467/s53824971/09bced07-cf54f369-6f52477d-312a8b21-dac82b06.jpg,validation," 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. " 198996e3-9b212c70-fb402da5-feca7c69-9510f6eb.jpg,validate/p14/p14754077/s54692652/198996e3-9b212c70-fb402da5-feca7c69-9510f6eb.jpg,validation," FINAL REPORT INDICATION: History of a prior esophageal food impaction, presenting with similar symptoms. Evaluate for radiopaque foreign body. COMPARISONS: Chest radiograph from ___. TECHNIQUE: AP and lateral views of the chest were obtained. FINDINGS: The lung volumes are low. There is mild bilateral bronchiectasis with associated bronchial wall thickening, not significantly changed from the prior exam. No focal airspace opacity is identified. There is no pleural effusion or pneumothorax. There is moderate cardiomegaly, which is stable. No radiopaque foreign body is identified. The esophagus is significantly dilated with an air-fluid level at the level of the thoracic inlet. This unchanged from the prior exam. IMPRESSION: 1. No evidence of radiopaque foreign body. Severely dilated esophagus with an air-fluid level in the high chest. 2. Stable mild bronchiectasis and bronchial wall thickening; no acute cardiopulmonary process. " 04f641c1-61030285-70b766ad-7189c11b-64101452.jpg,validate/p16/p16319384/s51991869/04f641c1-61030285-70b766ad-7189c11b-64101452.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Moderate cardiomegaly is unchanged. Calcification in the aortic knob is unchanged. Compared to study of ___, the pulmonary edema has resolved. There is no focal consolidation or pleural effusion or pneumothorax. There is mild scarring at the apices. IMPRESSION: No acute cardiopulmonary process. Moderate cardiomegaly. " 5b0c5f1d-714e9989-2fbc319d-9f5f9865-fda15779.jpg,validate/p13/p13781801/s55152822/5b0c5f1d-714e9989-2fbc319d-9f5f9865-fda15779.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON: None. INDICATION: ___-year-old with history of TB, with 10 days of worsening cough and pain. FINDINGS: Heart size is top normal. Mediastinal and hilar contours are normal. There is no pulmonary vascular congestion, pulmonary edema or pleural effusion. The lungs are well expanded and clear. There is excess soft tissue in the retrosternal airspace at the level of manubrium appreciated on the lateral view. No pneumothorax. IMPRESSION: 1. Small increase in retrosternal soft tissue density at the level of manubrium which is not large enough to signify a mass. However, if the symptoms persist, CT chest should be obtained to better investigate this finding. Stat read was called to ___, RN by Dr. ___ ___ telephone at 2:47 p.m., 10 minutes after the time of discovery. " a03b1b08-982bc0c7-306fe6f6-cc97cc00-722bb73d.jpg,validate/p10/p10374536/s54073359/a03b1b08-982bc0c7-306fe6f6-cc97cc00-722bb73d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p ICD COMPARISON: Chest radiograph from ___ FINDINGS: PA and lateral views of the chest provided. Single pacemaker lead is seen terminating in the right ventricle. Heart is borderline enlarged. Lung volume as on the lower side, however appears clear. There is no pleural effusion. No pneumothorax IMPRESSION: Single pacemaker lead in good position. No pneumothorax. " 6fa42c42-47de395e-7a6ba870-0dab7a52-6b3b1e11.jpg,validate/p15/p15512494/s55429366/6fa42c42-47de395e-7a6ba870-0dab7a52-6b3b1e11.jpg,validation," 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. " 1b76cf7a-4329262b-43d4001e-00ab7253-826eee12.jpg,validate/p19/p19116441/s55423001/1b76cf7a-4329262b-43d4001e-00ab7253-826eee12.jpg,validation," FINAL REPORT INDICATION: ___F with new onset AFib // Eval for acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs remain clear. There is no focal consolidation, effusion, or edema. Cardiomegaly is stable. No acute osseous abnormalities. Surgical clips in the right upper quadrant suggest prior cholecystectomy. IMPRESSION: Cardiomegaly without superimposed acute cardiopulmonary process. " db2177f9-ee12824d-7c5963ff-8583e8c6-78765f3d.jpg,validate/p16/p16911004/s57173983/db2177f9-ee12824d-7c5963ff-8583e8c6-78765f3d.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // eval for pna, cardiomegaly TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are hyperinflated. Moderate to large right and small to moderate left pleural effusions are noted. There is right basilar opacity which is likely at least in part due to atelectasis given adjacent effusion. There is additional opacity projecting over the right upper lung, on the lateral view localized posteriorly. There is moderate enlargement of the cardiac silhouette. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities. IMPRESSION: Bilateral pleural effusions, right greater than left with associated atelectasis particularly at the right lung base noting that infection is difficult to exclude. Superimposed asymmetric right upper lung opacity, potentially pulmonary edema or infection. Followup will be necessary after treatment. " 49d87aef-fd2576dd-681cb0f4-31d1fe6f-8c0ff9e8.jpg,validate/p19/p19310965/s50783506/49d87aef-fd2576dd-681cb0f4-31d1fe6f-8c0ff9e8.jpg,validation," FINAL REPORT INDICATION: Right upper quadrant abdominal pain. COMPARISON: Outside hospital CT abdomen and pelvis from ___. FINDINGS: The lungs are hypoinflated and exaggerate the pulmonary vascular markings. Otherwise, the lungs are clear with no evidence of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute fractures are identified. No free air is noted under the hemidiaphragms. Oral contrast is noted throughout the colon. IMPRESSION: Hypoinflated lungs with no acute cardiopulmonary findings. " 9e18cb58-bad24ded-acc90bad-08810fbc-4a90f43f.jpg,validate/p10/p10260379/s54043696/9e18cb58-bad24ded-acc90bad-08810fbc-4a90f43f.jpg,validation," WET READ: ___ ___ ___ 6:49 PM Nasogastric tube terminates in the upper esophagus. Interval right chest wall port catheter is in standard position. There are low lung volumes and heterogeneous opacification of the left lung base which could be a combination of atelectasis or developing pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old woman with met cholangiocarcinoma with new O2 requirement. // Please eval for aspiration vs. PNA TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are low, with left lower lobe atelectasis. There are patchy opacities extending into the left mid lung, suspicious for superimposed infection. The right lung appears grossly clear. A right internal jugular Port-A-Cath terminates in the right atrium, unchanged in position. A nasogastric tube terminates in the upper esophagus. A subsequent chest radiograph obtained later on the same day shows is has been repositioned. IMPRESSION: Patchy opacities of the left lung base suspicious for a combination of atelectasis and pneumonia. An nasogastric tube terminates in the proximal esophagus. A subsequent chest radiograph shows this has been repositioned. " 6e1841d3-694da963-63a84d1f-72d3ad03-7f8183a6.jpg,validate/p18/p18473276/s56380430/6e1841d3-694da963-63a84d1f-72d3ad03-7f8183a6.jpg,validation," FINAL REPORT HISTORY: Syncope, assess for acute process. COMPARISON: None. FINDINGS: Two views were obtained of the chest. The lungs are mildly low in volume giving the appearance of bronchovascular crowding but otherwise clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No acute intrathoracic process. " 6a2d629f-90507ac0-564ad566-6a7268f1-74b2329b.jpg,validate/p15/p15949474/s58647149/6a2d629f-90507ac0-564ad566-6a7268f1-74b2329b.jpg,validation," WET READ: ___ ___ ___ 8:16 AM No acute process. WET READ VERSION #1 ___ ___ ___ 2:03 AM No acute process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with febrile neutropenia without localizing sx's // acute process acute process IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute pneumonia, vascular congestion, or pleural effusion. " c4a54a5b-37cd018f-65afdd6b-d19ef238-232784d7.jpg,validate/p16/p16814932/s53987920/c4a54a5b-37cd018f-65afdd6b-d19ef238-232784d7.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. HISTORY: ___-year-old female with history of shortness of breath, tachypnea, pulmonary fibrosis, coughing blood. COMPARISON: ___. FINDINGS: Single frontal view of the chest was obtained. There are relatively low lung volumes. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged and the aorta calcified and tortuous. Increased interstitial markings persist likely relating to patient's chronic interstitial disease. No pleural effusion or pneumothorax is seen. IMPRESSION: 1. Low lung volumes. Chronic interstitial process. " a7a98b63-2c2b6024-1c54d4bc-c7d2812d-a9f51556.jpg,validate/p11/p11868766/s54843270/a7a98b63-2c2b6024-1c54d4bc-c7d2812d-a9f51556.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p open repair of 9cm thoracic aneurysm and type B dissection from left subclavian to right iliac. // continued O2 req - eval LLL collapse TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: The right-sided PICC terminates in the mid SVC. The appearance of the lungs is stable compared to prior, with left basilar opacities representing a combination of atelectasis and pleural fluid. There is a stable postoperative appearance of the cardiomediastinal silhouette. No evidence of pneumothorax. IMPRESSION: 1. Right PICC in appropriate position. 2. Stable left basilar atelectasis and pleural effusion. 3. Stable postoperative appearance of the cardiomediastinal silhouette. " efdcfc89-a008c952-73c326fc-5528d877-0c59c269.jpg,validate/p15/p15616804/s52856785/efdcfc89-a008c952-73c326fc-5528d877-0c59c269.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG- CT d/c'd // f/u effusions, atx TECHNIQUE: Chest two views COMPARISON: ___ 14:11 FINDINGS: Left chest tube has been removed since prior. Improved bibasilar atelectasis. There are small pleural effusions, similar. No definite pneumothorax. Shallow inspiration accentuates heart size. Normal pulmonary vascularity. Sternotomy. Small volume retro xiphoid air, in keeping with recent surgery. IMPRESSION: Improved basilar atelectasis. No pneumothorax. Small pleural effusions. " fb70c2de-6734503f-86ebaa72-a4c84b5e-bf8d6b09.jpg,validate/p16/p16780111/s59711190/fb70c2de-6734503f-86ebaa72-a4c84b5e-bf8d6b09.jpg,validation," FINAL REPORT INDICATION: Back pain. COMPARISON: Chest radiograph ___. PET-CT ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are unchanged. The heart size is within normal limits. Pulmonary vascularity is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Multiple sclerotic osseous metastatic lesions are re-demonstrated including involvement of both distal clavicles and left lateral sixth rib, all which were better visualized on the recent PET-CT from ___. IMPRESSION: No acute cardiopulmonary abnormality. Multiple osseous sclerotic metastases, better seen on the recent PET-CT from ___. " 980c8665-91539268-e6140a19-127ec0cb-d9b44980.jpg,validate/p17/p17617605/s55312125/980c8665-91539268-e6140a19-127ec0cb-d9b44980.jpg,validation," FINAL REPORT INDICATION: ___F with chest tightness, palpitations // please evaluate for acute abnormality TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: A PA and lateral chest radiograph demonstrates well inflated lungs bilaterally. There is no focal opacity. There is no pneumothorax, pleural effusion, or evidence of pulmonary edema. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: Normal chest radiograph. " 1c02c261-38d0d5f9-8ff26c6f-477f4bbb-e1fc73bf.jpg,validate/p15/p15056079/s59113726/1c02c261-38d0d5f9-8ff26c6f-477f4bbb-e1fc73bf.jpg,validation," FINAL REPORT HISTORY: Leukocytosis and cough. Evaluate for a new infiltrate. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate an unchanged cardiomediastinal silhouette. There is no good evidence for acute pneumonia. No pneumothorax or large pleural effusion is seen. IMPRESSION: No good evidence for pneumonia. " 467782a5-21eb4120-f9e904bb-eb5b91b1-d1e9e9d2.jpg,validate/p14/p14127042/s59306547/467782a5-21eb4120-f9e904bb-eb5b91b1-d1e9e9d2.jpg,validation," FINAL REPORT INDICATION: History of positive PPD. COMPARISON: Chest radiograph, ___. FINDINGS: There has been interval placement of a right port with tip terminating in the cavoatrial junction. The cardiomediastinal and hilar contours are stable with mild tortuosity of the descending aorta. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. IMPRESSION: No sign of active or prior TB infection. " eca62acd-9f8c4e8b-88ad2f04-f09c6b45-c50d5068.jpg,validate/p19/p19669984/s56535331/eca62acd-9f8c4e8b-88ad2f04-f09c6b45-c50d5068.jpg,validation," FINAL REPORT INDICATION: History of renal transplant, shortness of breath, please evaluate. COMPARISONS: Most recently from ___ chest radiograph. FINDINGS: The heart size is mildly enlarged. There is slight mediastinal widening, however, this is overall stable compared to the prior exam. There is a small linear density at the left lung base which is likely secondary to atelectasis. There are no pleural effusions. No pneumothoraces are seen. The visualized osseous structures are unremarkable. Incidental note is made of a hiatal hernia. IMPRESSION: No focal consolidation concerning for infection. No pulmonary edema. Atelectasis at the left lung base. " 145831f0-dc6a9856-605825a0-966612fb-72f96f3f.jpg,validate/p16/p16568389/s52106460/145831f0-dc6a9856-605825a0-966612fb-72f96f3f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with perforated abdomen TECHNIQUE: Upright AP view of the chest COMPARISON: CT abdomen and pelvis ___ at 13:25 FINDINGS: An enteric tube tip is within the stomach. Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Atelectasis is seen within the right lung base. No focal consolidation, pleural effusion or pneumothorax is present. Excreted contrast administered for a recent CT exam is seen within the collecting systems bilaterally. Previously demonstrated pneumoperitoneum on CT is not well visualized on the current radiograph. IMPRESSION: Known pneumoperitoneum seen on CT is not well assessed on the current radiograph. Mild right basilar atelectasis. Enteric tube tip within the stomach. " d395d52c-6caec80f-45d0e5da-190276ce-cbdf349a.jpg,validate/p16/p16454913/s57308800/d395d52c-6caec80f-45d0e5da-190276ce-cbdf349a.jpg,validation," FINAL REPORT HISTORY: Intermittent hypotension with volume overload. FINDINGS: In comparison with the study of ___, the tracheostomy tube remains in place. There is continued enlargement of the cardiac silhouette, which appears less prominent because of the PA view. Bilateral pleural effusions are again seen, with compressive atelectasis at the bases. There appears to be some fullness of pulmonary vessels consistent with elevated pulmonary venous pressure. An area of oblique opacification at the right base could represent a region of atelectasis. The appearance would be somewhat unusual for superimposed pneumonia. " c3c6a2d9-633705f3-0c496313-1dfd1fb1-5f674d05.jpg,validate/p18/p18335908/s50272336/c3c6a2d9-633705f3-0c496313-1dfd1fb1-5f674d05.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with dyspnea // acute cariopulm disease TECHNIQUE: Single frontal view of the chest, portable semi-upright COMPARISON: ___ FINDINGS: The patient is slightly rotated. The cardiac silhouette remains enlarged. Mediastinal contours are unremarkable. No pleural effusion is seen. There is no pneumothorax. Subtle increase in opacity at the right lung base may be due to overlying soft tissue although underlying consolidation is not excluded. " 2bfec577-6c145351-5716c9c5-9c7829c4-7c9a4491.jpg,validate/p10/p10373824/s57404221/2bfec577-6c145351-5716c9c5-9c7829c4-7c9a4491.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with dyspnea and tachycardia. COMPARISON: ___. FINDINGS: A frontal upright view of the chest was obtained portably. Lungs are mildly hyperinflated, unchanged. Since two days ago, there are new bibasilar opacities, which may represent atelectasis, aspiration or infection. Bi-apical pleuroparenchymal scarring, right worse than left, is unchanged. No pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. Moderate dextroscoliosis is unchanged. An old healed left rib fracture is seen. IMPRESSION: Bibasilar opacities, new from ___, may represent atelectasis, aspiration, or infection. " 8d4c87d9-bdb17b2b-054fd0b0-64f67a31-3001a075.jpg,validate/p15/p15110470/s52338199/8d4c87d9-bdb17b2b-054fd0b0-64f67a31-3001a075.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: CTA chest and chest radiographs, both dated ___. CLINICAL HISTORY: Prior CABG with chest pain and shortness of breath, question pneumonia or CHF. FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires and mediastinal clips are again seen. The heart is stable and mildly enlarged. There is no focal consolidation, effusion, or pneumothorax. No signs of CHF/pulmonary edema. The mediastinal contour is stable and normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. Stable mild cardiomegaly. No signs of CHF or pulmonary edema. " be6b1cde-766722d6-8540d70c-1a56431c-43318906.jpg,validate/p13/p13383248/s52828606/be6b1cde-766722d6-8540d70c-1a56431c-43318906.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___M with upper back pain, hypertensive // rule out mediastinal dilation or changes rule out mediastinal dilation or changes TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CTA from ___ and chest radiograph from ___. FINDINGS: There is tortuosity of the descending thoracic aorta. The cardiomediastinal and hilar contours are otherwise within normal limits. Lungs are well expanded. Focus of linear atelectasis noted at the right lung base. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " a1f6e653-328556d3-df944c2a-4268d2a6-d984d11f.jpg,validate/p14/p14325592/s54007039/a1f6e653-328556d3-df944c2a-4268d2a6-d984d11f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p MVC, now w/pneumothorax, ETT // lines/tubes lines/tubes COMPARISON: ___ IMPRESSION: ET tube tip is 4 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Bibasal consolidations appear to be unchanged involving the vast majority of the mid lung and lower lobes. The findings might representing combination of pulmonary edema and widespread infectious process, especially giving the lack of the findings back on the CT from ___ does pulmonary hemorrhage or lung contusion are not there reliably etiology. No definitive pneumothorax is seen. Small amount of bilateral pleural effusion cannot be excluded. " 98288b4f-601d7bcb-e624d540-c7391912-e051c6e6.jpg,validate/p10/p10917306/s54737217/98288b4f-601d7bcb-e624d540-c7391912-e051c6e6.jpg,validation," FINAL REPORT HISTORY: History of recent left hip fracture after fall with left rib pain and continued hip pain. Evaluate for fracture. COMPARISON: Chest radiograph from ___. TECHNIQUE: Upright frontal and lateral chest radiographs were obtained. FINDINGS: The visualized lung fields are clear without pleural effusion, pneumothorax or focal consalidation. The cardiac and mediastinal silhouette is unremarkable. A left cervical rib is present. No rib fractures are seen. IMPRESSION: No rib fracture identified. No evidence of acute cardiopulmonary disease. " aff8441e-5c880d47-f73bf2fb-eb0abd0c-cf5e8377.jpg,validate/p14/p14637100/s58338719/aff8441e-5c880d47-f73bf2fb-eb0abd0c-cf5e8377.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Congestive heart failure with shortness of breath x 1 day. FINDINGS: AP and lateral views of the chest were provided. There is diffuse pulmonary edema, increased from prior exam. Difficult to exclude a left pleural effusion. No large pneumothorax. Heart size cannot be assessed. Atherosclerotic calcification at the aortic knob again noted. Bony structures appeared grossly unchanged. IMPRESSION: Severe pulmonary edema. " d9bea9e4-6496e5aa-004635b5-2150cc0c-1b6d7f20.jpg,validate/p19/p19478022/s55531817/d9bea9e4-6496e5aa-004635b5-2150cc0c-1b6d7f20.jpg,validation," 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. " 6b5c62b1-f5c82521-8a7e3344-82da87c8-4b15ec36.jpg,validate/p18/p18834094/s55023931/6b5c62b1-f5c82521-8a7e3344-82da87c8-4b15ec36.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 2 EXAMS INDICATION: ___ year old woman with stroke // NGT placement NGT placement IMPRESSION: Comparison to ___. The nasogastric tube was advanced by approximately 4-5 cm. The tip now projects over the middle parts of the stomach. " 7891875d-41410189-8a74147e-9732fdfe-97b44733.jpg,validate/p14/p14245215/s55216984/7891875d-41410189-8a74147e-9732fdfe-97b44733.jpg,validation," WET READ: ___ ___ 11:57 PM Increased, more dense, right lower lung airspace opacification. Increased left lung opacification may relate to a layering effusion, volume loss from mucous plugging, or even consolidation. Otherwise, unchanged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Sepsis, hypovolemia, underlying CHF and status post IVF and hypoxemia, question pulmonary edema. CHEST, SINGLE AP VIEW, ROTATED POSITIONING: Compared to earlier the same day at 12:53 p.m. and allowing for technical differences, the degree of opacity at the right base may be slightly increased. The degree of opacity at the left lung apex is also increased. Otherwise, I doubt significant interval change. As before, there is truncation of the left-sided airway, though this occurs slightly more proximal now at the distal left main stem bronchus, with near-complete opacification of the left lung, notably worse in the left lung apex than it was on the prior film. The left hemidiaphragm is obscured. The right lung shows background COPD with patchy opacity and possible pleural fluid/thickening at the right base, which also appears slightly worse compared with the prior film. Allowing for patient rotation, the trachea remains midline. An area of focal expansion of the trachea immediately above the aortic knob is suggested, probably unchanged. There is mild vascular plethora visualized in the aerated portion of the right upper lung, but otherwise, no definite evidence of CHF. IMPRESSION: Overall similar to CXR from earlier the same day, but with increased opacity at left apex and ? right base since that film. Compared with the film from ___, where there was considerable opacification of the left mid zone, findings in the left upper lung and right base have clearly progressed. If clinically indicated, CT may help for further assessment. " ad915692-2542cc5c-bca324c4-e5e87425-a7ae2fbf.jpg,validate/p19/p19054301/s55467916/ad915692-2542cc5c-bca324c4-e5e87425-a7ae2fbf.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: ___-year-old man status post CABG. Evaluate for effusion after thoracentesis. An AP portable upright chest radiograph shows significant diminution in what was previously a large left pleural effusion. There is now only some haziness in the left costophrenic and cardiophrenic angles and residual overlying plate-like subsegmental atelectasis. No pneumothorax. Intact sternal wires are seen in this patient status post CABG. CONCLUSION: Notable decrease in left pleural effusion with residual overlying subsegmental atelectasis at the left base. " a34d7f9b-d0270ce5-8048424a-a0a77010-5ae78454.jpg,validate/p10/p10821855/s56513395/a34d7f9b-d0270ce5-8048424a-a0a77010-5ae78454.jpg,validation," 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. " c3ab7330-992f2893-ebd35a90-84ee8f64-3922a960.jpg,validate/p19/p19358609/s53320690/c3ab7330-992f2893-ebd35a90-84ee8f64-3922a960.jpg,validation," 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. " 115d1a3a-3a692161-9cb1bd23-1eed7c3f-74a257bb.jpg,validate/p18/p18458646/s50789560/115d1a3a-3a692161-9cb1bd23-1eed7c3f-74a257bb.jpg,validation," FINAL REPORT HISTORY: CLL, or shortness of breath and cough. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. There are better lung volumes. There is mild right basilar atelectasis. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. Mild right basilar atelectasis. " eca6a99d-781c75c9-6a79917c-c048425e-7f8ef9e6.jpg,validate/p15/p15754509/s58560337/eca6a99d-781c75c9-6a79917c-c048425e-7f8ef9e6.jpg,validation," WET READ: ___ ___ 10:22 PM No Pneumothorax. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:36 P.M., ___ HISTORY: Bilateral pleural effusions. Right pigtail catheter placed. IMPRESSION: AP chest compared to ___, 9:01 a.m.: Moderate right pleural effusion may have decreased slightly since insertion of the right pleural pigtail catheter, which is looped at mid level in the right hemithorax and could be effectively occluded. Clinical assessment required. Moderate left pleural effusion is stable. Mild interstitial edema is new. Heart is top normal size, increased slightly since earlier in the day. " 48f660da-20732ff5-749ce96c-464eb5fe-b1bb99eb.jpg,validate/p19/p19231238/s58402348/48f660da-20732ff5-749ce96c-464eb5fe-b1bb99eb.jpg,validation," 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. " e703602c-eabdcb91-c472a91c-904fc756-4ef123b7.jpg,validate/p16/p16247826/s58023908/e703602c-eabdcb91-c472a91c-904fc756-4ef123b7.jpg,validation," 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. " 17617ec8-39d6013f-fb6db8ba-077eff79-4d0c9478.jpg,validate/p15/p15816924/s55017954/17617ec8-39d6013f-fb6db8ba-077eff79-4d0c9478.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with dyspnea. COMPARISON: None listed. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b195aa1a-d79d1582-9c82c8d5-0563665b-cc79e565.jpg,validate/p18/p18796351/s57773287/b195aa1a-d79d1582-9c82c8d5-0563665b-cc79e565.jpg,validation," 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. " 2820e560-69b076b3-f72991c1-80acdb4e-70640c7f.jpg,validate/p14/p14517029/s54424905/2820e560-69b076b3-f72991c1-80acdb4e-70640c7f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with HTN, DM, CKD presenting 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. Prominent anterior spurs in the T-spine noted. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " e99cd850-3e0ac449-8419f1c1-067f3b2a-1f5c5ef6.jpg,validate/p15/p15329360/s57899745/e99cd850-3e0ac449-8419f1c1-067f3b2a-1f5c5ef6.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with intracranial hemorrhage. Evaluate ETT placement. COMPARISON: Chest radiograph ___ at 8:22 a.m. from ___ ___. FINDINGS: A frontal supine view of the chest was obtained portably. The endotracheal tube is low, ending 1.1 cm above the carina. A nasogastric tube follows the expected course ending below the diaphragm, although the tip is not visualized. There is bibasilar atelectasis, more significant on the right. No pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Endotracheal tube ends 1.1 cm above the carina and could be pulled back 2-3 cm to avoid bronchial intubation. Discussed with Dr. ___ by phone at 11:05 a.m. ___. " 5a520c1c-45905da5-d1876e41-1db43af2-1ab3b9a7.jpg,validate/p15/p15756536/s59900692/5a520c1c-45905da5-d1876e41-1db43af2-1ab3b9a7.jpg,validation," 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. " e0cb0cdb-07308619-052cb0a7-5289e5dc-ab276471.jpg,validate/p14/p14683932/s57030313/e0cb0cdb-07308619-052cb0a7-5289e5dc-ab276471.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. COMPARISON: Chest radiograph from ___ PA AND LATERAL CHEST RADIOGRAPHS: Lungs are clear. There is no confluent consolidation or pulmonary edema. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax. IMPRESSION: No acute cardiopulmonary process " 1fc21137-ffe43d6f-bdc77820-dbf565cc-6878ddf8.jpg,validate/p15/p15957987/s59920416/1fc21137-ffe43d6f-bdc77820-dbf565cc-6878ddf8.jpg,validation," FINAL REPORT HISTORY: Esophageal cancer with acute shortness of breath. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: Left-sided Port-A-Cath tip terminates at the SVC /right atrial junction. The patient is status post esophagectomy and gastric pull-through. Gastroesophageal stent is re- demonstrated in unchanged position. Cardiac and mediastinal contours are unchanged. Worsening ill-defined parenchymal and nodular opacities are noted within both lung bases when compared to the prior chest radiograph, with continued small bilateral pleural effusions, right greater than left. Left basilar chest tube remains in unchanged position. Bibasilar atelectasis also persists. There is no pulmonary vascular congestion. No pneumothorax is identified with scarring in the lung apices again noted. Multiple clips are noted within the right upper quadrant of the abdomen. IMPRESSION: Worsening bibasilar parenchymal and nodular opacities concerning for infection and/or aspiration. Persistent small bilateral pleural effusions, right greater than left, with continued bibasilar atelectasis. " 866ca6d8-2e2c9f8e-30c53e59-47322e89-d4d04068.jpg,validate/p12/p12436918/s51694657/866ca6d8-2e2c9f8e-30c53e59-47322e89-d4d04068.jpg,validation," FINAL REPORT Evaluate for resolution of previous pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: PA AND LATERAL VIEWS OF THE CHEST. Lungs are clear. The previously seen pneumonia has resolved. No new opacities concerning for pneumonia. The cardiac, mediastinal, hilar contours are normal. The pleural surfaces are normal. IMPRESSION: Resolution of pneumonia. No new areas of consolidation. " de166a21-1f259eeb-039db715-6b84b3d6-12a06135.jpg,validate/p18/p18030170/s56129306/de166a21-1f259eeb-039db715-6b84b3d6-12a06135.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. COMPARISONS: Chest radiographs from ___ and PET-CT from ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: Left perihilar enlargement reflecting left hilar and mediastinal lymphadenopathy appears somewhat more prominent even allowing for differences in technique. There are a number of small-to-medium-sized pulmonary nodules, mostly projecting over the left upper lobe, as seen previously, probably increased. In addition, however, projecting over the right mid lung, there is a potential nodule of substantial size which has no clear correlate on the prior PET-CT. There is no pleural effusion or pneumothorax. The bones appear demineralized. IMPRESSION: Suspected increase in metastatic disease. Correlation with planned CT is suggested. " bfed04b0-4b1d703b-b7219364-bc89f2b9-09d59c1c.jpg,validate/p18/p18175023/s57178372/bfed04b0-4b1d703b-b7219364-bc89f2b9-09d59c1c.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with near syncope. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear of focal consolidation. There is no effusion or pneumothorax. The cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. IMPRESSION: No acute cardiopulmonary process. " 0aafebc6-92dcdcc2-198466b3-bf64ad18-26b04f6c.jpg,validate/p14/p14145527/s53687733/0aafebc6-92dcdcc2-198466b3-bf64ad18-26b04f6c.jpg,validation," 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. " b0f5712f-ce7faae0-33f23b1e-5266e0b1-f422e5b6.jpg,validate/p17/p17156194/s54447583/b0f5712f-ce7faae0-33f23b1e-5266e0b1-f422e5b6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Midsternal chest pain with fatigue and cough. FINDINGS: PA and lateral views of the chest are provided demonstrating no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. The bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 967dc8d0-867d422a-ed5ad465-5d9c21e8-381c3d60.jpg,validate/p10/p10007795/s54054513/967dc8d0-867d422a-ed5ad465-5d9c21e8-381c3d60.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with respiratory distress. Evaluate for interval change. FINDINGS: Comparison is made to prior study from ___. The heart size is enlarged, but stable. There is a right-sided PICC line with lead tip at the proximal SVC. There is a persistent left retrocardiac opacity and right basilar opacity, which appear stable. There is improvement of the pulmonary edema. Left-sided pleural effusion, which is unchanged. " 2ee7ec05-e38b36da-a1f9e061-7c5911c5-746bd000.jpg,validate/p14/p14022439/s54836942/2ee7ec05-e38b36da-a1f9e061-7c5911c5-746bd000.jpg,validation," FINAL REPORT INDICATION: ___M with CP // evidence of infection or pneumo TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Median sternotomy wires are again noted. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " b222863d-acae5cd2-417c0501-f9d3c9a1-dbf44bd7.jpg,validate/p13/p13688709/s50657859/b222863d-acae5cd2-417c0501-f9d3c9a1-dbf44bd7.jpg,validation," FINAL REPORT AP CHEST, 4:48 A.M., ___ HISTORY: A ___-year-old man with a cavitated right lung mass, now with increased secretions and cough. IMPRESSION: AP chest compared to ___, read in conjunction with a chest CTA, ___: New consolidation in the axillary region of the right lung is most likely pneumonia secondary to the obstructing mass at the right hilus seen on ___ chest CT. This is most likely lung carcinoma, originating cavitary mass in the right lower lobe extending to the pleura and to the hilus and mediastinum. There may be another small focus of pneumonia at the left lung base, due to auto-aspiration of purulent material. Left subclavian line ends in the SVC. Heart size is normal. Findings were discussed by telephone with the surgical resident at 9:50 a.m. " 0821c587-df7336a8-97e2a350-67c98495-adc98e22.jpg,validate/p18/p18866430/s56585895/0821c587-df7336a8-97e2a350-67c98495-adc98e22.jpg,validation," FINAL REPORT INDICATION: Lethargy and cough, evaluate for infiltrate. COMPARISON: Chest radiograph from ___. FINDINGS: AP and lateral views of the chest were obtained. Lungs are clear with no focal consolidation, effusion or pneumothorax. There is no evidence of CHF. The heart is mildly enlarged, unchanged from prior exam. The bony structures are intact. There is atherosclerotic calcification of the aortic knob. IMPRESSION: No acute intrathoracic process. " 79d4bf97-761b2580-a3fdec2f-d188f328-08f84770.jpg,validate/p10/p10781468/s54657000/79d4bf97-761b2580-a3fdec2f-d188f328-08f84770.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ESRD on dialysis, PPD+ // r/o TB r/o TB IMPRESSION: In comparison with the study of ___, there has been almost complete clearing of the opacification at the left base. The residual opacification probably represents a combination of atelectasis and effusion. However, in the appropriate clinical setting, developing pneumonia would be difficult to exclude in the posterior aspect of the left lower lobe. Remainder the study is within normal limits with no vascular congestion. " 799e8e9e-f6278fe1-dd4e81a1-5cd9a799-617645e0.jpg,validate/p15/p15610009/s59082501/799e8e9e-f6278fe1-dd4e81a1-5cd9a799-617645e0.jpg,validation," FINAL REPORT HISTORY: Right internal jugular central venous catheter placement. COMPARISON: Same day 8:42 p.m. TECHNIQUE: Portable frontal chest radiograph single view. FINDINGS: Compared to earlier same day examination, the right internal jugular access central venous catheter has been partially withdrawn with the tip now projecting over the low SVC. Otherwise no significant change from two hours prior with redemonstration of bibasilar opacities most likely representing aspiration given appearance on previous CT. " 9ee9024f-d678e3f0-6dc447c5-cb4d65ff-f27119ff.jpg,validate/p19/p19314531/s57159544/9ee9024f-d678e3f0-6dc447c5-cb4d65ff-f27119ff.jpg,validation," 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. " 1bd5b7e5-93794456-7b75267f-128a3518-fcfa17fc.jpg,validate/p15/p15488435/s58716197/1bd5b7e5-93794456-7b75267f-128a3518-fcfa17fc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___. CLINICAL HISTORY: ___-year-old female with shortness of breath upon exertion with wheezing, question pulmonary edema or pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. There are small bilateral pleural effusions. A dextroscoliosis of the T-spine is noted. The heart is stable in size. There is a nodular opacity in the right perihilar region which may represent superimposed bony structures though a true pulmonary nodule is difficult to exclude. No pneumothorax is seen. No overt pulmonary edema. Bony structures appear intact. Right AC joint arthropathy is noted. IMPRESSION: Small bilateral pleural effusions. Possible right pulmonary nodule for which non-emergent chest CT is recommended to further assess. " b0b3bd61-2b58f767-5af11f88-ee713bc3-3efd9a6f.jpg,validate/p13/p13280109/s50418714/b0b3bd61-2b58f767-5af11f88-ee713bc3-3efd9a6f.jpg,validation," FINAL REPORT INDICATION: ___F w/ shortness of breath and numbness in all extremities TECHNIQUE: PA and lateral views the chest. COMPARISON: Chest x-ray from ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 14845011-c4808369-54be4def-558dcd40-5f680b28.jpg,validate/p11/p11794355/s56574857/14845011-c4808369-54be4def-558dcd40-5f680b28.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Increased leg weakness. History of multiple sclerosis. TECHNIQUE: Chest, AP and lateral. COMPARISON: ___. 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 small nodular focus projecting over the left mid lung, although likely a summation artifact or focus of sclerosis along the end of the left third rib. The lungs appear otherwise clear. IMPRESSION: No evidence of acute cardiopulmonary disease. Small apparent nodular opacity, probably artifact; repeat radiographs with AP and lateral technique are recommended when clinically appropriate to reassess. " 844e772f-a2c519aa-179c84e8-f3b313e3-f7c2ba75.jpg,validate/p18/p18747069/s54096238/844e772f-a2c519aa-179c84e8-f3b313e3-f7c2ba75.jpg,validation," FINAL REPORT HISTORY: Intubated with NG tube placement. TECHNIQUE: Portable frontal view of the chest. COMPARISON: Chest radiographs from ___ until 4:21 today. CT chest ___. FINDINGS: An endotracheal tube is in satisfactory position, 5 cm above the carina. A left PICC terminates in the upper to mid SVC. The enteric tube courses along the esophagus and terminates of the field of view, likely within the stomach. There are severe, diffuse, bilateral interstitial opacities which are largely unchanged from this morning but worse from ___. There is no pneumothorax. There are probable small bilateral pleural effusions. The cardiomediastinal contours are unchanged. The imaged upper abdomen is unremarkable. IMPRESSION: Massive bilateral parenchymal opacities, likely edema, worse from yesterday. " b9f9b6ad-96ef34ec-801ac851-c2a200f0-9a61647b.jpg,validate/p12/p12542274/s51045804/b9f9b6ad-96ef34ec-801ac851-c2a200f0-9a61647b.jpg,validation," FINAL REPORT INDICATION: Asthma with persistent 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. Hyperinflation of the lungs and hyperlucency superiorly reflect severe emphysema. There is no evidence of pneumonia or heart failure, or pleural abnormality. IMPRESSION: Severe emphysema. No pneumonia or CHF. " 8a7f3009-860766dd-ce4a7f94-0d4d2656-b41ac4c0.jpg,validate/p12/p12131616/s58038354/8a7f3009-860766dd-ce4a7f94-0d4d2656-b41ac4c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p line placement for HD. Evaluate left IJ line placement. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from the prior day. FINDINGS: The new left IJ dialysis line tip projects in the low SVC. The right IJ tip is at the cavoatrial junction. The orogastric tube courses below the left hemidiaphragm and out of view. The endotracheal tube terminates 6.5 cm above the carina, which may be positional in nature. Cardiomediastinal silhouette is prominent, but unchanged. Tenting of left diaphragm and left-sided effusion/consolidation is unchanged since the prior day. No evidence of pneumothorax. Median sternotomy wires are intact. IMPRESSION: 1. The new left IJ dialysis line tip projects at the low SVC. No evidence of pneumothorax. 2. Unchanged left lower lobe consolidation/effusion. NOTIFICATION: The above findings were communicated via telephone by Dr. ___ to ___ (cardiovascular surgery) at 13:00 on ___, ___ min after discovery. " 9f9960b2-751480ba-8ed0503d-674f6fbc-f0462401.jpg,validate/p19/p19994730/s55355225/9f9960b2-751480ba-8ed0503d-674f6fbc-f0462401.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fever, anemia, questionable adenopathy. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. The hilar and mediastinal contours are unremarkable. Normal lung structure without evidence of adenopathy, lung nodules, pulmonary edema, or pulmonary infection. Normal size of the cardiac silhouette. " 1a3d9778-48fceaee-6694a03b-736b5c57-c6410403.jpg,validate/p14/p14186859/s58601407/1a3d9778-48fceaee-6694a03b-736b5c57-c6410403.jpg,validation," 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. " 8d3fc4ea-efb552c2-a1411aca-77b0ce6f-0cb6c805.jpg,validate/p10/p10983866/s55116795/8d3fc4ea-efb552c2-a1411aca-77b0ce6f-0cb6c805.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxemia, evaluation for pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have decreased, likely reflecting a lesser inspiratory effort. Widespread bilateral interstitial opacities, better characterized on previous CT examinations. No additional or secondary parenchymal opacities. Sternal wires, moderate cardiomegaly, no larger pleural effusions. No pneumothorax. " eca7c2bb-ee701a8f-05da1115-f85924ff-e9eb667e.jpg,validate/p16/p16192347/s55987726/eca7c2bb-ee701a8f-05da1115-f85924ff-e9eb667e.jpg,validation," FINAL REPORT INDICATION: Fall. COMPARISONS: None. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable. No fracture is identified. IMPRESSION: 1. No acute cardiopulmonary process. 2. No fracture identified. If concern for a rib fracture persists, dedicated rib radiographs could be obtained. " bc884c32-21cc4522-c2e102bd-4ea5af24-050769d7.jpg,validate/p16/p16011145/s55586523/bc884c32-21cc4522-c2e102bd-4ea5af24-050769d7.jpg,validation," FINAL REPORT INDICATION: History of bilateral pneumonia and NSTEMI. Please evaluate. COMPARISONS: Radiograph from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. There is a diffuse chronic interstitial abnormality. More dense opacity seen at the lung bases. A superimposed infectious process is suspected. The lungs are hyperinflated. There is a 1.4-cm nodule in the right upper lobe, for which a CT is recommended to evaluate for malignancy. There is no evidence of a pneumothorax or pleural effusion. The visualized osseous structures are unremarkable. IMPRESSION: 1. Diffuse interstitial abnormality in the lungs which are hyperinflated suggesing COPD. Interstitial edema or other acute process superimposed on chronic lung disease is possible. Increased density at the bases may also be due to infection. 2. 1.4 cm nodule in the upper right lung. A chest CT is recommended to evaluate for malignancy. ___ d/w Dr. ___ by Dr. ___ by phone at ___:___p on the day of the exam by phone. " 73d955fd-e0307b08-ce56ce8c-3a37e911-69fdf588.jpg,validate/p13/p13126641/s58499535/73d955fd-e0307b08-ce56ce8c-3a37e911-69fdf588.jpg,validation," 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. " 6e21e7e4-7509226c-6086b1ff-b2c1d232-e4fc8699.jpg,validate/p17/p17427285/s51147382/6e21e7e4-7509226c-6086b1ff-b2c1d232-e4fc8699.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with mets breast ca and h/o pleuralcentesis // cough and sob COMPARISON: Prior chest radiograph from ___ as well as the CT of the chest from ___. FINDINGS: PA and lateral views of the chest provided. Left chest wall Port-A-Cath again seen with catheter tip extending to the region of the low SVC near the cavoatrial junction. Significant opacification of the right hemi thorax is again noted which likely represent a combination of airspace consolidation with a small to moderate pleural effusion. There is a small new left pleural effusion. Crowding of bronchovascular tear in the left lower lung with mild atelectasis noted. Heart size is difficult to assess. No large pneumothorax. Bony structures are intact. IMPRESSION: As above. ___, MD CC: DR. ___ ___ " f947213f-614ee076-2570a259-333a08e6-e6aaaeba.jpg,validate/p17/p17804391/s58861008/f947213f-614ee076-2570a259-333a08e6-e6aaaeba.jpg,validation," WET READ: ___ ___ ___ 10:13 AM 1. Right chest tube tip likely deep within right cardiophrenic angle with side port in appropriate positioning. Differential includes intra-abdominal positioning. Clinical correlation is recommended. If persistent concern recommend a dedicated CT for further evaluation. 2. Hypoinflated lungs with right lower lobe atelectasis. 3. Stable moderate right apical and basilar pneumothorax. 4. Minimally displaced rib fracture through posterior sixth right rib. WET READ VERSION #1 ___ ___ ___ 1:57 AM 1. Right chest tube tip likely deep within right cardiophrenic angle with side port in appropriate positioning. Differential includes intra-abdominal positioning although the absence of free intraperitoneal air is reassuring. Clinical correlation is recommended. Consider shallow oblique for further evaluation. 2. Hypoinflated lungs with right lower lobe atelectasis. 3. Stable small right apical pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Status post chest tube placement for pneumothorax. Assess chest tube. COMPARISON: None. FINDINGS: Frontal and lateral chest radiograph demonstrates hypoinflated lungs with crowding of vasculature and right lower lobe atelectasis or contusion. No pleural effusion or left pneumothorax. Stable moderate right apical and basilar pneumothorax. A right chest tube courses inferioromedially, with apparent) abdominal course on lateral radiograph Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. Minimally displaced rib fracture through posterior sixth right rib. IMPRESSION: 1. Low lying right chest tube, concerning for infradiaphragmatic extension. This could be further assessed by CT if warranted clinically. 2. Right lower lobe atelectasis or contusion. 3. Stable moderate right apical and basilar pneumothorax. 4. Minimally displaced rib fracture through posterior sixth right rib. " 9a7580c8-de65fbef-5e523279-c4ac8336-e056a453.jpg,validate/p13/p13224377/s52069284/9a7580c8-de65fbef-5e523279-c4ac8336-e056a453.jpg,validation," FINAL REPORT PORTABLE CHEST FILM ___ AT 504 CLINICAL INDICATION: ___-year-old with AML, question pulmonary edema. Comparison is made to the patient's previous study dated ___ at 437. Portable AP upright chest film ___ at 5:04 a.m. is submitted. IMPRESSION: 1. Persistent retrocardiac consolidation which would be concerning for aspiration or pneumonia, less likely compressive atelectasis in the setting of a layering small effusion. There is increasing airspace opacity at the right medial lung base. In addition, there is a perihilar fullness and and evidence of peribronchial cuffing suggesting superimposed mild pulmonary edema. No pneumothorax is seen. Overall cardiac and mediastinal contours are likely stable. The endotracheal tube and left subclavian central line are unchanged in position. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. Low lung volumes. " 543892eb-79f440c8-3af41d7d-d43bce95-014739cd.jpg,validate/p14/p14951077/s50555269/543892eb-79f440c8-3af41d7d-d43bce95-014739cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute leukemia, currently receiving reinduction chemotherapy. Complaining of shortness of breath on exertion, recent echo showing mildly reduced EF from prior. // please eval for pulmonary edema, consolidation, or other abnormality please eval for pulmonary edema, consolidation, or other abn IMPRESSION: In comparison with the study of ___, the left subclavian a PICC line again extends to the cavoatrial junction or upper right atrium. Changes consistent with old granulomatous disease are again seen in the apical region pan mild indistinctness of pulmonary vessels again could reflect some mild elevation of pulmonary venous pressure. " 4796c083-f38d23b0-36808d8d-71d57a5d-1cf29624.jpg,validate/p15/p15161526/s53678161/4796c083-f38d23b0-36808d8d-71d57a5d-1cf29624.jpg,validation," 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. " 1199ef62-ecb66322-215302ff-7926d569-4c2f8f1f.jpg,validate/p19/p19434192/s53042102/1199ef62-ecb66322-215302ff-7926d569-4c2f8f1f.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with pain with swallowing after EGD. COMPARISON: None. FINDINGS: PA and lateral views of the chest. There are trace bilateral pleural effusions. The lungs are clear of focal consolidation. The cardiomediastinal silhouette is within normal limits. There is no visualized pneumomediastinum. Hypertrophic changes are seen in the spine without acute osseous abnormality. No free air seen below the diaphragm. IMPRESSION: Trace bilateral effusions otherwise, no acute cardiopulmonary process. " ac022cbd-28ab4a8f-5738d112-ca06f49d-fe1bf16e.jpg,validate/p17/p17733460/s54315220/ac022cbd-28ab4a8f-5738d112-ca06f49d-fe1bf16e.jpg,validation," FINAL REPORT INDICATION: ___ year old man with new onset SOB and ascites // ?hepatic hydrothorax vs bilateral pulmonary congestion TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Moderate right and small left pleural effusions are new since ___. Bibasilar atelectasis and low lung volumes are stable. Otherwise, the lungs are clear. No pneumothorax. The cardiomediastinal silhouette is stable. Clips are noted in the right upper abdomen. IMPRESSION: Moderate right and small left pleural effusions are new since ___. " 44c617f9-3b4527d5-4da9ba7d-e7d10f91-4e612928.jpg,validate/p14/p14278729/s58788059/44c617f9-3b4527d5-4da9ba7d-e7d10f91-4e612928.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with asthma, p/w c/o SOB; also with LLQ/LUQ abd pain, distension, no BM for 2 days; // CXR: eval for consolidationCT A/P: diverticulitis 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. " ec29e018-853124a1-a0a629d5-3137ff7c-4bd52ad2.jpg,validate/p19/p19681724/s51004588/ec29e018-853124a1-a0a629d5-3137ff7c-4bd52ad2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DKA // Infiltrates, pulmonary edema, interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal lung volumes. Normal appearance of the cardiac silhouette and of the hilar and mediastinal structures. No pneumonia, no pulmonary edema. " e9a6c89a-a94baf5e-f2a1f292-12d71de0-772ea559.jpg,validate/p12/p12122134/s51706553/e9a6c89a-a94baf5e-f2a1f292-12d71de0-772ea559.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CTA from ___ and chest radiograph from ___. CLINICAL HISTORY: Short of breath and cough. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear and well inflated. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " b36339dc-bf941017-f6dee006-d60f1693-10b336b1.jpg,validate/p15/p15193875/s55678349/b36339dc-bf941017-f6dee006-d60f1693-10b336b1.jpg,validation," 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. " 13709d72-9545d425-2d489998-baca3057-d72f087f.jpg,validate/p18/p18817291/s57958584/13709d72-9545d425-2d489998-baca3057-d72f087f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough, fever, hempotosyis TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Linear opacities within the lung bases likely reflect areas of subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Bibasilar subsegmental atelectasis. Otherwise, no acute cardiopulmonary abnormality. " e4ba0a1f-b96b94e0-d422fe91-b58b8842-2ea57aa2.jpg,validate/p18/p18624005/s55466256/e4ba0a1f-b96b94e0-d422fe91-b58b8842-2ea57aa2.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with a history of right breast cancer and lymphoma treated with radiation therapy complicated by constrictive pericarditis and chronic trans radiated right pleural effusion who presents with chest pain // dyspnea, chest pain TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest PA and lateral ___. CT chest without contrast ___. FINDINGS: Opacity of the right lung, pleural thickening and mediastinal distortion consistent with post radiation changes better assessed with recent chest CT. An overlying pneumonia or pulmonary embolus cannot be excluded. Heart size is normal. No pneumothorax. IMPRESSION: Opacification of the right lung with pleural thickening and mediastinal distortion is consistent with postradiation changes. An overlying pneumonia or pulmonary embolus cannot be excluded. " b9a00818-61f3d6e6-0311d0df-53bdbe12-97763f5c.jpg,validate/p17/p17395750/s59173918/b9a00818-61f3d6e6-0311d0df-53bdbe12-97763f5c.jpg,validation," FINAL REPORT HISTORY: Status post mechanical fall, left clavicle, shoulder, rib and T-spine pain. Arrived in C-collar, please evaluate for fracture. 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 injury identified. IMPRESSION: No acute cardiopulmonary process. " 2208e29f-df812f78-e1eba718-c337c9aa-73fee005.jpg,validate/p15/p15006805/s56940997/2208e29f-df812f78-e1eba718-c337c9aa-73fee005.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with history of intermittent fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged with a left ventricular predominance. Aortic core valve device is re- demonstrated in unchanged position. Extensive atherosclerotic calcifications of the thoracic aorta are again noted. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " bb4a6bbc-afb7cd1d-40b22ce5-47d29abf-158c3f76.jpg,validate/p15/p15037065/s57882448/bb4a6bbc-afb7cd1d-40b22ce5-47d29abf-158c3f76.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with DOE // r/o acute process COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided.Midline sternotomy wires and prosthetic cardiac valve again noted. The heart is moderately enlarged. The aorta appears calcified. No focal consolidation, large effusion or pneumothorax is seen. The imaged bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Moderate cardiomegaly, otherwise unremarkable. " 1e653ca5-33339064-48dce69f-36157280-d9fd4ff8.jpg,validate/p17/p17615451/s53051715/1e653ca5-33339064-48dce69f-36157280-d9fd4ff8.jpg,validation," FINAL REPORT AP CHEST, 10:13 P.M. ON ___ HISTORY: ___-year-old with fever. Assess for infiltrate or other evidence of infection. IMPRESSION: AP chest compared to ___ through ___: Aside from mild subsegmental atelectasis left lower lobe, left lung is clear. There is new irregular opacification at the right lung apex, probably acute infection. Right lung is otherwise clear. Lipoma bulges the right lower costal pleural margin. Heart size normal. Right PIC line ends in the upper right atrium and would need to be withdrawn 2 cm to confidently place it in the low SVC. Dr. ___ was paged at 8:53 a.m., one minute following recognition of the findings. " eeac24b0-83a7fc84-960acf44-1faf78a8-0df8c266.jpg,validate/p14/p14718940/s58993475/eeac24b0-83a7fc84-960acf44-1faf78a8-0df8c266.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: ___ radiograph. FINDINGS: Persistent cardiomegaly accompanied by pulmonary vascular congestion and improving interstitial edema. Additional tubular-appearing opacity in right upper lobe may reflect prominent vasculature or an area of mucoid impaction. Attention to this region on followup PA and lateral radiograph would be helpful in this regard. " 28f3bd90-7f9ed878-70a82399-e55f2bcb-447f0273.jpg,validate/p16/p16679893/s54712042/28f3bd90-7f9ed878-70a82399-e55f2bcb-447f0273.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with possible mass on OSH Xray // Please eval for mass in the right hilar region COMPARISON: MRCP performed on ___. FINDINGS: PA and lateral views of the chest provided. There is collapse of the right lower lobe. The left lung is clear. Clips in the left axilla noted. No pneumothorax. Heart size is not enlarged. No acute osseous abnormality. IMPRESSION: Right lower lobe collapse, for which chest CT is recommended to further assess. " 1860bc4a-f9ea2d36-e7107487-58d50ec6-811baf45.jpg,validate/p13/p13772123/s50950664/1860bc4a-f9ea2d36-e7107487-58d50ec6-811baf45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness and SOB and weight loss x 2 weeks. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray of ___ and ___. FINDINGS: Heart size is top normal. Lungs are hyperinflated without focal consolidation, pleural effusion, or pneumothorax. Bibasilar atelectasis is mild. Intact median sternotomy wires. The aorta is calcified and tortuous. IMPRESSION: No new focal consolidation concerning for pneumonia. " 0e81cd50-a5e3d69d-e5d1968d-509e3f3c-3e7ae72d.jpg,validate/p19/p19705710/s56377963/0e81cd50-a5e3d69d-e5d1968d-509e3f3c-3e7ae72d.jpg,validation," FINAL REPORT HISTORY: Not feeling well, cough. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The study is somewhat limited due to low lung volumes and the patient's chin and neck obscuring assessment of the right lung apex. Streaky bibasilar airspace opacities likely reflect atelectasis though aspiration or infection cannot be completely excluded. The cardiac, mediastinal and hilar contours are unchanged with mild enlargement of cardiac silhouette and tortuosity of the thoracic aorta again noted. There is crowding of the bronchovascular structures but no overt pulmonary edema is present. A small left pleural effusion is unchanged. Compression deformity of an upper lumbar vertebral body is unchanged. Marked degenerative changes of the left glenohumeral joint are present. IMPRESSION: Persistent bibasilar airspace opacities may reflect atelectasis but infection or aspiration cannot be excluded. Small left pleural effusion. " 8bacfaf4-785eb836-788f2915-5e3092ed-b09943c2.jpg,validate/p14/p14819550/s57308718/8bacfaf4-785eb836-788f2915-5e3092ed-b09943c2.jpg,validation," 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. " 28dc347c-80e73a2e-ce8fb6c8-bb8e8d81-8017230f.jpg,validate/p18/p18297072/s50767017/28dc347c-80e73a2e-ce8fb6c8-bb8e8d81-8017230f.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever and cough. STUDY: PA and lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs demonstrate consolidation of the right middle lobe. There is no pleural effusion or pneumothorax. IMPRESSION: Right middle lobe pneumonia. " 6baaa546-6e9a7088-c875ee6b-9cfed345-e5bdda9a.jpg,validate/p16/p16566006/s57976565/6baaa546-6e9a7088-c875ee6b-9cfed345-e5bdda9a.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with a new fever after fall. Suspect pneumonia. Evaluate for rib fracture or pneumothorax. IMPRESSION: AP chest compared to ___ through ___: I do not see a displaced rib fracture, but conventional chest radiograph, particularly performed bedside, is not sensitive for detecting any but gross chest cage trauma. If there are focal findings, detailed views of those areas should be requested. There is no pneumothorax or pleural effusion. Lungs are clear and heart is normal size. " ae25883d-319b3d91-2594cfcc-e3e92b35-017a7181.jpg,validate/p15/p15971063/s51815052/ae25883d-319b3d91-2594cfcc-e3e92b35-017a7181.jpg,validation," FINAL REPORT CLINICAL HISTORY: Subarachnoid hemorrhage due to anterior communicating artery aneurysm status post coiling, now intubated, coughed up blood, chest tube placed. CHEST, FOUR FILMS SEMISUPINE: The tip of the endotracheal tube lies in the satisfactory position 4.5 cm from the carinal angle. Some opacities are now seen in the left lung, which were not present on the prior chest x-ray taken at 5 a.m. and these could represent areas of hemorrhage or aspiration. The right lung appears clear. " 5ec51fd9-3f47d811-9872837d-037d4dab-59e15ed7.jpg,validate/p17/p17527875/s52486078/5ec51fd9-3f47d811-9872837d-037d4dab-59e15ed7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS wedge // check interval change check interval change IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Bilateral pleural effusions with atelectatic changes in are again much more prominent on the right. No evidence of postoperative pneumothorax. " 0d989d41-f7bf51df-9570dddf-b4801e00-6ca2be9f.jpg,validate/p19/p19103751/s55222595/0d989d41-f7bf51df-9570dddf-b4801e00-6ca2be9f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of mm new cough // r/o consolidation r/o 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. Mild streaks of atelectasis are seen at the left base. " 0cc2674f-8298209f-25792271-246af867-f6d8e314.jpg,validate/p10/p10203235/s59904210/0cc2674f-8298209f-25792271-246af867-f6d8e314.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with shortness of breath TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: The patient is status post median sternotomy and CABG. Moderate cardiomegaly is unchanged compared to the previous study. Atherosclerotic calcifications are noted within the aorta which is mildly tortuous, unchanged. Mild interstitial pulmonary edema is worse compared to the previous study without large pleural effusion, focal consolidation or pneumothorax. No acute osseous abnormalities detected. IMPRESSION: Mild interstitial pulmonary edema, worse in the interval. " 9b5162d7-ce9ee318-c5e83658-13e15d94-dac687cd.jpg,validate/p13/p13689440/s59012959/9b5162d7-ce9ee318-c5e83658-13e15d94-dac687cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis and new respiratory distress // pulmonary edeam vs effusions COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There are no larger pleural effusions but signs of mild fluid overload. Unchanged course of the PICC line, unchanged position of the pacemaker leads. " b7ebe6b9-b67c571d-c7d018f3-8ff840c5-0205b96f.jpg,validate/p14/p14558830/s57993027/b7ebe6b9-b67c571d-c7d018f3-8ff840c5-0205b96f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pleural effusion after PleurX placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. There is still presence of right-sided loculated pleural effusion with minimal interval change, and unchanged overall position of the right PleurX catheter. There is slight right mediastinal shift most likely due to underlying volume loss. Left lung is essentially clear. There is no pneumothorax. No focal consolidations have developed in the interim. " 0c166c83-22ca6c0b-9f5ca9e2-625e989b-879e7cf0.jpg,validate/p12/p12389333/s58987188/0c166c83-22ca6c0b-9f5ca9e2-625e989b-879e7cf0.jpg,validation," FINAL REPORT HISTORY: COPD, shortness of breath, rule out effusion or volume overload. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: Chest x-ray from ___ at 14:28 p.m. Compared with the prior study, there are very pronounced new miliary or micronodular opacities at both right and left bases. There is upper zone redistribution, without overt CHF, possibly slightly more pronounced than on the prior film. Minimal atelectasis at the left base. Possible tiny bilateral effusions. No pneumothorax detected. The cardiomediastinal silhouette is similar to the prior film, with stable mild cardiomegaly. The hila, which have a relatively tapered appearance, may be slightly more prominent. Probable background COPD. IMPRESSION: 1. Mild cardiomegaly and upper zone redistribution, without overt CHF. 2. Probable background COPD. 3. Compared with ___, there is now a very pronounced micronodular/miliary pattern at both lung bases. This pattern is quite distinctive and could reflect the presence of TB or other granulomatous processes or possibly a viral pneumonia. Pneumoconioses can also give rise to this appearance, but would not be expected to develop so quickly. 4. Possible small bilateral effusions. " d0730d56-6c198e86-49d9f5b9-d535af54-1d40ca67.jpg,validate/p19/p19758044/s59722626/d0730d56-6c198e86-49d9f5b9-d535af54-1d40ca67.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right empyema sp vats decort // ptx, effusion ptx, effusion IMPRESSION: COMPARED TO CHEST RADIOGRAPHS ___ THROUGH ___. 2 RIGHT APICAL THORACOSTOMY TUBES HAVE BEEN INSERTED. THE PLEURAL ABNORMALITY HAS CHANGED DISTRIBUTION, NOW WITH A LARGER LATERAL COMPONENT IN THE RIGHT UPPER CHEST. NO DEFINITE PNEUMOTHORAX, BUT THERE MAY BE NEW DEPENDENT PLEURAL EFFUSION IN THE LOWER HEMI THORAX ACCOUNTING FOR SLIGHT LEFTWARD MEDIASTINAL SHIFT WITH NO APPARENT LEFT LUNG ATELECTASIS. LEFT LUNG CLEAR. LEFT PIC LINE ENDS IN THE LOW SVC. " 469e653c-1c5d226d-06f0b6a2-8840720e-da4a2782.jpg,validate/p16/p16257001/s55594472/469e653c-1c5d226d-06f0b6a2-8840720e-da4a2782.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Intracranial aneurysm central line placement. FINDINGS: There is a right subclavian line with tip in the SVC. Feeding tube is present with tip at least in the fourth portion of the duodenum. NG tube tip is in the stomach. Lung volumes are slightly low with some volume loss at both bases. There is no pneumothorax. " b1266a76-716cc818-be4b8402-a8094922-680be62f.jpg,validate/p11/p11708364/s58145209/b1266a76-716cc818-be4b8402-a8094922-680be62f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman POD2 incisional hernia repair with desats // Any cardiopulmonary process COMPARISON: Chest radiographs ___. IMPRESSION: Previous severe bibasilar atelectasis has improved on both sides. Mediastinum is still midline. Heart size normal. Upper lobe pulmonary vessels mildly engorged, but there is no pulmonary edema. Pleural effusion is minimal if any. No pneumothorax. " 057a2b6b-444ff9ad-71739ee3-25c03fbb-77be84f0.jpg,validate/p10/p10459005/s52455423/057a2b6b-444ff9ad-71739ee3-25c03fbb-77be84f0.jpg,validation," WET READ: ___ ___ ___ 2:11 AM There is mild pulmonary vascular congestion without overt edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF // pulm edema pulm edema IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. There is no longer any pulmonary edema. Severe cardiomegaly is chronic and heart size may have increased since ___. Left heart border is obscured. Whether this is a function of lordotic positioning or indicates new abnormality in the lingula would require a lateral view. There is no pleural effusion or pneumothorax. Indwelling transvenous right atrial pacer and right ventricular pacer defibrillator leads follow their expected courses from the left pectoral generator. " 4ed8c054-c46ac47b-3b75a033-9257345e-4e1b3334.jpg,validate/p12/p12293866/s57226960/4ed8c054-c46ac47b-3b75a033-9257345e-4e1b3334.jpg,validation," FINAL REPORT INDICATION: ___F with cough and pain, 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. Lung volumes are slightly low. An area of opacification overlying the heart on lateral view may represent focal consolidation. The lungs are otherwise clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Possible opacity in the right middle lobe projecting over the heart may reflect developing pneumonia. No evidence of consolidation or other acute cardiopulmonary process elsewhere. " 1e9440d9-962518f9-5ed97549-ea146f36-4df5fbbd.jpg,validate/p18/p18303550/s55799630/1e9440d9-962518f9-5ed97549-ea146f36-4df5fbbd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval COMPARISON: Prior chest radiographs since ___ most recently one ___. IMPRESSION: Large left pleural effusion has increased, depressing the left hemidiaphragm and displacing the cardiac silhouette to the right. No pneumothorax. Right lung and right pleural space are normal. Left lower lobe is densely consolidated. A metal clip projecting over the left infrahilar region were a large mass was seen on a chest CT scan performed elsewhere on ___, may be a fiducial marker for noninvasive therapy. " 1f545e17-66d9ca53-5a8d0ce0-5102470d-c93430f2.jpg,validate/p10/p10594556/s52634790/1f545e17-66d9ca53-5a8d0ce0-5102470d-c93430f2.jpg,validation," FINAL REPORT HISTORY: Cough. Evaluation for pneumonia. History of non-small cell lung carcinoma and multiple recent necrotic pneumonia. 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 redemonstrate opacification of the left hemithorax, unchanged in appearance since the prior exam with air bronchograms and air-filled cystic structure adjacent to the left axilla. The right lung is grossly clear. Clips are seen within the right axillary region and right upper quadrant. No focal consolidation, right pleural effusion or pulmonary edema is identified. IMPRESSION: Unchanged opacification of the left hemithorax with leftward shift of mediastinal structures. Right lung is grossly clear. " dd5f38a1-5351f63c-b64104c2-7961d144-fc67e79d.jpg,validate/p10/p10456513/s51747718/dd5f38a1-5351f63c-b64104c2-7961d144-fc67e79d.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Chest x-ray of one day earlier. FINDINGS: The patient is status post recent esophagectomy procedure. Stable postoperative appearance of the mediastinum with expected rightward widening related to the pull-up. Surgical drain remains in place, as well as a nasogastric tube and chest tube. Endotracheal tube terminates 5 cm above the carina. Persistent bilateral lower lobe opacities, with slight improvement on the left and slight worsening on the right, predominantly in the retrocardiac areas. Small left pleural effusion is unchanged. There is no visible pneumothorax. " d3662723-2e45b49d-8265f164-f1d9b884-707b4685.jpg,validate/p12/p12054589/s57083223/d3662723-2e45b49d-8265f164-f1d9b884-707b4685.jpg,validation," FINAL REPORT HISTORY: Status post AAA repair, follow-up edema and ET tube. CHEST, SINGLE AP PORTABLE SUPINE VIEW. COMPARISON: Chest x-ray from ___. An ET tube is present, tip approximately 4.2 cm above the carina. An orogastric-type tube is present. Due to underpenetration, it can only be traced to the lowermost portion of the mediastinum, though it may extend inferior to that. A left IJ central line is present, tip over proximal SVC. A right IJ sheath is present, tip overlying the lower right brachiocephalic vessel. There are low inspiratory volumes, with prominence of the mediastinum, upper zone redistribution, and diffuse vascular blurring, consistent with CHF. There is bibasilar atelectasis. Small effusions cannot be excluded. Mediastinal and CHF findings are similar to the film from ___. Pulmonary vascular plethora may also be accentuated by supine technique. The appearance of the cardiomediastinal silhouette is likely accentuated by rotated positioning. " fe3d0bae-5f60e60d-de4de5e4-afca1710-8cf0fbb4.jpg,validate/p14/p14875942/s56594395/fe3d0bae-5f60e60d-de4de5e4-afca1710-8cf0fbb4.jpg,validation," FINAL REPORT INDICATION: Chronic chest wall pain, mainly anterior, but also left thoracic pain, known old T6 fracture. Please evaluate for any rib fractures. COMPARISON: Comparison is made to chest radiograph performed ___. CHEST PA AND LATERAL RADIOGRAPH: Demonstrates stable enlarged cardiac silhouette with a left-sided single-lead pacemaker with tip terminating in the right ventricle. Low lung volumes are noted with stable bibasilar atelectasis. No focal opacities concerning for pneumonia present. No pleural effusion or pneumothorax is evident. Evaluation of the ribs is limited due to body habitus as well as patient position. No displaced rib fracture evident. IMPRESSION: Severely limited evaluation of the ribs. If continued concern for rib fracture, recommend dedicated rib series. " f4c6a569-b8544b46-f1358466-ef6e9c84-abda2cf6.jpg,validate/p16/p16562848/s57184362/f4c6a569-b8544b46-f1358466-ef6e9c84-abda2cf6.jpg,validation," FINAL REPORT INDICATION: ___F with infection // evidence of pneumonia TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: Relatively linear right basilar opacities seen most likely atelectasis. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f9e0a43d-a963110b-c977a7ad-fa1dd59d-f5ee3334.jpg,validate/p15/p15478350/s58452051/f9e0a43d-a963110b-c977a7ad-fa1dd59d-f5ee3334.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Fever, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate low lung volumes with no convincing signs of pneumonia or CHF. No effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Low lung volumes with no convincing signs of pneumonia. " b72f4937-01e74a9a-7fb58bbb-d470a1fe-f9824168.jpg,validate/p18/p18192009/s59382384/b72f4937-01e74a9a-7fb58bbb-d470a1fe-f9824168.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess retrocardiac opacities seen in prior radiograph from ___. Cardiomediastinal contours are normal. Retrocardiac opacities are grossly unchanged, likely due to atelectasis. There is no evidence of pneumonia or pleural effusion. " ce8866d6-a3fc0023-00fb8f22-a7560e10-fb7a7ee9.jpg,validate/p11/p11632236/s57440636/ce8866d6-a3fc0023-00fb8f22-a7560e10-fb7a7ee9.jpg,validation," FINAL REPORT AP CHEST, 9:39 A.M., ___ HISTORY: ___-year-old man with possible aspiration pneumonia. IMPRESSION: AP chest compared to ___. Edema has improved only in the right upper lobe. Extensive consolidation elsewhere in both lungs is unchanged, and at least in the left mid lung has the appearance of likely pneumonia. Cardiac silhouette is obscured. Of note, mediastinal venous engorgement is no longer present suggesting there is no elevation of central venous pressure or volume. Dual-channel left jugular and right internal jugular lines both end in the upper SVC. There is no pneumothorax. " d5bf11e7-94e9801c-38c190a3-1715290d-d5814847.jpg,validate/p17/p17574863/s53983438/d5bf11e7-94e9801c-38c190a3-1715290d-d5814847.jpg,validation," WET READ: ___ ___ ___ 5:19 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___ h/o cirrhosis ___ ___'s s/p tx ___on tacro, CKD (anuric) on HD p/w fever and abd pain. // eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unchanged. No pneumothorax, pleural effusion, or consolidation. Unchanged configuration of vascular stent. IMPRESSION: No acute cardiopulmonary process. " 3dbd28b8-7a9c64c9-21a4aabc-9484e301-907759e4.jpg,validate/p18/p18016603/s52191794/3dbd28b8-7a9c64c9-21a4aabc-9484e301-907759e4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Non-ST elevation myocardial infarction. Question pulmonary edema. COMPARISONS: ___ and ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged, including calcification of the aortic arch and slightly prominent heart size, although probably overall within normal limits, but with a left ventricular configuration. There is no clear evidence for pleural effusion or pneumothorax. There are patchy opacities in the left lower lobe, not present on earlier radiographs from ___ and increased from ___, superimposed on streaky lingular atelectasis. However, there are no findings suggestive of pulmonary edema. IMPRESSION: Focal left basilar opacity, which appears superimposed on preexisting lingular atelectasis and probably within the medial left lower lobe with air bronchograms. Differential considerations, include included atelectasis; in the appropriate clinical setting, pneumonia is not excluded, however. Correlation with other patient factors is suggested. " 64d11907-c090ab32-491736ac-2a88c7fc-0b92228a.jpg,validate/p12/p12168568/s53843565/64d11907-c090ab32-491736ac-2a88c7fc-0b92228a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ESRD on HD // r/o TB TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Low lung volumes. There is a Hickman catheter over the right lung with the tip in the right atrium. There is patchy opacification at the left base. There is a subcentimeter density projecting over the left eighth posterior rib, which likely represents a calcified granuloma. 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. Subcentimeter density in left lung, likely representing a calcified granuloma from prior TB exposure. 2. Patchy opacification of left base, which could represent atelectasis, or pneumonia in the appropriate clinical setting. NOTIFICATION: Pertinent critical findings were posted by Dr. ___ ___ on ___ at 17:04 to the Department of Radiology online critical communications system for direct communication to the referring provider. " fe5aa03b-efe85be7-0594e460-1231dcee-2988a76f.jpg,validate/p17/p17716210/s59601699/fe5aa03b-efe85be7-0594e460-1231dcee-2988a76f.jpg,validation," WET READ: ___ ___ ___ 8:06 PM clear lungs. spinal cord stimulator, g-tube unchanged. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes. No acute changes. Borderline diameter of the azygos vein. Spinal stimulator devices in situ. Normal size of the cardiac silhouette. No evidence of pneumonia. " cc3a783b-9c6df72e-a8f565fa-7b16c3f6-b49a9eb8.jpg,validate/p17/p17527875/s54839464/cc3a783b-9c6df72e-a8f565fa-7b16c3f6-b49a9eb8.jpg,validation," 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. " 9ad850c5-4e81ea99-79cf195c-749da7c1-d5b3bc12.jpg,validate/p10/p10667959/s51229022/9ad850c5-4e81ea99-79cf195c-749da7c1-d5b3bc12.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with progressive dyspnea // r/o infiltrate LLL r/o infiltrate LLL IMPRESSION: Compared to chest radiographs since ___, most recently ___. Mild cardiac enlargement is new, but pulmonary vasculature is unremarkable and there are no other findings to suggest active cardiac decompensation. There is no pleural effusion. Thoracic aorta is heavily calcified and top-normal size. Atherosclerotic calcifications are also considerable in the head and neck vessels and coronary arteries. " 5183d6f5-3777e84c-c83ec3a2-e8496465-8534362b.jpg,validate/p12/p12446890/s57011635/5183d6f5-3777e84c-c83ec3a2-e8496465-8534362b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is not engorged. No pleural effusion or pneumothorax is seen. Mild to moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 9be4ccd3-9cd8e4a0-977ad1bb-d8f3c816-5f1da208.jpg,validate/p19/p19398915/s55197331/9be4ccd3-9cd8e4a0-977ad1bb-d8f3c816-5f1da208.jpg,validation," FINAL REPORT INDICATION: ___ year old man with cirrhosis, hepatic hydrothorax, tips-resistant // eval status of hepatic hydrothorax TECHNIQUE: Portable AP upright view of the chest COMPARISON: ___ FINDINGS: There is a large right pleural effusion with severe compressive atelectasis and a very small amount of remaining aerated lung. Confluent diffuse airspace opacities are also present in the left lung. There is no large left effusion. No pneumothorax. Cardiac silhouette is largely obscured IMPRESSION: 1. Moderate pulmonary interstitial edema and large right pleural effusion. " 3454b8ce-820d15d3-9aa1fa2b-6c7ccf20-63f27914.jpg,validate/p17/p17515299/s57404802/3454b8ce-820d15d3-9aa1fa2b-6c7ccf20-63f27914.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with sob // eval for ptx COMPARISON: None available FINDINGS: Lung volumes are low. 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. " f254521a-ffdf3c85-8d0aaec7-be86877f-d2aaec70.jpg,validate/p19/p19076862/s55840129/f254521a-ffdf3c85-8d0aaec7-be86877f-d2aaec70.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with hypoxia // infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lung volumes are slightly low. The cardiomediastinal silhouette is unremarkable. The central pulmonary vasculature appears mildly engorged. There is left basilar atelectasis. Minimal opacity is seen in the right infrahilar region and at the left base. No definite correlate is seen on the lateral view, however, in the appropriate clinical context, this may represent focal pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Right infrahilar and left basilar opacity, in the appropriate clinical context, may represent pneumonia. " 9c04bf9c-67493336-5beb6754-126bd9e0-92f02e4c.jpg,validate/p12/p12097647/s50321039/9c04bf9c-67493336-5beb6754-126bd9e0-92f02e4c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SBO; NGT placed, then advanced. Pls eval location of tip. // NGT advanced; pls eval placement. NGT advanced; pls eval placement. IMPRESSION: In comparison with the earlier study of this date, the patient has taken a better inspiration. The tip of the nasogastric tube again appears to be just above the large hiatal hernia. Continued low lung volumes. " 402ec1ad-8a7ec057-bd0d04ec-2db0bbb5-44ebc4ed.jpg,validate/p13/p13874311/s52095100/402ec1ad-8a7ec057-bd0d04ec-2db0bbb5-44ebc4ed.jpg,validation," FINAL REPORT INDICATION: 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. " 79aaf594-56b1e86d-4f9d1375-c87cadd6-f79d6298.jpg,validate/p13/p13714199/s55713386/79aaf594-56b1e86d-4f9d1375-c87cadd6-f79d6298.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with sickle cell disease, p/w chest pain and fever // eval for acute chest syndrome 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 and stable. IMPRESSION: No acute cardiopulmonary process. " dc05b018-a2de031a-7f7afc29-d2322bed-2b79d34b.jpg,validate/p18/p18238066/s52908880/dc05b018-a2de031a-7f7afc29-d2322bed-2b79d34b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ILD who is now s/p VATS biopsy, intubated and with chest tube. // evaluate for interval changes TECHNIQUE: Portable AP film was obtained COMPARISON: ___ FINDINGS: The patient has been extubated in the NG tube removed. A right-sided chest tube remains in good position. No pneumothorax. There are that persistent bilateral congestive changes though these 2 have improved versus the prior radiograph dated ___ at more focal opacities in both lung bases suggest atelectasis and or infection. IMPRESSION: Improvement in the amount of pulmonary edema. No pneumothorax. " d8734c96-a1590a3f-a7bfda8f-d600fa02-87d2e67f.jpg,validate/p17/p17237809/s58015942/d8734c96-a1590a3f-a7bfda8f-d600fa02-87d2e67f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cabg and TV repair // evaluate for effusion evaluate for effusion IMPRESSION: In comparison with the study of ___, there is still substantial enlargement of the cardiac silhouette without appreciable pulmonary edema. Retrocardiac opacification most likely reflects a combination of pleural fluid and volume loss in the left lower lobe. " c89ffe5c-ed1df24d-730c4597-eaf6582f-1c2e239e.jpg,validate/p19/p19648179/s53874147/c89ffe5c-ed1df24d-730c4597-eaf6582f-1c2e239e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with a 9 day history of productive cough, no fever. Several people in dorm with 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 acute cardiopulmonary abnormality. " a7c5b2e0-693acf79-e63c2d3a-8db10802-2d3ad617.jpg,validate/p16/p16454913/s51261911/a7c5b2e0-693acf79-e63c2d3a-8db10802-2d3ad617.jpg,validation," FINAL REPORT HISTORY: Copious secretions, question interval change. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 20:25 p.m., there has been interval worsening of the degree of opacification seen relatively diffusely throughout both lungs as well as more confluent opacity at the left lung base. The cardiomediastinal silhouette is enlarged, but grossly stable. There is upper zone redistribution and diffuse alveolar opacities and left-greater-than-right pleural effusions. There is underlying collapse and/or consolidation at the left base. Subtle undulation along the right chest wall raises the question of rib fractures of indeterminate acuity. A tracheostomy tube is in place. A left-sided PICC line is present. The tip is not well visualized due to underpenetration. A Dobbhoff tube is present, tip overlying fundus, extending beyond the inferior edge of this film. Inferior subluxation of the right humeral head with respect to the glenoid is suggested. IMPRESSION: Diffuse opacity in both lungs with bilateral left-greater-than-right effusions and left base collapse and/or consolidation, significantly worse compared with ___. This could represent worsening CHF, now with pulmonary edema. However, the possibility of an associated infectious infiltrate, particularly at the left base, cannot be excluded. " 945000b6-e5356227-3c6ae3ec-99c98e6a-ecf5a6e1.jpg,validate/p12/p12848368/s52727636/945000b6-e5356227-3c6ae3ec-99c98e6a-ecf5a6e1.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple prior studies most recently ___. FINDINGS: The patient is status post median sternotomy and CABG. The heart size is mildly enlarged but stable. There is no evidence of vascular engorgement nor pulmonary edema. The aorta is again tortuous. On the lateral view, there is a possible suggestion of a pericardial effusion, likely a chronic finding. The lungs are clear. IMPRESSION: Normal volume status. Possible pericardial effusion. " 0ac229a5-05fca976-966dfc22-e8ae3370-4bdb0874.jpg,validate/p12/p12578953/s54252184/0ac229a5-05fca976-966dfc22-e8ae3370-4bdb0874.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with 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. There are no acute osseous abnormalities. Diffusely distended loops of colon are noted within the upper abdomen. IMPRESSION: No acute cardiopulmonary abnormality. Diffuse distention of colonic loops of bowel in the upper abdomen. " bafae563-540c18ad-3a1bf35a-1fe19ef4-30aff014.jpg,validate/p12/p12763939/s53079289/bafae563-540c18ad-3a1bf35a-1fe19ef4-30aff014.jpg,validation," WET READ: ___ ___ ___ 9:07 PM no evidence of ptx ______________________________________________________________________________ FINAL REPORT Status post removal of left-sided chest tube. Evaluate for pneumothorax. Left chest tube has been removed. Very small apical pneumothorax is not excluded. Otherwise, the lung appears to be fully expanded. Position of the other various lines and tubes remains unaltered. IMPRESSION: No pneumothorax identified. " 5b59c6e7-ac14d1f5-2daee605-60518cfe-9742fd89.jpg,validate/p11/p11681834/s51751086/5b59c6e7-ac14d1f5-2daee605-60518cfe-9742fd89.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // r/o acute process TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 2166829a-2f3d3c0f-ad37b5db-ffe43e7c-c50735f3.jpg,validate/p14/p14304873/s51530471/2166829a-2f3d3c0f-ad37b5db-ffe43e7c-c50735f3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cabg POD 4 // evaluate for effusion evaluate for effusion COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lung volumes have improved substantially since ___ with only moderate mild to moderate residual atelectasis at both lung bases. Small bilateral pleural effusions are probably unchanged. Cardiomediastinal silhouette is a normal postoperative appearance. A constellation of ring shadows in the left supra hilar lung could be residual of unusual atelectasis, since the largest component was larger on ___. It could also be loculations of air and fluid in the anterior pleural space. I would pursue this with additional imaging only if the patient is symptomatic. In the absence of clinical findings, followup chest radiograph in 4 weeks is appropriate. " c2cdd0a9-74077cd3-3d7af9d7-a4e1f7ea-4bc58717.jpg,validate/p17/p17466237/s51002332/c2cdd0a9-74077cd3-3d7af9d7-a4e1f7ea-4bc58717.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and cough. 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 process. " e710ca12-93921217-c40dbc97-689d5952-a4a2229a.jpg,validate/p15/p15366293/s53906930/e710ca12-93921217-c40dbc97-689d5952-a4a2229a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tracheal mass s/p stent placement now with significant coughing // ?stent migration, new infiltrate Surg: ___ (Tracheal stent) ?stent migration, new infiltrate IMPRESSION: In comparison with the previous study, the tracheal stent has migrated caudally several cm so that the lower tip is almost at the level of the carina. Subsequent study shows the stent returned to its previous position. No evidence of acute focal pneumonia " 02153f30-3a6d8c08-23015026-0d72e4a3-b10e2910.jpg,validate/p15/p15173403/s51265275/02153f30-3a6d8c08-23015026-0d72e4a3-b10e2910.jpg,validation," FINAL REPORT HISTORY: Recent chest tube removal. Evaluate for interval change. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiographs ___ and ___. CT torso ___. FINDINGS: The overlying brace with somewhat obscures evaluation. There is no definite pneumothorax seen after chest tube removal. Small bilateral pleural effusions are unchanged with fluid seen in the left major fissure. There has been improved aeration of the left lung base with persistent, residual bibasilar atelectasis. The cardiac and mediastinal contours are unchanged. Severely displaced right rib fractures are unchanged in orientation and demonstrate small adjacent hematoma. There has been improvement in the subcutaneous air seen along the right lateral chest wall. IMPRESSION: No definite pneumothorax after chest tube removal. " f0ac91d6-2a0a9459-5ef0e67c-a5c576d2-9ae73036.jpg,validate/p17/p17641105/s57492737/f0ac91d6-2a0a9459-5ef0e67c-a5c576d2-9ae73036.jpg,validation," FINAL REPORT HISTORY: History is CHF and right foot osteo, now with weakness concerning for pneumonia. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: There has been interval removal of the right-sided PICC line. The lungs are well expanded and clear. Heart size is top normal. The aorta is mildly tortuous and demonstrates atherosclerotic calcification. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " b867d216-618f7fb4-f5a92ec1-95a19c8e-bb087230.jpg,validate/p16/p16903085/s55745747/b867d216-618f7fb4-f5a92ec1-95a19c8e-bb087230.jpg,validation," FINAL REPORT INDICATION: Chest pain, here to evaluate for cardiopulmonary disease or infiltrate. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral upright radiographs of the chest. FINDINGS: The lungs are symmetrically expanded and well aerated with no focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax. The pleura is within normal limits. There is no pulmonary vascular congestion or pulmonary edema. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The trachea is midline. IMPRESSION: No acute cardiopulmonary process. " 9acd7d25-62095064-695a2a5f-3837c915-8faec86f.jpg,validate/p19/p19992525/s53101264/9acd7d25-62095064-695a2a5f-3837c915-8faec86f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph dated ___. CLINICAL HISTORY: Productive cough, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is a severe dextroscoliosis of the thoracic spine with spinal stabilization hardware in place, unchanged from prior exam. There is a band-like consolidation in the right lower lung which is new from prior exam and could represent pneumonia in the correct clinical setting. There is a trace right pleural effusion. Left lung is clear. Cardiomediastinal silhouette is difficult to assess but appears grossly stable. No free air below the right hemidiaphragm. IMPRESSION: Band-like opacity in the right lower lung could represent pneumonia. Followup to resolution is advised. " 82844b5e-1e2cfc49-ed479211-60abef11-1abce620.jpg,validate/p16/p16890126/s50397823/82844b5e-1e2cfc49-ed479211-60abef11-1abce620.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: Cardiac, mediastinal, and hilar contours are unremarkable. There are low lung volumes. Minimal streaky opacities in the lung bases likely reflect atelectatic changes. No focal consolidation, pleural effusion, or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with probable mild atelectasis at the lung bases. " c2804777-2183cdce-94ba468a-461b25e8-b13e4a74.jpg,validate/p16/p16312465/s56065215/c2804777-2183cdce-94ba468a-461b25e8-b13e4a74.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Orthopnea and left-sided chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A Port-A-Cath terminates in the right atrium. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. Streaky left basilar opacity is most consistent with minor atelectasis. Otherwise, the lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 69600b21-dbe7530a-77b7aa8d-d291e1af-83f0b6cd.jpg,validate/p14/p14235312/s51200669/69600b21-dbe7530a-77b7aa8d-d291e1af-83f0b6cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with increased work of breathing // ? volume overload, consolidation TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior exam there is no significant interval change. IMPRESSION: No change. " 93b04dce-8c498091-76d4329c-0350dc84-92994c99.jpg,validate/p16/p16635089/s54079801/93b04dce-8c498091-76d4329c-0350dc84-92994c99.jpg,validation," WET READ: ___ ___ 11:49 PM The orogastric tube ends in the stomach. The endotracheal tube ends 3 cm above the carinal. Clear lungs. Stable cardiac and mediastinal silhouettes ___ ___ 23:48. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intubated, ogt placement resp failure // eval for OGT placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 4:10 p.m. IMPRESSION: The orogastric tube ends in the stomach. The endotracheal tube ends 3 cm above the carinal. Clear lungs except for right retrocardiac atelectasis . Stable cardiac and mediastinal silhouettes " 0c5f1614-966c1b31-a5a3870f-52ed8086-2b3e410c.jpg,validate/p12/p12997220/s55756425/0c5f1614-966c1b31-a5a3870f-52ed8086-2b3e410c.jpg,validation," FINAL REPORT INDICATION: Stroke. COMPARISON: ___. PORTABLE UPRIGHT AP VIEW OF THE CHEST: A right-sided dual-lumen pacemaker device is noted with leads terminating in the right atrium and right ventricle. Moderate enlargement of cardiac silhouette is relatively unchanged. The aorta is tortuous and diffusely calcified. Lung volumes are decreased from the prior study, which causes crowding of the bronchovascular structures. Small right pleural effusion has developed from the prior study, and there is mild patchy opacity in the right lung base which may represent area of atelectasis. No pneumothorax is present. IMPRESSION: Small right pleural effusion and patchy opacity in the right lung base which may reflect atelectasis. " adc62a54-3c51da1b-05ef3b48-f8d9ede6-0f9368ea.jpg,validate/p14/p14091568/s53246476/adc62a54-3c51da1b-05ef3b48-f8d9ede6-0f9368ea.jpg,validation," FINAL REPORT INDICATION: ___F with fever and cough // eval for pneumonia TECHNIQUE: PA and lateral views 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. " 8172c24d-019b3a36-03e2e1e1-fdc2affe-49437b26.jpg,validate/p14/p14571320/s50973532/8172c24d-019b3a36-03e2e1e1-fdc2affe-49437b26.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with cough, sweating, and diffuse rhonchi. IMPRESSION: PA and lateral chest compared to ___: Patient has a history of Hodgkin's disease treated with at least radiation, accounting for the non-physiologic appearance of the mediastinum and paramediastinal radiation changes in both upper lobes. Lateral view shows nodal calcification which has developed in the interim. There are no changes in the contours of the treated mediastinum to suggest tumor recurrence, although CT scanning would be much more sensitive in picking up a subtle recurrence. Lung periphery is clear. There is no pleural effusion. Heart size is normal. " c64ba5b6-72f9a2fc-51c75cd2-bb7dfced-5ce560a1.jpg,validate/p16/p16969625/s50368609/c64ba5b6-72f9a2fc-51c75cd2-bb7dfced-5ce560a1.jpg,validation," FINAL REPORT INDICATION: Bradycardia, shortness of breath, evaluate for pneumonia or heart failure. COMPARISONS: Chest radiograph, ___. SINGLE AP VIEW OF THE CHEST: Lung volumes are low. There is no focal consolidation to suggest pneumonia. Cardiac silhouette is enlarged; however, there are no findings of heart failure. There is no definite pleural effusion. No pneumothorax is seen. Patchy opacities are seen at the left lung base and are unchanged, likely representing atelectasis. Mediastinal contours and sternotomy wires are unchanged. IMPRESSION: No acute cardiopulmonary process. " 7306f941-7c5a3b5a-734b6d18-5d8069bb-eafd7b79.jpg,validate/p10/p10020944/s54060261/7306f941-7c5a3b5a-734b6d18-5d8069bb-eafd7b79.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man COPD s/p PNA and extubation // improvement TECHNIQUE: Portable semi-upright chest radiograph COMPARISON: ___ FINDINGS: Unchanged left PICC. Aeration of the right lung is essentially unchanged. Right lower lobe consolidation which may represent pneumonia, aspiration, or atelectasis, is unchanged. Cardiomediastinal contours are stable. IMPRESSION: No significant change since ___. " cad9d21d-4b96f65a-0b496cb1-0a71815d-eb5ff88d.jpg,validate/p19/p19631869/s54928011/cad9d21d-4b96f65a-0b496cb1-0a71815d-eb5ff88d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with PMHx notable for congestive heart failure (EF ___%), aortic stenosis s/p TAVR (___), 3-vessel coronary artery disease (s/p PCI of the LAD and RCA), paroxysmal afib (previously on amio), COPD on home oxygen, AAA s/p ___ ___ admitted for shortness of breath. // ? lung infiltrate COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have increased. Bilateral areas of parenchymal opacities at both the left and the right lung base have decreased in extent and severity. No new parenchymal opacities. No pulmonary edema. No larger pleural effusions. Known an unchanged scarring in the left upper lobe. Normal size of the heart, status post aortic valve replacement. Status post sternotomy. Mild elongation of the descending aorta. " 4059bc67-571d2df2-b02b18f2-814d0508-98c2bbdc.jpg,validate/p11/p11494804/s50519508/4059bc67-571d2df2-b02b18f2-814d0508-98c2bbdc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: PICC line placement. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: A right-sided PICC line terminates in the lower superior vena cava. The cardiac, mediastinal and hilar contours appear stable. The lungs appear clear. Although the left costophrenic sulcus is partly excluded, it appears effaced, so a trace pleural effusion is possible on that side. Metallic biliary stents project over the left upper quadrant. IMPRESSION: PICC line terminating in the superior vena cava. No findings suggestive of pneumonia. " 237a7f93-2362164a-fcd490bb-660774ac-3341143c.jpg,validate/p13/p13117765/s51819499/237a7f93-2362164a-fcd490bb-660774ac-3341143c.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: VATS right upper lobe wedge resection. IMPRESSION: AP chest compared to ___: Small right pleural effusion or pleural thickening remains, improved since ___. Mild-to-moderate cardiomegaly longstanding. Pulmonary vasculature no longer engorged. No pulmonary edema. Multiple lung nodules noted. " f7f0872c-63080f1e-68fc7487-775279fa-eedaa25f.jpg,validate/p10/p10496352/s59699644/f7f0872c-63080f1e-68fc7487-775279fa-eedaa25f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asthma and tbm // interval change interval change IMPRESSION: Comparison to ___. No relevant change. Minimal atelectasis at the left lung basis. No pneumonia, no pleural effusions, no pulmonary edema. Normal size of the heart. " 8c4f6fb6-b115e7a2-a632297c-4694c605-b81cd891.jpg,validate/p17/p17125981/s57373790/8c4f6fb6-b115e7a2-a632297c-4694c605-b81cd891.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post CABG with dropping hematocrit. Comparison is made with prior study ___. Increased opacity in the right lower lobe is consistent with atelectasis and small right pleural effusion. There are low lung volumes. There is no evident pneumothorax. Mild vascular congestion is unchanged. Left lower lobe retrocardiac opacity has increased consistent with increasing atelectasis. Lines and tubes are in unchanged standard position. " c680bf94-764e3a50-f1080e06-0930448c-c15e555b.jpg,validate/p15/p15367414/s58259750/c680bf94-764e3a50-f1080e06-0930448c-c15e555b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p CABG w/hypoxia r/o effusion/infiltrate s/p CABG w/hypoxia r/o effusion/infiltrate IMPRESSION: Comparison to ___. The minimal left apical pneumothorax is stable. No evidence of tension. Stable position of the left chest tube and of the other monitoring and support devices. Mild atelectasis at the right lung bases persists. Moderate cardiomegaly is unchanged. No overt pulmonary edema. " f151d2b1-ec9dc562-268c0263-ac0eeb6e-d53c2cc7.jpg,validate/p15/p15857820/s54630407/f151d2b1-ec9dc562-268c0263-ac0eeb6e-d53c2cc7.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG // interval change TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph FINDINGS: Lung volumes are low but improved compared to ___ chest radiograph. Bibasilar atelectasis and bilateral pleural effusion have also improved. Previously seen right IJ has been removed. There are no complications nor pneumothorax. There is stable mild cardiomegaly without pulmonary vascular congestion or pulmonary edema. Kyphosis of thoracic spine. Median sternotomy wires are intact and aligned. Mediastinal surgical clips are seen. IMPRESSION: 1. Overall improvement of lung volumes, bibasilar atelectasis and bilateral small pleural effusions without complete resolution. 2. Right IJ seen in ___ portable chest radiograph has been removed. No complications nor pneumothorax seen. " 32e2d9f8-063618ea-ddfd9069-f1cf0fac-30da9391.jpg,validate/p12/p12240787/s51108414/32e2d9f8-063618ea-ddfd9069-f1cf0fac-30da9391.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tracheal stenosis s/p revised T tube and partial thyroidectomy in OR on ___ // eval for interval change, pneumothorax eval for interval change, pneumothorax IMPRESSION: Compared to prior chest radiographs since ___ most recently 18:15 on ___. Previous mild pulmonary edema has improved. A small right pleural effusion, moderate cardiomegaly, and mediastinal venous engorgement are still present. Persistent abnormality in the right upper lobe was attributed to fissural pleural effusion but could be consolidation as well. Suggest a follow-up for possible pneumonia. Variable consolidation in the left lower lobe has been a recurrent feature, presumably atelectasis and/or aspiration. " 5065d49b-5ac58408-b84d89f2-9748b383-54adfb33.jpg,validate/p12/p12578647/s56383557/5065d49b-5ac58408-b84d89f2-9748b383-54adfb33.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post OLT, now evaluate for an acute chest process. Comparison is made with prior study performed a day earlier. Bibasilar opacities are consistent with atelectasis. There are lower lung volumes. Cardiomediastinal contours are normal. Lines and tubes are in unchanged standard positions. There is no pneumothorax or large pleural effusion. " 7101faef-041355c1-3a890dd6-2b979f79-be090fde.jpg,validate/p11/p11573149/s55410363/7101faef-041355c1-3a890dd6-2b979f79-be090fde.jpg,validation," FINAL REPORT CLINICAL INDICATION: Recent CABG and now fever. Evaluation for pneumonia. COMPARISON: Chest radiograph ___. FINDINGS: Portable semi-upright frontal view of the chest. There vascular congestion and moderate pulmonary edema have increased since ___. The mediastinal contour is widened. The heart is enlarged. Sternotomy wires and clips over the left mediastinum are related to the prior CABG procedure. There is contrast material in the left upper quadrant, likely from a prior imaging study. IMPRESSION: Moderate pulmonary edema and vascular congestion is worse since ___. COMMENT: ___ discussed with ___. " 258e79d5-500701f3-d77ebc71-099f1af0-817f7f39.jpg,validate/p18/p18813207/s50384453/258e79d5-500701f3-d77ebc71-099f1af0-817f7f39.jpg,validation," WET READ: ___ ___ ___ 9:26 AM Interval development of a small right and trace left pleural effusion with mild central vascular pulmonary congestion/edema. WET READ VERSION #1 ___ ___ ___ 7:02 PM Interval development of a small right and trace left pleural effusion with mild central vascular pulmonary congestion/edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new dx of Adult T cell lymphoma. Now hypoxic. // evidence of infiltrate, effusion TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: moderate right and small left pleural effusions have increased. There is mild vascular congestion. Cardiac size is top-normal. Widening mediastinum is again noted, patient has known mediastinal lymphadenopathy. There is no evident pneumothorax " f9f1831f-a6112d49-62685dda-c11ff2cd-e1d205ae.jpg,validate/p17/p17246353/s58585823/f9f1831f-a6112d49-62685dda-c11ff2cd-e1d205ae.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with MS, here with whole body 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. " 6895c9a2-46872c49-4535af38-38318cac-979b81b6.jpg,validate/p12/p12088626/s53602342/6895c9a2-46872c49-4535af38-38318cac-979b81b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cough, rising leukocytosis and tachycardia // Is there a new pulmonary process? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung parenchyma is normal. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " 187f221f-7291e14f-c9505840-b13359e6-35fcdfd0.jpg,validate/p14/p14003502/s58501372/187f221f-7291e14f-c9505840-b13359e6-35fcdfd0.jpg,validation," 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. " ea975acd-5122216a-8dcf9a49-c1fc9324-61b275dc.jpg,validate/p16/p16625317/s50418759/ea975acd-5122216a-8dcf9a49-c1fc9324-61b275dc.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with diarrhea // eval for infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Increased interstitial markings are again seen bilaterally, grossly similar as compared to the prior study, consistent with mild to moderate pulmonary vascular congestion. No pleural effusion is seen currently. The cardiac silhouette remains mild to moderately enlarged. Mediastinal contours are stable. No focal consolidation is seen. IMPRESSION: Mild to moderate pulmonary vascular congestion again seen, similar to prior. No definite pleural effusion seen on the current study. Persistent cardiomegaly. " 7040bf14-b8ecef3a-5f49a6e3-77abce89-400ba2e9.jpg,validate/p17/p17001101/s52821744/7040bf14-b8ecef3a-5f49a6e3-77abce89-400ba2e9.jpg,validation," FINAL REPORT INDICATION: ___M with chest tightness // ?cause for chest pain TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no effusion, consolidation, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 20089fb3-429319f2-4274aea1-f7e9b915-6d164dbd.jpg,validate/p16/p16388704/s58559756/20089fb3-429319f2-4274aea1-f7e9b915-6d164dbd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post endoscopy, new coughing, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have slightly decreased, and as a consequence, the heart appears minimally larger than on the previous examination. Otherwise, there is no relevant change, the lung parenchyma is normal. There is no evidence of pneumonia. No pleural effusions. No hilar or mediastinal abnormalities. Minimal tortuosity of the thoracic aorta. " 62c24e2b-3d3015a1-95271d1a-29fee7c7-f923afd1.jpg,validate/p14/p14868639/s55105526/62c24e2b-3d3015a1-95271d1a-29fee7c7-f923afd1.jpg,validation," 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. " 158cfcba-bacc4db6-930616d8-3f741efe-a607b292.jpg,validate/p15/p15975672/s57316131/158cfcba-bacc4db6-930616d8-3f741efe-a607b292.jpg,validation," WET READ: ___ ___ ___ 6:11 AM Right lower lobe pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, leukocytosis // Eval for PNA or acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Overall lung volumes are low.There is an opacity at the right lung base. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Right humeral hardware is present. IMPRESSION: Right lower lobe pneumonia. " 252dc5a7-de5d9bbb-f3c9a843-07b1fb8c-f83d2309.jpg,validate/p12/p12324647/s53512946/252dc5a7-de5d9bbb-f3c9a843-07b1fb8c-f83d2309.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with back pain // eval for back pain TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No definite focal consolidation is seen. There is no pleural effusion or a pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. The visualized thoracic vertebral body heights are grossly maintained. IMPRESSION: No acute cardiopulmonary process. " 65e29800-741ca93e-67488045-5fe72956-b0965e64.jpg,validate/p15/p15597371/s56799145/65e29800-741ca93e-67488045-5fe72956-b0965e64.jpg,validation," 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. " 8dde6ba4-2e2c16c3-34442da8-f4eb84cf-e87f714a.jpg,validate/p15/p15586571/s54863664/8dde6ba4-2e2c16c3-34442da8-f4eb84cf-e87f714a.jpg,validation," WET READ: ___ ___ ___ 12:04 PM Endotracheal tube tip is 6 cm above the carina. There is no pneumothorax. There is cardiomegaly, upper zone redistribution and blurring of vascular detail consistent with mild CHF. There appears to be an esophageal stent in the lower esophagus. A pigtail catheter tip is seen left upper quadrant. There is increasing atelectasis or consolidation in the left lower lobe. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with tachypnea. // assess for tachypnea COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: Endotracheal tube tip is 6 cm above the carina. There is no pneumothorax. There is cardiomegaly, upper zone redistribution and blurring of vascular detail consistent with mild CHF. There appears to be an esophageal stent in the lower esophagus. A pigtail catheter tip is seen left upper quadrant. There is increasing atelectasis or consolidation in the left lower lobe. " d74b1ff7-c49d8de4-5eb60fb6-b2587760-ea1a77af.jpg,validate/p15/p15844438/s52620367/d74b1ff7-c49d8de4-5eb60fb6-b2587760-ea1a77af.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Followup pulmonary edema. Comparison is made with prior study performed a day earlier. There are persistent low lung volumes. Cardiac size cannot be evaluated. Widened mediastinum is grossly unchanged. Mild vascular congestion has improved. Bibasilar atelectasis has improved on the left side. There is no pneumothorax or enlarging effusions. Right IJ catheter tip is in the lower SVC. " 79d782c0-58bb4e36-989b638f-e7ed6a16-100281f4.jpg,validate/p11/p11381413/s55780698/79d782c0-58bb4e36-989b638f-e7ed6a16-100281f4.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of ___, there are slightly lower lung volumes but no evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " c2e88237-cbb12865-651f54ba-b449e44d-789c240b.jpg,validate/p10/p10078115/s58448677/c2e88237-cbb12865-651f54ba-b449e44d-789c240b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with left basal ganglia hemorrhage and fever. COMPARISON: ___, ___. FINDINGS: Portable supine chest radiograph demonstrates superior migration of the endotracheal tube which is now located at least 6.3 cm from the level of the carina, with the change in position likely the result of the change in neck extension. An NG tube is in place, its tip is not seen below the inferior margin of the film. An esophageal temperature probe is in place. A right subclavian central venous catheter tip is located at the cavoatrial junction. The lungs are clear, with somewhat low lung volumes. There is no pleural effusion or pneumothorax. The cardiac silhouette and mediastinal contours are unchanged. IMPRESSION: 1. ETT tube now at least 6.3 cm from the carina, suggest advancement for more optimal positioning. 2. No acute chest abnormality. " 88483e85-612722da-457d03e1-d7e660d4-080e12de.jpg,validate/p16/p16105001/s52847424/88483e85-612722da-457d03e1-d7e660d4-080e12de.jpg,validation," WET READ: ___ ___ ___ 5:01 PM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with fatigue, pain between the shoulder blades // r/o PNA, pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___. FINDINGS: Top normal heart size noted not significantly changed. Hilar and mediastinal contours are normal. The lungs are clear without focal consolidation, effusion or pneumothorax. Minimal basal atelectasis is noted on the left side. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Top normal heart size, mild left basal atelectasis. Otherwise unremarkable. " 06d0887e-d1594839-946e938f-32b8711c-35bf246d.jpg,validate/p10/p10476869/s57858155/06d0887e-d1594839-946e938f-32b8711c-35bf246d.jpg,validation," 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. " d3275e55-9f81d289-64fa86d9-36dbae81-381a8afe.jpg,validate/p12/p12982394/s51669577/d3275e55-9f81d289-64fa86d9-36dbae81-381a8afe.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The aorta remains tortuous. The cardiac silhouette is top normal. IMPRESSION: No acute cardiopulmonary process. " 3a8ad427-339e3218-edad034e-d8bba9a1-dbd58800.jpg,validate/p18/p18981235/s55275160/3a8ad427-339e3218-edad034e-d8bba9a1-dbd58800.jpg,validation," 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. " 5c756224-9e79487c-aa2b2ad0-e24b0c8e-1af9aeab.jpg,validate/p15/p15874317/s57669135/5c756224-9e79487c-aa2b2ad0-e24b0c8e-1af9aeab.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with dyspnea. 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 overall heart size is at the upper limit of normal variation. No typical configurational abnormality is identified. There is a relative prominence of the left ventricular contour to the left and posteriorly but no signs of significant left atrial enlargement is present. The thoracic aorta is generally moderately widened and shows extensive wall calcifications predominantly in the arch, but also extending into the descending aorta. On the lateral view, the typical calcifications in the aortic valve are identified. A permanent pacer is located in left anterior axillary position that is connected to two intracavitary electrodes, one of which terminates towards the right atrial appendage, the second terminates in the apical portion of the right ventricle. These findings are stable when compared with the next preceding examination when the patient had to be examined in sitting semi-upright position using AP frontal projection view. The latter finding explains that the heart shadow appeared somewhat larger than it is now. Pulmonary vasculature is not congested and there is no evidence of any acute or chronic parenchymal infiltrates. Lateral and posterior pleural sinuses are free and no pneumothorax is identified in the apical area. IMPRESSION: Stable chest findings in elderly female patient with permanent pacer, dual electrodes in place, borderline heart size but no evidence of pulmonary vascular congestion or any acute infiltrates. Extensive aortic wall calcifications and calcium deposits in the aortic valve area already seen on previous examinations. " 9804ebe9-94585e59-6a8ad2d7-fc266a94-78fcf349.jpg,validate/p10/p10078115/s52365458/9804ebe9-94585e59-6a8ad2d7-fc266a94-78fcf349.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with intracranial hemorrhage, now status post external ventricular drain placement. COMPARISON: ___ - ___. FINDINGS: Portable upright chest radiograph demonstrates an endotracheal tube with its tip at the level of the clavicular heads. An NG tube passes through the stomach, and a right subclavian central venous catheter tip is at the cavoatrial junction. There is an interval decrease in lung volumes; small bilateral pleural effusions and bibasilar atelectasis is mild and increased. The cardiac silhouette is enlarged and unchanged. The mediastinal contours are little changed. Pulmonary vasculature is normal and improved. IMPRESSION: 1. Endotracheal tube projects just beyond the thoracic inlet, and might be advanced 1.5 cm for more optimal seating. 2. Interval decrease in lung volumes with increase in bibasilar atelectasis and small bilateral pleural effusions, although edema has improved. " c074a370-9c7ca429-08af699b-8e17f736-51fb9617.jpg,validate/p13/p13598624/s50835225/c074a370-9c7ca429-08af699b-8e17f736-51fb9617.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with trauma. COMPARISON: None. TECHNIQUE: Single supine AP view of the chest. FINDINGS: The lungs are clear. Cardiac silhouette is slightly enlarged, probably due to fluid resuscitation. There is no pleural effusion, pneumothorax or pneumonia identified. IMPRESSION: No evidence of acute cardiopulmonary process. " b6692b1e-2b09e7ca-32ca9ab3-d4d2e63d-60681b4e.jpg,validate/p15/p15754509/s53577183/b6692b1e-2b09e7ca-32ca9ab3-d4d2e63d-60681b4e.jpg,validation," FINAL REPORT AP CHEST, 6:12 A.M., ___ HISTORY: Gastric resection. Multiple intestinal perforations. Right thoracentesis. Question mucous plug. IMPRESSION: AP chest compared to ___: Moderate right pleural effusion slightly smaller. Small-to-moderate left pleural effusion and mild interstitial edema both unchanged. No pneumothorax. The right pigtail catheter is folded several times at mid level in the right hemithorax and could be partially occluded. Right lower lobe is partially obscured by the heart because of patient rotation. There is some volume loss, but none appreciably changed since ___ Left lung is fully expanded and right upper and middle lobes are not atelectatic. " e2d3bfb5-9deb4497-76052333-68765c02-8c6e9d47.jpg,validate/p17/p17135687/s59559187/e2d3bfb5-9deb4497-76052333-68765c02-8c6e9d47.jpg,validation," FINAL REPORT INDICATION: ___M w/ GSW x 4 to chest; intubated, s/p BL CT w/ initial output approx 1 L w/ T4 paraplegia // assess for interval changes EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: Moderate right pneumothorax is similar to ___. There is increased subpulmonic component of the pneumothorax. Moderate left pleural effusion and lung base atelectasis is similar to prior. Slight left mediastinal shift is stable. 2 right and 1 left chest tubes are in unchanged position. Tracheostomy tube is unchanged in position. Transesophageal tube courses below the diaphragm and out of view. Multiple bullet fragments are in unchanged position. IMPRESSION: Moderate right pneumothorax and left lung base atelectasis is similar to ___. " 26104f40-3500c70a-c50d51f7-11cf2687-23800df4.jpg,validate/p11/p11124675/s54566416/26104f40-3500c70a-c50d51f7-11cf2687-23800df4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with influenza, ? pna on admission, now clinically improved, please eval for pna at lung bases, interval change v admit pa/lat as rec by Dr. ___ // ___ year old woman with influenza, ? pna on admission, now clinically improved, please eval for pna at lung bases, interval change v admit pa/lat as rec by Dr. ___ ___: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is enlarged, unchanged. Mediastinal contour including prominence of the main pulmonary artery. And known para-aortic lymphadenopathy are unchanged. No interval development of parenchymal abnormality is demonstrated. No new focal consolidations seen. No confirmation of previously suspected lung bases abnormalities as seen on the current examination " d1681b28-1be87b98-b05bc566-159993dd-4e83a805.jpg,validate/p18/p18291658/s53417462/d1681b28-1be87b98-b05bc566-159993dd-4e83a805.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with metastatic gastroesophageal CA on palliative chemo presents with abdominal radiation to back pain. // Please do CXR upright . Eval for obstruction, perforation, pancreatitis, kidney stones. TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Distal aspect of right Port-A-Cath is not well seen, but may terminate in the mid to low SVC without evidence of pneumothorax. Lungs are clear without focal consolidation. Slight blunting left costophrenic angle seen which may be due to pleural thickening versus trace pleural effusion. The cardiac and mediastinal silhouettes are stable. There is no pulmonary edema. No evidence of free air is seen beneath the diaphragms. IMPRESSION: Slight blunting of the left costophrenic angle is nonspecific and may be due to pleural thickening versus trace pleural effusion. " ba78675d-e2a9d999-8ba90392-a9af83f0-083513b0.jpg,validate/p10/p10610928/s50296889/ba78675d-e2a9d999-8ba90392-a9af83f0-083513b0.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with new feeding tube placement. COMPARISON: ___. FINDINGS: There are new bibasilar opacities which likely reflect atelectasis, though superimposed aspiration might also have this appearance in this gentleman who presented with seizure. Bilateral apical opacities are new from prior and may reflect developing apical pulmonary edema, possibly from a neurogenic cause. There is no effusion or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal. An NG tube is in place, the tip is in the stomach with sidehole in the distal esophagus, this may be advanced several centimeters for more optimal positioning. The ET tube tip is positioned ~ 6 cm above the level of the carina. IMPRESSION: 1. Bibasilar atelectasis with possible aspiration in this patient with seizure. 2. Developing apical opacities which may reflect developing neurogenic pulmonary edema, recommend attention on followup. " 84832fff-7a009bd3-a66212d6-16058751-d73a7bb1.jpg,validate/p15/p15367414/s58382238/84832fff-7a009bd3-a66212d6-16058751-d73a7bb1.jpg,validation," 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. " ea492071-ce8640f9-c8defff5-9776e373-f41e943c.jpg,validate/p19/p19053616/s57952844/ea492071-ce8640f9-c8defff5-9776e373-f41e943c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SBO s/p NGT placement // NGT placement TECHNIQUE: Portable AP COMPARISON: Chest radiograph on ___ and ___. FINDINGS: An NG tube ends in the stomach and should be advanced 5 cm for appropriate placement. 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. IMPRESSION: 1. NG tube should be advanced 5 cm for appropriate placement. No acute cardiopulmonary process. " 038cb9a5-5fbba2a8-92ff439e-493026fd-b0dc8019.jpg,validate/p19/p19685014/s54669691/038cb9a5-5fbba2a8-92ff439e-493026fd-b0dc8019.jpg,validation," FINAL REPORT INDICATION: ___F with kidney/panc transplant and RCA stenting with sharp left sided CP. // pneumonia? TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. Calcified mediastinal lymph nodes are again noted. No acute osseous abnormalities. Right-sided breast implant is noted. IMPRESSION: No acute cardiopulmonary process. " 4b673a26-3822f4b8-314679f6-1a8033ec-0d8007d3.jpg,validate/p18/p18656167/s59848195/4b673a26-3822f4b8-314679f6-1a8033ec-0d8007d3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with shortness of breath // eval for infiltrate COMPARISON: ___. FINDINGS: AP portable upright view of the chest. Lung volumes are low with bronchovascular crowding likely accounting for subtle opacities in the lower lungs. The possibility of an early pneumonia is difficult to exclude in the correct clinical setting. No large effusion or pneumothorax. Heart and mediastinal contours are normal.Imaged osseous structures are intact. IMPRESSION: Subtle opacity in the lower lungs likely bronchovascular crowding, though difficult to exclude an early pneumonia. " 29914f1e-d56c776d-06514f7e-8fd03226-656601cf.jpg,validate/p10/p10021927/s56404554/29914f1e-d56c776d-06514f7e-8fd03226-656601cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxic respiratory failure s/p intubation // Confirm ET tube placement Confirm ET tube placement IMPRESSION: The tip of the endotracheal tube measures approximately 4.5 cm above the carina. Little change in the appearance of the heart and lungs from the study of 1 hour previously. " ffcecbb8-80c37257-feef5100-f94ab7c5-e7ad6e84.jpg,validate/p15/p15996479/s52742270/ffcecbb8-80c37257-feef5100-f94ab7c5-e7ad6e84.jpg,validation," WET READ: ___ ___ ___ 5:56 PM Subtle opacity at the right lung base medially which could represent atelectasis although pneumonia would be possible in the proper clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with asthma, p/w cough and SOB x 5d, no fevers // evaluate for pneumonia TECHNIQUE: PA and lateral views the chest. COMPARISON: Multiple previous exams dating back to ___ with most recent from ___. FINDINGS: There is subtle focal consolidation identified at the right lung base medially also seen overlying the heart posteriorly on the lateral view. This is new since most recent prior but is similar to opacity seen on prior exam dated ___. Elsewhere, lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Subtle opacity at the right lung base medially which could represent atelectasis although pneumonia would be possible in the proper clinical setting. " 5adc29b9-49d68148-173a78c4-41fc319d-f8d51bfc.jpg,validate/p17/p17967970/s51979569/5adc29b9-49d68148-173a78c4-41fc319d-f8d51bfc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with non-small cell lung ca s/p VATS RUL wedge resection. // post-chest tube pull 4hrs post (14:45) TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 7 hours earlier IMPRESSION: Small right apical hydro pneumothorax has minimally enlarged. Small layering bilateral effusions are otherwise stable. Chest tube has been removed. No other interval changes from prior study. " dca6c764-5f11a9b8-db721b98-dd5f7dfd-f179bfc7.jpg,validate/p19/p19898065/s55566269/dca6c764-5f11a9b8-db721b98-dd5f7dfd-f179bfc7.jpg,validation," FINAL REPORT HISTORY: Chest discomfort. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. Very minor atelectasis/scarring is seen at the lingula. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " d39ed236-02b16992-c889ed9c-647aefc2-5818354c.jpg,validate/p14/p14286831/s51327796/d39ed236-02b16992-c889ed9c-647aefc2-5818354c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with low ___ sat in the setting of alcohol withdrawal. // eval for possible aspiration. TECHNIQUE: Chest single view COMPARISON: ___ FINDINGS: Shallow inspiration. Increased pulmonary vascularity compared prior exam. Borderline heart size. Small right pleural effusion, new. Bibasilar opacities, atelectasis versus infiltrate. Benign calcified paratracheal lymph node. IMPRESSION: Increased pulmonary vascularity. Right pleural effusion. Bibasilar opacities, atelectasis versus infiltrate. " 26434631-c70ae548-f0495dd0-67b828be-eba5ee33.jpg,validate/p17/p17886133/s56629981/26434631-c70ae548-f0495dd0-67b828be-eba5ee33.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with chest pain // chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Post CABG cardiomediastinal changes are noted. A coronary stent is noted. Severe kyphosis noted. IMPRESSION: No acute cardiopulmonary process. " da60eff0-af6e7692-9c0ca266-657316cd-72cffa24.jpg,validate/p12/p12089662/s53249647/da60eff0-af6e7692-9c0ca266-657316cd-72cffa24.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure , TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Right IJ catheter tip is in themid SVC. Cardiac size is top normal. ET tube is in standard position. NG tube tip is out of view below the diaphragm. There are persistent low lung volumes. There is no evident pneumothorax. Bilateral opacities likely aspiration pneumonia have improved on the right. There are no new lung abnormalities. " aa969749-48c067f2-aec20601-0e9547a2-308242b6.jpg,validate/p13/p13417577/s53575102/aa969749-48c067f2-aec20601-0e9547a2-308242b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea // eval for acute process COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Airspace consolidation within the left lower lobe is concerning for pneumonia. The previously noted right pleural effusion has resolved. A cavitary structure in the left lung apex measures 2.6 x 2.6 cm with peripheral/apical opacity could reflect prior infection or malignancy. A retrocardiac opacity better assessed on previous imaging is consistent with a known hiatal hernia. Please correlate clinically. Cardiomediastinal silhouette is stable. Bony structures appear intact. IMPRESSION: 1. Left lower lobe pneumonia. 2. Cavitary lesion in the left apex with apical opacity, question sequelae of old infection/malignancy. Consider CT to further assess once the acute symptoms resolve. 3. Hiatal hernia. " a1f5e354-0ae7624d-b28b2736-9896b76a-8a5de018.jpg,validate/p16/p16952127/s58934633/a1f5e354-0ae7624d-b28b2736-9896b76a-8a5de018.jpg,validation," FINAL REPORT EXAM: Chest, single erect portable view. CLINICAL INFORMATION: CHF, shortness of breath. COMPARISON: ___. FINDINGS: Single erect AP portable view of the chest was obtained. The left hemidiaphragm remains elevated. There is blunting of the left costophrenic angle, which could be due to a small pleural effusion. Left retrocardiac opacity is seen, which may be due to underpenetration, although underlying consolidation and/or pleural effusion, atelectasis not excluded. There is prominence of the central vasculature and the interstitium suggesting pulmonary edema. The cardiac silhouette is enlarged. The aortic knob is calcified. " f0a3c9cd-2fa54a01-ad2dc57d-975467f1-3e4a9f03.jpg,validate/p17/p17421663/s58957294/f0a3c9cd-2fa54a01-ad2dc57d-975467f1-3e4a9f03.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Multifocal pneumonia, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a relatively massive increase in extent and severity of the pre-existing multifocal pneumonia. The pneumonia is more severe in both the right upper and lower lobe and in the left upper lobe. No evidence of pleural effusions. Unchanged size of the cardiac silhouette. No pneumothorax. " 78ba3b3c-baf0ce66-c7f776fa-51593808-06b1bae0.jpg,validate/p14/p14120635/s57975511/78ba3b3c-baf0ce66-c7f776fa-51593808-06b1bae0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with toxic metabolic encephalopathy // Interval change Interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous mild pulmonary edema has cleared. Severe enlargement of cardiac silhouette has slightly improved. Moderate left pleural effusion is smaller but severe consolidation persists at the base of the left lung either atelectasis, or pneumonia. No pneumothorax. Tracheostomy tube midline. Right PIC line ends in the low SVC. Esophageal drainage tube passes into a nondistended stomach and out of view. " 19b3c87e-a47ec107-690a9491-d40bae8c-6813cf82.jpg,validate/p16/p16970050/s53257797/19b3c87e-a47ec107-690a9491-d40bae8c-6813cf82.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ngt placement // ?location of NGT ?location of NGT IMPRESSION: The study of ___, there has been placement of a nasogastric tube that extends only to the upper stomach with the side port proximal to the esophagogastric junction. The tube should be pushed forward about 8-10 cm for more optimal positioning. Patient has taken a better inspiration. Left hemidiaphragm is now sharply seen, consistent with resolution of pleural effusion and volume loss in left lower lobe. Tube extending from the neck to the abdomen could represent a ventriculoperitoneal shunt. " 3035cc38-9d8f40e2-4b07da1d-b40c08ab-e9811ea2.jpg,validate/p15/p15426827/s58192939/3035cc38-9d8f40e2-4b07da1d-b40c08ab-e9811ea2.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with HCC and failure to thrive, status post PICC placement. FINDINGS: Single frontal view of the chest demonstrates a right PICC with tip at the caval-brachiocephalic junction. An enteric tube traverses below the diaphragm into the stomach and out of view. There is now complete opacification of the right hemithorax with left shift of the trachea and cardiomediastinal silhouette, consistent with a large pleural effusion. The left lung is decreased in volume but relatively well aerated. There is no large effusion on the left. Limited view of the right humerus raises question of osseous demineralization. IMPRESSION: 1. Right PICC with tip at the caval-brachiocephalic junction. 2. Marked increase of right pleural effusion, now opacifying the entire right hemithorax. " 3a07bff8-e4c817f4-106550ca-24b920af-c13157c9.jpg,validate/p11/p11902171/s59684877/3a07bff8-e4c817f4-106550ca-24b920af-c13157c9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with PICC replacement // Evaluate for PICC placement TECHNIQUE: Portable semi upright AP view of the chest COMPARISON: ___ FINDINGS: Left PICC tip terminates in the mid SVC. Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. Skin ___ project over the right humeral head. IMPRESSION: Left PICC tip terminates in the mid SVC. " 6e16e296-b37e0620-1dbcbcfe-f6ec58bb-83d33d60.jpg,validate/p16/p16381668/s52524496/6e16e296-b37e0620-1dbcbcfe-f6ec58bb-83d33d60.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST. REASON FOR EXAM: Intubated patient, patient with severe head bleed, assess NG tube. Comparison is made with prior study ___. NG tube tip is out of view below the diaphragm. ET tube tip is in standard position 6.4 cm above the carina. Moderate cardiomegaly and tortuous aorta are stable. Right subclavian catheter tip is at the cavoatrial junction or upper right atrium. There is no pneumothorax. Bibasilar opacities, larger on the left side, are a combination of small effusions and adjacent atelectasis. Left perihilar atelectases are unchanged. There is mild stable vascular congestion. " e594d76e-5804f07c-ae813e81-d9404d8f-5132f809.jpg,validate/p17/p17774821/s58334838/e594d76e-5804f07c-ae813e81-d9404d8f-5132f809.jpg,validation," 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. " 35728a42-f0df8e8c-854f7885-86e32537-272f07cb.jpg,validate/p19/p19015407/s54556418/35728a42-f0df8e8c-854f7885-86e32537-272f07cb.jpg,validation," 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. " 596ad6f5-8bab2b9c-a34dc664-aff7c451-eab22c6a.jpg,validate/p16/p16413527/s52978234/596ad6f5-8bab2b9c-a34dc664-aff7c451-eab22c6a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, hypoxia // r/o pneumonia TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. There is pectus excavatum causing slight chronic leftward mediastinal shift. IMPRESSION: No evidence of acute cardiopulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:54 AM, 25 minutes after the discovery of the findings. " 3f4b5692-cb209fd8-8f35d602-f84da3c4-05150110.jpg,validate/p17/p17623580/s52949910/3f4b5692-cb209fd8-8f35d602-f84da3c4-05150110.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Tracheobronchomalacia. Acute on chronic shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including enlargement of the left ventricle. There is a marked elevation of the right hemidiaphragm, as seen previously, with streaky associated right basilar opacity suggesting atelectasis. There is no pleural effusion or pneumothorax. Bony structures are unremarkable. There has been no definite change. IMPRESSION: No evidence of acute cardiopulmonary disease. " 3051fef1-27db804a-787b141a-0cfbb572-19b033b5.jpg,validate/p19/p19175407/s57705667/3051fef1-27db804a-787b141a-0cfbb572-19b033b5.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with SOB. TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ at 11:34 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. The patient is status post median sternotomy and CABG. Left-sided 2 lead pacemaker is stable in position. IMPRESSION: No acute cardiopulmonary process. " 904b2715-3a0b1fa2-f3001b04-8f57adb4-59109bc2.jpg,validate/p11/p11951880/s58538646/904b2715-3a0b1fa2-f3001b04-8f57adb4-59109bc2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with diffuse pulmonary nodules status post VATS wedge biopsy COMPARISON: Chest radiographs since ___, most recently ___. FINDINGS: AP view of the chest provided. Again seen are diffuse nodular opacities in bilateral lungs, little change compared to prior study. There is minimal right-sided subcutaneous emphysema, likely from recent biopsy. No pneumothorax seen. IMPRESSION: Diffuse nodular opacities, little change from prior study. " 1e272277-3907e63d-b3b4e966-50e061d2-a76269b7.jpg,validate/p11/p11272182/s58765548/1e272277-3907e63d-b3b4e966-50e061d2-a76269b7.jpg,validation," WET READ: ___ ___ ___ 9:52 PM Malpositioned right subclavian central venous catheter with tip likely in the left subclavian vein. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with right subclavian line TECHNIQUE: Supine AP view of the chest COMPARISON: ___ at 19:19 FINDINGS: Right subclavian central venous catheter tip is malpositioned, coursing across the midline, and tip likely within the left subclavian vein. The endotracheal tube has been withdrawn, with tip now terminating approximately 5 cm from the carina. Enteric tube remains in unchanged position. No pneumothorax is demonstrated. Patchy opacities in the lung bases likely reflect atelectasis, but aspiration is not excluded. No large pleural effusion is present. The cardiac and mediastinal contours are unchanged. IMPRESSION: 1. Malpositioned right subclavian central venous catheter with tip likely in the left subclavian vein. 2. Endotracheal tube has been withdrawn, now in standard position. " 00dc6377-b4cdfc0b-44b95713-a9c67922-ec90bf47.jpg,validate/p10/p10900906/s54445253/00dc6377-b4cdfc0b-44b95713-a9c67922-ec90bf47.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. CLINICAL 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. Cardiomediastinal silhouette is within normal limits. Presumed intrathecal pump components seen projecting over the upper thoracic spinal canal. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8a974b55-7905aeef-de50b2d2-243b8217-904e73f2.jpg,validate/p15/p15278197/s57371906/8a974b55-7905aeef-de50b2d2-243b8217-904e73f2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with avr // r/o ptx, s/p ct d/c TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: There is a small residual pneumomediastinum, decreased compared to the prior study. Widening of the mediastinum is similar in degree. Mild pulmonary vascular engorgement persists with linear atelectasis in the right lung base, at the site of the prior chest drain. The chest tubes have been removed. The Swan-Ganz catheter has been removed, a large poor right internal jugular catheter terminates in the mid SVC. There is a focal airspace opacity adjacent to the left heart border which likely reflects atelectasis but infection cannot be excluded. IMPRESSION: No pneumothorax seen. Linear atelectasis at the right lung base. An opacity adjacent the left heart border likely reflects atelectasis, infection cannot be excluded. " 7ff7ca4e-c0efbdc6-73306eff-524bc39f-475f50d4.jpg,validate/p10/p10364180/s58001632/7ff7ca4e-c0efbdc6-73306eff-524bc39f-475f50d4.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with study of ___, there is again enlargement of the cardiac silhouette. Progressive improvement in pulmonary vascular congestion as well as the opacification at the right base. No evidence of pneumothorax. " ea9916fe-ba305f19-5ac1b161-373d5a5c-0f394884.jpg,validate/p16/p16984543/s57643427/ea9916fe-ba305f19-5ac1b161-373d5a5c-0f394884.jpg,validation," FINAL REPORT HISTORY: Female with hypertension, diabetes and few months of progressive dyspnea on exertion. Assess for pneumonia. COMPARISON: Chest radiograph ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Low lung volumes bilaterally with clear lungs. No pleural effusion or pneumothorax. Heart size is top normal with tortuous aorta and normal mediastinal contour and hila. Moderate degenerative change of thoracic spine without additional bony abnormality. IMPRESSION: Low lung volumes bilaterally. No pneumonia. " 8708ba6f-757e83e1-b0cf42f4-36da9d87-94845b9f.jpg,validate/p18/p18074247/s51038308/8708ba6f-757e83e1-b0cf42f4-36da9d87-94845b9f.jpg,validation," FINAL REPORT HISTORY: Fever, tachycardia. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Nerve stimulator device projects over the left mid hemithorax with a single lead coursing cephalad into the neck. Heart size remains mildly enlarged. Mediastinal and hilar contours are unremarkable. Streaky retrocardiac opacity may reflect atelectasis but infection is not excluded. No pleural effusion or pneumothorax is present. There is no pulmonary vascular congestion. Remote right mid clavicular fracture is re- demonstrated. IMPRESSION: Streaky retrocardiac opacity could reflect atelectasis but infection cannot be completely excluded. " 4bec5083-c8a5e44d-53850699-da61a58f-24a7d27a.jpg,validate/p16/p16557329/s55986715/4bec5083-c8a5e44d-53850699-da61a58f-24a7d27a.jpg,validation," 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. " b983e49f-53c6624b-fd7a6bce-c6334f34-cee90ab9.jpg,validate/p10/p10425278/s51089363/b983e49f-53c6624b-fd7a6bce-c6334f34-cee90ab9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough/fever. hx carcinoid resection // ? pneumonia ? pneumonia IMPRESSION: Heart size and mediastinum are stable. Bi apical scarring, right mediastinal shift and cystic opacities in the it SS are stable. Pleural thickening in the right costophrenic angle is unchanged. No new focal consolidations or masses seen. " 08b2444a-7e3cd396-0cb5f9c6-489b8f4c-73144e62.jpg,validate/p12/p12888020/s58406006/08b2444a-7e3cd396-0cb5f9c6-489b8f4c-73144e62.jpg,validation," FINAL REPORT HISTORY: Severe malnutrition. Evaluate for cardiopulmonary process. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The heart is of normal size with normal cardiomediastinal contours. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body. IMPRESSION: No evidence for acute cardiopulmonary process. " d38b16f9-625522c2-e32c8e9f-22c4aa87-3bdb29d1.jpg,validate/p15/p15289580/s57392289/d38b16f9-625522c2-e32c8e9f-22c4aa87-3bdb29d1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxic resp failure, multifocal pna, unable to wean O2, followup on infiltrates, edema COMPARISON: Chest radiograph from ___. FINDINGS: AP view of the chest provided. Compared to prior study from a day ago, there is no significant change with respect to the multi-focal consolidation. Right central line terminates int the low SVC. IMPRESSION: Similar extensive multi-focal pneumonia. " 104602ba-0cbe70a6-c436c9c7-49c4aea0-b5154f14.jpg,validate/p13/p13484611/s56489525/104602ba-0cbe70a6-c436c9c7-49c4aea0-b5154f14.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p ICD // confirm lead placement TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Pacemaker leads terminate in right atrium and right ventricle expected location. There is no pneumothorax Lungs are clear except for left mid lung calcified granuloma and left hilar calcified lymph nodes, reflecting prior granulomatous exposure. " 47986574-371ebb79-2f83cdab-32003b77-5a2e5948.jpg,validate/p16/p16190725/s54810136/47986574-371ebb79-2f83cdab-32003b77-5a2e5948.jpg,validation," WET READ: ___ ___ 9:24 AM Severe enlargement of the cardiac silhouette, increased from the prior likely related to pericardial effusion given history with new moderate pulmonary edema and bilateral pleural effusions. WET READ VERSION #1 ___ ___ 7:43 PM Severe enlargement of the cardiac silhouette, increased from the prior likely related to pericardial effusion given history with new moderate pulmonary edema and bilateral pleural effusions. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman pre-pericardial window for tamponade // pre-op baseline study in unstable patient Surg: ___ (pericardial window) COMPARISON: Chest radiographs ___ IMPRESSION: Moderate to large bilateral pleural effusion, left greater than right, increased since ___. Interval increase in already moderately enlarged cardiomediastinal silhouette is due at least to progressive cardiomegaly and mediastinal venous engorgement but perhaps to mediastinal or pericardial fluid collection as well. Mild pulmonary edema may have developed, but the severity is exaggerated by the con current pleural effusions. " 6cff059d-d8238798-fd869b78-a1647e83-93146336.jpg,validate/p12/p12852471/s50371763/6cff059d-d8238798-fd869b78-a1647e83-93146336.jpg,validation," FINAL REPORT INDICATION: History of trauma, question pneumothorax. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs provided. FINDINGS: The lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Spinal fusion hardware is present within the thoracolumbar spine. IMPRESSION: No evidence of pneumothorax. " 21b6228a-c8a685d1-0ec683eb-27dbcedf-1562d60f.jpg,validate/p18/p18969321/s59088595/21b6228a-c8a685d1-0ec683eb-27dbcedf-1562d60f.jpg,validation," 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. " 6a2bf05f-ad8538e8-2d0421c0-d1389aea-ada53fd9.jpg,validate/p12/p12458842/s51546509/6a2bf05f-ad8538e8-2d0421c0-d1389aea-ada53fd9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with sob/JVD/tachy // R/O CHF COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is marked cardiomegaly with mild pulmonary edema. Tiny right pleural effusion is present. No pneumothorax. No convincing signs of pneumonia. Mediastinal contour appears grossly unremarkable. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Cardiomegaly with mild edema and tiny right pleural effusion. " 58d02b48-613058ae-90386b4c-2aa1107f-89ed0891.jpg,validate/p13/p13602190/s53702850/58d02b48-613058ae-90386b4c-2aa1107f-89ed0891.jpg,validation," WET READ: ___ ___ ___ 1:38 PM 1. No evidence of acute cardiopulmonary process. 2. Hyperexpansion suggesting COPD. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with s/p recent liver biopsy now with pleuritic chest discomfort and SOB, evaluate for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. Hyperexpansion suggests COPD. Mild thoracic scoliosis is unchanged. Hyperdensity overlying the anterior aspect of a lower thoracic intervertebral space likely represents superimposition of structures. Cholecystectomy clips are noted projecting over the right upper quadrant. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Hyperexpansion suggesting COPD. " 3be3e6fc-159c8929-844c207b-525a21d9-4b17dcfb.jpg,validate/p14/p14537217/s58961251/3be3e6fc-159c8929-844c207b-525a21d9-4b17dcfb.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old man with productive cough. FINDINGS: Comparison is made to prior study, ___. The heart size is within normal limits. There is some atelectasis at the lung bases; however, no definite areas of consolidation are seen. There are no pleural effusions. There are no pneumothoraces. No cavitating areas are seen. Bony structures are intact aside for mild degenerative changes of the right AC joint. " cec81ee9-b2e7c03a-4cc60300-cbfcbb64-b8d31e09.jpg,validate/p17/p17011846/s50666514/cec81ee9-b2e7c03a-4cc60300-cbfcbb64-b8d31e09.jpg,validation," FINAL REPORT INDICATION: Hypoxia, intoxicated, evaluate for infiltrate. COMPARISON: ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. Bony structures are intact. IMPRESSION: No acute cardiopulmonary process. " efd16427-ebde1c86-4c1e2640-ec626d6f-667b04ca.jpg,validate/p10/p10679975/s50479271/efd16427-ebde1c86-4c1e2640-ec626d6f-667b04ca.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with cough, pneumonia. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. No acute skeletal abnormalities. IMPRESSION: No acute cardiopulmonary process. " 1bece0d3-aee75fbd-0d99538f-5b9dc964-18fe7c69.jpg,validate/p18/p18171555/s55488152/1bece0d3-aee75fbd-0d99538f-5b9dc964-18fe7c69.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with left chest pain. Dyspnea status post fall. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates low lung volumes. There is a non displaced fractures are identified within the posterior ___ left rib. Linear lucency within the posterior fifth rib is thought to be artifactual. There is no focal consolidation. Heart size is within upper limits of normal. Mediastinal and hilar contours are unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: Nondisplaced fracture through the posterior fourth rib. No pneumothorax. NOTIFICATION: Findings discussed with doctor ___ by Dr. ___ at 13:19 on ___. " 8fcd37f9-a352a7cc-1f60d64d-ce07b5f1-c5e1d65d.jpg,validate/p11/p11551769/s54383084/8fcd37f9-a352a7cc-1f60d64d-ce07b5f1-c5e1d65d.jpg,validation," 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 ___. " 804b6ed2-d6a7fb42-77b461e6-839de5f6-8361d6c3.jpg,validate/p18/p18911164/s51230794/804b6ed2-d6a7fb42-77b461e6-839de5f6-8361d6c3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with productive 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. " abbb4417-b2eca7b7-5a14e30f-8eeb2a6e-9b0bb933.jpg,validate/p13/p13505226/s51891019/abbb4417-b2eca7b7-5a14e30f-8eeb2a6e-9b0bb933.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Fever and abdominal pain, question consolidation. FINDINGS: PA and lateral views of the chest were provided. Since the prior exam, the NG tube has been removed. There are low lung volumes with basilar lung atelectasis noted. No definite signs of pneumonia, effusion or pneumothorax. The cardiomediastinal silhouette appears grossly stable. No free air below the right hemidiaphragm. The bony structures are intact. " bf994ad9-8de6d750-0bb74ef4-ee6304f1-77f52414.jpg,validate/p19/p19743260/s56113237/bf994ad9-8de6d750-0bb74ef4-ee6304f1-77f52414.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain for three days. 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. " 331361b8-9f1d3bfa-55fb4fcf-d764d041-9fd7409f.jpg,validate/p16/p16412660/s59087735/331361b8-9f1d3bfa-55fb4fcf-d764d041-9fd7409f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hypotension // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Lungs are hyperinflated, but clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " aa5cf390-ae7afc2d-f86822b6-27a32669-5d546da6.jpg,validate/p13/p13658228/s55366734/aa5cf390-ae7afc2d-f86822b6-27a32669-5d546da6.jpg,validation," WET READ: ___ ___ ___ 1:41 PM No acute cardiopulmonary abnormality. Moderate cardiomegaly unchanged from yesterday but increased from ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with chest pain after fall // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Moderate cardiomegaly, possibly slightly increased from ___. No rib fracture seen on limited assessment. No CHF, focal infiltrate or effusion detected. Mild upper zone redistribution again noted. The azygos vein measures 9.7 mm. IMPRESSION: Again seen is moderate cardiomegaly. This is slightly more pronounced than on ___ and somewhat more globular, but similar to 1 day earlier. Upper zone redistribution, without overt CHF. NOTIFICATION: Interval increase in size of cardiac silhouette compared with ___ and globular appearance raising possibility of pericardial fluid was discussed by Dr. ___ by phone with Dr ___ at 22;___ on ___. " d4d6e8bf-a9db630c-debd8fea-0638fde8-7437a1ef.jpg,validate/p19/p19017919/s53530746/d4d6e8bf-a9db630c-debd8fea-0638fde8-7437a1ef.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p AVR/ CABG ..respiratory failure- MRSA PNA, and HD for renal failure // eval for pulm edema, effusions eval for pulm edema, effusions COMPARISON: ___ IMPRESSION: Right PICC line tip is at the level of mid SVC. Up of tube passes below the diaphragm terminating most likely in the stomach. Left internal jugular line tip is at the junction of left brachycephalic vein and SVC. Cardiomediastinal silhouette is unchanged. Bilateral pleural effusions and bibasal consolidations are unchanged. " b323107a-1dd4a145-5f0901c7-ebfeeac8-72d2f7b8.jpg,validate/p15/p15957987/s58332010/b323107a-1dd4a145-5f0901c7-ebfeeac8-72d2f7b8.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with pleural drain, ? resolution of pneumothorax. COMPARISONS: ___. FINDINGS: Portable AP chest radiograph is obtained with the patient in the upright position. Esophageal stent and Port-A-Cath are unchanged. A pigtail catheter again noted projecting over the left base. Cardiomediastinal contour is unchanged. Right pleural effusion is perhaps slightly worse, left pleural effusion is stable. Mild bilateral atelectasis. No pneumothorax. IMPRESSION: No significant changes compared to the prior study. " e81a0d59-3f29637b-32b0df70-5e8b0406-3996a405.jpg,validate/p17/p17347503/s58822780/e81a0d59-3f29637b-32b0df70-5e8b0406-3996a405.jpg,validation," WET READ: ___ ___ ___ 12:34 PM Normal chest radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F awoke with left-sided headache and facial pain, chest tightness. Evaluate for stroke, ACS TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. IMPRESSION: Normal chest radiograph. " 81ecaa5f-753501d3-5a90aa27-635075b1-ed0d24fe.jpg,validate/p11/p11110923/s56562258/81ecaa5f-753501d3-5a90aa27-635075b1-ed0d24fe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with HIV presenting with 2 days of productive cough and 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. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 3cd0bd90-4e20ad18-5f8d3bca-022ec5b3-a95d35bf.jpg,validate/p13/p13771151/s50689054/3cd0bd90-4e20ad18-5f8d3bca-022ec5b3-a95d35bf.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fever, on steroids. Question pneumonia. FINDINGS: PA and lateral views of the chest. No prior. Left-sided central line is seen with catheter tip in the mid SVC. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " a9c31209-f57909c0-8c01e0bd-a5870f21-ba13d0ab.jpg,validate/p19/p19405755/s59625287/a9c31209-f57909c0-8c01e0bd-a5870f21-ba13d0ab.jpg,validation," WET READ: ___ ___ ___ 8:48 PM Retrocardiac streaky opacity new relative to prior exam. Findings thought likely atelectatic in etiology though early infection cannot entirely be excluded. A ___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with elevated white count, cough. // Any acute infectious process? Any acute infectious process? COMPARISON: Chest radiographs ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 7e929e39-83d7b474-f907cb7b-b04f6d2e-a7e56a09.jpg,validate/p11/p11184688/s54401522/7e929e39-83d7b474-f907cb7b-b04f6d2e-a7e56a09.jpg,validation," FINAL REPORT HISTORY: Dyspnea. COMPARISON: Chest radiograph ___. FINDINGS: Single AP view of the chest was reviewed. Severe cardiomegaly is again seen. A left axillary dual lead pacemaker defibrillator is present with leads terminating in unchanged positions in the right atrium and right ventricle. Indistinctness and enlargement of the hila with promiment interstitial markings is consistent with pulmonary edema. There is no pneumothorax or large pleural effusion. IMPRESSION: Moderate to severe pulmonary edema. " 68339234-13cf0e66-82c19836-15834534-faaba558.jpg,validate/p12/p12538134/s52003114/68339234-13cf0e66-82c19836-15834534-faaba558.jpg,validation," WET READ: ___ ___ ___ 8:43 PM No significant change since the prior exam. ______________________________________________________________________________ FINAL REPORT INDICATION: History of hypoxia. Please rule out pneumonia, pneumothorax or effusion. COMPARISONS: Chest radiograph performed on the same day at 12:43 p.m. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The right lung is clear. The patient is status post left lower lobectomy. There is slight elevation of the left hemidiaphragm, unchanged compared to the prior exam. Again seen are retrocardiac and lateral left basilar opacities unchanged compared to the prior exam and may be secondary to scarring. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is stable. There are calcifications of the aortic knob. The osseous structures are again notable for thoracotomy changes; the left sixth rib is not seen posteriorly. IMPRESSION: No significant interval change compared to the study performed earlier on the same day. " 0957f59f-7d86cb6d-2beb4f9d-4be22481-6e515a8d.jpg,validate/p16/p16359377/s51573300/0957f59f-7d86cb6d-2beb4f9d-4be22481-6e515a8d.jpg,validation," FINAL REPORT CLINICAL HISTORY: Atrial fibrillation and orthopnea. Evaluate for pulmonary edema. CHEST AP The heart is somewhat enlarged. The lung fields are clear. There is no evidence of failure. The costophrenic angles are sharp. IMPRESSION: Cardiomegaly, no failure. " 1e932aa0-dc0cfc51-eae235b2-4e42d7da-a0f9a220.jpg,validate/p17/p17763728/s52764325/1e932aa0-dc0cfc51-eae235b2-4e42d7da-a0f9a220.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Evaluate retrocardiac opacity seen in prior study. Patient with HIV, on HAART. Comparison is made with prior study, ___. There is moderate cardiomegaly. Small bilateral pleural effusions are larger on the left side and are associated with adjacent opacities, most likely atelectases, though superimposed infection cannot be totally excluded. There is mild vascular congestion with no pneumothorax. " 0f3ec72b-378c9fa1-4d30bb59-1cdb60b5-3f00a0a0.jpg,validate/p13/p13875177/s57081335/0f3ec72b-378c9fa1-4d30bb59-1cdb60b5-3f00a0a0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough please compare to portable xray // ? effusions ? effusions IMPRESSION: In comparison with the study ___ ___, the cardiac silhouette again is mildly enlarged. However, there is no evidence of pulmonary vascular congestion, pleural effusion, or acute focal pneumonia. " 62433209-dbddcfd5-9708c7cd-0a817deb-c2cbaba3.jpg,validate/p17/p17520239/s54756882/62433209-dbddcfd5-9708c7cd-0a817deb-c2cbaba3.jpg,validation," 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. " 9c965c3b-0d9aee40-e5551a54-d7224ffa-4f2559fc.jpg,validate/p11/p11063243/s59920097/9c965c3b-0d9aee40-e5551a54-d7224ffa-4f2559fc.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___. FINDINGS: Right subclavian catheter terminates at the cavoatrial junction. Heart size and mediastinal contours are normal. Lungs are clear except for minor atelectasis at the left lung base with adjacent small left pleural effusion. " edf4b420-ab475812-501d334d-550fd532-406e5ffd.jpg,validate/p19/p19603912/s51243149/edf4b420-ab475812-501d334d-550fd532-406e5ffd.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with FB sensation in her chest // acute process? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Left-sided pacer device is stable in position. The patient is status post median sternotomy and CABG. The cardiac and mediastinal silhouettes are stable. No focal consolidation is seen. There is no pleural effusion or pneumothorax.There is pulmonary vascular congestion. IMPRESSION: Pulmonary vascular congestion. " 16c1bc0c-90207d40-b93a861d-ad0bc18e-ac97afb2.jpg,validate/p10/p10296904/s51710336/16c1bc0c-90207d40-b93a861d-ad0bc18e-ac97afb2.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fever chills and productive cough. COMPARISON: None. FINDINGS: PA and lateral views of the chest. There is evidence of prior, remote median sternotomy with wires in place. The lungs are clear of consolidation or effusion. There is partial obscuration of the right heart border which may be due to slight pectus deformity. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 2153fe12-57866880-09cb3d9e-47dac4d7-8d4b7763.jpg,validate/p17/p17926625/s56958762/2153fe12-57866880-09cb3d9e-47dac4d7-8d4b7763.jpg,validation," 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. " 20d2ab4b-01c2a6ec-72424f20-9099d1ea-4d92018a.jpg,validate/p15/p15805011/s53237329/20d2ab4b-01c2a6ec-72424f20-9099d1ea-4d92018a.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. Question acute process. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear without pneumothorax or pleural effusion, although the extreme right costophrenic angle is excluded. Again noted is asymmetric left lateral pleural thickening in the left base, similar as compared to ___, but new since ___. IMPRESSION: 1. No acute cardiopulmonary process. 2. Redemonstration of asymmetric left basal lateral pleural thickening. Further assessment by cross-sectional imaging should be considered to exclude underlying neoplasm. " 2de867f5-4ea0d89d-ed87d266-a68e6ae8-e763ce04.jpg,validate/p17/p17763551/s56354149/2de867f5-4ea0d89d-ed87d266-a68e6ae8-e763ce04.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with chest pain and shortness of breath. Evaluate pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are low with bronchovascular crowding. No focal consolidation, edema, effusion, or pneumothorax. The heart remains severely enlarged. IMPRESSION: Cardiomegaly. No focal pneumonia. " 2a2a496c-391fc9f1-c20e4c78-7dc2c93c-8c864684.jpg,validate/p19/p19845148/s54911068/2a2a496c-391fc9f1-c20e4c78-7dc2c93c-8c864684.jpg,validation," FINAL REPORT AP CHEST, 11:31 P.M. ___ HISTORY: ___-year-old woman after NG tube placement. IMPRESSION: AP chest compared to ___: Nasogastric tube ends in the mid stomach. In the location of recent previous pneumonia, left lower lobe, there is slightly greater peribronchial opacification today than on ___ suggesting problem with recurrent aspiration. Similar abnormality is probably present at the right lung base medially. Upper lungs are clear. Heart size is normal. No appreciable pleural effusion and no pneumothorax. " 3252f9fb-45e2500f-6df57700-e5ee0cfd-c8a2e573.jpg,validate/p14/p14464902/s59591153/3252f9fb-45e2500f-6df57700-e5ee0cfd-c8a2e573.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dyspnea, immunosuppression and large hematoma along the right chest. Question pneumonia or rib fracture. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: There is a dual-lead pacemaker/ICD device with leads terminating in the right atrium and ventricle, respectively. The heart is mildly enlarged. Patchy calcification is noted along the aortic arch. There is no definite pleural effusion or pneumothorax, although there is persistent blunting of the right costophrenic angle, which may suggest a small persistent loculated pleural effusion versus scarring. Slight thickening of the minor fissure is unchanged. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 2237ce1b-4e2cc867-8744df00-f635ab68-9583b564.jpg,validate/p10/p10286475/s53501085/2237ce1b-4e2cc867-8744df00-f635ab68-9583b564.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CML, sepsis and recurrent CHF now s/p Right chest tube and left ___ // ? pneumothorax, improvement in effusions ? pneumothorax, improvement in effusions IMPRESSION: In comparison with the study ___ ___, the patient has taken a much better inspiration. There is enlargement of the cardiac silhouette with left ventricular prominence, though the pulmonary vascularity is now essentially within normal limits and there is no definite evidence of right pleural effusion. Continued opacification the left base silhouetting the hemidiaphragm, most likely reflecting volume loss left lower lobe pleural fluid. " b4cda5eb-c9d21497-b2dd0503-9af42526-96487607.jpg,validate/p11/p11280493/s51363789/b4cda5eb-c9d21497-b2dd0503-9af42526-96487607.jpg,validation," FINAL REPORT HISTORY: Overdose and low oxygen saturation. TECHNIQUE: AP upright portable 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. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " d0110db4-2f1aef40-94a35767-fb37f9a2-104645f0.jpg,validate/p15/p15455450/s54993875/d0110db4-2f1aef40-94a35767-fb37f9a2-104645f0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with small apical PTX s/p CT placement // any change in size of PTX? IMPRESSION: In comparison to prior radiograph from earlier the same date, a left pleural catheter has changed in position, and a moderate left pneumothorax has slightly increased in size, with both apical and lateral components. Exam is otherwise remarkable for improving consolidation at the right lung base, potentially a resolving focus of aspiration although infectious pneumonia is also possible in the appropriate setting. " 9a7fd46b-69b02da8-abd1a5ac-7a3085ac-ab8f74fe.jpg,validate/p19/p19024359/s55213219/9a7fd46b-69b02da8-abd1a5ac-7a3085ac-ab8f74fe.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old woman with cough, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Normal chest radiographs. " deb9824c-6e6bdc18-a817aef4-28152535-5c562115.jpg,validate/p18/p18123902/s54377810/deb9824c-6e6bdc18-a817aef4-28152535-5c562115.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // Eval for infiltrates COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Port-A-Cath resides over the right chest wall with catheter tip seen in the mid 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. " 6e1f0504-ad1a2472-7b04c49e-ba821940-14d27622.jpg,validate/p18/p18780736/s51705102/6e1f0504-ad1a2472-7b04c49e-ba821940-14d27622.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: In comparison study of ___, there again are bilateral pleural effusions with compressive atelectasis at the bases. Streaks of atelectasis is seen in the right mid lung. No definite acute focal pneumonia. There is a rounded opacification in the left mid zone. This was not appreciated on the CT scan of ___. It also was not seen on the chest x-ray of ___, so that the current appearance may represent a fortuitous combination of shadows. Nevertheless, this area should be evaluated on the next chest radiograph. Port-A-Cath again extends to the mid portion of the SVC. " 219a9b69-fba72c60-a9d7c6c2-cd9486e3-b8a49dbb.jpg,validate/p19/p19978239/s54071141/219a9b69-fba72c60-a9d7c6c2-cd9486e3-b8a49dbb.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough and confusion. COMPARISON: ___. FINDINGS: Patient is rotated to the right. There is right basilar atelectasis. Evidence of hiatal hernia is again seen. The aorta is unfolded and calcified. There is mild interstitial edema. Cardiac silhouette is top normal to mildly enlarged. There is compression deformity of a lower thoracic vertebral body of indeterminate age, though was not apparent on study from ___. Correlate for acuity. " b79713c4-9556b56e-6e29225e-8ac28ae5-f9f0dd5c.jpg,validate/p17/p17652927/s54988924/b79713c4-9556b56e-6e29225e-8ac28ae5-f9f0dd5c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, cardiomyopathy. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Cardiomegaly with no pulmonary edema. Left pectoral pacemaker. No pleural effusions. No pneumonia. No other relevant changes. " 1443d3fe-adec59cc-f3362baf-20690019-6ec1599d.jpg,validate/p12/p12797228/s50817290/1443d3fe-adec59cc-f3362baf-20690019-6ec1599d.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Hypoxemia. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 3 cm above the carina. The NG tube tip is in the stomach. Heart size and mediastinum are unremarkable. Lungs are well aerated with unchanged scarring in the right apex, chronic as well as still present minimal bibasilar atelectasis better appreciated on the CT torso. Overall, no substantial interval change to explain hypoxemia has been demonstrated on the current radiograph. " 0e84ecb9-e2af107b-ea4f95d5-72d4f05d-b370c7ca.jpg,validate/p10/p10065383/s58618981/0e84ecb9-e2af107b-ea4f95d5-72d4f05d-b370c7ca.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: ARDS, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The consolidations and opacities in both lungs are constant in extent and severity. The monitoring and support devices are also constant. No pneumothorax. " 5f0b9341-fda55817-7591c9c1-4841a68e-1b7d6e7b.jpg,validate/p15/p15110728/s56994551/5f0b9341-fda55817-7591c9c1-4841a68e-1b7d6e7b.jpg,validation," FINAL REPORT STUDY: Chest radiograph. INDICATION: Chest pain, multiple MIs. Query widened mediastinum. The patient has a pacemaker and AICD in good position. Heart size is normal. Mediastinal size as questioned is normal. The lungs are grossly clear. No good evidence of failure. Degenerative change in the thoracic spine. CONCLUSION: No acute cardiopulmonary findings. " 50b2543f-e4ce03c3-ed708289-dc6d8b30-19fe5444.jpg,validate/p10/p10966979/s50541328/50b2543f-e4ce03c3-ed708289-dc6d8b30-19fe5444.jpg,validation," FINAL REPORT HISTORY: Cough and fever. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 4fef3650-99736d42-1483f76f-d9c132aa-a4bae3c6.jpg,validate/p11/p11812774/s54042768/4fef3650-99736d42-1483f76f-d9c132aa-a4bae3c6.jpg,validation," FINAL REPORT HISTORY: Asthma and shortness of breath. COMPARISON: ___. FINDINGS: The lungs are clear without infiltrate or effusion. Compared to the prior study, there is no significant interval change. IMPRESSION: No focal infiltrate. " 111d0af4-3debb72e-513b1a91-1c3b5d37-a203b27f.jpg,validate/p15/p15160240/s56217047/111d0af4-3debb72e-513b1a91-1c3b5d37-a203b27f.jpg,validation," 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. " c890557a-07b80e6f-91bf25fa-8aeeb371-dc90fc3c.jpg,validate/p13/p13364138/s53364439/c890557a-07b80e6f-91bf25fa-8aeeb371-dc90fc3c.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with productive cough. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " c0beb9e2-197a4184-1c5ba2c3-dd4add3e-4f82f157.jpg,validate/p17/p17846223/s51611112/c0beb9e2-197a4184-1c5ba2c3-dd4add3e-4f82f157.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with night sweats cough, recent mycobacterium infection // PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. The lungs are hyperinflated and clear. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine IMPRESSION: No acute cardiopulmonary abnormalities COPD " 30b12960-af4bffa5-615613dd-d0a3cdcc-f885a90f.jpg,validate/p10/p10817099/s59649487/30b12960-af4bffa5-615613dd-d0a3cdcc-f885a90f.jpg,validation," FINAL REPORT PORTABLE SEMI-UPRIGHT CHEST OF ___ COMPARISON: ___ radiograph. FINDINGS: Interval extubation. Cardiomediastinal contours are within normal limits and without change. Improved aeration at the lung bases with residual subsegmental atelectasis at the left lung base. IMPRESSION: Improving aeration at lung bases with residual left lower lobe subsegmental atelectasis. " 093ae289-de13be69-5ceb61a1-928eb485-95711ba2.jpg,validate/p19/p19528443/s59610901/093ae289-de13be69-5ceb61a1-928eb485-95711ba2.jpg,validation," 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. " bcf1b5a4-5c0b4a2d-8f50a04a-8d2b1390-745e36e4.jpg,validate/p19/p19104400/s58101793/bcf1b5a4-5c0b4a2d-8f50a04a-8d2b1390-745e36e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough and fever. TECHNIQUE: Chest, PA and lateral. COMPARISON: CT from ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. Known mid thoracic vertebral body lesion is not well visualized on radiography. IMPRESSION: No evidence of acute cardiopulmonary disease. " f722fedb-e3e18262-5e6431c5-9426846d-8f3d939d.jpg,validate/p10/p10042810/s52077136/f722fedb-e3e18262-5e6431c5-9426846d-8f3d939d.jpg,validation," FINAL REPORT HISTORY: Patient with recent pneumonia, assess for resolution. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The lungs are hyperinflated with flattening of both hemidiaphragms. The previous bibasilar opacities have essentially cleared. The upper lung zones are hyperlucent with attenuation of pulmonary vessels and destruction of parenchyma, consistent with severe emphysema. No new focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Bilateral hilar enlargement is suggestive of underlying pulmonary hypertension. The heart size is normal. IMPRESSION: 1. Interval clearing of bibasilar pneumonia. No additional new consolidation. 2. Lung findings consistent with severe emphysema, particularly right upper lung zone. 3. Bilateral hilar enlargement, likely secondary to underlying pulmonary hypertension. " 00403194-74208678-d1960975-ebca4fc1-dc803228.jpg,validate/p10/p10482766/s58288693/00403194-74208678-d1960975-ebca4fc1-dc803228.jpg,validation," FINAL REPORT INDICATION: History: ___M with one week of mid epigastric pain, SOB, chills. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Aside from aortic knob calcifications, the cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear without focal consolidation. Chronic rib deformities in the right posterior upper ribs are again seen. IMPRESSION: No acute cardiopulmonary process. " de434ee0-d3621e61-95783f3e-7b5f00e6-21b580ed.jpg,validate/p12/p12109423/s51422248/de434ee0-d3621e61-95783f3e-7b5f00e6-21b580ed.jpg,validation," WET READ: ___ ___ ___ 9:09 PM No short interval change since preceding film < 1 h ago. - ___ ______________________________________________________________________________ FINAL REPORT HISTORY: Line placement. FINDINGS: The IJ line is unchanged in position. Heart and lungs are also unchanged with the study of one hour previously. " 65d7b5b9-3d4f6217-fc72f008-d571a27d-6b9590e6.jpg,validate/p18/p18819076/s52022210/65d7b5b9-3d4f6217-fc72f008-d571a27d-6b9590e6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumonia // needs f/u xray week of ___ to check for resolution needs f/u xray week of ___ to check for resolution IMPRESSION: In comparison with the study of ___, the right upper lobe opacification has essentially cleared. No evidence of acute cardiopulmonary disease at this time. " b373c362-96ec1a28-3e930638-c386c4fa-acb1bfbe.jpg,validate/p12/p12607933/s53887301/b373c362-96ec1a28-3e930638-c386c4fa-acb1bfbe.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after ascending aortic replacement. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. The ET tube tip, the replaced aortic valve, the Swan-Ganz catheter are in unchanged position. Heart size and mediastinum are unchanged including cardiomegaly. Mild pneumopericardium is present. Pericardial opacity on the right is stable. There is no evidence of pulmonary edema. Bilateral pleural effusions are most likely present. " 94771829-b8970e0d-9c4e5f0c-0c569a51-41634d52.jpg,validate/p11/p11260982/s59087758/94771829-b8970e0d-9c4e5f0c-0c569a51-41634d52.jpg,validation," FINAL REPORT HISTORY: Hypertension and shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The aorta remains tortuous but unchanged. The mediastinal hilar contours are otherwise within normal limits. The pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 50a84c6d-4bea7285-0094dcc4-037ce35d-1bcec8d5.jpg,validate/p14/p14105959/s50627937/50a84c6d-4bea7285-0094dcc4-037ce35d-1bcec8d5.jpg,validation," 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. " 91ac1c68-9ad1cb56-91511844-8e1bc5c0-cc38cb5c.jpg,validate/p16/p16295551/s57334084/91ac1c68-9ad1cb56-91511844-8e1bc5c0-cc38cb5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and CT chest ___ FINDINGS: Lung volumes are low. Heart size appears mildly enlarged, unchanged. The aorta is tortuous. Hilar contours are unremarkable. Chain sutures from prior right upper lobe wedge resection are again noted. Streaky opacities in the lung bases likely reflect areas of atelectasis and scarring without focal consolidation. Pulmonary vasculature is not engorged. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. IMPRESSION: Status post right upper lobe wedge resection. Low lung volumes with patchy opacities in the lung bases likely reflective of atelectasis and scarring. " 88582389-429823fb-85d72678-3a8ec20f-a2bff31c.jpg,validate/p10/p10500801/s54115982/88582389-429823fb-85d72678-3a8ec20f-a2bff31c.jpg,validation," 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. " ec1262e4-27cb86fb-c7567a68-7a4e4c2b-11df6a76.jpg,validate/p12/p12268481/s57783779/ec1262e4-27cb86fb-c7567a68-7a4e4c2b-11df6a76.jpg,validation," WET READ: ___ ___ 6:40 PM Clear lungs without focal consolidation. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Celiac disease, evaluation for infectious process. COMPARISON: Chest x-ray from ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes. Borderline size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. No pleural effusions, no pneumonia, no pulmonary edema. " 1794ff55-1cf99035-8d9f8d84-c51113e3-15370659.jpg,validate/p10/p10667727/s57357121/1794ff55-1cf99035-8d9f8d84-c51113e3-15370659.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with with effusion recently extubated // progression of pleural effusion/edema progression of pleural effusion/edema IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is enlargement of the cardiac silhouette with bilateral pleural effusions and compressive atelectasis at the bases, more prominent on the right, with mild pulmonary edema. Monitoring and support devices are essentially unchanged. " d2a1e361-839ef675-58bb09c4-9663224f-c0c7fe64.jpg,validate/p10/p10717732/s54331568/d2a1e361-839ef675-58bb09c4-9663224f-c0c7fe64.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p AVR/VATs // eval hemothorax COMPARISON: ___. IMPRESSION: Worsening parenchymal and pleural opacities in the left hemi thorax. The left central venous access line, the heart and the sternotomy wires as well as the right lung are unchanged. " 73932c5f-5dc21c6b-c7617552-a179067c-9dd56c79.jpg,validate/p13/p13250012/s50611486/73932c5f-5dc21c6b-c7617552-a179067c-9dd56c79.jpg,validation," FINAL REPORT AP CHEST, 9:13 P.M. ON ___ HISTORY: Urosepsis and hypoxia. IMPRESSION: AP chest compared to ___, 10:47 a.m.: Generalized decrease in pulmonary vascularity could be due to hypovolemia. Stomach is considerably distended with air, less so with fluid. The heart is normal size. There is no detectable pneumothorax or pleural effusion. Right jugular line ends close to the superior cavoatrial junction. " 074d491b-86319af7-399069a5-b9297a08-0611007c.jpg,validate/p14/p14763475/s51478615/074d491b-86319af7-399069a5-b9297a08-0611007c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // ?pna COMPARISON: ___ IMPRESSION: No relevant change as compared to the prior image. No evidence of pneumonia, no other pathologies of the lung parenchyma. Normal size of the cardiac silhouette. No pleural effusions. " 91b05cc4-421ed5c8-83164f43-b8be2082-52229bd6.jpg,validate/p19/p19063497/s52901626/91b05cc4-421ed5c8-83164f43-b8be2082-52229bd6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with non-productive cough x 7 days // ? pneumonia COMPARISON: ___ FINDINGS: There is no focal consolidation, effusion, or pneumothorax. Mild cardiomegaly is similar to prior. The cardiomediastinal silhouette is otherwise normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Left chest cardiac device and 2 lead tips appear in similar position compared to prior. IMPRESSION: No acute intrathoracic process. " 79f24cba-12e3217d-31e8ce83-ec91a799-a5243a4d.jpg,validate/p16/p16312859/s54231141/79f24cba-12e3217d-31e8ce83-ec91a799-a5243a4d.jpg,validation," FINAL REPORT EXAMINATION: Of ___, there is little interval change. No evidence of focal pneumonia, vascular congestion, or pleural effusion. In comparison INDICATION: ___F with SLE, fevers, productive cough, pleuritic chest pain // Pleuritis/effusion? Pneumonia? Pleuritis/effusion? Pneumonia? " 081e122b-2c235076-22bcb4df-ec77201b-f744d809.jpg,validate/p14/p14538785/s51755413/081e122b-2c235076-22bcb4df-ec77201b-f744d809.jpg,validation," WET READ: ___ ___ ___ 7:59 AM Left-sided pleural drainage catheter present. No significant interval change in size of the left-sided pleural effusion. WET READ VERSION #1 ___ ___ 9:48 PM Left-sided pleural drainage catheter present. No significant interval change in size of the left-sided pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleaural effusion s/p chest tube. Please complete exam by ___ // empyema getting smaller? chest tube in place? IMPRESSION: As compared to previous study of earlier the same date, there has not been a relevant change in the appearance of a moderate left pleural effusion with adjacent left lower lobe atelectasis and or consolidation. Note is made of improved aeration of the right lung base with resolving atelectasis and decreased pleural effusion. " a293ca74-6c606351-689b4a30-ce65adf6-bb706a62.jpg,validate/p10/p10658645/s51781682/a293ca74-6c606351-689b4a30-ce65adf6-bb706a62.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with well-controlled HIV, now with dyspnea, fever, and cough. COMPARISON: Comparison is made with chest radiograph from ___. FINDINGS: PA and lateral images of the chest demonstrates 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 radiograph. " 7e3412ae-be19e0c9-775616ba-9cee5184-c2c27213.jpg,validate/p16/p16444136/s58525727/7e3412ae-be19e0c9-775616ba-9cee5184-c2c27213.jpg,validation," FINAL REPORT INDICATION: History: ___F with SOB // SOB TECHNIQUE: Portable frontal view of the chest. COMPARISON: None. FINDINGS: There is a moderate right and a small left pleural effusion. There is no focal consolidation or pneumothorax. The cardiac silhouette is difficult to see however the heart size is likely normal. The mediastinal contours are normal. IMPRESSION: Moderate right and small left pleural effusions. " 53d44074-0dd0adaa-204644be-75359612-0958118b.jpg,validate/p14/p14755254/s55666758/53d44074-0dd0adaa-204644be-75359612-0958118b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ___ huff placement, please verify position // ___ year old man with ___ huff placement, please verify position ___ year old man with ___ huff placement, please verify position IMPRESSION: In comparison with the study of ___, there has been placement of a Dobhoff tube that extends at least to the upper stomach, were crosses the lower margin of the image. Continued substantial enlargement of the cardiac silhouette with pulmonary vascular congestion. No acute focal pneumonia. Sixth " 811553a6-6e317661-9370e7af-564ab615-3ef1b92d.jpg,validate/p14/p14105959/s54564669/811553a6-6e317661-9370e7af-564ab615-3ef1b92d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: ___ year old man with altered mental status, leukocytosis TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and CABG. Heart size remains mildly enlarged. The mediastinal and hilar contours are unchanged. There is crowding of the bronchovascular structures due to low lung volumes without overt pulmonary edema. Patchy opacities in lung bases likely reflect atelectasis. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. Electronic device is again noted within the left upper chest wall. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 1ba3ff3a-473a8f43-bb09bf1f-4941cfc0-279fece0.jpg,validate/p17/p17105437/s59786785/1ba3ff3a-473a8f43-bb09bf1f-4941cfc0-279fece0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with wheezing and history of pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are hypoinflated, causing crowding of the pulmonary vasculature. There are linear opacities at the bases, likely atelectasis. The hilar and cardiomediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Hypoinflated lungs with bilateral probable atelectasis. However, early pneumonia in the proper clinical setting cannot be fully excluded. " 524f8b66-94869572-9a9ad07b-043729b4-057d0982.jpg,validate/p13/p13567471/s55621635/524f8b66-94869572-9a9ad07b-043729b4-057d0982.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with MRSA bacteremia and now with fever. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size and mediastinum are stable in appearance. Post-sternotomy wires are unremarkable. Lungs are hyperinflated, but essentially clear with no evidence of pneumonia. " 74e3139c-edd6eb80-5fc8a7f5-47d754a3-71b7519f.jpg,validate/p15/p15367414/s57966656/74e3139c-edd6eb80-5fc8a7f5-47d754a3-71b7519f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval infiltrate IMPRESSION: In comparison to ___ radiograph, postoperative appearance of cardiomediastinal contours is stable. Multifocal atelectasis in the left mid and both lower lungs has decreased in extent. Very small bilateral pleural effusions persist, and there is no evidence of pneumothorax. " 74a103a5-3a28d9b1-78077a85-e4608718-801bfaec.jpg,validate/p14/p14508231/s57871209/74a103a5-3a28d9b1-78077a85-e4608718-801bfaec.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are within normal limits. Lungs are clear. No pleural effusion or pneumothorax is present. Cervical spinal fusion hardware is again seen. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary process. " 4bc5a751-e27a6f87-a8f2ae66-2c901bdb-ebdc5cff.jpg,validate/p11/p11856988/s58296885/4bc5a751-e27a6f87-a8f2ae66-2c901bdb-ebdc5cff.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with lower extremity edema and increasing shortness of breath. Assess for CHF. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unchanged hyperexpansion of the lungs, with new opacity seen in the lingula. There is no pleural effusion, or pneumothorax. The cardiac silhouette remains mildly enlarged, the mediastinal contours are normal with the exception of calcification of the aortic knob. The pulmonary vasculature is normal. IMPRESSION: 1. No CHF. 2. Increased lingular opacity likely atelectasis. As there is no explanation for this, further evaluation with CT is recommended to exclude an obstructive mass. Findings were entered into the radiology web-based results reporting tool for clinician notification. " e2a8ec6c-16a63bc9-57945fa9-072569f1-29016dec.jpg,validate/p17/p17381287/s54452084/e2a8ec6c-16a63bc9-57945fa9-072569f1-29016dec.jpg,validation," WET READ: ___ ___ 7:21 PM slight increased interstitial edema. moderate cardiomegaly, likely little changed from prior given AP technique. probable small pleural effusions. no pneumothorax ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with dyspnea on exertion and bacteremia. FINDINGS: Comparison is made to prior study from ___. There has been removal of the PICC line. There is again seen prominence of pulmonary interstitial markings consistent with mild fluid overload. There is unchanged cardiomegaly. No pneumothoraces or definite consolidations are seen. " fcbb6cfd-147bd0dd-0841bdc7-c7b02335-26e6478c.jpg,validate/p12/p12032220/s57509417/fcbb6cfd-147bd0dd-0841bdc7-c7b02335-26e6478c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with pneumonia in ___, follow up to resolution. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are clear. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is a dextroconvex scoliosis of the thoracic spine. There is a severe compression deformity of a lower thoracic vertebral body, age indeterminate. IMPRESSION: 1. No evidence of residual pneumonia. 2. Severe compression fracture of a lower thoracic vertebral body, age indeterminate. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 15:43 into the Department of Radiology critical communications system for direct communication to the referring provider. " 95c8076b-2a8f8b7d-53e5b585-e9bdf5d8-13ad9a60.jpg,validate/p10/p10562293/s53388147/95c8076b-2a8f8b7d-53e5b585-e9bdf5d8-13ad9a60.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with fever, diarrhea and lower abdominal pain on chemotherapy. 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. There is no pulmonary edema. IMPRESSION: No acute cardiopulmonary pathology. " 1b014f62-c4a63c57-d3ce71d7-9ce9dd5b-258b88de.jpg,validate/p14/p14766138/s57554528/1b014f62-c4a63c57-d3ce71d7-9ce9dd5b-258b88de.jpg,validation," FINAL REPORT INDICATION: Chest pain, rule out acute process TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs with direct comparison made to study from ___. FINDINGS: There has been interval increase in the left pleural effusion, now moderate in size. There is obscuration of the left hemidiaphragm which likely due to a combination of pleural effusion and compressive atelectasis, although developing consolidation cannot be excluded. The right lung is clear. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax. IMPRESSION: Interval increase in left pleural effusion, now moderate with likely compressive atelectasis, although a developing consolidation cannot be excluded at the left lung base. " 9267321c-7d1feb1c-44f6279f-8af3802a-62fcc675.jpg,validate/p18/p18997544/s56502360/9267321c-7d1feb1c-44f6279f-8af3802a-62fcc675.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Seizure-like activity. 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. There is a streaky opacity in the left lower lobe probably due to atelectasis. IMPRESSION: No evidence of acute disease. " acff0917-4ddeea3e-d73148de-2e14c902-3d918724.jpg,validate/p13/p13477622/s57116188/acff0917-4ddeea3e-d73148de-2e14c902-3d918724.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) IN O.R. INDICATION: ___ year old man s/p MIE, NGT dc'd // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the nasogastric tube has been removed. Little change in the appearance of the heart and lungs with bibasilar atelectatic changes and blunting of the costophrenic angles. " fc69d057-5612b4e3-6eacbd8c-c9cbdbf0-529659ab.jpg,validate/p12/p12734486/s53021844/fc69d057-5612b4e3-6eacbd8c-c9cbdbf0-529659ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with epilepsy now in intermittent status and decreased mental status; now tachypneic // r/o aspiration; source of tachypnea. Please perform at 8AM r/o aspiration; source of tachypnea. Please perform at 8AM COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Lower lobes were clear on ___, atelectasis has developed at the right base, and there is consolidation on the left also possibly atelectasis or pneumonia. Upper lungs are clear. Pleural effusions are small if any. Heart size top- normal. No pneumothorax. ET tube is in standard placement esophageal drainage tube passes below the diaphragm and out of view. " c783b030-d620b80f-32a38dd8-a9480d12-0a79960a.jpg,validate/p17/p17641109/s54944468/c783b030-d620b80f-32a38dd8-a9480d12-0a79960a.jpg,validation," 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. " 205ea89a-8a0abeea-259ed78f-96b3bfd4-ebeb2196.jpg,validate/p17/p17396346/s53479433/205ea89a-8a0abeea-259ed78f-96b3bfd4-ebeb2196.jpg,validation," WET READ: ___ ___ 6:56 PM Aeration is improved with mild residual pulmonary edema and small right pleural effusion. Linear atelectasis seen bilaterally. Marked cardiomegaly. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Pulmonary edema, to assess for change. FINDINGS: In comparison with study of ___, the patient has taken a much better inspiration. There is still substantial enlargement of the cardiac silhouette with mild residual pulmonary edema. Basilar atelectatic changes seen bilaterally. " 463313ef-dfc8b6ea-6baf2047-256a3cfc-7ac3c288.jpg,validate/p16/p16201645/s58399504/463313ef-dfc8b6ea-6baf2047-256a3cfc-7ac3c288.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post right pneumectomy, evaluation. COMPARISON: ___. FINDINGS: The patient has undergone right pneumectomy, there is beginning of fluid filling of the pneumonectomy space. Unchanged extensive air collection in the soft tissues. Unchanged normal appearance of the left hemithorax. " dd080488-c4f44d1f-7f6591d4-d022ccad-b76ac49f.jpg,validate/p10/p10466300/s53135818/dd080488-c4f44d1f-7f6591d4-d022ccad-b76ac49f.jpg,validation," WET READ: ___ ___ ___ 5:42 AM 1. Low lung volumes with bibasilar atelectasis. No focal consolidation. 2. Mild pulmonary edema. 3. Severe compression deformity of the T12 vertebral body of unknown chronicity. Correlate with focal tenderness. 4. Apparent inferior subluxation of the right humeral head with respect to the glenoid, but this may be projectional. Correlate with history of shoulder pain/trauma. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old man with cerebral palsy and weakness, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low which leads to bronchovascular crowding. There is mild pulmonary edema as well as atelectasis at the left lung base. There is asymmetric elevation of the left hemidiaphragm. No focal consolidation is identified. The cardiomediastinal silhouette and hilar contours are normal. There is a severe compression deformity of the T12 vertebral body. There is also apparent inferior subluxation of the right humeral head with respect to the glenoid. IMPRESSION: 1. Low lung volumes with bibasilar atelectasis. No focal consolidation. 2. Mild pulmonary edema. 3. Severe compression deformity of the T12 vertebral body of unknown chronicity. Correlate with focal tenderness. 4. Apparent inferior subluxation of the right humeral head with respect to the glenoid, but this may be projectional. Correlate with history of shoulder pain/trauma. " fd759660-fc95c135-cf97351d-d8f19e7c-86c4e8d4.jpg,validate/p11/p11826927/s54383535/fd759660-fc95c135-cf97351d-d8f19e7c-86c4e8d4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female with HIV, feeling unwell, hypotensive, assess pneumonia. FINDINGS: AP and lateral views of the chest were provided. A dialysis catheter is seen extending from the level of the IVC into the right atrium. Patient is slightly rotated to her right on the frontal projection, limiting evaluation. Allowing for this, the lungs appear clear. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette appears grossly within normal limits. A vascular stent is seen in the left axilla adjacent to a hyperdense tubular structure in the left upper arm, likely an old AV fistula. IMPRESSION: No acute findings in the chest. " 3287d373-d67efd95-9250d121-ab68d661-f770354d.jpg,validate/p12/p12385889/s59314903/3287d373-d67efd95-9250d121-ab68d661-f770354d.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with leukemia, status post transplant, on high-dose immunosuppression, now with productive cough and upper respiratory symptoms. COMPARISON: PA and lateral chest radiograph, ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: Lungs are well inflated and clear bilaterally with no evidence of masses, lesions, pleural effusions or pneumothorax. The cardiomediastinal silhouette is within normal limits. Hila are unremarkable with no evidence of adenopathy. Pleural surfaces are unremarkable. No osseous abnormalities are identified. IMPRESSION: No evidence of infection or malignancy; however, pneumonia can be radiographically occult on plain film. If there is sufficient clinical concern, CT of the chest is recommended for better assessment of possible infection. " f8d7366b-655b2199-ea588a15-ff0d6c35-96bd5f59.jpg,validate/p18/p18183364/s57225863/f8d7366b-655b2199-ea588a15-ff0d6c35-96bd5f59.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. Evaluation for pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Stable left linear opacities in the left upper and lower lung likely represent scarring. The lungs are clear without focal consolidation, edema, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. A left pectoral pacemaker is in unchanged position. Spinal hardware overlies the cervical spine. IMPRESSION: No acute cardiopulmonary process. " 7b56ff91-033a564b-f1f6a429-07b6bac1-19c78d29.jpg,validate/p17/p17574863/s59746056/7b56ff91-033a564b-f1f6a429-07b6bac1-19c78d29.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post liver transplant, Dobbhoff placement. COMPARISON: ___, 7:54 p.m. FINDINGS: As compared to the previous radiograph, tube has been repositioned. Tip is now projecting over the middle parts of the stomach and the tip is pointing downwards. No evidence of complications. Otherwise unchanged radiograph. " 797106e4-43314844-f6257b47-4fcca9b3-55a00fb3.jpg,validate/p19/p19356325/s56395812/797106e4-43314844-f6257b47-4fcca9b3-55a00fb3.jpg,validation," 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. " d5e93677-a5ed9674-41aa14ac-0f2ee556-3fbcfa54.jpg,validate/p16/p16742247/s56965153/d5e93677-a5ed9674-41aa14ac-0f2ee556-3fbcfa54.jpg,validation," WET READ: ___ ___ 8:23 AM Right PICC ends in the mid to low SVC. No evidence of pneumothorax. Since ___ there has been interval improvement in diffuse bilateral pulmonary airspace opacities. WET READ VERSION #1 ___ ___ ___ 7:51 PM Right PICC ends in the mid to low SVC. No evidence of pneumothorax. Since ___ there has been interval improvement in diffuse bilateral pulmonary airspace opacities. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PICC in place // picc ok to use? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Right PICC tip is in themid SVC. Cardiac size is normal. Extensive diffuse bilateral peribronchial and rounded opacities with peripheral predominance have improved from prior study. There is no pneumothorax or pleural effusion. " 83624091-50b88b20-76fa5699-0ca1b197-dc26ed63.jpg,validate/p18/p18244442/s55965735/83624091-50b88b20-76fa5699-0ca1b197-dc26ed63.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is bibasilar atelectasis. No definite pleural effusion is seen on the lateral view. There is rounded retrocardiac opacity seen, which was not optimally assessed on this study, may be due to a large hiatal hernia. The aorta is calcified and tortuous. The cardiac silhouette is enlarged. No definite focal consolidation is seen. There is no pneumothorax. Kyphoplasty/vertebroplasty in the mid-to-lower thoracic spine is noted. IMPRESSION: Large retrocardiac rounded opacity may correspond to a large hiatal hernia. Correlate with history of such. Basilar atelectasis without definite focal consolidation. " 7fb968e0-24582382-fb832297-e23928ed-627c02f9.jpg,validate/p11/p11069015/s55351024/7fb968e0-24582382-fb832297-e23928ed-627c02f9.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___. FINDINGS: As compared with a recent study, there has not been a substantial change in the appearance of the chest. Left chest tubes remain in place, with persistent moderate loculated left effusion, but no visible pneumothorax. " cc7f2e94-2188d919-dd7a0912-70fe35c1-b6e48c11.jpg,validate/p15/p15877362/s51858737/cc7f2e94-2188d919-dd7a0912-70fe35c1-b6e48c11.jpg,validation," 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. " 251d86ef-f8e9ead5-25495853-36402f8e-1447be83.jpg,validate/p18/p18370560/s57108858/251d86ef-f8e9ead5-25495853-36402f8e-1447be83.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o M s/p fall, L ptx and L rib fx- s/p pigtail, now placed to WS // interval change- please obtain film at 20:00 tonight ___ TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Left pigtail catheter is in place with interval decrease in pleural effusion. Minimal apical pneumothorax is most likely present. Cardiomediastinal silhouette is stable. Right basal atelectasis is unchanged. " 224f6906-9dc621bd-1653104c-4ff49b7b-eb5b1956.jpg,validate/p18/p18039147/s52099667/224f6906-9dc621bd-1653104c-4ff49b7b-eb5b1956.jpg,validation," FINAL REPORT INDICATION: ___-year-old man status post right VATS with shortness of breath. Study requested to rule out a pneumothorax. COMPARISON: Prior chest radiographs from ___ and ___. TECHNIQUE: Portable semi-erect AP chest radiograph. FINDINGS: As compared to prior chest radiograph from ___, trace right apical pneumothorax persists. Right-sided chest tube is in unchanged position with its tip projecting over the right lung apex. Lung volumes remain low exaggerating bronchovascular structures. Right lung base opacities are again identified and likely reflect post-surgical changes. The cardiac silhouette is normal. There still remains a small amount of subcutaneous gas along the right neck. IMPRESSION: Trace right apical pneumothorax with small amount of subcutaneous gas in the right neck. Opacities in the right lung likely reflect post-surgical changes. " 5e58a43b-a5431f12-7758d942-cbf0aa44-26c15810.jpg,validate/p19/p19747837/s54991663/5e58a43b-a5431f12-7758d942-cbf0aa44-26c15810.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with heart history, gait changes, eval heart and lungs COMPARISON: ___ chest CT and chest radiograph. FINDINGS: PA and lateral views of the chest provided. Frontal view excludes the right CP angle limiting assessment. There is improved aeration at the right lung base with probable mild residual pleural thickening versus tiny effusion. Otherwise, lungs are clear. No large pneumothorax. No signs of pulmonary edema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Minimal residual pleural thickening versus tiny effusion at the right lung base. Right CP angle partially excluded. " 818ffa3b-252881ec-8dd38e8c-77906b61-39c23110.jpg,validate/p11/p11620358/s50851273/818ffa3b-252881ec-8dd38e8c-77906b61-39c23110.jpg,validation," WET READ: ___ ___ 1:10 PM No evidence of fracture, however dedicated rib series more sensitive. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M status post fall with mechanical fall, tripping over sidewall, landing on the left side, left rib pain question rib fracture. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. CTA chest dated ___. FINDINGS: Cardiomediastinal silhouette is unchanged. Apparent blunting at the right lateral costophrenic angle is due to pleural fat as seen on ___ CTA. There is no concerning parenchymal consolidation. There is no evidence for rib fracture, however dedicated rib series is more sensitive. There is no evidence of pneumothorax. Mild elevation of right hemidiaphragm is grossly stable. IMPRESSION: No evidence of fracture, however dedicated rib series is more sensitive. No acute cardiopulmonary process. " 088c1a5d-d1f33f49-10964f4b-17e84d5c-deb3bd54.jpg,validate/p10/p10577647/s54433415/088c1a5d-d1f33f49-10964f4b-17e84d5c-deb3bd54.jpg,validation," FINAL REPORT INDICATION: History: ___F with epigastric pain // eval for acute process TECHNIQUE: Single portable AP radiograph COMPARISON: Radiograph dated ___ FINDINGS: Single portable upright chest radiograph demonstrate low lung volumes. A left chest porta catheter terminates within the anticipated location of the right atrium. Heart size is upper limits of normal in size. There is no evidence of pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: Low lung volumes without acute intrathoracic abnormality. " 2297a66e-96795c2c-7ce9d90d-3a8d7224-7d38bb3d.jpg,validate/p19/p19057990/s58798979/2297a66e-96795c2c-7ce9d90d-3a8d7224-7d38bb3d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fungemia and VRE bacteremia // Evaluate for pneumonia TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is a left intra hilar opacity, new as compared to the previous study and potentially might represent developing infectious process. No pleural effusion or pneumothorax is seen. Attention to this area is recommended and preferably PA and lateral radiographs of the chest would be beneficial for pre size characterization. " 2f1f9570-c158d4e3-34cd6323-5d77fb62-8d45bb5f.jpg,validate/p11/p11104911/s54941437/2f1f9570-c158d4e3-34cd6323-5d77fb62-8d45bb5f.jpg,validation," 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. " ed81cb6d-831086fd-c5be0671-68d2f744-ef9ffbdd.jpg,validate/p12/p12464244/s52567221/ed81cb6d-831086fd-c5be0671-68d2f744-ef9ffbdd.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs. INDICATION: ___-year-old woman with a poorly functioning Port-A-Cath. TECHNIQUE: Chest PA and lateral. COMPARISON: Prior chest radiograph from ___. FINDINGS: Right-sided Port-A-Cath terminates at the origin of the SVC. There is a plug-like opacity at the tip of the catheter. Cardiomediastinal and hilar contours are normal. Lungs are clear. Pleural surfaces are normal. IMPRESSION: Right sided Port-A-Cath terminates at the origin of the SVC. " 4e9d52ed-a386ff29-d9145313-6b1d8b36-24dd2ae4.jpg,validate/p13/p13280760/s54669145/4e9d52ed-a386ff29-d9145313-6b1d8b36-24dd2ae4.jpg,validation," 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. " 40334a7f-ab88fb98-5bfcf0da-349924d4-931f16aa.jpg,validate/p19/p19336651/s51046023/40334a7f-ab88fb98-5bfcf0da-349924d4-931f16aa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with panc cancer, pneumonia. // assess for pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the known right upper lobe predominant parenchymal opacity, likely reflecting an pneumonia, is stable in extent and severity. A pre-existing right basal opacity has minimally decreased in extent. The left lung appears unchanged. Mild fluid overload persists. Minimal left pleural effusion is present on today's image. Unchanged mild cardiomegaly, stable alignment of the sternal wires. " bf44008d-05a32fb8-7a55cfb3-5de30a28-b1c324eb.jpg,validate/p17/p17652927/s54375114/bf44008d-05a32fb8-7a55cfb3-5de30a28-b1c324eb.jpg,validation," 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. " edc5548c-29fcf058-f24ef364-5943103e-e4208ca6.jpg,validate/p14/p14508231/s55464583/edc5548c-29fcf058-f24ef364-5943103e-e4208ca6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain, lightheadedness // Evaluate for ACS 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. Left humeral head replacement is noted, new in the interval. Cervical fusion hardware is partially visualized. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 5b406f26-55dfa960-cb2fab5e-98e99338-874636f3.jpg,validate/p19/p19747459/s52089463/5b406f26-55dfa960-cb2fab5e-98e99338-874636f3.jpg,validation," 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. " 9074690c-96d1ffe7-2ef7dd7d-c6351357-db2ffae9.jpg,validate/p16/p16679893/s51882950/9074690c-96d1ffe7-2ef7dd7d-c6351357-db2ffae9.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with lung Ca c/b PNA and hemoptysis, intubated // Interval change? Pulm edema? COMPARISON: Radiographs from ___ IMPRESSION: Endotracheal tube, feeding tube, and left-sided PICC line are unchanged in position. Study is somewhat limited due to patient rotation. However allowing for this, there has been no interval change. There is again seen elevation of the right hemidiaphragm and bilateral pleural effusions. There remains prominence of the pulmonary interstitial markings suggestive of mild pulmonary edema. No pneumothoraces are identified. " 8074d349-2d640e8f-66b264c9-adc00962-1f9e9af8.jpg,validate/p12/p12070984/s53185384/8074d349-2d640e8f-66b264c9-adc00962-1f9e9af8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph and INDICATION: ___M w/SOB, DOE, and dry cough. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No significant interval change other than perhaps slightly lower lung volumes. No focal consolidation, edema, effusion, or pneumothorax. Mild cardiomegaly persists, overall unchanged. The descending aorta may be slightly tortuous, unchanged. Appearance of the thoracic spine with degenerative changes and some loss of vertebral body height is overall similar to the prior exam. Slight eventration of the right hemidiaphragm is also overall unchanged. IMPRESSION: No acute cardiopulmonary process. " 6363d5e3-90120efb-6db9ef7c-96bea8d2-9d200d6c.jpg,validate/p11/p11874868/s59586689/6363d5e3-90120efb-6db9ef7c-96bea8d2-9d200d6c.jpg,validation," 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. " 070ad934-c8f12c0d-f18329c4-e59d6fc7-75c1f0ed.jpg,validate/p12/p12371641/s50998535/070ad934-c8f12c0d-f18329c4-e59d6fc7-75c1f0ed.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with worsening secretions. Comparison is made to the patient's previous studies dated ___ at 257. A portable supine chest film ___ at ___ is submitted. IMPRESSION: 1. Endotracheal tube has its tip 3.5 cm above the carina. A right subclavian central line has its tip in the distal SVC. A nasogastric tube is seen coursing below the diaphragm with the tip projecting over the stomach. There are layering bilateral effusions with associated airspace opacity most likely reflecting compressive atelectasis. The pulmonary edema has slightly worsened. The heart remains enlarged. Mediastinal contours are unchanged. Calcification in the aorta consistent with atherosclerosis. No evidence of pneumothorax, although the sensitivity to detect a pneumothorax is diminished given supine technique. " 8ca79f77-def91ef7-b5ca2f1e-e0e46dd3-4ad5254b.jpg,validate/p16/p16651473/s52257269/8ca79f77-def91ef7-b5ca2f1e-e0e46dd3-4ad5254b.jpg,validation," 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. " 49e9afbb-57d55a73-c3a90f20-e5d7c6bc-8d4a77de.jpg,validate/p18/p18797250/s51149169/49e9afbb-57d55a73-c3a90f20-e5d7c6bc-8d4a77de.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with COPD, DM w/fever, evaluate for source. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: A CLUSTER OF PERIBRONCHIAL OPACITIES WITH POSSIBLE MILD BRONCHIECTASIS IN THE RIGHT UPPER LOBE COULD BE AN ACUTE INFECTION, OR CHRONIC BRONCHIECTASIS. TWO SMALL OVOID OPACITIES IN THE LEFT UPPER LUNG, AN 11 MM LESION PROJECTING OVER THE FIRST ANTERIOR INTERSPACE AND A SUB CM LESION PROJECTING OVER THE SECOND ANTERIOR INTERSPACE COULD BE DUE TO ACUTE INFECTION AS WELL. LOWER LUNGS ARE CLEAR. THERE IS NO PLEURAL ABNORMALITY OR EVIDENCE OF CENTRAL LYMPH NODE ENLARGEMENT. HEART SIZE IS NORMAL. LATERAL VIEW SHOWS HEAVY CALCIFICATION IN THE PROXIMAL ARTERIES OF THE AORTIC ARCH. S shaped scoliosis of the thoracic spine is noted with moderate underlying degenerative changes. IMPRESSION: 1. SMALL PNEUMONIA OR CHRONIC BRONCHIECTASIS, RIGHT UPPER LOBE. 2. TWO LEFT UPPER LOBE LUNG NODULES COULD BE INFECTIOUS BUT NEED TO BE FOLLOWED. RECOMMENDATION(S): Follow-up chest radiographs in 3 weeks following treatment are recommended to ensure resolution and to evaluate for persistence of left upper lobe nodules. NOTIFICATION: The findings were discussed with ___, R.N. by ___ ___, M.D. on the telephone on ___ at 1:42 PM, 2 minutes after discovery of the findings. " cc66e1e0-21e3069f-5b6bce62-127f5fee-02e5d4c2.jpg,validate/p12/p12272471/s55549068/cc66e1e0-21e3069f-5b6bce62-127f5fee-02e5d4c2.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with prior pleural effusion, in need of evaluation. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The heart size is within normal limits. The mediastinal contours demonstrate a minimally tortuous aorta, but are otherwise unremarkable. The lungs are clear of consolidation. Minimal residual right-sided pleural effusion remains. There is no pneumothorax. IMPRESSION: Improvement in right pleural effusion. " 1c3e822a-a1abbf76-be4e7c0d-5c3020eb-5789515c.jpg,validate/p17/p17643710/s50132406/1c3e822a-a1abbf76-be4e7c0d-5c3020eb-5789515c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old female with a new cerebellar tumor. Evaluate for acute process prior surgery. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no focal consolidation to suggest pneumonia, pleural effusion or pneumothorax. No evidence of pulmonary edema. Heart size is normal. Thoracic aorta is tortuous. Mild dextrocurvature of the lower thoracic spine may be positional. IMPRESSION: No acute cardiopulmonary process. " 9ae025b1-178bde68-79e83e2f-61320156-7bd1a675.jpg,validate/p17/p17529132/s50134553/9ae025b1-178bde68-79e83e2f-61320156-7bd1a675.jpg,validation," FINAL REPORT EXAMINATION: Chest PA and lateral INDICATION: ___M with chest pain. Evaluate for pneumothorax. 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, specifically no evidence of pneumothorax. " 8b1aaf32-a45cb911-2dfa64d4-3a898d5c-ea386978.jpg,validate/p13/p13968659/s58554519/8b1aaf32-a45cb911-2dfa64d4-3a898d5c-ea386978.jpg,validation," 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. " 96445278-754eef8b-9ec68637-7f0686bc-e2f87be8.jpg,validate/p16/p16355861/s52923104/96445278-754eef8b-9ec68637-7f0686bc-e2f87be8.jpg,validation," FINAL REPORT INDICATION: ___M with progressive sob // eval for pulmonary edema, other cardiopulmonary pathology TECHNIQUE: AP and lateral views of the chest. COMPARISON: Chest x-ray from ___. FINDINGS: There is a left basilar opacity likely due to a combination of moderate pleural effusion and underlying atelectasis. Blunting of the lateral and posterior costophrenic angles on the right suggests small effusion. These changes have increased since prior exam. Pulmonary vascular congestion is again noted. The cardiomediastinal silhouette is stable. Mitral annular calcifications are again noted. Left chest wall dual lead pacing device is again noted. No acute osseous abnormalities. IMPRESSION: Moderate left pleural effusion with underlying atelectasis noting infection would also be possible. Pulmonary vascular congestion and probable small right pleural effusion as well. " 866e5676-f3b3bac7-a33533b1-903b3997-bc9b77e4.jpg,validate/p12/p12488897/s56105566/866e5676-f3b3bac7-a33533b1-903b3997-bc9b77e4.jpg,validation," 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. " 74f6a623-10a61c51-3980a465-ca08bde7-a2ed94a8.jpg,validate/p12/p12292383/s51607378/74f6a623-10a61c51-3980a465-ca08bde7-a2ed94a8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF new cough. // ? fluid overload IMPRESSION: In comparison to ___ chest radiograph, mild cardiomegaly is accompanied by pulmonary vascular congestion, new minimal edema and small pleural effusions, with adjacent bibasilar atelectasis or consolidation. " 3d1e0a2d-29c8c22a-d92db52a-df146df0-c399557c.jpg,validate/p18/p18909627/s58899506/3d1e0a2d-29c8c22a-d92db52a-df146df0-c399557c.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Hypertension, assess cardiac size. Comparison is made with prior studies, ___ and ___. Cardiac size is normal. There are low lung volumes. There are minimal bibasilar atelectases, larger on the left side. Mediastinal silhouette is unchanged. There is no evidence of pneumonia or CHF. " 01b56684-3babf3d7-c956f33b-ada39c76-67c3b5f4.jpg,validate/p19/p19919570/s59230885/01b56684-3babf3d7-c956f33b-ada39c76-67c3b5f4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with analplastic astrocytoma, s/p resection, radiation and biopsy ___ ___ V70.9 // pneumonia or other abnormality COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Patient has had median sternotomy and aortic valve replacement. Heart size is normal. Lungs are clear and there is no pleural abnormality. " 826ecfd7-48cd6c47-5ebcf302-c2589ca7-99267ea3.jpg,validate/p19/p19431075/s53099053/826ecfd7-48cd6c47-5ebcf302-c2589ca7-99267ea3.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cirrhosis status post total hip replacement, now with acute onset dyspnea concerning for aspiration. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in a semi upright position. COMPARISON: ___. FINDINGS: A weighted esophageal catheter terminates in the region of the gastroesophageal junction. A right PICC terminates in the mid superior vena cava, which appears retracted compared to prior. Retrocardiac density likely corresponds to known left lower lobe consolidation, better seen on today's CT. No pleural effusion or pneumothorax is seen. No pulmonary edema is evident on this view. The main pulmonary artery is enlarged, as seen on CT. IMPRESSION: 1. Left lower lobe consolidation, better evaluated on CT. 2. Weighted enteric catheter with tip in the region of the gastroesophageal junction. Subsequent radiographs demonstrate interval repositioning of the enteric catheter. " b200de2d-33da7fa5-35fd7d6d-a274196e-1c442c9c.jpg,validate/p15/p15220389/s54798558/b200de2d-33da7fa5-35fd7d6d-a274196e-1c442c9c.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___-year-old woman with metastatic osteosarcoma with leukocytosis, here to evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: A right Port-A-Cath terminates in the mid SVC. The inspiratory lung volumes are slightly decreased from the most recent prior study. Streaky opacities in the lower lobes on the lateral radiograph likely represent mild basilar atelectasis. No focal consolidation concerning for pneumonia, pleural effusion or pneumothorax is detected. The cardiomediastinal and hilar contours are within normal limits. Right humeral hardware is re- demonstrated and the patient's known humeral lesion is incompletely evaluated. IMPRESSION: No focal consolidation concerning for pneumonia. " 9e805bb8-9b5b5ba0-a5f21d7d-73b51746-f511ddec.jpg,validate/p13/p13514385/s57837425/9e805bb8-9b5b5ba0-a5f21d7d-73b51746-f511ddec.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with pulmonary edema. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: Two frontal images of the chest demonstrate moderate pulmonary edema, which has worsened since prior imaging. There is increased opacity in the right lung base, consistent with a moderate right pleural effusion. There is a small left basilar opacity again seen, consistent with a small left pleural effusion and atelectasis. Moderate cardiomegaly is again seen, stable. IMPRESSION: Moderate pulmonary edema, worse since previous imaging. Bilateral pleural effusions, right greater than left. " bc7b649b-d47c59a0-0e18c64a-39b3b184-066da66f.jpg,validate/p11/p11947526/s56105350/bc7b649b-d47c59a0-0e18c64a-39b3b184-066da66f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with cp, sob started today fever yesterday lungs clear // r/o PNA vs AD TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: As compared to the prior examination dated ___, there has been no relevant interval change. 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. " ef02f416-70219126-6c3d8fbf-807c73fc-d7bd31a6.jpg,validate/p18/p18929056/s50442960/ef02f416-70219126-6c3d8fbf-807c73fc-d7bd31a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA/LAT) INDICATION: ___ year old woman with cough, wheezing, sob. h/o COPD // r/o pna CONGESTED COUGH,WHEEZING AND INCREASING SOB SINCE ___ HX COPD R/O PNEUMONIA IMPRESSION: Comparisons ___. Unchanged minimal retrocardiac atelectasis, seen on the lateral radiograph only. No evidence of pneumonia or other pathologic lung parenchymal process. Minimal millimetric nodular opacity projecting over the right upper lung, between the posterior aspect of the sixth and seventh rib, is only seen on the frontal radiograph and likely reflect a structure in the soft tissues. Unchanged moderate cardiomegaly without pulmonary edema, elongation of the descending aorta. " 08ca9824-1ab63f30-71a696b3-9a13a482-2d09c92b.jpg,validate/p13/p13166211/s50534609/08ca9824-1ab63f30-71a696b3-9a13a482-2d09c92b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F h/o stage IV recurrent invasive ductal carcinoma of the R breast, stage IV on palliative chemo (Lapatinib/Capecitabine) with new PE who is transferred to the FICU with worsening cough, dyspnea and hypoxia. // s/p OGT placement, please verify location TECHNIQUE: Chest single view COMPARISON: ___ 20:56 FINDINGS: Enteric tube tip is in the mid stomach. Left basilar opacity has mildly worsened since prior. Bilateral pulmonary nodules and consolidations are otherwise similar. Stable pleural effusions. Endotracheal tube tip in good position. Surgical clips bilateral axilla, right abdomen. Normal heart size, pulmonary vascularity. Bilateral hilar fullness, consistent with adenopathy, stable. Left PICC line projects over left axilla. IMPRESSION: Enteric tube tip is in the mid stomach. Mildly worsened left basilar opacity, otherwise stable pulmonary findings " 6d38cfcc-0b2ab376-526da941-26b16516-7fad1386.jpg,validate/p12/p12717357/s55342779/6d38cfcc-0b2ab376-526da941-26b16516-7fad1386.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with fever. Evaluate for pneumonia. COMPARISON: ___. TECHNIQUE: Upright AP and lateral chest radiographs. FINDINGS: The lungs are well expanded. There is a retrocardiac opacity which can be confirmed with a spinal sign in the lateral view and is obscuring the posterior margin of the left hemidiaphragm. No other focal opacities are noted. Heart size cannot be accurately assessed in this AP view, but the heart appears mildly enlarged. There is no pleural effusion or pneumothorax. IMPRESSION: Left lower lobe consolidation is most likely pneumonia. " 936f1a7b-9a77a19d-640f9f63-47721e2f-195a31c2.jpg,validate/p16/p16609016/s56088519/936f1a7b-9a77a19d-640f9f63-47721e2f-195a31c2.jpg,validation," FINAL REPORT INDICATION: ___ year old man with chronic pul fibrosis s/p cardiac surgery. Evaluate interstitial lung disease. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___, ___. FINDINGS: Compared to ___, minimal residual pulmonary edema is seen. Small residual left pleural effusion is likely. Compared to preop radiograph on ___, previously seen fibrosing interstitial lung disease account for bilateral opacities. The heart size is normal and unchanged. The mediastinal and hilar contours are unchanged. Right jugular catheter is in right atrium, unchanged from prior. No pneumothorax seen. Sternotomy wires are aligned and intact. Aortic calcification is unchanged. IMPRESSION: Improving pulmonary edema. Similar extent of pulmonary fibrosis. " 6ab99d31-eb50688b-21290b5b-2d4e3a20-c3bcd103.jpg,validate/p12/p12435705/s52750938/6ab99d31-eb50688b-21290b5b-2d4e3a20-c3bcd103.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tube ___ to pleural effusion, b/l PNA // interval changes, chest tube placement interval changes, chest tube placement IMPRESSION: In comparison with the study of ___, the small chest tube but the right is no longer seen. No evidence of pneumothorax. The retrocardiac region has cleared and the left hemidiaphragm is quite well seen. This suggests a expectoration of a mucous plug that had cause collapse of the left lower lobe. Basilar opacifications on the right are consistent with atelectasis. " 28c5de31-65e84a73-489e242f-91a04912-29fdefc2.jpg,validate/p16/p16981603/s57511227/28c5de31-65e84a73-489e242f-91a04912-29fdefc2.jpg,validation," WET READ: ___ ___ ___ 8:05 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: ___M with chest pain // eval for pneumothorax TECHNIQUE: Chest PA and lateral 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 intrathoracic process. " 116d8e1f-a0d54aac-e6128c2b-7070ca0f-00568079.jpg,validate/p13/p13652184/s50872813/116d8e1f-a0d54aac-e6128c2b-7070ca0f-00568079.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with pneumothorax following MVC. Follow progression of pneumothorax. TECHNIQUE: Portable AP chest radiograph was obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Small left apical pneumothorax has not changed size. Multiple lateral left rib fractures are substantially displaced. Small bilateral pleural effusions continue to be seen, and the cardiac, mediastinal and hilar contours are normal. IMPRESSION: Unchanged left apical pneumothorax. " 98ad511d-f551ac34-857418f7-e2f5e5e9-6d4a3106.jpg,validate/p18/p18180310/s59611790/98ad511d-f551ac34-857418f7-e2f5e5e9-6d4a3106.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with history of glioblastoma and seizures with significant secretions and new fever overnight. Study requested to rule out pneumonia. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: Lung volumes remain low, accentuating the cardiac silhouette and bronchovascular structures. There is increased opacity at the right upper lung which could be related to prominence of the azygos fissure and azygous vein due to increased venous pressures. However, in the appropriate clinical setting, these findings could also be related to aspiration. In addition, there is an increased area of opacity along the right perihilar region and right lung base which could be related to atelectatic changes. However, in the appropriate clinical setting, early pneumonia should also be considered. A left PICC line remains unchanged, terminating in the mid SVC. IMPRESSION: Increased opacity at the right upper lung which could be related to increased venous pressures and increased right perihilar region and right lung base opacity. In the appropriate clinical setting, aspiration and early pneumonia should also be considered. " fa058296-9cec3107-a9c22fa0-4f82d921-cc522f70.jpg,validate/p12/p12724735/s52606347/fa058296-9cec3107-a9c22fa0-4f82d921-cc522f70.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y.o F with ESRD, on HD, presenting with dyspnea, found to have pulmonary edema, now s/p 4L fluid removal // interval change of pulmonary edema COMPARISON: Chest x-ray dated ___ at 06:26 FINDINGS: Again seen is a dual-lumen catheter with both lumens overlying the right atrium. There is moderate cardiomegaly, probably less pronounced and with better definition of the cardiomediastinal borders. There is upper zone redistribution, but there has been marked improvement in the CHF/ remain pulmonary edema findings. Mild residual vascular blurring a is present. Probable residual left base atelectasis, seen is increased retrocardiac density, but the left hemidiaphragm is now distinctly visible. No gross effusion. The right hemidiaphragm is elevated. No pneumothorax is identified. Clips noted over left thoracic inlet. Densely calcified tortuous splenic artery is again noted. IMPRESSION: Marked interval improvement in the CHF findings. Now only minimal residual upper zone redistribution and slight vascular blurring. " 844a09ef-24e89b2c-d4989482-a43cd7ad-ad1fdd11.jpg,validate/p16/p16646670/s59831667/844a09ef-24e89b2c-d4989482-a43cd7ad-ad1fdd11.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pulmonary nodules s/p R VATS wedge resections x 3 // rule-out pneumothorax, hemothorax rule-out pneumothorax, hemothorax COMPARISON: Comparison to prior study dated ___ FINDINGS: Portable AP chest film ___ at 17 34 is submitted. IMPRESSION: Cardiac and mediastinal contours are stable. There has been interval placement of a right chest tube and interval appearance of patchy opacity in the right mid lung which likely is postoperative in etiology given the presence of chain sutures in this vicinity. No large pneumothorax is appreciated, although the sensitivity to detect pneumothorax is diminished as the patient was imaged supine. Lung volumes are lower and the vasculature is slightly prominent but no overt pulmonary edema. No pleural effusions. Numerous bilateral pulmonary nodules are better appreciated on the recent chest CT dated ___. " a5be4003-1e183933-96ab153f-b336e2bb-1dcd777a.jpg,validate/p19/p19349343/s50982662/a5be4003-1e183933-96ab153f-b336e2bb-1dcd777a.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Hematemesis after EGD. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size is stable. Slight widening of the mediastinum is demonstrated but may be related to expiratory character of the study, followup chest radiograph is recommended. New left basal opacity is demonstrated as well as left mid lung opacities might potentially reflect aspiration. No pleural effusion is seen. No pneumothorax is seen and no mediastinum is demonstrated. " a54f0262-689150e6-1812d5d0-adc3292a-3beb44dd.jpg,validate/p14/p14019847/s53691339/a54f0262-689150e6-1812d5d0-adc3292a-3beb44dd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new rising leukocytosis and febrile // please eval for PNA, acute process TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: The lungs are better inflated on today's study with a more optimal inspiratory effort. The trachea is central. The cardiomediastinal contour is notable for enlargement of the right hilum, this is likely vascular as there is evidence of pulmonary vascular congestion on the prior study however continued attention on followup is recommended. No consolidation, pneumothorax or pleural effusion seen. The visualized bony structures are unremarkable in appearance. IMPRESSION: Prominence of the right hilum is likely vascular given the appearance on the prior chest radiographs however continued attention on followup is recommended. " eb6e2cd0-01002404-cc3f6dd1-cebd61c9-0f718b8c.jpg,validate/p18/p18780736/s53082729/eb6e2cd0-01002404-cc3f6dd1-cebd61c9-0f718b8c.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CLL pleural effusions s/p pleurex catheter // eval for interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___. FINDINGS: Since ___, the left pneumothorax is unchanged in size. The bilateral focal opacities have decreased in density, consistent with resolving pneumonia. Stable small right pleural effusion. Right Port-A-Cath ends in the mid SVC. Unchanged mild cardiomegaly. Mediastinal borders and hilar structures are normal. IMPRESSION: Since ___, resolving multifocal pneumonia, and unchanged small left pneumothorax. " 489dbbe2-c49bf624-e915d058-bc69558c-86b42115.jpg,validate/p12/p12219154/s56028372/489dbbe2-c49bf624-e915d058-bc69558c-86b42115.jpg,validation," 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. " 8221dd78-9e803786-7412f166-c900ae0c-a6dd8386.jpg,validate/p13/p13484611/s56489525/8221dd78-9e803786-7412f166-c900ae0c-a6dd8386.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p ICD // confirm lead placement TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Pacemaker leads terminate in right atrium and right ventricle expected location. There is no pneumothorax Lungs are clear except for left mid lung calcified granuloma and left hilar calcified lymph nodes, reflecting prior granulomatous exposure. " 8f47bc49-8be55ba3-669a2cfc-220661d8-51689882.jpg,validate/p14/p14716808/s55667433/8f47bc49-8be55ba3-669a2cfc-220661d8-51689882.jpg,validation," WET READ: ___ ___ ___:___ AM Slight interval improvement in bibasilar opacities compared to the prior exam, with mild residual disease. No significant interval change in extent of multiple prior compression deformities compared to the most recent prior exam. Unchanged right posterior second and third rib fractures. D/w Dr. ___ by Dr. ___ by phone at 6p on the day of the exam. WET READ VERSION #1 ___ ___ ___:___ PM Slight interval improvement in bibasilar opacities compared to the prior exam, with mild residual disease. No significant interval change in extent of multiple prior compression deformities compared to the most recent prior exam. Unchanged right posterior second and third rib fractures. D/w Dr. ___ by Dr. ___ by phone at 6p on the day of the exam. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of myeloma and RSV. Please assess for PNA or interval change from last week. // ___ year old man with hx of myeloma and RSV. Please assess for PNA or interval change from last week. ___ year old man with hx of myeloma and RSV. Please assess for PNA or interval change from last week. IMPRESSION: In comparison with the study of ___, there is little change. Cardiomediastinal silhouette is stable. Bilateral basilar atelectatic changes are again seen. Fractures of the right posterior second and third ribs are again seen, with the latter possibly representing a pathologic lesion. No evidence of acute focal pneumonia. " ddc8b8bb-6ab695d3-3c13a8c5-8d63ca02-c9649dd9.jpg,validate/p14/p14500788/s58066206/ddc8b8bb-6ab695d3-3c13a8c5-8d63ca02-c9649dd9.jpg,validation," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumonia or effusion. COMPARISON: Chest radiographs, ___, ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiograph of the chest. FINDINGS: There is no concerning focal airspace opacity. There is slight blunting of bilateral costophrenic sulci, likely due to atelectasis. The cardiomediastinal silhouette and hilar contours are normal. The heart is not enlarged. The aorta is somewhat tortuous. No large pleural effusion is detected. There is no pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary abnormality. No focal airspace opacity to suggest pneumonia. " 2913d0ec-c9f25b61-20a66cf7-59d4f5b4-b31e68fc.jpg,validate/p18/p18843419/s53503161/2913d0ec-c9f25b61-20a66cf7-59d4f5b4-b31e68fc.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with increased shortness of breath. Evaluate for fluid overload. COMPARISONS: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is mildly enlarged with a left ventricular configuration. Lung volumes are low. The lungs are otherwise clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. There is significant degenerative changes of the right acromioclavicular joint. Osseous structures are otherwise unremarkable. No radiopaque foreign body. IMPRESSION: Mild cardiomegaly. No evidence of fluid overload. " f5fde381-031c99d4-babe45f8-3a2aa046-889aa799.jpg,validate/p11/p11291823/s50272040/f5fde381-031c99d4-babe45f8-3a2aa046-889aa799.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with a history of ESRD on HD (___), Afib on coumadin, COPD, CAD, DM, R AKA, L TKR who was initially transferred from ___ ___ with L distal femur fracture, c/b respiratory failure // eval interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Lung volumes have slightly decreased. The areas of atelectasis at the right lung base have also increased. The retrocardiac atelectasis is unchanged. The radiograph continues to show signs of mild predominantly interstitial pulmonary edema. No larger pleural effusions. " c01f546e-1ce99890-6d1ba517-2e3bceff-2d048419.jpg,validate/p18/p18497352/s50690516/c01f546e-1ce99890-6d1ba517-2e3bceff-2d048419.jpg,validation," 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. " 6e90291e-aae70cf5-20af20c6-44365865-d91207a7.jpg,validate/p15/p15964158/s55555425/6e90291e-aae70cf5-20af20c6-44365865-d91207a7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from approximately 30 minutes earlier. CLINICAL HISTORY: Chest tube position, assess location of tip. FINDINGS: Supine portable AP view of the chest was provided. Again seen is the right chest tube with tip at the medial aspect of the right lung. Retraction by approximately 14 cm would result in a location at the right lung apex. There is minimal residual right pneumothorax. Extensive right chest wall emphysema is again noted as well as displaced right rib fractures. " 94b4c3b8-a35f2618-e4bcb793-3d4ba242-b4f848a4.jpg,validate/p19/p19555515/s54197314/94b4c3b8-a35f2618-e4bcb793-3d4ba242-b4f848a4.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Again, slightly low lung volumes are seen. Given this, there is no focal consolidation, pleural effusion, or evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable with the aorta being tortuous. There is no overt pulmonary edema. Some degenerative changes are seen along the spine. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " b358b8de-e18e0ad2-ab4e91d4-6e24982f-b9d2b886.jpg,validate/p12/p12938496/s54392997/b358b8de-e18e0ad2-ab4e91d4-6e24982f-b9d2b886.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with prior CTA imaging showing aspiration pneumonia. Has this resolved. IMPRESSION: PA and lateral chest compared to ___: Lungs are fully expanded and clear. Moderate cardiomegaly has improved slightly. Pulmonary vasculature and mediastinal veins are not distended, there is no edema or pleural effusion. Right transjugular dialysis catheter ends in the upper right atrium. " c98ccf96-3004f2ee-8c43b99a-78d490e4-97943e4b.jpg,validate/p19/p19969918/s57926967/c98ccf96-3004f2ee-8c43b99a-78d490e4-97943e4b.jpg,validation," WET READ: ___ ___ ___ 8:02 PM Right lower lobe opacity has become denser and more wedge-like since 10am. Findings are compible with pneumonia and progressive consolidation. Ongoing aspiration is another possibility. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:52 P.M., ___ HISTORY: ___-year-old man with respiratory distress and previous consolidation. IMPRESSION: AP chest compared to ___ through ___ at 10:33 a.m.: Large scale consolidation in the right lower lung, predominantly lower lobe, was new earlier today compared to ___. It has grown slightly more radiodense over the past eight hours, probably active pneumonia. Small right pleural effusion is presumed and should be monitored in order to detect any development of empyema. Left lung is clear. Cardiomediastinal silhouette is normal. The patient has a tracheostomy tube in standard placement. No pneumothorax. " 720cf5ed-6e77ba50-58c389ae-b5b4ce49-bf2947e8.jpg,validate/p17/p17823467/s58670257/720cf5ed-6e77ba50-58c389ae-b5b4ce49-bf2947e8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG // eval for pneumothorax s/p chest tube removal TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: The left-sided chest tube is been removed. There is a small left apical pneumothorax. The ET tube and NG tube have been removed. There is a small right effusion is increased compared to the study from 2 days prior the right IJ line is unchanged IMPRESSION: Small left apical pneumothorax " a16e1643-c832de64-247fb3bf-d9607920-00880e63.jpg,validate/p17/p17370807/s51778469/a16e1643-c832de64-247fb3bf-d9607920-00880e63.jpg,validation," 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 " 8e94a2a9-873486aa-210b6f53-8f36c36d-60f38a96.jpg,validate/p13/p13370962/s55639018/8e94a2a9-873486aa-210b6f53-8f36c36d-60f38a96.jpg,validation," FINAL REPORT HISTORY: Fall unwitnessed. TECHNIQUE: Chest, frontal and lateral views. COMPARISON: None. FINDINGS: The lungs are hyperinflated, with flattening of the diaphragms. There is no consolidation, pleural effusion, or evidence of pneumothorax. The aorta is calcified. The cardiac silhouette is not enlarged. Multilevel degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. Hyperinflated lungs, which may be due to chronic obstructive pulmonary disease. " 59002727-0741e3ea-94cfa0ad-e900d72c-eecbb167.jpg,validate/p13/p13383248/s50014324/59002727-0741e3ea-94cfa0ad-e900d72c-eecbb167.jpg,validation," 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. " c063d0e5-9c47e346-b8f0a96c-6de306b8-0f068bc1.jpg,validate/p12/p12246481/s51160344/c063d0e5-9c47e346-b8f0a96c-6de306b8-0f068bc1.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Acute renal failure. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been no significant interval change. Linear lingular atelectasis/scarring is again seen. There is persistent bibasilar atelectasis and right hemidiaphragm eventration. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 613f114d-c05de583-fb5e30f4-d89c8f30-5d483b3a.jpg,validate/p19/p19017919/s50566971/613f114d-c05de583-fb5e30f4-d89c8f30-5d483b3a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p AVR/ CABG ..respiratory failure- MRSA PNA, and HD for renal failure // Eval interval change and position of new tracheostomy Eval interval change and position of new tracheostomy COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Moderate to large left pleural effusion and moderate right pleural effusion both smaller. Left lower lobe still collapsed. Moderate enlargement cardiomediastinal silhouette stable. No pneumothorax Tracheostomy tube midline. Feeding tube passes into the stomach and out of view. Left jugular catheter ends in the left brachiocephalic vein. Right PIC line ends in the mid to low SVC. " 37d437f9-b81c39e0-c81aca63-9d22a352-582e8a81.jpg,validate/p17/p17515299/s57404802/37d437f9-b81c39e0-c81aca63-9d22a352-582e8a81.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with sob // eval for ptx COMPARISON: None available FINDINGS: Lung volumes are low. 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. " e10ac1d4-bdc1cbbb-4eb40ac7-8eddaf6f-3eaa2b09.jpg,validate/p19/p19069731/s57585145/e10ac1d4-bdc1cbbb-4eb40ac7-8eddaf6f-3eaa2b09.jpg,validation," FINAL REPORT INDICATION: Abdominal pain. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. A nodular opacity identified in ___ is no longer seen. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary abnormality. Findings were relayed to Dr. ___. " 97966785-9a0c07d1-b09f968e-537cc5c9-35bb7550.jpg,validate/p17/p17915506/s56516546/97966785-9a0c07d1-b09f968e-537cc5c9-35bb7550.jpg,validation," FINAL REPORT SINGLE AP PORTABLE VIEW OF THE CHEST REASON FOR EXAM: Status post right lower lobectomy. Comparison is made with prior study, ___ and ___. Cardiomediastinal contours are normal. Right chest tube has a loop in the apex and it's tip is in the lower mid chest. There is a moderate right pneumothorax. Cardiomediastinum is midline. There is no pleural effusion. Cardiac size is normal. The azygos vein is distended, likely due to position of the patient. Ill-defined opacities in the left lower lobe are likely atelectasis. " aa0f5e33-bc82868e-1a8da5a1-0338ac7c-7ec05565.jpg,validate/p10/p10449408/s50483339/aa0f5e33-bc82868e-1a8da5a1-0338ac7c-7ec05565.jpg,validation," WET READ: ___ ___ ___ 8:15 PM Left PICC repositioned with tip now terminating in the mid SVC. Interval extubation and removal of NG tube from ___. Otherwise, no acute change in appearance of the chest. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:20 P.M. ON ___ CLINICAL HISTORY: ___-year-old woman with cirrhosis and GI bleed. PIC line reposition. IMPRESSION: AP chest compared to ___: Pulmonary vascular congestion has improved. There is no longer consolidation or asymmetric edema in the right lower lobe. Heart is still severely enlarged as are pulmonary arteries. Left PIC line ends at the origin of the SVC. Small left pleural effusion stable. No pneumothorax. " d2848456-5eb55465-d554abd7-0535dc15-0d311fb5.jpg,validate/p11/p11168569/s50497838/d2848456-5eb55465-d554abd7-0535dc15-0d311fb5.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with coronary artery disease and cardiomyopathy status post biventricular ICD placement. Rule out pneumothorax, evaluate placement. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: There is better aeration of lung fields compared to previous chest radiograph. Previous minimal fluid overload has resolved. The left cardiac device is unchanged in position, and the wires end at the right atrium, right ventricle and left ventricle. No pneumothorax is seen, and the cardiac and mediastinal contours are normal. IMPRESSION: No pneumothorax. The left BiV-ICD has leads ending in the right atrium, right ventricle, and left ventricle. " 3ee5ee56-b8eb67c5-943da959-e3a6f32b-0e4e8bac.jpg,validate/p19/p19059028/s55097998/3ee5ee56-b8eb67c5-943da959-e3a6f32b-0e4e8bac.jpg,validation," FINAL REPORT INDICATION: Patient with night sweats and productive 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. Multiple surgical clips project over right upper abdomen. IMPRESSION: No evidence of acute cardiopulmonary process. " 4eb35481-1008b69e-0d681621-cbfaf824-c8cccccc.jpg,validate/p17/p17762094/s53614630/4eb35481-1008b69e-0d681621-cbfaf824-c8cccccc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mediastinal mass and LLL nodule s/p robotic-assisted thymectomy/LUL wedge c/b PE and reintubation // interval changes TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " edfd8b2c-0993df38-275df4a9-916a8ca0-4e7d7e47.jpg,validate/p16/p16852352/s56896613/edfd8b2c-0993df38-275df4a9-916a8ca0-4e7d7e47.jpg,validation," FINAL REPORT HISTORY: Decreasing oxygen saturation. FINDINGS: In comparison with study of ___, there are continued low lung volumes. Bibasilar atelectasis persists, more prominent on the right. Upper lung zones are clear without vascular congestion. Blunting of the left costophrenic angle suggests a small pleural effusion on this side. " 613f2e0d-587eccff-4fbf5b74-d6898eb2-217d0b01.jpg,validate/p15/p15714399/s54381029/613f2e0d-587eccff-4fbf5b74-d6898eb2-217d0b01.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB // eval acute process COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Left chest wall pacer device is seen with single lead extending into the right heart. 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. " a5070a6b-a6e29afc-6ddee5b8-78f5d2dc-1dd5f444.jpg,validate/p18/p18016258/s54144245/a5070a6b-a6e29afc-6ddee5b8-78f5d2dc-1dd5f444.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with STEMI, cardiogenic shock, intubated, s/p ET tube pulled back 2 CM // ET tube in correct place? EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___ 03:40 FINDINGS: ET tube terminates 3 cm above the carina. There is worsening of pulmonary edema compared to 5 hr prior. There is bibasilar opacity which is likely due to atelectasis and/ or pleural effusions. Mildly enlarged cardiac silhouette is increased compared to 5 hr prior. Widened mediastinum is reflective of enlarged vascular pedicle. Transesophageal tube courses below the diaphragm and out of view. Right PICC terminates in low SVC. IMPRESSION: ET tube terminates 3 cm above the carina. There is worsening of pulmonary edema compared to 5 hr prior. " a6bba951-bd8e2afc-9e3e6096-20d962a5-61ab8991.jpg,validate/p19/p19975796/s55892323/a6bba951-bd8e2afc-9e3e6096-20d962a5-61ab8991.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with lung cancer, post obstructive pna // Et tube position, interval change COMPARISON: Radiographs ___ IMPRESSION: Tip of the endotracheal tube is 3.1 cm above the carinal. Rest of the support lines and tubes are unchanged position. There is again seen consolidation with areas of lucency in the right upper lobe suggestive of post obstructive pneumonia. Emphysematous changes are noted. There are no pneumothoraces. " 7b26fe33-0168133a-d8f8f8b0-fd7b6adf-6e477c3b.jpg,validate/p14/p14464902/s58282318/7b26fe33-0168133a-d8f8f8b0-fd7b6adf-6e477c3b.jpg,validation," FINAL REPORT INDICATION: History of liver and kidney transplant with acute dyspnea and hypoxia. COMPARISONS: Chest radiograph ___. Chest radiograph ___. FINDINGS: Again seen is hazy opacification of the bilateral lungs, most likely representing pulmonary edema, although may be infection, ARDS, or pulmonary hemorrhage. The cardiac silhouette is moderately enlarged and stable. Small bilateral effusions are unchanged. An opacification at the right base most likely represents atelectasis, although a developing infection cannot be excluded. There is no pneumothorax. Pacemaker electrodes are in standard position. IMPRESSION: 1. Unchanged moderate pulmonary edema and pleural effusions. 2. Probable right basilar atelectasis although developing pneumonia cannot be excluded. " cb79e904-8fb2399c-59443857-81d784ad-3bad72c8.jpg,validate/p11/p11032138/s59518794/cb79e904-8fb2399c-59443857-81d784ad-3bad72c8.jpg,validation," FINAL REPORT HISTORY: ___M with right sided chest pain. COMPARISON: None. FINDINGS: 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. There is no acute osseous abnormality. IMPRESSION: Normal chest radiograph. " 263d0841-cb77dd61-bcaf9f7d-01779a5d-fb2fa362.jpg,validate/p17/p17075209/s55058040/263d0841-cb77dd61-bcaf9f7d-01779a5d-fb2fa362.jpg,validation," WET READ: ___ ___ ___ 3:46 PM No acute intrathoracic process. Persistent moderate cardiomegaly without overt edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with chest pain. Evaluate for consolidation. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes of substantially improved since the prior exam. The lungs are well-expanded and clear. No focal consolidation, edema, effusion, or pneumothorax. The heart remains moderately enlarged. The mediastinum is not widened. Hilar contours are within normal limits. No acute osseous abnormality. Surgical clips projecting over the upper abdomen. IMPRESSION: No acute intrathoracic process. Persistent moderate cardiomegaly without overt edema. " 99bb5ff5-fb200e62-dbb48f94-3384d6cb-8a705657.jpg,validate/p16/p16042873/s55416811/99bb5ff5-fb200e62-dbb48f94-3384d6cb-8a705657.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with trache // intrapulmonary fluids? infiltrates? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the left central venous access line has been removed. Moderate cardiomegaly persists. Low lung volumes with bilateral areas of atelectasis. Tracheostomy tube and right PICC line are in unchanged position. The right PICC line should be slightly pulled back, as its tip projects over the right atrium. " e8273d2d-b421f3e8-941158de-9283c081-6153e950.jpg,validate/p18/p18143542/s54717693/e8273d2d-b421f3e8-941158de-9283c081-6153e950.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p intubation // tube position on prior examinations. IMPRESSION: Compared to chest radiographs since ___, most recently ___. Stomach is chronically distended, but it appears to be more grossly dilated today than on prior examinations. New ET tube in standard placement. However left lower lobe is now largely collapsed, more atelectatic now than prior to intubation. Upper lungs are clear. Pleural effusion small if any. No pneumothorax. Heart size normal. Coronary stent in place. " 93002424-6f5d8d08-601ee52d-06060d18-231d9345.jpg,validate/p12/p12580546/s53497598/93002424-6f5d8d08-601ee52d-06060d18-231d9345.jpg,validation," FINAL REPORT HISTORY: New left-sided chest pain and cough. COMPARISON: ___. FINDINGS: There is a new 1.4 cm mass in the right chest. CT is recommended for further evaluation. Otherwise the lungs are clear without infiltrate or effusion. The cardiac and meddastinal silhouettes are normal. IMPRESSION: The 1.4 cm mass in the right lower lung. Recommend CT for further assessment. This finding was submitted to critical results reporting at ___ after attempt to reach physician who ordered exam at the time of dictating this report by Dr. ___ at 11:10 a.m. on ___. " ac91051d-b5f1be63-843874ff-5a70ac87-0e0dd4d9.jpg,validate/p12/p12554603/s55559068/ac91051d-b5f1be63-843874ff-5a70ac87-0e0dd4d9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough and fever. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Subtle opacity projecting over the right lung base is concerning for a right lower lobe pneumonia. Lungs are otherwise clear. No effusion or pneumothorax. Cardiomediastinal silhouette appears unchanged. Clips the right upper quadrant noted. Bony structures are intact. IMPRESSION: Vague opacity at the right lung base is concerning for right lower lobe pneumonia. " 1f0e5f23-6a8f38f8-f58cf617-27004a44-5d1672b6.jpg,validate/p14/p14982705/s55414861/1f0e5f23-6a8f38f8-f58cf617-27004a44-5d1672b6.jpg,validation," FINAL REPORT HISTORY: Worsening shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided pacemaker device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus. The patient is status post median sternotomy and CABG. The cardiac silhouette size is moderately enlarged. The mediastinal and hilar contours are within normal limits and unchanged. There is minimal pulmonary vascular congestion. Blunting of the costophrenic angles posteriorly on the lateral view is chronic and compatible with small effusions. There is no pneumothorax. There are mild degenerative changes in the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion and trace bilateral pleural effusions. " a64b2d89-e408726e-382a235e-2c3461c3-a0e3c679.jpg,validate/p11/p11151938/s57389232/a64b2d89-e408726e-382a235e-2c3461c3-a0e3c679.jpg,validation," 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. " 01929759-7563cf92-fa7ee95f-486a9fd6-d63e5b71.jpg,validate/p19/p19797689/s50306353/01929759-7563cf92-fa7ee95f-486a9fd6-d63e5b71.jpg,validation," FINAL REPORT HISTORY: AFib, CHF, pneumonia, pulmonary edema. CHEST, SINGLE AP PORTABLE VIEW. Compared with ___, no definite change is detected. Equivocal minimal new linear atelectasis and pleural blunting at the right lung base. Again seen is background COPD, with moderate cardiomegaly and calcified aorta. There is upper zone redistribution, similar to prior, but no overt CHF. Also again seen is a small left effusion with underlying collapse and/or consolidation. As before, the right hemidiaphragm is slightly eventrated. On the right, no focal opacity, consolidation or gross effusion. " 29ec5d2a-31e7506f-7e5eae15-f3845953-e43fe52b.jpg,validate/p10/p10635271/s56204132/29ec5d2a-31e7506f-7e5eae15-f3845953-e43fe52b.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old woman with large pulmonary embolism and type B aortic dissection. Persistent oxygen requirement. FINDINGS: Comparison is made to previous study from ___. There is cardiomegaly. There are bilateral pleural effusions, left greater than right. There is a prominent gastric air bubble at the left base. There is minimal prominence of the pulmonary interstitial markings without overt pulmonary edema. There are no focal pneumothoraces. " a34157b9-3e588f34-1f79570b-3d24c9e5-f4a6133c.jpg,validate/p13/p13556220/s55120025/a34157b9-3e588f34-1f79570b-3d24c9e5-f4a6133c.jpg,validation," 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 findings in the chest. " d83bc164-ffe34c94-4ea3344a-5280e63b-a6cbbada.jpg,validate/p15/p15931924/s53623545/d83bc164-ffe34c94-4ea3344a-5280e63b-a6cbbada.jpg,validation," FINAL REPORT INDICATION: Aneurysm, rule out effusion. TECHNIQUE: Bedside frontal chest radiograph. COMPARISON: Outside hospital chest CT ___ 21:51. FINDINGS: Widening of the mediastinum is compatible with known aortic aneurysm. Heart is moderately enlarged but unchanged. No pulmonary edema. The known, trace left pleural effusion is not appreciated on this study. No pneumothorax or focal consolidation worrisome for infection. IMPRESSION: Widened mediastinum compatible with known aortic aneurysm. No large effusion. " 64f29972-d9c447e1-34ae9672-a28699e5-a6171a39.jpg,validate/p19/p19023232/s56730436/64f29972-d9c447e1-34ae9672-a28699e5-a6171a39.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion. Evaluate for pulmonary infiltrates. COMPARISON: Prior radiographs of the chest dated ___ and ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate low lung volumes with resulting bronchovascular crowding. Increased opacities at the bilateral bases reflect small bilateral pleural effusions with adjacent atelectasis. There is cephalization of pulmonary vessels, indistinct hila bilaterally, and increased interstitial markings, consistent with pulmonary edema. Superimposed infection cannot be excluded. There is no pneumothorax. IMPRESSION: Cephalization of pulmonary vessels, indistinct hila, and increased interstitial markings are consistent with pulmonary edema. Superimposed infection cannot be excluded. " 62cdb335-6b875ad2-6bc23ac8-b5c24fd8-5a4b60eb.jpg,validate/p11/p11885997/s56086823/62cdb335-6b875ad2-6bc23ac8-b5c24fd8-5a4b60eb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Newly diagnosed lymphoma, status post VATS, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumothorax after VATS. Normal appearance of the lung parenchyma, no pleural effusions. No focal parenchymal opacity suggesting pneumonia. Normal size and shape of the cardiac silhouette. " b80dd959-c9db8c57-4ef52d7f-06b86479-e90652cd.jpg,validate/p10/p10165672/s56328548/b80dd959-c9db8c57-4ef52d7f-06b86479-e90652cd.jpg,validation," 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. " f8fc0f9c-cbdc2dae-2f41c4c2-5ad39bb7-e8283ce0.jpg,validate/p17/p17767787/s52583609/f8fc0f9c-cbdc2dae-2f41c4c2-5ad39bb7-e8283ce0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea // ?PNA COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Hilar congestion is again noted with improvement in pulmonary edema. Bilateral pleural effusions are small and appears slightly improved. Basilar compressive atelectasis is present. Heart size is top-normal. Mediastinal contour is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Overall there is interval improvement with mild residual hilar congestion and small bilateral pleural effusions. Top-normal heart size. " 8ecc8280-bc844e1b-eb475631-0072eedc-3ec194a9.jpg,validate/p17/p17592232/s59750445/8ecc8280-bc844e1b-eb475631-0072eedc-3ec194a9.jpg,validation," FINAL REPORT INDICATION: ___ year old man with worsening muscle weakness. Evaluate for fluid overload and infection. TECHNIQUE: Chest PA and lateral. COMPARISON: ___. FINDINGS: A small right effusion has slightly increased since 1 day ago. Right pleural thickening is likely chronic. There is no pneumothorax. Bibasilar opacities are relatively unchanged. The cardiac and mediastinal contours are stable. Pulmonary edema is mild and unchanged. IMPRESSION: Stable mild pulmonary edema and slight interval increase in the small right pleural effusion. Bibasilar opacities are most consistent with atelectasis or infection in the correct clinical setting. " 68aa547f-4909ae2d-048cbb20-1e811e7a-2f82afcc.jpg,validate/p14/p14982705/s54111156/68aa547f-4909ae2d-048cbb20-1e811e7a-2f82afcc.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with heart failure symptoms, evaluate for possible pulmonary edema. 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 patient is status post sternotomy and previous bypass surgery. The heart is moderately enlarged. The configuration is the same with some relative prominence of the left ventricular contour to the left and posteriorly. Left atrial enlargement is also present but of more moderate degree. Previously described coronary calcifications and multiple surgical clips related to bypass surgery appear unchanged. Again noted is an upper zone re-distribution pattern with distended vessel in the upper pulmonary area and some interstitial edema on the bases with perivascular haze and a few peripheral lymph lines. Also noted is accentuated visibility of both minor and major fissure related to some wetness in the pleural spaces. There is evidence of some mild degree of chronic pulmonary congestion, may have increased slightly, but there is no significant advancement into interstitial edema and no central alveolar edema can be identified. No new discrete pulmonary parenchymal infiltrates are present. No pneumothorax is seen in the apical area. In comparison with the next previous examination of ___, there may be a mild degree of progression of CHF. Same can be stated when comparison is extended to the chest examination of ___. IMPRESSION: Mild degree of chronic CHF in patient, moderate cardiomegaly status post bypass surgery. No new acute infiltrates are seen and no major pleural effusions can be identified. " d6814cf9-55fe2bdc-5a4364b3-1249d083-e888f006.jpg,validate/p13/p13031024/s52753211/d6814cf9-55fe2bdc-5a4364b3-1249d083-e888f006.jpg,validation," FINAL REPORT INDICATION: ___F with fever, cough // infiltrate? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ef4436b7-2a864023-7ff8312f-db25bd9e-0425e75c.jpg,validate/p10/p10457298/s58440104/ef4436b7-2a864023-7ff8312f-db25bd9e-0425e75c.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain, shortness of breath, ? fluid overload. COMPARISON: None. FINDINGS: PA and lateral views of the chest were obtained. The heart is normal in size and cardiomediastinal contour is unremarkable. Lungs are clear. There is no pulmonary edema. No pleural effusions or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " ed8282b9-9a1ccf19-0829516f-adbbc95a-aa5c02e4.jpg,validate/p18/p18615258/s56892952/ed8282b9-9a1ccf19-0829516f-adbbc95a-aa5c02e4.jpg,validation," FINAL REPORT INDICATION: Chills and altered mental status. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. There is no pulmonary edema. Mild degenerative change is seen at the right acromioclavicular joint. IMPRESSION: No acute cardiopulmonary process. " 7264764a-dd177fd1-d97d526c-79bcf38b-ca072601.jpg,validate/p11/p11184688/s57666958/7264764a-dd177fd1-d97d526c-79bcf38b-ca072601.jpg,validation," FINAL REPORT INDICATION: ___F with presyncope // ? pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Parking cardiomegaly is again seen but not as severe as on previous exam. There has been interval resolution of the previously seen pulmonary edema. There is no focal consolidation or effusion. Left chest wall dual lead pacing device is again seen. No acute osseous abnormality. IMPRESSION: Marking cardiomegaly without superimposed acute cardiopulmonary process. " 2247fd4f-e311bf33-cc8c5788-d8acb403-1ce78b29.jpg,validate/p13/p13865370/s57641740/2247fd4f-e311bf33-cc8c5788-d8acb403-1ce78b29.jpg,validation," WET READ: ___ ___ ___ 8:19 PM Extremely low lung volumes accentuating the pulmonary vasculature. Small right-sided pleural effusion. Suggestion of increased retrocardiac density could correspond to left base atelectasis or possibly infection. There is a suggestion of increased density projecting over the costovertebral sulcus on the lateral view. ______________________________________________________________________________ FINAL REPORT HISTORY: Post-operative hypoxemia. Evaluate for aspiration pneumonitis, pneumonia or effusion. COMPARISON: Multiple chest radiographs from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate low lung volumes and improvement of pulmonary edema. Again seen is right middle and lower lobe collapse which has progressively worsened over the past three days. A new left lower lobe opacity is suspicious for pneumonia. There is no pneumothorax. Also noted is distension of the stomach and small bowel. IMPRESSION: 1. Probable small left lower lobe pneumonia, less likely atelectasis, new over the past three days. 2. Right middle lobe and lower lobe collapse, worse over the past three days. 3. Improvement of pulmonary edema. 4. Distention of the stomach and small bowel warrants clinical evaluation and, if necessary, additional imaging. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___. " e523ff5d-c93cc0bb-84710838-75e4b093-10441e9f.jpg,validate/p12/p12344119/s52721549/e523ff5d-c93cc0bb-84710838-75e4b093-10441e9f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with persistent tachycardia and tachpnea // evaluate for pulm edema evaluate for pulm edema COMPARISON: The only prior chest radiographs are from ___. IMPRESSION: Lung volumes are lower today, mild pulmonary edema is new. Moderate cardiomegaly and mediastinal venous engorgement have increased suggesting volume overload or biventricular heart failure. A right jugular central venous infusion port ends in the region of the superior cavoatrial junction. " bad9f074-c9433af6-40133835-871b9e84-980ed4b3.jpg,validate/p14/p14707155/s56551997/bad9f074-c9433af6-40133835-871b9e84-980ed4b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with hypoxia during exertion, known elevated left hemidiaphragm // ?acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___ FINDINGS: There is stable elevation of the left hemidiaphragm with adjacent platelike atelectasis and/or scarring at the left lung base. The cardiomediastinal silhouette and pulmonary vasculature are stable since the prior exam. Again seen is a dual lead pacemaker, with expected position of the leads. No focal consolidation is identified. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " d44e3e79-18169733-cd7e7ccf-4971dbc1-aa7b4b83.jpg,validate/p17/p17757767/s57654684/d44e3e79-18169733-cd7e7ccf-4971dbc1-aa7b4b83.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. Evaluate for interval change. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate slight increase in lung volumes with otherwise clear lungs. The cardiac and mediastinal contours are normal. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary process. " db0bcef4-25b60391-7fb7376f-a5678878-ebbaf7c3.jpg,validate/p12/p12288549/s56286217/db0bcef4-25b60391-7fb7376f-a5678878-ebbaf7c3.jpg,validation," FINAL REPORT CLINICAL HISTORY: Nasogastric tube placed secondary to ileus, now has abdominal pain and distention. Evaluate position of nasogastric tube. CHEST AP The tip of the nasogastric tube and the side hole lies within the stomach. Some atelectasis in the right base is noted. The lung fields are otherwise clear. IMPRESSION: Nasogastric tube within the stomach. " 6dde6727-ad2a607e-4ae0c709-9036e911-c3cdcfa2.jpg,validate/p13/p13996091/s54047068/6dde6727-ad2a607e-4ae0c709-9036e911-c3cdcfa2.jpg,validation," FINAL REPORT HISTORY: Febrile neutropenia. COMPARISON: None at this institution. FINDINGS: PA and lateral chest radiographs. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal. There are surgical clips in the left breast and axilla. IMPRESSION: No evidence of acute cardiopulmonary process. " af0eaf52-99ba94f2-b884186f-f77fcf80-a0a6a5ed.jpg,validate/p16/p16258846/s50967940/af0eaf52-99ba94f2-b884186f-f77fcf80-a0a6a5ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough decreased breath sounds right middle lobe // evaluate for pneumonia evaluate for pneumonia IMPRESSION: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural " 03f89c24-750485b4-59433e02-ccf315cf-3cfe4cb6.jpg,validate/p14/p14827673/s58867136/03f89c24-750485b4-59433e02-ccf315cf-3cfe4cb6.jpg,validation," 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. " ba3870e3-3754ee80-e75b138b-304c5e9e-73ff2d6d.jpg,validate/p13/p13110443/s54269730/ba3870e3-3754ee80-e75b138b-304c5e9e-73ff2d6d.jpg,validation," FINAL REPORT Chest EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M on Aspirin presenting with acute dysarthria left-sided weakness secondary to pontine and subthalamic hemorrhage // interval changes interval changes COMPARISON: Its ___ through ___. IMPRESSION: Previous mild pulmonary edema has cleared but severe bibasilar atelectasis persists. Moderate cardiomegaly is chronic. ET tube in standard placement. Nasogastric tube passes into the stomach and out of view. Right PIC line ends in the low SVC. Pleural effusions are presumed, but not large. No pneumothorax. " a632d27f-0a473811-2b9f6908-e939332b-5be50309.jpg,validate/p14/p14690121/s54865185/a632d27f-0a473811-2b9f6908-e939332b-5be50309.jpg,validation," FINAL REPORT INDICATION: History: ___F with status epilepticus now s/p ETT placement // eval ETT placement TECHNIQUE: Frontal view of the chest COMPARISON: Chest radiograph ___ FINDINGS: ET tube terminates 4 cm above the carina. Transesophageal tube courses below the diaphragm and out of view. There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: ET tube terminates 4 cm above the carina. " f4912d91-fbc5bc7e-096669f2-53435d13-cef5cb33.jpg,validate/p18/p18519417/s59274963/f4912d91-fbc5bc7e-096669f2-53435d13-cef5cb33.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Lethargy. COMPARISON: ___. FINDINGS: Single semi-erect AP portable view of the chest was obtained. In the interval since the prior study, there has been development of a right basilar opacity felt to most likely represent pleural effusion with overlying atelectasis though underlying consolidation is not excluded. Dedicated PA and lateral views would be helpful for further evaluation if/when patient able. Aside from minimal left basilar atelectasis, the left lung is clear. No evidence of left-sided pleural effusion is seen. There is no evidence of pneumothorax. The aorta is slightly tortuous. The cardiac silhouette is not enlarged. No overt pulmonary edema is seen. IMPRESSION: Interval development of right basilar opacity, which may be due to pleural effusion and overlying atelectasis versus consolidation. Dedicated PA and lateral views would be helpful for further evaluation if/when patient able. " 61f6df7b-54d15301-986c9538-938823c5-b50c0c74.jpg,validate/p12/p12927984/s51226307/61f6df7b-54d15301-986c9538-938823c5-b50c0c74.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with COPD, dCHF presenting with SOB. // eval pulm edema vs. COPD vs. PNA TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiograph from ___ FINDINGS: Lungs are hyperinflated, compatible with is history of COPD. Moderate rounded bibasilar atelectasis, left greater than right, is increased since ___. Multiple bilateral pleural calcifications are again seen, possibly from prior asbestos exposure. Asymmetric thickening of the apical pleural margin, left worse than right, is again noted. The cardiomediastinal silhouette and hilar contours are normal. No pneumothorax or pleural effusion. IMPRESSION: 1. Hyperinflated lungs, compatible with patient history of COPD. No evidence of pneumonia or pulmonary edema. 2. Increased rounded bibasilar atelectasis, left greater than right, since ___. 3. Multiple bilateral pleural calcifications. Please correlate with patient history of exposure. " af5250f7-8015062f-0f38982d-25bcc88d-8546cd0c.jpg,validate/p11/p11733507/s56496496/af5250f7-8015062f-0f38982d-25bcc88d-8546cd0c.jpg,validation," FINAL REPORT HISTORY: Weakness. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Bilateral pleural and diaphragmatic plaques/calcifications suggest prior asbestos exposure. Additional left-sided pleural thickening is seen. Left basilar atelectasis is seen. No pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. The aorta is calcified. What is presumed to be a VP shunt is partially imaged overlying the right hemithorax. Evidence of DISH is seen along the spine. IMPRESSION: Bilateral pleural and diaphragmatic plaques suggest prior asbestos exposure. Pleural thickening is seen along the lateral left hemithorax, underlying mesothelioma can not be excluded on this study. If there is concern for such, chest CT is more sensitive. " ab0d16b0-1d4e9fdf-d32c365f-72274b6e-b2b9da55.jpg,validate/p16/p16013344/s51936643/ab0d16b0-1d4e9fdf-d32c365f-72274b6e-b2b9da55.jpg,validation," FINAL REPORT INDICATION: Patient being evaluated for acute CVA. Evaluate for acute process. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a mildly enlarged heart. The lungs are well aerated and clear. There is no pneumothorax or pleural effusion. The left hemidiaphragm is somewhat flattened, unchanged in appearance compared to prior exam. IMPRESSION: Mild cardiac enlargement. No focal opacity. " 14df3ecf-9325aa3c-6b7f416e-3b2cc74d-a5472119.jpg,validate/p16/p16803716/s56709139/14df3ecf-9325aa3c-6b7f416e-3b2cc74d-a5472119.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with productive cough and fever // pneumonia pneumonia COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lungs are clear. There is no pleural effusion or pneumothorax. No evidence of pneumonia noted. " 81072f43-edc469c2-afcf4a38-0698932f-6d892a72.jpg,validate/p15/p15882198/s54843084/81072f43-edc469c2-afcf4a38-0698932f-6d892a72.jpg,validation," FINAL REPORT HISTORY: ETT placement. COMPARISON: None. FINDINGS: Single portable supine frontal image of the chest. The ETT terminates 5.1 cm above the carina. The NG tube projects over the left upper quadrant. The lungs are well expanded. The ill-defined opacities in the left lung base, which may represent atelectasis, but cannot exclude pneumonia or aspiration in the right clinical setting. There is no pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: 1. ETT terminates 5.1 cm above the carina. NG tube is in the stomach. 2. Left lung base opacity, which may represent atelectasis but cannot exclude pneumonia or aspiration in the right clinical setting. " 021d9c03-dcb8445e-c9b35007-79f7531a-c430af55.jpg,validate/p16/p16056611/s58379130/021d9c03-dcb8445e-c9b35007-79f7531a-c430af55.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest tube removal, to look for pneumothorax. TECHNIQUE: PA and lateral chest views were read in comparison with prior chest radiograph from ___. FINDINGS: Removal of the right chest tube. There is no evidence of pneumothorax. There is no pleural effusion. Minimal atelectasis in the right perihilar region and at the right lung base is present and unchanged since prior study. Left mild platelike atelectasis in the left lower lung base is also stable. Heart size, mediastinal and hilar contours are in unchanged appearance. IMPRESSION: No pneumothorax. Minimal bilateral lower lung atelectasis is unchanged. " 95294456-6f183c90-aaeb3c6e-d1d1fcad-d42ce57c.jpg,validate/p13/p13306938/s56346958/95294456-6f183c90-aaeb3c6e-d1d1fcad-d42ce57c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH: INDICATION: Multiple rib fractures, lower extremity injury, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are constant. There is a slight increase in extent of the known and pre-existing left pleural effusion. The size of the cardiac silhouette is constant, as is the contour of the aorta. Unchanged appearance of the right lung. " 484b09b4-62875429-626c1198-df613e46-ceff41aa.jpg,validate/p17/p17561108/s51682754/484b09b4-62875429-626c1198-df613e46-ceff41aa.jpg,validation," FINAL REPORT HISTORY: Patient with lymphoma in remission, prior chemotherapy-induced pneumonitis, now with fever and malaise for one week. Evaluate for infiltrate. COMPARISON: ___. FINDINGS: AP and lateral radiographs of the chest. A right chest wall port is noted with the catheter in the upper-to-mid portion of the SVC. Again noted are chronic right pleural and parenchymal scarring with volume loss. Right-sided rib resection is also again seen. Compared to the prior radiograph, there are subtle new multifocal, reticulonodular opacities in both upper lobes. There is also a subtle new focal opacity in the left lower lobe. IMPRESSION: New upper-lobe predominant reticular and nodular pattern, which could represent an atypical or opportunistic pneumonia and less likely an asymmetrical distribution of pulmonary edema. " 6246a56a-1339c228-b0bfeed0-e32dd1d3-e6289185.jpg,validate/p11/p11837162/s53356773/6246a56a-1339c228-b0bfeed0-e32dd1d3-e6289185.jpg,validation," 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. " b6efbd77-f443cf60-9c64f85e-a2ffc0fc-7f6f2f97.jpg,validate/p17/p17529132/s50134553/b6efbd77-f443cf60-9c64f85e-a2ffc0fc-7f6f2f97.jpg,validation," FINAL REPORT EXAMINATION: Chest PA and lateral INDICATION: ___M with chest pain. Evaluate for pneumothorax. 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, specifically no evidence of pneumothorax. " 0c6d4e45-84511433-da399047-c8081635-daa7ef9f.jpg,validate/p16/p16454913/s58857823/0c6d4e45-84511433-da399047-c8081635-daa7ef9f.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with tracheobronchoplasty, history of gastric perforation, productive cough and abdominal pain. Comparison is made with prior study, ___. Cardiomegaly and widened mediastinum are stable. Bibasilar opacities have improved due to improving lung expansion and improved atelectasis. Small-to-moderate right and small left pleural effusions are grossly unchanged. Lines and tubes are in standard position. Mild-to-moderate pulmonary edema has minimally improved. The opacities in the lower lobe that have improved could be due to atelectasis , but superimposed infection cannot be excluded. " f9263d65-966eb2f3-e9f1dfa0-80716e13-42211cb0.jpg,validate/p11/p11816734/s53317430/f9263d65-966eb2f3-e9f1dfa0-80716e13-42211cb0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with hyperglycemia, bibasilar crackles COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low limiting assessment. There is no focal consolidation concerning for pneumonia. No large effusion or pneumothorax. Mild lower lung atelectasis noted. There is subtle prominence of the pulmonary hila likely reflecting hilar congestion. There is no frank edema or large effusion. No pneumothorax. Heart size appears top-normal. The aorta is unfolded. There is tracheobronchial tree calcification. The imaged bony structures are intact. IMPRESSION: Mild pulmonary vascular congestion without frank edema. " a6fa3085-5c96e50f-d28a4b39-87d54f48-aca752f5.jpg,validate/p11/p11129702/s54734525/a6fa3085-5c96e50f-d28a4b39-87d54f48-aca752f5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph from ___. CLINICAL HISTORY: Abdominal pain and fevers, question consolidation in the lungs. FINDINGS: PA and lateral views of the chest were provided. The lung volumes are low with bibasilar atelectasis. The possibility of pneumonia in the lower lungs is therefore suboptimally assessed. The mid to upper lungs appear well aerated. The cardiomediastinal silhouette appears grossly stable. The previously noted PICC line has been removed. A drainage catheter projects over the right upper quadrant. No free air below the right hemidiaphragm. Bony structures are intact. IMPRESSION: Bibasilar opacities and atelectasis, pneumonia difficult to exclude. Interval removal of PICC line. " ddf6cb2e-f42d1d4e-efa6feb9-e88043d5-bbca675f.jpg,validate/p17/p17612000/s56412866/ddf6cb2e-f42d1d4e-efa6feb9-e88043d5-bbca675f.jpg,validation," WET READ: ___ ___ ___ 9:25 PM : bibasialr consolidations likely combination of atelectasis and moderate pleural effusion. Hazy prominence of pulm vscualture suggest mild pulm edema. ___ ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with shortness of breath and known congestive heart failure for pulmonary edema. AP radiograph of the chest was reviewed in comparison to ___. There is bilateral perihilar interstitial prominence continuing toward the lung periphery associated with bilateral pleural effusions as well as presence of the ___ B and ___ A line, finding consistent with at least moderate interstitial pulmonary edema. Reevaluation after diuresis is suggested. ADDENDUM: Discussed with Dr. ___ ___ the phone by Dr. ___ on ___, approximately at 9:30 a.m. " 88827f17-dd2ff5dd-db0d2d89-136a30d8-ca92f929.jpg,validate/p14/p14319319/s57957540/88827f17-dd2ff5dd-db0d2d89-136a30d8-ca92f929.jpg,validation," FINAL REPORT HISTORY: Ulcerative colitis and diffuse abdominal pain, evaluate for free air. COMPARISON: ___. 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 diaphragms. IMPRESSION: No acute cardiopulmonary process. No evidence of free air beneath the diaphragms. " 785c26a3-beab7526-c5217195-a8e1f811-b99fb2ab.jpg,validate/p19/p19650702/s58995858/785c26a3-beab7526-c5217195-a8e1f811-b99fb2ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p rigid bronchoscopy // r/o PTX r/o PTX IMPRESSION: Status post bronchoscopy. No evidence of pneumothorax. The bronchial and the tracheal stent are in unchanged position. Mild cardiomegaly. Retrocardiac atelectasis. Mild fluid overload but no overt pulmonary edema. " f8f169da-e6fe0e72-79155793-29c428fd-53364576.jpg,validate/p17/p17274694/s59631684/f8f169da-e6fe0e72-79155793-29c428fd-53364576.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough and had cold for one week. Please evaluate for acute infectious process. COMPARISON: No relevant comparisons available. TWO VIEWS OF THE CHEST: The lungs are low in volume and show minimal interstitial opacities, which are likely accentuated due to the low lung volumes. The cardiac silhouette is top normal. The mediastinal silhouette shows a prominent right paratracheal stripe. There is prominence of both hila, right greater than left, better seen on the lateral view. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. Enlarged right hila and right paratracheal stripe could be related to adenopathy. A chest CT is recommended for further evaluation. " d6408030-135fdda7-969f5b9e-cdd31d64-938154c5.jpg,validate/p16/p16873651/s53564319/d6408030-135fdda7-969f5b9e-cdd31d64-938154c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with recent DES to LAD, now with acute onset dyspnea // r/o effusion, 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. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " 1385bcfc-2c05e015-6c962ac5-6a153882-ddfe2ed1.jpg,validate/p13/p13140362/s52567077/1385bcfc-2c05e015-6c962ac5-6a153882-ddfe2ed1.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a ___-year-old woman with a history of cancer and biopsy, presenting with left breast pain. 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. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " d800b780-5ec32621-9cde1b35-2ca994b8-48d9658b.jpg,validate/p15/p15818607/s53618889/d800b780-5ec32621-9cde1b35-2ca994b8-48d9658b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with right upper quadrant abdominal pain and chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, CT chest ___ FINDINGS: Patient is status post median sternotomy and CABG. Cardiac silhouette size is top normal, unchanged. Mediastinal and hilar contours are similar. AICD device is again noted with leads terminating in the right atrium ventricle. Pulmonary vasculature is not engorged. Minimal patchy bibasilar airspace opacities may reflect resolving aspiration/infection, better demonstrated on the previous CT. No new focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted in the lower thoracic spine. IMPRESSION: Minimal patchy bibasilar airspace opacities may reflect resolving aspiration/infection which was seen on the previous CT. No new focal consolidation. " 2e48ba73-51cf233a-e4fbaf1e-ee91399f-f538ae79.jpg,validate/p14/p14508643/s57935306/2e48ba73-51cf233a-e4fbaf1e-ee91399f-f538ae79.jpg,validation," FINAL REPORT HISTORY: Nausea, vomiting, diarrhea, faint right lower lobe. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. MRCP ___. FINDINGS: The heart size is mildly enlarged but unchanged. The aortic knob is calcified. Mediastinal and hilar contours are within normal limits. The pulmonary vascularity is not engorged. The lungs are hyperinflated with flattening of the diaphragms compatible with COPD. No focal consolidation, pleural effusion or pneumothorax is identified. Diffuse demineralization the osseous structures is noted. Clips in the right upper quadrant of the abdomen are present. On the lateral view, rounded calcifications within the upper abdomen are within a tortuous splenic artery. IMPRESSION: No acute cardiopulmonary abnormality. " 07efd610-5639c8e4-dba2765d-b46d7fbb-9c16c94f.jpg,validate/p17/p17441556/s58036020/07efd610-5639c8e4-dba2765d-b46d7fbb-9c16c94f.jpg,validation," FINAL REPORT INDICATION: ___ -year-old woman with chest pain, evaluate for pneumothorax. COMPARISON: Chest radiograph ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: There is no pneumothorax. Lungs are fully expanded and clear. Mediastinal and cardiac contours are normal. There is no pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: No pneumothorax. Normal chest radiograph. " fe21092d-18ee6ed4-6016a7d6-f8ba5e12-87fdddcb.jpg,validate/p12/p12175804/s50839295/fe21092d-18ee6ed4-6016a7d6-f8ba5e12-87fdddcb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___ y.o. woman with multiple medical problems most notable for hypertension, severe COPD on 4L NC, dCHF, iron deficiency anemia presenting with exertional dyspnea, hematochezia, and abdominal pain. TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___, PET-CT ___ FINDINGS: Cardiac silhouette size remains mildly enlarged with prominent epicardial fat pad. Mediastinal and hilar contours are unchanged with atherosclerotic calcifications noted at the aortic knob. Lungs are hyperinflated with mild emphysematous changes again noted within the upper lobes. There is mild upper zone vascular redistribution without frank pulmonary edema. Patchy opacities in the lung bases likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: Mild bibasilar atelectasis. Mild emphysema. Mild pulmonary vascular congestion. " 29436acb-1a052fe3-f9a0282a-aa8a477d-db6d84db.jpg,validate/p14/p14693603/s53752781/29436acb-1a052fe3-f9a0282a-aa8a477d-db6d84db.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Verification of central venous line placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has two new central venous access lines. One of the lines is a double-lumen catheter inserted over the left internal jugular vein. The tip of the catheter projects over the inflow tract of the right atrium. There is no left pneumothorax. On the right, projecting over the vena cava, a second catheter is depicted. Its tip cannot be exactly visualized as it projects over the very dense spine. Its course, however, is unremarkable. Atelectasis at the right lung bases, but no evidence of right pneumothorax. " a2f85591-b619fae4-11df797e-bca9888d-c1405378.jpg,validate/p17/p17894333/s59266996/a2f85591-b619fae4-11df797e-bca9888d-c1405378.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with cough x5 weeks TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Metallic stents in the region of the right brachiocephalic vein and SVC remains in unchanged position. Cardiac, mediastinal and hilar contours are similar, with the heart size within normal limits. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. Lungs are hyperinflated with flattening of the diaphragms. There are diffuse mild atherosclerotic calcifications throughout the thoracic aorta. Subsegmental atelectasis versus scarring is seen within the right lung base. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " f6fc34ef-0d77d318-4fffeb33-fa39d0ab-bdff2a7f.jpg,validate/p17/p17967970/s59244051/f6fc34ef-0d77d318-4fffeb33-fa39d0ab-bdff2a7f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS RUL wedge. post op bronchitis vs pna. Now worsened right pleural effusion recently drained // check interval change check interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Moderate right pleural effusion is slightly larger today than on ___, following removal of the previous right basal pleural pigtail drainage catheter. Left pleural space is normal. Lungs are grossly clear. Heart size normal. " a5abbe98-d0affc26-b4a0a3e8-71b77231-d91c35e0.jpg,validate/p16/p16312465/s58368453/a5abbe98-d0affc26-b4a0a3e8-71b77231-d91c35e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and fever // assess for consolidation COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a newly appeared parenchymal opacity in the left upper lobe. The opacity is better seen on the frontal than on the lateral image. In addition, the previously seen area of atelectasis, better visualized on the lateral than on the frontal image, is slightly more extensive than before. In the appropriate clinical setting, the findings are strongly suspicious of pneumonia. No larger pleural effusions. Normal size of the cardiac silhouette. Normal position of the right pectoral Port-A-Cath. NOTIFICATION: At the time of dictation and observation, 11:31, on the ___, the referring physician ___. ___ was paged for NOTIFICATION:. " ae469188-a0202d48-201ff2aa-b960f5d5-46f801ad.jpg,validate/p18/p18526154/s56648303/ae469188-a0202d48-201ff2aa-b960f5d5-46f801ad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic lung cancer and left lower lobe stenosis. Evaluate after stent removal. TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: Plain chest radiograph dated ___ and dating back to ___. Correlation made to chest CT dated ___. FINDINGS: Stable abnormal perihilar soft tissue prominence corresponds to the patient's known left perihilar mass with associated left hilar lymphadenopathy. There is no new lobar collapse or consolidation following the removal of the left lower lobe endobronchial stent. There is no pneumothorax. Left lower lobe linear atelectasis is stable. There is no pleural effusion. Heart size is normal despite the projection. IMPRESSION: Stable appearance of left lung status post left lower lobe endobronchial stent removal. Stable abnormal left perihilar soft tissue which corresponds to the patient's known primary lung malignancy with associated left hilar lymphadenopathy. " 71882344-bf935368-7e395f12-18263a98-8c68c5bc.jpg,validate/p10/p10582978/s50685568/71882344-bf935368-7e395f12-18263a98-8c68c5bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with anemia and hyperkalemia // r/o acute process COMPARISON: None FINDINGS: PA and lateral views of the chest provided. The heart is mildly enlarged. The hila appear mildly congested bilaterally. There is no frank pulmonary edema. In the retrocardiac space in the region of the left lower lobe, subtle opacity is noted, difficult to exclude an early pneumonia. No large effusion or pneumothorax. Bony structures appear intact. IMPRESSION: Mild hilar congestion. Atelectasis versus pneumonia at the left lung base. " f207f257-03a7c640-96106b61-3c4d7bcf-59df7b38.jpg,validate/p12/p12176298/s59938674/f207f257-03a7c640-96106b61-3c4d7bcf-59df7b38.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post wedge resection, assessment for interval change. COMPARISON: ___, 5:34 a.m. FINDINGS: As compared to the previous radiograph, the post-procedural pneumothorax on the right has slightly increased in extent. The transparency of the lung parenchyma at the right lung bases has also increased, potentially reflecting improved ventilation. The monitoring and support devices, including the two right chest tubes are in constant unchanged position. Newly appeared parenchymal opacity in the left lung. The opacity is relatively widespread and show subtle air bronchograms. Developing pneumonia would be a likely diagnosis. Otherwise the left lung is unchanged. Unchanged appearance of the cardiac silhouette. At the time of dictation and observation, 10:14 a.m., on ___, the referring physician, ___. ___ was called and the findings were discussed over the telephone. " 184f32ed-a2063134-6085e470-e581b81f-e86e9232.jpg,validate/p14/p14286831/s59574558/184f32ed-a2063134-6085e470-e581b81f-e86e9232.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F transferred from ortho service. Presented to ___ after being found down after a fall found to have R periprosthetic femur fracture s/p ORIF ___ Post op course c/b agitation/ violence with high scoring CIWAs. Admitted to the ICU for phenobarb protocol // ?pneumonia/infectious ?pneumonia/infectious IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. Continued opacification at the right base with silhouetting the hemidiaphragm, consistent with pleural fluid and underlying compressive atelectasis. There is the development of increased opacification at the left base with silhouetting of the hemidiaphragm, consistent with substantial volume loss in the left lower lobe and small pleural effusion. Cardiac silhouette remains at the upper limits of normal and there is mild elevation of pulmonary venous pressure. In view of the extensive pulmonary changes, it would be very difficult to exclude superimposed pneumonia in the appropriate clinical setting, especially in the absence of a lateral view. There has been insertion of a right IJ catheter that extends to the mid portion of the SVC. No evidence of post procedure pneumothorax. " 77f9a152-04e7972e-d3952408-d0c66699-261cff34.jpg,validate/p10/p10646211/s53700548/77f9a152-04e7972e-d3952408-d0c66699-261cff34.jpg,validation," 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. " d76479d3-dc5f1510-599b35a0-361f80da-8b2991ad.jpg,validate/p16/p16784686/s55432642/d76479d3-dc5f1510-599b35a0-361f80da-8b2991ad.jpg,validation," 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. " 0303d7a5-94d57c62-d9e50a7a-2e2990ce-d1c55040.jpg,validate/p19/p19966115/s51546515/0303d7a5-94d57c62-d9e50a7a-2e2990ce-d1c55040.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Leg swelling. COMPARISON: ___. TECHNIQUE: Chest, AP upright. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. There is a retrocardiac opacity that is not specific obscuring medial left hemidiaphragmatic contours. Otherwise the lungs appear clear. IMPRESSION: Left lower lobe opacity, which could be seen with atelectasis, although an infectious process is not excluded and results should be correlated with clinical presentation. No evidence of congestive heart failure. " af4fe45a-09e6abf8-4717c8c1-f322894e-5d427f93.jpg,validate/p17/p17846379/s57878069/af4fe45a-09e6abf8-4717c8c1-f322894e-5d427f93.jpg,validation," FINAL REPORT INDICATION: History of pneumonia and CHF. Now with desaturation. COMPARISON: Chest radiograph, ___. Chest radiograph ___. Chest radiograph, ___. FINDINGS: A right PICC ends in the mid SVC. A moderate right pleural effusion has slightly decreased in size. A persistent consolidation at the right base is likely atelectasis, although an underlying infectious process cannot be excluded. At the left base, there is new decreased lung transparency, particularly adjacent to the heart border. This likely represents new pneumonia or atelectasis. Would recommend short term follow up with repeat radiographs. There is no pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: 1. New opacification at the left base may represent early pneumonia or atelectasis. Would recommend short term follow up with subsequent radiographs. 2. Slight decrease in size of moderate right pleural effusion. 3. Persistent consolidation in the right base is likely atelectasis, although pneumonia cannot be excluded. " 274267b7-5996c31f-eb174657-f9646cbd-a18bf56a.jpg,validate/p19/p19164077/s51866308/274267b7-5996c31f-eb174657-f9646cbd-a18bf56a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with spontaneous pneumothorax, chest tube placed to water seal for 4 hours. Evaluate for interval change. COMPARISON: Chest radiographs from ___ at 23:15 and 21:30. FINDINGS: A trace left apical pneumothorax, which was likely present on the post chest tube radiograph from yesterday, is unchanged. The left chest tube is unchanged in position. The lungs are clear. The hilar and cardiomediastinal contours are normal. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Trace left apical pneumothorax is likely unchanged from the post chest tube radiograph from yesterday. " 34340bd1-aa7e29af-893a8739-637c5bd2-cb22a31b.jpg,validate/p12/p12623286/s54755393/34340bd1-aa7e29af-893a8739-637c5bd2-cb22a31b.jpg,validation," FINAL REPORT INDICATION: History of asthma. Shortness of breath. Evaluate for pneumonia. COMPARISONS: Chest radiograph, ___. 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. Results were telephoned to Dr. ___ at 1:15 p.m. ___ by Dr. ___. " df92e9ee-9288ebcf-0b8a78b5-ba37ce4a-2cd233dc.jpg,validate/p10/p10800175/s56509020/df92e9ee-9288ebcf-0b8a78b5-ba37ce4a-2cd233dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute respiratory distress. // aspiration pneumonitis aspiration pneumonitis IMPRESSION: In comparison with the study ___ ___, the pulmonary vascular congestion has substantially decreased. The left perihilar opacification appears to be decreasing, but was shown on CT to represent a left lung mass. " 9664176f-c08109f1-60823f1c-26711a1a-310900e9.jpg,validate/p18/p18280086/s55180358/9664176f-c08109f1-60823f1c-26711a1a-310900e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new oxygen requirement, tachypnea // eval for pna, pulm edema COMPARISON: Chest x-ray from ___ at ___ FINDINGS: There is increased upper zone redistribution, consistent with mild fluid overload/ CHF. Again seen is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. Hazy density adjacent to this could represent a small left effusion. There is patchy opacity at the right lung base, which is more pronounced on the current examination, with minimal blunting of the right costophrenic angle. IMPRESSION: 1. CHF, more pronounced on the current film, with small bilateral effusions. 2. Left lower lobe collapse and/or consolidation and increased patchy opacity at the right base. While this could relate to the presence of CHF, the possibility of an associated infectious infiltrate cannot be excluded. " 0f6a1f1e-694fdcbb-3c661645-353e7ec4-36e432bd.jpg,validate/p11/p11184688/s50952107/0f6a1f1e-694fdcbb-3c661645-353e7ec4-36e432bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with CHF, now with worsening rhonchi on exam // Is there a pneumonia? TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Since the prior study there is substantial interval improvement of pulmonary edema with no edema currently seen. Severe cardiomegaly is unchanged. No pleural effusion demonstrated. " 33600585-f7e73d58-77279cb1-1ffae6ed-ce852ed2.jpg,validate/p14/p14631209/s51659810/33600585-f7e73d58-77279cb1-1ffae6ed-ce852ed2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // cough cough IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " ffa1d676-11c42e68-057b5abd-07949b83-58ef5b83.jpg,validate/p15/p15063475/s51361405/ffa1d676-11c42e68-057b5abd-07949b83-58ef5b83.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest tightness and cough. Evaluate for pneumonia. 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: Unremarkable chest radiographic examination. " ba101935-e57877f9-1a4784e1-48e77ee8-e2c3f80f.jpg,validate/p14/p14644694/s53850637/ba101935-e57877f9-1a4784e1-48e77ee8-e2c3f80f.jpg,validation," FINAL REPORT INDICATION: Left-sided chest pain. Evaluate for effusion. COMPARISON: ___. FRONTAL AND LATERAL CHEST: Low lung volumes result in bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Mild left basilar atelectasis is noted. Heart size is normal. Aortic tortuousity is unchanged. Hilar contours are stable. IMPRESSION: No pneumonia, edema or effusion. " 1f0ccee7-ea1bbf97-62cd19c2-ddba205b-068a73fe.jpg,validate/p13/p13187449/s50547309/1f0ccee7-ea1bbf97-62cd19c2-ddba205b-068a73fe.jpg,validation," FINAL REPORT HISTORY: Wheezing and shortness of breath. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The cervical portion of the trachea is tapered proximally consistent with tracheobronchitis. The heart, lungs, pleural and mediastinal surfaces appear normal. IMPRESSION: Findings consistent with tracheobronchitis. COMMENT: Findings emailed to the ED ___ nurses at ___ by ___. " 5a39dcc0-e1e75618-00e18be7-0634f688-f9698703.jpg,validate/p16/p16131849/s51775838/5a39dcc0-e1e75618-00e18be7-0634f688-f9698703.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with recent right PTX // check interval change COMPARISON: Chest radiographs since.___.1 for impression IMPRESSION: Small loculated pleural effusion or pleural thickening lung the left lower costal pleural surface and in the posterior pleural sulcus is unchanged since ___. A wide band of linear scarring in the juxta hilar left midlung is unchanged. Emphysema is severe. Right lung is otherwise clear of focal abnormality. Region of calcified pleural thickening along the right upper mediastinum is also a scar. Heart size normal. " a4343319-29abc89d-5bb15116-efc3d6ad-270fc4e5.jpg,validate/p14/p14109373/s59787237/a4343319-29abc89d-5bb15116-efc3d6ad-270fc4e5.jpg,validation," FINAL REPORT INDICATION: History: ___M with pedestrian struck, closed head trauma TECHNIQUE: Supine AP view of the chest COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Lungs are clear. No pleural effusion or pneumothorax is present. Pulmonary vasculature is normal. No displaced fractures are visualized. IMPRESSION: No acute cardiopulmonary process. " 6570e3ae-6cb9dc34-ad4eca25-145e6b36-e54998f4.jpg,validate/p11/p11551927/s56440054/6570e3ae-6cb9dc34-ad4eca25-145e6b36-e54998f4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cirrhosis and pancreatitis 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. " 09978fbc-25ef10c9-58682e15-ef64064b-7214b568.jpg,validate/p17/p17470135/s57197753/09978fbc-25ef10c9-58682e15-ef64064b-7214b568.jpg,validation," 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. " 764e8f8c-999c4758-925774fe-d6fb3137-af6951df.jpg,validate/p10/p10080695/s57985622/764e8f8c-999c4758-925774fe-d6fb3137-af6951df.jpg,validation," 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. " e84612fe-cd2844f1-a4469f83-3739fbae-55323894.jpg,validate/p17/p17894020/s52742435/e84612fe-cd2844f1-a4469f83-3739fbae-55323894.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable. The Port-A-Cath catheter tip terminates at the level of cavoatrial junction. Lungs are essentially clear with unchanged linear scarring at the right lower lung. There is no appreciable pleural effusion or pneumothorax. " 35251186-0a40a264-e54d3ed1-c51634b6-669c0625.jpg,validate/p11/p11943854/s59587603/35251186-0a40a264-e54d3ed1-c51634b6-669c0625.jpg,validation," FINAL REPORT HISTORY: 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. " 91160668-7b6c84ed-45fca21d-f22e4787-29f7e239.jpg,validate/p18/p18699864/s56391881/91160668-7b6c84ed-45fca21d-f22e4787-29f7e239.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with R PTX // check CXR with CT on a pneumostat. Please do around 10:___:30am TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. FINDINGS: Stable to minimal improvement in previously noted small right pneumothorax with right pleural drainage catheters in unchanged position. Lungs are otherwise clear. Cardiomediastinal silhouette is unchanged. No pleural effusions or pneumonia. IMPRESSION: Stable to minimal improvement in previously noted small right pneumothorax. " 4351aea6-e9b981f5-27a07fb8-df3af296-1c038ed5.jpg,validate/p12/p12006266/s51770791/4351aea6-e9b981f5-27a07fb8-df3af296-1c038ed5.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with mantle cell lymphoma and respiratory failure. COMPARISONS: ___ to ___. FINDINGS: Two portable AP supine and upright chest radiographs were obtained. An endotracheal tube tip remains 4.5 cm above the carina. The tip of an enteric catheter is not clearly seen. Right basilar opacities have partially cleared; the right hemidiaphragm is now more clearly seen. Pleural catheters are in unchanged positions. Small effusions have nearly resolved. No pneumothorax is present. A left-sided PICC line ends at the brachiocephalic/SVC junction. IMPRESSION: Improved aeration of the right base. " 754f08e1-648f16f5-17ea9866-5ced8dd4-006c0483.jpg,validate/p16/p16851578/s57818653/754f08e1-648f16f5-17ea9866-5ced8dd4-006c0483.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with left sided chest pain // 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. " 621f946b-885e7922-5091dc2f-5c147291-405039fb.jpg,validate/p19/p19643415/s55588919/621f946b-885e7922-5091dc2f-5c147291-405039fb.jpg,validation," 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. " ea0425a9-0aa9e34d-c07e898f-1afd2050-216a12df.jpg,validate/p19/p19580035/s54821204/ea0425a9-0aa9e34d-c07e898f-1afd2050-216a12df.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old woman with cough, likely pneumonia. FINDINGS: Comparison is made to prior study from ___. The heart size is within normal limits. There are some atelectases within the bases and within the right upper lobe. The nodular density reported projecting over the right first rib is less well seen on today's study. If there is persistent concern, CT scan could be recommended. There are no pleural effusions or focal consolidation. No pneumothoraces are identified. Spinal hardware is seen within the lower thoracolumbar junction. " eaf63981-055578d2-08587d87-bb7adaff-4dbfdec3.jpg,validate/p12/p12763897/s56849193/eaf63981-055578d2-08587d87-bb7adaff-4dbfdec3.jpg,validation," 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. " 4e3a03bd-cb4d247a-ed51a39c-4d245be0-65ba62bb.jpg,validate/p14/p14034311/s59048293/4e3a03bd-cb4d247a-ed51a39c-4d245be0-65ba62bb.jpg,validation," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: Chest x-ray of ___. FINDINGS: The patient is status post median sternotomy and coronary artery bypass surgery. Stable appearance of cardiomediastinal contours in the post-operative setting, allowing for technical differences between the exams. Previously reported pulmonary vascular congestion has resolved, and a focus of increased opacity in the right lung base medially has slightly improved. Minimal residual atelectasis is present at the left lung base, and note is made of persistent small pleural effusions. IMPRESSION: Improved pulmonary vascular congestion and bibasilar opacities with residual atelectasis and/or consolidation at the right lung base medially. " 8c3064c7-66eee9f8-eefcc8d7-6fe5be5a-6e460ab5.jpg,validate/p18/p18719719/s57640202/8c3064c7-66eee9f8-eefcc8d7-6fe5be5a-6e460ab5.jpg,validation," FINAL REPORT INDICATION: Leg swelling. Assess for congestive heart failure. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, which accentuate bronchovascular markings. There is no focal consolidation, or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is top normal. There is blunting of the left costophrenic angle posteriorly, which may be due to a small pleural effusion and/or thickening. Pacemaker leads project over right atrium and ventricle. Sternotomy wires are in place and appear intact. Multiple surgical clips project over cardiac silhouette. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of CHF. " 94d80f34-294b5ccb-626d4f2b-c3ec7e61-5c912cb6.jpg,validate/p13/p13294218/s54603062/94d80f34-294b5ccb-626d4f2b-c3ec7e61-5c912cb6.jpg,validation," FINAL REPORT INDICATION: New left bundle-branch block and dyspnea on exertion. COMPARISONS: Chest CT ___. FINDINGS: A small 3-mm round nodule is present in the right lower lobe. This is stable from the prior CT scan in ___. The lungs are otherwise clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable small right lower lobe pulmonary nodule. " df4ad31b-b7160918-24a00ccb-7a083f09-fb30aed6.jpg,validate/p15/p15692257/s56959355/df4ad31b-b7160918-24a00ccb-7a083f09-fb30aed6.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: History of melanoma. 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. IMPRESSION: No evidence of acute cardiopulmonary process. No evidence of intrathoracic metastatic spread within the limitations of this study technique. " a7da68e7-d6962bf5-4040f5ae-8bb7db7d-290a5fe3.jpg,validate/p19/p19403960/s55424057/a7da68e7-d6962bf5-4040f5ae-8bb7db7d-290a5fe3.jpg,validation," FINAL REPORT CLINICAL HISTORY: Pericardial effusion with drain in place. CHEST Cardiac size remains enlarged. The position of the pericardial drain is unchanged. Bilateral effusions are present, somewhat larger than they were on the prior chest x-ray of ___, which is more marked on the left. Some opacities are seen in the right lower lobe and left lower lobe. These could represent areas of pneumonia. IMPRESSION: Increasing effusion, particularly on the left. Patchy opacities, possibly representing pneumonia. " 793cc91e-f32a5541-a543df56-4a2176e7-b1af8d41.jpg,validate/p13/p13510413/s58126166/793cc91e-f32a5541-a543df56-4a2176e7-b1af8d41.jpg,validation," FINAL REPORT HISTORY: Nausea, vomiting, leukocytosis and chills at home. COMPARISON: ___, CT chest ___. TECHNIQUE: PA and lateral chest radiograph, four views. FINDINGS: Moderate cardiomegaly and widening of the thoracic aorta is unchanged compared to prior examination. Correlation to prior CT chest shows normal-caliber thoracic aorta and this widened appearance is likely due to overlap of the ascending and descending portions. Hilar contours are unremarkable. There is plate-like atelectasis in the left lung base. The lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " d9ebb390-d4fa78e6-5ad4167f-a0e0a291-e740f7c1.jpg,validate/p11/p11692070/s51327307/d9ebb390-d4fa78e6-5ad4167f-a0e0a291-e740f7c1.jpg,validation," 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. " 34fde7f4-5b21c45d-a104533b-395b4555-9e76a9e7.jpg,validate/p11/p11948145/s52899877/34fde7f4-5b21c45d-a104533b-395b4555-9e76a9e7.jpg,validation," FINAL REPORT INDICATION: ___M with cough and myalgias, 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. No focal lung consolidation is seen. Views of the upper abdomen are unremarkable. IMPRESSION: No evidence of pneumonia. " 30cde4e5-82c07b62-8f182ef3-53706572-d1cfd004.jpg,validate/p17/p17564540/s53789311/30cde4e5-82c07b62-8f182ef3-53706572-d1cfd004.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness, elevated CRP. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: Cardiomediastinal and hilar contours are unchanged and unremarkable. Calcified tortuous aorta is unchanged. Calcified tortuous aorta is also unchanged. There is bibasilar atelectasis, however no focal consolidation or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 9e0ef2d2-3548b27d-e0ea1627-227e34d6-fc12f3f8.jpg,validate/p16/p16179342/s51523318/9e0ef2d2-3548b27d-e0ea1627-227e34d6-fc12f3f8.jpg,validation," WET READ: ___ ___ 11:13 PM Right internal jugular central venous catheter is now in the low SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CVL adjustment // CVL placement CVL placement IMPRESSION: Compared to chest radiographs since ___, most recently ___. Right internal jugular catheter has been pulled back to the mid SVC. No pneumothorax mediastinal widening or associated pleural effusion. Severe cardiomegaly is chronic. Pulmonary vascular congestion and borderline edema have improved slightly. Bibasilar atelectasis, mild on the right, moderate on the left has worsened. Transvenous right atrial and right ventricular pacer leads are continuous from the left axillary generator. " f026f09c-43ce4f66-67b24ea6-e26e7353-738c09e5.jpg,validate/p16/p16287374/s50493232/f026f09c-43ce4f66-67b24ea6-e26e7353-738c09e5.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain status post MVC. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal right base linear atelectasis/scarring, unchanged. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Hilar contours are stable. No displaced fracture seen. IMPRESSION: No acute cardiopulmonary process. " 80db1edf-5285e633-b0133a4b-468731ea-6f0e735b.jpg,validate/p12/p12731439/s51184221/80db1edf-5285e633-b0133a4b-468731ea-6f0e735b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with breast cancer metastatic to the lung, new coughing and wheezing // assess for pulmonary edema, infection, new infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is top-normal is overall unremarkable. There are extensive interstitial changes within the lungs, left more than right involving both apex and lower lobes with honeycomb being and potentially traction bronchiectasis, reflecting known fibrosis. No new abnormalities to suggest interval development of infectious process demonstrated. Postradiation changes in the left upper lobe are re- demonstrated. " 0b026a28-3ab24fb7-3fae6040-62c9a17b-5619476f.jpg,validate/p15/p15197176/s53962332/0b026a28-3ab24fb7-3fae6040-62c9a17b-5619476f.jpg,validation," FINAL REPORT INDICATION: Chronic lung disease with radiation fibrosis, presenting with acute cough and chills. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: The focal opacities over the left mid lung visualized on ___ are mildly improved. There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is top normal. The cardiac, hilar, and mediastinal contours are within normal limits. IMPRESSION: Mild improvement of left lung opacities which, likely related to prior radiation treatments. " 19ac0b63-ab168e00-0ad6a556-3fe513fa-288db378.jpg,validate/p17/p17652927/s53569352/19ac0b63-ab168e00-0ad6a556-3fe513fa-288db378.jpg,validation," FINAL REPORT INDICATION: Right PICC line in place for home milrinone but withdrew approximately 5 cm. Evaluate location. COMPARISON: ___. FINDINGS: The right PICC has withdrawn and now terminates in the right subclavian vein. Mild cardiomegaly is unchanged. The lung fields are clear. There is no pneumothorax or pleural effusion. IMPRESSION: Right PICC now terminates in the right subclavian vein. " 48105cb8-0fc0b66d-20d7c14c-dcd32e8f-5ee5a7bf.jpg,validate/p18/p18513773/s52761885/48105cb8-0fc0b66d-20d7c14c-dcd32e8f-5ee5a7bf.jpg,validation," FINAL REPORT INDICATION: ___M with shortness of breath COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Lungs appear hyperinflated with flattening of hemidiaphragms, suggestive of emphysematous changes. Cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. IMPRESSION: No findings convincing for pneumonia. " 9af3edf9-f79b573f-c5697857-712255bf-c3469540.jpg,validate/p11/p11098772/s57045589/9af3edf9-f79b573f-c5697857-712255bf-c3469540.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Chest pain. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. There are chunky calcified lymph nodes in the central mediastinum as well as two small calcified granulomas projecting over the left mid lung. A very small calcified granuloma is also noted at the left lung apex and there is potentially one or more tiny calcified nodules in the right upper lobe. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. The bony structures are unremarkable. IMPRESSION: Small parenchymal granulomas and chunky calcified lymph nodes, suggesting prior granulomatous exposure. " 9573492d-8bf1e4a5-fc7dda60-83b39b6c-4110d61a.jpg,validate/p17/p17527875/s50449899/9573492d-8bf1e4a5-fc7dda60-83b39b6c-4110d61a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS wedge resection, d/c CT // please time for 12:00, CT d/c at 8:30AM TECHNIQUE: Chest PA and lateral COMPARISON: ___ ___ FINDINGS: Mild-to-moderate cardiomegaly is stable. Widened mediastinum has improved. Right pneumothorax is small. The right lower lobe atelectasis has increased. Left lower lobe atelectasis is stable. Vascular congestion has resolved. Bilateral effusions are small larger on the right side. Right chest wall subcutaneous emphysema is stable IMPRESSION: Small right pneumothorax Increasing right lower lobe atelectasis Small bilateral effusions " 7934ee17-9c392106-926e08fa-8b995714-8c5617fd.jpg,validate/p18/p18156199/s53334611/7934ee17-9c392106-926e08fa-8b995714-8c5617fd.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with positive PPD. Rule out TB. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette and hilar contours are unremarkable. There are no pleural effusions or pneumothoraces. IMPRESSION: Normal chest x-ray. No evidence of TB. " 621cfa11-334120bc-0efcd469-b2721f2f-0dd8dd36.jpg,validate/p10/p10292574/s56038579/621cfa11-334120bc-0efcd469-b2721f2f-0dd8dd36.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right lower flank pain over the costal margin, status post fall, evaluation for abnormalities and rib fracture. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, neither the frontal nor the lateral view are of substantial differences. The lung volumes are normal. There is minimal blunting of the right costophrenic sinus, better seen on the lateral than on the frontal radiograph. The abnormality is caused by a small pleural effusion. This effusion could tentatively be caused by a subtle rib fracture in the lateral aspects of the eighth right rib. The fracture is not substantially displaced. No evidence of pneumonia. No pneumothorax. No pulmonary edema. Calcified granuloma in the left lung apex is unchanged. No hilar or mediastinal abnormalities. At the time of dictation and observation, the referring physician, ___. ___, 2:08 p.m., on ___, was paged for notification. " ad1ae7eb-c97cac95-69dd3d3f-f183dad5-d9fb75cb.jpg,validate/p13/p13961294/s59154069/ad1ae7eb-c97cac95-69dd3d3f-f183dad5-d9fb75cb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with history of NICM EF ___%, afib who presents with ___ edema, concerning for HF exacerbation // evidence of pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is rotated somewhat to the left. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable,, with stable mild enlargement of the cardiac silhouette. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " eef8d642-a2958eb7-0023a536-ea88d83b-d24e4f1d.jpg,validate/p17/p17784248/s57618321/eef8d642-a2958eb7-0023a536-ea88d83b-d24e4f1d.jpg,validation," FINAL REPORT HISTORY: Recurrent left effusion. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate interval resolution of left pleural effusion with minimal residual pleural effusion. The lungs are hyperexpanded indicative of emphysema. Post-radiation fibrotic changes of the left apex are again noted. Surgical clips in the left axilla are also seen. The cardiac and mediastinal contours are unchanged. IMPRESSION: Near complete resolution of left pleural effusion. " 85c3f81e-d51e65dc-a1cec184-cbf8d4d6-bb7e3755.jpg,validate/p15/p15712408/s58139684/85c3f81e-d51e65dc-a1cec184-cbf8d4d6-bb7e3755.jpg,validation," 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. " 8ead6a36-f7e0cce4-b48cb291-8e7bc24a-44f382c6.jpg,validate/p10/p10231735/s57479529/8ead6a36-f7e0cce4-b48cb291-8e7bc24a-44f382c6.jpg,validation," WET READ: ___ ___ ___ 9:23 PM Small left apical pneumothorax. No right pneumothorax. Tissue expander projects over the right upper lung. Bilateral subcutaneous postoperative air. Bilateral subcutaneous drains. No pleural effusion or focal airspace consolidation. Findings discussed with Dr. ___ by Dr. ___ at 21:21 by telephone at the time of discovery. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Rule out pneumonia. COMPARISON: ___. FINDINGS: Bilateral air collections in the lateral soft tissues. 2-cm left apical pneumothorax. No visible right pneumothorax. Tissue expander projects over the right upper lung. Bilateral subcutaneous drains in situ. No evidence of pleural effusions or parenchymal opacities. Mild overinflation of the stomach. Mild cardiomegaly. " 1e1fabb6-7e42cbb1-e3e4356a-2d8c4e4e-6adceb4f.jpg,validate/p19/p19349343/s51542312/1e1fabb6-7e42cbb1-e3e4356a-2d8c4e4e-6adceb4f.jpg,validation," FINAL REPORT INDICATION: Intermittent chest pain. COMPARISON: Chest radiograph from ___. FINDINGS: Again noted is tortuosity of the aorta, stable in comparison to prior study from ___. Cardiomediastinal silhouette appears stable. The lungs are clear with no evidence of a consolidation, effusion, and pneumothorax. No acute fractures identified. IMPRESSION: No acute cardiopulmonary process. " c5194cac-a42f7df8-d99c232f-66cc5578-35d8c3b8.jpg,validate/p12/p12077313/s56379543/c5194cac-a42f7df8-d99c232f-66cc5578-35d8c3b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with post intubation // post intubation TECHNIQUE: Single frontal view of the chest COMPARISON: ___, earlier today, at 16:34 FINDINGS: Endotracheal tube terminates 2.3 cm above the level of the carina. Enteric tube courses below the diaphragm, inferior aspect not included on the image. Subtle left base opacity may be due to atelectasis, given mild elevation the adjacent left hemidiaphragm versus aspiration, although does not appear increased as compared to the prior study. Subtle linear streaky right mid lung opacity is more conspicuous than on the prior study and most likely represents atelectasis. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are grossly stable. " 689e3768-106b631b-254efe23-61aa528f-8de406bc.jpg,validate/p11/p11861017/s53904019/689e3768-106b631b-254efe23-61aa528f-8de406bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SDH, febrile elevated WBC // eval for interval change eval for interval change IMPRESSION: Comparison to ___. Monitoring and support devices are stable. Moderate right and small left pleural effusion are unchanged. Subsequent areas of atelectasis are again visualized. No new focal parenchymal abnormalities are present. " de9ecc2e-bd11a6cb-6bbd9d96-54fc0760-40bfa7c3.jpg,validate/p14/p14493762/s55893022/de9ecc2e-bd11a6cb-6bbd9d96-54fc0760-40bfa7c3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESLD s/p ulcer repair now with resp failure s/p intubation // eval pneumonia eval pneumonia IMPRESSION: In comparison with the study of ___, of the monitoring and support devices remain in place. The bilateral pulmonary opacifications appear stable on the right but increasing in severity on the left. Much of this could represent elevation of pulmonary venous pressure. However, superimposed ARDS, as suggested in the Clinical History, could certainly present this pattern, especially since there is no appreciable enlargement of the cardiac silhouette. In the appropriate clinical setting, superimposed pneumonia would have to be considered. " 42732966-d327d51b-97eea049-0971e8a2-da58f108.jpg,validate/p18/p18039514/s55032599/42732966-d327d51b-97eea049-0971e8a2-da58f108.jpg,validation," WET READ: ___ ___ ___ 8:22 PM Minimally increased left basilar opacity - may be due to increasing left pleural effusion with increased atelectasis. However, given recent vomiting - aspiration also possible. Consider PA/Lateral for further assessment WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Gastric adenocarcinoma, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a newly developed subtle pleural opacity at the left lung base, obliterating the left costophrenic sinus. The change could be caused by a small pleural effusion. The morphology of the change is not typical for pneumonia or aspiration. Mild deviation of the trachea to the right, potentially caused by a small retrosternal goiter. No acute lung changes. Borderline size of the cardiac silhouette without pulmonary edema. " 8331dc8a-310e694c-646b28eb-4dcdc164-a4d3fdf8.jpg,validate/p15/p15882369/s57305743/8331dc8a-310e694c-646b28eb-4dcdc164-a4d3fdf8.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes. The bronchovascular markings are accentuated at the lung bases. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Low lung volumes, but no acute cardiopulmonary process. " 31616ed5-9165037e-698ed28b-370af941-831420e4.jpg,validate/p11/p11848597/s51420676/31616ed5-9165037e-698ed28b-370af941-831420e4.jpg,validation," 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. " a0f52139-76b785a8-810bedc8-31db6010-b883aa21.jpg,validate/p14/p14972005/s56175195/a0f52139-76b785a8-810bedc8-31db6010-b883aa21.jpg,validation," FINAL REPORT INDICATION: ___M with dyspnea // infiltrate? effusion? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Compared with prior, there has been no significant interval change. Small-moderate right pleural effusion persists with adjacent atelectasis. The left lung is clear. The cardiomediastinal silhouette is stable. Median sternotomy wires are again noted. No acute osseous abnormalities identified. IMPRESSION: No significant interval change. Right-sided pleural effusion with associated atelectasis. Please note superimposed infection cannot be excluded. " fcf93ae2-0afd94ff-1962ba0b-0e2cefb2-a03cde64.jpg,validate/p18/p18923852/s51447103/fcf93ae2-0afd94ff-1962ba0b-0e2cefb2-a03cde64.jpg,validation," 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. " f0b4b1b2-49c3a9ad-560ad358-4e7c86a9-5b1cf39e.jpg,validate/p15/p15184004/s53332317/f0b4b1b2-49c3a9ad-560ad358-4e7c86a9-5b1cf39e.jpg,validation," 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 ___ ___. " 207463d3-b082dd8d-5251dbbd-85b271b3-3db9e219.jpg,validate/p12/p12761308/s51139685/207463d3-b082dd8d-5251dbbd-85b271b3-3db9e219.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough for 10 days // Eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Dual lead left-sided pacemaker stable in position. The lungs remain hyperinflated, consistent with chronic obstructive pulmonary disease.No focal consolidation is seen. Mild biapical pleural thickening is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Anchor screw noted overlying the right humeral head. IMPRESSION: COPD. No definite focal consolidation. " 8299d9bb-e5df9cea-26fe0f06-fd8963ff-6a5c38a6.jpg,validate/p11/p11368395/s54382189/8299d9bb-e5df9cea-26fe0f06-fd8963ff-6a5c38a6.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: New atrial fibrillation, widened mediastinum. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Note is made that the original dictation was lost and the study was brought to our review today on ___. Heart size is top normal. Mediastinum is unremarkable. There is mild degree of interstitial pulmonary edema and small amount of pleural effusion better appreciated on the lateral view. Substantial pectus is seen on the lateral view as well. Minimal bibasal atelectasis are noted. " 66ae245d-fcc47d4d-bf9cdfa7-bccaea1b-762a9338.jpg,validate/p13/p13214943/s56684953/66ae245d-fcc47d4d-bf9cdfa7-bccaea1b-762a9338.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female with history of marginal cell lymphoma, NASH cirrhosis, recent GIB c/b CoNS bacteremia admitted for progressive anxiety, anorexia and weight loss and found to have COP/CEP, now transferred to the ICU s/p fasciotomy for spontaneous left thigh hematoma and compartment syndrome requiring high volume blood transfusion and coagulopathy. // eval for pulmonary congestion, edema eval for pulmonary congestion, edema IMPRESSION: Comparison to ___. The lung volumes remain low. Mild pulmonary edema is unchanged. Mild cardiomegaly. Minimal right pleural effusion. Bilateral areas of atelectasis persist in unchanged manner. " 79c8c4e9-8cbf9da2-85c43523-0ef513f1-ad8f77bc.jpg,validate/p12/p12388290/s52957619/79c8c4e9-8cbf9da2-85c43523-0ef513f1-ad8f77bc.jpg,validation," FINAL REPORT HISTORY: Status post assault with pain over left clavicle and left upper ribs. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes results in bronchovascular crowding. There is no 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 clavicular abnormality is identified on this frontal radiograph. IMPRESSION: No evidence of acute intrathoracic injury. However, CT is more sensitive for detection of rib fractures. " 218d1c93-0e3c7a85-76dca3b3-1b9ebcc9-e2b4c42d.jpg,validate/p12/p12056668/s50120531/218d1c93-0e3c7a85-76dca3b3-1b9ebcc9-e2b4c42d.jpg,validation," FINAL ADDENDUM ADDENDUM: The CT from ___ shows a large loculated left basilar pleural effusion that appears to remain on chest radiographs from ___ and ___. It is likely that the new thoracostomy tube does not communicate with this loculation. As mentioned in the original report, the moderate free left effusion is decreased. These findings were discussed by Dr. ___ with ___ of the thoracic surgery service via telephone at 5:14 PM on ___. ______________________________________________________________________________ FINAL REPORT INDICATION: Left chest tube. COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The patient is rotated rightwards. There is a new left thoracostomy pigtail catheter terminating at the left base, with decrease in size of a moderate-sized left pleural effusion. Adjacent atelectasis is present. Right pleural effusion and atelectasis have worsened. There is no pneumothorax. IMPRESSION: Left basilar thoracostomy tube, with interval decrease of a moderate left effusion. Worsening right basilar atelectasis and right effusion. " 0ea9beb2-a9d3f10d-1534ad44-d49b2923-293eb461.jpg,validate/p19/p19461413/s55255799/0ea9beb2-a9d3f10d-1534ad44-d49b2923-293eb461.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PNA // interval change in PNA interval change in PNA IMPRESSION: ET tube tip is 4 cm above the carinal. NG tube tip is in the stomach. Right internal jugular line tip is in the proximal right atrium and should be pulled back 2 cm to secure it position at the cavoatrial junction or above. There is mild improvement in multifocal consolidations. Left pleural effusion is moderate, unchanged. " b12bea4e-2dd3b5bc-d3d4063e-c6d088f8-8b2386a2.jpg,validate/p18/p18630328/s51291037/b12bea4e-2dd3b5bc-d3d4063e-c6d088f8-8b2386a2.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with myasthenia, aspiration pneumonia, continued oxygen requirement, assess for new infiltrates. FINDINGS: AP single views were obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of ___. The heart size remains normal and no configurational abnormalities are identified. The pulmonary vasculature is not congested. Relatively low positioned and flattened diaphragms are again identified and indicate COPD and emphysematous changes. Irregular pulmonary vascular distribution in the periphery is also seen and some linear densities raise the possibility of interstitial fibrosis or scar formations. The previously existing and poorly identified right internal jugular vein approach central venous line has been exchanged to a wider bore catheter that is now identified to reach well into the lower SVC. There are now several poorly delineated infiltrates in the left lung both in the upper lung field as well as in perihilar position and on the base. These densities are compatible with multiple aspiration infiltrates in this patient. Noteworthy is that on the previous examination some of these densities were already detectable albeit not to the same extent as they exist now. A previously suspected retrocardiac density on the right base has not developed further but cannot be evaluated in detail on this single plain chest examination. IMPRESSION: Multiple parenchymal densities in the left hemithorax compatible with aspiration pneumonitis. " c56b9b6f-51dd22d5-747f3784-ae9b1bd8-2db2f19e.jpg,validate/p12/p12824980/s58252666/c56b9b6f-51dd22d5-747f3784-ae9b1bd8-2db2f19e.jpg,validation," FINAL REPORT HISTORY: Cough and back pain, to assess for pneumonia. FINDINGS: No previous images. The heart is normal in size and there is no evidence of vascular congestion or pleural effusion. No acute focal pneumonia. A prominence of the superior mediastinum to the right most likely represents tortuosity of the brachiocephalic vessels. No evidence of acute focal pneumonia. There is displacement of the lower cervical trachea to the right, consistent with a thyroid mass. Extensive hypertrophic spurring is seen in the thoracic spine. Several opacifications projected over just glenoid portion of the left shoulder are consistent with free joint bodies. " 0a09b8a9-8515255d-b662e209-c3dbd0d8-8b7bb7d1.jpg,validate/p12/p12480139/s58011974/0a09b8a9-8515255d-b662e209-c3dbd0d8-8b7bb7d1.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with pulmonary embolus. COMPARISON: No radiograph comparison available. Outside hospital CT dated ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is enlargement of the pulmonary arteries bilaterally, consistent with known pulmonary emboli. There is consolidation in the medial right middle lobe. No pleural effusion or pneumothorax is seen. Heart size is top normal. IMPRESSION: 1. Enlarged pulmonary arteries, consistent with known pulmonary emboli. 2. Right middle lobe consolidation, which may represent pulmonary infarct, pneumonia, or hemorrhage. Differential diagnosis also includes malignancy. Follow up chest radiograph is recommended after treatment to ensure resolution. Preliminary findings were discussed with Dr. ___ by Dr. ___ by phone at the time of patient's admission. Updated impression and recommendation were discussed with Dr. ___ by Dr. ___ by phone at 8:16 a.m. on ___ after attending radiologist review. " acbd0741-e06fbc98-86d357ac-a70dc63d-3bb1b2a1.jpg,validate/p12/p12183689/s59085982/acbd0741-e06fbc98-86d357ac-a70dc63d-3bb1b2a1.jpg,validation," FINAL REPORT INDICATION: Status post stroke. Evaluate for interval change. COMPARISONS: Chest radiograph from ___. TECHNIQUE: A single upright AP view of the chest was obtained. FINDINGS: A tracheostomy tube and right internal jugular central venous catheter are in unchanged position. Bibasilar atelectasis, slightly greater on the right than the left, is stable. There is no new opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No significant change in the bibasilar atelectasis. " b3716cdf-4e9eff33-6654c075-33f8b897-281c1eb2.jpg,validate/p12/p12831242/s54322474/b3716cdf-4e9eff33-6654c075-33f8b897-281c1eb2.jpg,validation," FINAL REPORT AP CHEST HISTORY: Alcoholic cirrhosis. Abdominal pain. IMPRESSION: AP chest compared to ___ through ___: Greater opacification in the lower lungs and perihilar left lung, accompanied by increase in heart size, though still normal, suggests pulmonary edema is the explanation for the new pulmonary findings. Small bilateral pleural effusions, right greater than left are likely. ET tube is in standard placement. Nasogastric tube and feeding tube pass into the stomach and out of view. Left PIC line ends in the upper SVC, right jugular line in the lower. No pneumothorax. " 7b4f0d4f-68fa7caa-947e723c-90c21858-34e70d45.jpg,validate/p15/p15497612/s58364790/7b4f0d4f-68fa7caa-947e723c-90c21858-34e70d45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: r/o PTX, pna TECHNIQUE: AP chest x-ray COMPARISON: NONE FINDINGS: The lungs are clear except for minimal streaky density at the bases consistent with subsegmental atelectasis or scarring. There is no pneumothorax. The cardiac silhouette and mediastinal contours are within normal limits for technique. There are no concerning bone findings. IMPRESSION: Unremarkable study. " 77c246c1-b48e8aee-e825b594-18917178-ec3d9e2c.jpg,validate/p17/p17177703/s54968893/77c246c1-b48e8aee-e825b594-18917178-ec3d9e2c.jpg,validation," 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. " fed77f74-ef528822-ab229abe-2dcaffe8-dcc18c1b.jpg,validate/p12/p12457153/s50887457/fed77f74-ef528822-ab229abe-2dcaffe8-dcc18c1b.jpg,validation," FINAL REPORT HISTORY: Cough. COMPARISON: ___. FINDINGS: PA and lateral views of chest demonstrate clear lungs. The aorta is very tortuous. There is no pneumothorax or pleural effusion. There is no pulmonary edema. Lung volumes are lower today and then 2 days prior. Minimal left lower lobe atelectasis is again present. IMPRESSION: No evidence of pneumonia. " e533e855-f034f56c-e454ad5d-53eb8fc8-d982f2f5.jpg,validate/p13/p13623186/s51661784/e533e855-f034f56c-e454ad5d-53eb8fc8-d982f2f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HIV and fever // eval for pneumonia eval for pneumonia IMPRESSION: Compared to prior chest radiographs since ___ most recently ___. Lungs are clear. . Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 7f55084a-6056b9c5-e7f71983-8fcce042-9b9f997a.jpg,validate/p11/p11796003/s53790507/7f55084a-6056b9c5-e7f71983-8fcce042-9b9f997a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with cough TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Mild enlargement of the cardiac silhouette is re- demonstrated. The mediastinal and hilar contours are unchanged with similar widening of the superior mediastinum, potentially due to mediastinal lipomatosis. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. There are mild multilevel degenerative changes noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 7ff34d1c-3bb626b0-f5eacd24-54f0331a-40ab7aca.jpg,validate/p15/p15388421/s54677434/7ff34d1c-3bb626b0-f5eacd24-54f0331a-40ab7aca.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with FTT // eval for acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Distal aspect of the right sided PICC is difficult to see but likely terminates in the low SVC/ cavoatrial junction. Patient is status post median sternotomy and CABG.There are small to moderate bilateral pleural effusions with overlying atelectasis. No pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Bilateral pleural effusions with overlying atelectasis. Right base opacity most likely represents combination of pleural effusion and atelectasis, but underlying consolidation is not excluded. " 900860cd-f864de0b-1afe76e4-633ea136-a20936ce.jpg,validate/p12/p12010209/s55240136/900860cd-f864de0b-1afe76e4-633ea136-a20936ce.jpg,validation," 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. " 0c77df02-657acb6f-edf11baf-65471cb5-9b4b1af1.jpg,validate/p15/p15267202/s55564350/0c77df02-657acb6f-edf11baf-65471cb5-9b4b1af1.jpg,validation," FINAL REPORT HISTORY: Chest tube removal, to assess for pneumothorax. FINDINGS: In comparison with study of ___, there is no evidence of pneumothorax. Extremely low lung volumes with bilateral effusions and compressive atelectasis at the bases and probable elevation of pulmonary venous pressure. The endotracheal tube has been removed. " d18a6ed1-045a28e2-d44e5cfe-037944b9-56017740.jpg,validate/p17/p17724257/s59309153/d18a6ed1-045a28e2-d44e5cfe-037944b9-56017740.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old male hx of ESRD secondary to DM/HTN s/p ECD kidney transplant ___ c/b chronic allograft nephropathy on monthly belatacept infusion and prednisone coming in with several metabloic derangements, will now start dialysis. // For outpatient dialysis. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: Sternotomy wires are intact and aligned. Left lower lobe platelike atelectasis is unchanged. There is no pneumothorax. Mild cardiomegaly despite low lung volumes is stable. IMPRESSION: Stable left lower lobe platelike atelectasis. Stable mild cardiomegaly. " a3e4e591-bdd7e07b-5e81eb95-d1dab1d0-c82d2d09.jpg,validate/p11/p11877234/s58828010/a3e4e591-bdd7e07b-5e81eb95-d1dab1d0-c82d2d09.jpg,validation," WET READ: ___ ___ ___ 6:58 PM A right-sided PICC terminates in knee proximal SVC, similar in appearance to the prior exam. Moderate pulmonary vascular congestion as well as bilateral hilar opacities are suggestive of mild pulmonary edema. Retrocardiac opacity as well as a small are most likely atelectasis opacity at the base of the right lung however infection should be considered in the appropriate clinical setting. Stable cardiomegaly. Small left pleural effusion. No pneumothorax. WET READ VERSION #___ ___ ___ ___ 6:56 PM A right-sided PICC terminates in knee proximal SVC, similar in appearance to the prior exam. Moderate pulmonary vascular congestion as well as bilateral hilar opacities are suggestive of mild pulmonary edema. Opacity at the base of the right lung is likely atelectasis. Stable cardiomegaly. Small left pleural effusion. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with end stage CHF admitted for symptom control. Please confirm PICC placement prior to use // confirm PICC location confirm PICC location COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Right PIC line ends just before the origin of the SVC. Transvenous right ventricular pacemaker lead unchanged in position with the tip oriented toward the floor of the middle third of the right ventricle. Severe cardiomegaly is chronic. Pulmonary edema is mild and small right pleural effusion has decreased substantially since ___. Small left pleural effusion however is larger and is probably accompanied by some left basal atelectasis, obscured by cardiac silhouette. There is no pneumothorax. " 546b28dc-b8bbfdda-50c86bbe-60dcb75e-0b08bde8.jpg,validate/p10/p10709096/s52828533/546b28dc-b8bbfdda-50c86bbe-60dcb75e-0b08bde8.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman status post fall, evaluate for fracture. COMPARISON: None. FINDINGS: PA and lateral views of the chest were obtained. Lateral view is limited by patient's arm being down by her side. Heart is top normal in size and cardiomediastinal contour is unremarkable. Calcifications are noted in the aortic arch. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. No displaced fracture is identified. IMPRESSION: No acute intrathoracic abnormality. " 9b983dec-ca1258f7-41255764-7658e0f0-f9fdf559.jpg,validate/p12/p12734486/s56290479/9b983dec-ca1258f7-41255764-7658e0f0-f9fdf559.jpg,validation," 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 (discharged 4 days ago w/ E coli UTI on cefepime) with CVL that may have been pulled. // eval placement of CVL eval placement of CVL IMPRESSION: Compared to chest radiographs ___ through ___. Lung volumes are lower reflected in basal atelectasis, right greater than left. Upper lungs clear. Pleural effusion small if any. Mild cardiomegaly unchanged. Entire thoracic aorta is tortuous and probably generally enlarged, but unchanged. Healed rib fractures responsible for thickening of the right lower lateral costal pleural margin. " 7315e63d-e2072c86-0f19e51d-f4f7c6a1-4bdaa166.jpg,validate/p12/p12503315/s51367051/7315e63d-e2072c86-0f19e51d-f4f7c6a1-4bdaa166.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic adenocarcinoma // Assess Rlung for worsening pneumothorax IMPRESSION: As compared to ___ chest radiograph, a large right pleural effusion has apparently increased size, and there is likely a substantial hydro pneumothorax component at the apex, less well demonstrated due to apparent semi upright rather than fully upright positioning on this radiograph. Right lung is densely consolidated and partially atelectatic. Left pigtail pleural catheter remains in place in the lower left hemi thorax with a persistent small left apical pneumothorax and small left pleural effusion. Pulmonary vascular congestion is accompanied by mild to moderate edema. Worsening left lower lobe consolidation is also demonstrated. No other relevant changes. " 3f6ada2a-c307b1a7-62ce247b-9bb30c79-b70cc13a.jpg,validate/p13/p13412848/s57910880/3f6ada2a-c307b1a7-62ce247b-9bb30c79-b70cc13a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with heart failure presenting with weight gain and cough // evalaute for pulmonary edema evalaute for pulmonary edema COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Severe cardiomegaly and generally large and tortuous thoracic aorta are chronic findings. Lungs are clear and there is no pleural effusion. " 11839af7-add5f164-80066f8f-16744f2b-44560d84.jpg,validate/p10/p10027957/s57665959/11839af7-add5f164-80066f8f-16744f2b-44560d84.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with left-sided chest pain. Evaluate for left pleural or parenchymal disease. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___, ___, and ___. FINDINGS: Lung volumes are slightly low, causing mild bronchovascular crowding. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No acute intrathoracic process. " 75b46f6a-3847478a-60a0785e-ecef8e40-327f76b2.jpg,validate/p16/p16617005/s59472246/75b46f6a-3847478a-60a0785e-ecef8e40-327f76b2.jpg,validation," 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 " ec47d8a9-eb88ebc4-e28497ae-89059e4b-050082fb.jpg,validate/p16/p16939016/s58269288/ec47d8a9-eb88ebc4-e28497ae-89059e4b-050082fb.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG // eval for effusion COMPARISON: ___ FINDINGS: Interval removal of the left-sided internal jugular catheter. The feeding tube and tunnel dialysis catheter unchanged in appearance. Bibasal opacities have improved. Moderate left pleural effusion has decreased. Small right-sided pleural effusion has also decreased. Mild interstitial pulmonary edema. Moderate cardiomegaly. IMPRESSION: Improved pleural effusions and adjacent bibasilar lung opacities. " ab9cd122-67c23ea8-1861c8e2-d01ed014-4445c07b.jpg,validate/p11/p11494099/s59630030/ab9cd122-67c23ea8-1861c8e2-d01ed014-4445c07b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cough, surgical procedure. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size is enlarged. Mediastinum is enlarged, both stable. Tortuous aorta is unchanged. Lungs are essentially clear. No pleural effusion or pneumothorax is demonstrated. " eba5db55-17b093bb-d3cf42f7-a220e3e9-e26bc03c.jpg,validate/p11/p11810174/s54505765/eba5db55-17b093bb-d3cf42f7-a220e3e9-e26bc03c.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with URI symptoms for three weeks with persistent productive cough and left basal rales. IMPRESSION: PA and lateral chest compared to ___ through ___: Mild cardiomegaly unchanged. Lungs clear. No pleural effusion. Mild left-sided pleural thickening, probably not clinically significant. No evidence of central lymph node enlargement. Incidental note is made of atherosclerotic calcification in both carotid arteries present since ___ on the left, ___ on the right. " 21f919e9-dbac0c30-c068d295-026f7419-da3ab8a9.jpg,validate/p14/p14368217/s57644114/21f919e9-dbac0c30-c068d295-026f7419-da3ab8a9.jpg,validation," FINAL REPORT INDICATION: History: ___M with hypoxia TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. The heart size is mildly enlarged. The aorta is tortuous. There is mild pulmonary vascular congestion. Streaky bibasilar airspace opacities may reflect atelectasis though infection or aspiration cannot be completely excluded. Blunting of the costophrenic angles on the lateral view suggests small bilateral pleural effusions. Elevation of the right hemidiaphragm is unchanged. No pneumothorax is present. Multiple old left-sided rib fractures are present. IMPRESSION: Mild pulmonary vascular congestion and small bilateral pleural effusions. Streaky bibasilar airspace opacities, possibly atelectasis but infection or aspiration cannot be excluded. " 044da80c-706257e8-ee39ce02-4b164b62-29f13301.jpg,validate/p16/p16108772/s59441409/044da80c-706257e8-ee39ce02-4b164b62-29f13301.jpg,validation," FINAL REPORT HISTORY: Male with history of ischemic/nonischemic cardiomyopathy and COPD. Assess for retrocardiac density on previous radiograph. COMPARISON: Chest radiograph, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Partial clearing of retrocardiac opacity with minimal residual opacity remaining. Stable tortuous aorta with mildly enlarged heart and moderate scoliosis. No new focal opacity, pleural effusion, pneumothorax or pulmonary edema. Mediastinal contour and hila appear normal. No additional bony abnormality. IMPRESSION: Partial clearing of left retrocardiac opacity with minimal residual opacity remaining. Results were conveyed via telephone to ___, RN by Dr. ___ on ___ at 1:45 p.m. within 15 minutes of results. " 124d9c57-7f06a605-9a36bef6-63a9bbaf-304d5b04.jpg,validate/p19/p19791816/s58082910/124d9c57-7f06a605-9a36bef6-63a9bbaf-304d5b04.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Status post endotracheal intubation. COMPARISONS: Earlier in the same day. TECHNIQUE: Chest, portable AP upright. FINDINGS: The patient has been intubated. An endotracheal tube terminates about 6 cm above the carina. An orogastric tube courses into the stomach, where it terminates. The stomach is mildly distended. There is mild but increased left basilar opacity and elevation of the left hemidiaphragm suggesting atelectasis. Otherwise, evaluation of the lung parenchyma is obscured by a large pleural plaque involving the right hemithorax. There is no pneumothorax. IMPRESSION: Status post endotracheal intubation. Mild gastric distention, but orogastric tube in place. Suspected mild but increased left basilar volume loss. " 51c0ed41-0479d778-86c32f53-86559da6-13b6a46e.jpg,validate/p19/p19402508/s59777344/51c0ed41-0479d778-86c32f53-86559da6-13b6a46e.jpg,validation," FINAL REPORT HISTORY: Chest pain, rule out pneumonia. COMPARISON: Chest radiograph ___ and ___. FINDINGS: Frontal and lateral views of the chest were performed. The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The hilar and pleural structures are normal. The imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 012a6d1b-c05da2f6-bf9215df-77a25513-0d05ad53.jpg,validate/p10/p10865085/s55816200/012a6d1b-c05da2f6-bf9215df-77a25513-0d05ad53.jpg,validation," FINAL REPORT INDICATION: Lightheadedness and cough. Evaluate for cardiomegaly. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. Mediastinal contours are unremarkable. Asymmetric opacity at the right heart border just inferior to the right pulmonary hilum is unchanged in overall appearance from CXR from ___ years ago and again has no correlate on the lateral view. This may reflect an area of scarring, or anomalous vasculature though underlying mass is difficult to exclude. IMPRESSION: 1. No acute cardiopulmonary process. 2. Asymmetric opacity at the right infrahilar/ right heart border is grossly unchanged from prior chest radiograph. For definitive characterization, a nonemergent chest CT may be performed. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 1:15 PM, 30 minutes after discovery of the findings. " 0956fcfe-4b53c5fd-81e78578-ad88abb4-98f6050a.jpg,validate/p11/p11607177/s56328938/0956fcfe-4b53c5fd-81e78578-ad88abb4-98f6050a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with advanced heart failure, VT, AF s/p RHC today // pneumothorax, edema, effusion s/p RHC TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Right Swan-Ganz l catheter tip is in a right lower subsegmental artery, should be withdrawn approximately 8 cm for more standard position. Severe cardiomegaly is stable. Pacer leads are in standard position. Mild vascular congestion has improved. There is no pneumothorax or large effusions NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:24 PM, 5 minutes after discovery of the findings. " 288d8ace-e4e2e933-d6e6c4b4-3bfd0a43-ba517401.jpg,validate/p19/p19797689/s56757830/288d8ace-e4e2e933-d6e6c4b4-3bfd0a43-ba517401.jpg,validation," WET READ: ___ ___ ___ 8:07 AM No significant change from the study performed on admission. WET READ VERSION #1 ___ ___ ___ 8:26 PM No significant change from the study performed on admission. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with crackles on exam // Please eval for pulm edema Please eval for pulm edema IMPRESSION: In comparison with the earlier study of this day, there is again enlargement of the cardiac silhouette without definite vascular congestion. Opacification of the left bases consistent with pleural effusion and volume loss in the left lower lobe. " 9893264f-0eb0e0b8-0a72fe1e-874f717e-24140e37.jpg,validate/p16/p16343839/s50795703/9893264f-0eb0e0b8-0a72fe1e-874f717e-24140e37.jpg,validation," FINAL REPORT TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Right chest wall deformity is again noted and unchanged in appearance, likely a combination of post-traumatic and post-surgical findings. Right pleural thickening and bronchiectasis is likewise unchanged. There is no focal consolidation, pleural effusion or pneumothorax. The heart is normal in size with atherosclerotic calcification seen in the aortic arch. Surgical clips are seen in the left upper quadrant from nephrectomy. Nodular opacity seen over the left lung is increased in size to 8mm. Other nodules seen on subsequent chest CT not as well seen on the radiograph. IMPRESSION: No acute intrathoracic process. Increased size of left pulmonary nodule, please refer to subsequent CT for full evaluation. " d775784f-c7c939ee-d8792ba4-c297bffb-3b7e5f09.jpg,validate/p18/p18134008/s52845683/d775784f-c7c939ee-d8792ba4-c297bffb-3b7e5f09.jpg,validation," WET READ: ___ ___ ___ 5:42 PM Interval increase in right infrahilar opacity concerning for infection vs. aspiration ______________________________________________________________________________ FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old female with leukocytosis and history of CLL, evaluate for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: ___. FINDINGS: There is retrocardiac opacity that likely reflects patient's known hiatal hernia. However, there is an asymmetric right infrahilar opacity when compared to the prior exam. This likely reflects infection versus aspiration. There are bilateral interstital opacites present as well. No pleural effusions or pneumothoraces are seen. The heart is slightly enlarged. Mitral annular calcifications noted. Aortic arch calcifications are noted. There is no evidence of pneumoperitoneum. Partial visualization of plate and screw fixation of the left humerus is seen fixating the surgical neck fracture of the humerus. IMPRESSION: 1. Interval increase in right infrahilar opacity concerning for infection versus aspiration. Follow up radiography may be helpful to confirm this; however, this appearance may be part of a more generalized pattern of pulmonary edema without an additional process. 2. Findingsl consistent with mild to moderate pulmonary edema. " 608b3604-37a6a14a-455ebb1d-45167a61-c90205b1.jpg,validate/p18/p18116982/s53226174/608b3604-37a6a14a-455ebb1d-45167a61-c90205b1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with hx of AML, s/p allo with progressive cough and diffuse rhonchi. Please assess for PNA. // ___ year old man with hx of AML, s/p allo with progressive cough and diffuse rhonchi. Please assess for PNA. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: CHEST RADIOGRAPHS FROM ___. FINDINGS: The lungs are well expanded and clear. There is no pleural abnormality. The heart size is normal. The hilar and mediastinal contours are unremarkable. IMPRESSION: No pneumonia. " febd1673-c8423f3d-32fd0f4d-e0fe64e5-0102072e.jpg,validate/p12/p12108578/s57067272/febd1673-c8423f3d-32fd0f4d-e0fe64e5-0102072e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cirrhosis p/w ascites // Evaluate for infection vs volume overload COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pre-existing right pleural effusion has almost completely resolved. A minimal amount of effusion is seen on the lateral radiograph only. Overall smaller lung volumes. No cardiomegaly. No pulmonary edema. No pneumonia. " d9cfef6f-fdfdab3f-982e16d2-050d7e3c-f0913646.jpg,validate/p16/p16864674/s57358758/d9cfef6f-fdfdab3f-982e16d2-050d7e3c-f0913646.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with et tube placed // eval for tube COMPARISON: Prior study from earlier same day. FINDINGS: AP portable supine view of the chest. There has been interval placement of an endotracheal tube which is seen terminating approximately 5.6 cm above the carinal. A nasogastric tube is seen descending into the left upper quadrant of the tip is not included within the imaged field. A layering right pleural effusion is again noted, large in size with residual areas of aerated lung noted. Tiny clips project over the expected region of the right lung base. The left lung is clear though volume is low. IMPRESSION: Appropriate position of endotracheal and nasogastric tubes. Large right pleural effusion layers posteriorly. " 4df3639f-dc2cd979-2a7fc937-a02fc105-a3c00863.jpg,validate/p11/p11814438/s57223284/4df3639f-dc2cd979-2a7fc937-a02fc105-a3c00863.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and fever. COMPARISON: None available in the ___ system. PA AND LATERAL CHEST RADIOGRAPH: 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. No pneumonia. " 6b08203a-7089cde5-929a2363-459a538f-7140b8c4.jpg,validate/p17/p17702558/s51280398/6b08203a-7089cde5-929a2363-459a538f-7140b8c4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NSCLC p/w dyspnea, found to have pleural effusion, treated with chest tube drainage // ?interval change ?interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Moderate to large left pleural effusion, which improved on ___, is unchanged, left basal pigtail pleural drainage catheter still in place. . Left lower lobe is poorly aerated, and a large left infrahilar mass is demonstrated on the chest CTA ___. Right lung is clear. No pneumothorax. " 91ab0fea-ab4c1b09-7da12baf-c1abc395-e68ae6a6.jpg,validate/p13/p13622492/s54748678/91ab0fea-ab4c1b09-7da12baf-c1abc395-e68ae6a6.jpg,validation," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Hip fracture, preop. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated somewhat flattening the diaphragms, consistent with chronic obstructive pulmonary disease. There is slight blunting of the bilateral posterior costophrenic angles which likely relates to hyperinflation, although very trace pleural effusion is not entirely excluded. There is mild left base atelectasis/scarring. No focal consolidation is seen. The cardiac silhouette is top normal. The aorta is calcified and tortuous. IMPRESSION: 1. Left base atelectasis/scarring. 2. COPD. Blunting of the posterior costophrenic angles may relate to hyperinflation, although trace pleural effusion is difficult to exclude. " 30161db1-e03af292-f4daa171-3ec26ba2-30cbefa5.jpg,validate/p11/p11388787/s52145540/30161db1-e03af292-f4daa171-3ec26ba2-30cbefa5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pan // f/u pna F/U PNEUMONIA RESIDUAL CHECK RESOLUTION NO COUGH IMPRESSION: In comparison with the study of ___, there is again prominence of the left ventricle with tortuosity of the descending aorta. Some hyperinflation of the lungs suggests underlying chronic pulmonary disease. The left basilar opacification appears less prominent on the lateral view. This could well represent sequela of previous pneumonia. Coronary artery stent is again seen on the lateral view, as well as calcification in the region of the aortic valve. " f5eaf2e8-bf40b454-6406a5a4-5e118f8c-8d2667f9.jpg,validate/p16/p16233333/s58518597/f5eaf2e8-bf40b454-6406a5a4-5e118f8c-8d2667f9.jpg,validation," WET READ: ___ ___ ___ 10:40 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M with episode of chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph ___ 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. A chronic anterior compression fracture in the lower thoracic spine is unchanged. Unchanged irregularity of the posterolateral left ninth and tenth ribs suggests prior fracture. IMPRESSION: No acute cardiopulmonary abnormality. " dec9f514-f2169947-a65e565e-1f835668-21ce0b79.jpg,validate/p15/p15652922/s57711148/dec9f514-f2169947-a65e565e-1f835668-21ce0b79.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxic respiratory failure // ___ year old man with hypoxic respiratory failure ___ year old man with hypoxic respiratory failure IMPRESSION: In comparison with the study of ___, there is little change in the monitoring and support devices. Continued bilateral pleural effusions with compressive atelectasis at the bases. More heterogeneous opacification, especially in the left perihilar region, is worrisome for superimposed pneumonia in the appropriate clinical setting. The cardiac silhouette remains at the upper limits of normal in size or mildly enlarged. Indistinctness of pulmonary vessels would be consistent with increased pulmonary venous pressure. " 5d266060-9d8853c5-a9654c23-630667b5-6be32296.jpg,validate/p13/p13751863/s54138211/5d266060-9d8853c5-a9654c23-630667b5-6be32296.jpg,validation," 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. " 638f3e85-fd8b5f74-04343ca6-a8ba9a1b-c83128e5.jpg,validate/p16/p16853288/s55095977/638f3e85-fd8b5f74-04343ca6-a8ba9a1b-c83128e5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough. Evaluate 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 acute cardiopulmonary abnormality. " 5007ff07-3b2e31c6-a389556c-e4d85c95-d39b5fff.jpg,validate/p14/p14948860/s54211198/5007ff07-3b2e31c6-a389556c-e4d85c95-d39b5fff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with seizure // 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. " c689da54-c26a78a0-034a0172-f0164acd-a354f173.jpg,validate/p19/p19960115/s58409024/c689da54-c26a78a0-034a0172-f0164acd-a354f173.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval COMPARISON: ___ IMPRESSION: Left pleural effusion is large. There is new right mediastinal shift. Port-A-Cath catheter tip is at the level of lower SVC. No pneumothorax is seen. When compared to ___ CT the amount of fluid is similar. The CT also provided better appreciation of small right pleural effusion as well as nodular opacities in the right lung better seen than on the current chest radiograph. " 18f93696-0399386c-acab31ba-5e4abbbe-fbf61cf7.jpg,validate/p10/p10352831/s54295885/18f93696-0399386c-acab31ba-5e4abbbe-fbf61cf7.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man after a single-lead pacemaker. Confirm lead placement. IMPRESSION: PA and lateral chest compared to ___: Transvenous right ventricular pacemaker lead takes a long course through the right atrium, terminating in the right ventricle anteriorly. There is no pneumothorax, pleural effusion, or mediastinal widening. Patient has had median sternotomy for CABG. There are many healed left posterolateral rib fractures. The heart is mildly enlarged, but the lungs are clear. " 252d75b7-aa4cc4be-9feab988-d468882a-5afec944.jpg,validate/p12/p12530892/s58202853/252d75b7-aa4cc4be-9feab988-d468882a-5afec944.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // acute cardiopulm disease 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. " 4a87840c-03d97b7a-b5416b51-e8345167-3a11147e.jpg,validate/p11/p11607177/s54291485/4a87840c-03d97b7a-b5416b51-e8345167-3a11147e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with impella placed on ___. // assess impella placement, and for pulmonary edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Swan-Ganz catheter tip is at the right lower lobe pulmonary vein. Cardiomediastinal silhouette is unchanged. ET tube tip is 4.3 cm above the carinal. Vascular congestion has improved in the interim. " d229e232-c547b638-b5440f63-988565f4-20b723b8.jpg,validate/p17/p17446597/s55334135/d229e232-c547b638-b5440f63-988565f4-20b723b8.jpg,validation," WET READ: ___ ___ ___ 7:54 PM improved aeration of left lung since ___. right basilar opacity and pleural effusion are similar. pulmonary edema is similar. ETT 4.0 cm above carina. Right IJ catheter, NGT, Left PICC unchanged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxia, increased secretion, fluid overload, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Effusion and lung opacity on the right are constant. The left lung base shows a slightly improved radiolucency, likely reflecting improved ventilation. The size of the cardiac silhouette is unchanged. There is no evidence of pneumothorax or newly appeared parenchymal abnormalities. " 3627a3e6-11ef14dd-20be075f-12556b68-bcf54da4.jpg,validate/p15/p15127507/s52897613/3627a3e6-11ef14dd-20be075f-12556b68-bcf54da4.jpg,validation," FINAL REPORT INDICATION: Seizure and concern for aspiration. COMPARISON: Multiple priors from ___ - ___. FINDINGS: PA and lateral chest radiographs demonstrate severe cardiomegaly, unchanged since ___. There is no focal consolidation, pleural effusion, pneumothorax, or interstitial edema. Segmental retrocardiac atelectasis is noted. IMPRESSION: No acute cardiopulmonary process. " 2be234a9-00162dfa-3148190a-0a1eac4a-d25bf3f1.jpg,validate/p11/p11311721/s54202218/2be234a9-00162dfa-3148190a-0a1eac4a-d25bf3f1.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with left sided chest pain and numbness in left arm TECHNIQUE: PA and lateral COMPARISON: Chest x-ray on ___ 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. " 5241f3be-b550d83f-64210ab5-c20cba7b-0a2ef136.jpg,validate/p16/p16778367/s53707216/5241f3be-b550d83f-64210ab5-c20cba7b-0a2ef136.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with first time seizure, cough // 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. " 2ca447ea-abd2b28b-d88658b9-e79698df-b027e9ae.jpg,validate/p11/p11811888/s50214207/2ca447ea-abd2b28b-d88658b9-e79698df-b027e9ae.jpg,validation," FINAL REPORT AP CHEST, 4:30 P.M., ___ HISTORY: A ___-year-old man with pneumonia and seizures, question worsening pneumonia. IMPRESSION: AP chest compared to ___: Widespread ground-glass pulmonary opacification and consolidation present on ___ have improved. There is no pulmonary edema or pleural effusion. The heart size is normal. A feeding tube ends in the stomach. " 85bc09e3-cb263f3d-212e5d1c-ac58a845-7495bc55.jpg,validate/p10/p10180652/s53458894/85bc09e3-cb263f3d-212e5d1c-ac58a845-7495bc55.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old male with chest pain for one hour, radiating down his arm. Evaluate for pneumonia or mediastinal widening. COMPARISON: ___. FINDINGS: Frontal AP upright and lateral views of the chest were obtained. The lung volumes are slightly low, resulting in bronchovascular crowding. Increased opacity at the left lower lobe is likely atelectasis and crowding of vessels, although it could represent pneumonia in the appropriate clinical setting. The remainder of the lungs are clear. There is no pleural effusion or pneumothorax. Heart size is within normal limits allowing for technique. Mediastinal silhouette and hilar contours are normal. The patient is status post right upper extremity amputation. A left chest port catheter ends in the distal SVC. IMPRESSION: Left lower lobe opacity is likely atelectasis but could represent pneumonia in the appropriate clinical setting. Per discussion with Dr. ___ (ED physician), there is little clinical concern for pneumonia. " 89c89962-c52b94da-e8e49b20-061a4548-57bb7669.jpg,validate/p11/p11026100/s57460262/89c89962-c52b94da-e8e49b20-061a4548-57bb7669.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Complex cyst, re-assessment for presence of abnormal parenchymal lesions. COMPARISON: ___. Heart size is mildly enlarged, stable. Mediastinum is stable. Assessment of the lung parenchyma demonstrates right upper lobe minimal scarring, stable as compared to ___. The rest of the lungs are clear, and there is no pleural effusion or pneumothorax. If clinically warranted, further correlation with chest CT to exclude the possibility of radiographically occult lesions is recommended. " 1d9731b4-5a879e83-f7007d6c-2b20661b-68cc22c1.jpg,validate/p19/p19336651/s54729547/1d9731b4-5a879e83-f7007d6c-2b20661b-68cc22c1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w pancreatic ca on chemo p/w cough and fever COMPARISON: ___ and ___. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires again noted. Diffuse bilateral pulmonary opacities are concerning for multifocal pneumonia. Superimposed edema difficult to exclude. Small bilateral pleural effusions are noted. No pneumothorax. Cardiomediastinal silhouette grossly unchanged. Bony structures intact. IMPRESSION: Diffuse pulmonary opacities concerning for multifocal pneumonia, difficult to exclude edema. Tiny bilateral pleural effusions. Followup to resolution. " 58bdb280-319efff4-984cc769-d82a1f9f-81ca49cb.jpg,validate/p18/p18358382/s51589294/58bdb280-319efff4-984cc769-d82a1f9f-81ca49cb.jpg,validation," WET READ: ___ ___ ___ 9:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph Frontal and lateral chest radiograph INDICATION: Diaphoretic and weak. Assess for acute process. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are hyperexpanded and the diaphragms are flattened. The cardiomediastinal silhouette is unchanged, without frank cardiac enlargement. Again seen are are intact median sternotomy wires with mediastinal clips. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy is detected. No CHF, pleural effusion or pneumothorax. Minimal atelectasis or scarring at the right lung base is unchanged. The extreme right costophrenic angle is excluded from the film. IMPRESSION: No acute pulmonary process. No significant change compared with ___. " 8997f755-94fc1aab-5938e24d-8c0d8c70-9d35e1c6.jpg,validate/p11/p11607584/s50750384/8997f755-94fc1aab-5938e24d-8c0d8c70-9d35e1c6.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Cough, rhonchi; rule out pneumonia. COMPARISON: ___. FINDINGS: Subtle left lower lobe opacities are new concerning for infection. Right lung is unremarkable. Prior sternotomy was done for mitral valve repair and tricuspid annulus plasty. The cardiac contour is not dilated. There is no pleural effusion or pneumothorax. CONCLUSION: New left lower lobe opacity is concerning for pneumonia. This was discussed directly by telephone with Dr. ___. " 0db19fca-73058b34-7fba8375-c50c923d-425cf448.jpg,validate/p19/p19596467/s58553372/0db19fca-73058b34-7fba8375-c50c923d-425cf448.jpg,validation," 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. " 8fc3f4e9-906f4cd2-509d0293-42359d2e-ef25f00c.jpg,validate/p10/p10229323/s51923955/8fc3f4e9-906f4cd2-509d0293-42359d2e-ef25f00c.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Shortness of breath. Portable AP radiograph of the chest was reviewed in comparison to ___. Since the prior study, there is slightly less nodular appearance of the consolidations and more diffuse widespread picture is seen, although still some nodular opacities can be demonstrated. Again as previously mentioned, the etiology might be septic emboli versus pulmonary edema or less likely multifocal pneumonia. Extensive hemorrhage into the lungs is a possibility. Fat emboli would be less likely. Correlation with chest CT is strongly recommended. " 2a160296-b97b26ca-9bd8ea0b-c9eefaf9-3d41e0c6.jpg,validate/p17/p17991099/s59634718/2a160296-b97b26ca-9bd8ea0b-c9eefaf9-3d41e0c6.jpg,validation," FINAL REPORT HISTORY: COPD with weakness and light-headedness. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size remains moderately enlarged. The mediastinal contours are stable with calcification of the aortic arch again noted. The hilar contours are unremarkable. No pulmonary edema or focal consolidation is demonstrated. No pleural effusion or pneumothorax is seen. Attenuation of the pulmonary vasculature towards the apices may reflect emphysema. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 68a7c239-a5166bd8-c7bcf9ee-71f0d3cd-29141cda.jpg,validate/p11/p11610947/s56375216/68a7c239-a5166bd8-c7bcf9ee-71f0d3cd-29141cda.jpg,validation," FINAL REPORT INDICATION: ___ year old man with fever and cough, decreased breath counds at the bases // ? pneumonia 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: Normal chest radiographs. NOTIFICATION: Findings were communicated to Dr. ___ at 12:14 p.m. on ___ by phone. " 32329dc5-0a29a426-b1f2376e-c83fff81-8afc8af5.jpg,validate/p12/p12745171/s52072859/32329dc5-0a29a426-b1f2376e-c83fff81-8afc8af5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with abnormality found on shoulder films. looking for definition. // ? lesion COMPARISON: Chest radiograph from ___, CTA chest from ___, and shoulder radiograph from ___. FINDINGS: PA and lateral views of the chest provided. This chest radiograph study confirms the previous radiographic finding of a subtle right para-mediastinal opacity. This opacity appears larger than the last available chest radiograph from ___. Upon review of the CTA exam from ___, this opacity is likely reflecting normal vascular structure but this assumption should be confirmed by a repeat chest CT. Heart is moderately enlarged. Tortuous descending aorta is seen. There may be a small left pleural effusion. IMPRESSION: Right paramediastinal opacity, likely normal vascular structure. Confirmation with chest CT is recommended. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 14:20 into the Department of Radiology critical communications system for direct communication to the referring provider. " 2b68d9e9-79620937-88381b84-48283e15-074563ab.jpg,validate/p18/p18747069/s51980549/2b68d9e9-79620937-88381b84-48283e15-074563ab.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: New pneumonia, evaluation of the renal surgery. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The severity and extent of the massive bilateral parenchymal opacities is constant. Constant appearance of the cardiac silhouette. No larger pleural effusions. No new parenchymal opacities. No pneumothorax. " a7da9002-727cf4e1-37496dd9-51bbc42b-577e8b6c.jpg,validate/p18/p18056761/s55740320/a7da9002-727cf4e1-37496dd9-51bbc42b-577e8b6c.jpg,validation," FINAL REPORT HISTORY: Asthma, allergies, shortness of breath for 3 days, night sweats, fever/chills, and cough. Patient is from ___. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded. There is an area of patchy opacity at the right lower lobe that could reflect an infectious process. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: Area of patchy opacity at the right lower lobe that could reflect infectious process. Recommend clinical correlation. These findings were communicated to Dr. ___ at 4:25 p.m. on ___ by phone. " ba3c1146-56b96aa3-7d633de3-4608bd48-f098f536.jpg,validate/p15/p15886512/s56389403/ba3c1146-56b96aa3-7d633de3-4608bd48-f098f536.jpg,validation," 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. " 30290c0e-95e6e14c-bf39630a-e32ace7a-6d3f26f3.jpg,validate/p14/p14347948/s50370223/30290c0e-95e6e14c-bf39630a-e32ace7a-6d3f26f3.jpg,validation," 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. " 28459016-6b0ed211-ac7a7cdb-ea6d3152-468f8e47.jpg,validate/p15/p15378092/s53626183/28459016-6b0ed211-ac7a7cdb-ea6d3152-468f8e47.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST PA AND LATERAL. INDICATION: ___-year-old male patient with lymphoma, increased bands with concern for infection. Assess 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 portable AP chest examination of ___. Again on the frontal PA view, the patient makes a very poor inspirational effort resulting in relatively high-positioned diaphragms and thereto related crowded appearance of the pulmonary basal vasculature. There is no conclusive evidence for any new parenchymal infiltrate and the lateral pleural sinuses are free. Previously described right-sided Port-A-Cath system advanced via internal jugular approach remains in unchanged position and terminates at the level of the carina overlying the right-sided mediastinal structures. On the lateral view, the patient makes a very inspirational effort with normally positioned diaphragms and resolution of the crowded appearance of the pulmonary vasculature on the frontal view. The lateral view demonstrates normal vasculature, absence of any atelectatic structures or pulmonary parenchymal infiltrates with the posterior pleural sinuses clearly free from any fluid accumulation. IMPRESSION: No evidence of acute infiltrates or pleural effusions. No pneumothorax in apical area in this patient with lymphoma and increased bands raise concern for infections. " 86c59c54-f5a2618e-1873d2e4-0c4bd2af-17c64d52.jpg,validate/p11/p11423795/s56059941/86c59c54-f5a2618e-1873d2e4-0c4bd2af-17c64d52.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT exchanged ___, transferred from ___ to West campus // ?ETT placement ?ETT placement IMPRESSION: As compared to ___, no relevant change is seen. The monitoring and support devices are constant. Low lung volumes. Moderate cardiomegaly with mild fluid overload but no overt pulmonary edema. Minimal blunting of the left costophrenic sinus, likely caused by a small left pleural effusion. Partial left lower lobe atelectasis. " 648e4a69-e0a8e7c8-97d37c37-4277a97f-badc2b4b.jpg,validate/p15/p15195922/s54029031/648e4a69-e0a8e7c8-97d37c37-4277a97f-badc2b4b.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CTA ___ and chest radiograph ___. FINDINGS: The heart size remains moderately enlarged, unchanged. Lungs are clear and the pulmonary vasculature is normal. The mediastinal and hilar contours are unremarkable. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Moderate cardiomegaly, unchanged, and compatible with the patient's history of ASD and Ebstein's anomaly. " 6fc70fce-cd204729-0018d9bf-8eedeb9b-b64e99ff.jpg,validate/p17/p17015391/s58847767/6fc70fce-cd204729-0018d9bf-8eedeb9b-b64e99ff.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with possible seizure and fall. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Left chest wall vagal nerve stimulator is again seen. Where seen, the lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 492a4031-c2cfdec4-74d34ff1-ed2529a7-0662066e.jpg,validate/p17/p17907922/s54671658/492a4031-c2cfdec4-74d34ff1-ed2529a7-0662066e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left PTX // eval for change in PTX IMPRESSION: In comparison to the previous radiograph from earlier today, a left pneumothorax has increased in size and is now moderate, with the apical visceral pleural line now overlying the level of the fifth posterior left rib. Exam is otherwise remarkable for worsening bibasilar atelectasis and persistent left lower lobe lung nodule. NOTIFICATION: The findings were discussed ___ ___, M.D. by ___ ___, M.D. on the telephone on ___ at 3:46 PM, 5 minutes after discovery of the findings. " 28a40d1f-e127b71e-9821c260-4d541e61-a70b1ae9.jpg,validate/p12/p12839846/s57080029/28a40d1f-e127b71e-9821c260-4d541e61-a70b1ae9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man ___ with multiple right sided rib fractures and small apical PTX on right // evaluate any interval change in PTX on right. Please perform at roughly ___ on ___ TECHNIQUE: Chest single view COMPARISON: ___ 18:59 FINDINGS: There is elevation of the right hemidiaphragm, similar. Right pneumothorax is not definitely identified. Acute rib fractures, stable. There is acute fracture of the right scapula. There is a shallow inspiration. There are no infiltrates. Better lung aeration compared with prior exam. IMPRESSION: Acute right scapula, multiple rib fractures, stable. Right pneumothorax is not definitely identified. Elevated right hemidiaphragm " 63175fce-6c853670-a67457ab-232eb1da-3b941a6b.jpg,validate/p18/p18849858/s58416410/63175fce-6c853670-a67457ab-232eb1da-3b941a6b.jpg,validation," WET READ: ___ ___ ___ 5:04 AM 1. Trace left pleural effusion, significantly decreased since ___. 2. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Chest pain. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrates well inflated clear lungs. Trace left pleural effusion has significantly decreased since previous examination. No right pleural effusion. No pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. IMPRESSION: 1. Near resolution of left pleural effusion since ___. 2. No pneumonia. " 06ffa385-6ead50f8-cb4fe7ff-7f9500c3-794b4158.jpg,validate/p18/p18403514/s59532707/06ffa385-6ead50f8-cb4fe7ff-7f9500c3-794b4158.jpg,validation," 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. " f99cc594-fd419aac-5666baa5-c4cfdab4-a05236ee.jpg,validate/p13/p13529237/s53176672/f99cc594-fd419aac-5666baa5-c4cfdab4-a05236ee.jpg,validation," FINAL REPORT HISTORY: Acute onset chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 6a36c264-0792e1b9-1c64f8a1-6084ae78-bd813ab9.jpg,validate/p16/p16611822/s58149202/6a36c264-0792e1b9-1c64f8a1-6084ae78-bd813ab9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with interstitial lung disease who has cough that is productive x 19 days as well as a temp ___.7 in the office, otherwise feels well // pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs demonstrate interval slight progression of a bilateral reticular pattern of chronic interstitial fibrotic lung disease with a subpleural and basilar predominance. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Slow progression of diffuse interstitial lung disease, likely a fibrotic subtype of NSIP. No definite superimposed pneumonia, but subtle infectious abnormalities may be difficult to detect in the setting of diffuse lung disease. " 7d53fb38-95386788-8b5eb40d-27e68325-cef53141.jpg,validate/p18/p18855788/s59327867/7d53fb38-95386788-8b5eb40d-27e68325-cef53141.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // ?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. IMPRESSION: No acute cardiopulmonary process. " 2e204594-b1ed6be4-910d7d23-b60897cd-45dc87ed.jpg,validate/p13/p13040755/s59138645/2e204594-b1ed6be4-910d7d23-b60897cd-45dc87ed.jpg,validation," WET READ: ___ ___ ___ 7:59 AM Interval removal of left pleural pigtail catheter, with slight interval increase in size of left pneumothorax inferiorly, and redistribution of previously seen air-fluid level in the posterior medial left lung, likely due to supine portable technique. No evidence of mediastinal shift. The findings were discussed via telephone by Dr. ___ with Dr. ___ (ordering provider) on ___ at 8:50 PM, 2 minutes after discovery of the findings. WET READ VERSION #1 ___ ___ ___ 9:47 PM Interval removal of left pleural pigtail catheter, with slight interval increase in size of left pneumothorax inferiorly, and redistribution of previously seen air-fluid level in the posterior medial left lung, likely due to supine portable technique. No evidence of mediastinal shift. The findings were discussed via telephone by Dr. ___ with Dr. ___ (ordering provider) on ___ at 8:50 PM, 2 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p pigtail pull // increase pneumothorax IMPRESSION: As compared to the previous radiograph from earlier the same date, a left pigtail pleural catheter has been removed, with slight increase in size of a moderate left pneumothorax with apical and basilar components. No other relevant changes except for development of gastric distension in the imaged portion of the upper abdomen. " 5293bf11-05b45f1b-608082b1-7f847842-a714c8dd.jpg,validate/p10/p10088966/s59946493/5293bf11-05b45f1b-608082b1-7f847842-a714c8dd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man pre-op MVR/CAD // eval for acute process eval for acute process IMPRESSION: Comparison to ___. Stable moderate cardiomegaly. Decreasing lung volumes with increasing interstitial opacities, notably at the right than left lung base. The changes could reflect developing pneumonia or moderate interstitial pulmonary edema. No pleural effusions are present. " 18665ddc-99788d8e-09ccf862-26a90955-c682251b.jpg,validate/p17/p17608002/s57080873/18665ddc-99788d8e-09ccf862-26a90955-c682251b.jpg,validation," FINAL REPORT INDICATION: ___F with dyspnea, SVT // evaluate for acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs remain clear without focal consolidation, effusion, or edema. Moderate cardiomegaly and enlarged pulmonary arteries are again noted. No acute osseous abnormalities. IMPRESSION: Cardiomegaly without acute cardiopulmonary process. " 280d67ad-f00f4e35-dd1917c0-078e5a2e-f778aeff.jpg,validate/p13/p13598803/s53411620/280d67ad-f00f4e35-dd1917c0-078e5a2e-f778aeff.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with severe pneumonia and resp failure in early ___ // assess for degree of clearance of infiltrates Emphysema, history of aspergillosis in the setting of bronchiectasis and cavitary lung disease. TECHNIQUE: Upright PA and lateral chest COMPARISON: Chest radiographs ___, ___ and ___. Chest CT ___. FINDINGS: Large cicatricial cysts in the lung apices, parenchymal scarring and architectural distortion are similar to the prior study. Lateral view suggests new material may have collected in one of the large cystic spaces, possible mycetoma. Volume loss at the lung apices with associated elevated of the hila is also unchanged. The pulmonary artery is newly enlarged, elevated, and lobulated. There is a new dense opacity in the left lower lobe and to a lesser extent at the right base. There is no pleural effusion or pneumothorax. The heart is not enlarged. IMPRESSION: 1. Worsening bibasilar opacities, left greater than right, may reflect pneumonia, possibly cryptogenic organizing pneumonia if patient has no clinical symptoms of pneumonia. 2. Retracted hila and interval increase in caliber of the pulmonary artery suggests the patient may be prone to pulmonary hypertension save report 3. Possible mycetoma, chronicity indeterminate. NOTIFICATION: The findings were telephoned to Dr. ___ by ___ ___ at 16:30, ___, ___ min after discovery and amended by an email from Dr ___ ___. " 4dab16d7-606dbef4-fea1fe83-807584e9-ae643450.jpg,validate/p15/p15459844/s52680748/4dab16d7-606dbef4-fea1fe83-807584e9-ae643450.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with shortness breath, evaluate for acute process. TECHNIQUE: AP chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. Lungs appear hyperinflated with emphysematous changes, with likely bullae in the left lung apex. There are areas of irregular scarring and retraction with nodular opacities in the right upper lung. Airspace opacities in the right mid and lower lung are consistent with pneumonia. The left lung is clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: 1. Right lower lobe consolidation. 2. Irregular scarring and retraction with nodular opacities in the right upper lung. Recommend CT to exclude a neoplastic lesion. 3. Hyperinflated lungs with emphysematous changes. RECOMMENDATION(S): Dedicated CT chest for further evaluation of right upper lung. NOTIFICATION: The findings and recommendation above were discussed by Dr. ___ ___ with Dr. ___ on the ___ ___ at 7:59 AM, 5 minutes after discovery of the findings. " 5f34959d-ee1b4bb7-663abf88-ea88843f-6d2123b6.jpg,validate/p12/p12043836/s54428651/5f34959d-ee1b4bb7-663abf88-ea88843f-6d2123b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new right sided chest pain // interval change in effusion TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Small to moderate right pleural effusion, moderate right pneumothorax are unchanged. Aeration of the right upper lung has mildly improved. Right basal opacities are unchanged. Left lung is grossly clear. Cardiomegaly is a stable. Right right basal pigtail catheter is in unchanged position. Sternal wires are aligned " deab22fe-dd1cd517-2de27d19-29c14f92-e8f01e1c.jpg,validate/p10/p10307557/s52477488/deab22fe-dd1cd517-2de27d19-29c14f92-e8f01e1c.jpg,validation," 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. " 72e409a4-b0955077-e10fb8ed-de570b24-3f32a909.jpg,validate/p14/p14718940/s58063981/72e409a4-b0955077-e10fb8ed-de570b24-3f32a909.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with dyspnea. Evaluate for pneumonia. COMPARISON: ___. TECHNIQUE: Frontal upright and lateral chest radiograph. FINDINGS: There are bilateral diffuse interstitial thickening and upper vascular re-distribution compatible with interstitial edema. There are no focal opacities suggestive of pneumonia. Heart size is mildly enlarged, although assessment is limited in this AP projection. There is no pleural effusion or pneumothorax. IMPRESSION: Interstitial pulmonary edema. " 540ae61b-6eb1c290-a53170e3-55e2d810-be98848a.jpg,validate/p16/p16996209/s55474629/540ae61b-6eb1c290-a53170e3-55e2d810-be98848a.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Assessment of the NG tube placement. The AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. Currently, the Dobbhoff tube has been replaced by the NG tube terminating in the stomach. TIPS catheter is in place. Heart size, mediastinum, and lungs are essentially unremarkable. Elevated diaphragm bilaterally might affect substantial amount of pleural fluid. " 1160c877-891f297e-e35f2e63-9fa2ac18-bd8704a3.jpg,validate/p11/p11540803/s52133158/1160c877-891f297e-e35f2e63-9fa2ac18-bd8704a3.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with new onset atrial fibrillation and shortness of breath. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is top normal. Mediastinal and hilar contours unremarkable. 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. IMPRESSION: No acute cardiopulmonary process. " 468a1675-344a56da-7cf12651-0344086a-8454a87a.jpg,validate/p19/p19175595/s52445151/468a1675-344a56da-7cf12651-0344086a-8454a87a.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old male with a pneumothorax and rib fractures. IMPRESSION: AP chest compared to ___: Consolidation at the base of the left lung which worsened from ___ through ___ at 12:08 a.m. is unchanged. This could be atelectasis alone or aspiration. A small amount of fluid has accumulated in the left hemithorax with persistence of the moderate left pneumothorax, unchanged in volume since it was first detectable radiographically on ___. Heart size is top normal. The fractures of the right middle ribs laterally are probably chronic. " f60ec255-ef71f882-af1e63eb-eab5fa3d-96d53a90.jpg,validate/p18/p18829312/s55801816/f60ec255-ef71f882-af1e63eb-eab5fa3d-96d53a90.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with leukemia and increasing cough, congestion. Assess for abnormalities. 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, thoracic aorta and mediastinal structures are unchanged. Thus, no evidence of significant cardiac enlargement. The pulmonary vasculature is not congested. No signs of acute infiltrates and the pleural spaces are free. No pneumothorax in the apical area on the frontal view. Mild degree of S-shaped scoliosis in the thoracic spine is unchanged. On the next preceding examination of ___, a small opacity was suspected on the frontal view in mid portion of the right hemithorax overlying the anterior third rib. There is no progression of this lesion and an acute infiltrate is not seen. This patient has a large record of multiple chest examinations and CTs. Thus, the pulmonary infiltrate of ___ cannot be confirmed. " 15a11fef-711d820f-7aee316f-5a174ed0-6e036908.jpg,validate/p10/p10150980/s59680876/15a11fef-711d820f-7aee316f-5a174ed0-6e036908.jpg,validation," FINAL REPORT INDICATION: Syncope and increased confusion. Evaluate for acute cardiopulmonary process. COMPARISON: Chest radiograph from ___, ___. TECHNIQUE: Frontal upright and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. Cardiac size is top normal, allowing for AP view. Otherwise, cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. " d91078fb-0c3833fb-b112ef31-9272a2a1-768dce01.jpg,validate/p12/p12471831/s57252239/d91078fb-0c3833fb-b112ef31-9272a2a1-768dce01.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: AP chest x-ray ___. PA and lateral chest x-ray ___. INDICATION: Concern for pneumonia on prior radiograph. FINDINGS: Note is again made of right-sided PICC line with tip terminating in the right brachiocephalic vein. There is mild cardiomegaly which is stable. Mediastinal and hilar contours are stable. There is a subtle opacity in the right upper lobe as well as blunting of the right costophrenic angle. IMPRESSION: Subtle right upper lobe opacification which, given history of ___, ___ represent an early developing pneumonia. Clinical correlation and followup chest x-ray ___ be helpful. " 4f4d5e6b-34c1b421-e174a4a4-76e01ecc-8147e84e.jpg,validate/p14/p14642407/s59997145/4f4d5e6b-34c1b421-e174a4a4-76e01ecc-8147e84e.jpg,validation," FINAL REPORT INDICATION: History of hypoxia, shortness of breath and cough. Question pneumonia. COMPARISONS: ___. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: The lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. A small right upper lobe nodule is consistent with a calcified granuloma. Bones are intact. IMPRESSION: No acute cardiopulmonary process. " ba1ed432-8e3d8262-bc1c7138-cf00f586-79b6d24a.jpg,validate/p10/p10909149/s57583403/ba1ed432-8e3d8262-bc1c7138-cf00f586-79b6d24a.jpg,validation," 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. " f4ddfe4e-715f86f7-a2b4c78a-2b572b0d-606c7df5.jpg,validate/p15/p15781965/s57593600/f4ddfe4e-715f86f7-a2b4c78a-2b572b0d-606c7df5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___M with left ant cp and palpable mass ___ rib location // r/o thoracic mass/intrapulmonary r/o thoracic mass/intrapulmonary COMPARISON: ___ FINDINGS: The lungs remain clear. The heart and mediastinal structures are unremarkable. The bony thorax is grossly intact. IMPRESSION: No active disease. Dedicated rib radiographs may be helpful if further evaluation is indicated. " 63e1dcd0-1b1d38fb-f882f529-4e743dd0-cc0c7f43.jpg,validate/p14/p14567555/s58598656/63e1dcd0-1b1d38fb-f882f529-4e743dd0-cc0c7f43.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, s/p E. coli bacteremia, now with cough and low-grade fevers // please eval for infiltrate, consolidation please eval for infiltrate, consolidation IMPRESSION: Heart size and mediastinum are stable. Bibasal consolidations are persistent consistent with bilateral pneumonia. Bilateral pleural effusion is small, unchanged. No pulmonary edema noted. " d80e5229-bff553f2-a41e1efa-6fcdc20a-e4dd0867.jpg,validate/p15/p15002645/s50800468/d80e5229-bff553f2-a41e1efa-6fcdc20a-e4dd0867.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chest pain, shortness of breath. 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. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " faa4733a-b992c77c-d3c6714b-1e9e3e6f-06fd0b5a.jpg,validate/p16/p16980011/s52507867/faa4733a-b992c77c-d3c6714b-1e9e3e6f-06fd0b5a.jpg,validation," 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. " 9cb103a3-441cb66a-f43c44eb-fd0f6f0f-1b5a941f.jpg,validate/p12/p12685249/s59957629/9cb103a3-441cb66a-f43c44eb-fd0f6f0f-1b5a941f.jpg,validation," WET READ: ___ ___ ___ 11:43 PM 1. Endotracheal tube is low lying, terminating at the level of the carina. Recommend withdrawal by approximately 3-4 cm. 2. Low lung volumes with bibasilar opacities likely atelectasis. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with seizures with altered mental status post with intubation TECHNIQUE: Supine AP view of the chest COMPARISON: None. FINDINGS: An endotracheal tube is low lying, terminating at the level of the carina. Lung volumes are low. Heart size is mildly enlarged. The aorta is tortuous and diffusely calcified. Hilar contours are unremarkable. The pulmonary vasculature is normal. Bibasilar airspace opacities are more pronounced on the left, likely reflective of atelectasis. No pleural effusion or pneumothorax is present. Multiple clips are demonstrated in the right upper quadrant of the abdomen. IMPRESSION: 1. Endotracheal tube is low lying, terminating at the level of the carina. Recommend withdrawal by approximately 3-4 cm. 2. Low lung volumes with bibasilar opacities likely atelectasis. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 6:57 PM. " de271042-b1818d79-72736a97-afeed86c-e9ccb751.jpg,validate/p10/p10425278/s56572628/de271042-b1818d79-72736a97-afeed86c-e9ccb751.jpg,validation," FINAL REPORT HISTORY: Post lobectomy with chest pain. Evaluate for acute process. COMPARISON: Chest radiograph dated ___ in conjunction with chest CTA obtained MDCT 10 minutes prior. FINDINGS: Frontal and lateral radiographs of the chest demonstrate postsurgical changes in the right lower lobe with opacification at the right base proven to represent effusion in the resection cavity on the CT with elevation of the right hemidiaphragm. The left lung is clear. No left pleural effusion. No pneumothorax. Normal heart size. Stable mediastinal and hilar contours. The overall appearance of the chest is not significantly changed from ___. IMPRESSION: Stable postoperative appearance of right lower lobectomy. No significant change from prior. " b67cd139-11d3def4-dd27dd95-352e5abf-1593d5ae.jpg,validate/p18/p18465343/s51903210/b67cd139-11d3def4-dd27dd95-352e5abf-1593d5ae.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with pleuritic chest pain and cough // eval pna TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Blunting of the left costophrenic angle on the lateral view suggests chronic pleural thickening rather than small effusion. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 4bc79dc7-e15ca41a-29ac9f76-67a0f290-827cc0ee.jpg,validate/p15/p15713699/s51699868/4bc79dc7-e15ca41a-29ac9f76-67a0f290-827cc0ee.jpg,validation," WET READ: ___ ___ ___ 11:19 PM Minimal atelectasis the lung bases. No focal consolidation, pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with reported BOOP/COP p/w worsening cough and DOE. // ? new infiltrates ? new infiltrates IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. Minimal bibasal atelectasis are noted. For pre size details please review chest CT obtained the same day later. " 71fb90f8-52185693-30314329-af205678-5396b3b4.jpg,validate/p13/p13718835/s55842550/71fb90f8-52185693-30314329-af205678-5396b3b4.jpg,validation," FINAL REPORT INDICATION: ___-year-old male unable to ambulate or sit up for at least three days. Evaluate for acute cardiopulmonary process. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal AP semi-upright chest radiograph. FINDINGS: The lungs are well expanded. There is unchanged appearance of the left base. While some of this density may be accounted for by elevated hemidiaphragm, there is also increased retrocardiac opacity. Left effusion is suspoected given presence on prior with similar appearance on the frontal view. Mild cardiomegaly is also stable from prior. There is no pneumothorax. No mediastinal widening is identified. IMPRESSION: Stable mild cardiomegaly. Left base opacity as described above and similar to prior. Suspect underlying effusion and atelecatsis although infection is not excluded. Consider PA and lateral views to further charcterize when patient is amenable. " d1681e00-e559183d-c737d576-201eceba-488c2774.jpg,validate/p12/p12763897/s50803666/d1681e00-e559183d-c737d576-201eceba-488c2774.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: An enteric tube is seen which courses through the stomach and tip appears to be post pyloric in position. Lung volumes are low. The cardiac, mediastinal and hilar contours are normal. Patchy opacities in the lung bases may reflect aspiration or infection and appear progressed in the interval. No pleural effusion or pneumothorax is seen. There is no pulmonary edema. IMPRESSION: Patchy opacities in the lung bases are worse compared to the previous exam, and may reflect areas of aspiration or infection. " fc893a90-7742cfa1-e65e6d84-6cedf449-93aa5b93.jpg,validate/p13/p13690191/s55490363/fc893a90-7742cfa1-e65e6d84-6cedf449-93aa5b93.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, fever // r/p CAP COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. There is no evidence of pneumonia or pulmonary edema. No pleural effusions. Normal size of the heart. The lateral radiograph shows flattening of the hemidiaphragms, likely caused by mild overinflation. " 7ed2cf9a-b3995376-332c3d95-a52a4196-fe68a7bc.jpg,validate/p17/p17217213/s53172399/7ed2cf9a-b3995376-332c3d95-a52a4196-fe68a7bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with diabetes, neuropathy, OSA, presenting with fever, white count, and malaise. TECHNIQUE: Chest AP and lateral COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged. The mediastinal and hilar contours are unremarkable. Subsegmental atelectasis is seen within the right upper lobe and left mid lung field. No pulmonary edema, focal consolidation, pleural effusion or pneumothorax is demonstrated. Mild elevation of the left hemidiaphragm is unchanged. Multilevel degenerative changes are again identified in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " f4a3066b-84e02c36-c4c3a84b-7fd15085-0f94d570.jpg,validate/p11/p11787183/s51365859/f4a3066b-84e02c36-c4c3a84b-7fd15085-0f94d570.jpg,validation," WET READ: ___ ___ 2:14 AM Lingula pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: None. FINDINGS: A lingular opacity in left mid lung zone consistent with pneumonia. Cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax. IMPRESSION: Lingular pneumonia. " 8e4c41ed-b699b877-17d2ca2b-fc95e799-f1d60a54.jpg,validate/p16/p16509046/s54731567/8e4c41ed-b699b877-17d2ca2b-fc95e799-f1d60a54.jpg,validation," FINAL REPORT EXAM: Chest, AP upright and lateral views. CLINICAL INFORMATION: ___-year-old male with history of bilateral leg pain and swelling, left greater than right. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Right-sided axillary stents are seen coursing to the right upper extremity, not fully imaged. Dual-lumen left-sided dialysis catheter is seen, with lumens terminating in the right atrium. There are low lung volumes. Moderate bibasilar atelectasis is seen, underlying consolidation due to infection and/or aspiration is not excluded. No large pleural effusions are seen, although a trace right pleural effusion would be difficult to exclude. There may be mild pulmonary vascular congestion. The aorta is calcified and tortuous. The cardiac silhouette is top normal. IMPRESSION: Moderate bibasilar opacities may be due to atelectasis, although underlying consolidation and/or aspiration cannot be excluded. Low lung volumes. No large pleural effusion is seen, although a trace right pleural effusion is difficult to exclude. " d0a7564d-280a8262-05514bcc-22b9d235-c4c909d6.jpg,validate/p19/p19197131/s59367277/d0a7564d-280a8262-05514bcc-22b9d235-c4c909d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M s/p seizure with chipped upper tooth COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. No radiopaque foreign bodies seen within the imaged field. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Pectus excavatum deformity of the sternum is noted. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. No radiopaque foreign body in the imaged soft tissues. " dd5c39a5-16e05bed-945ea589-fec92767-9eee9941.jpg,validate/p17/p17592232/s52595114/dd5c39a5-16e05bed-945ea589-fec92767-9eee9941.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ man hospitalized with significant recent worsening in his weakness in the setting of recent progressive sub-acute generalized weakness and suspicious pulmonary nodules on chest CT // interval assessment, IMPRESSION: In comparison to ___ radiograph, right lower lobe consolidation has slightly worsened and is concerning for evolving pneumonia. Nonspecific left lower lobe opacity has slightly improved. Known left upper lobe nodule is seen to better detail on recent CT. Exam is otherwise remarkable for mild interstitial edema. " a8de6b72-e93a4f15-b960874f-1289c85c-3a9018fd.jpg,validate/p14/p14559218/s52692364/a8de6b72-e93a4f15-b960874f-1289c85c-3a9018fd.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with rales at the right apex // ? abnormality COMPARISON: COMPARED TO RADIOGRAPHS FROM ___ IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " cad22841-486f4875-a17a05b4-aca73961-9fd37b6f.jpg,validate/p10/p10216097/s52212875/cad22841-486f4875-a17a05b4-aca73961-9fd37b6f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF now with tailored therapy // eval PA catheter placement eval PA catheter placement IMPRESSION: In comparison with the study of ___, there is little overall change. Continued substantial enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure and pseudo tumor of pleural fluid in the major fissure on the right. Swan-Ganz catheter remains in good position. " df6b4395-7e16bc3d-68572eee-497ed4bf-e7338313.jpg,validate/p14/p14371035/s58555103/df6b4395-7e16bc3d-68572eee-497ed4bf-e7338313.jpg,validation," 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. " 47cbe758-49bcc814-ecb5c771-97ed8dbb-9489a934.jpg,validate/p18/p18005274/s54052535/47cbe758-49bcc814-ecb5c771-97ed8dbb-9489a934.jpg,validation," 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. " 8de7fedb-e7ae8b04-ac0faab7-7a5c616d-0052615d.jpg,validate/p15/p15007710/s57053735/8de7fedb-e7ae8b04-ac0faab7-7a5c616d-0052615d.jpg,validation," 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 " 2f2da075-115e38d3-86ffe905-11aa8a04-1a1c3bd5.jpg,validate/p17/p17950066/s59393382/2f2da075-115e38d3-86ffe905-11aa8a04-1a1c3bd5.jpg,validation," FINAL REPORT HISTORY: Infiltrate seen on x-ray earlier this month with some chest congestion. Rule out infiltrate. COMPARISON: None available. TECHNIQUE: Upright AP and lateral chest radiographs. FINDINGS: There are increased bibasilar opacities, left greater than right. There is blunting of the right posterior costophrenic angle, likely related to pleural fluid. Evaluation of the cardiac silhouette is limited by overlying opacities. Upper lungs are well aerated. There is no pneumothorax. IMPRESSION: 1. Left greater than right bibasilar opacities, potentially due to atelectasis, a component of infection, although chronic process is also possible. Correlation with priors would be helpful. Repeat evaluation is recommended upon completion of treatment. 2. Right sided pleural effusion. " 04d99384-8b04ff56-ef8d9d2a-0e1457f9-941297a0.jpg,validate/p10/p10779064/s52068427/04d99384-8b04ff56-ef8d9d2a-0e1457f9-941297a0.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with Hodgkin lymphoma after ST elevation MI, assessment of interval change. AP radiograph of the chest was compared to ___ obtained at 1:02 p.m. There is interval improvement of interstitial pulmonary edema that is still present, mild to moderate. Intra-aortic balloon pump tip is currently more proximal than on the prior study approximately 1 cm below the roof of the ascending aorta. The heart size and mediastinum are unchanged. " 1e58bc4a-ec5508bc-a7a439ec-519e1db3-1816bbc9.jpg,validate/p15/p15137987/s55878948/1e58bc4a-ec5508bc-a7a439ec-519e1db3-1816bbc9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Transient visual loss, evaluation for intrathoracic process. COMPARISON: ___. FINDINGS: As compared to a previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette, tortuosity of the thoracic aorta. Mild hiatal hernia. No evidence of pneumonia, pleural effusions or pulmonary edema. No lung nodules or masses. " aab319a0-7035d806-5613bfdc-7943ca0d-73ee76ec.jpg,validate/p19/p19962126/s53836198/aab319a0-7035d806-5613bfdc-7943ca0d-73ee76ec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // ett ett IMPRESSION: ET tube tip is 7 cm above the carinal. NG tube is in the stomach. Heart size and mediastinum are stable. There is interval progression of bibasal opacities concerning for a combination of interstitial edema and multifocal infection. No interval increase in pleural effusion noted. " 18a5f8b7-d1950461-44af659f-1685cc8c-c72a7182.jpg,validate/p13/p13077594/s56394157/18a5f8b7-d1950461-44af659f-1685cc8c-c72a7182.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // interval change interval change IMPRESSION: Compared to chest radiographs since ___ most recently ___ through ___. Lungs are clear aside from mild left infrahilar atelectasis. No pulmonary edema or vascular congestion. Heart size normal. Pleural effusions small if any. No pneumothorax. Cardiopulmonary support devices in standard placements. " 3f6de191-05465e83-fc2779f8-3754858d-044a7647.jpg,validate/p10/p10165672/s59771833/3f6de191-05465e83-fc2779f8-3754858d-044a7647.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with renal transplant, now with productive cough, rule out pneumonia. COMPARISONS: PA and lateral chest radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is unremarkable. There are no acute skeletal abnormalities. IMPRESSION: No acute cardiopulmonary process. " d4c2b407-f69da0e6-87fd8d1c-a40fde24-107faf32.jpg,validate/p18/p18560079/s59429342/d4c2b407-f69da0e6-87fd8d1c-a40fde24-107faf32.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ALS, reports worsening dyspnea // r/o infiltrate r/o infiltrate IMPRESSION: No previous images. There are relatively low lung volumes. Cardiac silhouette is within normal limits and there is tortuosity of the aorta. No acute focal pneumonia, vascular congestion, or pleural effusion. Of incidental note is the substantial dilatation of gas-filled colon, consistent with an adynamic ileus in this region. " 00e58d8a-0a71745d-6ee16b49-25b46329-bce7b799.jpg,validate/p16/p16960956/s57277267/00e58d8a-0a71745d-6ee16b49-25b46329-bce7b799.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with COPD with new cough on prednisone // ___ male on prednisone, r/o infiltrate COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Bilateral pleural scars, right more than left. Parenchymal scarring at the basal lateral aspect of the right hemi thorax. Mild overinflation. All fractured ribs that are healed on the left. A moderate cardiomegaly. No evidence of pneumonia or other acute pathologic process. " d76164be-3de881f9-3464002b-05519b02-23fa2934.jpg,validate/p13/p13413453/s50693256/d76164be-3de881f9-3464002b-05519b02-23fa2934.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with hypotension, history of esophageal squamous cell carcinoma. COMPARISON: Prior exam is dated ___ with PET-CT dated ___ FINDINGS: PA and lateral views of the chest provided. Previous PICC line has been removed. There is a small f linear density abutting left heart border, question scarring or atelectasis. Otherwise lungs are clear. No signs of pneumonia or edema. Cardiomediastinal silhouette is normal. Bony structures are intact. Degenerative changes of the left shoulder noted. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 7562a7f4-58370fbe-f17910b5-4700dad6-89700e5d.jpg,validate/p13/p13174181/s56693722/7562a7f4-58370fbe-f17910b5-4700dad6-89700e5d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with smoke inhalation. // eval for acute process 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 acute osseous abnormalities are identified. Mild dextrocurvature of the thoracolumbar spine is noted. IMPRESSION: No acute cardiopulmonary process. " b17763cf-1d868420-1dc53e78-38f58f21-caebaf30.jpg,validate/p16/p16863013/s50548801/b17763cf-1d868420-1dc53e78-38f58f21-caebaf30.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with 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. Calcified tortuous aorta is present. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " c978f098-d0f558f3-c9af7918-d0b9ff1a-4fda680e.jpg,validate/p19/p19543748/s58623725/c978f098-d0f558f3-c9af7918-d0b9ff1a-4fda680e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Small right pleural effusion. Diffuse bilateral pulmonary nodules of unchanged size and extent. No evidence of pneumonia or other acute lung disease. Unchanged size of the cardiac silhouette. Unchanged elongation of the descending aorta. " d67c7003-99d0c1f6-068cd15a-0e095b28-11f152ce.jpg,validate/p16/p16108772/s57131850/d67c7003-99d0c1f6-068cd15a-0e095b28-11f152ce.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with possible aspiration event // please eval for signs of aspiration please eval for signs of aspiration IMPRESSION: In comparison with the earlier study of this date, the patient has taken a better inspiration. No definite evidence of acute focal consolidation after the aspiration event. " 7b3a0ee2-7c7ba948-f2f436ce-404c9198-bc1636f1.jpg,validate/p18/p18097367/s56892528/7b3a0ee2-7c7ba948-f2f436ce-404c9198-bc1636f1.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with flu like symptoms // please eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: The lungs are moderately well inflated with mild prominence of interstitial markings without lobar consolidation or pulmonary edema. No pleural effusions. Cardiomediastinal silhouette appears normal. There is diffuse demineralization with multilevel degenerative changes of the thoracic spine and a right humeral prosthesis. IMPRESSION: Moderately well inflated lungs with no pulmonary edema or lobar consolidation. " 3981c0dd-a62e0837-830150a4-c132fb8e-dc6d52ea.jpg,validate/p18/p18512570/s57042759/3981c0dd-a62e0837-830150a4-c132fb8e-dc6d52ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with positive quant gold, want to see if any suspicious lesions for TB // any evidence of TB any evidence of TB IMPRESSION: No previous images. No evidence of acute cardiopulmonary disease or old healed tuberculous disease. " 8b9fd98b-32d706c3-ef6e5dbf-113afbb0-a323c56c.jpg,validate/p13/p13540048/s59657132/8b9fd98b-32d706c3-ef6e5dbf-113afbb0-a323c56c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with productive cough. Evaluate for pneumonia. 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. No free air under the diaphragm is seen. IMPRESSION: No acute intrathoracic process. " 037eae16-6d868d04-6458324f-8cffd479-f84f84c9.jpg,validate/p12/p12452974/s57344131/037eae16-6d868d04-6458324f-8cffd479-f84f84c9.jpg,validation," FINAL REPORT INDICATION: Fever, question pneumonia. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There are small bilateral pleural effusions. Low lung volumes. There is no consolidation or pneumothorax. The cardiac, mediastinal, and hilar contours are normal. There are dilated loops of small bowel in the upper abdomen. No free air. IMPRESSION: 1. Small bilateral pleural effusions. 2. Dilated loops of small bowel. These are better seen on concurrent abdominal x-ray from today. No free air. " 1241870d-b593861d-b4f2a9e4-c3df2ae5-65beac1c.jpg,validate/p16/p16351823/s56728721/1241870d-b593861d-b4f2a9e4-c3df2ae5-65beac1c.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with new heart block. Evaluate for etiology of heart block. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray 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. Degenerative changes are present throughout the thoracic spine with extensive anterior bridging osteophyte formation. IMPRESSION: No acute cardiopulmonary process. " 7239cbad-bceae15d-a1c96ec4-66f22b90-445cc158.jpg,validate/p10/p10817855/s57739296/7239cbad-bceae15d-a1c96ec4-66f22b90-445cc158.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/worsening hip plain s/p right bipolar hemiarthroplasty in ___, then car accident in ___ with dashboard injury to right knee. Admitted for right total hip revision. // productive cough with mild leukocytosis COMPARISON: None. FINDINGS: There are flattened diaphragms suggestive of probable background COPD. However, on the frontal view, inspiratory volumes are relatively low. There is bibasilar atelectasis. No air bronchograms or confluent opacity to suggest focal consolidation. No CHF. Minimal blunting of left costophrenic angle. No gross effusion. Allowing for low lung volumes, the cardiomediastinal silhouette is likely unchanged. IMPRESSION: Probable bibasilar atelectasis, new compared with ___. An early pneumonic infiltrate is considered much less likely. Suspect background COPD. " 13d1581e-d6428d21-392eba5c-b35087a0-dc23305b.jpg,validate/p10/p10949720/s56045705/13d1581e-d6428d21-392eba5c-b35087a0-dc23305b.jpg,validation," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The pacemaker and leads are unchanged in appropriate position. Tortuous aorta with calcified aortic knob is again present. The heart size is also mildly enlarged. Pulmonary vasculature remains prominent. Bibasilar atelectasis also remains. No large pleural effusion is present. No pneumothorax is seen. IMPRESSION: Perivascular congestion suggesting early failure. No large pleural effusion. " 38d03b04-0d7ed79f-2cf5f34d-96d831d3-227a44aa.jpg,validate/p19/p19720782/s57890092/38d03b04-0d7ed79f-2cf5f34d-96d831d3-227a44aa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hypoxia to ___% // assess for infiltrate TECHNIQUE: Upright AP view of the chest COMPARISON: Chest CTA ___ and chest radiograph ___. FINDINGS: Lung volumes are decreased compared to the prior exam. Heart size remains within normal limits. Mediastinal contour is unchanged. Within the right upper lobe and perihilar region, there is chronic opacification compatible with radiation fibrosis. Mild pulmonary edema is demonstrated with perhaps slight enlargement of a moderate size right pleural effusion which is partially loculated superiorly and medially. Right basilar opacification may reflect atelectasis but infection is not excluded. No pneumothorax is seen. IMPRESSION: Mild pulmonary edema with moderate right pleural effusion, perhaps slightly increased compared to the prior study. Chronic opacity within the right upper lobe and perihilar region is compatible with radiation fibrosis. Right basilar opacity may reflect atelectasis but infection is not completely excluded. " cdb79ed0-534d7a81-0215d63a-32a4dc3e-072550f2.jpg,validate/p12/p12238407/s58328113/cdb79ed0-534d7a81-0215d63a-32a4dc3e-072550f2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemic resp failure // eval for edema, infiltrates TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 6.4 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are unchanged. Distension of the azygos vein is re- demonstrated and although potentially might represent vasculature engorgement, lymphadenopathy in this location cannot be excluded and giving the persistence of this finding, correlation with chest CT is justified. Bibasal opacities are present and currently there is more nodular appearance in the left lower lobe again would be justified to assess with chest CT. " 7388703f-b59dc723-8cfdf1e9-14139936-c4a0baf2.jpg,validate/p16/p16920541/s54911730/7388703f-b59dc723-8cfdf1e9-14139936-c4a0baf2.jpg,validation," FINAL REPORT INDICATION: ___F with SOB // Eval for pulmonary edema TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits for technique. Old healed right posterior rib fractures are seen at multiple levels. IMPRESSION: No acute cardiopulmonary process. " 60e7c7d5-1c2abc66-800ac408-dd817202-8db4f3f1.jpg,validate/p17/p17155697/s53976627/60e7c7d5-1c2abc66-800ac408-dd817202-8db4f3f1.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post left thoracotomy, resection of sixth rib, rule out pneumothorax. COMPARISON: ___. FINDINGS: Status post right rib resection. A chest tube is in situ on the left. No convincing evidence of left pneumothorax. The lung volumes remain low. No pleural effusions. No acute lung pathology. Borderline size of the cardiac silhouette without pulmonary edema. " 1a4e9083-5776d6ed-1f44600f-9a1a2d61-6b06201e.jpg,validate/p11/p11711832/s53333961/1a4e9083-5776d6ed-1f44600f-9a1a2d61-6b06201e.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with dizziness and fatigue. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were performed. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Lung volumes are low, exaggerating heart and mediastinal contours. The aorta is tortuous. Clips project over the right upper quadrant. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " ebe3eef9-9ac7eafd-5289754d-565e0dd0-151605c7.jpg,validate/p13/p13021148/s52812870/ebe3eef9-9ac7eafd-5289754d-565e0dd0-151605c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, aortic stenosis s/p TAVR // interval change, pulmonary edema TECHNIQUE: Single frontal view of the chest COMPARISON: Portable chest x-ray ___ FINDINGS: Mediastinal widening is improved. Moderate cardiomegaly is stable. Mild pulmonary edema has improved. There is mild pulmonary vascular congestion. There is a small pleural effusion at the right lung base. There is no pneumothorax. There has been interval removal of the endotracheal tube. A right IJ catheter terminates in the upper origin of the SVC. Patient is status post TAVR. IMPRESSION: 1. Mild pulmonary edema and mediastinal widening have improved. Moderate cardiomegaly stable. 2. Interval removal of the endotracheal tube. No pneumothorax. " f8c9f511-1a512c2b-f4aca243-9349c7f0-c6b9f727.jpg,validate/p19/p19960115/s59556276/f8c9f511-1a512c2b-f4aca243-9349c7f0-c6b9f727.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia // Interval change? Interval change? COMPARISON: Prior chest radiographs ___ through ___ at 18:03. IMPRESSION: Greater opacification on both sides of the chest is due to increasing moderate pulmonary edema and moderate pleural effusions, right greater than left. Rightward mediastinal shift indicates severe atelectasis in the right lung. ET tube is in standard placement. The nasogastric drainage tube can be traced only as far as the mid esophagus, and the tip is not identified. Left subclavian line ends in the low SVC. No pneumothorax. " 663c0b1a-072042ac-0ccdcb5d-1c9d1cdf-9498cc61.jpg,validate/p11/p11053913/s53503744/663c0b1a-072042ac-0ccdcb5d-1c9d1cdf-9498cc61.jpg,validation," FINAL REPORT INDICATION: Chest pain, evaluate for acute cardiopulmonary process. COMPARISON: None. FINDINGS: The right costophrenic angle is excluded from these radiographs. The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary process. " 7bf046f9-18898711-4375498f-1c2a8724-dda1c2ff.jpg,validate/p14/p14793590/s58364828/7bf046f9-18898711-4375498f-1c2a8724-dda1c2ff.jpg,validation," 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. " ce83c83f-c7aaf1e2-755dc039-e2154b27-cfb9ab1d.jpg,validate/p17/p17542952/s59949260/ce83c83f-c7aaf1e2-755dc039-e2154b27-cfb9ab1d.jpg,validation," FINAL REPORT INDICATION: History: ___F with weakness, malaise // Eval for pneumonia TECHNIQUE: Upright PA and lateral chest COMPARISON: Chest radiographs ___ and ___ FINDINGS: The lungs are hyperexpanded similar to the prior study with emphysematous changes. Heart size is normal. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is anterior fusion of several upper thoracic levels. IMPRESSION: COPD without evidence of acute abnormality. " 0f85693e-e9446621-7e5b0f09-d216f17f-00be4853.jpg,validate/p10/p10380616/s54152644/0f85693e-e9446621-7e5b0f09-d216f17f-00be4853.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old woman s/p tracheobronchoplasty // interval change, please evaluate COMPARISON: Chest radiographs dated ___ and ___. Chest radiograph dated ___. FINDINGS: Persistent small right pleural effusion and pleural thickening, unchanged since at least ___. Focal opacity in the right lung base, best seen on the lateral view with obscuring of the right hemidiaphragm, is overall unchanged, and may suggest aspiration. Stable postoperative appearance of the cardiomediastinal silhouette with mild cardiomegaly. Perhaps mild increased pulmonary vascular congestion compared to the prior exam, but no frank pulmonary edema. No pneumothorax. No left pleural effusion. Surgical clips projecting over the right upper quadrant are unchanged. Compression deformity in the thoracic spine vertebrae are unchanged since ___. IMPRESSION: No change in right pleural thickening or pleural effusion for several days. No change in right lower lobe consolidation best seen on lateral view. " e20ac897-1890b3de-26f06c18-2dc0a00b-45fc8800.jpg,validate/p10/p10818683/s50961597/e20ac897-1890b3de-26f06c18-2dc0a00b-45fc8800.jpg,validation," FINAL REPORT INDICATION: Right-sided chest pain, rule out pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear and the lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. Heart is normal size. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 6fd06881-6a7fdc87-da797f05-dc71e150-661b9476.jpg,validate/p16/p16074678/s57264403/6fd06881-6a7fdc87-da797f05-dc71e150-661b9476.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: eval pulm edema IMPRESSION: Comparison to ___. The lung volumes remain low and the cardiac silhouette is still enlarged. On today's examination, there is widening of the but secures vein and a of the central pulmonary CT capacity vessels. Overall, the finding is indicative of mild pulmonary edema. Minimal retrocardiac atelectasis. Unchanged position of the right PICC line. " 05f91876-86d88167-c6d4be97-37acb0c9-cbf80ee0.jpg,validate/p12/p12835005/s55746083/05f91876-86d88167-c6d4be97-37acb0c9-cbf80ee0.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and hydropneumothorax. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: A large right hydropneumothorax is noted, with a substantial fluid component. No shift of midline structures is identified to indicate tension. There is atelectasis of the right lung, with the left lung appearing grossly clear. No left-sided pleural effusion or pneumothorax is identified. Heart size appears normal and the mediastinal contours are unremarkable. No pulmonary edema is present. No acute osseous abnormalities are detected. IMPRESSION: Large right hydropneumothorax without shift of midline structures. " 30cd1e9a-7f459adc-408d3087-d4f99a65-1736fa21.jpg,validate/p10/p10517939/s51043579/30cd1e9a-7f459adc-408d3087-d4f99a65-1736fa21.jpg,validation," FINAL REPORT INDICATION: Fever, evaluate for pneumonia or fluid overload. COMPARISON: None available. FINDINGS: Frontal upright and lateral chest radiographs demonstrate well-expanded lungs. Cardiomediastinal silhouette is unremarkable. Lungs show mild basilar atelectasis without focal consolidation. Sternotomy wires and aortic valve replacement are noted. No pleural effusion and no pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 91721a16-f50327ae-728f746d-87c70d1b-cbf6f044.jpg,validate/p17/p17500951/s56981708/91721a16-f50327ae-728f746d-87c70d1b-cbf6f044.jpg,validation," 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. " 836cc568-7d9ebbd7-f4a3063a-0cc948f7-94748235.jpg,validate/p17/p17244595/s55813572/836cc568-7d9ebbd7-f4a3063a-0cc948f7-94748235.jpg,validation," WET READ: ___ ___ ___ 4:57 AM Stable appearance of the left lung following pneumonectomy. New moderate size right pneumothorax. The findings were discussed with ___ ___, M.D. by ___, M.D. on the telephone on ___ at 4:56 AM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with L pneumonectomy and acute increased WOB // interval change in PNX interval change in PNX IMPRESSION: Stable appearance of the left lung following pneumonectomy. New moderate size right pneumothorax. NOTIFICATION: The findings were discussed with ___ ___, M.D. by ___, M.D. on the telephone on ___ at 4:56 AM, 5 minutes after discovery of the findings. " 7f1bd4ec-e142b30f-a45b8427-fcec6e1e-a9b3f7df.jpg,validate/p18/p18868527/s50971136/7f1bd4ec-e142b30f-a45b8427-fcec6e1e-a9b3f7df.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever s/p proctocolectomy, j pouch, diverting ileostomy. // r/o pneumonia r/o pneumonia IMPRESSION: In comparison with the study to over ___, there is increased opacification at the right base anteriorly, consistent with a middle lobe pneumonia. NOTIFICATION: Dr. ___ " 22c13af3-87810914-5810e66a-592612ff-aa205e0c.jpg,validate/p12/p12228452/s52220211/22c13af3-87810914-5810e66a-592612ff-aa205e0c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypoxia, assess for edema or pneumonia. FINDINGS: AP upright portable chest radiograph obtained. There is confluent opacity in the right upper lobe concerning for pneumonia. Less confluent opacity is also noted in the right lower lung, also representing pneumonia. The left lung appears mostly clear. The heart size is difficult to assess, but appears top normal. Patient is slightly rotated to the left, which limits the evaluation. Bony structures are intact. IMPRESSION: Multifocal pneumonia in the right lung. Limited exam due to portable AP technique. " d2806846-6c9712fe-5af15e46-5fa46761-28c1ed8a.jpg,validate/p11/p11304959/s59458226/d2806846-6c9712fe-5af15e46-5fa46761-28c1ed8a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute decompensated heart failure and new fever // ___ year old man with acute decompensated heart failure and new fever ___ year old man with acute decompensated heart failure and n IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube have been removed. Little overall change in the appearance of the heart and lungs. " cbba1c1b-baa08812-9bf09668-f10eec71-d6c20e98.jpg,validate/p10/p10410641/s58535435/cbba1c1b-baa08812-9bf09668-f10eec71-d6c20e98.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Bilateral pigtail catheters, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the known right pneumothorax is stable. On the left, there is no evidence of pneumothorax. The right pleural effusion has completely resolved. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " 3c2871a4-d3661d48-66ec912f-baad6257-cf41e141.jpg,validate/p13/p13327132/s57590747/3c2871a4-d3661d48-66ec912f-baad6257-cf41e141.jpg,validation," 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. " 7d2e08e5-614daca2-b12237c9-1c72f075-f54dd238.jpg,validate/p15/p15280647/s59167794/7d2e08e5-614daca2-b12237c9-1c72f075-f54dd238.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Borderline enlargement of the cardiac silhouette is re- demonstrated with coronary artery stents re- visualized on the lateral view. Aorta remains mildly tortuous. Mediastinal and hilar contours otherwise are unchanged. Pulmonary vasculature is normal in the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Lungs are mildly hyperinflated. 4 mm nodular opacity projecting over the right lung apex is noted, which could be within the lung or osseous structures. IMPRESSION: 1. No acute cardiopulmonary abnormality. 2. 4 mm nodular opacity projecting over the right lung apex. It is unclear if this lies within the lung or osseous structures. Further assessment with shallow oblique imaging is recommended. " 1e5e2fcd-c8209dc8-6d339ff5-4ea4a963-d0ed7d87.jpg,validate/p19/p19132043/s58646952/1e5e2fcd-c8209dc8-6d339ff5-4ea4a963-d0ed7d87.jpg,validation," FINAL REPORT EXAM: Chest, single semi-erect AP portable view. CLINICAL INFORMATION: Shock, confusion, fall. COMPARISON: ___. FINDINGS: The patient is rotated somewhat to the left. A right-sided port is seen, terminating in the lower SVC/cavoatrial junction. Additional dual-lumen large bore right-sided central venous catheter is seen, terminating at the proximal right atrium. There is mild central pulmonary vascular engorgement. Bibasilar opacities are seen, which could relate to vascular congestion, consolidation, infection or aspiration. No large pleural effusion is seen, although trace pleural effusion would be difficult to exclude. There is no pneumothorax. Cardiac silhouette is enlarged, appear slightly more so than the prior study, although this may relate to differences in patient position and technique. Mediastinal contours are stable. The patient is status post ORIF of partially imaged right humerus. " 1b1c6c63-766cd20d-2b6a187f-dc26bb70-2133458b.jpg,validate/p14/p14202087/s50420865/1b1c6c63-766cd20d-2b6a187f-dc26bb70-2133458b.jpg,validation," 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. Unchanged plate-like opacity in the right lung with minimal enlargement of the right hilus. No evidence of nodular structure, suggesting the presence of metastatic disease. Borderline size of the cardiac silhouette without evidence of pulmonary edema. " d129298a-641cb100-6889d4ba-a64ada40-2fb83617.jpg,validate/p12/p12697610/s59149620/d129298a-641cb100-6889d4ba-a64ada40-2fb83617.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after Whipple surgery with fever. Portable AP radiograph of the chest was reviewed in comparison to ___. As compared to the prior study, there is interval development of bibasal atelectasis in particular on the left associated with pleural effusions most likely related to surgery. Upper lungs are essentially clear and there is no pneumothorax demonstrated. No pulmonary edema is seen as well. " 98c97f57-06404ad2-3371d428-c9a78ef2-d182fc23.jpg,validate/p13/p13609618/s58172370/98c97f57-06404ad2-3371d428-c9a78ef2-d182fc23.jpg,validation," FINAL REPORT INDICATION: ___F with hypoxia, exertional chest pain, exertional hypoxia, RLE pain + swelling // evaluate for PE, acute process TECHNIQUE: Single portable view of the chest. COMPARISON: Chest x-ray from ___ and chest CT from ___. FINDINGS: Increased interstitial markings are seen throughout the lungs bilaterally but appear most severe overlying the upper lobes. Lung volumes are relatively low. There is no definite superimposed focal consolidation and the pattern appears grossly similar compared to prior. Cardiomediastinal silhouette is unchanged. Known adenopathy is better seen on prior CT scan. Posterior left rib fractures are noted. Left breast prosthesis is visualized. IMPRESSION: Chronic fibrotic changes in the lungs without definite acute cardiopulmonary process noting that subtle changes could easily be obscured. " b1b0a9da-ec549215-1046190e-154736b4-c549ef45.jpg,validate/p13/p13978368/s50240143/b1b0a9da-ec549215-1046190e-154736b4-c549ef45.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with history of lung cancer presenting with dyspnea on exertion and cough. Rule out acute process. COMPARISONS: Chest radiograph ___ ___. Multiple prior chest CTs, most recently ___ ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is of normal size with stable cardiomediastinal contours. Right perihilar and right perifissural opacities are consistent with the patient's known lung cancer and similar to ___. Left apical opacity is also stable and compatible with known apical neoplasm. Blunting of the right costophrenic angle is compatible with a moderate-sized pleural effusion, similar to ___. No radiopaque foreign body. Osseous structures are unremarkable. IMPRESSION: Right perihilar, right mid lung, and left apical opacities, similar to ___. No obvious superimposed pneumonia or significant interval disease progression, allowing for differences in technique. Moderate-sized right pleural effusion. " cd0db556-3ec7bab6-2c9a5651-aef31ce4-9cd84c0c.jpg,validate/p13/p13214943/s59628410/cd0db556-3ec7bab6-2c9a5651-aef31ce4-9cd84c0c.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with fever // is there pneumonia COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: There is stable elevation of the right hemidiaphragm. There small bilateral pleural effusions left greater than right. There is no pneumothorax or CHF. There is no new consolidation. " f9991d67-0053c955-0e47a205-e7394435-86dbdee5.jpg,validate/p18/p18976991/s57077023/f9991d67-0053c955-0e47a205-e7394435-86dbdee5.jpg,validation," WET READ: ___ ___ ___ 7:31 AM Right lower lung not completely imaged. There is blunting of the left costophrenic angle, which may represent effusion. Moderate cardiomegaly is unchanged. There is new vascular engorgement without frank pulmonary edema. WET READ VERSION #1 ___ ___ 8:21 PM Right lower lung not completely imaged. There is blunting of the left costophrenic angle, which may represent effusion. Moderate cardiomegaly is unchanged. There is new vascular engorgement without frank pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD, diastolic CHF, now POD #1 from ex-lap with increasing O2 requirement // Pulmonary edema? COMPARISON: ___. IMPRESSION: As compared to the previous image, the lung volumes have decreased. Moderate cardiomegaly persists. At the bases of the right lung, there is a new parenchymal opacity that could reflect aspiration or pneumonia in the appropriate clinical setting. Mild atelectasis at the left lung base. No pneumothorax. " b98ef54a-c25de3f1-7da72768-639cbe84-7a2ab4a3.jpg,validate/p13/p13826513/s56852637/b98ef54a-c25de3f1-7da72768-639cbe84-7a2ab4a3.jpg,validation," WET READ: ___ ___ ___ 9:55 PM Left IJ catheter removed. Left PICC retracted and now terminates in the mid to low SVC. Otherwise, similar appearance of the chest. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever, intubated // pneumonia? pneumonia? COMPARISON: Chest radiographs ___ through ___:53. IMPRESSION: Left internal jugular line has been removed. Left PIC line ends in the mid to low SVC. Severe infiltrative pulmonary abnormality unchanged for several days. Heart is top-normal size. Pleural effusions are presumed, but not large. No pneumothorax. ET tube in standard placement. " 57cc27ef-08587022-67b0b1d4-9b7330e6-6bdf15d5.jpg,validate/p13/p13261938/s57339384/57cc27ef-08587022-67b0b1d4-9b7330e6-6bdf15d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p arrest, cooling with C2 dens fracture and rib fractures // interval change interval change IMPRESSION: In comparison with the study ___, the monitoring and support devices are unchanged. The endotracheal tube again lies close to the orifice of the right mainstem bronchus. The opacification at the right base has decreased, suggesting some improvement in pleural effusion and underlying atelectasis. " e65bef1d-b7c4193d-e61ca1bf-fe3ca6eb-aa92f899.jpg,validate/p19/p19550773/s52883930/e65bef1d-b7c4193d-e61ca1bf-fe3ca6eb-aa92f899.jpg,validation," FINAL REPORT INDICATION: ___ year old man with large right pleural effusion s/p chest tube // ?chest tube placement TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: right-sided chest drain in situ. Interval decrease in size of the right-sided pleural effusion. No right-sided pneumothorax. The cardiomediastinal shadow is unchanged.Low lung volumes most likely a contribute to the increased bronchovascular markings seen in the lung bases. Spondylotic changes of the thoracic spine. IMPRESSION: Chest drain in the appropriate position. Interval decrease in size of the right-sided pleural effusion. No pneumothorax. " d6cc35dd-8ce39db9-ed654e56-e52948bb-403fb434.jpg,validate/p14/p14095662/s54928646/d6cc35dd-8ce39db9-ed654e56-e52948bb-403fb434.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dry cough and malaise. COMPARISONS: None. TECHNIQUE: Chest, AP and lateral. FINDINGS: The heart is mild-to-moderately enlarged. The chest is hyperinflated. There is mild unfolding and calcification along the thoracic aorta. There is no definite pleural effusion or pneumothorax. Fissures are thickened and the interstitium is moderately prominent. Projecting over the medial left upper lobe is a focal opacity which has vague borders and measures about 3 cm. This is compatible but not diagnostic of a focal consolidation. A pulmonary mass with associated atelectasis would be an additional consideration. The bones are probably demineralized. IMPRESSION: 1. Focal opacity in the left upper lobe, which could be seen with consolidative pneumonia, but a mass is not excluded. If clinical circumstances suggest pneumonia, then short-term followup radiographs could be considered within four weeks for close surveillance. Otherwise, chest CT could be considered, although the latter cannot always distinguish malignancy from infection. 2. Findings consistent with mild-to-moderate interstitial pulmonary edema. Atypical infection or severe airway inflammation are other possibilities, but probably less likely. 3. Cardiomegaly. " 65657fbc-27b09a9e-6e21e757-74349060-99f066fa.jpg,validate/p17/p17595498/s54405753/65657fbc-27b09a9e-6e21e757-74349060-99f066fa.jpg,validation," FINAL REPORT HISTORY: Increasing pain in the back and pain in the chest due to metastatic non-small cell lung cancer. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Reference chest CT from___ ___. FINDINGS: The heart size is normal. Mediastinal contour is unremarkable, although mediastinal lymphadenopathy was noted on the prior CT. Right hilar enlargement is compatible with known lymphadenopathy. 3.5 cm right upper lobe mass and 1.4 cm ill-defined nodule within the medial aspect of the superior segment of the left lower lobe are compatible with known sites of malignancy. Lungs are hyperinflated with flattening of the diaphragms and evidence of emphysematous changes. No focal consolidation, pleural effusion or pneumothorax is seen. There is diffuse demineralization of the osseous structures which limits detailed assessment. Known osseous metastatic lesions involving the thoracic spine, predominantly within the upper thoracic spine as well as within the ribs bilaterally are better seen on the recent CT. IMPRESSION: Right upper lobe 3.5 cm mass and 1.4 cm ill-defined nodule in the left lower lobe compatible with known malignancy. Unchanged right hilar adenopathy, and mediastinal lymphadenopathy is better seen on the prior CT. Diffuse osseous metastatic lesions are better seen on the prior CT and diffuse osteopenia limits assessment of the osseous structures. If there is continued concern for a fracture, then CT is suggested. " 7618797e-c3dd799d-67067605-3fe55a66-704c3292.jpg,validate/p13/p13306576/s57821890/7618797e-c3dd799d-67067605-3fe55a66-704c3292.jpg,validation," FINAL REPORT HISTORY: Chest heaviness and pressure. 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. Substantial degenerative changes are seen involving the right AC joint with possible partial subluxation. " e63119d7-012e699d-6e4b1471-b3f77679-55c39a59.jpg,validate/p16/p16302600/s59228067/e63119d7-012e699d-6e4b1471-b3f77679-55c39a59.jpg,validation," FINAL REPORT INDICATION: Productive cough, here to evaluate for pneumonia. COMPARISON: No prior studies available. Correlation is made to CT thoracic spine from ___. TECHNIQUE: PA and lateral upright radiographs of the chest. FINDINGS: The lungs are symmetrically well expanded. Streaky linear opacities in the left lung base are most compatible with atelectasis or pleural parenchymal scarring. No focal consolidation concerning for pneumonia, 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. An ovoid calcified density projects over the left upper abdomen measuring 5.2 x 3.4 cm in size, which is compatible with peripherally calcified left renal structure which has not yet been fully characterized IMPRESSION: 1. No acute cardiopulmonary process. 2. 5.2 x 3.7 cm peripherally calcified density in the left upper abdomen within the left kidney seen on prior CT T spine which has never been fully characterized at this institution. Nonurgent multiphasic MR abdomen or alternatively CT should be done if not already performed. Findings were emailed by Dr. ___ to the ___ ___ nurses on ___ to arrange for followup as findings were discovered following the patient's discharge. " 6c19e92f-027ef13e-0541e747-efa2c2bc-b0d02f83.jpg,validate/p10/p10040221/s51524239/6c19e92f-027ef13e-0541e747-efa2c2bc-b0d02f83.jpg,validation," FINAL REPORT INDICATION: Crackles in the left lower lobe on exam, rule out pneumonia. COMPARISON: Chest radiographs on ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no consolidation, pneumothorax, or pleural effusion. The cardiac, mediastinal, and hilar contours are normal. There is no pulmonary vascular congestion. IMPRESSION: Normal radiographic examination of the chest. These findings were reported to Dr. ___ office at 5 o'clock p.m. on ___ by telephone. " 4176bcd1-894594c7-c50a2f44-691f1155-8443bd01.jpg,validate/p13/p13728029/s50174162/4176bcd1-894594c7-c50a2f44-691f1155-8443bd01.jpg,validation," WET READ: ___ ___ 6:19 AM Probable right middle lobe pneumonia, possibly multifocal involving the lingula. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___F with sob/chest pain, history of pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: ___ AP chest radiographs FINDINGS: There is marked hyperinflation consistent with COPD. HETEROGENEOUS OPACIFICATION IN THE RIGHT MID AND LEFT PERIHILAR LUNG IS PROBABLY DUE TO BILATERAL PNEUMONIA. Probable trace right pleural effusion. No pneumothorax. Heart size is normal. IMPRESSION: BILATERAL PNEUMONIA. RECOMMENDATION(S): REPEAT CHEST RADIOGRAPHS IN NO MORE THAN 4 WEEKS TO DOCUMENT SUBSTANTIAL CLEARING. " 3db2c7e2-c73c78b7-98ec8602-9b2b265f-f16057f3.jpg,validate/p12/p12229037/s55331516/3db2c7e2-c73c78b7-98ec8602-9b2b265f-f16057f3.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath. COMPARISON: None. FINDINGS: There are extensive bilateral pulmonary consolidations worrisome for multifocal pneumonia. There is elevation of the anterior right hemidiaphragm. No pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Multifocal bilateral consolidations raise concern for multifocal pneumonia. Underlying mild vascular congestion not excluded. " 9e27697c-cda85029-a5e57623-839846b7-038728c3.jpg,validate/p14/p14913896/s55057884/9e27697c-cda85029-a5e57623-839846b7-038728c3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___F with cough x 2 days // eval pneumonia eval pneumonia COMPARISON: ___ and ___ FINDINGS: There is streaky density bilaterally most consistent with scarring or subsegmental atelectasis. Addition, there are ill-defined radiopacity is projected in the lower lungs, particularly adjacent to the right heart border, that probably represent bronchiectasis. This assessment is difficult due to overlying costochondral cartilage. There is no definite focal consolidation. The heart is normal in size. The aorta is tortuous and calcified. Mediastinal structures are stable. The bony thorax is grossly intact. IMPRESSION: No definite acute change. The lung findings as described likely represent subsegmental atelectasis or scarring and bronchiectasis. CTA may be helpful if further evaluation is clinically indicated. " 9c0f9ebf-8bb5f3a4-5328ebf7-d16a8690-e1836bf0.jpg,validate/p14/p14372745/s52592875/9c0f9ebf-8bb5f3a4-5328ebf7-d16a8690-e1836bf0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Left back pain worse with inspiration TECHNIQUE: Upright AP view of the chest COMPARISON: ___ FINDINGS: Assessment of the lung bases is limited due to poor penetration. The cardiac, mediastinal and hilar contours are unchanged, with the heart size appearing top normal. No focal consolidation, large pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. IMPRESSION: Limited study but no acute cardiopulmonary abnormality. " 530e795b-2c47ced4-6e07bccb-44aef5fc-f0491117.jpg,validate/p17/p17592232/s53990265/530e795b-2c47ced4-6e07bccb-44aef5fc-f0491117.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left pneumothorax s/p pigtail. // interval change, evaluate pneumothorax interval change, evaluate pneumothorax IMPRESSION: Compared to prior chest radiographs, ___ through ___:30. Change in contour of right basal consolidations suggests it is atelectasis. Remainder the right lung is clear and there is no right pleural abnormality. On the left, lower lobe atelectasis is improving left pneumothorax is small if any, pigtail drainage catheter in place. Heart size normal. Tracheostomy tube in standard placement. Left PIC line ends in the low SVC. A new, unidentified device with a cable projecting over the left lower chest is presumably external. " ca9a68ab-252b2536-3f49ca46-90b80bcb-fd523592.jpg,validate/p15/p15541469/s54182053/ca9a68ab-252b2536-3f49ca46-90b80bcb-fd523592.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p flex endoscopic removal of food bolus // ?PTX, pneumomediastinum COMPARISON: ___. IMPRESSION: As compared to the previous image, the patient continues to show air in the soft tissues of the neck. The extent of the subtle pneumomediastinum is also unchanged. No evidence of pneumopericardium. No visible pneumothorax. Newly developed bilateral basal areas of atelectasis. " e6255c0f-55947d35-563ec3ab-e8d31851-9f2c9ebb.jpg,validate/p11/p11434374/s59464595/e6255c0f-55947d35-563ec3ab-e8d31851-9f2c9ebb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumothorax // change? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Compared to the prior study there continues to be a moderate right-sided pneumothorax with right chest tube in place. The size of the pneumothorax slightly larger than on the study from the prior day. There is a small right effusion that is also larger than on the prior exam. The remainder the appearance of the chest is unchanged. There continues to be left lower lobe infiltrate and effusion as well IMPRESSION: Slight increase in right pneumothorax and right effusion. " 03717538-e720f20c-1772f929-142181c2-d26ba836.jpg,validate/p11/p11585485/s50285171/03717538-e720f20c-1772f929-142181c2-d26ba836.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo man with h/o b-cell lymphoma in remission, h/o right pleural effusion /p talc pleurodesis in ___. Last CXR ___ showed slight improved but persistent pleural effusion and new 15 mm opacity overlying the right anterior sixth rib. Need eval of this opacity as well as status of pleural effusion // ___ yo man with h/o b-cell lymphoma in remission, h/o right pleural effusion /p talc pleurodesis in ___. Last CXR ___ showed slight improved but persistent pleural effusion and new 15 mm opacity overlying the right anterior sixth rib. Need eval of this opacity as well as status of pleural effusion___ yo man with h/o b-cell lymphoma in remission, h/o right pleural effusion /p talc pleurodesis in ___. Last CXR ___ showed slight improved but persistent pleural effusion and new 15 mm opacity overlying the right anterior sixth rib. Need eval of this opacity as well as status of ple IMPRESSION: Comparison to ___. Unchanged appearance of the right chronic pleural effusion. The effusion has not increased. Moderate cardiomegaly. Severe scoliosis. Unremarkable appearance of the lung parenchyma. " 17be1c0d-30f54095-7e91ffe1-bbde39a5-0b0712b6.jpg,validate/p18/p18539425/s54664099/17be1c0d-30f54095-7e91ffe1-bbde39a5-0b0712b6.jpg,validation," FINAL REPORT INDICATION: Chest pain and abnormal labs. History of MDS. COMPARISONS: Chest radiograph, ___. 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. " c2337e0d-1dcb232a-44b2afc1-b41c1b9d-5ee3f90b.jpg,validate/p14/p14929790/s54431376/c2337e0d-1dcb232a-44b2afc1-b41c1b9d-5ee3f90b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, fever // 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. " 277ba34c-b79f3361-8609eb35-bb4ccdee-6171f241.jpg,validate/p10/p10976602/s57753813/277ba34c-b79f3361-8609eb35-bb4ccdee-6171f241.jpg,validation," 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. " 6fe2e585-1da5755c-b1a27404-cbadfbd8-f45286a2.jpg,validate/p12/p12607710/s59971894/6fe2e585-1da5755c-b1a27404-cbadfbd8-f45286a2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with hyperglycemia, diaphoresis TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Streaky and linear opacities are noted in both perihilar regions and lung bases likely reflective of atelectasis and/or scarring. No focal consolidation, pleural effusion or pneumothorax is present. Pulmonary vasculature is not engorged. IMPRESSION: No focal consolidation. No multiple areas of scarring and/or atelectasis in both lungs. " 67daeea1-3759ce83-a0619d1e-24b36d5c-43cc3512.jpg,validate/p13/p13751863/s54926182/67daeea1-3759ce83-a0619d1e-24b36d5c-43cc3512.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: CXR from ___ and chest CT from ___. CLINICAL HISTORY: ___-year-old man with shortness of breath, status post diuresis, assess change in pulmonary edema. FINDINGS: Upright portable AP view of the chest was provided. The left chest wall Port-A-Cath is unchanged in position with catheter tip in the expected region of the low SVC. Bilateral pleural effusions, small in size, persist. There is pulmonary interstitial edema which appears slightly increased from prior exam. Lower lung opacities could represent atelectasis, though the possibility of pneumonia is difficult to exclude. There is no pneumothorax. The heart is top normal in size. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Slightly increased pulmonary edema and small persistent pleural effusions. Lower lung opacities appear increased, could represent atelectasis or possibly pneumonia. Mild cardiomegaly unchanged. " 4189d316-e2d17939-8c41526b-5e00f5e2-75fb5ef7.jpg,validate/p17/p17063162/s57354112/4189d316-e2d17939-8c41526b-5e00f5e2-75fb5ef7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleuritic chest pain, rule out disease. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No lung parenchymal disease, no pleural effusions. No mediastinal abnormalities. " ffb49b4d-c1e2e9da-0def9e3c-58a3081d-c1a13e61.jpg,validate/p10/p10692417/s56004476/ffb49b4d-c1e2e9da-0def9e3c-58a3081d-c1a13e61.jpg,validation," 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. " 0651fe0a-ccbd8671-3af020f1-fe1b6a56-aeb8c4d1.jpg,validate/p13/p13259676/s56115130/0651fe0a-ccbd8671-3af020f1-fe1b6a56-aeb8c4d1.jpg,validation," FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with the study of ___, there has been placement of a Dobbhoff tube that coils in the upper stomach with the tip in the region of the esophagogastric junction pointing upward. Continued enlargement of the cardiac silhouette with elevated pulmonary venous pressure. Extensive opacification in the retrocardiac region is consistent with volume loss in the left lower lobe. Continued moderate cardiomegaly. " 85b9b90e-bd3cd18b-fc931233-39226c81-4c080dc8.jpg,validate/p18/p18781799/s53635113/85b9b90e-bd3cd18b-fc931233-39226c81-4c080dc8.jpg,validation," WET READ: ___ ___ ___ 8:20 AM Mild vascular congestion is slightly improved since yesterday's study. There is no pleural effusion or pneumothorax. Heart size is stable. WET READ VERSION #___ ___ ___ 11:03 PM Mild vascular congestion is slightly improved since yesterday's study. There is no pleural effusion or pneumothorax. Heart size is stable. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dyspnea // Assess volume IMPRESSION: Persistent widening of mediastinum and hilar contours due to a combination of lymphadenopathy and mediastinal lipomatosis as shown on prior PET-CT. Heart size is normal. Lung volumes are slightly improved since the recent study with associated improved aeration of the lung bases. No evidence of pulmonary edema or pneumonia. " 7eb5dc9e-8432626c-e48bb94e-1328b675-1f03d52f.jpg,validate/p15/p15854395/s55835521/7eb5dc9e-8432626c-e48bb94e-1328b675-1f03d52f.jpg,validation," 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. " 27bfbb08-fbd04c58-71521cc2-d3d11e8d-b4c0904c.jpg,validate/p15/p15783233/s52709752/27bfbb08-fbd04c58-71521cc2-d3d11e8d-b4c0904c.jpg,validation," WET READ: ___ ___ 2:03 PM Relatively linear left basilar opacities potentially atelectasis in the setting of low lung volumes. Infection or aspiration is not entirely excluded. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with fevers, abd discomfort, s/p whipple surgery 9 days ago // please evaluate for pna TECHNIQUE: Single portable view of the chest. COMPARISON: Correlation is made to chest CT from ___. FINDINGS: Lung volumes are slightly low. Relatively linear opacities at the left lung base with obscuration of the left costophrenic angle, potentially atelectasis. Elsewhere, lungs are clear. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities. IMPRESSION: Relatively linear left basilar opacities potentially atelectasis in the setting of low lung volumes. Infection or aspiration is not entirely excluded. " f2cd6490-f72a4f8d-5da2f9a4-023e4a6e-79715465.jpg,validate/p16/p16051431/s53743046/f2cd6490-f72a4f8d-5da2f9a4-023e4a6e-79715465.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent multifocal pneumonia, treated with abx, now off abx but increased SOB and new fever // eval for worsening/returning pneumonia. Also eval dobhoff placement eval for worsening/returning pneumonia. Also eval dobhoff placement IMPRESSION: Comparison to ___. The top of catheter is unchanged. The tip projects over the middle parts of the stomach. Decrease in extent of the pre-existing right pleural effusion. The left pleural effusion is overall stable. Relatively extensive bilateral basal parenchymal opacities, as well as opacities in the right upper lobe have only minimally decreased and represent the clinically known multifocal pneumonia. Stable appearance of the cardiac silhouette. No pulmonary edema. " 2588bf19-2a43640e-6d89ff1c-a3d032a3-419c70b2.jpg,validate/p17/p17393801/s51246929/2588bf19-2a43640e-6d89ff1c-a3d032a3-419c70b2.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Hypertension, chest pain, right internal jugular line placement. AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. AP radiograph of the chest demonstrates that the right internal jugular line being inserted terminating at the level of low SVC. Left basal consolidation associated with left pleural effusion as well as right basal consolidation appears to be slightly progressed as compared to the prior study. There is no evidence of pneumothorax. " 189b58b0-6716d247-4186802e-582db03e-9a5eb602.jpg,validate/p15/p15002645/s56992385/189b58b0-6716d247-4186802e-582db03e-9a5eb602.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal 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. Mild prominence of the left hilum is stable as compared to ___ though. There is no overt pulmonary edema. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 198de658-1227d01c-476b2711-045c0b08-734edabe.jpg,validate/p18/p18767957/s54957849/198de658-1227d01c-476b2711-045c0b08-734edabe.jpg,validation," FINAL REPORT HISTORY: Postoperative, to assess for fluid overload before transfusing. FINDINGS: In comparison with study of ___, there are slightly lower lung volumes. There is enlargement of the cardiac silhouette with engorgement of indistinct pulmonary vessels consistent with some elevated pulmonary venous pressure. The left hemidiaphragm is not as well seen, suggesting volume loss in the left lower lobe and possible left effusion. " 70b0d303-398862ac-048beedd-668170cb-7a32a632.jpg,validate/p12/p12785654/s54250975/70b0d303-398862ac-048beedd-668170cb-7a32a632.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp failure on trach // eval interval change IMPRESSION: Since a recent radiograph of 1 day earlier, the bibasilar patchy and linear opacities have developed, and may reflect atelectasis or aspiration. Small bilateral pleural effusions are also noted. No other relevant changes. " ffe52554-8f36db4d-93ff5af5-d7a19b02-5e0beea9.jpg,validate/p11/p11900721/s57671851/ffe52554-8f36db4d-93ff5af5-d7a19b02-5e0beea9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrosis, known pulm edema, ascites // subjective dyspnea, sob, crackles r/o pulm edema, eval interval change subjective dyspnea, sob, crackles r/o pulm edema, eval inter COMPARISON: Comparison to ___ at 15 26 FINDINGS: Portable semi-erect chest film ___ at 435 is submitted. IMPRESSION: There continues to be a layering left effusion with retrocardiac opacity likely reflecting compressive atelectasis, although pneumonia cannot be excluded. The pulmonary vasculature still is prominent suggesting a component of mild pulmonary edema. Overall cardiac and mediastinal contours are stable. No pneumothorax. " 252f7960-2993ac76-a0c4222d-d8e78493-85c4cb46.jpg,validate/p12/p12668338/s59502206/252f7960-2993ac76-a0c4222d-d8e78493-85c4cb46.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Increased oxygen requirement. Portable AP radiograph of the chest was reviewed in comparison to ___. The right PICC line tip is at the level of mid SVC. Heart size and mediastinum are stable. Enlargement of the cardiac silhouette is redemonstrated. There is mild vascular engorgement, which overall is unchanged as compared to the prior study as well as slightly more prominent bibasal opacities. " 59d120bd-b9f88eb9-2312b1c4-d222e984-f7c7e250.jpg,validate/p19/p19950555/s55073581/59d120bd-b9f88eb9-2312b1c4-d222e984-f7c7e250.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Chest pain and shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The patient is status post median sternotomy and CABG. Heart size is normal. An epicardial lead is noted on the lateral view. Mediastinal and hilar contours are unremarkable. Lung volumes are somewhat low with minimal atelectasis noted within the left lung base. No focal consolidation, pleural effusion or pneumothorax is present. The pulmonary vasculature is normal. Multilevel degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " cd9a45d8-e82b81b0-465280f9-bded3885-2ffaa2e1.jpg,validate/p14/p14191651/s57863185/cd9a45d8-e82b81b0-465280f9-bded3885-2ffaa2e1.jpg,validation," FINAL REPORT HISTORY: Shortness breath, headache, AIDS. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. 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 acute cardiopulmonary process. " 437d9223-45b694dc-a525d8da-4ebd9b2b-507026bc.jpg,validate/p11/p11438336/s53673602/437d9223-45b694dc-a525d8da-4ebd9b2b-507026bc.jpg,validation," WET READ: ___ ___ 10:38 PM persistent mild edema. new opacity at right lung base seen on both views is concerning for developing infection. new small right pleural effusion. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Evaluate for pulmonary edema. REFERENCE EXAM: ___. FINDINGS: Again seen is moderately enlarged heart, pulmonary vascular re-distribution and small bilateral effusions compatible with fluid overload. In addition there is a new right lower lobe infiltrate which could be infectious in etiology. " 451d3f67-988855bd-528302f2-b9645af6-2ef03e83.jpg,validate/p11/p11805066/s54518343/451d3f67-988855bd-528302f2-b9645af6-2ef03e83.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx RUL mass s/p trach // interval change interval change IMPRESSION: Compared to chest radiographs ___ through ___. Tracheostomy tube midline. No evidence of complications. Bronchial stent is more angulated in the right main bronchus than it was earlier. This could reflect change in orientation of the bronchus rather than dislodgement. Small right pleural effusion persists. Hyperexpansion of the consolidated right upper lobe is unchanged. Severe left lower lobe atelectasis and small to moderate left pleural effusion worsened from ___, subsequently unchanged. Heart size normal. No pneumothorax. Vascular line ends outside the left chest wall. " 21d5fb3d-f788e53d-59ee24b1-e524fc5c-2bfe0360.jpg,validate/p19/p19014190/s56126072/21d5fb3d-f788e53d-59ee24b1-e524fc5c-2bfe0360.jpg,validation," WET READ: ___ ___ ___ 7:50 PM Lines and tubes in satisfactory positions. Unchanged blunting of the bilateral costophrenic angles suggest tiny bilateral pleural effusions. No focal consolidation. Mild cardiomegaly is not significantly changed. No pneumothorax. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CLINICAL HISTORY: Status post motor vehicle accident, reexploration for bleeding. CHEST The position of the various support lines and tubes remains unchanged and satisfactory. No pneumothorax is present. Blunting of both costophrenic angles is present. No evidence of pneumonia. " 47e28e05-891f69a1-3454dc8c-75b9ccde-189cb923.jpg,validate/p14/p14659758/s57272885/47e28e05-891f69a1-3454dc8c-75b9ccde-189cb923.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain, evaluate for pneumothorax or pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lung volumes remain low. Heart is normal in size. Cardiomediastinal contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. A linear density at the left base likely reflects mild atelectasis. IMPRESSION: No acute intrathoracic abnormality. " a610b921-ab56568f-df6eb375-d5bbe4c0-de4d9896.jpg,validate/p11/p11712892/s53717876/a610b921-ab56568f-df6eb375-d5bbe4c0-de4d9896.jpg,validation," WET READ: ___ ___ 9:47 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with pancreatitis, sob, and ___ of asthma // fluid from pancreatitis? pna? COMPARISON: None available 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. S shaped curvature of the thoracolumbar spine is noted. No free air below the right hemidiaphragm is seen. Surgical clips overlying the right upper quadrant likely represent prior cholecystectomy. IMPRESSION: No acute intrathoracic process. " 35185b74-7c1c6a50-7c103be6-0d2f8de9-293fbd95.jpg,validate/p10/p10439374/s52232245/35185b74-7c1c6a50-7c103be6-0d2f8de9-293fbd95.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o cirrhosis, hip washout, now with signs of volume overload on exam // interval change IMPRESSION: Since a recent radiograph of ___, a right PICC has been withdrawn, now terminating the junction of the right brachiocephalic vein and superior vena cava. Mild pulmonary vascular congestion is present but previously noted interstitial edema has resolved. " c4413621-b455a6ac-203067f5-07c6887c-2c12217d.jpg,validate/p13/p13340973/s51346054/c4413621-b455a6ac-203067f5-07c6887c-2c12217d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with left lateral chest wall pain // cause of chest pain EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: None available. FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. IMPRESSION: No acute cardiopulmonary process. " c66c2d79-1d2ccdd0-d9f87aec-af26913f-79f4358e.jpg,validate/p12/p12010209/s55193484/c66c2d79-1d2ccdd0-d9f87aec-af26913f-79f4358e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have minimally decreased, likely caused by a lesser inspiratory effort than on occasion of the previous examination. However, a plate-like zone of increased density at the right lung base is visible both on the lateral and on the frontal image. The morphology of this change rather suggestive of atelectasis, but in the appropriate clinical setting could also reflect pneumonia. Otherwise, the radiograph is unchanged. Borderline size of the cardiac silhouette with minimal enlargement of the leftventricle. Mild tortuosity of the thoracic aorta. No pulmonary edema. No pleural effusions. The mediastinal contours are unremarkable. " 45b96592-48cb0b82-6ac91779-04fbf7a5-0e03a1ac.jpg,validate/p18/p18551029/s52880243/45b96592-48cb0b82-6ac91779-04fbf7a5-0e03a1ac.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Rash, cough, evaluation for abnormalities. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. No pneumothorax. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. The lung parenchyma is unremarkable, no pneumonia, no pulmonary edema. No nodules or masses. " 00a89da5-0565c375-69f8f49b-ce862b73-46505485.jpg,validate/p14/p14106194/s54222611/00a89da5-0565c375-69f8f49b-ce862b73-46505485.jpg,validation," WET READ: ___ ___ ___ 1:33 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with ___ abd pain. TECHNIQUE: Single portable AP view of the chest was obtained. COMPARISON: None available. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are normal. There is no pleural effusion or pneumothorax. No subdiaphragmatic air is identified. The lungs are clear. IMPRESSION: No acute intrathoracic process. " e3f5c6dc-26a493e0-21ee31d0-abae625b-e18363a6.jpg,validate/p17/p17077582/s58610279/e3f5c6dc-26a493e0-21ee31d0-abae625b-e18363a6.jpg,validation," 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. " 6bce6d85-87b10354-f1517e0c-67d71bd7-854d5cd5.jpg,validate/p19/p19729398/s53513452/6bce6d85-87b10354-f1517e0c-67d71bd7-854d5cd5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p PPM implant, known lung CA // ptx leads ptx leads COMPARISON: Chest radiographs since ___, most recently one ___. IMPRESSION: New transvenous right ventricular pacer lead follows the expected course from the left pectoral generator. There is no pneumothorax mediastinal widening or associated pleural effusion. Patient has had median sternotomy and mitral valve replacement. Moderate cardiomegaly and a moderate right pleural effusion are chronic. Also unchanged is severe scarring and volume loss in the right upper lobe and compensatory hyperinflation of the right middle lobe. Hyperinflation in the left long reflects emphysema. " 6f9c341c-61cc40c7-e272ad6b-9c22f2b9-2ff2f347.jpg,validate/p17/p17086599/s59537120/6f9c341c-61cc40c7-e272ad6b-9c22f2b9-2ff2f347.jpg,validation," 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 aorta remains slightly tortuous. There is no pulmonary edema. The cardiac silhouette is top normal to mildly enlarged, stable with left ventricular configuration. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 819cdc74-82dc1439-d5396257-4fbc455c-88bae77b.jpg,validate/p14/p14540393/s59763021/819cdc74-82dc1439-d5396257-4fbc455c-88bae77b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with influenza A and heart failure exacerbation, worsening cough // ?PNA ?PNA IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is significant enlargement of the cardiac silhouette with mediastinal venous engorgement and mild to moderate pulmonary edema. Probable small bilateral pleural effusions with compressive atelectasis at the bases. " fd824e1b-2d36b09c-acb439ac-6e71549d-d875bf9c.jpg,validate/p13/p13050559/s52355641/fd824e1b-2d36b09c-acb439ac-6e71549d-d875bf9c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lymphoma s/p RUL lobectomy // Eval PTX/Effusion IMPRESSION: As compared to ___, lung volumes are improved. Cardiomediastinal contours are stable, with persistent postoperative alterations in the right hemi thorax related to recent right upper lobe resection. Right chest tube remains in place, with persistent small amount of pleural fluid at the right apex, but there is no evidence of apical pneumothorax. Unusually sharp appearance of right hemidiaphragm could potentially represent a basilar pneumothorax, attention to this region on short-term followup radiographs may be helpful in this regard. " e1d1573d-38a7d2b1-8a4128cf-6adfcf94-40e6abc9.jpg,validate/p17/p17540438/s55991693/e1d1573d-38a7d2b1-8a4128cf-6adfcf94-40e6abc9.jpg,validation," 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. " 3e5ec897-a906078f-1415424c-b95f9145-ffa151fc.jpg,validate/p15/p15226510/s52789029/3e5ec897-a906078f-1415424c-b95f9145-ffa151fc.jpg,validation," FINAL REPORT AP CHEST, 6 A.M. ON ___ HISTORY: A ___-year-old woman with trauma. Intubated yesterday. IMPRESSION: AP chest compared to ___ at 7:29 p.m.: ET tube in standard placement. The lungs grossly clear. The heart size is normal. No pneumothorax. Nasogastric tube passes below the diaphragm and out of view. " c4e6115e-811f57b1-ad27d096-64c06fc4-09a63ebc.jpg,validate/p12/p12457153/s51233483/c4e6115e-811f57b1-ad27d096-64c06fc4-09a63ebc.jpg,validation," 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. " 859ae0fc-4cc90c03-27772c20-436e8ef6-d490c64c.jpg,validate/p18/p18869899/s53147122/859ae0fc-4cc90c03-27772c20-436e8ef6-d490c64c.jpg,validation," FINAL REPORT INDICATION: ___-year-old female patient status post sternal debridement. Study requested for assessment of infiltrates. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: Portable AP chest radiograph. FINDINGS: As compared to prior chest radiograph from ___, there has been interval increase of right-sided basilar atelectasis. The left lung volume has increased. There are no new focal consolidations. Mild cardiomegaly is stable. Right PICC line is unchanged in position. IMPRESSION: Interval increase of right-sided atelectasis with no new focal consolidations. " 5dabea37-b53c912b-dfc12b70-e0eeadb4-07ca38f7.jpg,validate/p18/p18259298/s50878220/5dabea37-b53c912b-dfc12b70-e0eeadb4-07ca38f7.jpg,validation," FINAL REPORT INDICATION: GI bleed, question pneumonia or CHF. COMPARISON: Chest radiograph from ___. FINDINGS: One portable AP upright view of the chest. The lungs are clear. There is no evidence of edema. There is no pleural effusion or pneumothorax. Heart size is enlarged and stable. The aorta is tortuous with atherosclerotic calcification of the aortic arch and a prominent rounded contour of the lower thoracic aorta, unchanged. Again seen are the small radiodensities projecting over the right mid to lower lung and left upper abdomen, unchanged. Small calcified granulomas in the left mid/upper lung are unchanged. IMPRESSION: No acute cardiopulmonary process. " 1a876c43-004c35fc-7977b4de-584b5665-3a588f9c.jpg,validate/p12/p12465063/s51518321/1a876c43-004c35fc-7977b4de-584b5665-3a588f9c.jpg,validation," FINAL REPORT CHEST TWO VIEWS: ___ HISTORY: ___-year-old male with CHF and dyspnea on exertion. Question pulmonary edema. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear of focal consolidation or effusion. There is no pulmonary edema. Cardiac silhouette is enlarged but stable in configuration. Prosthetic aortic valve is noted as well as median sternotomy wires. No acute osseous abnormality is identified. Hypertrophic changes seen in the spine. IMPRESSION: No acute cardiopulmonary process. " 4dcbfc78-fc0611e2-e8c721c1-7024c7e6-78c8d4ad.jpg,validate/p13/p13648633/s58573317/4dcbfc78-fc0611e2-e8c721c1-7024c7e6-78c8d4ad.jpg,validation," 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 ___. " a5e1c709-038dc8e5-c4615212-a65e772a-746957a2.jpg,validate/p17/p17894713/s54239119/a5e1c709-038dc8e5-c4615212-a65e772a-746957a2.jpg,validation," FINAL REPORT HISTORY: Left rib pain. Rule out acute injury. COMPARISON: None available FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size. The cardiomediastinal silhouette and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax. No displaced rib fracture identified. IMPRESSION: Normal chest radiograph. " b6a733b1-bb65ad0c-5b365705-5cf17723-bca8434c.jpg,validate/p19/p19396070/s53699844/b6a733b1-bb65ad0c-5b365705-5cf17723-bca8434c.jpg,validation," 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. " 9d1952c7-40b1d17f-3bfe6b9c-b961d050-ae82b5da.jpg,validate/p12/p12439188/s55632506/9d1952c7-40b1d17f-3bfe6b9c-b961d050-ae82b5da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD on HD, intubated, also left lower lobe collapse // Assess for interval change Assess for interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Patient is rotated severely to the left, which obscures the left lower lobe, but there does appear to be greater atelectasis there. Right lung grossly clear. No pneumothorax. Heart size normal. ET tube in standard placement. Drainage tube passes through the esophagus to the stomach and out " 8cf593ab-373e166a-aaca746d-4716dfed-defa77f6.jpg,validate/p11/p11842879/s54461955/8cf593ab-373e166a-aaca746d-4716dfed-defa77f6.jpg,validation," FINAL REPORT HISTORY: Dermatomyositis and right upper lobe consolidation. Evaluate. COMPARISON: Chest radiograph ___ and chest CTA 0:39 today. FRONTAL AND LATERAL VIEWS OF THE CHEST: There is patchy airspace consolidation throughout the right lung, new from yesterday but unchanged from this morning. Opacities are worse throughout the left lung. Changes consistent with multifocal aspiration pneumonia. No pleural effusion or pneumothorax. Heart size is normal. Mediastinum and hilar structures are unremarkable. " 66ca5dae-90018545-e51aa33a-1fde8347-ec721bf6.jpg,validate/p12/p12385857/s54931292/66ca5dae-90018545-e51aa33a-1fde8347-ec721bf6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ and chest CT on ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Subtle opacity involving the right middle lobe may represent an area of infection. No pleural effusion or pneumothorax is seen. A nodular density is seen in the mid, left lower lobe is consistent with known mass, better characterized on prior PET-CT. As before there are streaks of fibrosis seen in the bilateral lungs consistent with posttreatment changes. IMPRESSION: Subtle opacity involving the right middle lobe may represent an early focus of infection. Short-term followup radiographs may be helpful in this regard. . " 1539d6bb-7e68d090-2c96a488-b7211787-7d5e6f73.jpg,validate/p16/p16971820/s51295336/1539d6bb-7e68d090-2c96a488-b7211787-7d5e6f73.jpg,validation," FINAL REPORT INDICATION: Abdominal distention. Evaluate for free air. COMPARISON: Chest radiograph ___ and CT chest ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: There is no free air under the right hemidiaphragms. A left MediPort terminates in the mid SVC. Increased density involving both hila from ___ is consistent with hilar lymphadenopathy. Heart size is normal. No pleural effusion, pneumothorax or focal airspace consolidation. The scattered pulmonary nodules are better detailed on the prior chest CT. " 9983f34a-676f9996-b7be00f2-4ff1d227-64b46a48.jpg,validate/p10/p10677834/s58741224/9983f34a-676f9996-b7be00f2-4ff1d227-64b46a48.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Abdominal pain. History of small bowel obstruction. 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. Surgical clips project over the right upper quadrant of the abdomen. IMPRESSION: No evidence of acute disease. No free air identified. Normal bony structures. " dec080e6-9c9f2a53-7d6c9ec8-36cf37d3-b4996b7b.jpg,validate/p12/p12711845/s56802901/dec080e6-9c9f2a53-7d6c9ec8-36cf37d3-b4996b7b.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with acute resp failure, now intubated // placement of ET tube TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 06:31 FINDINGS: Interval placement of an ET tube with the tip 1 cm proximal to the carina and retraction by approximately 3.5 cm is advised. The cuff appears mildly overinflated. Right lower lobe airspace opacification shows mild progression compared to prior image. Small associated pleural effusion. The left lung is clear. No pulmonary edema. No pneumothorax. The cardiomediastinal shadow is unchanged. IMPRESSION: Retraction of the ET tube by 3.5 cm advised. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 8:53 AM, 5 minutes after discovery of the findings. " cdf65c27-62c40de7-c482ca6e-1712a2c5-87a855c8.jpg,validate/p13/p13562596/s55377608/cdf65c27-62c40de7-c482ca6e-1712a2c5-87a855c8.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough // r/o PNA COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: There is a poor inspiratory effort limiting observation of the bases. There is chronic scarring or small area of atelectasis. Cardiomegaly is present but there is no CHF. Degenerative change and scoliosis is present in the spine. " 4a3ed1d0-1d399dc3-b1b1e9e9-64b336cf-44ff6e4b.jpg,validate/p11/p11845452/s51497254/4a3ed1d0-1d399dc3-b1b1e9e9-64b336cf-44ff6e4b.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain, dyspnea and cough // eval for PNA 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. " 5f1374ab-dac0398f-fd74104b-45f155eb-197edf11.jpg,validate/p19/p19335880/s51191268/5f1374ab-dac0398f-fd74104b-45f155eb-197edf11.jpg,validation," FINAL REPORT INDICATION: Chest 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. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 0b872ce2-63b1caa6-2df6b3f4-385f769d-85663cd7.jpg,validate/p17/p17741851/s55944982/0b872ce2-63b1caa6-2df6b3f4-385f769d-85663cd7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cva r.o // acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Clips are seen projecting over the anterior chest wall. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. Apparent widening of the right AC joint is new in the interval and may reflect prior resection. No free air below the right hemidiaphragm is seen. IMPRESSION: As above. " 4c3274a2-3690c35f-efc56440-f514cc19-37e21cf5.jpg,validate/p18/p18179234/s51898564/4c3274a2-3690c35f-efc56440-f514cc19-37e21cf5.jpg,validation," 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. " 64cdeb43-62007543-1e0600bb-b09d02c9-4d7ce702.jpg,validate/p17/p17165725/s54974439/64cdeb43-62007543-1e0600bb-b09d02c9-4d7ce702.jpg,validation," FINAL REPORT HISTORY: Recurrent pseudomonas empyema, check tube placement. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ at 3:36 a.m. There is a dual-lumen central line on the right, with both lead tips over the right atrium. There is a right-sided PICC line, with tip over mid/lower SVC. No pneumothorax is detected. A pigtail-type catheter overlies the right lung base, now over the mid portion of the right hemidiaphragm. On the prior film, it was somewhat more medial in position. There is upper zone re-distribution and diffuse vascular blurring, consistent with CHF. The right hemidiaphragm is slightly elevated, with atelectasis at the right base. Possible trace bilateral effusions. Cardiomediastinal silhouette is unchanged. IMPRESSION: Right pigtail catheter present, lying slightly more lateral than on the prior film. CHF, right base atelectasis, and possible small bilateral effusions. No pneumothorax detected. " 8f73a6bb-d5ab5a4e-f8fa4a67-a4880d1d-2aa171ca.jpg,validate/p13/p13184831/s53628234/8f73a6bb-d5ab5a4e-f8fa4a67-a4880d1d-2aa171ca.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dyspnea on exertion*** WARNING *** Multiple patients with same last name! // r/o acute infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is severe enlargement of the cardiac silhouette. Mediastinum is widened. Left base opacity is seen worrisome for large consolidation, underlying pleural effusion or pulmonary mass not excluded. No pleural effusion seen on the right. Biapical pleural thickening seen. Dual lead left-sided pacer device is seen with leads extending to the expected positions of the right atrium and right ventricle. IMPRESSION: Severely enlarged cardiac silhouette. Widened mediastinum. Left lower lobe consolidation may be due to infection, aspiration, underlying pulmonary mass not excluded. Chest CT may help further assess the above findings. " a22d174b-5f3d6059-af455051-e0beec47-0beed6d4.jpg,validate/p11/p11017660/s50720121/a22d174b-5f3d6059-af455051-e0beec47-0beed6d4.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient with persistent shortness of breath, following treatment for right-sided pneumonia, history of kidney transplant and HIV. COMPARISON: Prior chest radiograph from ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph from ___, there has been interval improvement of right middle lobe pneumonia. There is minimal opacification over the area of recent pneumonia, this could represent scarring or residual opacities from prior infectious process. No new consolidations are identified. There are no pleural effusions or pneumothorax. The cardiomediastinal silhouette is normal. There is a rib deformity on the right. Osseous structures are otherwise intact. IMPRESSION: Interval improvement of right middle lobe pneumonia, with minimal opacity in the right lower lobe, which may represent scarring or residual opacification from prior infectious process. " 27175b96-5577d1be-15c832c6-02275c90-585b1a11.jpg,validate/p16/p16750854/s52699129/27175b96-5577d1be-15c832c6-02275c90-585b1a11.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISON: Radiographs from ___ and CT also from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The patient is status post aortic valve replacement surgery as well as coronary artery bypass graft surgery. 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. " bd4ee657-dc939711-2dae7182-4ead4eec-73789707.jpg,validate/p11/p11415374/s54601244/bd4ee657-dc939711-2dae7182-4ead4eec-73789707.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs PA and lateral INDICATION: ___ year old man with worsening dyspnea on exertion. // ?COPD, PNA, mass, IPF, pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs PA and lateral ___ FINDINGS: There is platelike atelectasis at the right lung base, similar to ___. The lungs are hyperinflated and is associated with bilateral hemidiaphragm flattening, suggesting chronic lung disease. There are no lung masses, focal consolidations, pleural effusions or pneumothorax. The mediastinum, hila, and heart are within normal limits. No acute osseous abnormalities. IMPRESSION: 1. Bilateral lung hyperinflation and flattening of the diaphragms suggests chronic lung disease. 2. No evidence of pneumonia, pulmonary edema or lung mass. " 5f8639fd-3712027f-63b47dcc-40901960-b36fb6fc.jpg,validate/p12/p12323587/s52233874/5f8639fd-3712027f-63b47dcc-40901960-b36fb6fc.jpg,validation," FINAL REPORT INDICATION: ___F with cough, sore throat // pna? TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Lower thoracic dextroscoliosis is noted. No acute osseous abnormalities. Surgical clips in the right upper quadrant suggest prior cholecystectomy. IMPRESSION: No acute cardiopulmonary process. " 101213f0-c6920dad-866d5b67-9a434956-536440a6.jpg,validate/p13/p13305035/s51313327/101213f0-c6920dad-866d5b67-9a434956-536440a6.jpg,validation," FINAL REPORT PORTABLE AP SEMI-ERECT CHEST FILM, ___ AT 3:51. CLINICAL INDICATION: ___-year-old with cerebellar stroke and newly placed nasogastric tube, evaluate for positioning. Comparison to prior study ___ at ___. Single portable semi-erect chest film ___ at 3:51 is submitted. IMPRESSION: 1. Interval removal of the Dobbhoff feeding tube with placement of a nasogastric which is seen coursing in the upper esophagus and then the distal portion is seen with the tip likely within the stomach, although the mid portion of the tube is not well visualized on the current examination. Therefore, followup imaging would be advised. Left subclavian PICC line unchanged in position with its tip in the distal SVC. 2. Heart remains enlarged. Improving mild-to-moderate pulmonary edema with likely layering effusions and associated patchy opacities which may reflect compressive atelectasis, although pneumonia cannot be entirely excluded. No evidence of pneumothorax. Status post median sternotomy. " 52b44d03-ba8ac916-81d2e35f-1394d409-44b510c9.jpg,validate/p16/p16773335/s58670491/52b44d03-ba8ac916-81d2e35f-1394d409-44b510c9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HF, PNA // eval for PNA, HF progression IMPRESSION: Cardiomegaly and pulmonary vascular congestion are accompanied by near resolution of interstitial edema. Worsening right middle lobe opacity results in partial obscuration of the right heart border and could be due to developing pneumonia in the appropriate clinical setting. Slight worsening of left retrocardiac opacification and apparent slight increase in size of a small left pleural effusion. No other relevant changes. " 979a5208-d298e7cb-2697eea7-c7edb07d-642b856b.jpg,validate/p15/p15968244/s52101206/979a5208-d298e7cb-2697eea7-c7edb07d-642b856b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p CABG, CTs d/c'd // evaluate for pneumothrax evaluate for pneumothrax COMPARISON: Chest radiographs ___ through ___. IMPRESSION: No pneumothorax or appreciable change in small left pleural effusion since ___ following removal of pleural drainage tubes. Mediastinal drains have also been removed, and there has been a slight increase in cardiac diameter, but previous mild pulmonary edema has resolved. Following tracheal extubation, lung volumes are maintained and mild left lower lobe atelectasis is stable. Right jugular introducer ends just above the origin of the SVC. Transvenous right atrial right ventricular pacer leads in standard positions unchanged. " bdfd4d32-722794a3-e96355e4-63101ab0-51f99fb8.jpg,validate/p14/p14670928/s59024522/bdfd4d32-722794a3-e96355e4-63101ab0-51f99fb8.jpg,validation," WET READ: ___ ___ ___ 9:50 PM port-a-cath has access needle in place, not an unexpected finding. lungs clear, cardiomediastinal contours unremarkable. no pleural effusons or pneumothorax. ___ ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess for metal in the port. There is no radiopaque/metal density material in the port. The port tip is at the mid SVC. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. " 8759246b-8d700501-e66736d4-566d5d2d-c61619de.jpg,validate/p13/p13174810/s56459321/8759246b-8d700501-e66736d4-566d5d2d-c61619de.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Trauma, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in constant position. There is unchanged evidence of retrocardiac opacities, right basal lung opacities and a relatively extensive consolidation on the right along the chest wall. The post-surgical clips and sternotomy wires are in constant position. Constant appearance of the heart. " 08367d27-ce96135e-acd49df5-3532c0ab-b590f796.jpg,validate/p19/p19272089/s51022703/08367d27-ce96135e-acd49df5-3532c0ab-b590f796.jpg,validation," FINAL REPORT AP CHEST 9:53 P.M. ___ HISTORY: Low ET tube. Re-evaluate. IMPRESSION: AP chest compared to ___, 9:47 p.m.: Endotracheal tube has been withdrawn to standard position, tip roughly 3.5 cm from the carina. Nasogastric tube passes into the stomach and out of view. Low lung volumes exaggerate mild cardiomegaly, and supine positioning makes mediastinal and pulmonary vascular engorgement more prominent than it probably is. No pulmonary edema. No appreciable pleural effusion or pneumothorax. " 4881e1bb-418e7712-25451786-e4b2cbfd-4486e71a.jpg,validate/p13/p13138475/s53675886/4881e1bb-418e7712-25451786-e4b2cbfd-4486e71a.jpg,validation," WET READ: ___ ___ ___ 5:48 PM Bilateral consolidations appear more dense the earlier today. No pneumothorax. Slight increase in left pleural effusion. d/w Dr. ___ by ___ at ___ on ___ by phone. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Intubated patient with rapid desaturation. Comparison is made with prior study performed four hours earlier. There are no acute interval changes. There is no evidence of pneumothorax. Extensive bilateral lung opacities are unchanged. Lines and tubes are in unchanged standard position. " 9dcec5c0-a8ceb396-a65a29ed-7e721b63-ac6dee8e.jpg,validate/p10/p10296819/s53139884/9dcec5c0-a8ceb396-a65a29ed-7e721b63-ac6dee8e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: pacemaker implantation today // Rule out pneumothorax COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Minimal bilateral symmetrical apical scarring. Normal size of the cardiac silhouette. Left pectoral pacemaker with correctly positioned leads. No pneumothorax. No pleural effusions. No pulmonary edema. " b0422143-07e53192-af4d3d37-2a48cbf9-7a297383.jpg,validate/p11/p11610947/s53247773/b0422143-07e53192-af4d3d37-2a48cbf9-7a297383.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ppd positive, no symptoms. Evaluate for active for latent TB. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ 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. " 7793c011-30b74b40-2c2949f7-cd1ea5c9-361aa704.jpg,validate/p13/p13245281/s53645655/7793c011-30b74b40-2c2949f7-cd1ea5c9-361aa704.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___ year old woman with shortness of breath TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ at 01:54 from outside hospital FINDINGS: Lung volumes are low. Heart size is accentuated as result of the low lung volumes appearing mildly to moderately enlarged. The mediastinal and hilar contours are unremarkable. Crowding of bronchovascular structures is present with possible mild pulmonary vascular engorgement. Streaky opacities in the lung bases likely reflect areas of increasing atelectasis. No focal consolidation, pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with worsening bibasilar atelectasis and possible mild pulmonary vascular congestion. " 6f900115-bef60c1f-5700291b-61cd0bce-b34780ac.jpg,validate/p18/p18699864/s53029088/6f900115-bef60c1f-5700291b-61cd0bce-b34780ac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with R PTX // R/O PTX with CT on waterseal for 3 hrs. Please do around noon R/O PTX with CT on waterseal for 3 hrs. Please do around noon IMPRESSION: Compared to chest radiographs ___ through ___ at 04:38. Small to moderate right pneumothorax has recurred, with right pleural drainage catheter slightly repositioned and reported to be on water seal. Lungs clear. No pleural effusion. Normal cardiomediastinal silhouette. " c7e8e2bc-4eec351f-7537ee20-ad4758af-5540e9f7.jpg,validate/p19/p19265629/s56713536/c7e8e2bc-4eec351f-7537ee20-ad4758af-5540e9f7.jpg,validation," FINAL REPORT INDICATION: History: ___F with bilateral acute limb ischemia // Pre-op evaluation TECHNIQUE: Chest PA and lateral COMPARISON: None. 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. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 372c1a45-d66ccbe2-ba9a687e-778605c1-b7513c77.jpg,validate/p13/p13826980/s53490692/372c1a45-d66ccbe2-ba9a687e-778605c1-b7513c77.jpg,validation," FINAL REPORT HISTORY: Recent adjustment of ET tube and placement of NG tube. Compared with earlier the same day, the ET tube has been retracted and now lies approximately 1.5 cm above the carina, immediately below the level of the clavicles, on this lordotic film. An NG tube is present, tip over fundus. The left mainstem bronchus is poorly visualized and there is increased opacity in the retrocardiac region consistent with left lower lobe (?medial and/or upper segments) collapse and/or consolidation. The appearance is similar, possibly slightly worse, compared with the earlier film. There is minimal atelectasis at the right base, with an elevated right hemidiaphragm. No gross left effusion. The right costophrenic angle is excluded from the film. IMPRESSION: 1. ET tube has been retracted slightly, although only 14 mm above the carina. It lies at the lower edge of the medial clavicles. 2. Marked left perihilar consolidation as described, probably slightly worse compared with earlier the same day. Nonvisualization of the left mainstem bronchus. 3. NG tube in satisfactory position. " 59504007-43dda415-260cf382-607d7f5a-3910ff9c.jpg,validate/p14/p14268088/s58790849/59504007-43dda415-260cf382-607d7f5a-3910ff9c.jpg,validation," WET READ: ___ ___ ___ 12:06 AM 1. Nasogastric tube ultimately ends in the stomach. 2. Persistent areas of bibasilar opacity are consistent with bilateral pleural effusions and adjacent atelectasis. 3. Persistent cardiomegaly. 4. Mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new NG tube // eval for NG tube placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: The NG tube has been ultimately with demonstrated in the stomach. Bilateral pleural effusions are large. Cardiomegaly is persistent. Bibasal atelectasis is present. Mild interstitial pulmonary edema is a possibility " 7cce3054-3c4ecc22-7c37ca2a-f0065e1d-4d783479.jpg,validate/p19/p19533131/s51703310/7cce3054-3c4ecc22-7c37ca2a-f0065e1d-4d783479.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L tib plateau frx // preop Surg: ___ (L tib plateau ORIF) preop IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No vascular congestion, pleural effusion, or acute focal pneumonia. Right Port-A-Cath extends to the mid portion of the SVC. " 5e9aecc0-7557a3fa-26d1422c-1b7f029f-7d5c0d83.jpg,validate/p17/p17979157/s59638835/5e9aecc0-7557a3fa-26d1422c-1b7f029f-7d5c0d83.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ ___ ___. FINDINGS: Heart size, mediastinal and hilar contours are normal. A questionable area of increased opacity is observed in the right infrahilar region on the frontal radiograph, without a definitive correlate on the lateral view. A small linear opacity in the retrocardiac region is unchanged since ___ and probably due to focal scarring. Lungs are otherwise clear, and there are no pleural effusions or acute skeletal findings. IMPRESSION: Nonspecific opacity in right infrahilar region, not fully characterized by chest radiography. If persistent on short-term followup chest x-rays, consider chest CT for more complete evaluation. " 1afbaf76-fdea32b4-f3953183-8daa6a94-913559fc.jpg,validate/p10/p10100177/s58169230/1afbaf76-fdea32b4-f3953183-8daa6a94-913559fc.jpg,validation," FINAL REPORT HISTORY: Right upper quadrant abdominal pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vascularity is normal. The lungs are clear. No pleural effusion, pneumothorax, or focal consolidation is present. No acute osseous abnormalities are seen. IMPRESSION: Normal chest radiograph. " 19afc477-ee797859-63fa9393-f9ccec0c-d8da07e9.jpg,validate/p14/p14982705/s59918331/19afc477-ee797859-63fa9393-f9ccec0c-d8da07e9.jpg,validation," FINAL REPORT HISTORY: Fluid overload, renal failure. COMPARISON: ___. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: Moderate cardiomegaly is unchanged from prior examination. The mediastinal contour is unremarkable. A new consolidation at the right lung base may represent asymmetric pulmonary edema, although it appears out of proportion to only mild central pulmonary vascular congestion with relative lack of interstitial edema elsewhere. A right internal jugular wide-bore catheter terminates at the level of the mid SVC. A left anterior chest wall ICD remains in position with unchanged position of the intracardiac as well as a single extracardiac lead. This extracardiac lead follows a somewhat tortuous path but is unchanged since at least ___. There is no pleural effusion or pneumothorax. IMPRESSION: New focal consolidation at the right lung base which may represent asymmetric edema, although it appears out of proportion to mild central vascular congestion and lack of interstitial edema favoring a diagnosis of pneumonia. Results were discussed over the telephone with Dr. ___ by Dr. ___ at 11:40AM on ___ at time of initial review. " 53621a05-9e228733-f7a91da3-5660925c-65339e28.jpg,validate/p16/p16818936/s59349342/53621a05-9e228733-f7a91da3-5660925c-65339e28.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Left upper quadrant pain, assess for pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate 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 findings in the chest. " 72d45f7c-fe29dada-62ff96dc-5426dc62-cdb2c88f.jpg,validate/p11/p11174141/s56953276/72d45f7c-fe29dada-62ff96dc-5426dc62-cdb2c88f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M needs med clearence // acute process TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to PA and lateral chest radiographs dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are detected. IMPRESSION: No evidence of acute cardiopulmonary process. " ed9628e5-62ce1427-67e04f11-6daf5632-424ef2d1.jpg,validate/p19/p19016834/s55946640/ed9628e5-62ce1427-67e04f11-6daf5632-424ef2d1.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Word finding difficulty, right lower lobe crackles, assess pneumonia. FINDINGS: PA and lateral views of the chest were obtained. The lungs are hyperinflated with markedly widened AP diameter of the chest which is compatible with emphysema. An area of presumed scarring at the right lung base appears stable from most recent prior exam. There is no new consolidation, effusion, or pneumothorax seen. Cardiomediastinal silhouette appears stable. Bony structures intact. IMPRESSION: COPD, scarring at the right lung base. No definite signs of pneumonia or CHF. " 8c5620ff-babb8028-6711d7af-6d71e045-104e64af.jpg,validate/p10/p10635380/s59870515/8c5620ff-babb8028-6711d7af-6d71e045-104e64af.jpg,validation," FINAL REPORT INDICATION: ___M with AMS // evidence of pneumonia TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: There is biapical scarring with superior retraction of the hila as seen on previous exam. Elsewhere, lungs are clear without focal consolidation worrisome for infection or pulmonary edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 2f7cca8e-1a2d2c3a-368a7ac1-335c5b82-5a2f5611.jpg,validate/p13/p13958040/s56732780/2f7cca8e-1a2d2c3a-368a7ac1-335c5b82-5a2f5611.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough. Right upper quadrant pain and tenderness. TECHNIQUE: Chest, PA and lateral. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are unremarkable. There is lung volumes are low. There is no pleural effusion or pneumothorax. Opacities at the lung bases are faint but greater on the right than left. Elsewhere, lungs appear clear. IMPRESSION: Basilar opacities, probably compatible with atelectasis, although developing pneumonia is not excluded. " 14ef4218-1bd0ac26-442df5f4-0556de15-24226173.jpg,validate/p17/p17763551/s55464006/14ef4218-1bd0ac26-442df5f4-0556de15-24226173.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p cabg and ct removal // r/o ptx IMPRESSION: In comparison to prior radiograph of 1 day earlier, various support and monitoring devices have been removed with residual Swan-Ganz catheter in place. Small to moderate right apical pneumothorax was probably present in retrospect on the previous radiograph but more difficult to detect due to supine positioning of the patient on the prior study. Tiny left apical pneumothorax is new following removal of left chest tube. Exam is otherwise remarkable for pulmonary vascular congestion, worsening bibasilar atelectasis, and probable small bilateral pleural effusions. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 1:37 PM, 15 minutes after discovery of the findings. " 3a83b4ee-99fbe928-a83618b9-270f20ea-c3cea3a8.jpg,validate/p16/p16911517/s56338189/3a83b4ee-99fbe928-a83618b9-270f20ea-c3cea3a8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fatigue, cough // ? pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided Port-A-Cath terminates in the upper to mid SVC without evidence of pneumothorax. No focal consolidation is seen. There is no pleural effusion. Cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " 7fd829f7-d00ca3dd-478bc665-cbd592e3-bdebe210.jpg,validate/p11/p11897283/s58470516/7fd829f7-d00ca3dd-478bc665-cbd592e3-bdebe210.jpg,validation," 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. " fc19b695-81bb62ee-64f7fe5d-fcef9fcd-317d71e3.jpg,validate/p11/p11242103/s50141318/fc19b695-81bb62ee-64f7fe5d-fcef9fcd-317d71e3.jpg,validation," FINAL REPORT INDICATION: Patient with chest pain. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. There is no focal consolidation, pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pneumothorax. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " 94c13f24-bbbcb841-e8232965-c19e8ccd-6f1720e6.jpg,validate/p19/p19332871/s53778413/94c13f24-bbbcb841-e8232965-c19e8ccd-6f1720e6.jpg,validation," FINAL REPORT INDICATION: Recent hernia repair, now hypoxic and tachypneic. COMPARISON: ___. FINDINGS: Portable AP chest radiograph demonstrates low lung volumes with bibasilar opacifications that may be due to fluid overload, however, an infectious etiology cannot be excluded. The right Port-A-Cath terminates in the standard position. The NG tube courses below the diaphragm and terminates in the right upper quadrant. TIPS is noted. The heart size is mildly enlarged. " 6e149a20-d3fc0d0f-f9f5a4f6-b80ce3ec-7c6de31c.jpg,validate/p14/p14964445/s50885007/6e149a20-d3fc0d0f-f9f5a4f6-b80ce3ec-7c6de31c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with sudden onset of severe back pain 5 days ago / TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph FINDINGS: Mild enlargement of the cardiac silhouette is again noted with left ventricular predominance. The aorta is tortuous but unchanged mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. Lung volumes are low with streaky and linear opacities in the lung bases compatible with atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. The osseous structures are diffusely demineralized with compression deformity of a vertebral body at the thoracolumbar junction appearing unchanged. IMPRESSION: 1. Low lung volumes with bibasilar atelectasis. 2. Diffuse osteopenia with compression deformity at the thoracolumbar junction appearing unchanged. Please note that the assessment for compression fractures is limited given the presence of osteopenia and if there is high concern for a vertebral body fracture, CT is recommended. " 7cdf33b5-67d1f915-5c0404ce-18ea34c9-07845291.jpg,validate/p11/p11123733/s56359769/7cdf33b5-67d1f915-5c0404ce-18ea34c9-07845291.jpg,validation," WET READ: ___ ___ ___ 5:05 PM Mild pulmonary edema. Left lower lobe collapse. Increased bilateral pleural effusions, left greater than right. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with abd pain, shortness of breath, hypoxia, altered mental status // CT heal: eval for ICHCT A/P: eval for pancreatitic stent locationCXR: eval for consoldiation TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is chest radiographs from ___ and ___. FINDINGS: There are low lung volumes with collapse of the left lower lobe. There is mild pulmonary edema. There is a small right and a small moderate left pleural effusions, increased from prior exam. Median sternotomy wires and mediastinal clips are noted. IMPRESSION: Mild pulmonary edema. Left lower lobe collapse. Increased bilateral pleural effusions, left greater than right. " f85812ba-2ba17cc1-f47be311-f81d0568-c1f0e172.jpg,validate/p10/p10668217/s53831270/f85812ba-2ba17cc1-f47be311-f81d0568-c1f0e172.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with pleuritic pain felt at epigastrium 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. No subdiaphragmatic free air is present. Clips from prior cholecystectomy are noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 06258a3c-6f2fed47-f6fdc864-c31275ce-0322fe4e.jpg,validate/p17/p17424385/s55338219/06258a3c-6f2fed47-f6fdc864-c31275ce-0322fe4e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with stage II renal cell cancer, for intrathoracic disease. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is top normal, stable. Mediastinum is stable. Lungs are essentially clear. Of note is nodular opacity projecting over the left lower lung, approximately 8.5 mm in diameter, not clearly seen on prior examination. Given patient's history, re-assessment with chest CT is required for precise characterization of this abnormality. There is no pleural effusion or pneumothorax. " dfe9ac46-aba6b34f-32f29cea-b2dcde02-45d54265.jpg,validate/p15/p15405794/s52944528/dfe9ac46-aba6b34f-32f29cea-b2dcde02-45d54265.jpg,validation," FINAL REPORT HISTORY: Pneumothorax status post VATS. COMPARISON: ___ at 10:45. FINDINGS: Single frontal view of the chest. No current convincing evidence of pneumothorax. Bibasilar atelectasis and low lung volumes persist. No pleural effusion. Heart size and cardiomediastinal contours are normal. IMPRESSION: No convincing evidence of PTX " 9f25bb20-8b7dd9da-fdeee447-00d9507c-82a01214.jpg,validate/p11/p11424300/s50302206/9f25bb20-8b7dd9da-fdeee447-00d9507c-82a01214.jpg,validation," 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 lungs appear clear. A fracture of the proximal left humerus is not imaged in detail on this examination, but is better characterized on a separate series from the same day. Mild degenerative changes affect the lower thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. " 7acaf016-46c0f28e-fd9faec0-02308070-70201f8d.jpg,validate/p10/p10361825/s58481436/7acaf016-46c0f28e-fd9faec0-02308070-70201f8d.jpg,validation," 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. " e73acf8e-2dbe490d-5477abdc-ecbd5ec3-3e84c5e4.jpg,validate/p11/p11990968/s54314565/e73acf8e-2dbe490d-5477abdc-ecbd5ec3-3e84c5e4.jpg,validation," WET READ: ___ ___ ___ 7:00 PM Cardiomegaly. Please ___ with subseq CTA chest WET READ VERSION #1 WET READ VERSION #2 ___ ___ ___ 6:56 PM Large pericardial effusion concerning for tamponade. Unknown etiology. Recommend pericardial window. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with chest pain, palpitations. COMPARISON: Comparison is made with a prior study from ___. FINDINGS: PA and lateral views of the chest were provided. The heart remains moderately enlarged. Trace pleural effusion is again noted. There is no evidence of pneumonia or pneumothorax. Bony structures are intact. IMPRESSION: Stable cardiomegaly with a trace pleural effusion. Please refer to subsequent CTA chest for further details. " d5230f60-af196644-e4abc8a4-a682ce17-043d6c20.jpg,validate/p13/p13948850/s58707560/d5230f60-af196644-e4abc8a4-a682ce17-043d6c20.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and difficulty swallowing. COMPARISON: ___, ___, ___. FINDINGS: PA and lateral chest radiographs. The patient is rotated to the right. Chronic linear atelectasis in the left lower lobe is again noted. However, there is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Again noted is a hiatal hernia. IMPRESSION: No acute cardiopulmonary process. " 1135a0a6-3628de77-2ae1d626-589f03a5-d4bc1ad4.jpg,validate/p15/p15459210/s58161594/1135a0a6-3628de77-2ae1d626-589f03a5-d4bc1ad4.jpg,validation," FINAL REPORT HISTORY: ___M with recent Whipple p/w fungemia. COMPARISON: ___. FINDINGS: AP upright and lateral views the chest were provided. There is a right upper extremity PICC line. With its tip at the level of the right axilla. Midline sternotomy wires and mediastinal clips are unchanged. There is an AICD with leads extending into the region of the right ventricle. The heart remains mildly enlarged. There is no focal consolidation, effusion, or pneumothorax. No overt edema is present. Clips in the upper abdomen noted. IMPRESSION: Right arm PICC line tip in the right axilla. Mild cardiomegaly. " b3323ecd-08d84d02-b71a8366-d6f1ba88-f62cea20.jpg,validate/p19/p19982872/s58149247/b3323ecd-08d84d02-b71a8366-d6f1ba88-f62cea20.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain // eval for acute process COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 5d0b2c23-01ced0aa-38c9e66e-5e6d763f-8b0effd1.jpg,validate/p12/p12297844/s56778175/5d0b2c23-01ced0aa-38c9e66e-5e6d763f-8b0effd1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cardiac arrest // ? worsening PTX TECHNIQUE: Portable chest COMPARISON: ___ at ___. FINDINGS: There is increase in a bandlike area of the left upper lung of dense consolidation. Given history of cardiac arrest is unclear if this is due to contusion/hemorrhage a left lateral pneumothorax is now more clearly visualized. There is a large amount of subcutaneous emphysema that is increased compared to prior. The ET tube is 6 cm above the Carina. NG tube tip is in the stomach. IMPRESSION: Worsened appearance of the left lung " 297f5f89-684b945f-e937aab9-21604add-5e71244b.jpg,validate/p15/p15200162/s57688503/297f5f89-684b945f-e937aab9-21604add-5e71244b.jpg,validation," FINAL REPORT INDICATION: ___ y/o man with chest pain. COMPARISON: Chest radiograph ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: The lungs are fully expanded and clear. The cardiomediastinal and hilar contours are normal. Surgical clips project over the right axilla. Median sternotomy wires are noted. There is no pleural effusion or pneumothorax. Pleural surfaces are unremarkable. IMPRESSION: No acute cardiopulmonary process. " c0bf3e36-975f43a0-486c68e5-89bc244f-068f695e.jpg,validate/p16/p16421524/s55646184/c0bf3e36-975f43a0-486c68e5-89bc244f-068f695e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Please perform exam at 5am on ___.___ year old man with pneumothorax after impailed chest on metal fence. Pls perform standing, expiratory PA and lateral films. // Please perform exam at 5am on ___.Is pneumothorax stable compared to prior films? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the known right pneumothorax is unchanged. No evidence of tension. Appearance of the cardiac silhouette and of the left lung persist. " a1fa7fcf-a1bd79c4-2dc63be8-7bc36fef-e8ae0954.jpg,validate/p11/p11306899/s59247402/a1fa7fcf-a1bd79c4-2dc63be8-7bc36fef-e8ae0954.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of ovarian cancer, shortness of breath, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. The right chest tube was removed. Small dorsal pleural effusion, seen on the previous examination and better seen on the lateral than on the frontal image, is unchanged. Unchanged alignment of sternal wires. Unchanged size of the cardiac silhouette. No new parenchymal opacity. Known calcified granuloma at the right lung apex, projecting over the clavicle. " f4a7a8b8-9cd16bba-0c745a43-737c2be5-8b5268fc.jpg,validate/p14/p14314096/s53432942/f4a7a8b8-9cd16bba-0c745a43-737c2be5-8b5268fc.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with left foot drop, preop evaluation. 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. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 282ec689-45f1fd8f-a445e66f-623bc4b0-bc41ccc4.jpg,validate/p18/p18131667/s55408501/282ec689-45f1fd8f-a445e66f-623bc4b0-bc41ccc4.jpg,validation," WET READ: ___ ___ 10:20 AM 1. No definite radiographic evidence for acute cardiopulmonary process. 2. Rounded opacity overlying the left lower lung field. Recommend repeat radiograph with nipple markers. ______________________________________________________________________________ FINAL REPORT HISTORY: Immunosuppressed, now with fever. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. FINDINGS: No definite focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. A rounded density is seen overlying the left lower lung field on the anterior projection, without a correlate on the lateral view, and likely represents a nipple shadow. The cardiomediastinal silhouette is stable. No acute bony abnormality is detected. IMPRESSION: 1. No definite radiographic evidence for acute cardiopulmonary process. 2. Rounded opacity overlying the left lower lung field. Recommend repeat radiograph with nipple markers. " 0ab1bfef-a8647799-1fc8efb6-24cc8665-b0af86b3.jpg,validate/p19/p19920828/s51300870/0ab1bfef-a8647799-1fc8efb6-24cc8665-b0af86b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with history of herniated discs, neck and back pain with saddle anesthesia and no rectal tone 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. " ee12ec95-609e9ca0-ee827602-3f40e873-35addc83.jpg,validate/p10/p10554304/s57854819/ee12ec95-609e9ca0-ee827602-3f40e873-35addc83.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___ through ___. FINDINGS: AP and lateral AP and lateral chest radiographs were obtained. Lung volumes are low. Interstitial markings are prominent. There are bibasilar septal lines and thickening of the right minor fissure. The mediastinum is not widened. IMPRESSION: Severe interstitial pulmonary edema. " 267ab423-9c785bc4-08ead19d-23bdff7d-fd7e8792.jpg,validate/p18/p18718102/s57941906/267ab423-9c785bc4-08ead19d-23bdff7d-fd7e8792.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis. intubated // eval for interval change COMPARISON: ___ at 22:02 FINDINGS: The ET tube tip lies slightly above the level of the clavicular heads approximately 4.2 cm above the carina. The right subclavian central line tip overlies the cavoatrial junction. An NG tube is present. Due to underpenetration is difficult to trace through the lower mediastinum into the abdomen. The cardiomediastinal silhouette is unchanged. Again seen are diffuse patchy opacities in both lungs. The distribution and density appears similar to the prior study. The foci themselves appear slightly less distinct, but I suspect this is predominantly due to technique and slight motion. IMPRESSION: 1. ET tube tip appears slightly higher than on yesterday's exam. NG tube not well visualized in the lower mediastinum, due to technical factors. 2. Otherwise, I doubt significant interval change. Diffuse bilateral parenchymal abnormalities are similar to the prior exam. Please see comment above. " f296006b-def651c7-f009fb6c-a9326249-492a54c0.jpg,validate/p17/p17011846/s52796254/f296006b-def651c7-f009fb6c-a9326249-492a54c0.jpg,validation," FINAL REPORT INDICATION: Chest pain. Evaluation for infection or rib fracture. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate low lung volumes and bibasilar opacities most consistent with atelectasis given the lack of corresponding findings on lateral view. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable. No fracture is identified. " c85ce85c-b2c48160-183fae49-b65bbd08-9647c849.jpg,validate/p15/p15345462/s52468354/c85ce85c-b2c48160-183fae49-b65bbd08-9647c849.jpg,validation," WET READ: ___ ___ ___ 12:28 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M w/chest pain and fever, please eval for pna, mediastinal widening // ___M w/chest pain and fever, please eval for pna, mediastinal widening 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. IMPRESSION: No acute cardiopulmonary abnormality. " f6839fe2-bce1e01a-6dabaa82-12c11c9e-4cc0c24e.jpg,validate/p13/p13732430/s52237398/f6839fe2-bce1e01a-6dabaa82-12c11c9e-4cc0c24e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with post op fever // post op fever TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: None IMPRESSION: Heart size and mediastinum are unremarkable. Left basal opacity might represent atelectasis or developing infectious process. Rest of the lungs are clear. There is no pleural effusion or pneumothorax. " e61a0e34-286366e3-0f902099-d98ef610-973d2f18.jpg,validate/p12/p12104123/s59868362/e61a0e34-286366e3-0f902099-d98ef610-973d2f18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with shortness of breath. Evaluate for pneumonia, effusion, or pulmonary edema. COMPARISON: Chest radiographs, most recently from ___, dating back to ___. MRCP from ___. FINDINGS: There are low lung volumes with bibasilar subsegmental atelectasis. Pneumonia in these regions cannot be completely excluded. The cardiac silhouette is mildly enlarged, which is chronic. There is no pneumothorax. Pulmonary vascularity is normal. IMPRESSION: Chronic bibasilar subsegmental atelectasis. Pneumonia in these regions cannot be fully excluded. " 4d7f3c69-009d6d2b-83c165b3-0b1cf7a3-5e18ec30.jpg,validate/p17/p17138846/s52185137/4d7f3c69-009d6d2b-83c165b3-0b1cf7a3-5e18ec30.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ankle fx // pre-op Surg: ___ (ORIF left ankle) pre-op IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. No evidence of pneumonia, vascular congestion, or pleural effusion. " 04dde993-c1d2d8dc-07516196-d8ea36a7-fb6cf86d.jpg,validate/p10/p10206502/s50085097/04dde993-c1d2d8dc-07516196-d8ea36a7-fb6cf86d.jpg,validation," FINAL REPORT HISTORY: Persistent cough x2 weeks, fevers, shortness of breath. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___, and CT torso dated ___. FINDINGS: Median sternotomy wires are noted to be aligned and intact. A biventricular pacing system is seen with leads terminating in right atrium, right ventricle, and left anterior oblique marginal vein. Additionally noted are wires from a prior right pacemaker. Redemonstrated are stable interstitial markings, most prominent in the bilateral lung bases, and consistent with the patient's known interstitial lung disease. There is no focal consolidation, overt pleural effusion, pneumothorax, or pulmonary edema identified. The heart size is normal. The aorta is noted to be tortuous. Mediastinal and hilar contours are otherwise unchanged. IMPRESSION: Stable interstitial lung disease. No evidence of acute cardiopulmonary process. " 33864ac8-7d178ca6-2b35ee5a-20ba2a4e-775f9994.jpg,validate/p17/p17634496/s59307840/33864ac8-7d178ca6-2b35ee5a-20ba2a4e-775f9994.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old ___ man with h/o psoriasis who will be starting TNFalpha inhibitor treatment with positive quantiferon gold test. He is otherwise asymptomatic // Please assess for signs of tuberculosis Please assess for signs of tuberculosis IMPRESSION: Comparison to ___. 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 evidence of TB. " ba962cba-46a97567-7a12e70c-306fc0c1-0d9ebbe0.jpg,validate/p11/p11677206/s51825061/ba962cba-46a97567-7a12e70c-306fc0c1-0d9ebbe0.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with tiny right apical pneumothorax. evaluate for stability. Please perform at 2pm on ___. thank you. // ? stable right pneumothorax. TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___, and ___ and CT chest from ___. . FINDINGS: The lungs are well expanded. The mass is again noted in the right upper lung laterally. There is no pleural effusion. The previously seen right apical pneumothorax has resolved. The cardiomediastinal silhouette is unremarkable. IMPRESSION: 1. Resolved right apical pneumothorax. 2. Mass in the right upper lung laterally, similar prior exam. " b61d6ea7-86337e7b-a45f71ca-ab8729de-3ed7c515.jpg,validate/p17/p17006872/s58375724/b61d6ea7-86337e7b-a45f71ca-ab8729de-3ed7c515.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with recurrent pneumothorax and a broken right chest drain, to evaluate for pneumothorax. COMPARISON: Chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPHS: Again seen is a right chest tube terminating in the right apical pleural space. Small right apical pneumothorax, is slightly larger since the prior study of ___. Evidence of prior sub-segmental resection is seen in the right upper lobe. The left lung is clear, without consolidation, pleural effusion, or pneumothorax. IMPRESSION: Small right apical pneumothorax, larger in size since the prior study. " 92f54698-089af0d6-730d5104-82b693d5-8420be8a.jpg,validate/p15/p15438558/s50937588/92f54698-089af0d6-730d5104-82b693d5-8420be8a.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with history orthopnea/PND, who presents for evaluation. COMPARISON: Chest radiographs from ___, ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal borders are unremarkable. The lungs are well expanded and clear. There is no pneumothorax. There is a small right sided pleural effusion. The visualized osseous structures are unremarkable. IMPRESSION: No acute abnormalities identified to explain patient's orthopnea/PND. " 8c3fcc91-d4435511-9936719f-481d6709-dbbc3687.jpg,validate/p16/p16330120/s54128999/8c3fcc91-d4435511-9936719f-481d6709-dbbc3687.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS CLINICAL HISTORY: Cough and chest pain. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The lung volumes are low. The lungs appear clear within the limitations of technique. The heart is at the upper limits of normal size with a left ventricular configuration. There is no pleural effusion or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " feb66c55-95ae0541-4fe71674-3ad29a22-03ed6e87.jpg,validate/p16/p16646862/s58501968/feb66c55-95ae0541-4fe71674-3ad29a22-03ed6e87.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CTA chest from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Weakness and dizziness, assess infection. FINDINGS: PA and lateral views of the chest were provided. The heart is top normal in size, and there is mild central hilar congestion with mild interstitial edema. No large effusion or pneumothorax. Linear density at the level of the minor fissure likely represents atelectasis or scarring. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild edema. Top normal heart size. " 5e9196e5-ae35dafe-8583a894-a2d06917-32e72863.jpg,validate/p17/p17396841/s53398311/5e9196e5-ae35dafe-8583a894-a2d06917-32e72863.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DAH, ILD, s/p PEA arrest, intubated // eval for interval change eval for interval change COMPARISON: Comparison to ___ at 05:16 FINDINGS: Portable semi-erect chest radiograph ___ at 04:36 is submitted. IMPRESSION: Nasogastric tube, endotracheal tube and right internal jugular central line unchanged in position. Overall cardiac mediastinal contours are stable given differences in patient positioning. Bilateral parenchymal opacities with a more consolidative appearance at the left base are likely not significantly changed given differences in technique between studies and are consistent with reported NSIP. Pneumonia or aspiration at the left base cannot be excluded. There is residual right chest wall subcutaneous emphysema. No obvious pneumothorax. " 1d14b5c9-11508caf-d56ca05e-08500ad7-0aa2c4a0.jpg,validate/p11/p11185907/s50152426/1d14b5c9-11508caf-d56ca05e-08500ad7-0aa2c4a0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F mech fall 4 steps at 5AM +HS -___ w/ possible C1 lateral mass fx and L rib fxs ___ w/ L tension PTX s/p L CT placement // -dc'ed chest tube ?pneumo,Please do at 1:30 am COMPARISON: Chest from ___ FINDINGS: Again seen is background COPD and hyperinflation. Multiple left-sided rib fractures are again noted. The previously seen pigtail catheter has been removed. Probable small pneumothorax seen anteriorly on the lateral view. A very small left effusion is again noted. The small right pleural effusion persists. No definite right-sided pneumothorax detected, though the lucency at the right lung base remains visible. A thin curvilinear density at the right lung apex is noted, but does not clearly represent a pneumothorax. Cardiomediastinal silhouette is unchanged. Again seen is upper zone redistribution, without overt CHF. Minimal subsegmental atelectasis and/or scarring at both bases again noted. Nodular density at the right mid/lower zone laterally is again noted. IMPRESSION: Interval removal of left pigtail catheter. Small residual pneumothorax, with small fluid levels, is noted. No definite right-sided pneumothorax. Please see comment above. Attention to this area on followup films is requested. Upper zone redistribution, without overt CHF, unchanged. Small right greater left effusions again noted, without significant change Right lower lung nodule again noted. Please see separate report of ___ CT scan, recommending repeat chest CT in ___ months to evaluate this nodule. " 038ef1e7-7499e48d-9a86072d-a2ea81eb-25f7a27b.jpg,validate/p15/p15964158/s50425561/038ef1e7-7499e48d-9a86072d-a2ea81eb-25f7a27b.jpg,validation," 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. " b976cc83-6d65e799-1756e13a-f30fe922-8c99169e.jpg,validate/p16/p16891573/s50927114/b976cc83-6d65e799-1756e13a-f30fe922-8c99169e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with tachycarda poor historian altered ms 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. " 753d457b-778cce8d-356811d3-b6056edb-f6bab225.jpg,validate/p16/p16376495/s53505233/753d457b-778cce8d-356811d3-b6056edb-f6bab225.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest discomfort. 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. Nipple shadows are present bilaterally. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " e623eaa6-30d6dc85-8ac75f9c-ae0975e2-8eea27cd.jpg,validate/p16/p16980933/s54309625/e623eaa6-30d6dc85-8ac75f9c-ae0975e2-8eea27cd.jpg,validation," WET READ: ___ ___ ___ 7:23 PM Displaced fracture along the posterior aspect of the left 7th rib. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain and dyspnea after heavy lifting. Also with left posterior rib pain. Assess for acute intrathoracic process and/or fracture. COMPARISON: None. 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. Discontinuity of the cortex along the posterior aspect of the left seventh rib is consistent with a minimally displaced fracture. Subtle irregularity of the posterior 8th rib may represent a non-displaced fracture. IMPRESSION: 1. Minimally displaced fracture involving the posterior arch of the left seventh rib, and possibly also the left posterior 8th rib. 2. No pneumothorax. " cec87917-2bb90d79-4354184f-9679e2c1-35f05ae0.jpg,validate/p19/p19441625/s56210855/cec87917-2bb90d79-4354184f-9679e2c1-35f05ae0.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: An influenza, status post pneumonia, evaluation for resolution of changes. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, pre-existing parenchymal opacities, terminating at the right lung bases, have almost completely resolved. Only subtle peribronchial scars are seen on today's image. There is no evidence of secondary changes such as adenopathy or pleural effusion. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. " a19ce87f-aebb3a5e-cf200cc8-2f7e9981-06896b1b.jpg,validate/p15/p15403852/s52758965/a19ce87f-aebb3a5e-cf200cc8-2f7e9981-06896b1b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with tachypnea // interval change/eval for acute process COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: The right-sided dialysis catheter is unchanged in position. Tracheostomy position is stable. There is no pneumothorax. There has been some improvement in the previously noted patchy density in the left mid and lower lung zones. There is no new consolidation or pneumothorax. There is a probable small left pleural effusion. " ec7b4999-261c4347-1c5c15b4-081f30c7-dba6fcda.jpg,validate/p19/p19047476/s55860869/ec7b4999-261c4347-1c5c15b4-081f30c7-dba6fcda.jpg,validation," FINAL REPORT HISTORY: ___. COMPARISON: ___. FINDINGS: AP and lateral views of the chest demonstrates a tortuous aorta with calcified aortic knob, as well as dilatation of the ascending aorta. Bibasilar atelectasis is present. Multiple tiny nodules verses vessels on end appear to be present in the lungs all sub 3 mm and benign appearing on this radiograph. Cardiac size is normal. No pleural effusion or pneumothorax. A veterbra plana deformity of the mid thoracic veterbral body is noted, age indeterminate. IMPRESSION: 1. Ascending aortic aneurysm. 2. No evidence of acute pulmonary process. 3. Veterbra plana deformity of T8, better seen on the MR from the same day. " bdfe5775-a0b22b2b-810ce2b4-88bc5e90-a231462d.jpg,validate/p10/p10417060/s52806303/bdfe5775-a0b22b2b-810ce2b4-88bc5e90-a231462d.jpg,validation," WET READ: ___ ___ ___ 2:25 AM Persistent mildly displaced distal right clavicular fracture with interval increase soft tissue superior to fracture site most consistent with a hematoma. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with shortness of breath. Assess for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Clavicular radiograph ___, CT chest ___. FINDINGS: The lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour and hila are unremarkable. Again seen is a mildly displaced distal right clavicular fracture with interval increase in soft tissue density projecting superiorly most consistent with a hematoma. IMPRESSION: Persistent mildly displaced distal right clavicular fracture with interval increase soft tissue superior to fracture site most consistent with a hematoma. " dd509917-9df19fc9-69d168a1-57363753-883b41f9.jpg,validate/p11/p11304959/s53490931/dd509917-9df19fc9-69d168a1-57363753-883b41f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SOB, CHF vs pneumonia sepsis // Interval change Interval change IMPRESSION: In comparison with the earlier study of this date, there is little interval change in the enlargement of the cardiac silhouette with elevation of pulmonary venous pressure and left pleural effusion with compressive basilar atelectasis. The lateral view shows that there is increased opacification just behind 1 of the major fissures and possibly also just anterior to the fluid collections. In view of the clinical history, this is worrisome for developing pneumonia " 090098c8-8bae1e65-477302dc-d375d38d-16152761.jpg,validate/p18/p18770942/s57971510/090098c8-8bae1e65-477302dc-d375d38d-16152761.jpg,validation," WET READ: ___ ___ 8:29 PM Moderate to severe cardiomegaly with globular configuration, cardiomyopathy versus pericardial effusion, which could be considered, with mild to moderate edema. No free air. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Abdominal pain. Question perforation. COMPARISONS: None. TECHNIQUE: Chest, portable AP upright. FINDINGS: The heart is moderate-to-severely enlarged with globular configuration. This could relate to cardiomyopathy, but pericardial effusion could yield this appearance as well. There is upper zone redistribution of enlarged indistinct pulmonary vessels, suggesting mild to moderate edema. The retrocardiac space in the left lower lobe is under-penetrated and accordingly difficult to assess, although not necessarily abnormal. There is no definite pleural effusion on the right; it is difficult to assess for one on the left. There is no free air. IMPRESSION: 1. Marked enlargement of the cardiac silhouette. Dilated cardiomyopathy or pericardial effusion should be considered as possible etiologies. 2. Findings suggesting mild-to-moderate pulmonary vascular congestion. 3. No evidence for free air. 4. Limited visualization of the left lung base owing to portable technique and underpenetration associated with attenuation of soft tissues. If physical findings or other concern referred to the site, then follow-up radiographs could be considered, preferably with PA and lateral technique, if possible. " f3ef0d3f-fa2f717a-0e4ba266-15c07acb-78413453.jpg,validate/p12/p12902262/s52301401/f3ef0d3f-fa2f717a-0e4ba266-15c07acb-78413453.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with dCHF, pulmonary hypertension, dyspnea. // Please assess for edema, interval change. EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Portable Chest radiograph, frontal view COMPARISON: Chest radiograph ___. Chest radiograph ___ FINDINGS: There is acute consolidation of left lower lobe which could be due to atelectasis but pneumonia cannot be ruled out. There is bilateral small to moderate pleural effusions. Moderate to severe cardiomegaly is unchanged. Hiatal hernia is again noted. IMPRESSION: Acute left lower lobe collapse can be due to atelectasis but pneumonia cannot be ruled out. " ecba3b38-d5e84810-05844209-b048c56d-24f8741c.jpg,validate/p14/p14847272/s59162939/ecba3b38-d5e84810-05844209-b048c56d-24f8741c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with fall // eval infiltrate COMPARISON: ___ and ___. FINDINGS: AP upright and lateral views of the chest provided. The lungs remain largely clear. Please note, the subtle tree-in-___ opacity seen on CT performed earlier today, not clearly visualized. No large effusion or pneumothorax. Cardiomediastinal silhouette appears stable. Bony structures are intact. IMPRESSION: As above " 8814918d-6a9976e3-89bb16eb-dae0807a-dcb6449f.jpg,validate/p12/p12489152/s53623799/8814918d-6a9976e3-89bb16eb-dae0807a-dcb6449f.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain under right breast and sternum. Postop hysterectomy. COMPARISON: ___. FINDINGS: Frontal 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. No free air detected below the hemidiaphragm. IMPRESSION: No acute cardiopulmonary process. " 06f0b4d7-33dda27e-ef6bb974-83aec7e3-69f30794.jpg,validate/p11/p11231984/s59567076/06f0b4d7-33dda27e-ef6bb974-83aec7e3-69f30794.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M status post altercation, dementia, paranoia TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Cardiac silhouette size is mildly enlarged. The aorta is tortuous. Hilar contours are normal. Pulmonary vasculature is not engorged. Linear opacities within the left lung base are compatible with subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. The osseous structures are diffusely demineralized with H-type configuration of the vertebral bodies diffusely. IMPRESSION: No acute cardiopulmonary abnormality. " 740ad370-b2aa42a1-ad9385a5-bcd8c93f-c0ff702b.jpg,validate/p11/p11573149/s56466109/740ad370-b2aa42a1-ad9385a5-bcd8c93f-c0ff702b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have slightly increased. Parenchymal opacities predominating in the upper and mid lung zones are unchanged. Unchanged areas of moderate pulmonary edema. An aortic balloon pump is in unchanged position, with the tip projecting 5 mm below the top aspect of the aortic arch. Right internal jugular vein catheter. No pleural effusions. " bc7b8a9d-d9181926-3344b231-11495605-38f74648.jpg,validate/p11/p11786671/s52039375/bc7b8a9d-d9181926-3344b231-11495605-38f74648.jpg,validation," FINAL REPORT INDICATION: ___M with recent appendectomy now 3 days wound infection, recent chest pain, bronchospasm, bibasilar crackles, hx asthma. // eval ? compressive atelectesis, infiltrate, free air TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Extremely low lung volumes are again noted. Bibasilar opacities are therefore likely secondary to atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is unchanged. No acute osseous abnormalities. No free air seen below the diaphragm. IMPRESSION: Limited exam with low lung volumes. Bibasilar opacities are likely atelectasis noting that infection cannot be excluded. " 27a14963-c5ff46c8-8f407c57-9f98abe6-1b2a9648.jpg,validate/p16/p16426000/s50656115/27a14963-c5ff46c8-8f407c57-9f98abe6-1b2a9648.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right first rib resection and entry intro pleural space. // assess for evolution of pneumothorax, PLEASE PERFORM STUDY AT 5 AM ___ assess for evolution of pneumothorax, PLEASE PERFORM STUDY A IMPRESSION: In comparison with the study of ___, there is a right chest tube in place with almost complete re-expansion of the right lung. No evidence of pneumonia or vascular congestion. " 50826a36-cd949ff0-0f128322-c29eade7-b9187d8c.jpg,validate/p10/p10585182/s50982628/50826a36-cd949ff0-0f128322-c29eade7-b9187d8c.jpg,validation," WET READ: ___ ___ ___ 7:28 AM Patchy diffuse opacities worse at the right apex and right lower lobe are concerning for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with hyperglycemia, hypoxia // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is severe dextroscoliosis of the thoracic spine. Platelike scarring in the left mid lung is unchanged. Diffuse patchy opacities are worse at the right lung apex and right lung base. There is mild cardiomegaly. A right chest port ends in the mid SVC. IMPRESSION: Patchy diffuse opacities worse at the right apex and right lower lobe may represent multifocal pneumonia or asymmetric pulmonary edema. " e5241a8f-911c8c80-43e823b1-9fca0465-66f54aec.jpg,validate/p12/p12911473/s54436622/e5241a8f-911c8c80-43e823b1-9fca0465-66f54aec.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Evaluate NG tube. NG tube tip is in the antrum of the stomach. This examination was centered in the thoracoabdominal region, the upper lungs were not included on the field of view. Bibasilar opacities, larger on the left side, are unchanged from ___. Multiple surgical clips project in the right upper quadrant. Cardiac size is top normal. " 921b6adc-c25943fc-4b50f591-4f62a8ca-466ec8e9.jpg,validate/p18/p18160122/s56417792/921b6adc-c25943fc-4b50f591-4f62a8ca-466ec8e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with febrile neutropenia and cough, evaluate for pneumonia COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. Pulmonary vasculature is normal. Cardiomediastinal and hilar contours are normal. Pleural surfaces are normal. Right sided central catheter terminates in the low SVC. There is no pneumothorax. IMPRESSION: No pneumonia. " daf9ac33-9aedd927-f921c4fb-0fb4bf90-26fb9b42.jpg,validate/p17/p17846379/s50274769/daf9ac33-9aedd927-f921c4fb-0fb4bf90-26fb9b42.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Worsening rhonchi, evaluation for interval change. COMPARISON: ___, 4:32 a.m. FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. There might be an interval increase in extent of the pre-existing left pleural effusion, the right pleural effusion is unchanged. Unchanged relatively extensive areas of bilateral basal atelectasis. No evidence of pneumonia. Unchanged mild pulmonary edema. " cd5200fa-e598eeaf-13b2722e-b3da61bf-bba9e97e.jpg,validate/p14/p14464902/s51503811/cd5200fa-e598eeaf-13b2722e-b3da61bf-bba9e97e.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with status post cardiac arrest, question infection. COMPARISON: ___. FINDINGS: In comparison with the prior exam, continued asymmetric resorption of the pulmonary edema has occurred. While opacities still exist, given the rate of resorption, it would be premature to call this pneumonia, although this is a possibility. No pleural effusion is present. Cardiac size is still enlarged. Pacemaker leads terminating in unchanged correct position. IMPRESSION: Improvement in the previously mild pulmonary edema. " dbe0d9e8-c6e23215-995dc1f9-06d417f0-175eff73.jpg,validate/p12/p12831893/s51119959/dbe0d9e8-c6e23215-995dc1f9-06d417f0-175eff73.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with mvc, sob, 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 unremarkable. No pulmonary edema is seen. No displaced fracture is seen. IMPRESSION: Mildly enlarged cardiac silhouette. No pulmonary edema. No displaced fracture seen. " d3a61bf7-afbe86a6-9373eda0-cd2d0863-d83fe252.jpg,validate/p12/p12706696/s50328756/d3a61bf7-afbe86a6-9373eda0-cd2d0863-d83fe252.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pacemaker // pls perform a CXR prior to the MRI, as requested by radiology pls perform a CXR prior to the MRI, as requested by radiolog FINDINGS: Lungs are well expanded and essentially clear. Borderline cardiomegaly is unchanged. There is no edema pulmonary edema or vascular engorgement. Transvenous right atrial right ventricular pacer leads are continuous from the left gastric pectoral generator. No pneumothorax. " 9f333a0c-60a7770d-00fd9b63-a2a70789-3f032454.jpg,validate/p17/p17554575/s59962973/9f333a0c-60a7770d-00fd9b63-a2a70789-3f032454.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypertension, diabetes, GERD, dyspnea, weakness, question infection or fluid overload. FINDINGS: PA and lateral views of the chest were obtained. The lungs are hyperlucent with widened AP diameter of the chest, suggesting underlying COPD. There is a large retrocardiac opacity which is slightly increased in size compared with the prior study and likely represents a large hiatal hernia. There is no focal consolidation, effusion, or pneumothorax. No signs of CHF. Heart size appears stable. Mediastinal contour reflects an unfolded thoracic aorta. Bony structures are intact though demineralized. IMPRESSION: No pneumonia or CHF. Large hiatal hernia. COPD. " ed40a12b-fbd3f828-266cd49b-ea6e41ef-b3284574.jpg,validate/p10/p10272054/s52182370/ed40a12b-fbd3f828-266cd49b-ea6e41ef-b3284574.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST, AP PORTABLE SINGLE VIEW. INDICATION: ___-year-old female patient with DKA, evaluate for consolidation. FINDINGS: AP single view of the chest has been obtained with patient in upright position. The heart size is within normal limits. No configurational abnormality is identified. Unremarkable appearance of thoracic aorta. The pulmonary vasculature is not congested. No signs of acute parenchymal infiltrates are present and the lateral pleural sinuses are free. No evidence of pneumothorax in the apical area. Skeletal structures of the thorax grossly unremarkable. Multiple contorted wires and lines are overlying the right hemithorax and shoulder area. They must be external. Our records include a previous chest examination dated ___. This examination demonstrated a small left-sided pleural effusion and basal pulmonary changes suggestive of atelectasis. On the present examination, no residuals are seen. IMPRESSION: Normal chest findings as can be identified on portable AP single view examination. " 93fb0dd7-ff2d52c5-2095451c-b03f5cb1-a4ea341c.jpg,validate/p15/p15353701/s51820676/93fb0dd7-ff2d52c5-2095451c-b03f5cb1-a4ea341c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female with history of severe mitral regurgitation (s/p Mitraclip ___ and ___), diastolic heart failure, afib, hypertension, asthma, prior breast cancer, and recent admission for acute decompensated heart failure complicated by hypoxic respiratory failure and cardiogenic shock presented from SNF for dyspnea on ___, requiring CCU admission for BiPAP // interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: There is a interval increase in bilateral interstitial opacities concerning for moderate pulmonary edema. Bilateral pleural effusions, right greater than left, persists. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Moderate pulmonary edema, slightly increased. Persistent right greater than left pleural effusions. " 0dc36079-fe7021e1-0a73359c-7ee5e539-207c9653.jpg,validate/p13/p13560495/s52326439/0dc36079-fe7021e1-0a73359c-7ee5e539-207c9653.jpg,validation," WET READ: ___ ___ ___ 3:12 AM 1. Mild prominence of the right atrial border may be related to patient positioning however small pericardial effusion of the differential. 2. Hypoinflated lungs with bibasilar atelectasis. 3. No definite pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Cough and shortness of breath. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrates hypoinflated lungs with bibasilar, left greater than right atelectasis. Lower lung volumes compared to prior radiograph could potentially accentuate the right heart border and increased prominence of the pulmonary vascularity. Mediastinal contour and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. IMPRESSION: 1. Increased prominence of right heart border and pulmonary vascularity compared to ___ chest radiograph, possibly due to accentuation by lower lung volumes, especially since cardiac echo was normal in ___. Repeat chest radiograph with improved inspiratory level could be performed for confirmation. Alternatively, it if cardiovascular symptoms or signs are present, repeat echo could be performed 2. No pneumonia. NOTIFICATION: The updated findings were discussed by Dr. ___ with ___ QA nurses via email on ___ at 10:03 AM. " ffc207d7-7ce2d68b-0721afec-22122b41-259b0dde.jpg,validate/p11/p11639395/s59947365/ffc207d7-7ce2d68b-0721afec-22122b41-259b0dde.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with wheezing // eval for hyperinflation, parenchymal changes 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 " 028ce6a1-48a516eb-6f63d63a-092a077c-0d3a1096.jpg,validate/p14/p14290495/s51207386/028ce6a1-48a516eb-6f63d63a-092a077c-0d3a1096.jpg,validation," 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. " 57eaeae4-69971d5f-691e2964-57d74846-aa64c934.jpg,validate/p12/p12676094/s55497735/57eaeae4-69971d5f-691e2964-57d74846-aa64c934.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with acute chest pain radiating to the back. COMPARISON: Chest CT from ___. FINDINGS: The lungs are hyperinflated but clear of focal consolidation suspicious for infection. Linear left basilar opacity is seen is most suggestive of atelectasis or scarring. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Hyperinflation without acute cardiopulmonary process. " 80ffa5fc-59326987-5d7fe559-1ae9a329-17040c3e.jpg,validate/p12/p12022180/s52265485/80ffa5fc-59326987-5d7fe559-1ae9a329-17040c3e.jpg,validation," FINAL REPORT INDICATION: Left-sided chest pain. COMPARISON: None available. FINDINGS: The left hilum is slightly larger than expected and may be due to lymph nodes. No other signs of lymphadenopathy are noted. 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. The left hilum is slightly larger than expected and may be due to lymph nodes. A 6 week followup chest radiograph is recommended to evaluate for interval change. " 865be794-25b576cb-9927492d-68e081a2-0ac82491.jpg,validate/p16/p16294326/s54102953/865be794-25b576cb-9927492d-68e081a2-0ac82491.jpg,validation," FINAL REPORT HISTORY: Recent surgery, rule out pneumonia. COMPARISON: Prior chest radiograph and CT torso from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiac silhouette is within normal limits. There is bilateral hilar and right paratracheal lymphadenopathy new since prior examination from ___. A small focal opacity in the right upper lung, projecting over the ___ posterior rib is also new since prior. The right lung is otherwise clear. There is a new small left pleural effusion. Increased opacity at the left lung base is likely reflective of atelectasis. There is no pneumothorax or pulmonary vascular congestion. IMPRESSION: 1. New bilateral hilar and mediastinal lymphadenopathy and small focal opacity in the right upper lung for which further evaluation with a chest CT is recommended. 2. New small left pleural effusion. " 13bcd7af-12f6c28e-e3d421ea-324b368f-51b5c3da.jpg,validate/p11/p11505655/s53119662/13bcd7af-12f6c28e-e3d421ea-324b368f-51b5c3da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // Interval change? COMPARISON: Radiograph from ___. FINDINGS: AP portable upright view of the chest. A right PICC terminates at the mid SVC. The heart is mildly enlarged. The hilar mediastinal contours remain within normal limits. Mild central pulmonary vascular congestion appears new since the ___ examination, with small bilateral pleural effusions. There is no pneumothorax or focal consolidation. An endotracheal tube terminates 4.4 cm above the carina. IMPRESSION: 1. New small bilateral pleural effusions with mild pulmonary vascular congestion. 2. Right PICC terminating at the mid SVC. 3. Endotracheal tube terminates 4.4 cm above the carina. " 5510730f-4ef49593-68e39424-ecc7ad0d-3d2a4873.jpg,validate/p14/p14395025/s51710615/5510730f-4ef49593-68e39424-ecc7ad0d-3d2a4873.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypercapneic resp failure s/p intubation // Eval tube placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___ at 14:___ FINDINGS: There has been interval placement of an endotracheal tube, terminating approximately 6.2 cm above the level of the carina. The lungs remain hyperinflated. There has been interval development of patchy opacity at the left lung base which may be due to atelectasis or aspiration, giving short-term interval. Patchy lateral right apical opacity is again seen, more prominent as compared to chest radiograph from ___, and while could theoretically be related to scarring, given patient is underlying emphysema and COPD and again, nonemergent chest CT recommended to further assess. Right infrahilar opacity may relate to confluence of vascular structures although consolidation underlying pulmonary nodule not excluded. Slight blunting of the left costophrenic angle. Mediastinal contours are stable. Hilar contours are stable. Cardiac silhouette is top-normal. IMPRESSION: Endotracheal tube terminates 6.2 cm above the Carina. Interval development of patchy left basilar opacity, may be due to atelectasis or aspiration given short-term interval. Patchy lateral right apical opacity again seen, more prominent as compared to chest radiograph from ___, and while could theoretically be related to scarring, given patient is underlying emphysema and COPD and again, nonemergent chest CT recommended to further assess. Right infrahilar opacity may relate to confluence of vascular structures although consolidation or underlying pulmonary nodule not excluded. " 0fd4cce4-68a02e27-35ed0ac9-41c03a4d-4f56782b.jpg,validate/p14/p14349552/s55166492/0fd4cce4-68a02e27-35ed0ac9-41c03a4d-4f56782b.jpg,validation," FINAL REPORT INDICATION: Dyspnea. Concern for CHF. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors, most recently on ___. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Mild cardiomegaly is unchanged from multiple priors. There is no pulmonary vascular congestion. IMPRESSION: No evidence for acute pulmonary edema. An attempt was made to call these results to Dr. ___. " 2a3ce2c6-5c24c747-e8034078-f9c2725d-ac133704.jpg,validate/p14/p14540393/s50938361/2a3ce2c6-5c24c747-e8034078-f9c2725d-ac133704.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with COPD and heart failure with worsening cough and fever to 101.5 // r/o PNA r/o PNA IMPRESSION: COMPARED TO PRIOR CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY ___ AND ___ AT 11:48. MILD PULMONARY EDEMA HAS WORSENED SINCE EARLIER IN THE DAY. SEVERE CARDIOMEGALY MEDIASTINAL VENOUS ENGORGEMENT ARE CHRONIC. SMALL RIGHT PLEURAL EFFUSION HAS PROBABLY INCREASED. PATIENT HAS HAD MEDIAN STERNOTOMY AND REPLACEMENT OF TO CARDIAC VALVES. " 9ed38615-028e9356-c449c852-a1b0e5f9-a6d022bf.jpg,validate/p14/p14393219/s55374056/9ed38615-028e9356-c449c852-a1b0e5f9-a6d022bf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fevers for the past two weeks, likely due to ascending cholangitis, but need to rule out pneumonia // Please assess for pneumonia as part of fever workup TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Left-sided Port-A-Cath tip terminates in the mid SVC. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is present. Mild degenerative changes are noted in the lower thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " a2937902-8212a926-34ff6286-a606679f-724aef4a.jpg,validate/p12/p12043836/s54095352/a2937902-8212a926-34ff6286-a606679f-724aef4a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with chest pain and shortness of breath TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ and CT chest ___ FINDINGS: Patient is status post median sternotomy with mitral and tricuspid valve replacements. Moderate to severe cardiomegaly is re- demonstrated, unchanged. Mediastinal and hilar contours are similar with marked mediastinal lymphadenopathy again noted. There has been interval removal of the previously noted left subclavian central venous catheter. Moderate to large loculated right pleural effusion remains unchanged with continued right basilar opacification. Left lung is clear. No pulmonary edema or pneumothorax is seen. No acute osseous abnormality is detected. IMPRESSION: No substantial interval change in appearance of moderate to large loculated right pleural effusion and right basilar opacification. " 814e2b14-2ccb8856-e049ef17-54412e85-103f5cfc.jpg,validate/p17/p17212019/s57130901/814e2b14-2ccb8856-e049ef17-54412e85-103f5cfc.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. Question acute pathology. 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. " 984c4b86-2b9ee2f7-5a94fd04-89046b72-6978b616.jpg,validate/p18/p18574619/s53312152/984c4b86-2b9ee2f7-5a94fd04-89046b72-6978b616.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RUL and possible lingular pneumonia in ___ // evaluate for clearance of pneumonia evaluate for clearance of pneumonia COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Previous pneumonia in the right upper lobe and possibly lingula, has resolved. Lungs are fully expanded and clear. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. " 2b00fd9e-2778d823-5574b6e7-5e014e97-df2b7d72.jpg,validate/p12/p12047910/s51733930/2b00fd9e-2778d823-5574b6e7-5e014e97-df2b7d72.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with syncope TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph, CT chest ___ 14:21 FINDINGS: Patient is status post median sternotomy and CABG. Heart size is mildly enlarged with a moderate hiatal hernia noted. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Patchy opacities are seen in the lung bases, more pronounced on the left, worse in the interval, and may reflect superimposed aspiration on a background of chronic interstitial abnormality. No pleural effusion or pneumothorax is present. Compression deformity of the T12 vertebral body is re- demonstrated. Fractures of the right fifth and sixth lateral ribs are again noted. IMPRESSION: Right fifth and sixth lateral rib fractures. No pneumothorax. Patchy opacities in the lung bases, more pronounced on the left, may reflect superimposed aspiration on a background of chronic interstitial abnormality. Moderate hiatal hernia. " 0c0e3903-2f744a5c-3750bad4-6d772736-6bf1c8a2.jpg,validate/p17/p17763117/s54899257/0c0e3903-2f744a5c-3750bad4-6d772736-6bf1c8a2.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old female patient with delirium, leukocytosis, evaluate for pneumonia. FINDINGS: Patient's condition required examination in sitting upright position using AP frontal view and left lateral views. Comparison is made with the next preceding portable chest examination of ___. As before, there is status post sternotomy. Moderate cardiac enlargement is seen. Previously identified permanent pacer with dual intracavitary electrodes and ICD device in unchanged position. The same holds for the recently placed right-sided PICC line which is now seen to reach in the upper third of the right atrium. Moderate cardiac enlargement as before. No signs of acute CHF and no acute parenchymal infiltrates are present. Lateral and posterior pleural sinuses are free from any fluid accumulation. IMPRESSION: Stable chest findings, no evidence of new acute pneumonia. " 6484c0d4-bb2f652b-fc54c34c-6ed265d7-07aa0d43.jpg,validate/p14/p14130631/s53028604/6484c0d4-bb2f652b-fc54c34c-6ed265d7-07aa0d43.jpg,validation," FINAL REPORT The. EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p bronch // s/p bronch- acute changes s/p bronch- acute changes COMPARISON: Chest radiographs ___ through ___ 4:50 a.m. IMPRESSION: Since ___:50 today, Lung volumes have increase and aeration has improved radiographically, but is not appreciably different than the appearance on ___. This may therefore be due to variation in positive pressure support or variations in pulmonary edema. Moderate right pleural effusion is still present. There is still extensive Extensive infiltrative pulmonary abnormality throughout the right lung and in the left apex. Heart size is normal. Small left pleural effusion has increased since ___. There is no pneumothorax. ET tube in standard placement. Feeding tube passes into the stomach and out of view. " e6d767b8-0a77baa7-a20bf1cd-fa52e5f2-58b3f29d.jpg,validate/p15/p15336847/s57102494/e6d767b8-0a77baa7-a20bf1cd-fa52e5f2-58b3f29d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman PPD#___ s/p SVD c/b wound breakdown of ___ degree laceration and POD#___ s/p lsc diverting colostomy. pt desat w/ambulation, new oxygen req't, cough. +crackles in left lung base. // r/o pna, consolidation, pulm edema COMPARISON: None FINDINGS: AP portable semi upright view of the chest. Diffusely increased interstitial opacities are seen within the lungs which could reflect edema. The left lower lobe is poorly assessed due to underpenetration. No large effusions or pneumothorax is seen. The overall cardiomediastinal silhouette is notable for mild cardiomegaly. The bony structures appear intact. IMPRESSION: Bilateral interstitial opacities concerning for edema. Please correlate clinically. " db92fb2f-ca10e875-c064ced4-5b78574d-b48d0bfe.jpg,validate/p14/p14177324/s56442554/db92fb2f-ca10e875-c064ced4-5b78574d-b48d0bfe.jpg,validation," WET READ: ___ ___ ___ 8:04 AM No acute cardiopulmonary process. WET READ VERSION #1 ___ ___ ___ 6:28 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, dyspnea 2w after URI // Evaluate for pneumonia Evaluate for pneumonia IMPRESSION: In comparison with the study of ___, there is again hyperexpansion of the lungs, but no evidence of acute pneumonia, vascular congestion, or pleural effusion. " df731c91-fd7c4db7-8c98c4e8-19704970-fef73ccf.jpg,validate/p19/p19696298/s55477107/df731c91-fd7c4db7-8c98c4e8-19704970-fef73ccf.jpg,validation," FINAL REPORT HISTORY: Cough, shortness of breath, edema. TECHNIQUE: Upright AP view of the chest. COMPARISON: None. FINDINGS: The heart is moderately enlarged the aorta is unfolded. There are atherosclerotic calcifications of the aortic knob. Mild pulmonary edema is demonstrated with vascular indistinctness and perihilar haziness. There is blunting of the left costophrenic angle which could suggest a trace left pleural effusion. Patchy retrocardiac opacity likely reflects atelectasis. No pneumothorax is demonstrated. There are moderate multilevel degenerative changes in the thoracic spine. IMPRESSION: Mild pulmonary edema with possible trace left pleural effusion. Retrocardiac atelectasis. " 6800fb43-46750f4f-1b6d4a5f-f68da0ae-40b2d965.jpg,validate/p16/p16660031/s50934006/6800fb43-46750f4f-1b6d4a5f-f68da0ae-40b2d965.jpg,validation," FINAL REPORT HISTORY: Cough and fever. Assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are clear. There is no pneumothorax or pleural effusion aside from trace fluid on the minor fissure. Heart and mediastinal contours are unremarkable. IMPRESSION: No acute intrathoracic process. Trace fluid on the minor fissure. " 657bbf8d-df6958ac-fea7f21c-0639404f-4406bb1e.jpg,validate/p11/p11701953/s51820285/657bbf8d-df6958ac-fea7f21c-0639404f-4406bb1e.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON: None. INDICATION: ___-year-old with chronic pleuritic chest pain, intermittent shortness of breath. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear. There is no pulmonary edema, pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " 51655486-8a80752c-e0325692-4b0cee5a-911865df.jpg,validate/p17/p17879369/s55943583/51655486-8a80752c-e0325692-4b0cee5a-911865df.jpg,validation," FINAL REPORT INDICATION: Left-sided pleuritic chest pain. COMPARISON: CT ___, CT abdomen ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Mild atelectasis at the left lung base with left hemidiaphragmatic elevation as seen on the prior CT may be due to gaseous distention of bowel. There is no focal consolidation, pleural effusion, or pneumothorax. A nodule in the right mid lung is better seen on the prior CT. Calcified granulomas are noted in the left mid lung. Cardiac silhouette is top normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: No evidence of pneumonia or pulmonary infarct. " 0cc35e2a-3fadb691-022e47e7-2b265023-cd4e8b8c.jpg,validate/p13/p13462065/s53288377/0cc35e2a-3fadb691-022e47e7-2b265023-cd4e8b8c.jpg,validation," WET READ: ___ ___ ___ 8:25 PM NG tube placement with tip in the stomach, advanced between the ___ and ___ images. Improved aeration at the left lung base. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic pancreatitis, mesenteric ischemia, nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the nasogastric tube has been exchanged. New tube shows a normal course and the tip projects over the middle parts of the stomach. Pre-existing retrocardiac atelectasis has completely resolved. No evidence of pneumonia or other pathologic parenchymal process. Normal appearance of the mediastinum. " 27cfcfe8-f654bfc5-0cd91e41-93a3aeb8-10e0af84.jpg,validate/p14/p14750850/s51293817/27cfcfe8-f654bfc5-0cd91e41-93a3aeb8-10e0af84.jpg,validation," WET READ: ___ ___ ___ 8:10 AM Interval development of moderate pulmonary edema. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with chest pain ekg crackles // r/o pulmonary edema TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ and ___, and CTA of the chest dated ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates interval development of moderate pulmonary edema superimposed to chronic changes described in concurrent CT. There is a probable small right pleural effusion. No pneumothorax. Cardiac silhouette is unchanged. IMPRESSION: Interval development of moderate pulmonary edema. " 9999fc61-5c535171-d372476f-bcfc0873-6626e6f7.jpg,validate/p19/p19555515/s54197314/9999fc61-5c535171-d372476f-bcfc0873-6626e6f7.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Again, slightly low lung volumes are seen. Given this, there is no focal consolidation, pleural effusion, or evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable with the aorta being tortuous. There is no overt pulmonary edema. Some degenerative changes are seen along the spine. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 0c3bbbfc-ff5430c5-9813b34c-c4a5bee9-fa69ea7d.jpg,validate/p10/p10113898/s57754628/0c3bbbfc-ff5430c5-9813b34c-c4a5bee9-fa69ea7d.jpg,validation," FINAL REPORT HISTORY: Female with mediastinal mass compressing trachea. Status post biopsy of mass. Assess for pneumothorax. COMPARISON: Chest radiograph, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Large mediastinal mass shifting trachea leftwards with patent tracheal stent. Tip of right pleural drain impinges on mediastinum. No pneumothorax or pulmonary edema. Interval increase of bibasilar atelectasis, right greater than left with new small right pleural effusion. Heart size and left mediastinal contour are normal. No bony abnormality. IMPRESSION: 1. Mild increase in bibasilar atelectasis, right greater than left. No pneumothorax. 2. New small right pleural effusion. " d3e07051-d62b8f67-65b2dff9-a92ccb5f-8c0189f1.jpg,validate/p10/p10785570/s56167141/d3e07051-d62b8f67-65b2dff9-a92ccb5f-8c0189f1.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Epigastric pain, questionable pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal size of the cardiac silhouette. No pleural effusions. No parenchymal opacities. No pulmonary edema. Mild tortuosity of the thoracic aorta. " 48c19d9d-fec25fb7-7d282f11-776b3127-4ed5452e.jpg,validate/p10/p10161042/s54149326/48c19d9d-fec25fb7-7d282f11-776b3127-4ed5452e.jpg,validation," FINAL REPORT INDICATION: Hypoxia in a patient with a history of COPD. COMPARISON: Most recent chest radiograph from ___. FINDINGS: A bedside AP radiograph of the chest demonstrates clear lungs aside from minimal bibasilar atelectasis. The heart size is stably minimally enlarged, and there is slight widening of the upper mediastinal silhouette suggestive of central venous engorgement. There is no pneumothorax or pleural effusion. The pulmonary vascularity is normal and there is no edema. IMPRESSION: 1. Mild central venous engorgement suggestive of hypervolemia. 2. No evidence of decompensated congestive heart failure or pneumonia. " 5283a6f4-21a7a79d-8e16a68c-a176d4c1-2b88ebfd.jpg,validate/p19/p19526851/s57002334/5283a6f4-21a7a79d-8e16a68c-a176d4c1-2b88ebfd.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Myasthenia ___, CHF, and shortness of breath. Comparison is made with prior study, ___. Severe cardiomegaly is stable. Worsening left lower lobe consolidation is worrisome for progression of pneumonia. Left mid lung plate-like atelectasis is unchanged. There is no pneumothorax. If any, there is a small left pleural effusion. There is no evidence of pulmonary edema. " 8e084108-7a1dd451-86ccda75-d8543ec1-c96077a8.jpg,validate/p14/p14358282/s54860615/8e084108-7a1dd451-86ccda75-d8543ec1-c96077a8.jpg,validation," FINAL REPORT INDICATION: ICD firing with palpitations. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Please note that due to an error in PACS, this study is being interpreted on ___. The heart size is mildly enlarged but unchanged. Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Minimal atelectasis is noted in the left lung base and there is mild elevation of left hemidiaphragm. Right lung is clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: Minimal left basilar atelectasis. " a3167920-e45a65f4-64be1e29-76a331e7-ee679060.jpg,validate/p16/p16747532/s59047092/a3167920-e45a65f4-64be1e29-76a331e7-ee679060.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PsA starting MTX // ? nodules 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. " 4296f30e-6cac1bde-cc5ef90b-92e7dd02-49c38da1.jpg,validate/p14/p14189277/s54782423/4296f30e-6cac1bde-cc5ef90b-92e7dd02-49c38da1.jpg,validation," WET READ: ___ ___ ___ 8:37 AM Normal chest radiograph. Specifically, no pneumonia. WET READ VERSION #1 ___ ___ ___ 1:53 AM No acute cardiopulmonary process. Specifically no pneumonia. WET READ VERSION #2 ___ ___ ___ 2:03 AM 1. No acute cardiopulmonary process. Specifically no pneumonia. 2. 1.6 cm rounded opacity projecting over left lower hemi thorax, likely represents nipple shadow. If confirmation is required a BB marker can be placed on nipple with repeat radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with anxiety, mania. Assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: LEFT NIPPLE SHOULD NOT BE MISTAKEN FOR LUNG NODULE. . The lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: Normal chest radiograph. Specifically, no pneumonia. " 8874019b-7cc37ae6-c33ac42e-1b5c10e6-3419d759.jpg,validate/p13/p13978368/s53864763/8874019b-7cc37ae6-c33ac42e-1b5c10e6-3419d759.jpg,validation," FINAL REPORT HISTORY: Post-thoracentesis, to assess for pneumothorax. FINDINGS: In comparison with study of ___, there has been a thoracentesis on the right with removal of some pleural fluid. No evidence of pneumothorax. Little overall change in the appearance of the heart and lungs. " 7204e534-f3ca75d0-5c5102f1-68b9c3d7-41fdef9e.jpg,validate/p14/p14663313/s51614141/7204e534-f3ca75d0-5c5102f1-68b9c3d7-41fdef9e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with bilateral crackles, wheezing and dysnpnea. // ?pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minor bibasilar atelectasis is seen. There is no focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Some degenerative changes are seen along the spine. IMPRESSION: Basilar atelectasis without focal consolidation. " 3954dba6-29da5dd4-ef57ce9d-e2eee5dd-a76e3d68.jpg,validate/p13/p13736848/s57916109/3954dba6-29da5dd4-ef57ce9d-e2eee5dd-a76e3d68.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess ICD. There is mild-to-moderate cardiomegaly. Transvenous pacemaker lead tips terminate in standard position in the right atrium and right ventricle. There is no pneumothorax, pleural effusion or pulmonary edema. " 818e6e83-0f061241-2ad7a514-6007f4c2-98318c8b.jpg,validate/p18/p18456006/s56571669/818e6e83-0f061241-2ad7a514-6007f4c2-98318c8b.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and low sats. TECHNIQUE: Chest: Frontal and lateral views. COMPARISON: ___. FINDINGS: There is mild pulmonary edema. The cardiac and mediastinal silhouettes are similar as compared to the prior study. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. IMPRESSION: Pulmonary edema. " ed9bc6bd-23743be0-7e10445c-754033e0-ae6c4bbd.jpg,validate/p10/p10490439/s50876667/ed9bc6bd-23743be0-7e10445c-754033e0-ae6c4bbd.jpg,validation," WET READ: ___ ___ 10:16 PM worsening interstitial and alveolar opacities compared to the previous exam are suggestive of ARDS given clinical progression in spite of treatment for pulmonary edema in the setting of pancreatitis. D/w DR ___ on ___ at 10:15 pm via phone who stated the patient had been transferred to the MICU. ___ ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Possible pulmonary edema. FINDINGS: In comparison with study of ___, there is worsening bilateral pulmonary opacifications. This could reflect pulmonary edema or, as suggested in clinical history, superimposed ARDS. " f90a985b-e0ebbe62-bfe40107-e99c6162-7df4b246.jpg,validate/p16/p16319384/s59369376/f90a985b-e0ebbe62-bfe40107-e99c6162-7df4b246.jpg,validation," FINAL REPORT INDICATION: Dyspnea. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Left-sided pacemaker wires are stable. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 725dd314-82ae253e-3e87a932-7ddfcccc-b96c5160.jpg,validate/p18/p18719314/s50168138/725dd314-82ae253e-3e87a932-7ddfcccc-b96c5160.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with DLBCL currently volume overloaded, want to rule out effusion before starting methotrexate // Fluid status? Pleural effusion/pulmonary edema? Fluid status? Pleural effusion/pulmonary edema? IMPRESSION: In comparison with the study of ___, there are improved lung volumes. There is enlargement of the cardiac silhouette with left ventricular prominence and mild elevation of pulmonary venous pressure. The hemidiaphragms are quite well seen and there are residual atelectatic changes at the bases, more prominent on the right. The costophrenic angles are quite well seen, though this does not exclude the possibility of pleural fluid. If this is an important clinical determination, a lateral view could be obtained if the condition of the patient permits. If not, lateral decubitus views with horizontal beam could be obtained. The left PICC line is been pulled back. The appearance of the tip raises the possibility of extension into the azygos vein. " a0025412-c7fa305c-e2be7335-5cf02d4f-e26cb76e.jpg,validate/p15/p15009233/s50208186/a0025412-c7fa305c-e2be7335-5cf02d4f-e26cb76e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with shortness of breath. // Pulmonary edema? INCREASING SOB R/O PULMONARY EDEMA IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE IS LITTLE OVERALL CHANGE. AGAIN THERE IS SUBSTANTIAL ENLARGEMENT OF THE CARDIAC SILHOUETTE WITH CONTINUED PULMONARY EDEMA AND BILATERAL PLEURAL EFFUSIONS WITH COMPRESSIVE BASILAR ATELECTASIS. " 667afc08-55c6f81f-edd23a33-6a0a05e6-42e76f03.jpg,validate/p10/p10049334/s58877721/667afc08-55c6f81f-edd23a33-6a0a05e6-42e76f03.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with increased WOB // assess for pulmonary edema assess for pulmonary edema COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Previous moderate pulmonary edema has improved, moderate bilateral pleural effusions have redistributed dependently, but probably not enlarged, and now obscure the right heart border. Opacification at the lung bases is probably a combination of atelectasis, dependent edema overlying pleural effusion. No pneumothorax. . " def8631f-31dfd256-c976f3ba-e3391d83-63c4f62a.jpg,validate/p15/p15497573/s56352996/def8631f-31dfd256-c976f3ba-e3391d83-63c4f62a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with cardiac arrest being cooled. // change in PTX. Please do semi-upright film COMPARISON: Chest radiographs ___. IMPRESSION: The appearance of the contours in the left hemi thorax is certainly suggestive of pneumothorax, but still quite unusual for that condition. If it is pneumothorax the volume has not changed since the initial presentation on ___. If it is clinically important to determine with certainty whether pneumothorax is present, given the constraints on positioning this patient upright, CT scanning would be required. Leftward mediastinal shift is explained by severe left lower lobe atelectasis. Previous cardiomegaly has resolved. Right lung is clear. Tip of the endotracheal tube is no less than a 0.5 cm from the carina an should be advanced at least 3 cm for more secure seating. Soft a deal drainage tube passes to the mid portion of the nondistended stomach. In sign report. " ccf431ae-d387a00b-1d4d6a01-b5b768ba-68187778.jpg,validate/p12/p12357280/s50111838/ccf431ae-d387a00b-1d4d6a01-b5b768ba-68187778.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cardiac surgery // f/u effusions, atx f/u effusions, atx COMPARISON: Chest radiographs since ___, most recently ___ through ___. IMPRESSION: Moderate left lower lobe atelectasis and accompanying small left pleural effusion have both improved. Cardiomediastinal silhouette has a normal postoperative appearance including small pericardial effusion. There is no pneumothorax or pulmonary edema. " 749b02e6-ebc642da-0d743c06-7b73fb2b-b05b3a45.jpg,validate/p17/p17021161/s51232125/749b02e6-ebc642da-0d743c06-7b73fb2b-b05b3a45.jpg,validation," FINAL REPORT INDICATION: Evaluate for pulmonary edema in a patient with ESRD. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without pleural effusion or pneumothorax. There is no significant pulmonary edema. An unclear parenchymal process in the left upper lobe could represent a subtle pneumonia. The visualized upper abdomen is unremarkable. IMPRESSION: 1. An unclear parenchymal process in the left upper lobe could represent a pneumonia. If there are corresponding clinical symptoms, CT is recommended to verify this finding. 2. No significant pulmonary edema. NOTIFICATION: These findings were communicated via telephone by Dr. ___ to Dr. ___ at 12:20 on ___. " 87c9b749-73914ee5-917bd025-d0038eef-e5d773da.jpg,validate/p15/p15904475/s52125821/87c9b749-73914ee5-917bd025-d0038eef-e5d773da.jpg,validation," FINAL REPORT HISTORY: ___ -year-old female with history of pulmonary edema, now with shortness of breath. Evaluation for CHF. COMPARISON: Comparison is made to radiographs of the chest from ___ and ___. This study is read in conjunction with CT of the torso from ___. FINDINGS: AP and lateral views of the chest demonstrate stable moderate cardiomegaly. The mediastinal contours are unchanged. Pulmonary vascular engorgement and bibasilar hazy opacification is consistent with mild pulmonary edema. No large pleural effusion is identified. There is no focal consolidation or evidence of pneumothorax. IMPRESSION: Stable moderate cardiomegaly, with mild pulmonary edema. " 2d7ddf59-3926c8a4-12962733-9f8597d6-47ff14aa.jpg,validate/p11/p11873528/s55713273/2d7ddf59-3926c8a4-12962733-9f8597d6-47ff14aa.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old woman with chest pain and shortness of breath for one week, question pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well-expanded lungs without focal consolidation, effusion, or pneumothorax. Heart size is normal. Mediastinal contour and hilar configuration is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 4f04f940-7815d664-95a19e4a-640981b4-c404fc42.jpg,validate/p18/p18111896/s55461989/4f04f940-7815d664-95a19e4a-640981b4-c404fc42.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath on exertion. COMPARISON: Chest radiograph of ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. A right IJ approach dialysis catheter ends in the mid SVC. The lungs are clear without consolidation, pleural effusion, or pneumothorax. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary pathology. " 33aac685-1abdf680-75cd5689-530f4138-195db35f.jpg,validate/p18/p18767957/s52987117/33aac685-1abdf680-75cd5689-530f4138-195db35f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ ESRD s/p failed kidney txp on HD, HIV, DM2, PVD, dCHF w/ preserved EF, s/p L TMA ___, s/p L BKA, now febrile and diaphoretic // cardiopulmonary process TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Cardiomegaly is substantial. Right basal consolidation is new and concerning for infectious process. No pleural effusion or pneumothorax is seen. " 077e1185-d51f40ae-d69933f5-65d65f90-5065fd50.jpg,validate/p16/p16003391/s56817035/077e1185-d51f40ae-d69933f5-65d65f90-5065fd50.jpg,validation," 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. " 68a8b692-4ffe7861-fdaf88b8-bc66375b-e91193fc.jpg,validate/p11/p11281855/s58139958/68a8b692-4ffe7861-fdaf88b8-bc66375b-e91193fc.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with large pulmonary embolism, on ECMO, with hypoxia. Please evaluate for interval change, OG placement. COMPARISON: ___. FINDINGS: NG tube can be followed up until mid esophagus, but its distal end is not clearly seen in this patient with known hiatal hernia. Bilateral moderate pleural effusions are unchanged with bibasilar atelectasis. NG tube ends 2.5 cm above the carina. There is a new line coming from the abdomen, going to mid mediastinum. CONCLUSION: NG tube has been repositioned and its distal end is not definitively seen. It could be followed up until mid mediastinum. " 64daee24-30537f2b-5978a30c-569c2a14-94dfebb1.jpg,validate/p16/p16578228/s59335746/64daee24-30537f2b-5978a30c-569c2a14-94dfebb1.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The cardiac and mediastinal silhouettes are stable with an unfolded calcified aorta and the cardiac silhouette top normal to mildly enlarged. There is mild bibasilar atelectasis. There is slight blunting of the right costophrenic angle that may be due to a trace pleural effusion. There is minimal pulmonary vascular congestion. No pneumothorax is seen. IMPRESSION: 1. Possible trace right pleural effusion. Bibasilar atelectasis and minimal pulmonary vascular congestion. Stable cardiomediastinal silhouette. " 07d94ad5-93df8813-8cb17b0a-564e7f77-eadfb417.jpg,validate/p12/p12685738/s55602125/07d94ad5-93df8813-8cb17b0a-564e7f77-eadfb417.jpg,validation," FINAL REPORT CHEST RADIOGRAPH FROM ___ HISTORY: Fever status post liver transplant, evaluate for pneumonia, edema or effusion. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: The visualized lung fields are clear without any focal consolidation, pleural effusion or pneumothorax. The cardiac and mediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 87e27169-01c2179d-794af130-42c66216-fac725b4.jpg,validate/p15/p15985103/s54143989/87e27169-01c2179d-794af130-42c66216-fac725b4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metatastic endometrial CA p/w with large R pleural effusion, PE and postobstructive PNA // interval change in size of effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pigtail catheter on the right is in unchanged position. There is minimal improvement in aeration of the right lung but the very extensive parenchymal opacities still predominates in the right hemi thorax. No change in appearance of the cardiac silhouette and of the left lung. " 58bee234-36ca566b-5ba15206-c61bd456-00469bd6.jpg,validate/p17/p17454111/s51054835/58bee234-36ca566b-5ba15206-c61bd456-00469bd6.jpg,validation," FINAL REPORT HISTORY: Diabetes, coronary artery disease, hypertension with hyperkalemia and elevated white count. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size remains mildly enlarged, unchanged. The aortic knob is calcified. The mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is detected. Minimal peripheral linear opacity within the left mid lung field may reflect an area of subsegmental atelectasis. No acute osseous abnormalities are seen. Old right ___ posterior rib fracture is again noted. IMPRESSION: No acute cardiopulmonary abnormality. " 51354f7a-ec9183bd-44a31757-c7b873a1-d37e064c.jpg,validate/p10/p10781100/s54329532/51354f7a-ec9183bd-44a31757-c7b873a1-d37e064c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Cough, rule out pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. There is a new subtle retrocardiac opacity which is concerning for pneumonia in the correct clinical setting. An eventration of the right hemidiaphragm is noted. No pleural effusions are present. There is no pneumothorax. The cardiomediastinal silhouette is stable with an unfolded thoracic aorta. Bony structures are intact. IMPRESSION: Findings concerning for an early left lower lobe pneumonia. " 6b4be378-06b97ddf-584492c2-135900f0-d9a35a46.jpg,validate/p11/p11407375/s56749704/6b4be378-06b97ddf-584492c2-135900f0-d9a35a46.jpg,validation," FINAL REPORT HISTORY: Patient with chronic cough, eval progression on chest x-ray. COMPARISON: Chest radiographs from ___ and CT from ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Again visualized are diffuse interstitial reticular markings, stable since study from ___. The cardiomediastinal silhouette, and hilar contours are unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: Stable diffuse reticular interstitial lung markings consistent with chronic interstitial lung disease. No definitive consolidation is appreciated. However, given the severity of baseline disease, it is impossible to exclude a developing pneumonia. " 0230cc37-e97b0ac7-315e9ded-ed3c6c93-8f6b5015.jpg,validate/p16/p16033728/s51828825/0230cc37-e97b0ac7-315e9ded-ed3c6c93-8f6b5015.jpg,validation," FINAL REPORT INDICATION: Dyspnea, orthopnea for two months. Evaluate for cardiopulmonary process. COMPARISON: Chest radiograph ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: Again there is significant elevation of the left hemidiaphragm, increased as compared to the prior study. There are streaky opacities in the right infrahilar region, similar to slightly increased as compared to the prior study. The remainder of the lung fields are clear without focal opacity to suggest pneumonia. The cardiomediastinal silhouette is normal. The hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Severe elevation of the left hemidiaphragm, increased since the prior study. Direct visualization under fluoroscopy could help evaluate for diaphragmatic paralysis. 2. Persistent streaky opacities in the right infrahilar region similar to slightly increased compared to the prior study may represent chronic atelectasis, underlying infection not entirely excluded. There is no other focal airspace opacity to suggest pneumonia. " bb9fae7f-43d7d78c-d3657d86-aba6d912-55afca45.jpg,validate/p13/p13687936/s58087635/bb9fae7f-43d7d78c-d3657d86-aba6d912-55afca45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hepatosplenic T cell lymphoma c/b tumor lysis, with 10lb wt gain and aggressive IVF with hypoxia and dyspnea // ?pulm edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there has been interval development of bilateral perihilar opacities with most central predominance and slightly patchy appearance, highly concerning for interval development of pulmonary edema. Slight distension of the azygos vein is present by the relatively mild the as other etiologies should be considered.Other etiologies such as multifocal pneumonia, hemorrhage or ARDS are possible but substantially less likely. Small amount of bilateral pleural effusion is present. Right PICC line tip is at the cavoatrial junction. " b24a7e87-3d22a77f-8a20cd47-265e83a1-ef61c878.jpg,validate/p16/p16167724/s52040178/b24a7e87-3d22a77f-8a20cd47-265e83a1-ef61c878.jpg,validation," WET READ: ___ ___ 7:06 PM No pulmonary edema. Large right pleural effusion with underlying atelectasis. Underlying consolidation not excluded. Left lung without focal consolidation. Pneumomediastinum still present. Trach and L PICC in unchanged positions. G tube partly imaged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with SBP in 190's and possible pulmonary edema. FINDINGS: Comparison is made to prior study from ___. There is likely right lower lobe collapse with pleural effusion at the base. There is a left-sided PICC line with distal lead tip at the cavoatrial junction. The left lung is clear. There is no pulmonary edema. Catheters are seen projecting over the upper abdomen. There is a tracheostomy whose distal tip is 6.8 cm above the carina. There is lucency along the right trachea suggestive of pneumomediastinum. This is better assessed on the prior CT scan from ___. " 27c9cbdf-2284ecc5-213c0968-c91917da-e0e9ece6.jpg,validate/p17/p17477304/s59569343/27c9cbdf-2284ecc5-213c0968-c91917da-e0e9ece6.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CVA, ESRD, MRSA bacteremia with new elevated WBC. // r/o PNA given rising WBC EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Portable chest radiograph, upright PA and lateral views. COMPARISON: Chest radiograph ___ FINDINGS: There is diffuse pulmonary vascular congestion, more prominent in the right lower lobe. Cardiomegaly is noted. Bilateral lung apices are not well seen due to lordotic positioning. There is no focal consolidation to suggest pneumonia. There are small bilateral effusions. There is an old healed fracture at right distal clavicle. Sclerotic changes of the bones are again noted. " 035b3c94-500ee35c-10e923c5-3a5a2324-348b48c2.jpg,validate/p15/p15338518/s59291942/035b3c94-500ee35c-10e923c5-3a5a2324-348b48c2.jpg,validation," FINAL REPORT HISTORY: NG tube placement. FINDINGS: In comparison with earlier study of this date, the nasogastric tube extends well into the stomach with the tip beyond the lower limit of the image. The Dobbhoff tube has been removed. " 4b6ecada-785d240e-12d3f35e-ac9405da-5dc85d74.jpg,validate/p11/p11057357/s59579128/4b6ecada-785d240e-12d3f35e-ac9405da-5dc85d74.jpg,validation," WET READ: ___ ___ ___ 7:16 PM Mod-severe cardiomegaly. Probable central venous congestion with cephalization of pulm vasculature. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Chest pain, shortness of breath, assess for pleural effusion. FINDINGS: AP upright portable chest radiograph obtained. A dual-lead AICD projects over the left chest wall with lead tips extending into the right atrium and right ventricle as well as the tips extending along the epicardium at the level of the left atrium. There is mild pulmonary interstitial edema with cardiomegaly. No large pleural effusion is seen. No pneumothorax. IMPRESSION: Cardiomegaly with interstitial edema. " e303fef9-d12688ae-932682b7-7fddfdfa-0353633a.jpg,validate/p19/p19469328/s54287292/e303fef9-d12688ae-932682b7-7fddfdfa-0353633a.jpg,validation," FINAL REPORT HISTORY: Confusion. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: Again, there are low lung volumes. The patient's chin overlies the right apex. Given the above, the again areas of bilateral mid to lower lung atelectasis bilaterally. No discrete focal consolidation is seen. There is no pleural effusion or pneumothorax. Projecting over the left upper lobe again seen is a 6 mm calcific nodule most likely presenting a calcified granuloma. A few smaller rounded calcified nodules are seen projecting over the right lung, stable, also likely representing calcified granulomas. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Several areas of likely atelectasis in the mid to lower lung the lungs bilaterally, evolving infection is not excluded in the appropriate clinical setting. " 26e4db9e-4c3cbfa8-b775eaca-3d63b08e-6836f270.jpg,validate/p18/p18418794/s57827334/26e4db9e-4c3cbfa8-b775eaca-3d63b08e-6836f270.jpg,validation," 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. " e3066747-1d8a9770-baf27887-084d4160-ca0d79b2.jpg,validate/p17/p17990475/s56432923/e3066747-1d8a9770-baf27887-084d4160-ca0d79b2.jpg,validation," FINAL REPORT INDICATION: Recent colonoscopy now with back pain. Evaluate for air under the diaphragm or pneumatosis. TECHNIQUE: Upright frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes are normal and the lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. The mediastinal and hilar contours are unremarkable. There is no free air seen underneath either diaphragm. IMPRESSION: No free intra-abdominal air. " abd20044-492ff8ed-a66d4db4-a2723d6e-66042931.jpg,validate/p19/p19127072/s58914797/abd20044-492ff8ed-a66d4db4-a2723d6e-66042931.jpg,validation," 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. " 478eec4c-6f9f0468-30a07c6f-b71001e3-06653bae.jpg,validate/p17/p17907922/s50161221/478eec4c-6f9f0468-30a07c6f-b71001e3-06653bae.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p VATS LLL sup seg // R/O PTX post CT removal TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ at 10:59, ___. CT of the chest from ___. IMPRESSION: There has been interval removal left-sided chest tube. No pneumothorax. Small bilateral pleural effusions are stable from earlier today. No pulmonary edema. Left perihilar opacity and sutures are consistent with postsurgical change. Mediastinal contours and cardiac silhouette are normal. " f3b796c8-e969f433-c7c8b5ef-85394ec7-fd516dfa.jpg,validate/p19/p19849557/s54491669/f3b796c8-e969f433-c7c8b5ef-85394ec7-fd516dfa.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with shortness of breath. Evaluate for pulmonary edema. TECHNIQUE: Portable upright frontal chest radiograph was obtained. COMPARISON: Chest CT from ___ and chest radiograph from ___. FINDINGS: Lung volumes are mildly decreased, and there continues to be a right lower lobe rounded opacity which corresponds with a Bochdalek hernia noted on prior CT. A hiatal hernia is again seen. The cardiac silhouette is stable in size, and a cardiac pacing device and its leads are in stable position. No focal consolidation, pleural effusion or pneumothorax is seen. No overt pulmonary edema is noted. IMPRESSION: No acute cardiopulmonary process. " 4532b4ee-f6fa4a81-e2b23e11-b9d8134c-1f91a4e2.jpg,validate/p19/p19745571/s57008523/4532b4ee-f6fa4a81-e2b23e11-b9d8134c-1f91a4e2.jpg,validation," 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. " 595d2259-38d7386e-670ac019-d316b0e1-8d127c60.jpg,validate/p10/p10481168/s58297800/595d2259-38d7386e-670ac019-d316b0e1-8d127c60.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx widespread bony metastatic breast cancer w/c/o SOB, non-productive cough, and egophany right lung on exam // r/o infectious process or abnormalities r/o infectious process or abnormalities IMPRESSION: In comparison with the study of ___, there is little interval change and no evidence of acute focal pneumonia. Diffuse osseous metastatic disease is again seen as well as dense calcifications in the left breast. " f4cd0d4e-e4834f59-25a938c6-9c1971f6-08f705b8.jpg,validate/p17/p17754292/s59673249/f4cd0d4e-e4834f59-25a938c6-9c1971f6-08f705b8.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with babesiosis, persistent cough (worsening) fevers // eval for pulm process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Interval development of small bilateral pleural effusions. The lungs are clear, no acute focal consolidation. The cardiomediastinal silhouette is unremarkable. No pneumothorax. IMPRESSION: Interval development of small bilateral pleural effusion, otherwise no interval change. " 8c9fb3e0-d9fab40e-5e351d62-d2665641-e8050a13.jpg,validate/p18/p18186439/s56986002/8c9fb3e0-d9fab40e-5e351d62-d2665641-e8050a13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 3 months of cough and weight loss // r/o pna or mass r/o pna or mass IMPRESSION: Comparison to ___. Decreasing volume of the left hemi thorax with increasing opacities an soft tissue densities at the level of the left hilus. The findings are highly suspicious for malignant process located at the left hilus, with subsequent mediastinal lymphadenopathy. Until 8 further workup with CT is recommended. Moderate cardiomegaly. Left RECOMMENDATION(S): Highly suspicious process at the level of the left hilus, with extends to the left pleura, until 8 further workup with CT is strongly recommended. NOTIFICATION: At the time of dictation and observation, 11:53, on the ___, the referring physician ___. ___ was contacted in is practice by telephone and the findings were discussed. " 2cc6b7c5-5ea2df0b-949dea96-09ef21a8-7e139d05.jpg,validate/p17/p17724257/s52022473/2cc6b7c5-5ea2df0b-949dea96-09ef21a8-7e139d05.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with renal transplant, fever // r/o PNA COMPARISON: It___. FINDINGS: AP upright and lateral views of the chest provided. Midline sternotomy wires are again noted as well as mediastinal clips. Linear densities in the left lower lung likely reflect atelectasis. There may be mild pulmonary edema. The heart size is difficult to assess but appears grossly stable. The mediastinal contour is unremarkable. No large effusions are seen. Bony structures are intact. IMPRESSION: Probable mild pulmonary edema with left basal atelectasis. " b41cd04f-d3e8d5eb-23c9a3ac-f6cbb544-6819a608.jpg,validate/p15/p15554865/s50109133/b41cd04f-d3e8d5eb-23c9a3ac-f6cbb544-6819a608.jpg,validation," FINAL REPORT INDICATION: History: ___F with chest pain, now resolved. // Please evaluate for cardiomegaly, effusion, other intrathoracic process. COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: The heart size is mildly enlarged. Upper mediastinal contours are unremarkable. Lung volumes are low with minimal bibasilar atelectasis. Lungs are otherwise clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Mild cardiomegaly. " 38e56560-8e49bdb9-f03ba828-dbf5e9e8-202239b8.jpg,validate/p19/p19651885/s54418081/38e56560-8e49bdb9-f03ba828-dbf5e9e8-202239b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with arrythmia s/p thoracotomy and sympathectomy // eval post op change eval post op change COMPARISON: Chest radiographs ___ 8:21 a.m. IMPRESSION: Mild pulmonary edema is slightly worse postoperatively. Severe cardiomegaly is stable. Left apical pleural drain in place. Pneumothorax is minimal if any. There is no appreciable left pleural effusion. Subcutaneous emphysema in the left chest wall reflects recent surgery. Transvenous atrial biventricular pacer defibrillator leads follow their expected courses from the left pectoral generator. " 01041191-a4e39f64-dd2dec8d-2106c4ad-7cb03927.jpg,validate/p11/p11152196/s59241670/01041191-a4e39f64-dd2dec8d-2106c4ad-7cb03927.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman who is a smoker with a recent pneumonia. Question clearance of pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest demonstrate clear lungs at this time. The upper lobe opacity has resolved. Cardiac size is normal. Aorta is slightly tortuous but otherwise unremarkable. There is no pleural effusion or pneumothorax. Apical scarring/pleural thickening is noted bilaterally. IMPRESSION: Resolution of left upper lobe pneumonia. " 00800f98-a1cd8583-1fe0ca1d-abde4bff-b2c41f8a.jpg,validate/p16/p16977449/s53304058/00800f98-a1cd8583-1fe0ca1d-abde4bff-b2c41f8a.jpg,validation," FINAL REPORT INDICATION: ___M 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. There is mild tortuosity of the descending thoracic aorta. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 520daf36-ae5e599c-6ee23acd-db973915-45b4b665.jpg,validate/p11/p11943854/s57927894/520daf36-ae5e599c-6ee23acd-db973915-45b4b665.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with history of STS of left upper extremity. COMPARISONS: ___ to ___. FINDINGS: The lungs are well expanded. A vague opacity in the right middle lobe is seen only on the frontal projection without correlate on the lateral projection. No focal consolidation, effusion, or pneumothorax present. The cardiac and mediastinal contours are normal. IMPRESSION: Vague right middle lobe opacity is not confirmed on two views and may due to technique. Correlate with symptoms and exam and consider follow up radiographs if warranted. " e62f0dab-ae46330c-9225801a-32155292-65d1f322.jpg,validate/p10/p10207476/s56034080/e62f0dab-ae46330c-9225801a-32155292-65d1f322.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with bone marrow transplant and recent pneumonia, assess for interval change. COMPARISONS: ___. FINDINGS: Right PICC has been removed. Right mid lung opacities are not well appreciated on the current study suggesting they may have been due to aspiration. There is no focal consolidation, pleural effusion or pneumothorax. The heart is normal in size with mediastinal surgical clips noted. Bulge in aortic contour compatible with aneurysm seen on prior chest CT evaluations. IMPRESSION: Resolution of recent midlung opacities which as a result of their quick resolution may have been due to aspiration rather than pneumonia. " 85eaa924-75c95597-0e8ebcdd-e664f2b6-20c1972a.jpg,validate/p17/p17275231/s51428451/85eaa924-75c95597-0e8ebcdd-e664f2b6-20c1972a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Fevers to 101 and cough, assess pneumonia. FINDINGS: PA and lateral views of the chest were obtained. A CBD stent in the right upper quadrant is again noted as well as a catheter in the anterior upper abdomen with adjacent surgical clips. There is no definite sign of pneumonia, pleural effusion or pneumothorax. A subtle nodular opacity adjacent to the left heart border in the left lower lung is seen on the frontal view, possibly may represent a new pulmonary nodule as it was not clearly seen on the prior exam. Cardiomediastinal silhouette appears stable. The hyperinflated widened AP diameter reflects known underlying emphysema. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: Emphysema, possible nodule in the left lower lung. Recommend non-emergent CT to assess further. No signs of pneumonia or CHF. " a58ffdd5-dece277a-76e31297-d8b67ca9-fd05d7dc.jpg,validate/p10/p10205645/s52641488/a58ffdd5-dece277a-76e31297-d8b67ca9-fd05d7dc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea on exertion, to rule out congestive heart failure versus infiltrates. TECHNIQUE: PA and lateral chest views were read in comparison with prior radiograph from ___. FINDINGS: Electrodes through the left transvenous approach are unchanged in position, ending into the right atrium and right ventricle respectively; however, the pacemaker device has been repositioned from the left pectoral region to the right upper chest with a connector coursing from right to the left side. There are no lung opacities concerning for pulmonary edema or pneumonia. Heart size is normal. Mediastinal and hilar contours are unremarkable. There is no pleural abnormality. IMPRESSION: No pneumonia or pulmonary edema. " bb37d2a0-5295312f-3c12d059-9d5bf16e-169a4f16.jpg,validate/p13/p13031024/s57508385/bb37d2a0-5295312f-3c12d059-9d5bf16e-169a4f16.jpg,validation," WET READ: ___ ___ 11:18 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain, evaluate for acute process. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Mild cardiomegaly is unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. " 7a8d30b9-198318df-5209482e-d74393e0-6baf4063.jpg,validate/p14/p14065397/s51376546/7a8d30b9-198318df-5209482e-d74393e0-6baf4063.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MRSA endocarditis and Parkinsons disease, poor PO intake // Staged Dobhoff placement Staged Dobhoff placement IMPRESSION: Film 2. Shows the feeding tube correctly positioned in the stomach. The course is unremarkable. No complications, notably no pneumothorax. " fee5afd2-224a6a34-19c81668-a1273a49-323d6150.jpg,validate/p11/p11828845/s59949503/fee5afd2-224a6a34-19c81668-a1273a49-323d6150.jpg,validation," 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. " a1f748d1-82ca0c94-0a60ea34-7525a658-ad8bf282.jpg,validate/p18/p18159478/s55127510/a1f748d1-82ca0c94-0a60ea34-7525a658-ad8bf282.jpg,validation," FINAL REPORT INDICATION: ___M with cough // r/o acute infection 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: No acute cardiopulmonary process. " 668c9103-5266d831-b0974358-d7fc18ae-dbaebe51.jpg,validate/p17/p17148408/s56402944/668c9103-5266d831-b0974358-d7fc18ae-dbaebe51.jpg,validation," 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. " 53226a12-9fb75a92-a5bf3a66-e92d8a6a-225a5a15.jpg,validate/p15/p15481731/s52095126/53226a12-9fb75a92-a5bf3a66-e92d8a6a-225a5a15.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pneumomediastinum and small apical pneumothorax seen on chest CT // Evidence of worsening pneumomediastinum or pneumothorax? Evidence of worsening pneumomediastinum or pneumothorax? TECHNIQUE: AP and lateral upright chest radiographs were obtained. COMPARISON: Chest radiograph ___. CT ___. FINDINGS: Left PICC terminates in the low superior vena cava. The distal neo esophagus contains residual oral contrast along its posterior wall. The anterior tracheal wall has a trace amount of barium. There is no pleural effusion. Bilateral diffuse opacities and prominent interstitial markings of the mid to upper lungs are unchanged. Retrosternal lucency on lateral projection corresponds to area question pneumomediastinum on prior CT. Comparison is difficult due to differences in technique, however the volume of air is grossly unchanged. IMPRESSION: 1. Findings of the retrosternal air on lateral projection is unchanged compared to CT ___, accounting for differences in technique. 2. Unchanged bilateral mid to upper lung opacities and prominent interstitial markings. " 9bd7463b-833c78c0-d11b8bd6-03097c16-11111459.jpg,validate/p19/p19178984/s53430549/9bd7463b-833c78c0-d11b8bd6-03097c16-11111459.jpg,validation," FINAL REPORT HISTORY: Melanoma, to assess for disease status. 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 intrathoracic metastasis. " 36f2eeff-0e115bbb-a59ec824-01478b32-e22eae42.jpg,validate/p18/p18221698/s57514285/36f2eeff-0e115bbb-a59ec824-01478b32-e22eae42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___F with dyspnea, eval for volume overload COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Cardiomegaly is again noted with mild pulmonary edema. No large effusions or pneumothorax. No focal consolidation to suggest pneumonia. Imaged bony structures are intact. Mediastinal contour is normal. No free air below the right hemidiaphragm is seen. IMPRESSION: Cardiomegaly with mild pulmonary edema. " 2c4cfb2e-53866e84-408e4744-950a447a-7d1cfb4a.jpg,validate/p19/p19979173/s56718322/2c4cfb2e-53866e84-408e4744-950a447a-7d1cfb4a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH // rule out infectino TECHNIQUE: Portable AP chest radiograph. COMPARISON: CT torso ___ FINDINGS: Lung volumes are low on the right without convincing evidence of lobar atelectasis. There are multiple right-sided rib deformities consistent with old rib fractures. No pneumothorax. There is mild prominence of the bilateral hila and pulmonary vasculature consistent with a mild degree of congestive heart failure but no frank pulmonary edema. Mild cardiomegaly may be exaggerated by the projection. No consolidation or pleural effusion seen. IMPRESSION: 5 suggestive of mild congestive heart failure. No frank pulmonary edema seen. " f781880c-1c6568c5-798fbd8c-3badef68-373b93b3.jpg,validate/p18/p18116982/s57334157/f781880c-1c6568c5-798fbd8c-3badef68-373b93b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of AML, s/p allo with cough and rhonchi on right. // ___ year old man with hx of AML, s/p allo with cough and rhonchi on right. Please r/o PNA. TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No evidence of pneumonia demonstrated within the limitations of the study technique. " aac9a048-f93d9815-02db0d6e-5506410e-7fc036f1.jpg,validate/p12/p12393061/s57530450/aac9a048-f93d9815-02db0d6e-5506410e-7fc036f1.jpg,validation," FINAL REPORT HISTORY: Fever. COMPARISON: ___. FINDINGS: 3.4 cm right middle lobe mass is again seen and grossly unchanged in size since ___. Otherwise no parenchymal opacities concerning for pneumonia. Cardiac size is top normal. Trace left pleural effusion. No pneumothorax. IMPRESSION: No evidence of pneumonia. 3.4 cm right middle lobe mass. Trace left pleural effusion. " c4401eb2-9343b52d-db53d214-83a03221-4528ed29.jpg,validate/p14/p14309485/s51646035/c4401eb2-9343b52d-db53d214-83a03221-4528ed29.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pos ppd // eval for pos ppd eval for pos ppd IMPRESSION: No previous images. The cardiac silhouette is enlarged with left ventricular and possible left atrial enlargement. No evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Specifically, no evidence of old granulomatous disease. There appears to be some calcification in the mid neck on the left, which could be in the region of the carotid bifurcation. " c1bbf905-1a00d918-8d56d6d6-04e12cd2-7d0005de.jpg,validate/p16/p16787268/s55448011/c1bbf905-1a00d918-8d56d6d6-04e12cd2-7d0005de.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with left basal ganglia bleed and intraventricular hemorrhage. FINDINGS: Comparison is made to prior study from ___. The endotracheal tube, feeding tube, and left-sided central venous line are unchanged in position and appropriately sited. There are low lung volumes with a left retrocardiac opacity and left lower lobe atelectasis. There is some mild prominence of the pulmonary interstitial markings. There are no pneumothoraces. " a30d3551-e9d881bb-17794a84-739a312e-6785b1ea.jpg,validate/p15/p15878234/s51433361/a30d3551-e9d881bb-17794a84-739a312e-6785b1ea.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough. Assess for pneumonia. COMPARISON: Chest radiograph, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Right lung lucency is from prior right mastectomy. No interval change in mild streaky opacities in the right upper lung likely related to prior radiation therapy. No new focal opacity, pleural effusion or pulmonary edema. Heart size, mediastinum and hilar contours are normal. Mild aortic arch calcifications are noted with a mildly tortuous aorta. IMPRESSION: No radiographic evidence of acute cardiopulmonary process such as pneumonia. " 45c8c721-0d2c5d55-267f4fbc-626171ad-f83f503d.jpg,validate/p14/p14702995/s55832204/45c8c721-0d2c5d55-267f4fbc-626171ad-f83f503d.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough and fever. TECHNIQUE: Chest, AP upright and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is a patchy a new opacity in the left lower lobe with a small pleural effusion concerning for pneumonia. Very mild new interstitial process suggests coinciding fluid overload or airway inflammation. There is no evidence for pleural effusion on the right. IMPRESSION: Opacity in the left lower lobe suggestive of pneumonia. New mild interstitial process. " 9ad4ae97-e7e88cbc-dec2a463-08bb7f44-0747b2c7.jpg,validate/p18/p18845699/s52163001/9ad4ae97-e7e88cbc-dec2a463-08bb7f44-0747b2c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with desaturation // ? lobe collapse, ptx ? lobe collapse, ptx COMPARISON: Comparison to ___ at 06:06 FINDINGS: Portable semi-erect chest radiograph ___ at 11:36 is submitted. IMPRESSION: Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. The endotracheal tube is unchanged in position. There continue be patchy bibasilar opacities, slightly increased on the left, suggestive of atelectasis, although superimposed pneumonia cannot be entirely excluded. No pulmonary edema. Overall cardiac and mediastinal contours are stable. " f08f2f16-88c10281-b8c849a6-213713c1-b980bed0.jpg,validate/p11/p11967908/s57907800/f08f2f16-88c10281-b8c849a6-213713c1-b980bed0.jpg,validation," FINAL REPORT HISTORY: Cough and shortness of breath TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vascularity is mildly engorged, appearing somewhat asymmetrically more so on the right. Right apical pleural thickening and scarring with associated calcification is re- demonstrated, likely reflective of prior post treatment changes from prior radiation therapy. Small bilateral pleural effusions, right greater than left persists. There are associated atelectatic changes in both lower lobes. Patchy ill-defined opacity within the right mid lung field with associated peribronchial cuffing is new compared to the prior CT, and could reflect an area of infection. There is no pneumothorax. Multiple clips are noted in the right axillary region compatible with prior lymph node dissection. Mild deformity of the right breast shadow is compatible with prior lumpectomy. IMPRESSION: 1. Patchy vague opacity in the right mid lung field with associated peribronchial thickening could reflect an area of infection. 2. Mild pulmonary vascular congestion. 3. Small bilateral pleural effusions, right greater than left with associated bibasilar atelectasis, not significantly changed. 4. Unchanged right apical pleural thickening and scarring compatible with prior radiation changes. " 441f1317-2ac0d3ef-df87e5d3-739b0438-7ce68286.jpg,validate/p15/p15878234/s57709405/441f1317-2ac0d3ef-df87e5d3-739b0438-7ce68286.jpg,validation," FINAL REPORT INDICATION: Cough, history of breast cancer. Treated with radiation and chemotherapy. COMPARISON: None available. FINDINGS: PA and lateral veiws of the chest. No consolidation, pleural effusion or pneumothorax. Mild streaky opacities in the right upper lung may be due to radiation therapy. The cardiomediastinal and hilar contours are normal. There are aortic knob calcifications. IMPRESSION: No acute cardiopulmonary process. " 3c75b33f-09e013c2-e440b025-5a924843-96fd4914.jpg,validate/p10/p10039959/s51761406/3c75b33f-09e013c2-e440b025-5a924843-96fd4914.jpg,validation," WET READ: ___ ___ 10:09 PM No pneumonia. WET READ VERSION #1 ___ ___ 6:00 PM 1. Possible ascending aortic aneurysm measuring up to 5 cm in a patient with a tortuous aorta. 2. Subtle anterior disc space widening of a lower thoracic vertebral body may be projectional. Clinical correlation recommended for recent history of trauma or ligamentous injury. 3. No pneumonia. WET READ VERSION #2 ___ ___ 6:45 PM 1. Subtle anterior disc space widening of a lower thoracic vertebral body may be projectional. 2. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F w/chest pain, assess for occult pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are mildly hypoinflated with crowding of vasculature. No pleural effusion or pneumothorax. The aorta is tortuous. The heart, mediastinal contour and hila are otherwise unremarkable. No acute fracture. IMPRESSION: No pneumonia. " eb2c6b07-feaf0ca0-61c2d11c-08133642-02a0f5f4.jpg,validate/p15/p15211528/s56690022/eb2c6b07-feaf0ca0-61c2d11c-08133642-02a0f5f4.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with history of dCHF, cough and shortness of breath and drop in Hb and hemoptysis // DAH, pulm edema, pna TECHNIQUE: Single AP view. COMPARISON: Chest radiograph ___ FINDINGS: Severe cardiomegaly is unchanged. A cardiac conduction device and leads are in unchanged position. The patient is status post cardiac valve repair. Pulmonary edema is moderate and mildly improved. Patchy parenchymal opacities are slightly more subtle than on prior examinations. IMPRESSION: Moderate pulmonary edema is mildly improved and underlying parenchymal opacities are slightly more subtle. " ac2a2d78-33275f34-235c50cb-2753c891-5e34b4a0.jpg,validate/p13/p13721087/s52285864/ac2a2d78-33275f34-235c50cb-2753c891-5e34b4a0.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with decompensated congestive heart failure. FINDINGS: Comparison is made to previous study from ___. There is massive cardiomegaly which is stable. There is a persistent mild-to-moderate pulmonary edema which is unchanged. A left-sided single-lead pacemaker is again seen and unchanged. There are no pneumothoraces. " 31b82048-435d9f35-1ece7fc5-cab3c5f2-eea95544.jpg,validate/p17/p17217213/s58760291/31b82048-435d9f35-1ece7fc5-cab3c5f2-eea95544.jpg,validation," 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. " d98855ed-9417105e-f905966c-dd60c11e-20762705.jpg,validate/p11/p11648387/s50809405/d98855ed-9417105e-f905966c-dd60c11e-20762705.jpg,validation," WET READ: ___ ___ ___ 10:01 AM No acute cardiopulmonary process. No evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with chest pain and cough, evaluate for pneumonia. TECHNIQUE: PA and lateral chest x-ray. COMPARISON: Chest x-ray ___. FINDINGS: In comparison to radiograph from ___, the cardiomediastinal silhouette is stable and within normal limits. The bilateral hila are grossly unremarkable. No CHF, focal infiltrate, pleural effusion, or pneumothorax detected. Again seen at the right cardiophrenic angle is a stable soft tissue density, likely relating to epicardial fat, unchanged. Also again noted is biapical pleural-parenchymal scarring, similar to the prior film. IMPRESSION: No acute cardiopulmonary process. No evidence of pneumonia. " 02303488-2a0bbdc2-5f03e9bb-f824edb7-50fd5393.jpg,validate/p13/p13961236/s56455789/02303488-2a0bbdc2-5f03e9bb-f824edb7-50fd5393.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___. FINDINGS: Right PICC has been removed, and a single lead pacing device is unchanged in position. Cardiac silhouette remains enlarged, and is accompanied by improving pulmonary vascular congestion and persistent bilateral pleural effusions, which are partially layering on today's study, which was likely performed in a semi-upright position. Adjacent atelectasis at the lung bases is also noted. " be65a25d-b747ce55-c52417f0-6143b2f5-01af4497.jpg,validate/p13/p13815268/s51891652/be65a25d-b747ce55-c52417f0-6143b2f5-01af4497.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: CAD, shortness of breath, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate midline sternotomy wires and mediastinal clips. The lungs are clear without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 46c9a439-7d285c26-27ffa164-fcf4bf0a-e279953b.jpg,validate/p15/p15527518/s55578492/46c9a439-7d285c26-27ffa164-fcf4bf0a-e279953b.jpg,validation," WET READ: ___ ___ 1:07 AM No evidence of worsening volume overload. Stable mild pulmonary vascular congestion. No definite evidence of pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, new dyspnea // please evaluate for worsening volume overload please evaluate for worsening volume overload IMPRESSION: Comparison to ___. No relevant change. Sternotomy wires in correct position. Mild cardiomegaly with elongation of the descending aorta. No pulmonary edema, no pleural effusions. No pneumonia. " 0ec30347-7c6c7087-72ff2f90-4f937f65-67aeea1f.jpg,validate/p19/p19380289/s52258443/0ec30347-7c6c7087-72ff2f90-4f937f65-67aeea1f.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is mildly enlarged with a left ventricular predominance. The aorta is unfolded. There may be a small hiatal hernia. Mediastinal and hilar contours are otherwise unremarkable. Hyperinflation of the lungs with flattening of the diaphragms may suggest underlying COPD. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " b113f8af-2ec2ad8d-2570bbd0-1ae30e27-ead8dc36.jpg,validate/p12/p12043836/s56735832/b113f8af-2ec2ad8d-2570bbd0-1ae30e27-ead8dc36.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p EGD with cauterization with painful pleuritic pain centered around left port-a-cath // evaluation of left port migration, evidence of perforation post procedure TECHNIQUE: Portable AP chest radiograph COMPARISON: Prior chest radiographs from ___, ___, ___, ___ FINDINGS: Since ___, the large right loculated pleural effusion, moderate right basilar atelectasis, and mild pulmonary edema are all increased. Severe cardiomegaly is unchanged. The left Port-a-cath tip is again seen in the right atrium. No pneumothorax. Median sternotomy wires are intact and well aligned. IMPRESSION: 1. No evidence of pneumothorax. 2. The large right loculated pleural effusion, moderate right basilar atelectasis, and mild pulmonary edema are increased since ___. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 2:00 PM, 5 minutes after discovery of the findings. " 9c58edc8-8701c0b1-23e137d8-c11b1fce-c5e77ca2.jpg,validate/p10/p10954476/s51447039/9c58edc8-8701c0b1-23e137d8-c11b1fce-c5e77ca2.jpg,validation," FINAL REPORT HISTORY: Question perforation after food impaction. COMPARISON: None. FINDINGS: The lungs are clear but hyperinflated. Cardiac silhouette is normal. No pleural effusion or pneumothorax. No mediastinal air. IMPRESSION: No evidence of mediastinal air. Hyperinflated lungs. " 77691291-380e9d22-ccf4137d-b71c5fb0-01ad02ae.jpg,validate/p11/p11580750/s55690409/77691291-380e9d22-ccf4137d-b71c5fb0-01ad02ae.jpg,validation," FINAL REPORT HISTORY: Hypoxia. FINDINGS: In comparison with the earlier study of this date, the cardiac silhouette is slightly less prominent and there may be some improvement in the degree of pulmonary vascular congestion. There is ill-defined area of increased opacification in the left perihilar region. In the appropriate clinical setting, this could reflect a developing consolidation. Central catheter remains in place. " 0e5b582c-545693dc-b61cb332-2cdabe76-770b3242.jpg,validate/p13/p13034549/s59515335/0e5b582c-545693dc-b61cb332-2cdabe76-770b3242.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. The aorta is mildly tortuous and demonstrates atherosclerotic calcifications. Mediastinal and hilar contours are otherwise unremarkable. Lungs are clear. No pleural effusion or pneumothorax is present. The pulmonary vasculature is normal. There are mild degenerative changes noted in the imaged thoracolumbar spine. IMPRESSION: No acute cardiopulmonary abnormality. " 670af09c-09c50c97-95f628df-42bc6249-1aa43394.jpg,validate/p13/p13214943/s52716998/670af09c-09c50c97-95f628df-42bc6249-1aa43394.jpg,validation," FINAL ADDENDUM ADDENDUM The tip of the right subclavian catheter again extends to the mid to lower SVC. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, admitted with weight loss, leukocytosis, ? of pneumonia on OSH cxr // ? of pneumonia, picc placement ? of pneumonia, picc placement IMPRESSION: In comparison with the study of ___, there is diffuse bilateral pulmonary opacifications most likely related to pulmonary edema. However, in the appropriate clinical setting, would be difficult to unequivocally exclude superimposed pneumonia. Atelectatic changes are seen at the bases with blunting of both costophrenic angles suggesting small pleural effusions. " aef3889b-8f1f9a46-382d0736-9ec9113e-c43372ba.jpg,validate/p19/p19305450/s50003809/aef3889b-8f1f9a46-382d0736-9ec9113e-c43372ba.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with RUQ pain x 3 weeks, no sob/cough // eval pna, atelectasis 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. " 1627615f-f3dd828f-ad06c7c7-5c3e104c-86c64f48.jpg,validate/p18/p18397764/s58567852/1627615f-f3dd828f-ad06c7c7-5c3e104c-86c64f48.jpg,validation," 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. " cc66e40f-bb08cbf8-2f18fdd3-bc802bdd-c6bce91c.jpg,validate/p12/p12562031/s53059395/cc66e40f-bb08cbf8-2f18fdd3-bc802bdd-c6bce91c.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough and possible right middle lobe collapse. COMPARISON: Chest radiograph from another institution obtained at 15:00 p.m. today. FINDINGS: PA and lateral chest radiographs were obtained. A large left pneumothorax is associated with rightward shift of mediastinal structures and a small amount of pneumomediastinum. The right lung is clear. There is no nodule or effusion. Cardiac and mediastinal contours are normal. IMPRESSION: 1. Large left pneumothorax causes rightward shift of the mediastinum concerning for tension. 2. Small pneumomediastinum. NOTIFICATION: Findings were discovered at 17:05 and immediately disclosed to Dr. ___ ___ telephone at 17:06 on ___ by Dr. ___. " 5705bb9d-5f3729a2-5e264228-52af1790-6f64725d.jpg,validate/p15/p15878262/s50212651/5705bb9d-5f3729a2-5e264228-52af1790-6f64725d.jpg,validation," FINAL REPORT HISTORY: Chest pain. Assess for acute process. COMPARISON: None. TECHNIQUE: Frontal and lateral chest radiographs FINDINGS: The lungs are clear and pleural surfaces are unremarkable. Heart size, mediastinal contour and hila are unremarkable. Visualized osseous structures are unremarkable. IMPRESSION: Normal chest radiograph. " 7437efa3-85221b21-2a0c4b4b-47e296ac-74ee8f30.jpg,validate/p10/p10684181/s54567175/7437efa3-85221b21-2a0c4b4b-47e296ac-74ee8f30.jpg,validation," WET READ: ___ ___ ___ 11:46 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with presycnope vs seizure vs non-epileptic spell // r/o pna TECHNIQUE: Single AP view 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. IMPRESSION: No acute cardiopulmonary abnormality. " 7f8e1f58-167fbe63-e1a3e865-af09d1d8-833db582.jpg,validate/p12/p12010209/s55410492/7f8e1f58-167fbe63-e1a3e865-af09d1d8-833db582.jpg,validation," FINAL REPORT HISTORY: Myeloma and febrile neutropenia. FINDINGS: In comparison with study of ___, the central catheter has been removed. Cardiac silhouette remains within normal limits and there is no evidence of vascular congestion or pleural effusion. The questioned area of increased opacification on the right perihilar region is not confirmed on the current study. " b704ee34-790171bf-6b8387c4-503c6b64-f3407e50.jpg,validate/p10/p10582383/s51228230/b704ee34-790171bf-6b8387c4-503c6b64-f3407e50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with presyncope, found to have HR 40s, BP 90s // eval ? cardiomegaly, edema TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. Mediastinal hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax is present, however the left costophrenic angle is excluded from the field of view. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 45c8d0af-583c7a85-5ca8c073-114d6723-9a211ed3.jpg,validate/p19/p19270021/s52064937/45c8d0af-583c7a85-5ca8c073-114d6723-9a211ed3.jpg,validation," FINAL REPORT INDICATION: ___F w/chest pain, please eval for mediastinal widening, pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or edema. Cardiac silhouette is top-normal. Multiple radiopaque densities project over the anterior and mediastinum, presumably postsurgical. Laparoscopic band is visualized in the upper abdomen. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " f5d7b53d-f9780bea-e72501c2-ecb9dff2-da2f144c.jpg,validate/p11/p11146299/s56596013/f5d7b53d-f9780bea-e72501c2-ecb9dff2-da2f144c.jpg,validation," FINAL REPORT HISTORY: Lung adenocarcinoma, with a presumed parapneumonic effusion on the left, with the pigtail catheter to waterseal. Evaluate for interval change. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs again demonstrate multiple sternotomy wires and a pigtail catheter within the left hemithorax. The loculated left pleural effusion appears slightly decreased compared to the most recent chest radiograph, with improved aeration of the left lung. Right lung aeration appears unchanged. A minimal right pleural effusion is new. The cardiomediastinal silhouette is unchanged. There is no focal consolidation or pneumothorax. IMPRESSION: 1. Slightly decreased loculated left pleural effusion with improved aeration of the left lung. 2. New minimal right pleural effusion. " 713550cc-b9594414-afadae39-86a03847-4180264c.jpg,validate/p14/p14798553/s51250917/713550cc-b9594414-afadae39-86a03847-4180264c.jpg,validation," FINAL REPORT INDICATION: Fever and bacteremia. COMPARISON: None available. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs and normal cardiac silhouette. The aorta is unfolded. The hila are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " 318f7a92-42431840-1009d540-94e40928-48f58f0e.jpg,validate/p11/p11266603/s52749245/318f7a92-42431840-1009d540-94e40928-48f58f0e.jpg,validation," 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. " d9661ff6-877ac981-a20a8810-92309d46-173008ad.jpg,validate/p19/p19991135/s50498205/d9661ff6-877ac981-a20a8810-92309d46-173008ad.jpg,validation," FINAL REPORT AP CHEST, 5:35 A.M., ___ HISTORY: Lobectomy, assess interval change. IMPRESSION: AP chest compared to ___: Volume of the postoperative right lung has improved considerably, and the volume of the persistent right apical pleural space has decreased, though now it contains more fluid than air. Subcutaneous emphysema has increased. Two right pleural drains remain. Left lung is clear. Heart size is normal. Greater fullness in the right lower tracheobronchial angle could be due to paramediastinal pleural fluid, but should be carefully followed to exclude a developing hematoma. In the interim, the patient has been extubated. Heart size is normal. " bcee236d-12b95c81-fcb75a1d-35882dbd-11c426d8.jpg,validate/p12/p12661718/s57686785/bcee236d-12b95c81-fcb75a1d-35882dbd-11c426d8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hypoxia // r/o pe recent D&C. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Bilateral multifocal pulmonary opacities are demonstrated. No pleural effusion or pneumothorax is seen. IMPRESSION: Multi focal opacities could represent septic emboli, aspiration or multifocal pneumonia. Recommend CT for further evaluation. " ee253143-f9ca0f52-b954670f-c88f4b21-6a7784a1.jpg,validate/p13/p13006644/s55893870/ee253143-f9ca0f52-b954670f-c88f4b21-6a7784a1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory distress // Interval changes Interval changes IMPRESSION: Comparison to ___. Decrease in severity of the pre-existing pulmonary edema. The lung volumes have increased, likely reflecting improved ventilation. Stable borderline size of the cardiac silhouette. Stable bilateral pleural effusions. " e2bcce11-c785ce11-efc28456-c52d6381-4a8c3094.jpg,validate/p16/p16532616/s54496080/e2bcce11-c785ce11-efc28456-c52d6381-4a8c3094.jpg,validation," 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. " 55bafa3f-d2a9b428-47c0cf0c-ff54ddfc-5b99596d.jpg,validate/p18/p18551287/s50086854/55bafa3f-d2a9b428-47c0cf0c-ff54ddfc-5b99596d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness, cirrhosis, worsening liver function TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, CT chest ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. A TIPS catheter is seen within the right upper quadrant of the abdomen. Multiple embolization coils project over the epigastric region. No acute osseous abnormality is visualized. Previously demonstrated PICC is no longer visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 5cca6a63-4083caa0-a5df99e8-7aad0f37-c3872eb1.jpg,validate/p10/p10554304/s51142023/5cca6a63-4083caa0-a5df99e8-7aad0f37-c3872eb1.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with recent pneumonia. Assess for interval change. COMPARISON: Chest radiograph from ___ and chest CT from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: Mild peripheral predominant reticular opacities are consistent with patient's history of NSIP. No superimposed consolidation is identified. Chest radiographic findings are unchanged compared to prior examination of ___. There is no overt superimposed pulmonary edema or large pleural effusions. Cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. IMPRESSION: Unchanged background of fibrotic lung disease without superimposed acute cardiopulmonary process. " ede0bf30-a80ce3c5-a7a368da-00b01dea-7c3ebedd.jpg,validate/p17/p17052884/s52326355/ede0bf30-a80ce3c5-a7a368da-00b01dea-7c3ebedd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p L hallux debridement with coughing during OR // eval eval IMPRESSION: Compared to chest radiographs since ___ most recent ___. Lungs clear. Heart size normal. No pleural abnormality. Fractures lateral aspects left middle ribs, well-healed. " ec24093c-610c9f23-966abf13-b9046572-f952a57c.jpg,validate/p10/p10335334/s55799650/ec24093c-610c9f23-966abf13-b9046572-f952a57c.jpg,validation," FINAL REPORT AP CHEST, 10:23 A.M. ON ___ HISTORY: For renal transplant. Assess pulmonary status. IMPRESSION: Frontal chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. " 11d72a0e-19e0bec1-eeb30c70-e33f385e-8a1ef102.jpg,validate/p17/p17982968/s50785262/11d72a0e-19e0bec1-eeb30c70-e33f385e-8a1ef102.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with abdominal pain. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. There is no focal consolidation, pleural effusion, or pneumothorax. Heart size is within normal limits allowing for lung volumes. The mediastinal silhouette and hilar contours are normal. There is no free air under the diaphragm. IMPRESSION: No pneumonia, edema or effusion. " fa21b638-a3f3dba3-cca56fba-58cc45e8-5639b87d.jpg,validate/p12/p12971318/s56845447/fa21b638-a3f3dba3-cca56fba-58cc45e8-5639b87d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with PPD positive // r/o TB HX +PPD,VACCINATED IN FOREIGN COUNTRY NO S/S R/O ACTIVE TB,ABNORMALITY IMPRESSION: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease or old tuberculous disease. " 9f302925-b110f703-f774a90f-1ae809b8-3bc0ea16.jpg,validate/p12/p12591345/s55899215/9f302925-b110f703-f774a90f-1ae809b8-3bc0ea16.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of CHF and now with leukocytosis likely due to urinary tract infection. // eval for infection vs. volume overload. eval for infection vs. volume overload. IMPRESSION: In comparison with the earlier study of this, there is little overall change. Again there is striking elevation of the right hemidiaphragmatic contour with no evidence of vascular congestion or acute focal pneumonia. Severe changes are again seen in the right shoulder. " fc48c585-a2c82f62-2a697c5f-f4f1ff1a-71c1a67f.jpg,validate/p18/p18716721/s54370980/fc48c585-a2c82f62-2a697c5f-f4f1ff1a-71c1a67f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with 5 hr hx of acute onset SOB // Eval SOB COMPARISON: Prior CT dated ___. FINDINGS: PA and lateral views of the chest provided. There is persistent consolidation in the right lower lobe as seen on prior CT compatible with infarction. A small adjacent pleural effusion is likely present. No additional opacities of concern. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Consolidation in the right lower lobe likely representing known infarction with probable small adjacent effusion. " 697efd0d-0eb6deeb-57eab71c-7c6a193b-07810e98.jpg,validate/p18/p18092465/s59682889/697efd0d-0eb6deeb-57eab71c-7c6a193b-07810e98.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent ICU course including intubation and ECMO for CAP and eosinphilic pneumonia now with vomiting after drinking // Signs of aspiration? COMPARISON: ___ IMPRESSION: As compared to the previous image, the patient has been extubated and the nasogastric tube was removed. There is mild over distension of the stomach. The left PICC line is in unchanged position. Low lung volumes. Moderate cardiomegaly. No evidence of aspiration or pneumonia. No pleural effusions. " 39a37437-d38171ec-94a9816a-80d34868-05410d1d.jpg,validate/p18/p18554235/s59274119/39a37437-d38171ec-94a9816a-80d34868-05410d1d.jpg,validation," FINAL REPORT INDICATION: ___F intubated, transferred from OSH // eval ETT TECHNIQUE: Portable radiograph of the chest. COMPARISON: None. FINDINGS: The ET tube is 3.4 cm above the carina. An enteric tube traverses below the diaphragm with the tip in the body of the stomach. The heart size is normal. There is mild left basilar atelectasis. Note is made of mild pulmonary vascular congestion, otherwise the hilar and mediastinal contours are unremarkable. In the mid left hemithorax, there is an ill-defined opacity. There may be a small left pleural effusion. There is no evidence of pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: 1. Enteric and ET tube are in appropriate position. 2. Opacity in the mid left lung is concerning for pneumonia. Left lung base consolidation may be atelectasis vs. pneumonia. " efe6eac9-7d940ee0-066d1647-94d60684-e149ebc1.jpg,validate/p15/p15297415/s52587011/efe6eac9-7d940ee0-066d1647-94d60684-e149ebc1.jpg,validation," WET READ: ___ ___ ___ 8:04 PM 1. Interval placement of an endotracheal tube which terminates in the mid thoracic trachea and nasogastric tube which terminates within the stomach. 2. Right pleural effusion. Apparent increase may be related to patient positioning rather than true change in size. Right pigtail catheter again seen, with only the tip within the pleural space. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute mental status changes r/t hypercarbia // New intubation New intubation COMPARISON: Chest radiographs ___ through ___. IMPRESSION: New endotracheal tube in standard placement. Nasogastric tube passes to the distal portion of a nondistended stomach. Right pleural drainage catheter still in place. Probable small residual of right pleural effusion, and persistent right basal atelectasis. Previous pulmonary vascular congestion and borderline edema has cleared since 8:30. " f8584fd5-338a0f5c-bc03daf8-902c9582-ae2aabbd.jpg,validate/p14/p14573675/s58963468/f8584fd5-338a0f5c-bc03daf8-902c9582-ae2aabbd.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after biopsy. AP radiograph of the chest was reviewed. There is no definitive evidence of pneumothorax. The known mass is redemonstrated. No interval development of pleural effusion is seen. " 2be0604e-9332dd0e-8a6d15fa-cb7aa060-94e34db9.jpg,validate/p10/p10771543/s53710501/2be0604e-9332dd0e-8a6d15fa-cb7aa060-94e34db9.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female with shortness of breath. Question pneumonia or CHF. FINDINGS: AP and lateral views of the chest. No prior. The lungs are clear of confluent consolidation or pleural effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are notable for severe degenerative changes at the left glenohumeral joint. IMPRESSION: No acute cardiopulmonary process. " 05290388-3cd12f95-441fe5ac-17a494f5-525315c2.jpg,validate/p16/p16566006/s55744617/05290388-3cd12f95-441fe5ac-17a494f5-525315c2.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Stroke with left facial symptoms and droop. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. There is persistent blunting of the left costophrenic angle which may be due to a trace pleural effusion and/or atelectasis. No new focal consolidation is seen. The right lung is clear. The cardiac and mediastinal silhouettes are stable. There has been interval removal of a nasogastric tube. IMPRESSION: Possible trace left pleural effusion. No focal consolidation. " 5350ada3-0371b47b-0e044600-fea82c22-c52c55c2.jpg,validate/p16/p16042873/s51131277/5350ada3-0371b47b-0e044600-fea82c22-c52c55c2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recent hemorrhagic CVA, trach'ed and PEG'ed - now with fever and tachypnea // please evaluate for acute process TECHNIQUE: Portable upright chest radiograph COMPARISON: ___ FINDINGS: Tracheostomy tube is stable. Lung volumes remain low. Heart size and hilar structures are accentuated by low lung volumes. No definite new consolidation concerning for pneumonia. Right PICC terminates in the right atrium. IMPRESSION: Low lung volumes with no definite evidence of pneumonia. Right PICC is in the Right Atrium. " b033eba5-8106c0e6-1799f2a9-b301094e-5e1e9c93.jpg,validate/p16/p16097039/s56894288/b033eba5-8106c0e6-1799f2a9-b301094e-5e1e9c93.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // eval for pneumothorax, 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. " 00a86ff6-1677f162-b5460410-2dbaa9ba-7cf32bf8.jpg,validate/p18/p18221111/s51230316/00a86ff6-1677f162-b5460410-2dbaa9ba-7cf32bf8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, cough, evaluation. COMPARISON: No comparison available at the time of dictation. 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. " 695ab694-2e17207d-41434315-84c690d8-feef9a4b.jpg,validate/p10/p10678758/s56057134/695ab694-2e17207d-41434315-84c690d8-feef9a4b.jpg,validation," WET READ: ___ ___ ___ 7:58 PM No acute process. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with chest pain. Portable AP radiograph of the chest was reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No abnormality to explain patient's symptoms demonstrated on the current radiograph. " d4f28ce6-95c86387-8a17851d-84b0bc22-58988b7f.jpg,validate/p16/p16057879/s52384280/d4f28ce6-95c86387-8a17851d-84b0bc22-58988b7f.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with worsening volume overload. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. There are small-to-moderate bilateral pleural effusions, left greater than right. Indistinctness of the pulmonary vascular markings suggests vascular congestion. Cardiac silhouette is enlarged, but unchanged. Left chest wall triple-lead pacing device is again seen with leads in the right atrium, right ventricular apex and coronary sinus. Prosthetic valve component is also visualized. Cardiac silhouette is enlarged as seen on prior. Bones are diffusely osteopenic. IMPRESSION: Pulmonary vascular congestion with small-to-moderate left greater than right pleural effusions. " b9ea0404-d444046d-3a195191-a17626d7-f76147b9.jpg,validate/p13/p13098918/s57080651/b9ea0404-d444046d-3a195191-a17626d7-f76147b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with episode of hypoxia, concern prior to transfer for pneumonia, please evaluate for this and any other pathology, thanks // ? pneumonia ? pneumonia IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. Cardiac silhouette remains at the upper limits of normal in size. There is no definite vascular congestion or pleural effusion. Specifically, no definite acute focal pneumonia. Of incidental note is elevation of the left hemidiaphragmatic contour in an fixation device about previous fracture of the midshaft of the left humerus. " 6cd819aa-2ce05aaa-7ff9366c-0000ac0e-9fa2e012.jpg,validate/p18/p18551287/s54937160/6cd819aa-2ce05aaa-7ff9366c-0000ac0e-9fa2e012.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with UGIB and ___ balloon in place // ___ year old s/p R IJ cvl placement, check for placement Contact name: ___ , ___: ___ TECHNIQUE: Portable supine chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: There is a right IJ, which terminates in the right atrium and should be pulled back 2-3 cm. The ETT terminates 3 cm above the carina and should be pulled back 1-2 cm. There is a Minnesota tube coursing below the diaphragm. The patient is status post TIPS. Low lung volumes. Left retrocardiac opacification, which likely represents atelectasis. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. ET tube should be pulled back 1-2 cm. 2. Right IJ should be pulled back 2-3 cm. 3. Left retrocardiac opacification, which likely represents atelectasis. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:02 PM, 5 minutes after discovery of the findings. " 31703302-3709eb33-8c647500-02ce5cad-4ee76862.jpg,validate/p12/p12676709/s51034094/31703302-3709eb33-8c647500-02ce5cad-4ee76862.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with DOE // r/o lung disease TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Lungs are well expanded and clear. Hila, mediastinal contours, and heart borders are normal. No pleural effusion. IMPRESSION: Normal. " 95db53eb-0d011fa7-75a4aff2-2d129f41-3fc57829.jpg,validate/p14/p14349552/s58399458/95db53eb-0d011fa7-75a4aff2-2d129f41-3fc57829.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with chest pain COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. The heart is moderately enlarged with mitral annular calcification again noted. There is hilar congestion and mild pulmonary edema. Left mid lung linear density is most compatible with platelike atelectasis. No large pleural effusion or pneumothorax is seen. No convincing signs of pneumonia. The imaged bony structures are intact. IMPRESSION: Cardiomegaly, mild congestion/ edema. " d9750de7-81904b69-4942da82-b253bda2-b0de0c9e.jpg,validate/p18/p18971123/s57884521/d9750de7-81904b69-4942da82-b253bda2-b0de0c9e.jpg,validation," WET READ: ___ ___ ___ 7:10 PM Enteric tube remains in the stomach. Right PICC in unchanged position with tip at the cavoatrial junction. Otherwise unremarkable chest radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NG tube that was slightly pulled back - please eval if still in stomach // ___ year old woman with NG tube that was slightly pulled back - please eval if still in stomach ___ year old woman with NG tube that was slightly pulled back - please eval if still in stomach COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Feeding tube ends in the distal stomach. Lungs clear. Heart size normal. No pleural abnormality. " 85c954d7-919ab1a3-ca84354b-07ec5798-3cd9608b.jpg,validate/p12/p12938515/s56371803/85c954d7-919ab1a3-ca84354b-07ec5798-3cd9608b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube and endotracheal tube position. COMPARISON: ___, 3:59 a.m. FINDINGS: As compared to the previous radiograph, the patient has received a nasogastric tube. The tip of the tube is not included in the image. The course of the tube is unremarkable. The left and right internal jugular vein access lines are unchanged in appearance. Unchanged appearance of the heart and the lung parenchyma. " 1f16ba81-25b5392a-794e99b6-4fa98d5b-5683c363.jpg,validate/p15/p15002678/s59989751/1f16ba81-25b5392a-794e99b6-4fa98d5b-5683c363.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Persistent oxygen requirement in the setting of volume overload despite diuresis. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size is top normal. Mediastinum is stable. Right pleural effusion appears to be unchanged. There is interval progression of interstitial pulmonary edema. Minimal left pleural effusion cannot be excluded. Alternatively to pulmonary edema, diffuse infection is a possibility, although less likely, clinical correlation is advised. " b25c2546-0a0b15d5-9cfd7310-c3f1fbd0-2a7da078.jpg,validate/p17/p17554575/s54617690/b25c2546-0a0b15d5-9cfd7310-c3f1fbd0-2a7da078.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever and AMS // Please eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Cardiac and mediastinal silhouettes are stable. Large hiatal hernia is again seen. Mild basilar atelectasis is seen without definite focal consolidation. No large pleural effusion or pneumothorax. There is diffuse osteopenia. IMPRESSION: No significant interval change. Large hiatal hernia and mild basilar atelectasis without definite focal consolidation. " d14b91a7-2deb65ba-dea8e4b9-b7bbeb5e-f3ac734f.jpg,validate/p19/p19998350/s51819111/d14b91a7-2deb65ba-dea8e4b9-b7bbeb5e-f3ac734f.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for cardiopulmonary process. COMPARISON: None. FINDINGS: PA and lateral chest radiographs are provided. Lung volumes are low. There is no focal consolidation, pleural effusion or pneumothorax. The heart size is mildly enlarged. There is no evidence of CHF. IMPRESSION: No acute cardiopulmonary process. " 2c9c3e1d-0a8478d9-1393c11e-0079d8a2-5137230e.jpg,validate/p12/p12032220/s57509417/2c9c3e1d-0a8478d9-1393c11e-0079d8a2-5137230e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with pneumonia in ___, follow up to resolution. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The lungs are clear. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is a dextroconvex scoliosis of the thoracic spine. There is a severe compression deformity of a lower thoracic vertebral body, age indeterminate. IMPRESSION: 1. No evidence of residual pneumonia. 2. Severe compression fracture of a lower thoracic vertebral body, age indeterminate. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 15:43 into the Department of Radiology critical communications system for direct communication to the referring provider. " e7ae44f5-052bdfea-f25dfd91-39e5589b-e9a41fa8.jpg,validate/p16/p16904987/s53724230/e7ae44f5-052bdfea-f25dfd91-39e5589b-e9a41fa8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for nasogastric tube. COMPARISON: ___, 6:41 p.m. FINDINGS: As compared to the previous radiograph, the Dobbhoff catheter has been pulled back. The tip now projects over the gastroesophageal junction. The tube could be advanced by at least 5 cm. The parts of the lungs are not included in the image. All visible elements of the thorax appear unchanged as compared to the previous examination. " dd7a3a04-a4187604-03c18484-f3ccd5dd-462ed903.jpg,validate/p17/p17980556/s51711577/dd7a3a04-a4187604-03c18484-f3ccd5dd-462ed903.jpg,validation," FINAL REPORT INDICATION: Patient with TCA overdose, with acute kidney injury due to rhabdo and compartment syndrome. COMPARISONS: Chest radiographs from ___ through ___. FINDINGS: Portable semi-upright view of the chest demonstrates endotracheal tube terminating 4 cm above the carina. Right-sided central venous catheter tip projects over right atrium. Left PIC catheter tip projects over mid SVC. Low lung volumes accentuate bronchovascular markings. No pneumothorax. Retrocardiac consolidation persists. Diffuse bilateral patchy opacities reflect moderate pulmonary edema, unchnaged. IMPRESSION: 1. Left lung base consolidation, likely atelectasis with small left pleural effusion, unchanged. 2. Moderate pulmonary edema, not significantly changed since ___. " 75f51e34-e0b0e29f-85ec0820-5bace590-98001b7f.jpg,validate/p18/p18929056/s54328164/75f51e34-e0b0e29f-85ec0820-5bace590-98001b7f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with sudden onset chest wall when turning torso yesterday. 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, unchanged. Mild enlargement of the cardiac silhouette is similar. The aorta remains tortuous and diffusely calcified. Pulmonary vasculature is not engorged, and hilar contours are unchanged. Lungs are hyperinflated with emphysematous changes again noted in the upper lobes. Scarring in the lung apices is similar. No focal consolidation, pleural effusion or pneumothorax is detected. Clips are seen in the right upper quadrant of the abdomen. There are no acute osseous abnormalities. IMPRESSION: Emphysema. No acute cardiopulmonary abnormality. " cf3bccce-a39a5db1-6e0f98a8-5860e035-a23ff0e1.jpg,validate/p18/p18126920/s56930681/cf3bccce-a39a5db1-6e0f98a8-5860e035-a23ff0e1.jpg,validation," FINAL REPORT EXAMINATION: Chest two views. INDICATION: Cough. TECHNIQUE: Chest PA and lateral COMPARISON: Lung views from CT scan on ___. FINDINGS: The pleural thickening seen on the CT scan is better visualized on that cross sectional study. A smaller ple loss in the lower lungs left greater than right ural thickening seen in the left CP angle. The lungs are otherwise clear without infiltrate or effusion. There is some minimal volume IMPRESSION: No infiltrate " cd7c3554-7898d3f3-fb583eb8-cd5aa1e9-b88c7653.jpg,validate/p18/p18628502/s59181631/cd7c3554-7898d3f3-fb583eb8-cd5aa1e9-b88c7653.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent fever and cough for 2 weeks, prior CXR on ___. non-smoker, no asthma // r/o interim development of pneumonia COMPARISON: ___ THROUGH ___. FINDINGS: IMPRESSION: BORDERLINE CARDIOMEGALY IS UNCHANGED. SINCE AT LEAST ___. LUNGS ARE CLEAR. THERE IS NO PLEURAL ABNORMALITY OR EVIDENCE OF CENTRAL LYMPH NODE ENLARGEMENT. " a955e775-ec16c011-d3cda536-51a1418f-06f3f3da.jpg,validate/p17/p17445268/s52413471/a955e775-ec16c011-d3cda536-51a1418f-06f3f3da.jpg,validation," WET READ: ___ ___ ___ 7:18 PM NGT courses through the stomach and out of view. ETT tip 5 cm above carina. Mild worsening of the right lower lobe opacities compared to prior studies, may be due to mild superimposed edema. Small right pleural effusion, slightly larger since prior study. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: New OG tube placement. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube and the NG tube are in unchanged position. Heart size and mediastinum are unchanged. There is interval progression of right lung opacification most likely due to increase in pleural effusions and may potentially be also due to interval aspiration/asymmetric pulmonary edema. Left pleural effusion is unchanged. No evidence of pneumothorax is present. " 13bb2400-f7d97a00-ac08db82-224137b2-d2e86b98.jpg,validate/p11/p11877234/s53372551/13bb2400-f7d97a00-ac08db82-224137b2-d2e86b98.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with possible PICC malposition. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Right PICC is seen with tip in the mid SVC. Left chest wall single lead pacing device is again seen. Cardiac silhouette is enlarged but stable. The lungs are clear of consolidation or effusion. Hypertrophic changes noted in the spine. IMPRESSION: Right PICC with tip in the mid SVC. " bc2c5f00-a2c9de21-bddd46c8-4ebd175a-ea76c1bb.jpg,validate/p10/p10045929/s50857808/bc2c5f00-a2c9de21-bddd46c8-4ebd175a-ea76c1bb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bilateral rib fractures, known L apical pneumothorax, pig-tail in place // Change in pneumothorax Change in pneumothorax IMPRESSION: In comparison with the study of ___, there is little change in the degree of left apical pneumothorax with pigtail catheter remaining in place. Otherwise, little change. " 3ba27fd9-8d91435a-573ff8e0-bfd85ee0-b3de04d3.jpg,validate/p15/p15116019/s57939810/3ba27fd9-8d91435a-573ff8e0-bfd85ee0-b3de04d3.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Shortness of breath, status post tracheobronchoplasty ___, assess for pneumonia. FINDINGS: PA and lateral views of the chest are provided. The heart remains moderately enlarged. There is blunting of the right CP angle which likely represents a small pleural effusion. Micronodular opacities project over the right mid-to-lower lung which is new from prior exam and could represent atypical infection. The left lung appears largely clear. There is no pneumothorax. Mediastinal contour appear stable. Bony structures are intact. IMPRESSION: Cardiomegaly with tiny right pleural effusion. New micronodular opacities in the right mid-to-lower lung could represent atypical infection. Recommend followup to resolution. " 4d0fc083-bcc063db-5eb29c9b-8860db5e-e4536ba0.jpg,validate/p10/p10702059/s52123733/4d0fc083-bcc063db-5eb29c9b-8860db5e-e4536ba0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with productive cough COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. The heart remains mildly enlarged. There is a similar overall pattern of right hilar prominence. No large effusion or pneumothorax. No signs of edema or pneumonia. Left shoulder arthroplasty partially visualized as well as degenerative changes at the right shoulder. IMPRESSION: Stable mild cardiomegaly. Right hilar prominence is unchanged. " fb52df08-08284f07-76220e50-d3660b44-2ca2833d.jpg,validate/p18/p18059653/s55735973/fb52df08-08284f07-76220e50-d3660b44-2ca2833d.jpg,validation," FINAL REPORT HISTORY: Lightheadedness concerning for pneumonia. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: PA and lateral images of the chest. The lungs are well expanded. Mildly dilated upper lobe vessels are seen. There is no focal consolidation or mass. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette is top normal in size. IMPRESSION: No acute cardiopulmonary process. " e1a1e5b6-0dad0754-37c2ece5-f8692ab5-36767700.jpg,validate/p17/p17453200/s55480559/e1a1e5b6-0dad0754-37c2ece5-f8692ab5-36767700.jpg,validation," 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. " b86f6731-02ce8a24-4490077d-deead101-47f1aa4c.jpg,validate/p14/p14325424/s52369878/b86f6731-02ce8a24-4490077d-deead101-47f1aa4c.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with left subclavian attempt. Evaluate for pneumothorax. COMPARISON: Film from earlier the same day at 11:59 a.m. FINDINGS: Single portable view of the chest. There is a large left-sided pneumothorax with atelectasis of the left lung and mediastinal shift to the right. Endotracheal tube still remains low with tip approximately 1.3 cm from the carina. The enteric tube is seen with tip in the region of the gastric fundus, side port not visualized, but potentially in the lower esophagus. Increased opacity in the right lung is likely due to atelectasis. IMPRESSION: Large left pneumothorax with mediastinal shift. Endotracheal tube still low. Dr. ___ was aware of findings at time of dictation as he had called the reading room. " 5ab8e146-62775b9a-52f15061-2bbdaa5a-92287f51.jpg,validate/p13/p13391297/s57130222/5ab8e146-62775b9a-52f15061-2bbdaa5a-92287f51.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is normal. The aorta remains tortuous, and the hilar contours are stable. The pulmonary vasculature is normal. Streaky opacities in the lung bases are re- demonstrated, similar compared to the prior exam, and most likely reflective of atelectasis. Infection is not completely excluded. No pleural effusion or pneumothorax is seen. Partially imaged is cervical spinal fusion hardware. Mild elevation of the right hemidiaphragm is re- demonstrated, along with multiple clips in the right upper quadrant of the abdomen. IMPRESSION: Bibasilar airspace opacities likely reflect atelectasis though infection cannot be completely excluded. " 430853d3-2496a032-420bff3b-6456456e-16e417e4.jpg,validate/p13/p13066396/s50743801/430853d3-2496a032-420bff3b-6456456e-16e417e4.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with epigastric pain after colonoscopy // eval for free air 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. The aorta is slightly tortuous. No pulmonary edema is seen. Lucency is seen the level the left hemidiaphragm, some which appears to be within bowel, more laterally this is unclear but most likely within the stomach. If high clinical concern for pneumoperitoneum, consider CT. IMPRESSION: No acute cardiopulmonary process.Lucency is seen the level the left hemidiaphragm, some which appears to be within bowel, more laterally this is unclear but most likely within the stomach. If high clinical concern for pneumoperitoneum, consider CT. NOTIFICATION: Findings discussed with Dr. ___ at 20:45 on ___. Will start with repeat chest radiograph. " f79bbad4-a225c2a3-b8981e8a-da87bf1c-59440032.jpg,validate/p14/p14011220/s50066926/f79bbad4-a225c2a3-b8981e8a-da87bf1c-59440032.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with increasing O2 requirement and COPD. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs remain hyperinflated. No focal consolidation, effusion, pneumothorax, or edema. The heart is likely mildly enlarged given the hyperinflated lungs, unchanged. The mediastinum is not widened. Hilar contours are normal. Aortic knob calcifications and descending thoracic aorta calcifications are mild. Mild dextroconvex scoliosis of the upper thoracic spine and moderate levoconvex scoliosis of the thoracolumbar spine is more pronounced on today's exam and may be positional. Vertebral body heights of the visualized thoracic spine on the lateral view appear unchanged without significant loss of vertebral body height. IMPRESSION: 1. No pneumothorax. 2. Hyperinflated lungs. 3. mild cardiomegaly. No bronchovascular congestion, edema, or effusion. " d89236a6-298de398-b2c6298c-9602d642-6cda1d81.jpg,validate/p17/p17827349/s53689217/d89236a6-298de398-b2c6298c-9602d642-6cda1d81.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___ as well as a torso CT from ___. CLINICAL HISTORY: Rash, cramps, question infection. FINDINGS: PA and lateral views of the chest provided demonstrate clear, well-expanded lungs without focal consolidation, effusion, or pneumothorax. An azygous fissure is noted. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 4636f74f-176c4054-9a834ce7-98f87092-a7f2c2fd.jpg,validate/p12/p12443637/s59448613/4636f74f-176c4054-9a834ce7-98f87092-a7f2c2fd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with sob, recent c-section // eval for pna COMPARISON: No priors FINDINGS: PA and lateral views of the chest provided. Dense breast tissue partially obscures evaluation through the lower lungs. However, 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. " d822df10-702a1e42-3ecfa804-c026b16f-b74ea58a.jpg,validate/p12/p12425122/s59663104/d822df10-702a1e42-3ecfa804-c026b16f-b74ea58a.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with subdural hemorrhage and left eye proptosis. STUDY: AP and lateral chest radiograph. COMPARISON: ___ and ___. FINDINGS: A pacer unit projects over the left chest with leads in the right atrium and right ventricle. Sternotomy wires and mediastinal clips are unchanged. The heart size is at the upper limits of normal. The mediastinal contours demonstrate calcified atherosclerotic disease of the aortic knob with a mildly tortuous aorta. The previously described pulmonary edema has resolved. Pleuroparenchymal scarring, and possible pleural calcification, at the left base is longstanding, but there is no pleural effusion or pneumothorax. Degenerative changes are noted in the thoracic spine, primarily in the form of anterior osteophytes. IMPRESSION: No acute cardiopulmonary process. " a8abe3bc-2733755e-c8bad514-39ad7956-f52649f6.jpg,validate/p15/p15299171/s59151354/a8abe3bc-2733755e-c8bad514-39ad7956-f52649f6.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ___ No prior radiographs for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs and pleural surfaces are clear. There are no pleural effusions or acute skeletal findings. IMPRESSION: No radiographic evidence of pneumonia. " ff4ff019-34132aef-fa81d6e2-f7b461da-8e948a67.jpg,validate/p18/p18551287/s59474230/ff4ff019-34132aef-fa81d6e2-f7b461da-8e948a67.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with, question pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___, CXR ___. FINDINGS: PA and lateral views the chest provided demonstrate clear well expanded lungs of focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. A metallic coil and TIPS shunt noted within the upper abdomen. IMPRESSION: No acute findings. " 24960743-14f426d7-d057ceaa-ea719e12-5534250a.jpg,validate/p18/p18767957/s56233609/24960743-14f426d7-d057ceaa-ea719e12-5534250a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, chest pain // Eval for PNA, cardiopulmonary process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There has been no significant interval change. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable with possible minimal central vascular engorgement. IMPRESSION: No significant interval change. " 6a4408a7-12757451-f72a321c-f3107d7e-02f98857.jpg,validate/p16/p16733321/s56096678/6a4408a7-12757451-f72a321c-f3107d7e-02f98857.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent infiltrate // follow up infiltrate follow up infiltrate IMPRESSION: In comparison with the study of ___, there is been decrease in the rounded area of opacification in the right upper lung, most likely reflecting pneumonia. Much of the residual could merely reflect fibrous healing. The remainder of the study is unchanged with no evidence of focal consolidation or vascular congestion. " a20e7c5f-e9d1efe4-e4cf2e3b-9ce641f4-f20655d2.jpg,validate/p12/p12785654/s54011886/a20e7c5f-e9d1efe4-e4cf2e3b-9ce641f4-f20655d2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with BOT mass, s/p trach/peg ___, recurrent hypoxia ___ secretioons // eval interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Retrocardiac opacities have minimally improved. Right lower lobe atelectasis are unchanged. There is no pneumothorax or pleural effusion. Cardiomediastinal contours are unchanged. Tracheostomy is in standard position . " 13076a27-1d09e637-56d6b64d-5d5967a9-51b6ba9c.jpg,validate/p15/p15963601/s51753821/13076a27-1d09e637-56d6b64d-5d5967a9-51b6ba9c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Single AP upright and lateral chest views were read in comparison with prior radiographs from ___ and ___. FINDINGS: Mildly enlarged heart, mediastinal and hilar contours have similar appearance. Mild pulmonary vascular congestion is unchanged. There are no lung opacities concerning for infection or pulmonary edema. There is no pleural effusion or pneumothorax. A dual-lead right chest wall device is present with leads through the right transvenous approach ends into the right atrium and another into the right ventricle. " 9ec50308-cd5d34a9-3e45c92c-282614d3-871effd4.jpg,validate/p14/p14661372/s56660535/9ec50308-cd5d34a9-3e45c92c-282614d3-871effd4.jpg,validation," FINAL REPORT INDICATION: ___ year old man with recent unexplained weight loss; remote history of cigarette smoking // Evaluate for parenchymal lung disease TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unremarkable. Coronary calcifications in at least the LAD are moderate to severe. No pleural effusions or pneumothorax. No acute or aggressive osseus changes. IMPRESSION: No acute cardiopulmonary process. Coronary calcifications in at least the LAD are moderate to severe. " 18b65c08-14672c49-bb9c0a2b-f234fc7e-3194cf85.jpg,validate/p12/p12278812/s53331741/18b65c08-14672c49-bb9c0a2b-f234fc7e-3194cf85.jpg,validation," FINAL REPORT INDICATION: Confirmation of pacemaker integrity. COMPARISON: ___. FINDINGS: PA and lateral chest radiograph. Left-sided subpectoral pacer leads terminate in the right atrium and ventricle. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Intact dual-chamber pacer leads. " c8156b40-92c851b7-cb1535f8-d043d2bb-0dfbf8d7.jpg,validate/p17/p17797784/s52951335/c8156b40-92c851b7-cb1535f8-d043d2bb-0dfbf8d7.jpg,validation," FINAL REPORT INDICATION: ___-year-old with mild chest pain and shortness of breath, history of breast cancer. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: There is mild-to-moderate cardiomegaly. Calcification in the aortic knob is noted. Otherwise, the mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs are well expanded without focal consolidation concerning for pneumonia. A 1.0 cm round opacity projects at the lung base posteriorly, best seen on the lateral view. This is not definitively identified on the frontal view but may be present at the left lung base. The upper abdomen is unremarkable. Surgical clips are noted projecting over the breast tissue on the lateral view. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Apparent round opacity projecting over the posterior lung bases on the lateral view. Chest CT is recommended when clinically appropriate. " d3f34560-547533f8-68a9e4eb-98710338-2773a70a.jpg,validate/p13/p13107206/s59035277/d3f34560-547533f8-68a9e4eb-98710338-2773a70a.jpg,validation," FINAL REPORT INDICATION: A ___-year-old female with tobacco history now with cough and hypoxia. EXAMINATION: PA and lateral chest radiographs. COMPARISONS: ___ FINDINGS: There is hyperinflation of the lungs with irregularity of the peripheral pulmonary vascularity, in keeping with emphysema. There are no new focal opacities concerning for pneumonia. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal. IMPRESSION: Findings compatible with emphysema. No evidence of pneumonia. " 0da092f0-a32a20dc-eb398cf3-72cb7a75-b207ddad.jpg,validate/p11/p11981336/s52306702/0da092f0-a32a20dc-eb398cf3-72cb7a75-b207ddad.jpg,validation," FINAL REPORT HISTORY: Cough and hypotension, here to evaluate for pneumonia. 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. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The trachea is midline. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9af7c408-78512053-997e6069-58156ecc-5cb13337.jpg,validate/p18/p18170845/s58278671/9af7c408-78512053-997e6069-58156ecc-5cb13337.jpg,validation," FINAL REPORT INDICATION: ___ year old man with fever, cirrhosis. Evaluate for consolidation ___ TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are low, accentuating interstitial markings. There is increased opacity in the right base, likely due to atelectasis. Small right pleural effusion is possible. Healing rib fracture is seen on the right posterior sixth rib. Heart size is top-normal. The mediastinal and hilar contours are unremarkable. IMPRESSION: No pneumonia. " 98c48375-a87dca77-34210cd0-f41c05c5-0f3cb5f1.jpg,validate/p13/p13622559/s52786136/98c48375-a87dca77-34210cd0-f41c05c5-0f3cb5f1.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: AIDS, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes. Borderline diameter of the pulmonary arteries bilaterally. Normal size of the cardiac silhouette. No parenchymal opacities. No other relevant changes. No pneumonia, no pleural effusions. " 906ada86-ae028b6c-5ac025a0-d27475ee-2c577f93.jpg,validate/p11/p11630519/s54310846/906ada86-ae028b6c-5ac025a0-d27475ee-2c577f93.jpg,validation," WET READ: ___ ___ 6:24 PM No significant change from prior, including a left retrocardiac opacity, which is likely atelectasis, though pneumonia is difficult to completely exclude. No new opacity. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:44 P.M., ___ HISTORY: ___-year-old man with stroke and fever. IMPRESSION: AP chest compared to ___ through ___ at 4:54 a.m.: Consolidation developed at the left lung base since ___ was accompanied by ipsilateral mediastinal shift earlier in the day an indication of atelectasis. The shift has resolved, but the consolidation has not cleared, suggesting developing pneumonia. Moderate-to-severe cardiomegaly is chronic. Pulmonary vascular congestion is mild-to-moderate but improved since earlier today. Mediastinal contours are unremarkable. ET tube, nasogastric tube, and left subclavian line are all in standard placements. " edc63b09-19e3fd17-5bb10b1f-a8574d83-1c405a22.jpg,validate/p12/p12773009/s50325024/edc63b09-19e3fd17-5bb10b1f-a8574d83-1c405a22.jpg,validation," 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. " 43eca400-d2b680f3-d9616a10-89e1725e-6dc47587.jpg,validate/p11/p11888596/s55572723/43eca400-d2b680f3-d9616a10-89e1725e-6dc47587.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, hemoptysis and fever // ? pneumonia ? pneumonia IMPRESSION: There no prior chest radiographs available for review. Lateral view shows heterogeneous retrocardiac opacification, probably right lower lobe. This could be pneumonia, or, depending upon clinical circumstances aspirated material, including blood. No discrete lung mass or central adenopathy is seen, but this examination is not sensitive in detecting small airway lesions. Heart size top-normal. RECOMMENDATION(S): Repeat chest radiograph in ___ weeks to document clearing. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 2:___ PM, 1 minutes after discovery of the findings. ___, MD ___=___ " 8a7b884c-06f91558-466608f0-4a547ead-4c7b15c9.jpg,validate/p11/p11455001/s51974389/8a7b884c-06f91558-466608f0-4a547ead-4c7b15c9.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with repair of laparoscopic Nissen. COMPARISON: ___. FINDINGS: The endotracheal tube is in adequate position at 3.3 cm above the carina. The right subclavian line and the NG tube are unchanged. There is increased amount of bilateral pleural effusion. There is also worsening of the retrocardiac left atelectasis. There is more cephalization of the pulmonary vessels compatible with a mild volume overload. The mediastinal and cardiac contour are unchanged. There is no visible pneumothorax. CONCLUSION: Worsening of the bilateral moderate pleural effusion and the left retrocardiac atelectasis. New mild volume overload. " 2665072d-c7fef0eb-f2f6ea06-410f7840-65a6de79.jpg,validate/p14/p14439439/s50017086/2665072d-c7fef0eb-f2f6ea06-410f7840-65a6de79.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Renal failure, evaluate for pulmonary edema. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Patchy right mid-to-lower lower lung opacity seen on the frontal view is not substantiated on the lateral view and may be due to atelectasis or possibly vascular engorgement, consolidation is felt less likely. No pleural effusion or pneumothorax is seen. There is mild prominence of the hila which may be due to central pulmonary vascular engorgement with mild pulmonary vascular congestion. The cardiac silhouette is top normal. Mediastinal contours are unremarkable. There appeared to be some posterolateral right-sided rib deformities which may be due to prior trauma. IMPRESSION: Patchy right basilar opacity without priors for comparison may be due to atelectasis or vascular engorgement, consolidation felt less likely. Mild prominence of the hila may be due to central pulmonary vascular engorgement with mild vascular congestion. " 3ebcd7ba-8252697b-fa022343-5ea4c13a-76823ade.jpg,validate/p16/p16787711/s51785244/3ebcd7ba-8252697b-fa022343-5ea4c13a-76823ade.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with intermittent fever and night sweats. 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 malignancy or infection. " 936fe802-cd007509-07030b01-60cb9860-ee8f61b1.jpg,validate/p10/p10900387/s54116181/936fe802-cd007509-07030b01-60cb9860-ee8f61b1.jpg,validation," WET READ: ___ ___ 6:54 PM The contour of the heart has become somewhat more globular possibly reflecting pericardial effusion. Mild pulmonary edema and bibasilar opacities are not appreciably changed. In the right clinical setting underlying pneumonia cannot be excluded. Right PICC is in stable position. ___ to ___ at 6:55 pm, ___, by phone, 5 minutes after discovery. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___. FINDINGS: Stable cardiomegaly accompanied by worsening pulmonary edema. A more confluent opacity in the left retrocardiac region could reflect asymmetrical edema or developing infectious consolidation. " 647a3599-20f7a9e0-27d17a0f-dd11a8eb-a27e0eaa.jpg,validate/p19/p19416143/s54143815/647a3599-20f7a9e0-27d17a0f-dd11a8eb-a27e0eaa.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with cirrhosis, presents with altered mental status and abdominal pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Slightly lower lung volume is seen on current exam. The lungs are clear of confluent consolidation or effusion. The cardiomediastinal silhouette is within normal limits. The osseous and soft tissue structures are again notable for multiple right lateral rib fractures as well as a left lower lateral rib fracture as on prior. No pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 76a9cd8b-6aa4cefb-5b103d5f-e88a320a-2a17f680.jpg,validate/p12/p12204055/s57437231/76a9cd8b-6aa4cefb-5b103d5f-e88a320a-2a17f680.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG CT water seal trial // eval for penumo eval for penumo IMPRESSION: In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. With the left chest tube on water seal, there is no evidence of pneumothorax. The remainder the heart and lungs is unchanged, including the dense pleural calcification consistent with asbestos related disease. " 0e939e6f-73b19ca8-ca757c12-dbcb6344-c36cd5a8.jpg,validate/p19/p19717200/s59706456/0e939e6f-73b19ca8-ca757c12-dbcb6344-c36cd5a8.jpg,validation," FINAL REPORT INDICATION: ___ year old man with alcohol abuse. Now with chest pain and dyspnea after a fall. Evaluate for rib fracture. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lung volumes are low which causes crowding of bronchovascular structures. No focal opacity, pleural effusion or pneumothorax is identified. The heart size is likely normal. The mediastinal contours are normal. No rib fracture is identified. IMPRESSION: No rib fracture is identified. If there are focal areas of pain dedicated views of those areas are recommended. " 802871a0-129b2249-23319118-634c4ce4-162ad9a0.jpg,validate/p14/p14556716/s51484603/802871a0-129b2249-23319118-634c4ce4-162ad9a0.jpg,validation," FINAL REPORT INDICATION: Fever and productive cough, question pneumonia. 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. There is an opacity adjacent to the right heart border. IMPRESSION: Opacity adjacent to the right heart border, which may represent a benign fat collection or benign cyst. No pneumonia. " 854b453d-e6f4064f-388c56d6-4bdb471f-e10cbc8e.jpg,validate/p11/p11329913/s55701034/854b453d-e6f4064f-388c56d6-4bdb471f-e10cbc8e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with fevers to 104, chronic bronchitis/smoke, evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are hyperinflated without focal consolidation. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. Partially imaged cervical spine fusion hardware. IMPRESSION: Hyperinflated lungs without focal consolidation. " 3e89d316-44405939-9da15675-0f4af0a8-7053ca12.jpg,validate/p15/p15546076/s54700843/3e89d316-44405939-9da15675-0f4af0a8-7053ca12.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with left sided chest pain, shoulder pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is top normal. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is detected. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 5a164106-ce198292-34f951f4-c4c8b96d-1e1a80dd.jpg,validate/p19/p19016834/s54233043/5a164106-ce198292-34f951f4-c4c8b96d-1e1a80dd.jpg,validation," FINAL REPORT INDICATION: Cough and dyspnea. COMPARISONS: Chest radiograph ___. FINDINGS: There is continued opacification of the right base. It is not significantly worsened since the prior exam. This may be due to a combination of pleural effusion, atelectasis, and aspiration. In the proper clinical setting, pneumonia cannot be excluded. There is a stable moderate right pleural effusion. There is a small left pleural effusion. No new consolidation is identified. There is no pulmonary edema or pneumothorax. The cardiomediastinal silhouette is normal. An esophageal stent is unchanged in position. A drain is present overlying the mid abdomen. IMPRESSION: 1. Unchanged opacification at the right base. This may be due to atelectasis or aspiration. In the proper clinical setting, pneumonia cannot be excluded. 2. Stable moderate right and small left pleural effusions. " 61c0c5ca-55269293-c572326b-495a4114-91131fe9.jpg,validate/p14/p14772351/s58867295/61c0c5ca-55269293-c572326b-495a4114-91131fe9.jpg,validation," 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 again are low lung volumes. However, the heart remains within normal limits in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 483a3290-8ba3c32f-2f3e068a-5552cd22-af81fde8.jpg,validate/p14/p14995589/s59391296/483a3290-8ba3c32f-2f3e068a-5552cd22-af81fde8.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. ___-year-old female patient status post right lower lobectomy in ___ for stage IA non-small cell lung cancer. Now increased shortness of breath, check for interval change. 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 remains normal. No configurational abnormalities identified. The thoracic aorta is moderately widened and elongated and calcium deposits are seen in the wall, mostly at the level of the arch. There are no local aortic wall contour abnormalities. The pulmonary vasculature is not congested. No evidence of acute new infiltrates. The lateral and posterior pleural sinuses are free from any fluid accumulation and there is no evidence of pneumothorax in the apical area on the frontal view. Moderate degree of demineralization is seen in the skeletal structures with an accentuated kyphotic curvature in the thoracic spine as seen on the lateral view, but there is no evidence of any local vertebral body compression fracture. The diminished pulmonary vasculature in the right hemithorax is consistent with history of a right lower lobe resection performed in ___. No new parenchymal, pleural or vascular abnormalities have developed. " c14f4b97-b1b32f9c-5f3d5c70-2bf3a1c8-db3cd841.jpg,validate/p12/p12620123/s57901326/c14f4b97-b1b32f9c-5f3d5c70-2bf3a1c8-db3cd841.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PE // interval change interval change IMPRESSION: In comparison with the study of ___, the right IJ sheath appears unchanged. Cardiomediastinal silhouette is stable. Areas of increased opacification at the bases again could reflect atelectasis or mild elevation in pulmonary venous pressure. The left hemidiaphragm is not well seen, consistent with volume loss in the left lower lobe. " 78ac9720-8208e65a-ab2f098f-44e5d1bc-c0cccea5.jpg,validate/p11/p11069386/s59371691/78ac9720-8208e65a-ab2f098f-44e5d1bc-c0cccea5.jpg,validation," FINAL REPORT AP CHEST, 11:20 A.M. ON ___ HISTORY: A ___-year-old woman with CHF and dementia, short of breath and hypoxic. MI and pneumonia diagnosed. IMPRESSION: AP chest compared to ___ through ___. Moderate pulmonary edema worsened from ___, possible left upper lobe pneumonia developed on ___, unchanged. Edema, as evidenced in the right lung has improved. Small bilateral pleural effusions and severe cardiomegaly remain. " 6cd741ac-ca5b468d-56cbc481-6d5ae528-2658e1fb.jpg,validate/p18/p18807122/s52056669/6cd741ac-ca5b468d-56cbc481-6d5ae528-2658e1fb.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. 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. " 7982a0a5-d76421ab-63ca1b7d-1f44fafa-a9db012a.jpg,validate/p14/p14313382/s59209434/7982a0a5-d76421ab-63ca1b7d-1f44fafa-a9db012a.jpg,validation," 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. " bfdd5903-5f98e884-562996b3-b696588b-d4d520de.jpg,validate/p12/p12799209/s54912171/bfdd5903-5f98e884-562996b3-b696588b-d4d520de.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman after thymectomy. IMPRESSION: PA and lateral chest compared to ___: Normal postoperative appearance of mediastinum. Normal heart, lungs, hila, and pleural surfaces. " 2c20759f-c9e0d1f8-a05e1c22-4b556f02-f90da190.jpg,validate/p12/p12342869/s50350557/2c20759f-c9e0d1f8-a05e1c22-4b556f02-f90da190.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pleuritic chest pain, HA since ___, preceded by 3x days sore throat, no fevers. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Streaky perihilar opacities could reflect mild airways inflammation. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Possible mild central airways inflammation. No lobar consolidation. " 7fe9af13-b1e6a6a9-39409d93-dd2f9bc7-91b8a8a3.jpg,validate/p16/p16934858/s57372662/7fe9af13-b1e6a6a9-39409d93-dd2f9bc7-91b8a8a3.jpg,validation," FINAL REPORT PA AND LATERAL CHEST OF ___ No prior studies for comparison. Heart size, mediastinal and hilar contours are within normal limits. Lungs are overexpanded. Minimal scarring is present at the left lung base adjacent to the costophrenic angle. Diffuse vascular calcifications are present including the thoracic aorta, coronary arteries, and other vascular structures including the subclavian arteries and right axillary vessels. Bones are diffusely demineralized. Healing ninth lateral right rib fractures. IMPRESSION: 1. Hyperexpanded lungs suggestive of COPD. 2. Extensive vascular calcifications involving coronary arteries, thoracic aorta and other vascular structures. " a8bba6ce-2b56a650-cea0571e-95b31062-a541521a.jpg,validate/p10/p10101070/s53062846/a8bba6ce-2b56a650-cea0571e-95b31062-a541521a.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with cholangitis, now with hemoptysis. COMPARISON: None. FINDINGS: Lung volumes are low. There are small bilateral pleural effusions or pleural thickening. Minimal left upper lobe and left basal linear opacity could either be from scarring or atelectasis. There has been a prior sternotomy for aortic valve repair. There is no pneumothorax. Right humeral head is not included fully on this study and appears abnormally sclerotic. If warranted, a dedicated shoulder radiograph could be obtained for further characterization. " eee7653e-0db069c7-c8bda9ef-bf82f2d3-5f5bf3c6.jpg,validate/p13/p13007657/s57261517/eee7653e-0db069c7-c8bda9ef-bf82f2d3-5f5bf3c6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ESRD on HD with new fever, no localizing signs/symptoms // Evaluate for pneumonia TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. There is minimal bibasal opacity concerning for infectious process but atelectasis would be another possibility. No no substantial pleural effusion demonstrated. No pneumothorax is seen. " 34985633-bb640297-7d14d320-c53345b2-13c921d5.jpg,validate/p18/p18550032/s51020398/34985633-bb640297-7d14d320-c53345b2-13c921d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p right sided thoracentesis // r/o R TPA r/o R TPA IMPRESSION: In comparison with the earlier study of this date, there has been a right thoracentesis with removal of a substantial amount of pleural fluid. No evidence of post procedure pneumothorax. Continued enlargement of the cardiac silhouette with vascular congestion that is less pronounced than on the previous study. " 65190da1-371c6e0f-f33d0fea-a40e1930-a7706495.jpg,validate/p15/p15606157/s51207292/65190da1-371c6e0f-f33d0fea-a40e1930-a7706495.jpg,validation," WET READ: ___ ___ ___ 11:17 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with weakness, altered mental status, evaluate for infectious process for effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating ___ FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. The osseous structures and upper abdomen are unremarkable. Surgical clips projecting over bilateral upper quadrants and a partially visualized IVC filter studies. IMPRESSION: No acute cardiopulmonary process " 1be593e4-4c72841d-9ab08fad-7420f8f5-62cbe374.jpg,validate/p10/p10954531/s51733569/1be593e4-4c72841d-9ab08fad-7420f8f5-62cbe374.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DKA hypoxemia, intubated. ?PNA // any interval changes? assess lines/tubes any interval changes? assess lines/tubes IMPRESSION: Comparison to ___. Decrease in lung volumes an increase in radiographic density of the pre-existing bilateral basal parenchymal opacities. Moderate cardiomegaly persists. The monitoring and support devices are stable. " 4caa4909-0991fb7b-4ff59286-3aeceda8-87b70840.jpg,validate/p14/p14256999/s50897416/4caa4909-0991fb7b-4ff59286-3aeceda8-87b70840.jpg,validation," 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. " ee1ddb14-e9928f0e-5fd4e71c-8ccbf16a-4215d390.jpg,validate/p13/p13417577/s53261149/ee1ddb14-e9928f0e-5fd4e71c-8ccbf16a-4215d390.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with known pneumothorax on the left. Evaluation for size of pneumothorax. COMPARISON: Comparison is made to outside radiograph of the chest from two hours prior (___) as well as chest radiographs from ___. This study is read in conjunction with outside CT of the chest from ___ obtained on ___. FINDINGS: AP and lateral views of the chest demonstrate a moderate-sized left pneumothorax, not significantly changed since the prior outside study. There is no significant mediastinal shift or signs of tension. A small left pleural effusion is noted. Severe background emphysema is again seen. The cardiomediastinal silhouette is unremarkable. No focal consolidation is present. IMPRESSION: Moderate left pneumothorax and small left pleural effusion, not significantly changed from two hours ago. Severe emphysema. " 21868f4c-d5914d1e-7f153e92-ff3476f7-4fe24175.jpg,validate/p15/p15934121/s51301280/21868f4c-d5914d1e-7f153e92-ff3476f7-4fe24175.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever // 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. " c53964d9-0c5a4135-8a274d73-217f780a-c5158ceb.jpg,validate/p16/p16528352/s52140265/c53964d9-0c5a4135-8a274d73-217f780a-c5158ceb.jpg,validation," FINAL REPORT CHEST TWO VIEWS: ___ HISTORY: ___-year-old male with tube for empyema. Flushes are leaking out of skin margin. Evaluate chest tube. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. When compared to prior, the right-sided chest tube is in similar position based on the frontal exam located within posteriorly in the left chest cavity on the lateral adjacnet to loculated pleural air. Otherwise, there has been no change. Right-sided PICC is again seen; however, tip is not clearly identified. There is no visualized pneumothorax. Chronic deformity of the proximal right humerus is identified. IMPRESSION: Stable appearance of right pigtail catheter. " 08b89199-fb2b762c-234ea13d-809c866a-ff68b2c9.jpg,validate/p10/p10801854/s50944794/08b89199-fb2b762c-234ea13d-809c866a-ff68b2c9.jpg,validation," FINAL REPORT HISTORY: Malignant effusions, to assess for change. FINDINGS: In comparison with the study of ___, there again are moderate pleural effusions bilaterally with compressive atelectasis at the bases, more prominent on the right. No evidence of pulmonary vascular congestion. The lung volumes are decreased since the previous study. " 3f852d67-118c4487-63b0cd20-604712f1-2fa8e2af.jpg,validate/p17/p17967970/s51672159/3f852d67-118c4487-63b0cd20-604712f1-2fa8e2af.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS RUL wedge // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: There is a right pleural effusion, which appears unchanged in comparison to the prior chest radiograph. There is apical pleural thickening seen on the right. The left lung appears hyperinflated, but clear. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pneumothorax is seen. IMPRESSION: Unchanged right pleural effusion. " 79ecaac1-3cc2d1b0-36eba19b-b19171eb-fb8431b8.jpg,validate/p18/p18043576/s52310440/79ecaac1-3cc2d1b0-36eba19b-b19171eb-fb8431b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with mechanical ventillation // please assess for interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are in unchanged correct position. The pre-existing retrocardiac atelectasis as well as the opacity at the right lung base is minimally more severe than on the previous image. No other changes are noted. The appearance of the cardiac silhouette is unchanged. Normal alignment of the sternal wires of the CABG. " d47c064f-09f320da-d2e51b83-2d1e7a52-4a1bb152.jpg,validate/p10/p10803787/s52554158/d47c064f-09f320da-d2e51b83-2d1e7a52-4a1bb152.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___. COMPARISON: Radiograph of one day earlier. FINDINGS: Cardiomediastinal contours are stable in appearance in the postoperative period in this patient status post recent median sternotomy and mitral valve replacement. Central venous catheter continues to terminate in the lower superior vena cava. Tiny left apical pneumothorax is in retrospect slightly smaller than on the previous radiograph. Slight worsening of left retrocardiac atelectasis and adjacent small pleural effusion. Small right pleural effusion is apparently new. IMPRESSION: 1. Decreased size of left pneumothorax with residual tiny pneumothorax remaining. 2. Worsening left pleural effusion and left retrocardiac atelectasis. 3. Small right pleural effusion with adjacent basilar atelectasis. " df3b45f4-e0d08f42-95df654f-d043b412-409f2d00.jpg,validate/p15/p15240073/s52639799/df3b45f4-e0d08f42-95df654f-d043b412-409f2d00.jpg,validation," 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. " 07abfa7e-4a5577db-1243a485-fb5fa7f9-18e1df57.jpg,validate/p11/p11114467/s55935845/07abfa7e-4a5577db-1243a485-fb5fa7f9-18e1df57.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Dobhoff location. COMPARISON: ___ done at 11:15 a.m. FINDINGS: Two views of the chest are available showing Dobhoff tube probably in left lower lung. ET tube is in adequate position. Atrioventricular pacemaker is in adequate position. Moderate pulmonary edema with bilateral mild-to-moderate pleural effusion with compressive atelectasis is unchanged. Mild cardiac enlargement is stable. CONCLUSION: Dobhoff tube is in left lower lobe. Dr. ___ has been verbally contacted for the results. " 091a1b6a-18ec4848-b9785772-c081acc3-fe89ac44.jpg,validate/p11/p11409745/s51546774/091a1b6a-18ec4848-b9785772-c081acc3-fe89ac44.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with neuroendocrine pancreatic carcinoma presents w/ erythema, edema, and TTP around L Port-a-cath w/ associated L arm swelling and erythema // please evaluate lumen of the port from the site of insertion to the tip TECHNIQUE: Chest two views COMPARISON: ___ 11:46 FINDINGS: Right Port-A-Cath tip in the upper SVC. There is no catheter kink. Very shallow inspiration. There is stable mild left, new small right pleural effusions effusions. Left basilar opacity has improved. Mildly worsened right basilar opacity, likely atelectasis. Shallow inspiration accentuates heart size, pulmonary vascularity. There is no pneumothorax. IMPRESSION: Bilateral pleural effusions, with improved left basilar opacity. Mildly worsened right basilar opacity, likely atelectasis. " 96d25712-7ab13f24-a54adac1-8d407603-d20c8235.jpg,validate/p11/p11147672/s52725410/96d25712-7ab13f24-a54adac1-8d407603-d20c8235.jpg,validation," FINAL REPORT HISTORY: Acute chest congestion. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: PA and lateral images of the chest. There is an opacity in the right upper lung concerning for pneumonia. Lungs otherwise clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: Opacity in the right upper lung concerning for pneumonia. Recommend repeat chest radiographs in 4 weeks after treatment to exclude mass. " 72e89ada-b02c28a7-c3fa93b8-def6ba12-e7581cbb.jpg,validate/p17/p17021161/s51979375/72e89ada-b02c28a7-c3fa93b8-def6ba12-e7581cbb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with missed dialysis with clotted AV fistula // eval for fluid overload TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Subtle left base retrocardiac opacity most likely represents atelectasis, scarring, and vascular structures. Previously noted left upper lobe opacity appears to have resolved in the interval. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are grossly stable. IMPRESSION: No acute cardiopulmonary process. " 17b799d3-6ed06a4c-01f85752-fc07e4f4-548ca80c.jpg,validate/p15/p15377653/s51115079/17b799d3-6ed06a4c-01f85752-fc07e4f4-548ca80c.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with nasogastric tube placement for oral contrast. COMPARISON: Multiple prior radiographs dated ___ through ___. FINDINGS: Portable supine radiographs of the chest demonstrate low lung volumes, resulting in bronchovascular crowding. There is minimal cardiomegaly. Nasogastric tube is seen with the tip terminating in the stomach and the last sideport well below the GE junction. IMPRESSION: Nasogastric tube seen in the stomach with the last side port below the GE junction. " 515a209c-9076edc7-55c7e8f1-05b40a7b-697bba24.jpg,validate/p12/p12049932/s59334729/515a209c-9076edc7-55c7e8f1-05b40a7b-697bba24.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o IVDU, transferred for infected right lower extremity DVT // Evaluate ET position COMPARISON: ___, 20:14 IMPRESSION: As compared to the previous radiograph, the endotracheal tube has been pulled back. The tip of the tube is now located in the cervical region. And the tip projects 9 cm above the Carina. The endotracheal tube has added to be removed or to be repositioned. The current position represents malposition, given potential damage to the vocal cords. A telephone call was delivered to notify the referring physician's at the time of dictation and observation, 12:17, on ___. The nasogastric tube and a left central venous access line are in unchanged position. Unchanged appearance of the lung parenchyma and of the cardiac silhouette. " f9026658-bf34bd83-f097db47-685a5de1-8753f93d.jpg,validate/p19/p19777911/s57088604/f9026658-bf34bd83-f097db47-685a5de1-8753f93d.jpg,validation," FINAL REPORT INDICATION: Cough and low-grade fever in patient with history of AML, status post cord blood transplant. COMPARISONS: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. The hilar and cardiomediastinal contours are normal. The Hickman catheter positioning is unchanged, with the catheter tip terminating in mid SVC. IMPRESSION: Normal radiograph of the chest. NOTE: Findings were communicated to Dr. ___ by Dr. ___ ___ telephone on ___ at 10:53 a.m. " eaab00d5-1dfa758a-53fc7c24-238c696b-b97315b2.jpg,validate/p13/p13523180/s52224990/eaab00d5-1dfa758a-53fc7c24-238c696b-b97315b2.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Recent pneumonia and EKG changes. TECHNIQUE: Chest, AP upright and lateral. COMPARISON: None. FINDINGS: Within the limitations of technique, although the heart has a left ventricular configuration, it is probably normal in size. The aorta is mildly tortuous. There is a retrocardiac nodular density which is probably due to summation shadow of converging ribs and pulmonary markings; otherwise lung fields appear clear. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. When clinically feasible repeat standard PA and lateral radiography is suggested in order to reassess the left lung base regarding artifact versus, less likely, nodular density. " d3a779c0-7911a02e-a5f7f4ac-afc9d237-c4e343df.jpg,validate/p14/p14018555/s53337217/d3a779c0-7911a02e-a5f7f4ac-afc9d237-c4e343df.jpg,validation," FINAL REPORT INDICATION: ___M with h/o PNA, meningitis w/ AMS // acute process? TECHNIQUE: Portable AP semi-upright view of the chest COMPARISON: ___ FINDINGS: In comparison to the recent prior study, there is no significant change. Tracheostomy tube and right PICC line are unchanged in position. Pacemaker, sternotomy wires, and multiple surgical clips projecting over the upper abdomen. Opacification along the right lower lung medially and left lower lung laterally is unchanged and probably represents atelectasis. There is no large pleural effusion or pneumothorax. IMPRESSION: No substantial change compared to the prior examination. " a26db12f-49515d47-55c36857-b0f2c6f4-b9e1970f.jpg,validate/p19/p19557539/s51407935/a26db12f-49515d47-55c36857-b0f2c6f4-b9e1970f.jpg,validation," WET READ: ___ ___ ___ 4:51 PM New pulmonary edema with a more discrete opacity in the right lower lobe that likely also represents pulmonary edema however pneumonia cannot be ruled out. New small left pleural effusion. ______________________________________________________________________________ FINAL REPORT INDICATION: Status post PEA arrest and cooling protocol, evaluate pneumomediastinum and for evidence of infection. COMPARISON: Chest radiographs on ___ and ___ and CT chest on ___. FINDINGS: One portable upright view of the chest. The right internal jugular central venous catheter is stable. An ET tube ends 4.4 cm from the carina. NG tube traverses the esophagus and tip is below the level of this film. Compared to most recent study, there are new, mostly central and bibasilar opacities. A new right lower lobe heterogeneous opacity likely represents pulmonary edema; however, pneumonia cannot be ruled out. No pneumothorax. New small left pleural effusion. IMPRESSION: New pulmonary edema with a more discrete opacity in the right lower lobe that likely also represents pulmonary edema however pneumonia cannot be ruled out. New small left pleural effusion. " 6a06c256-e43777eb-e52ca837-cbe650c8-3df665c7.jpg,validate/p18/p18327512/s54595278/6a06c256-e43777eb-e52ca837-cbe650c8-3df665c7.jpg,validation," FINAL REPORT INDICATION: Mild shortness of breath with decreasing oxygenation. TECHNIQUE: Frontal chest radiograph. COMPARISON: Chest CT from ___. Chest radiographs from ___. FINDINGS: The heart is mildly enlarged. The hilar and mediastinal contours are within normal limits. There is mild central pulmonary vascular congestion and mild edema predominantly at the lung bases. There is no pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: Mild pulmonary edema and central vascular congestion. No pleural effusion. " e0f4f72b-47966f70-4675816d-81a8f900-e4b9fe96.jpg,validate/p17/p17767787/s51752253/e0f4f72b-47966f70-4675816d-81a8f900-e4b9fe96.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with altered mental status. Evaluate for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No change in the position of the subcutaneous ICD. Similar appearance of the lungs to ___. Pulmonary vascular congestion is mild, unchanged. No pleural effusion or pneumothorax. The cardiac silhouette remains enlarged, similar the prior exam which could be cardiomegaly and/or pericardial effusion. Aortic knob calcifications are mild. Dextroconvex curvature of the thoracic spine is mild. No evidence of an acute fracture. The mediastinum is not widened. IMPRESSION: No radiographic evidence of pneumonia. " 370156d9-4bd489f4-4df84af8-c404eafa-5ef30292.jpg,validate/p12/p12156452/s58472400/370156d9-4bd489f4-4df84af8-c404eafa-5ef30292.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: change in neuro status. Comparison is made with prior study ___. Moderate cardiomegaly is stable. There are low lung volumes. Increasing opacities in the left lower lobe could be due to increasing atelectasis but aspiration could also be present. There is a small left pleural effusion. The right IJ catheter tip is in the lower SVC. NG tube tip is out of view below the diaphragm. Widened mediastinum is stable. " 0deaa2c5-7f51fd0a-7175184f-81966674-fb2c60bd.jpg,validate/p15/p15023390/s58608143/0deaa2c5-7f51fd0a-7175184f-81966674-fb2c60bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with SOB, cough; s/p liver transplant. Decreased BS at left base. // Radiographic evidence of PNA/infiltrate or effusion to explain symptoms. SOB;COUGH COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Linear atelectasis has improved since ___. Lungs are otherwise clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Moderately severe Thoracolumbar scoliosis is chronic. " 96eff51a-91db71ee-994c97cc-dede2292-ef79a3ff.jpg,validate/p12/p12341711/s59169756/96eff51a-91db71ee-994c97cc-dede2292-ef79a3ff.jpg,validation," FINAL REPORT INDICATION: History: ___M with chest pain // acute cardiopulmonary process 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 size is normal. The mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 95d7c772-a7f9a152-f336229b-1873730d-334f8ee3.jpg,validate/p16/p16749381/s50760877/95d7c772-a7f9a152-f336229b-1873730d-334f8ee3.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with MSSA and endocarditis, status post cord decompression surgery, placement of OG tube placement. TECHNIQUE: Portable frontal semi-erect chest radiograph was obtained. COMPARISON: None available. FINDINGS: Low lung volumes bilaterally. The cardiac devices are in the stable position in the right atrium and right ventricle. Multiple surgical changes consistent with recent spine surgery are noted. Endotracheal tube is seen ending above the carina. OG tube is seen in the stomach with the tip going back to the GE junction. Blurring of left hemidiaphragm is seen which can be seen with an effusion. Blurring of the right hemidiaphragm is seen consistent with effusion. No focal consolidation is seen. IMPRESSION: OG tube is placed in the stomach with the tip going back to the GE junction. Findings conveyed to the clinical team by attending radiologist immediately following discovery. Bilateral lung volume loss with pleural effusion is seen. " 3f8a66a7-5da4baeb-efbdcf4d-2ac9c440-0b141d93.jpg,validate/p10/p10113898/s52735111/3f8a66a7-5da4baeb-efbdcf4d-2ac9c440-0b141d93.jpg,validation," FINAL REPORT PATIENT HISTORY: ___ years old woman with mediastinal mass with tracheal compression status post biopsy and bare-metal stents by two to the trachea 2 cm below the vocal cords. INDICATION: Pneumothorax, interval change in stent. TECHNIQUE: Portable AP single view chest x-ray in erect position. COMPARISON: Exam is compared to ___. FINDINGS: As compared to prior chest x-ray, there are no interval changes. The stent project in the same position without changes in caliber or confirmation. The right upper parahilar mass is redemonstrated. There is no pneumothorax or new consolidations. Cardiomediastinal silhouette is unchanged. There is moderate air gastric distension IMPRESSION: Status quo. " 37eea141-9dec4fde-13e1d42e-bdefc23b-5ba713a1.jpg,validate/p10/p10908645/s59918883/37eea141-9dec4fde-13e1d42e-bdefc23b-5ba713a1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with psychosis // eval for consolidation 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. " b00ffa4d-5e4d6ade-75de90c6-e3a67ccb-1c720602.jpg,validate/p12/p12739166/s56093202/b00ffa4d-5e4d6ade-75de90c6-e3a67ccb-1c720602.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath with increased confusion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes. There is mild mid lung atelectasis/scarring. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5aa421df-064c698c-668f2c1a-d13dbd15-2f813bf7.jpg,validate/p14/p14522445/s59475864/5aa421df-064c698c-668f2c1a-d13dbd15-2f813bf7.jpg,validation," 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. " 79f69bd8-2fdbdccc-e38e8a24-5ce44cd0-7e132d7a.jpg,validate/p17/p17608002/s56357623/79f69bd8-2fdbdccc-e38e8a24-5ce44cd0-7e132d7a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph PA and lateral INDICATION: ___ year old woman with pulmionary hypertension clinically suspicous for PVOD, COPD, worsened hypoxia // eval lung parenchyma, ?pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: CT chest ___ FINDINGS: There are no focal consolidations, pleural effusions or pneumothorax. Bibasilar opacities, likely due to atelectasis. No pulmonary edema. pulmonary artery is large, demonstrated on the prior CT. Moderate cardiomegaly, seen on prior CT. Aorta is tortuous. No acute osseous abnormalities. IMPRESSION: No pneumonia or pulmonary edema. If symptoms are persistent consider CT Chest for further evaluation. " 64d271e1-9a3b75a3-10f9920a-f1398585-bf077e96.jpg,validate/p19/p19919570/s54987974/64d271e1-9a3b75a3-10f9920a-f1398585-bf077e96.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with brain ca also on warfarin s/p seizure please eval cardiopulm change / intracranial bleed COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Port-A-Cath resides over the right chest wall with catheter tip in the region of the right atrium. Midline sternotomy wires and prosthetic cardiac valve are again seen. Lung volumes are low limiting evaluation. A similar overall pattern is seen compared with multiple prior imaging studies with prominent bronchovascular markings which in the setting of low lung volumes likely reflect bronchovascular crowding. The possibility of mild pulmonary vascular congestion is difficult to exclude in the correct clinical setting. There is no overt evidence for edema, effusion, pneumothorax or pneumonia. Cardiomediastinal silhouette is stable. Osseous structures appear intact. IMPRESSION: No overt signs of pneumonia or edema. Mild pulmonary vascular congestion difficult to exclude given extensive bronchovascular crowding in the setting of low lung volumes. " 3b9e92ac-115e63d0-5c901a0e-46af1a22-3e72b9b6.jpg,validate/p14/p14504676/s57691945/3b9e92ac-115e63d0-5c901a0e-46af1a22-3e72b9b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent cough, flushing // r/o infiltrate r/o infiltrate IMPRESSION: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Biapical pleural thickening is consistent with old healed granulomatous disease. " fd3f33f9-5ca5ad15-d8674872-8efa31b0-c870b602.jpg,validate/p14/p14690121/s53833498/fd3f33f9-5ca5ad15-d8674872-8efa31b0-c870b602.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old right-handed woman with a history of traumaticbrain injury in ___, anxiety/PTSD/Depression and seizure disorder admitted for increased seizure frequency and AED optimization. // eval for pneumonia eval for pneumonia COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 8ac5a339-7e6a72bf-9076ecbf-1ce4d3d5-036fa2c2.jpg,validate/p17/p17110944/s56836764/8ac5a339-7e6a72bf-9076ecbf-1ce4d3d5-036fa2c2.jpg,validation," 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. " 537d85d8-bed937ce-37cbc4fe-feebdaa9-6a402086.jpg,validate/p11/p11812613/s56339519/537d85d8-bed937ce-37cbc4fe-feebdaa9-6a402086.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hemoptysis and fatigue, hx of aspiration PNA with hemoptysis last ___, h/o throat cancer s/p xrt // r/o PNA or abnormality TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: In comparison with chest radiograph from ___, there is new central congestion with mild interstitial pulmonary edema. Mild overinflation is unchanged. Unchanged moderate cardiomegaly with elongation of the descending aorta. Left pectoral pacemaker is in stable position. IMPRESSION: 1. New mild interstitial pulmonary edema. Unchanged moderate cardiomegaly. 2. No evidence of pneumonia. NOTIFICATION: The findings were discussed with , N.P. by ___, M.D. on the telephone on ___ at 11:54 AM, minutes after discovery of the findings. " 66e1077a-89a26c10-e515c3fe-ffc8bd22-dee3c388.jpg,validate/p16/p16571136/s58439141/66e1077a-89a26c10-e515c3fe-ffc8bd22-dee3c388.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right mainstem lesion, status post stent placement, assessment for airway stent. COMPARISON: ___. FINDINGS: A stent has been placed in the right bronchial system. The stent is partially obscured by an ECG electrode. The perihilar cavitary lesion, known from a CT examination of ___, appears to be of unchanged appearance. The entire left lung shows a pattern of increasing predominantly nodular opacities. The opacities are likely to reflect an infectious change such as pneumonia. Borderline size of the cardiac silhouette without evidence of fluid overload. No pleural effusions. The pleural lesions visible on the CT examination from ___ are not visualized on today's image. There is no evidence of pneumothorax or pneumomediastinum. The findings were discussed over the telephone with Dr. ___ at the time of observation and dictation, 4:51 p.m., on ___. " 01e31a0f-4ee554a1-a4de8474-e89f8603-5e464ac5.jpg,validate/p15/p15510911/s59106369/01e31a0f-4ee554a1-a4de8474-e89f8603-5e464ac5.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with OGT placement // Eval for post OGT placement TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The enteric tube terminates in the stomach. The left subclavian terminates in lower SVC. The ETT is approximately 6.6 cm above the carina. Bilateral chest tubes are in satisfactory position. Ill-defined hazy opacification in the right upper lobe is concerning for pneumonia versus pulmonary hemorrhage. Retrocardiac opacity could be due to pneumonia versus atelectasis. No pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: 1. The enteric tube terminates in the stomach. 2. Right upper lobe opacity is concerning for pneumonia versus pulmonary hemorrhage. Retrocardiac opacity could be due to pneumonia versus atelectasis. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 4:21 PM, 20 minutes after discovery of the findings. " 5c873cc1-f9be42fd-0fe9dc2a-9dff1720-ee038b2a.jpg,validate/p15/p15394622/s52014456/5c873cc1-f9be42fd-0fe9dc2a-9dff1720-ee038b2a.jpg,validation," FINAL REPORT INDICATION: Presyncope. COMPARISON: Chest radiographs from ___ and ___. PA AND LATERAL VIEWS OF THE CHEST: There is a 6-mm nodular opacity in the right lower lung field seen on the two PA views. This opacity is possibly seen on the lateral view as well. It is new from the prior examination on ___, when the right hemidiaphragm was markedly elevated, possibly obscuring it. It was not present on the ___ radiograph. The lungs are otherwise clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. There is possible pleural thickening obscuring the right costophrenic sulcus. IMPRESSION: 1. No pneumonia or congestive heart failure. 2. 6-mm possible lung nodule in the right lower lung field, not seen on prior studies. Further evaluation with outpatient chest CT is recommended. NOTE: As the patient was discharged from the emergency department by the time study was dictated, an e-mail was sent to the ___ nursing group for communication to the patient's primary care physician. " 2eba15ec-00fa453f-488fc73c-7fd4a9c0-94e7d474.jpg,validate/p12/p12111976/s51554661/2eba15ec-00fa453f-488fc73c-7fd4a9c0-94e7d474.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with COPD presenting with cough and dyspnea. COMPARISON: Chest radiograph from ___ FRONTAL CHEST RADIOGRAPH: An ICD generator overlies the left chest wall. The single-lead is intact with the tip projecting over the expected position of the right ventricle. Median sternotomy wires appear intact on the single frontal view. There is increased opacification of the medial right lung base, which could reflect early developing pneumonia and/or focal congestion. There is no overt interstitial edema. No pneumothorax is identified. IMPRESSION: Subtle opacity in the medial right lung base may be due to early pneumonia and/or congestion. " 0098c823-856e096b-c5e1b7e9-3e01a249-228a6c73.jpg,validate/p19/p19988669/s50444035/0098c823-856e096b-c5e1b7e9-3e01a249-228a6c73.jpg,validation," FINAL REPORT INDICATION: Right pneumothorax, status post chest tube, evaluate if stable. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. The small right apical pneumothorax is unchanged. There is a possible small left apical pneumothorax, difficult to appreciate on prior studies. Lungs are otherwise clear. No pleural effusion. The cardiomediastinal and hilar contours are normal. IMPRESSION: Small right apical pneumothorax is unchanged compared to ___ at 11:12 a.m. Possible small left apical pneumothorax, difficult to appreciate on prior studies, attention on follow up. These findings were discussed with Dr. ___ by Dr. ___ at 1013am on ___ by phone at time of discovery. " c2087a86-804ece3a-b2d16e82-b67a804d-d7850857.jpg,validate/p12/p12466049/s56455509/c2087a86-804ece3a-b2d16e82-b67a804d-d7850857.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___ as well a chest radiograph from ___. CLINICAL HISTORY: Altered mental status, assess for pneumonia. FINDINGS: AP and lateral portable upright chest radiograph obtained. There is basilar atelectasis, more noted along the left lung base. There is no convincing sign of pneumonia though the more localized atelectasis in the left lung base may obscure subtle pneumonia. No large effusion or pneumothorax. No overt signs of CHF. Cardiomediastinal silhouette is normal. Bony structures are intact. Bilateral AC joint arthropathy is noted. IMPRESSION: Basilar atelectasis, cannot exclude subtle pneumonia at the left lung base. " d7454942-8c808def-8dbd02e7-172d0253-7740dd25.jpg,validate/p11/p11493670/s53232638/d7454942-8c808def-8dbd02e7-172d0253-7740dd25.jpg,validation," WET READ: ___ ___ 8:07 PM Very low lung volumes with suggestion of mild fluid overload. ______________________________________________________________________________ FINAL REPORT AP CHEST 6:06 P.M. ON ___ HISTORY: ___-year-old man with alcohol withdrawal and a broken femur, fever post-op. IMPRESSION: AP chest compared to ___: Increased mediastinal caliber, pulmonary vascular caliber and perfusion suggest mild interval cardiac decompensation and/or volume overload. Pulmonary edema has not yet occurred, and there is no appreciable pleural effusion or indication of pneumothorax. " d03af4c2-9cec63d9-7faf4134-dc0702d6-f00bd58f.jpg,validate/p16/p16724859/s54107534/d03af4c2-9cec63d9-7faf4134-dc0702d6-f00bd58f.jpg,validation," 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. " e399b513-c8136e71-11fd3220-b7245b82-bcfd8529.jpg,validate/p12/p12010209/s56144757/e399b513-c8136e71-11fd3220-b7245b82-bcfd8529.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Multiple myeloma with bilateral rales. Comparison is made to the prior study, ___. Cardiac size is top normal. Mild interstitial pulmonary edema is new. There are bibasilar atelectases. There is no pneumothorax or large effusions. " be94affd-b92abb91-36c0d7e5-fdfbc3e7-3d3e199b.jpg,validate/p16/p16213968/s55567250/be94affd-b92abb91-36c0d7e5-fdfbc3e7-3d3e199b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with productive cough/wheezing TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lung volumes are low. Elevation of the right hemidiaphragm is of unknown chronicity. Mild enlargement of cardiac silhouette is present. The mediastinal and hilar contours are unremarkable given the presence of low lung volumes. Crowding of bronchovascular structures is present without overt pulmonary edema. Patchy opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is detected. IMPRESSION: Low lung volumes with bibasilar atelectasis. Elevation of the right hemidiaphragm of unknown chronicity. " 805669e4-ad801cec-d5606b68-3ffc1686-4a3edd88.jpg,validate/p18/p18957964/s50757350/805669e4-ad801cec-d5606b68-3ffc1686-4a3edd88.jpg,validation," FINAL REPORT HISTORY: Shortness of breath, evaluate for pneumonia. COMPARISON: Chest radiograph from ___ FINDINGS: AP and lateral views of the chest were obtained. The exam is limited by low lung volumes and the patient's positioning and kyphosis. The heart is moderately enlarged. There are bilateral perihilar ill-defined opacities, similar in appearance to prior radiograph and consistent with pulmonary edema. The lung bases are poorly assessed secondary to kyphosis. The cardiomediastinal contour appears similar to prior radiograph. No large pneumothorax is seen. IMPRESSION: Unchanged pulmonary edema. " a69b6c07-a005724d-d0cec99a-fcb24cdb-d450ff18.jpg,validate/p10/p10684181/s51848128/a69b6c07-a005724d-d0cec99a-fcb24cdb-d450ff18.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough, chest pain and shortness of breath. 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 focal consolidation worrisome for infection. There is no pulmonary edema, pleural effusion, or pneumothorax. Imaged osseous structures are without an acute abnormality. Dextroscoliosis of the midthoracic spine is not significantly changed. Upper abdomen is notable for right upper quadrant surgical clips. IMPRESSION: No acute cardiopulmonary process. " 073bd56e-770df677-6b0bd031-346e0d87-7923d854.jpg,validate/p16/p16996526/s56016331/073bd56e-770df677-6b0bd031-346e0d87-7923d854.jpg,validation," WET READ: ___ ___ 4:59 PM R PICC now in distal SVC. ___ d/w ___ of IV nursing at ___. Linear left basal atelectasis WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess line. Right PICC tip is in the distal SVC. There are no other interval changes from prior study performed three hours earlier. Findings were discussed with IV nurse, ___, by Dr. ___ at 4:55 p.m. by phone on ___. " 37ee1e7f-ace895cc-4ea133ed-7ad462a2-b2f2f1ff.jpg,validate/p10/p10452422/s54487807/37ee1e7f-ace895cc-4ea133ed-7ad462a2-b2f2f1ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, abdominal pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Right-sided Port-A-Cath tip terminates in the proximal right atrium. Lung volumes are low. Heart size is borderline enlarged. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Streaky opacities in the lung bases likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 30eadeac-6c794489-cc12a06c-4cabb360-5e78273e.jpg,validate/p17/p17509107/s58875286/30eadeac-6c794489-cc12a06c-4cabb360-5e78273e.jpg,validation," FINAL REPORT INDICATION: Patient with abdominal wound infection with fevers. COMPARISONS: CT abdomen and pelvis of the same date, chest radiographs of ___ and ___. FINDINGS: Single portable view of the chest demonstrates low lung volumes, which accentuate bronchovascular markings. There is no pleural effusion. Retrocardiac opacities are noted. There is perihilar vascular congestion. Hilar and mediastinal silhouettes are otherwise unchanged. Heart is mildly enlarged. There is no pneumothorax. No focal consolidation. Sternotomy wires are noted, which appear intact. Aortic valve prosthesis is in place. Gastrojejunostomy and biliary stent projects over mid upper abdomen. Malpositioned Dobhoff tube has been removed. IMPRESSION: Low lung volumes. Perihilar vascular congestion. Retrocardiac opacity, likely atelectasis, or superimposed infection cannot be excluded. " 48b08a22-205d73ae-2c5e7524-034c5dbb-38e79bc1.jpg,validate/p16/p16486158/s51625052/48b08a22-205d73ae-2c5e7524-034c5dbb-38e79bc1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with endotracheal tube placement TECHNIQUE: Supine AP view of the chest COMPARISON: ___ 12:22 FINDINGS: Endotracheal tube tip is in standard position, terminating approximately 5.4 cm from the carina. Cardiac and mediastinal contours remain unchanged with the heart size top-normal. There is crowding of bronchovascular structures due to low lung volumes without overt pulmonary edema. Patchy bibasilar airspace opacities likely reflect atelectasis, new in the interval. No large pneumothorax or pleural effusion is detected. IMPRESSION: Endotracheal tube in standard position. Low lung volumes with bibasilar atelectasis. " 43d0eb0c-1810aafb-a159de27-4c3097f3-5881dbfd.jpg,validate/p15/p15687550/s57128116/43d0eb0c-1810aafb-a159de27-4c3097f3-5881dbfd.jpg,validation," 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. " af400823-050daee3-755dec42-46d0c45a-082efab8.jpg,validate/p10/p10233307/s54652300/af400823-050daee3-755dec42-46d0c45a-082efab8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with persistent vent requirement s/p IPH // pls eval interval change pls eval interval change IMPRESSION: Comparison to ___. No relevant change. Monitoring and support devices are stable. Low lung volumes. Moderate cardiomegaly without evidence of pulmonary edema or pleural effusions. No pneumonia. " a69cc85f-68d6a3e8-adc9ee94-1f71b971-dffa1b7c.jpg,validate/p12/p12643806/s55172012/a69cc85f-68d6a3e8-adc9ee94-1f71b971-dffa1b7c.jpg,validation," FINAL REPORT AP CHEST 12:58 P.M., ___ HISTORY: Small bowel obstruction. NG tube displaced. IMPRESSION: AP chest compared to ___, 1:44 p.m.: The course of the nasogastric tube suggests that it may be distorting the stomach. There is no free subdiaphragmatic gas, but clinical consideration should be given to repositioning of the NG tube so as to avoid any possibility of trauma. Moderate cardiomegaly is chronic. Pulmonary vasculature and mild edema have worsened since ___. Multiple right rib fractures in various stages of healing are noted. There is no pneumothorax or pleural effusion. " cbe80c64-158b040c-4d9fa5fb-d32b4995-d8dcb817.jpg,validate/p17/p17018536/s56977159/cbe80c64-158b040c-4d9fa5fb-d32b4995-d8dcb817.jpg,validation," FINAL REPORT AP CHEST, 4:24 A.M., ___ HISTORY: ___-year-old man with respiratory failure, question interval change. IMPRESSION: AP chest compared to ___: Severe left lower lobe consolidation developed after ___ and has not subsequently improved. There is leftward mediastinal shift suggesting a substantial component of atelectasis. Right lower lobe consolidation has increased since ___, conceivably pneumonia or atelectasis. Severe cardiomegaly developed between ___ and has not improved. Pulmonary hypertension diagnosed by the chest CT on ___ is not obvious on conventional chest radiographs. ET tube in standard position. Right PIC line ends in the low SVC and an upper enteric drainage tube in the cardia of a non-distended stomach. Small pleural effusions are presumed, but not increased. There is no pneumothorax. " fbecd68f-99270cbc-8ea6b5ef-a218e408-67a17d14.jpg,validate/p18/p18176683/s53836936/fbecd68f-99270cbc-8ea6b5ef-a218e408-67a17d14.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. Question pleural effusions. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: There is a moderate-to-large left-sided pleural effusion, new since the prior study. There is no shift of mediastinal structures. Probably, there is substantial associated atelectasis involving the left lower lobe and possibly parts of the lingula. The pulmonary vasculature is mildly prominent. There is no pleural effusion on the right. No pneumothorax is identified. IMPRESSION: Moderate-to-large left-sided pleural effusion. Findings suggesting mild vascular congestion. " 80011ee4-9a2c11ad-798e56b1-fa84652c-34e91822.jpg,validate/p13/p13859753/s51186861/80011ee4-9a2c11ad-798e56b1-fa84652c-34e91822.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Woman with increasing dyspnea, cause of dyspnea. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: The lungs are clear. There is no pneumothorax or pleural effusion. Mild cardiomegaly is stable 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. CONCLUSION: There is no significant change since ___. There are no acute cardiopulmonary findings. " 9cd913e0-b507cdb6-0f85980a-8def10ea-e095c428.jpg,validate/p14/p14477164/s59500236/9cd913e0-b507cdb6-0f85980a-8def10ea-e095c428.jpg,validation," 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. " 4a258f0d-c1ae3a6b-d1f9c0e3-f2513d7c-ab76e032.jpg,validate/p17/p17801051/s57450288/4a258f0d-c1ae3a6b-d1f9c0e3-f2513d7c-ab76e032.jpg,validation," FINAL REPORT HISTORY: Multiple myeloma on treatment with fevers and cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. The aorta is mildly unfolded. The pulmonary vascularity is normal. Minimal streaky bibasilar atelectasis is noted. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities visualized. IMPRESSION: Minimal bibasilar atelectasis. " 0b7c365b-1876f3c4-4b1cfc77-c0c2c8ce-ce4de4a6.jpg,validate/p10/p10024982/s55271482/0b7c365b-1876f3c4-4b1cfc77-c0c2c8ce-ce4de4a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M CAD, Afib here with NSTEMI and occlusion of SVG-OM which was deemed not intervenable now with PEA arrest after respiratory distress and intubation. // interval changes interval changes COMPARISON: Prior chest radiographs ___ through ___ at 00:06. IMPRESSION: Combination of moderate pleural effusion and bibasilar atelectasis is unchanged. Severe cardiomegaly is chronic. Upper lobes show the only mild pulmonary vascular congestion. ETT with the chin in flexion, is in standard position. Right subclavian line ends in the upper right atrium. Transvenous right atrial right ventricular pacer leads are continuous from the left pectoral generator. " 1ef5640d-dc6137a6-e8eaa0af-a37863ca-c517b961.jpg,validate/p19/p19507787/s54226985/1ef5640d-dc6137a6-e8eaa0af-a37863ca-c517b961.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with left jaw swelling, odynophagia, increased RR TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is top-normal in size. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion, focal consolidation or pneumothorax is present. No acute osseous abnormalities detected. IMPRESSION: Patchy bibasilar airspace opacities, likely atelectasis. Infection cannot be excluded in the correct clinical setting. " d08fc4e7-a02b9d6c-288d3282-d75755b5-d3403b5b.jpg,validate/p18/p18856901/s53875290/d08fc4e7-a02b9d6c-288d3282-d75755b5-d3403b5b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 6 weeks cough and wheeze // assess for infiltrate assess for infiltrate IMPRESSION: No previous images. Low lung volumes but no evidence of acute pneumonia, vascular congestion, or pleural effusion. " 86475f54-fec9b53d-d6277b7f-d70b200e-9ebcef26.jpg,validate/p11/p11546022/s52029928/86475f54-fec9b53d-d6277b7f-d70b200e-9ebcef26.jpg,validation," FINAL REPORT HISTORY: New stroke resultant dysphagia, now NG tube placement. Question aspiration pneumonia. CHEST, SINGLE AP PORTABLE VIEW: Rotated positioning. An NG tube is present -- the tip extends beneath the diaphragm, off the film. Compared with earlier the same day (16:46 p.m.), no gross change is identified. There is minimal patchy stranding at the right base medially and possible minimal retrocardiac atelectasis. No definite infiltrate is identified. No effusion is seen. No CHF. The cardiomediastinal silhouette is prominent with a left ventricular configuration. The hila are also prominent with a tapered configuration, unchanged, which could reflect an element of pulmonary hypertension. IMPRESSION: Minimal stranding at right base medially and in retrocardiac area. No definite infiltrate. " 29fa5032-1c28d262-ec635323-034efc9b-02ae99fa.jpg,validate/p19/p19302735/s50784114/29fa5032-1c28d262-ec635323-034efc9b-02ae99fa.jpg,validation," WET READ: ___ ___ 8:18 PM Low lung volumes with bibasilar atelectasis. No pneumothorax detected. Interval replacement of swan-ganz catheter with central venous catheter with tip projecting over mid-superior vena cava. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Chest tube removal. Assess for pneumothorax. Comparison is made with prior study performed the same day earlier in the morning. There are low lung volumes. There is no evident pneumothorax. Right IJ catheter tip is in the upper to mid SVC. Small bilateral pleural effusions are larger on the right side. There are bibasilar atelectases. Widened mediastinum is unchanged. The patient has known mediastinal lymphadenopathy. The stomach is distended. " 8db745f9-ac6bbbc8-fb12a7b3-64af1f48-545e4735.jpg,validate/p13/p13622559/s54981866/8db745f9-ac6bbbc8-fb12a7b3-64af1f48-545e4735.jpg,validation," FINAL REPORT AP CHEST 11:06 P.M. ON ___ HISTORY: ___-year-old man with AIDS and probable toxoplasmosis. Tachypneic and tachycardic. Possible PCP. IMPRESSION: AP chest compared to ___: Lung volumes are lower, which may exaggerate caliber of central vessels, but there looks to have been a substantial increase in pulmonary artery caliber suggesting worsening pulmonary hypertension. There are no radiographic abnormalities in the lungs to suggest pneumocystis pneumonia. Heart size is top normal but larger than it was early in this admission. Differential diagnosis of progressive pulmonary hypertension includes pulmonary emboli. Right PIC line ends low in the SVC. " f815ef4d-27995ea4-df5c1dcb-47c8b8ca-2d01c6c2.jpg,validate/p10/p10706411/s57756261/f815ef4d-27995ea4-df5c1dcb-47c8b8ca-2d01c6c2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxia, evaluation for pulmonary process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. A double-lumen catheter on the right is unchanged. The parenchymal opacities are apparently slightly increased in severity, but part of this impression might be due to reduced lung volumes. No pneumothorax. No pleural effusions. " bb8f8053-c9c85c39-14ffdd7c-64ec5c4c-92eb2620.jpg,validate/p14/p14946290/s59281792/bb8f8053-c9c85c39-14ffdd7c-64ec5c4c-92eb2620.jpg,validation," FINAL REPORT HISTORY: Left anterior chest pain TECHNIQUEPA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is normal. The lungs are well inflated and clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ad9ebe52-ddc561ba-b6ac6825-8ce50bbc-a854f5ac.jpg,validate/p11/p11658675/s51670044/ad9ebe52-ddc561ba-b6ac6825-8ce50bbc-a854f5ac.jpg,validation," WET READ: ___ ___ ___ 9:16 PM ET tube terminates 6 cm above the carina. A left upper extremity PICC terminates in the axilla. Enteric tube is within the stomach. Increasing opacities of the left lung base are likely atelectasis, though, developing infection/aspiration should be considered as well. No pneumothorax. ______________________________________________________________________________ FINAL REPORT HISTORY: PICC placement. FINDINGS: The left PICC line tip lies within the axilla. Other monitoring and support devices are essentially unchanged. Basilar opacifications most likely represent atelectasis. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. " 288981e5-a2ce4f45-ccad2e2e-12e2b8d6-017da0eb.jpg,validate/p14/p14557743/s57183190/288981e5-a2ce4f45-ccad2e2e-12e2b8d6-017da0eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of active pulmonary TB ___, treated. Now needs surveillance. asymptomatic // any signs on CXR of active TB? any signs on CXR of active TB? IMPRESSION: In comparison with the study of ___, there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. Specifically, no evidence of acute or old tuberculous disease. " ec17bd5a-f336a41a-a502c902-51d1ab29-3f9848b5.jpg,validate/p19/p19302111/s54772537/ec17bd5a-f336a41a-a502c902-51d1ab29-3f9848b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with ams confusiong s/p fall // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart is normal in size. The right hilus is asymmetrically enlarged. The aorta is tortuous. There is mild pulmonary vascular congestion without frank edema. Retrocardiac and right basal opacities could represent atelectasis or infection in the appropriate setting. No pneumothorax or pleural effusion. IMPRESSION: Mild vascular congestion without frank edema. Bibasilar opacities are consistent with atelectasis however infection should be considered in the appropriate setting. Enlarged right hilus may be related to vascular congestion or underlying mass. Recommend evaluation with CT when clinically appropriate. NOTIFICATION: . " d557fd2a-1c85f45e-fd9c6b18-e67c9da0-47423b40.jpg,validate/p17/p17752411/s58384708/d557fd2a-1c85f45e-fd9c6b18-e67c9da0-47423b40.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with non-small cell lung cancer, now with shortness of breath. COMPARISON: ___. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position. FINDINGS: Lung volumes are low. Right suprahilar and right upper lobe nodules are again seen. Bibasilar and perihilar fullness most likely represents atelectasis in the setting of low lung volumes. No pleural effusion or pneumothorax is detected on this single view. Heart size is normal. Aortic tortuosity is again seen. IMPRESSION: Low lung volumes, slightly limiting evaluation, with no radiographic evidence for acute process on this single view. Lung nodules as seen previously. " fe1a9332-d0136851-85b8b95e-160cb0ce-7e90c0cd.jpg,validate/p10/p10434657/s59655239/fe1a9332-d0136851-85b8b95e-160cb0ce-7e90c0cd.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with sepsis. Evaluate for pneumonia. TECHNIQUE: AP and lateral views were obtained. COMPARISON: None available. FINDINGS: There is bibasilar streaky atelectasis without focal consolidation. There is mild pulmonary vascular congestion. The cardiac silhouette is mildly enlarged. There is no pleural effusion or pneumothorax. Median sternotomy wires are noted. IMPRESSION: Bibasilar streaky atelectasis without focal consolidation. Mild pulmonary vascular congestion. " aa34e3e5-49158d09-6abda848-88d76527-c6c253d8.jpg,validate/p12/p12854165/s59903349/aa34e3e5-49158d09-6abda848-88d76527-c6c253d8.jpg,validation," FINAL REPORT AP CHEST, 6:31 A.M., ___. CLINICAL HISTORY: ___-year-old woman with acute hypotension. Question free air beneath the diaphragm. IMPRESSION: AP chest compared to ___: Small bilateral pleural effusion has increased. Lungs are clear. Heart size top normal. No pulmonary vascular engorgement. No free subdiaphragmatic gas. " 65998400-b4d2936f-24b7d35f-382b0ef6-943813f1.jpg,validate/p17/p17910941/s55125259/65998400-b4d2936f-24b7d35f-382b0ef6-943813f1.jpg,validation," 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. " d29ed427-457bd2b4-086d40f0-724c263a-fbd31bb0.jpg,validate/p11/p11885997/s59877636/d29ed427-457bd2b4-086d40f0-724c263a-fbd31bb0.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest tube removal. Comparison is made with prior study performed seven hours earlier. Widened mediastinum has improved. There is elevation of the right hemidiaphragm. Vascular congestion has almost resolved. Small right pneumothorax has increased from prior studies. Right mediastinal mass and right middle lobe medial consolidation are better seen on prior CT from ___. Right pleural effusion is small. Right subcutaneous emphysema has minimally increased from prior study. Findings were discussed with Dr. ___ by phone on ___ at the time of the discovery of the findings at 7:55 a.m. " 7be4bdd8-ad21238a-3ecd987d-d66517cf-4b882ce6.jpg,validate/p10/p10900387/s57384060/7be4bdd8-ad21238a-3ecd987d-d66517cf-4b882ce6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: HIV, cellulitis, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a minimal increase in density at the right lung base. On the lateral radiograph, a minimal right lower lobe volume loss can be appreciated. Overall, these could be consistent with early pneumonia. The referring physician, ___. ___, was paged for notification at the time of dictation, 9:08 a.m., ___. Otherwise, there is no relevant change. Moderate cardiomegaly without pulmonary edema. No pleural effusions. Unchanged aspect of the mediastinum and the hila. " e4b91b14-eb26c0cd-cab4a0be-4e24853b-9534ff60.jpg,validate/p19/p19183237/s58094002/e4b91b14-eb26c0cd-cab4a0be-4e24853b-9534ff60.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: PET-CT from ___. CLINICAL HISTORY: Extensive metastasis from known lung cancer with elevated white blood cell count, severe abdominal pain. Assess for free air. FINDINGS: PA and lateral views of the chest were provided. There is improved aeration of the left upper lobe with left upper lobe nodularity again seen. There is right basilar atelectasis and tiny right pleural effusion. Right hilar prominence corresponds to known tumor. No free air below the right hemidiaphragm. Heart size appears normal. Bony structures appear grossly intact. IMPRESSION: No free air below the right hemidiaphragm. Right basilar atelectasis with small right pleural effusion and right hilar mass and left upper lobe mass again noted. Please refer to subsequent CT of the torso for further details. " d2d80188-81439d5c-af6ca055-899c9818-e91fdd70.jpg,validate/p19/p19271682/s53452607/d2d80188-81439d5c-af6ca055-899c9818-e91fdd70.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NSCLC and new effusion s/p ___ with 800mL out // ? PTX. Pt in WPC Farr 1 ? PTX. Pt in WPC Farr 1 IMPRESSION: In comparison with the earlier study of this day, there has been a right thoracentesis with no evidence of acute pneumothorax. Otherwise little change. " 6c98eb52-0ed6369e-06dd50ff-f5250ae7-7a1ec2ff.jpg,validate/p16/p16789054/s51078085/6c98eb52-0ed6369e-06dd50ff-f5250ae7-7a1ec2ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with ILD, ___ lb weight loss in 3 months, increasing dyspnea on exertion TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest CT ___ and chest radiograph ___ FINDINGS: Lung volumes are reduced bilaterally. Chronic diffuse interstitial abnormality is re- demonstrated with increased interstitial markings noted most pronounced at the periphery and lung bases, not substantially changed in the interval. Heart size is mildly enlarged. Mediastinal and hilar contours are similar. No overt pulmonary edema, new focal consolidation, pleural effusion or pneumothorax is identified. There are multilevel mild to moderate degenerative changes with mild loss of height of a mid thoracic vertebral body anteriorly. IMPRESSION: No substantial interval change from the prior exam with continued chronic interstitial lung disease. No new focal consolidation demonstrated. " 33b4bac2-fa3ea1c3-599878fa-4aeb9478-a22e2524.jpg,validate/p13/p13209419/s53551447/33b4bac2-fa3ea1c3-599878fa-4aeb9478-a22e2524.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx positive PPD; believes may have had BCG vaccine in ___; living in ___ since ___ // hx positive PPD 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 evidence of acute or chronic TB " 9e60e6ea-57ad29ee-d81b3151-3044bb42-ff9e76bd.jpg,validate/p17/p17009581/s59591205/9e60e6ea-57ad29ee-d81b3151-3044bb42-ff9e76bd.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p gastrectomy now with tachycardia // fluid overlaoad TECHNIQUE: Portable AP Upright view of the chest COMPARISON: ___ FINDINGS: In comparison to the prior study, lung volumes are slightly lower. Cardiomediastinal silhouette is stable. There is no focal consolidation, large effusion, or pneumothorax. No pulmonary edema. IMPRESSION: Lower lung volumes, otherwise no acute intrathoracic abnormality. " 4af710a8-1fd9589a-9d905df5-9ade611a-f0f74321.jpg,validate/p11/p11100454/s52983444/4af710a8-1fd9589a-9d905df5-9ade611a-f0f74321.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with cough and fever. COMPARISON: None available. FINDINGS: There is a heterogeneous opacity in the right middle lobe as well as more linear opacity in the left lower lobe. There is mild cardiomegaly. The hilar and mediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Heterogeneous right middle lobe opacity concerning for early pneumonia. More linear left basilar opacity is likely atelectasis. " 0666b186-f121bc36-da6a62bd-87ac0f8f-d43f7124.jpg,validate/p18/p18143490/s58348221/0666b186-f121bc36-da6a62bd-87ac0f8f-d43f7124.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Asc aorta repair // eval for effusion, ptx TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 5 hours earlier IMPRESSION: Opacities in the lower lobes are a combination of stable moderate to large bilateral effusions and bibasilar atelectasis larger on the left. Widening mediastinum has improved. Cardiomegaly is stable. Vascular congestion is stable. Lines and tubes are in standard position there is no evident pneumothorax. Surgical clips are present in the right upper chest. " 0f5f0783-c10ea158-a1a2a44c-6ae21b2e-01962ee0.jpg,validate/p11/p11733507/s56253095/0f5f0783-c10ea158-a1a2a44c-6ae21b2e-01962ee0.jpg,validation," FINAL REPORT HISTORY: Patient with elevated WBC, abnormality seen on right lower lobe, rule out pneumonia. COMPARISON: ___. FINDINGS: Portable single frontal chest radiograph was obtained with the patient in supine position. A new right lower lung opacity is present. The left lung is clear. Bilateral pleural thickening with a prominent left lateral pleural mass as well as diaphragmatic plaques are again demonstrated. The cardiomediastinal silhouette and hilar contours are stable. There is no pleural effusion or pneumothorax. IMPRESSION: 1. New right lower lung opacity which may be secondary to aspiration or pneumonia. 2. Bilateral pleural thickening with prominent left pleural mass consistent with known asbestos exposure, better assessed on recent CT torso from ___. " 41b3ed88-a0cd3de0-d529f4f9-038c9b66-b492e547.jpg,validate/p15/p15749643/s55449310/41b3ed88-a0cd3de0-d529f4f9-038c9b66-b492e547.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with SOB // ?pleural effusions TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable with moderate to severe cardiomegaly and tortuous aorta. There is mild vascular congestion. Bilateral effusions small and are associated with adjacent atelectasis. There is no pneumothorax. There are moderate degenerative changes in the thoracic spine IMPRESSION: Vascular congestion with small bilateral effusions Stable cardiomegaly " f2a5d6c3-2a5b1f08-1ed5e103-2b96f049-497ad463.jpg,validate/p19/p19207120/s54491804/f2a5d6c3-2a5b1f08-1ed5e103-2b96f049-497ad463.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, viral symptoms, exposure to atypical PNA // Evidence of infection TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ and ___ FINDINGS: Subtle lateral left base opacity is felt to more likely represent atelectasis rather than consolidation. It is not clearly seen on the lateral view. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are stable. IMPRESSION: Subtle lateral left base opacity is felt to more likely represent atelectasis rather than consolidation. " cd80d600-f7aaee13-902bdf9d-4140413e-f50fe447.jpg,validate/p18/p18014061/s59597532/cd80d600-f7aaee13-902bdf9d-4140413e-f50fe447.jpg,validation," 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. " f7f95a43-0c293854-7f94a2ca-f73a18d0-00ff0ea0.jpg,validate/p14/p14711527/s50054457/f7f95a43-0c293854-7f94a2ca-f73a18d0-00ff0ea0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with 4 days of int L sided CP + SOB // eval for consolidation / pulm edema COMPARISON: ___ and ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. There is no overt edema. Heart appears top-normal in size. Mediastinal contour is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Top normal heart size, otherwise unremarkable. " b8739e82-ed3d3988-805ecbe5-be4eacd0-e8951384.jpg,validate/p11/p11855285/s52892936/b8739e82-ed3d3988-805ecbe5-be4eacd0-e8951384.jpg,validation," FINAL REPORT INDICATION: History: ___M with oral bleed, possible aspiration. // PNA? Aspiration? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Left pectoral pacemaker and its 2 leads are in unchanged positions. There is no consolidation, pneumothorax, or pleural effusion. Severely enlarged cardiac silhouette is similar to before. IMPRESSION: No radiographic evidence of pneumonia. " 5a82af5f-f74e3856-1ba486c3-b1993503-2abe29c0.jpg,validate/p10/p10504635/s58363234/5a82af5f-f74e3856-1ba486c3-b1993503-2abe29c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with swan-ganz catheter // evaluate for swan-ganz catheter placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild cardiomegaly and widened mediastinum are unchanged. Swan-Ganz catheter tip is in the main pulmonary artery. There is no pneumothorax pleural effusion or pulmonary edema. " 71834b3f-9c8e95c4-6b1ab06a-32cea300-25eb1f3d.jpg,validate/p16/p16625317/s57699248/71834b3f-9c8e95c4-6b1ab06a-32cea300-25eb1f3d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ESRD on HD, tachypnea, rales // eval for pulmonary edema COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Moderate cardiomegaly. Mild elongation of the descending aorta. Mild fluid overload. No pleural effusions. No pneumonia. " c648a07c-bc981ee6-72091692-075928e8-8cd0001e.jpg,validate/p15/p15721149/s59684350/c648a07c-bc981ee6-72091692-075928e8-8cd0001e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RUL cavity, increased sputum // ? pneumonia, enlarging lung abscess? ? pneumonia, enlarging lung abscess? COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Right upper lobe cavity, architectural distortion and volume loss are unchanged compared to the previous study. Left lung is clear. No new consolidations or changes that would be concerning for superimposed infection in the left and right lungs noted. Giving the complexity of the right upper lobe abnormality, assessment with chest CT would be beneficial. " 124a8964-665d33a2-55684de0-69b89dff-18e7f40e.jpg,validate/p15/p15664962/s53279195/124a8964-665d33a2-55684de0-69b89dff-18e7f40e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o breast cancer // r/o metastatic disease COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing pleural effusions have completely resolved. Moderate scoliosis of the thoracic spine. Borderline size of the cardiac silhouette with mild elongation of the descending aorta. Several smaller millimetric nodular structures on the frontal radiograph are not visualized on the lateral radiograph and likely reflect vascular shadows. No pneumonia, no pneumothorax, no atelectasis. " 92b84157-440dc3ff-f7db7120-da42f9e9-9686cebe.jpg,validate/p10/p10216097/s53279592/92b84157-440dc3ff-f7db7120-da42f9e9-9686cebe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF, R pleural effusion s/p chest tube placement and removal on ___ // Interval change IMPRESSION: As compared to ___, right pleural catheter has been removed, with slight increase in size of a moderate right pleural effusion but no definite pneumothorax. Persistent enlarged cardiac silhouette accompanied by pulmonary vascular congestion and worsening edema. " d75d4a29-ce525726-71719660-85aae2d0-8b38c7a1.jpg,validate/p18/p18011403/s54190681/d75d4a29-ce525726-71719660-85aae2d0-8b38c7a1.jpg,validation," FINAL REPORT HISTORY: CLL and failure to thrive concerning for aspiration pneumonia. COMPARISON: Multiple prior chest radiographs, most recently on ___. ___ chest CT. FINDINGS: Single frontal view of the chest. Right PICC is in stable position, terminating in the mid SVC. Heart size and mediastinal contours, including tortuosity of the aorta, are stable. Lung hyperinflation and bilateral calcified granulomas are similar to prior. The lungs otherwise appear clear without focal consolidation, pleural effusion, or pneumothorax. Mucous plugging and left upper lobe consolidation seen on ___ chest CT are not apparent on the current chest radiograph. IMPRESSION: No radiographic evidence of acute cardiopulmonary process. Previously seen abnormalities on ___ chest CT may not be radiographically apparent. " 1aede5fb-cf634f3a-6b6b3660-80b623ab-4c72bdcc.jpg,validate/p10/p10012768/s51169270/1aede5fb-cf634f3a-6b6b3660-80b623ab-4c72bdcc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple myeloma and new fever. // Evaluate for cause of fever. COMPARISON: None available. FINDINGS: Heart is upper limits of normal in size. Mediastinal hilar contours are normal. Lungs are clear except for linear bibasilar atelectasis and or scarring. Skeletal structures have been more fully assessed by recent skeletal survey of 1 day earlier. IMPRESSION: Linear bibasilar atelectasis or scar. No evidence " 9cef6d74-1794e62c-9eb14734-e9bc9c72-819fe469.jpg,validate/p14/p14290495/s59569910/9cef6d74-1794e62c-9eb14734-e9bc9c72-819fe469.jpg,validation," WET READ: ___ ___ ___ 7:43 AM Mildly increased opacity in the right upper lobe could represent a developing early pneumonia. WET READ VERSION #1 ___ ___ ___ 7:27 PM Mildly increased opacity in the right upper lobe could represent a developing early pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ?PNA on prior CXR // please eval for progression or resolution of PNA IMPRESSION: AS COMPARED TO ___ POORLY DEFINED CONSOLIDATION IN THE RIGHT UPPER LOBE HAS SLIGHTLY PROGRESSED, CONCERNING FOR EVOLVING FOCUS OF INFECTIOUS PNEUMONIA. EXAM IS OTHERWISE UNCHANGED. " ae0e7268-b71b7851-0aa4911c-525fb5a4-670a60f7.jpg,validate/p11/p11015757/s53912802/ae0e7268-b71b7851-0aa4911c-525fb5a4-670a60f7.jpg,validation," FINAL REPORT HISTORY: Chronic cough with history of tobacco use and international travel. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fracture is identified. IMPRESSION: No acute cardiopulmonary process. " 1fe33427-4151db63-514cd8e7-8c6d9b88-3812ad0f.jpg,validate/p18/p18785003/s55834519/1fe33427-4151db63-514cd8e7-8c6d9b88-3812ad0f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT // NG tube placement confirmation TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. The NG tube is in the stomach IMPRESSION: No change. " 9a4af92b-b906c487-11cb32b9-1baa1b6c-e42bd30d.jpg,validate/p10/p10364180/s55136438/9a4af92b-b906c487-11cb32b9-1baa1b6c-e42bd30d.jpg,validation," FINAL REPORT HISTORY: Weight loss. Rule out infection. 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. The lungs are hyperexpanded, consistent with known diagnosis of COPD. Previously described nodular opacities are better seen on prior chest CT from ___. No focal consolidation concerning for pneumonia is present. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary findings. " ba571de1-d184f9af-c3e2ac94-b6e108c7-6bf0a00d.jpg,validate/p18/p18296202/s58561335/ba571de1-d184f9af-c3e2ac94-b6e108c7-6bf0a00d.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever and hypoxia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes and elevation of the right hemidiaphragm. Bibasilar opacities are seen which could in part relate to atelectasis, although underlying consolidation is not excluded. No large pleural effusion is seen, although small is difficult to exclude. The cardiac silhouette is difficult to assess due to bibasilar opacities. The bibasilar opacities could also relate to chronic aspiration. " a0b63ce9-b50c02b4-c0d09c56-f8b24e54-f2d02155.jpg,validate/p12/p12595468/s58352387/a0b63ce9-b50c02b4-c0d09c56-f8b24e54-f2d02155.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with cough and low grade fevers // R/O pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lungs are well inflated and grossly clear. The heart is top-normal in size, unchanged. Aortic arch calcifications are again noted. No pleural effusion, overt pulmonary edema, pneumothorax, or evidence of pneumonia is seen. IMPRESSION: No acute cardiopulmonary process. " 44fa7428-8d61579f-bb111a18-d293d282-ed891eb7.jpg,validate/p12/p12251785/s54483644/44fa7428-8d61579f-bb111a18-d293d282-ed891eb7.jpg,validation," FINAL REPORT INDICATION: End-stage renal disease. Evaluate for pneumonia. COMPARISONS: Chest radiograph, ___. CTA chest, ___. FINDINGS: Since the prior exam, there are new bilateral ground glass opacities, consistent with increasing mild pulmonary edema. A linear opacity in the left mid lung zone is consistent with linear atelectasis, and unchanged from the prior exam. There is no new consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is enlarged, and unchanged from the prior exam. IMPRESSION: 1. New mild pulmonary edema. 2. Stable left basilar atelectasis. 3. Stable moderate cardiomegaly. " d89b5dd7-b9c399f4-e4276b92-a4e46df2-3cff1f26.jpg,validate/p17/p17396346/s59365662/d89b5dd7-b9c399f4-e4276b92-a4e46df2-3cff1f26.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with s/p fall // eval for trauma TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The cardiac silhouette remains enlarged. Mediastinal contours are grossly unremarkable. Patchy right lower lobe opacity is seen which could be due to atelectasis, pulmonary contusion in the setting of trauma, aspiration, or pneumonia. No large pleural effusion is seen. There is no evidence of pneumothorax. Multiple surgical clips are seen in the left axilla. No obvious displaced fracture is seen. IMPRESSION: Streaky right lower lobe opacities could be due to atelectasis, pulmonary contusion in the setting of trauma, aspiration, or pneumonia. " 76575059-eedc2216-f0a00944-88d1deac-4b039d0a.jpg,validate/p15/p15738125/s53874971/76575059-eedc2216-f0a00944-88d1deac-4b039d0a.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fall // acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Chronic deformity of the left sided ribs again seen. There is slight blunting left costophrenic angle, may be due to pleural thickening or pleural effusion. Bibasilar opacities are seen, right greater than left, may be due to aspiration although infectious process is not excluded in the appropriate clinical setting. There is no pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Bibasilar opacities could be due to aspiration or pneumonia. Chronic left-sided rib deformities. " 3d3cfe5e-efd6ac9c-84159619-debd7b54-a690775b.jpg,validate/p11/p11842879/s55200732/3d3cfe5e-efd6ac9c-84159619-debd7b54-a690775b.jpg,validation," FINAL REPORT INDICATION: Pneumonia, status post intubation. Evaluate for change. COMPARISONS: Chest radiographs from ___. ___ radiograph from ___. CTA of the chest from ___. TECHNIQUE: A single semi-upright AP view of the chest was obtained. FINDINGS: An endotracheal tube is in satisfactory position, 4.4 cm from the carina. A right internal jugular central venous catheter is unchanged with the tip at the atriocaval junction. An enteric tube courses below the diaphragm with the tip out of field of view. It is likely a post-pyloric position. There is improved aeration at the right base, though there are persistent bibasilar opacities, likely representing residual pneumonia. The apices of the lungs are clear. There is no pulmonary edema. There is no pleural effusion or pneumothorax. Again, subcutaneous air is noted overlying the neck. The cardiomediastinal silhouette is normal. IMPRESSION: Persistent bibasilar opacities, though there is interval improvement in the aeration at the right base. " 5c377843-87b7c493-8ce5c060-ad1bc05f-98f1522d.jpg,validate/p17/p17159286/s57990782/5c377843-87b7c493-8ce5c060-ad1bc05f-98f1522d.jpg,validation," WET READ: ___ ___ ___ 7:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M CKD pt on dialysis presents with flapping tremor and productive cough // ?PNA 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 identified. Right midclavicular deformity could represent prior trauma. IMPRESSION: No acute cardiopulmonary process. " 8ba18978-25037a3c-a96ef314-ad6b7166-3521e108.jpg,validate/p12/p12738736/s54182938/8ba18978-25037a3c-a96ef314-ad6b7166-3521e108.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough, sputum. 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 stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " 74addbbc-1928ae10-3322810c-576c27d0-0c314dc8.jpg,validate/p10/p10364180/s57334470/74addbbc-1928ae10-3322810c-576c27d0-0c314dc8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea, oxygen requirement, chronic heart failure, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the known and pre-described signs of moderate predominantly interstitial pulmonary edema are not substantially changed. The heart continues to be enlarged. A small atelectasis is seen at the left upper lobe base. The lateral radiograph revealed known small pleural effusions restricted to the area of the costophrenic sinuses. No new parenchymal opacities have appeared since the previous examination. " 7ba80136-0500fce9-83080f43-605c4d3b-7ab66d57.jpg,validate/p10/p10250159/s54015830/7ba80136-0500fce9-83080f43-605c4d3b-7ab66d57.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. COMPARISONS: ___. 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. " 4decce85-c6ede74e-7a8bc81c-e81edee9-5ec17116.jpg,validate/p10/p10500801/s58577720/4decce85-c6ede74e-7a8bc81c-e81edee9-5ec17116.jpg,validation," 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. " fa31aff9-67d5930d-5e4cb9e4-840362a2-e24e812c.jpg,validate/p10/p10326773/s53247576/fa31aff9-67d5930d-5e4cb9e4-840362a2-e24e812c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F presented to OSH with AMS and seizure, ACOMM aneurysm rupture now s/p coiling ___. Course complicated by increased intracranial pressures. // evaluate interval change TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___. FINDINGS: The left IJ central venous catheter and nasogastric tube are unchanged. There is no pneumothorax. Small bilateral pleural effusions are stable, but bibasilar subsegmental atelectasis has increased. Small bilateral pleural effusions are new. The cardiomediastinal silhouette is stable. IMPRESSION: New small pleural effusions with increased bibasilar subsegmental atelectasis. " 71b4cdae-bcd72ad2-fce67a4d-11f4c56d-e6bf4c99.jpg,validate/p13/p13124419/s51041418/71b4cdae-bcd72ad2-fce67a4d-11f4c56d-e6bf4c99.jpg,validation," 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. " b54ecc2f-c6d57364-987ba16a-d0b11a7a-0bea387a.jpg,validate/p12/p12724735/s52000866/b54ecc2f-c6d57364-987ba16a-d0b11a7a-0bea387a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with CHF // eval for pulmonary edema COMPARISON: CTA torso ___ and chest radiograph ___ FINDINGS: Bibasilar opacities may represent pleural effusions with overlying atelectasis. Prominence of the pulmonary vasculature is similar to prior. There is moderate pulmonary edema. There is no pneumothorax. Cardiomegaly and aortic calcifications are similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Right IJ catheter is grossly unchanged in position. Surgical clips are seen in the left apex. IMPRESSION: Bibasilar opacities may represent pleural effusions with overlying atelectasis. Pulmonary edema is moderate. " 84855938-83f7ba70-978290ac-e94b94e0-391d5735.jpg,validate/p13/p13562596/s53522993/84855938-83f7ba70-978290ac-e94b94e0-391d5735.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: DKA, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have decreased. As a consequence, there is increased vascular crowding at the lung bases and hilar structures are slightly larger than before. No evidence of pneumonia or other acute lung disease. Borderline size of the cardiac silhouette is unchanged. " 06486366-394378b1-d9cf35ae-2f450d60-635f10a4.jpg,validate/p11/p11057136/s53310635/06486366-394378b1-d9cf35ae-2f450d60-635f10a4.jpg,validation," WET READ: ___ ___ ___ 11:53 PM Interval development of a small right pneumothorax. Unchanged diffuse subcutaneous emphysema. No focal consolidation or pleural effusion. D/w Dr. ___ at 11:51 p.m. (3 minutes after discovery). ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe COPD and subcutaneous emphysema. // assess interval change of right apical PTX assess interval change of right apical PTX COMPARISON: Chest radiographs ___ through ___ at 4:42 a.m. IMPRESSION: Moderate right pneumothorax predominantly basal but with an apical component, is larger now than earlier in the day. The thoracostomy tube in the lower chest, unchanged in its oblique orientation ; was anterior to the right lung on ___ one chest CT was performed. Severe subcutaneous emphysema in the chest wall and neck is probably unchanged. Opacity at the right lung base is probably atelectasis. Vascular deficiency in the left lung reflects emphysema. Heart is normal size. " 7056e452-4ec71255-db984743-fe99d387-e51ff7d6.jpg,validate/p13/p13272752/s55862914/7056e452-4ec71255-db984743-fe99d387-e51ff7d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval COMPARISON: ___. IMPRESSION: As compared to the previous image, the extent of the existing fluid or pneumothorax on the left has increased despite drainage of the pathology. Unchanged appearance of the heart and of the right lung. " e01f46d1-e800fa81-d010603a-b6846b83-0d339d05.jpg,validate/p19/p19926820/s54678089/e01f46d1-e800fa81-d010603a-b6846b83-0d339d05.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NGT // NGT placement TECHNIQUE: Chest single view COMPARISON: ___ 14:29 FINDINGS: Enteric tube tip is well below diaphragm, tip not included on the radiograph. Shallow inspiration accentuates heart size, pulmonary vascularity, which are prominent and stable since prior. Stable mild interstitial prominence. IMPRESSION: Enteric tube tip well below diaphragm. " a45b5290-5802417e-484e59d3-b775eec6-e614ef4b.jpg,validate/p12/p12628189/s52395938/a45b5290-5802417e-484e59d3-b775eec6-e614ef4b.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Prior right central venous catheter is no longer seen. The lungs are clear of focal consolidation. Left base calcified nodule laterally is unchanged. Calcified left hilar lymph nodes are again seen. There is tortuosity of the descending thoracic aorta. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 46995c20-fe616847-dc82e45e-2a596cee-42d83c42.jpg,validate/p15/p15058800/s51654288/46995c20-fe616847-dc82e45e-2a596cee-42d83c42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with multiple myeloma and amyloidosis overlap on chemtherapy who has been receiving IVFs for concern for tumor lysis now with new oxygen requirement and dyspnea. // Please evaluate for pulmonary edema. COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a slight increase of the bilateral pleural effusions. Subsequent areas of atelectasis at the lung bases have also increased. Moderate cardiomegaly. Mild pulmonary edema persists. " aa97a8d2-59a2437a-c58be1e5-7926809c-109cc41e.jpg,validate/p14/p14690687/s51287286/aa97a8d2-59a2437a-c58be1e5-7926809c-109cc41e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, shortness of breath. FINDINGS: PA and lateral views of the chest provided demonstrate midline sternotomy wires and mediastinal clips. There is a left chest wall AICD with lead tip extending to the level of the right ventricle. The heart is mildly enlarged. There is mild pulmonary edema. No large effusion. Stable scarring at the right lateral lung base. Bony structures are intact. IMPRESSION: Mild pulmonary edema. Mild cardiomegaly. " 2b34b457-37aff397-0e327a11-5e481447-dc585f2a.jpg,validate/p11/p11639395/s59947365/2b34b457-37aff397-0e327a11-5e481447-dc585f2a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with wheezing // eval for hyperinflation, parenchymal changes 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 " cd96e919-8a62432f-09af6916-db802a56-8575d45a.jpg,validate/p10/p10767527/s50507057/cd96e919-8a62432f-09af6916-db802a56-8575d45a.jpg,validation," 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. " 93a1da69-d89000d7-a48ef114-e4aed36c-9fb348ce.jpg,validate/p19/p19707837/s57917553/93a1da69-d89000d7-a48ef114-e4aed36c-9fb348ce.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain. hb 5.5. // R/O CHF, pneumonia TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: There is hazy increased opacity projecting over the lung apices, left greater than right. This is not definitely parenchymal in nature and may be technical and due to overlying soft tissues. Elsewhere the lungs are clear, there is no effusion. There is an ill-defined contour of the aortic knob. There are diffuse lucencies throughout the bones particularly notable in the region of the left scapula and right clavicle. IMPRESSION: 1. Ill-defined contour of the aortic knob. In setting of chest pain, CT should be considered to further assess. Alternatively if low suspicion for acute aortic syndrome, repeat with PA and lateral views can be performed. 2. Increased opacity projecting over the upper lungs, left greater than right likely technical due to overlying soft tissues but can be further clarified by a PA and lateral. 3. Osseous findings compatible with patient's known multiple myeloma. NOTIFICATION: Findings discussed with Dr. ___ by Dr. ___ ___ the phone ___ min after time of discovery at 16:00 on ___ . " 987fd17b-a0b9b9d2-d2d36e73-aec4d78f-daed4d7e.jpg,validate/p15/p15792067/s54078825/987fd17b-a0b9b9d2-d2d36e73-aec4d78f-daed4d7e.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough and fever. Please perform a lateral view to evaluate for pneumonia. COMPARISON: Frontal chest radiograph performed approximately one hour prior to this exam. TECHNIQUE: A leftward rotated AP view and a lateral view of the chest were obtained. FINDINGS: The frontal view is extremely rotated to the left, with complete projection of the mediastinum over the left lung, which limits assessment. The expanded right lung is unremarkable. Assessment in the lateral view is also limited due to superimposition of the arms, but allowing for technical limitations, there is no spine sign, pleural effusion, or abnormality in the anterior mediastinum. No pneumothorax is identified. Artifacts from external hair devices are again seen. IMPRESSION: Limited examination. No evidence of acute cardiopulmonary process. " 162d39d5-7d7dbdf6-72e32988-7345e9af-f0601fc4.jpg,validate/p12/p12835005/s50522501/162d39d5-7d7dbdf6-72e32988-7345e9af-f0601fc4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Clamped chest tube, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the known pneumothorax on the right has minimally increased in severity after chest tube clamping. The clamped tube is in unchanged position. There is no evidence of tension. Unremarkable left lung. " 0e3ee832-ff1d8a6f-e5b09329-b6f39e6f-27b97cb8.jpg,validate/p17/p17876274/s54286402/0e3ee832-ff1d8a6f-e5b09329-b6f39e6f-27b97cb8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NSCLC and new left effusion s/p chest tube placement // ? PTX ? PTX IMPRESSION: Compared to prior chest radiograph ___, read in conjunction with chest CT ___. No appreciable left pleural effusion or pneumothorax following insertion of the basal pigtail pleural drainage catheter. Left suprahilar nodule and atelectasis unchanged. Large mediastinal hematoma, predominantly right paratracheal has developed since the chest radiograph on ___ but is shown on the intervening chest CT. Right lung grossly clear. Heart size normal. RECOMMENDATION(S): No appreciable left pleural effusion " e9442838-bab704de-c1a0aec8-30a0b62e-3352fb5b.jpg,validate/p16/p16968751/s54664956/e9442838-bab704de-c1a0aec8-30a0b62e-3352fb5b.jpg,validation," 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. " 2500c346-21b4971d-2f6ae2e3-5dfdc979-0d3fa1ee.jpg,validate/p13/p13365915/s56820651/2500c346-21b4971d-2f6ae2e3-5dfdc979-0d3fa1ee.jpg,validation," FINAL REPORT PORTABLE SUPINE CHEST, ___ COMPARISON: Radiograph of earlier the same date as well as previous chest radiographs dating back to ___. FINDINGS: Support and monitoring devices are in standard position. Previously present homogeneous opacity along the left upper mediastinum has resolved, and likely reflected left upper lobe collapse. Pulmonary vascular congestion is accompanied by mild-to-moderate edema as well as bilateral pleural effusions, small on the right and small to moderate on the left. No definite pneumothorax on this supine radiograph. " ecbba40d-b721a6ba-6b76d086-6f66bea8-1b39c296.jpg,validate/p15/p15284020/s59858816/ecbba40d-b721a6ba-6b76d086-6f66bea8-1b39c296.jpg,validation," FINAL REPORT INDICATION: History of aortic stenosis, now with shortness of breath, here to evaluate for congestive heart failure or pneumonia. COMPARISON: Prior chest radiographs dated ___, ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Marked elevation of the right hemidiaphragm is unchanged from the most recent prior study of ___. A right pectoral pacemaker is unchanged with two leads terminating in the right atrium and right ventricle. The right lung volume remains low; however, 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 cardiac silhouette remains top normal in size but stable. The mediastinal contours are within normal limits with calcification of the aortic knob again seen. There is exaggerated kyphotic curvature of the thoracic spine with diffuse osteopenia. IMPRESSION: Stable appearance of the chest from ___ without evidence of pneumonia or heart failure. " eca0bae9-536fbe89-ab12ffff-e46d1190-4d8e9571.jpg,validate/p13/p13007957/s56920676/eca0bae9-536fbe89-ab12ffff-e46d1190-4d8e9571.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with multiple seizures today // eval for pneumonia COMPARISON: None 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. Partially visualized AC joints noted to be widened bilaterally. No free air below the right hemidiaphragm is seen. A catheter projects over the left chest wall into the left neck. IMPRESSION: No acute intrathoracic process. " c680ed4f-49f40d5c-59001a7d-70ccc5e2-6f4a2471.jpg,validate/p12/p12307852/s51501763/c680ed4f-49f40d5c-59001a7d-70ccc5e2-6f4a2471.jpg,validation," FINAL REPORT HISTORY: Weight loss in longterm smoker. FINDINGS: No previous images. Hyperexpansion of the lungs is consistent with chronic pulmonary disease. However, no evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " 76f4d871-a9f3df75-465a0be9-66f08df8-65e15f89.jpg,validate/p16/p16085209/s56908106/76f4d871-a9f3df75-465a0be9-66f08df8-65e15f89.jpg,validation," 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. " 77045c30-64f194bf-cf8a20ad-4f973b36-28a90a90.jpg,validate/p11/p11074035/s59241633/77045c30-64f194bf-cf8a20ad-4f973b36-28a90a90.jpg,validation," FINAL REPORT INDICATION: Generalized malaise. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate hyperexpanded but clear lungs. There is no pleural effusion or pneumothorax. Heart size is normal. The cardiac, hilar, and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " 9aac6aed-c9aab0d7-7c734164-ac55df54-6393058f.jpg,validate/p11/p11448985/s52796955/9aac6aed-c9aab0d7-7c734164-ac55df54-6393058f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple traumas // Intubated pt Intubated pt IMPRESSION: Comparison to ___. Minimal increase in extent of a left pleural effusion, a left retrocardiac atelectasis and the minimal right basilar atelectasis. The monitoring and support devices continue to be in correct position. No new focal parenchymal opacities. No visible pneumothorax. " 999bd356-6cb9a4de-a9b00a69-c66f257b-59d1b449.jpg,validate/p18/p18005274/s54052535/999bd356-6cb9a4de-a9b00a69-c66f257b-59d1b449.jpg,validation," 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. " 146321a6-96294deb-e98fe00f-6e436ab2-ee01b321.jpg,validate/p15/p15805011/s56802822/146321a6-96294deb-e98fe00f-6e436ab2-ee01b321.jpg,validation," 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. " 45aa1a09-ed50dffa-f91421ee-590a536a-9867ca96.jpg,validate/p19/p19720782/s52924835/45aa1a09-ed50dffa-f91421ee-590a536a-9867ca96.jpg,validation," FINAL REPORT INDICATION: Severe COPD, admitted with COPD exacerbation. COMPARISON: Chest radiographs dated ___ and ___. TECHNIQUE: Portable upright frontal radiograph of the chest. FINDINGS: Elevation of the right lung base is unchanged. A moderate right pleural effusion is not significantly changed. There is no focal consolidation or pneumothorax, although the lung apices are partially obscured by overlying soft tissues of the neck. Prominence of the right perihilar region is unchanged and compatible with radiation changes. The cardiomediastinal contours are stable. Pulmonary vascular congestion is unchanged. " 2a5e26ac-c475bf85-c8cfadaa-ad436e66-41bf8720.jpg,validate/p15/p15057255/s55438767/2a5e26ac-c475bf85-c8cfadaa-ad436e66-41bf8720.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Status post fall with left hip pain. TECHNIQUE: Chest, AP and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable allowing for differences in technique. There is again moderate to large hiatal hernia. There is possibly a trace pleural effusion on the right. The lungs appear clear. IMPRESSION: Moderate to large hiatal hernia. No evidence of acute cardiopulmonary disease. " 73cf5ae1-a06e37b9-fb133485-e4065e31-e351a2bb.jpg,validate/p10/p10924565/s53997782/73cf5ae1-a06e37b9-fb133485-e4065e31-e351a2bb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with history of lung cancer presents with anemia, general weakness TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___ and chest CT ___ FINDINGS: Lung volumes are low. Cardiac, mediastinal and hilar contours are unchanged from the recent chest CT allowing for differences in technique. Pulmonary vasculature is not engorged. Focal opacity within the left lower lobe partially reflects the known cavitary mass seen on the previous CT, with probable superimposed infection or atelectasis. Additionally, multiple scattered pulmonary nodules seen on prior CT are not as well assessed on the current exam. Trace left pleural effusion is present. No right pleural effusion or pneumothorax is present. Innumerable sclerotic metastatic lesions are again seen within the osseous structures. IMPRESSION: Patchy opacity within the left lower lobe likely reflects a combination of the patient's known cavitary mass as well as superimposed infection or atelectasis. Trace left pleural effusion. Known bilateral pulmonary nodules are better assessed on the prior CT. Re- demonstration of diffuse sclerotic osseous metastases. " e44564a9-b9383832-2dc337ec-a7b742ac-2b69d9ad.jpg,validate/p18/p18785569/s53235732/e44564a9-b9383832-2dc337ec-a7b742ac-2b69d9ad.jpg,validation," FINAL REPORT AP CHEST 1:05 A.M., ___ HISTORY: ___-year-old man following attempted right IJ central venous line placement. Assess for complications. IMPRESSION: AP chest compared to chest radiographs since ___, most recently ___: Since moderate cardiomegaly has worsened, it is possible that increased caliber to the upper mediastinum, particularly to the right, could be due to venous engorgement. There is no way that I can exclude a small mediastinal hematoma, but it would be reasonable to follow this with conventional radiographs rather than jump to a chest CT scan. There is no pneumothorax. Atelectasis, due in part to large hiatus hernia, is slightly more pronounced today than before. There is no pleural effusion. " b3b1a0ec-be0304c8-cce6f241-9d4476c2-573735a6.jpg,validate/p15/p15805011/s51726414/b3b1a0ec-be0304c8-cce6f241-9d4476c2-573735a6.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with syncope. COMPARISONS: ___ to ___. FINDINGS: PA and lateral chest radiographs are limited by body habitus. Despite limitations, the lungs are well inflated and clear. No focal consolidation, effusion, or pneumothorax is present. Prominent left lateral pleural lipomatosis is unchanged. The cardiac and mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " a7f054a7-6fbb5a0b-cdcf17bb-ef4230bb-39fd42a5.jpg,validate/p19/p19736108/s55514987/a7f054a7-6fbb5a0b-cdcf17bb-ef4230bb-39fd42a5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough for several weeks, remote smoker, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal lung volumes. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. No parenchymal opacities, no pneumonia, no pleural effusions, no pulmonary edema. " 65a5f280-dd95a5ec-741fb4c3-0b23b1fc-e1d22ab7.jpg,validate/p19/p19231238/s56591583/65a5f280-dd95a5ec-741fb4c3-0b23b1fc-e1d22ab7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior radiograph from ___. CLINICAL HISTORY: Cough and fever. Assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained. Vague opacity in the left lower lung and right upper lobe are concerning for pneumonia. Please refer to subsequent CT for further evaluation. Otherwise the lungs appear clear. Heart and mediastinal contour appear normal. Bony structures are intact. IMPRESSION: Multifocal pneumonia better assessed on the subsequent CTA of the chest. " 898260d2-d8dc088a-2d52c631-aad20f60-6daa19f5.jpg,validate/p12/p12494432/s58786954/898260d2-d8dc088a-2d52c631-aad20f60-6daa19f5.jpg,validation," FINAL REPORT HISTORY: Right parapneumonic effusion, status post thoracentesis. Evaluation for interval change. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs show the large right pleural effusion has increased considerably from ___. There is also new left basilar segmental atelectasis. There is there is no pneumothorax. The cardiomediastinal silhouette is stable. IMPRESSION: Enlarging right pleural effusion. " 8eab631a-f16fecdd-a5a34aa6-3897b861-b6d0ba44.jpg,validate/p14/p14832062/s58103863/8eab631a-f16fecdd-a5a34aa6-3897b861-b6d0ba44.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient status post flash pulmonary edema, CHF after diuresis. Study requested for interval evaluation. COMPARISON: Prior chest radiographs from ___ through ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiographs from ___, there has been interval improvement of a right upper lobe opacity. However, there is slight worsening of pulmonary edema. There are small bilateral pleural effusions. There are no new focal consolidations. Mild cardiomegaly is stable. IMPRESSION: 1. Improving opacity in right upper lobe, likely related to asymmetrical edema. 2. Slight worsening of pulmonary edema with bilateral small pleural effusions. " 0457f435-f86860a5-42eb3961-a79f2f95-456b846f.jpg,validate/p10/p10333385/s56024807/0457f435-f86860a5-42eb3961-a79f2f95-456b846f.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No acute fractures identified. IMPRESSION: No acute cardiopulmonary process. " b15a6aaf-2ca56aa1-7ee5f2d7-0ec474ae-536a0dc8.jpg,validate/p17/p17913240/s54986141/b15a6aaf-2ca56aa1-7ee5f2d7-0ec474ae-536a0dc8.jpg,validation," 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. " d72fb9c9-3e186781-af0a7dc0-6fb7d6f0-c6d7b0f8.jpg,validate/p16/p16546662/s55857742/d72fb9c9-3e186781-af0a7dc0-6fb7d6f0-c6d7b0f8.jpg,validation," WET READ: ___ ___ ___ 2:48 AM 1. No evidence of acute cardiopulmonary process. 2. Interval decrease in small left pleural effusion. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with productive cough, evaluate for pneumonia. TECHNIQUE: Chest AP and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: There is hyperinflation suggestive of background COPD. Slight prominence of slight diffuse prominence of interstitial markings likely relates to chronic changes of COPD. There is no focal consolidation, pulmonary edema, or pneumothorax. A small left pleural effusion has decreased compared with the prior study. There is diffuse demineralization. IMPRESSION: 1. No evidence of acute pulmonary process. 2. Interval decrease in small left pleural effusion. " 3b31ed32-7ebc83f4-0ed81520-6f6da0a1-6c7df7d8.jpg,validate/p14/p14508231/s51101379/3b31ed32-7ebc83f4-0ed81520-6f6da0a1-6c7df7d8.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain and left shoulder pain. Question cardiopulmonary pathology. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear. There is no pneumothorax, vascular congestion, or large pleural effusion. Limited view of the left shoulder does not demonstrate gross abnormality. Patient is status post C6-7 anterior cervical fusion. IMPRESSION: No acute cardiopulmonary process. " 0290c7f6-2c2a6dcb-2271b34c-cc78bf01-0ce6802a.jpg,validate/p10/p10903630/s54545428/0290c7f6-2c2a6dcb-2271b34c-cc78bf01-0ce6802a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with neck infection, // r/o septic emboli r/o septic emboli COMPARISON: There are no prior chest radiographs available for review. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 53590ea2-03b260f4-6be5e455-c542dd05-9438e3c9.jpg,validate/p14/p14001555/s52202627/53590ea2-03b260f4-6be5e455-c542dd05-9438e3c9.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with O2 desat s/p lap cholecystectomy // ?pulmonary edema vs pna compare to prior study TECHNIQUE: Frontal view of the chest COMPARISON: ___ chest radiograph, ___ CT abdomen and pelvis FINDINGS: Mild bibasilar opacities are probably reflect atelectasis. There is no pneumothorax or large pleural effusion. Prominent pulmonary vessels are similar to before. Mildly enlarged cardiac silhouette is similar to before. Widened mediastinum likely reflect mediastinal fat as demonstrated on prior CT abdomen and pelvis. IMPRESSION: No radiographic evidence of pneumonia or pulmonary edema. No radiological explanation for hypoxia is identified. " e0e24964-ce4999dc-e21869b1-3beb875c-d56de543.jpg,validate/p15/p15089136/s51528743/e0e24964-ce4999dc-e21869b1-3beb875c-d56de543.jpg,validation," WET READ: ___ ___ ___:___ AM No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of lymphoma. Has productive cough, feeling of mucous in chest. Exam shows ?rales and absence of breath sounds on left base // eval for abnormality TECHNIQUE: Chest PA and lateral COMPARISON: ___, CT chest dated ___ FINDINGS: Lung volumes are slightly low. The cardiomediastinal silhouette and pulmonary vasculature are stable since the prior examinations. There is stable elevation of the left hemidiaphragm. Aortic knob calcifications are similar to the prior examination. There is no pleural effusion or pneumothorax. No definite consolidation is identified. IMPRESSION: No acute intrathoracic abnormality. NOTIFICATION: The findings were discussed with Dr. ___, ___O. by ___ ___, M.D. on the telephone on ___ at ___:___ AM, ___ minutes after discovery of the findings. " 3769f121-1b23a41f-e5322661-b70e9233-90c8435e.jpg,validate/p19/p19777911/s55508751/3769f121-1b23a41f-e5322661-b70e9233-90c8435e.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with frequent PVCs, concern for irritating PICC tip, PICC placement. FINDINGS: AP single view of the chest has been obtained with patient in upright position. A left-sided PICC line is seen to terminate overlying the right-sided mediastinal structures at the level 1 cm below the carina. This appears to be a safe distance above the entrance into the right atrium. The lungs are clear without evidence of pulmonary congestion. Moderate cardiac enlargement is present and mild elongation of the thoracic aorta is noted. On the next preceding portable chest examination of ___, the same left-sided PICC line reached well into the area of the right atrium and withdrawal by at least 3 cm was recommended. Apparently, this has been performed successfully as the line terminates now in safe position in the mid portion of the SVC and at least mechanically cannot get in contact with cardiac structures. " 0615e7d3-eb105727-84494321-35d3a4f1-5b9783b2.jpg,validate/p11/p11434374/s57351104/0615e7d3-eb105727-84494321-35d3a4f1-5b9783b2.jpg,validation," FINAL REPORT INDICATION: ___ year old man with pneumothorax // Eval for progression of pneumothorax, please perform at 2pm COMPARISON: The comparison is made with prior studies including ___ at 07:36. IMPRESSION: There is a moderate-to-large pneumothorax on the right. There is no pneumothorax on the left. There is atelectasis in the right lung base. There is persistent patchy consolidation in the left lung base. There is no CHF. The central line is unchanged. The pigtail catheter at the left base is unchanged. NOTIFICATION: Dr. ___ reported the findings to the patient's nurse, ___ by telephone on ___ at 6:13 PM, 5 minutes after discovery of the findings. " 123babca-33e01804-ece0b658-36783045-8b219b59.jpg,validate/p16/p16183583/s50930913/123babca-33e01804-ece0b658-36783045-8b219b59.jpg,validation," WET READ: ___ ___ 10:35 PM Bilateral hazy opacities in the lungs which could represent multifocal or atypical pneumonia in the proper clinical setting. Consider PA and lateral films to further assess. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with sob // r/o pna TECHNIQUE: Single portable view of the chest. COMPARISON: None per FINDINGS: There hazy bilateral perihilar and basilar opacities. There is no large effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Bilateral hazy opacities in the lungs which could represent multifocal or atypical pneumonia in the proper clinical setting. Consider PA and lateral films to further assess. " dc0e0b43-9fa7cd5e-149450ac-1440681e-c65423e8.jpg,validate/p10/p10699336/s58895498/dc0e0b43-9fa7cd5e-149450ac-1440681e-c65423e8.jpg,validation," WET READ: ___ ___ ___ 7:08 PM 1. There is a right-sided PICC line in unchanged position with distal tip projecting over the low SVC. Bilateral transpedicular rods and screws are seen projecting over the lower cervical and upper thoracic spine, in grossly appropriate location. The previously demonstrated tracheostomy is not clearly seen on the current radiograph. 2. The appearance of the mediastinal structures and lungs is overall unchanged in comparison to radiograph from ___, including bilateral layering pleural effusions and pulmonary vascular congestion and probable at least mild pulmonary edema. 3. More conspicuous in comparison to prior exams is widening of the right glenohumeral joint, concerning for posterior right shoulder dislocation. Posterior right shoulder dislocation was discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 7:03 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with trach, desating to ___% // evl for interval change evl for interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous mild pulmonary edema has improved in the upper lungs, but mild right pleural effusion. Right basal atelectasis has worsened, while left basal atelectasis has improved. Heart size top-normal. Right PIC line ends in the low SVC. No pneumothorax. " aadd0597-f3b457df-a7591274-765e7b1d-52f758d6.jpg,validate/p15/p15621083/s51616473/aadd0597-f3b457df-a7591274-765e7b1d-52f758d6.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with shortness of breath and palpitations. STUDY: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. Minimal degenerative change is seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " c4127695-21d08524-e805cf07-479f1e79-084a88dd.jpg,validate/p10/p10232572/s50900263/c4127695-21d08524-e805cf07-479f1e79-084a88dd.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with acute bleed post partum, now receiving significant fluids and products // evidence of pulm edema TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: Low bilateral lung volumes. No focal consolidation or pneumothorax. Mild central pulmonary vascular congestion. Minimal increased reticular markings suggests mild reticular edema. The size of the cardiac silhouette is likely normal within limits of projection. IMPRESSION: Pulmonary vascular congestion with minimal reticular edema. " 520ea455-429c77ec-41950de6-f06900bf-36f7b520.jpg,validate/p12/p12870544/s57008872/520ea455-429c77ec-41950de6-f06900bf-36f7b520.jpg,validation," 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 with GCS 5, intubated at the scene, suffering a large subdural hematoma, LUL collapse, and R ___-11th rib fractures now s/p craniotomy for evacuation of subdural hematoma with evidence of acute right ACA and MCA territory infarcts on MRI. // Please evaluate Please evaluate IMPRESSION: As compared to the previous examination, the patient was extubated and the both catheter was removed. Mild retrocardiac atelectasis persists. No pneumonia, no pulmonary edema. The right-sided rib fractures are not appreciated on the radiograph. Visualization of a lucency along the lower aspect of the right hemidiaphragm could indicate the presence of free air in the abdomen. According clinical correlation and, if needed, further workup is required. NOTIFICATION: At the time of dictation and observation, the referring physician ___. ___ was paged for notification, 8:05, on the ___. At the same time, an urgent email was sent to the referring physician and the results were posted on the radiology dashboard. " 03369eb2-30205216-797b6447-810a092e-86676058.jpg,validate/p14/p14100625/s57300661/03369eb2-30205216-797b6447-810a092e-86676058.jpg,validation," FINAL REPORT HISTORY: Cough, history of asthma. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " e2ea9630-45fb5eba-be4f955e-1600c466-c3c446f6.jpg,validate/p14/p14062965/s50624659/e2ea9630-45fb5eba-be4f955e-1600c466-c3c446f6.jpg,validation," FINAL REPORT HISTORY: Patient with recurrent CHF exacerbation, interval chest x-ray evaluation. COMPARISON: ___. FINDINGS: Portable single frontal chest radiograph was obtained with the patient in upright position. Lung volumes remain low. There is persistent bilateral pulmonary vascular congestion and interstitial edema. In addition, there is now an increased focal opacity in the left mid and lower lung fields. Bilateral small pleural effusions are stable. The heart size is difficult to assess due to parenchymal abnormalities. There is no pneumothorax. IMPRESSION: 1. Persistent pulmonary edema with bilateral pleural effusions. 2. New focal area of consolidation in left mid and lower lung fields, concerning for superimposed pneumonia. Findings were communicated with Dr.___ by Dr.___ at 1:10pm via telephone on ___. " aaab3b4c-3d861ea9-aeffc8ad-836f85e9-b60d6c93.jpg,validate/p13/p13875890/s50715470/aaab3b4c-3d861ea9-aeffc8ad-836f85e9-b60d6c93.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old woman s/p PICC placement. CXR to confirm placement of PICC. // CXR to confirm placement of PICC. CXR to confirm placement of PICC. IMPRESSION: AP chest compared to ___ through ___ at 14:18. Left PIC line ends in the mid SVC. Tracheostomy tube in standard position. Nasogastric drainage tube ends in the distal stomach. Bilateral perihilar consolidation has improved on the right, worsened slightly on the left. The shift may indicate that some of this is pulmonary edema. Left pleural effusion is small. No pneumothorax. Heart size normal. " 060ad146-b2482762-990576e8-3edcbe7d-134a6b5d.jpg,validate/p19/p19218701/s59801561/060ad146-b2482762-990576e8-3edcbe7d-134a6b5d.jpg,validation," 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. " 6175b359-1ed40e4e-b02c8358-d357c2c6-9a19f7c8.jpg,validate/p18/p18691929/s58855449/6175b359-1ed40e4e-b02c8358-d357c2c6-9a19f7c8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intubation recently, looking for ETT // intubation intubation IMPRESSION: ET tube tip is 2.5 cm above the carinal. Left subclavian line tip is at the level of lower SVC. Heart size and mediastinum are stable. Right basal opacity is minimal but more pronounced than on the prior study as well as the left basal consolidation. There is interval improvement in pulmonary edema. Multiple nodules are better appreciated on the recent chest CT " 0278038e-79deb5dd-7b6ece2e-a8e31548-27f06cc5.jpg,validate/p11/p11725800/s50520617/0278038e-79deb5dd-7b6ece2e-a8e31548-27f06cc5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p LLL wedge c.b hydropneumothorax, now resolved // Interval change Interval change IMPRESSION: Comparison to ___. No relevant change. Bilateral pleural effusions are stable. Proportional areas of atelectasis are seen at the lung bases. No new focal parenchymal abnormalities. Normal size of the heart. Stable correct position of the right internal jugular vein catheter. " 74bcd997-fb268313-ce61e987-bcc83298-3b1e3e9d.jpg,validate/p12/p12807885/s55000114/74bcd997-fb268313-ce61e987-bcc83298-3b1e3e9d.jpg,validation," 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. " 0307cb3a-6e48a82a-9cfde6f6-82e0be31-d4766b2b.jpg,validate/p11/p11455999/s54918160/0307cb3a-6e48a82a-9cfde6f6-82e0be31-d4766b2b.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Motor vehicle collision. 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 is no pleural effusion or pneumothorax. Mild leftward convex curvature is centered along the mid thoracic spine. IMPRESSION: No evidence of acute disease. " 07873b21-2b8107b1-8804923d-ced5d22a-7425f446.jpg,validate/p12/p12734486/s55686770/07873b21-2b8107b1-8804923d-ced5d22a-7425f446.jpg,validation," 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. " 6a45ac57-b9bdf785-7ed09e8a-401407e0-05adea7b.jpg,validate/p17/p17556194/s57339515/6a45ac57-b9bdf785-7ed09e8a-401407e0-05adea7b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with fever // eval for pna COMPARISON: Prior study from ___ and ___. CT chest from ___. FINDINGS: AP portable semi upright view of the chest. A tracheostomy tube projects over the superior mediastinum. A left upper extremity PICC line is seen with its tip again seen projecting over the aortic knob likely in the left distal brachiocephalic vein. Calcified mass projecting over the right lower lung is unchanged from multiple prior imaging studies and has been previously better characterized on chest CT as sequelae of prior empyema or hemothorax. No convincing evidence for pneumonia or edema. No large effusion is seen. No pneumothorax. Cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: No acute findings. " 0c5f6f6a-e53bc1c5-72645525-a44f6779-bd45d0b5.jpg,validate/p10/p10768059/s52989661/0c5f6f6a-e53bc1c5-72645525-a44f6779-bd45d0b5.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Linear opacity at the left lung base most suggestive of atelectasis. The lungs are otherwise clear without consolidation or large effusion. There is, however, blunting of the posterior costophrenic angles, raising possibility of trace effusions. Cardiomediastinal silhouette is within normal limits. Descending thoracic aorta is again noted. No acute osseous abnormality is identified. IMPRESSION: Small pleural effusions, new since prior. Otherwise, no change from prior. " 2a3b2694-5fe63655-e4da32c1-df3ab02c-e688af35.jpg,validate/p18/p18940953/s53378568/2a3b2694-5fe63655-e4da32c1-df3ab02c-e688af35.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with dyspnea // infiltrate? TECHNIQUE: Portable upright AP radiograph view the chest COMPARISON: Chest radiograph dated ___ FINDINGS: Patient slightly rotated. Lung volumes are low. Bilateral increased pulmonary congestion with moderate edema is demonstrated. Opacity in the right lower lobe with silhouetting of the right hemidiaphragm likely reflects a combination of a small right pleural effusion, atelectasis, and edema. No pneumothorax. No appreciable left pleural effusion. No acute osseous abnormality. The heart is moderately enlarged, similar to the prior exam. IMPRESSION: Findings most consistent with congestive heart failure and a right pleural effusion. " ee0d88e3-1c728e1b-8caed61e-514e2793-24b420e2.jpg,validate/p19/p19016834/s53458025/ee0d88e3-1c728e1b-8caed61e-514e2793-24b420e2.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with metastatic esophageal cancer with increased cough and dyspnea. Evaluate for pneumonia. COMPARISON: Chest radiographs ___, ___, ___; CT ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are hyperinflated. An esophageal stent is in place. A right basilar opacity is significantly improved from ___. Mild residual opacity may be scarring. No new opacity. Cardiac and mediastinal silhouettes and hilar contours are stable. Blunting of the right costophrenic sulcus is unchanged. No left effusion or pneumothorax. Loss of vertebral body height in the mid thoracic spine is unchanged. IMPRESSION: Substantial clearing of the right lower lobe opacity. Mild residual opacity is likely scarring rather than new pneumonia. No new opacity. " b1a46d62-da05c539-53c64998-081b533c-ba79cbde.jpg,validate/p12/p12862864/s50648983/b1a46d62-da05c539-53c64998-081b533c-ba79cbde.jpg,validation," FINAL REPORT HISTORY: Fever and cough. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 7e95b6dc-ab0b41bd-bdce6c34-f30ad8dd-6e83fabd.jpg,validate/p17/p17954167/s50709169/7e95b6dc-ab0b41bd-bdce6c34-f30ad8dd-6e83fabd.jpg,validation," FINAL REPORT HISTORY: Dullness to percussion, question edema or effusion. Lordotic positioning. There are low inspiratory volumes. There is evidence of CHF with pulmonary edema, similar to ___ at 10:53 a.m., but slightly worse in the right upper zone. A small-to-moderate right effusion is also probably slightly worse. Small left effusion and left lower lobe collapse and/or consolidation are similar. Possibility of underlying infectious infiltrate would be difficult to exclude. " 0de6869c-1f89e2a2-7d1c148c-4ab7bb50-49d6fc54.jpg,validate/p12/p12800545/s57823458/0de6869c-1f89e2a2-7d1c148c-4ab7bb50-49d6fc54.jpg,validation," FINAL REPORT HISTORY: Aphasia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is mildly enlarged. The aorta is mildly unfolded but unchanged. Mediastinal and hilar contours are normal, and there is no pulmonary vascular congestion. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. Remote left-sided rib fractures are present. IMPRESSION: No acute cardiopulmonary abnormality. " bcac3c29-76493306-8bfaad62-54ddd55e-e9c246d1.jpg,validate/p16/p16239957/s54185269/bcac3c29-76493306-8bfaad62-54ddd55e-e9c246d1.jpg,validation," FINAL REPORT HISTORY: TIA. 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 or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. No change from the x-ray from four hours prior. " d5ca415b-1735a1ca-de4711a0-97a96ac7-6d36da92.jpg,validate/p16/p16773288/s59608202/d5ca415b-1735a1ca-de4711a0-97a96ac7-6d36da92.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with thoracoabdominal AAA, desaturation. COMPARISON: ___. FINDINGS: There are new focal right lower lung opacities which are worrisome for aspiration or pneumonia. Left moderate pleural effusion with atelectasis is unchanged. Mediastinal and cardiac contour enlargement is stable. There is no pneumothorax. CONCLUSION: New right lower lung opacities are worrisome for aspiration or pneumonia. This was discussed verbally with the medical team. " fec64b77-d6529b0d-71ff34ca-9f603603-432a02ca.jpg,validate/p11/p11360447/s52060634/fec64b77-d6529b0d-71ff34ca-9f603603-432a02ca.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with hyponatremia of unknown origin. COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: The lungs are hyperexpanded but clear. The cardiomediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present. Elevation of the left hemidiaphragm is unchanged. Pacer leads terminate in the right atrium and right ventricle. IMPRESSION: No acute intrathoracic process. " 678f2f72-211580fb-98069c2e-85652f9e-d5f550a7.jpg,validate/p13/p13989115/s50962394/678f2f72-211580fb-98069c2e-85652f9e-d5f550a7.jpg,validation," 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. " 3b19c0c6-fc770e2b-17b2f631-2835b246-92072b5b.jpg,validate/p13/p13078138/s50700034/3b19c0c6-fc770e2b-17b2f631-2835b246-92072b5b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain, dyspnea. Eval heart and lungs. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unremarkable. There is likely streaky atelectasis at the lateral lung bases, but no pole consolidation or pleural effusions. No pneumothorax. Thoracic spine stabilization hardware is in place. IMPRESSION: No acute intrathoracic process. " 7d40f967-b134838c-fae7c193-9d036f74-780ab478.jpg,validate/p19/p19020115/s58376240/7d40f967-b134838c-fae7c193-9d036f74-780ab478.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cirrhosis and AMS 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. " 8bc4177e-d9ecf54a-a710b7ca-afef8db9-9c2e5308.jpg,validate/p11/p11597207/s57037456/8bc4177e-d9ecf54a-a710b7ca-afef8db9-9c2e5308.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new O2 requirement. Dementia. Risk for aspiration as well. // New O2 requirement. New O2 requirement. IMPRESSION: In comparison with the study of ___, there is little overall change. Again there is substantial enlargement of the cardiac silhouette with pulmonary vascular congestion send bilateral pleural effusions with compressive atelectasis at the bases. In the appropriate clinical setting, superimposed pneumonia would be difficult to exclude, especially in the absence of a lateral view. " cc291da1-e59d4dd3-df18e23f-fbae443d-50a4822c.jpg,validate/p18/p18681822/s54144131/cc291da1-e59d4dd3-df18e23f-fbae443d-50a4822c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent cough // ? etiology of cough ? etiology of cough IMPRESSION: No previous images. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " cea42e50-a307ceaa-0040016d-b0ef12a2-a6400cf9.jpg,validate/p19/p19022644/s53361756/cea42e50-a307ceaa-0040016d-b0ef12a2-a6400cf9.jpg,validation," FINAL REPORT HISTORY: Postoperative fever. 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 radiographs of the chest. " dfbf7930-15a37782-eefcf848-17461f4c-e239072c.jpg,validate/p14/p14597448/s56640687/dfbf7930-15a37782-eefcf848-17461f4c-e239072c.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with MDS and fevers. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Chest radiographs available from ___ and ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. Coarse interstitial opacities throughout both lungs are unchanged since ___. Vague nodular opacities within the left upper and right lower lung are unchanged, and no new nodules are detected. There is no pneumothorax, focal consolidation, or pleural effusion. Mild biapical thickening is unchanged. " 0341580b-04886744-5fc11c49-b8ba9257-9ff7b892.jpg,validate/p12/p12746526/s57589982/0341580b-04886744-5fc11c49-b8ba9257-9ff7b892.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with prod cough, sob, fever // r/o pna r/o pna IMPRESSION: Compared to chest radiographs ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 196cd5bf-30f61a47-ed1db53c-018757c1-7f43570b.jpg,validate/p10/p10145553/s54510240/196cd5bf-30f61a47-ed1db53c-018757c1-7f43570b.jpg,validation," FINAL REPORT HISTORY: Six weeks of cough. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Biapical pleural thickening/scarring is stable. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The lungs are relatively hyperinflated, with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. The cardiac and mediastinal silhouettes are stable and unremarkable. The hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " 8df6924e-9e7acf88-cf9ff97a-5e49de1f-daadd5c0.jpg,validate/p14/p14668169/s51798706/8df6924e-9e7acf88-cf9ff97a-5e49de1f-daadd5c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH s/p fall down stairs // ETT position, interval change IMPRESSION: As compared to previous study of 1 day earlier, endotracheal tube remains high, terminating above the level of the clavicles, nearly 10 cm above the carina. This could be advanced several cm for standard positioning. Side-port of nasogastric tube terminates at the GE junction level and could also be advanced. Exam is otherwise remarkable for improving right middle and right lower lobe opacities. " ae639e39-d8c75378-b43673b0-44e682f4-133f3d24.jpg,validate/p18/p18143542/s55070944/ae639e39-d8c75378-b43673b0-44e682f4-133f3d24.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // assess for interval change assess for interval change IMPRESSION: ET tube tip is 6 cm above the carinal. Left subclavian line tip is at the level of mid to lower SVC. Heart size and mediastinum are stable. Cardiomegaly is substantial. Coronary stents are re- demonstrated. There are bilateral pleural effusions, moderate. There is no pulmonary edema. There is right basal atelectasis, all unchanged since previous examination. " f92c542b-f597873d-01401abb-4e22fc34-8b8d1535.jpg,validate/p19/p19601036/s57143346/f92c542b-f597873d-01401abb-4e22fc34-8b8d1535.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylothorax sp right vats and replacement of left CT // effusion IMPRESSION: Left chest tube has been replaced, with slight decrease in left pneumothorax but increase in size of a small to moderate left pleural effusion. Right chest tube has apparently been repositioned, and a small right apical pneumothorax has slightly increased in size. Worsening left basilar atelectasis as well as development of a new confluent region of airspace opacity in the right lower lobe it, suspicious for acute aspiration event or hemorrhage given rapid development. Small right pleural effusion is also noted. Rounded lucency adjacent to right hemidiaphragm could reflect a basilar component of the right pneumothorax or free intraperitoneal air. Left lateral decubitus radiograph is rec to exclude this possibility NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ the telephone on ___ at 10:19 AM, minutes after discovery of the findings. " 272b3f03-3b93782b-ff36f282-054b28f3-31db2ffd.jpg,validate/p10/p10735843/s56368066/272b3f03-3b93782b-ff36f282-054b28f3-31db2ffd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PAF on long-standing amiodarone. Annual CXR. // Amiodarone-relate changes? COMPARISON: ___ IMPRESSION: 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. " de23806c-0dc350c4-0e8ff928-0a3405cb-66d25fc2.jpg,validate/p13/p13762124/s50863971/de23806c-0dc350c4-0e8ff928-0a3405cb-66d25fc2.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: On the initial radiograph, a feeding tube was coiled within the proximal thoracic esophagus, with tip directed cephalad, outside of the field of view. On the second radiograph, the feeding tube has been removed. On the third radiograph, a nasogastric tube is in place, with tip terminating within the stomach. Endotracheal tube and vascular sheath are in standard position on all three radiographs, and the appearances of the lungs and pleura are not appreciably changed since the recent study of earlier the same date. " ed298c7b-be81a398-e9143f17-2077171d-61b4b48b.jpg,validate/p18/p18036188/s51987912/ed298c7b-be81a398-e9143f17-2077171d-61b4b48b.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old woman with mitral valve replacement. Evaluate for pleural effusions. FINDINGS: Comparison is made to previous study from ___. An endotracheal tube, enteric tube, Swan-Ganz catheter are unchanged in position. Mediastinal drains are also seen. There is stable cardiomegaly and some prominence of mediastinum, consistent with the recent surgery. There is pulmonary edema, which is stable. There remains bilateral pleural effusions, left greater than right. The right-sided effusion have increased slightly since prior. There is an unchanged left retrocardiac opacity. " 110c56f2-d7b28c42-d25f7277-7666a413-5f63a42f.jpg,validate/p10/p10768526/s55151497/110c56f2-d7b28c42-d25f7277-7666a413-5f63a42f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest pain on the left, history of lung nodules. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Lung volumes have minimally decreased. There is no evidence of rib lesion, pneumothorax, pleural effusion or other change that might explain left-sided chest pain. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. Moderate tortuosity of the thoracic aorta. " 5c6595fd-2ddcfb25-3849ea88-83ab370c-f248ed5f.jpg,validate/p18/p18970086/s57580890/5c6595fd-2ddcfb25-3849ea88-83ab370c-f248ed5f.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and abdominal pain. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. The mediastinal and hilar contours are unchanged with calcified mediastinal and hilar lymph nodes again seen compatible with prior granulomatous disease. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion, focal consolidation or pneumothorax is present. No acute osseous abnormalities seen. IMPRESSION: No acute cardiopulmonary process. " 01852ba5-b32d23fe-14ef4b26-e7e142c9-f8d4c0ce.jpg,validate/p18/p18669714/s58108177/01852ba5-b32d23fe-14ef4b26-e7e142c9-f8d4c0ce.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fevers/chills, cough and chest pain // Please eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The aorta is tortuous. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear. There is no pleural effusion or pneumothorax. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary abnormality. " 8edb2f0f-c7b028fd-04aece7e-55615f2c-abe15c1c.jpg,validate/p13/p13306576/s57821890/8edb2f0f-c7b028fd-04aece7e-55615f2c-abe15c1c.jpg,validation," FINAL REPORT HISTORY: Chest heaviness and pressure. 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. Substantial degenerative changes are seen involving the right AC joint with possible partial subluxation. " d9fc4679-471930ff-ff96b012-5158b3a2-c6a1b8b0.jpg,validate/p17/p17244595/s55613326/d9fc4679-471930ff-ff96b012-5158b3a2-c6a1b8b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent PNX s/p CT and pleurodesis // interval change TECHNIQUE: Single AP portable view. COMPARISON: ___ at 05:50 FINDINGS: Rotated positioning. In addition, there is apparent marked volume loss on the left, with leftward shift of the mediastinum and apparent leftward hyper inflation of the right lung. As result, the carina is not well delineated. The tip of the ET tube lies at the upper edge of the medial clavicular heads. An NG tube is present. The sideport overlies the lower mediastinum and likely lies proximal to the GE junction. The NG tube tip overlies the upper abdomen. A left subclavian PICC line is also displaced leftward with the mediastinal structures, possibly at the level of the distal SVC. In the left hemithorax, there is opacification along lung apex and in the left mid and lower zones, with obscuration left hemidiaphragm and left costophrenic angle as well as the cardiomediastinal silhouette. In the right hemithorax chest tube is present. No definite pneumothorax is identified. Aside from some crowded markings at the right lung base, no focal infiltrate is identified on the right. Possible small right effusion. Doubt CHF. Compared with ___ allowing for differences in positioning no definite interval change on the left. Minimal atelectasis a small right effusion are new. IMPRESSION: Marked left-sided volume loss of left ward shift of the mediastinum is probably unchanged. Atelectasis at the right lung base and small right effusion are new. Right chest tube again seen. No obvious pneumothorax. " 0a863180-6296459e-ce0fd02f-ab5a2c43-c73016fb.jpg,validate/p11/p11549602/s50164546/0a863180-6296459e-ce0fd02f-ab5a2c43-c73016fb.jpg,validation," WET READ: ___ ___ ___ 9:23 PM Unchanged right basal consolidation and effusion with left basal chest tube without evidnece of pneumothorax. Rib fx and Tspine hardware as before ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old man with esophageal tear after vomiting. COMPARISON: ___ to ___. FINDINGS: An endotracheal tube ends at the level of the clavicles. An enteric catheter extends inferiorly off of the field of view. Right-sided internal jugular line ends at the cavoatrial junction. Two left-sided chest tubes are in unchanged position. A small right effusion is unchanged. Right basilar consolidation is also similar. No pneumothorax is present. Right-sided rib fractures and thoracic spine fusion and spacer hardware are unchanged. IMPRESSION: Stable right basal consolidation and small effusion. " 8ce7010e-d8cc6d91-0e62572f-5dbd5df6-5c9a3699.jpg,validate/p17/p17051420/s53249892/8ce7010e-d8cc6d91-0e62572f-5dbd5df6-5c9a3699.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___. HISTORY: ___-year-old male with chest pain, status post fall on to the left chest and left anterior lower chest, tenderness to palpation. Question rib fracture. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. Cardiomediastinal silhouette is within normal limits. There is no visualized rib fracture. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture seen. If clinical concern for rib fracture persists, suggest dedicated rib series, which is more sensitive. " 300ec86e-aba6cf41-e033381d-1564df6e-2f500d5b.jpg,validate/p16/p16566006/s53471708/300ec86e-aba6cf41-e033381d-1564df6e-2f500d5b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with h/o PNA, s/p STEMI w/ decreased BS at left base // eval PNA, effusion, interval change, pulm edema COMPARISON: ___. IMPRESSION: As compared to the previous examination, there is a decrease in extent of a pre-existing small left pleural effusion. Unchanged size of the cardiac silhouette. No pulmonary edema. No pneumonia. No pneumothorax. Constant alignment of the sternal wires. " 3d0ebae8-231f997a-74ecd7b5-54741bb4-424ee28d.jpg,validate/p15/p15417498/s50020898/3d0ebae8-231f997a-74ecd7b5-54741bb4-424ee28d.jpg,validation," FINAL REPORT INDICATION: ___M with ruq abs // eval for effusion TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Extremely low lung volumes are noted with secondary crowding of the bronchovascular markings. There is no definite focal consolidation or effusion. Calcific density projects over the posterior right fourth rib which could be a calcified granuloma or bone island. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Calcific density in the right upper quadrant suggest cholelithiasis. IMPRESSION: No acute cardiopulmonary process noting low lung volumes. " 187faa8f-f72c20db-2ec7c2e4-65a4eed6-e74ce16c.jpg,validate/p11/p11646138/s54913394/187faa8f-f72c20db-2ec7c2e4-65a4eed6-e74ce16c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p craniotomy, with saddle PE // ?interval change ?interval change IMPRESSION: In comparison with the earlier study of this date, there is little change. Continued low lung volumes accentuate the transverse diameter of the heart. Monitoring support devices are unchanged. No evidence of vascular congestion or acute focal pneumonia. " 317ccc0c-55005e45-419ab78a-a2196fb1-d166f239.jpg,validate/p19/p19634960/s56388524/317ccc0c-55005e45-419ab78a-a2196fb1-d166f239.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 15:07 CLINICAL INDICATION: ___-year-old with Dobbhoff nasogastric tube, check placement. Comparison is made to the patient's previous study dated ___. A portable upright AP view of the lower chest and upper abdomen is submitted dated ___ at 15:07. IMPRESSION: 1. Interval placement of a Dobbhoff feeding tube with the tip projecting over the proximal stomach. Advancement may be prudent to minimize risk of aspiration as the metallic portion has its proximal end near the gastroesophageal junction. There are persistent cystic and patchy opacities involving the left upper and mid lung that do not appear to be significantly changed when compared to prior study of ___. No air-fluid levels are seen within the regions of cavitary change to suggest an acute infection. The visualized right lung appears grossly clear. No evidence of pulmonary edema. " a5a05aa4-1dbcc548-c36b0adb-0c7a597b-422665d9.jpg,validate/p11/p11861017/s53980574/a5a05aa4-1dbcc548-c36b0adb-0c7a597b-422665d9.jpg,validation," FINAL REPORT INDICATION: ___M w/ ETT, confirm placement // ___M w/ ETT, confirm placement TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the endotracheal tube projects 2.7 cm from the carina. The tip of the feeding tube extends below the level of the diaphragms but beyond the field of view of this radiograph. The tip of the right internal jugular central venous catheter extends to the cavoatrial junction. Interval progression of the pulmonary edema with layering bilateral pleural effusions. The size of the cardiomediastinal silhouette is enlarged but unchanged. IMPRESSION: The tip of the feeding tube projects below the level the diaphragms but beyond the field of view of this radiograph. The tip of the endotracheal tube projects over the mid thoracic trachea. Interval progression of the pulmonary edema and layering bilateral pleural effusions. " 386f3989-399f50ac-f80589aa-642b131d-16e64e70.jpg,validate/p16/p16826047/s55573557/386f3989-399f50ac-f80589aa-642b131d-16e64e70.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY OF ___ COMPARISON: ___ radiograph. FINDINGS: Right-sided pleural catheter remains in place. A small lateral pneumothorax is present below the level of the minor fissure. Additionally, a pleural effusion has increased in size and is partially layering on this semi-upright radiograph. A small loculated component has developed medially at the right apex as well. Cardiac silhouette remains enlarged and is accompanied by mild pulmonary vascular congestion. Worsening confluent opacity at the right lung base is probably due to atelectasis, though infection should also be considered in the appropriate clinical setting. " ff1db861-71af2fcd-be383f4c-5648d2b3-b0c4a1c2.jpg,validate/p19/p19763545/s54135537/ff1db861-71af2fcd-be383f4c-5648d2b3-b0c4a1c2.jpg,validation," 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. " 47e6508f-61d8bee7-91450ba5-f365caeb-97a4cef9.jpg,validate/p12/p12643221/s59644462/47e6508f-61d8bee7-91450ba5-f365caeb-97a4cef9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with shortness of breath and weakness. Evaluate for pneumonia, other acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Mild cardiomegaly is unchanged. Calcified tortuous aorta is also unchanged. Lungs are grossly clear without pleural effusions or pneumothorax. Subtle left basilar opacity may be due to atelectasis or early aspiration. No focal consolidation identified. IMPRESSION: Subtle left basilar opacity may be due to atelectasis or early aspiration. " ac27c46e-05dcd49e-03e2c446-9dc824f5-0512d9a2.jpg,validate/p19/p19393974/s54325487/ac27c46e-05dcd49e-03e2c446-9dc824f5-0512d9a2.jpg,validation," FINAL REPORT INDICATION: History: ___F with altered mental status, lung crackles TECHNIQUE: Semi-upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Assessment is limited by patient rotation. Patient is status post median sternotomy and CABG. There is mild to moderate cardiomegaly which appears grossly unchanged. Atherosclerotic calcifications of the aorta are again noted. Pulmonary vasculature does not appear engorged. Lungs appear hyperinflated. Small bilateral pleural effusions are noted without focal consolidation. Patchy bibasilar opacities may reflect areas of atelectasis. No pneumothorax is identified. There is diffuse demineralization of the osseous structures with numerous compression deformities noted in the imaged thoracolumbar spine, many of which have developed in the interval and are of unclear chronicity. IMPRESSION: Limited exam. Small bilateral pleural effusions with probable bibasilar atelectasis. Multiple compression fractures throughout the imaged thoracolumbar spine have developed since ___, but of unclear age. " 4ed48601-34adfa26-77ef9eae-58a61473-95735d76.jpg,validate/p17/p17842239/s52790250/4ed48601-34adfa26-77ef9eae-58a61473-95735d76.jpg,validation," WET READ: ___ ___ ___ 9:44 PM Probable large layering bilateral pleural effusions (given supine positioning). Underlying consolidation is likely - though uncertain if compressive atelectasis vs aspiration or pneumonia. Stable moderate cardiomegaly. d/w ___ ___ @ 9:40 pm on ___ by telephone. ___ p_________________________________________________________________________________ FINAL REPORT HISTORY: AS, sepsis, acute process. CHEST, SINGLE AP PORTABLE VIEW. Although not labeled, this film is probably obtained supine. The cardiac silhouette is prominent, but similar to ___. There is hazy opacity diffusely through both lungs -- I suspect the presence of bilateral layering effusions. There is probably underlying collapse and/or consolidation, with suggestion of air bronchograms in the right infrahilar region. Clinical correlation to confirm that the film was obtained supine is recommended as it is difficult to assess the degree of aerated lung on this film. If clinically indicated, an upright, lateral and/or decubitus films could help to further assess the underlying lung. " 4bc41d5e-ad724041-977a6287-56530104-6c4c5114.jpg,validate/p11/p11053635/s52549176/4bc41d5e-ad724041-977a6287-56530104-6c4c5114.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath // shortness of breath shortness of breath IMPRESSION: No comparison. The lung volumes are normal. Markedly enlarged right hilus with a rounded masslike structure, seen on both the frontal and the lateral radiograph. In the periphery of the structure, a partial middle lobe atelectasis could be present. The findings are suspicious and require CT for workup. Moderate cardiomegaly. Mild elongation of the descending aorta. No pneumonia, no pulmonary edema, no pleural effusions. RECOMMENDATION(S): CT for workup of the enlarged right hilus is strongly recommended. NOTIFICATION: The workup recommendation was entered into the radiology dashboard system PE " ca2d38de-7b59312f-c9a6bd5f-ecca573c-eda0ddf3.jpg,validate/p18/p18448721/s58094866/ca2d38de-7b59312f-c9a6bd5f-ecca573c-eda0ddf3.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest x-ray INDICATION: ___ yo female with hx of alzheimer's dementia presenting from rehab facility with swollen R leg with + LENI with extensive thrombus in both L and R venous systems. // R/o pneumonia in presence of elevated WBC TECHNIQUE: AP projection COMPARISON: PA and lateral chest x-ray dated ___. FINDINGS: The visualized mediastinal structures are unremarkable. There is increased opacification of the retrocardiac area when compared with prior film. Additionally, there is poor delineation of the left hemidiaphragm. Given leukocytosis, these findings are concerning for left-sided pneumonia. IMPRESSION: Retrocardiac opacity concerning for left lower lung pneumonia. NOTIFICATION: The above findings were discussed with Dr. ___ by Dr. ___ ___ the phone on ___ at 16:46. " f36bb84a-83a4871b-7c8b903b-a12572f5-f5b890e5.jpg,validate/p16/p16046758/s51558900/f36bb84a-83a4871b-7c8b903b-a12572f5-f5b890e5.jpg,validation," WET READ: ___ ___ 8:34 PM improved L lung volume, but similar extent of R pleural effusion w/ associated atelectasis; no ptx. ______________________________________________________________________________ FINAL REPORT HISTORY: Right pleural effusion status post thoracentesis. CHEST (PORTABLE AP) Compared with ___ at 15:11 p.m. The degree of inspiration or aeration on the left side appears improved. The right pleural effusion may be very slightly smaller. No right-sided pneumothorax is detected. Otherwise, no significant change. " 9cd4c548-eb4d5ae3-810861a0-3acdd20c-487d534c.jpg,validate/p16/p16852352/s56849527/9cd4c548-eb4d5ae3-810861a0-3acdd20c-487d534c.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with AVM, to have Onyx embolization in angio today, for preop chest x-ray. Opacification on prior chest x-ray. COMPARISON: Chest radiographs from ___. FINDINGS: Supine portable AP view of the chest. There is mild bibasilar linear opacities consistent with atelectasis. The upper lungs are clear. The cardiac, mediastinal, and hilar contours are unremarkable. Possible sclerosis of the T9 left rib posteriorly and lateral portion of the left scapula. No pleural effusions. No pneumothorax. IMPRESSION: 1. Mild bibasilar atelectasis. 2. Possible sclerosis of the left posterior T9 rib and left scapula, which may be artifactual. Can further assess with conventional PA and lateral chest radiographs, and bone detail views, if clinically indicated. " 8f9a3028-42ba8774-3982df5a-0c25dcbe-961db115.jpg,validate/p10/p10954531/s57642634/8f9a3028-42ba8774-3982df5a-0c25dcbe-961db115.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Intubated transportation with pneumonia. Evaluate endotracheal tube placement. TECHNIQUE: Single frontal view of the chest. COMPARISON: None. FINDINGS: Endotracheal tube is in place roughly 6.5 cm cranial to the carina. Left internal jugular approach central venous catheter is in place terminating at the brachiocephalic confluence. Upper enteric tube tip is outside of field-of-view, terminating at least within the gastric body. Left base chest tube is in place. There is no large pneumothorax. There are prominent bilateral lower lobe opacities. Lung apices are clear. No large pleural effusion. IMPRESSION: 1. Bilateral lower lobe pneumonia or aspiration. 2. Endotracheal tube placement is somewhat high, recommend advancement by 2cm. 3. Left IJ central venous catheter tip terminates at the brachiocephalic confluence. " fe70fb53-787030c8-18b5150e-14902dc4-0222c019.jpg,validate/p17/p17276165/s52069525/fe70fb53-787030c8-18b5150e-14902dc4-0222c019.jpg,validation," FINAL REPORT AP CHEST, 4:56 P.M. ON ___ HISTORY: An ___-year-old man with ALS and an elevated white count. Suspect pneumonia. IMPRESSION: AP chest compared to ___. New dense consolidation left lower lobe consistent with pneumonia. Atelectasis is less likely because there is no elevation of the left hemidiaphragm. Right lung is clear. Definition of the left bronchial tree ends at the origin of the lower lobe bronchus which may be occluded. Findings were discussed by telephone with ___ at 5:45 p.m., 60 seconds after the findings were recognized. Right lung is grossly clear. Pleural effusion is small if any. Heart size normal. No pneumothorax. " ba0714e1-956bf841-2dda703a-1471c162-9f6d801b.jpg,validate/p11/p11057357/s54351585/ba0714e1-956bf841-2dda703a-1471c162-9f6d801b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Shortness of breath, cough TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left-sided AICD/ pacemaker device is noted with leads terminating in the regions of the right atrium and right ventricle. Epicardial leads are also seen terminating along the left heart border. Heart size remains mildly enlarged. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is identified. The lungs are hyperinflated with flattening of the diaphragms as before, suggestive of COPD. IMPRESSION: No acute cardiopulmonary abnormality. " 04e344ac-1f4d4abb-1721ee4a-5b516aa3-8f185465.jpg,validate/p14/p14151671/s56244417/04e344ac-1f4d4abb-1721ee4a-5b516aa3-8f185465.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with Productive cough x 3 weeks, fell increased weakness, fatigue. + chills // 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. IMPRESSION: No acute intrathoracic process. " 120b3eae-d7020550-0fb8be47-5ba2beff-74c7d42c.jpg,validate/p17/p17081205/s56630466/120b3eae-d7020550-0fb8be47-5ba2beff-74c7d42c.jpg,validation," WET READ: ___ ___ ___ 4:36 AM Nasogastric tube is coiled in the stomach. Wet read was discussed with Dr. ___ by Dr. ___ ___ telephone at 04:34 on ___, at the time of discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dobhoff // eval tube placement eval tube placement IMPRESSION: Compared to chest radiographs ___ through ___. Mild residual pulmonary edema atelectasis are restricted to the right lower lobe and improving. Small right pleural effusion is likely. Heart size normal. Lungs clear. Right PIC line ends in the low SVC. Feeding tube coils in the stomach and ending in the body. " 8cfc9faa-64d864ee-e3cbf642-4ab31c97-69571685.jpg,validate/p10/p10304297/s59831855/8cfc9faa-64d864ee-e3cbf642-4ab31c97-69571685.jpg,validation," FINAL REPORT HISTORY: Chest pain and left arm tingling. Evaluate for pneumonia or other acute process. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size. Stably tortuous aorta. Normal mediastinal contours. Asymetric prominence of the superior right hilus is unchanged from prior; however, a nonemergent CT scan is recommended to exclude a slow growing malignancy. No pleural effusion or pneumothorax. Clear lungs. Telephone notification to Dr ___ by Dr ___ at 8 am on ___. " 4bd46af1-6fcfcf91-2711fe30-53dbee39-2e09b275.jpg,validate/p19/p19189423/s56417855/4bd46af1-6fcfcf91-2711fe30-53dbee39-2e09b275.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with thalamic stroke, s/p dobhoff placement // please confirm dobhoff tube placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Dobbhoff tube is coiled in the oropharynx. . Patient has he has had projecting over the upper lungs. There is no interval development of focal consolidations. No interval increase in pleural effusion seen. " 7862c21c-e1fb79e3-b8213cf9-8663bd41-5ad37b09.jpg,validate/p13/p13718764/s51987880/7862c21c-e1fb79e3-b8213cf9-8663bd41-5ad37b09.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new dysarthria // r/o aspiration COMPARISON: ___. IMPRESSION: No relevant change. Normal lung volumes. Moderate cardiomegaly. No pulmonary edema. No pleural effusions. No pneumonia. " e3145d63-30320dc8-50f8ba18-7d94e07d-2dbad476.jpg,validate/p13/p13884592/s50286711/e3145d63-30320dc8-50f8ba18-7d94e07d-2dbad476.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. History of bipolar disorder. 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 disease. " b5bddf39-8f4f1836-c7fd06fe-029058cb-38079087.jpg,validate/p17/p17105437/s59199536/b5bddf39-8f4f1836-c7fd06fe-029058cb-38079087.jpg,validation," WET READ: ___ ___ ___ 2:45 PM Right lower lobe opacity may represent atelectasis, however aspiration or pneumonia could be considered in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M w/cough, r/o PNA // ___M w/cough, r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. And CTA of the chest dated ___. FINDINGS: Lung volumes are low, resulting in bronchovascular crowding. Area of opacity in the right lower lobe may represent atelectasis, however aspiration or pneumonia could be considered in the appropriate clinical setting. The heart remains enlarged. The aorta is tortuous. There is no pneumothorax. IMPRESSION: Right lower lobe opacity may represent atelectasis, however aspiration or pneumonia could be considered in the appropriate clinical setting. " 4bf623f2-baf13bc1-c1d95ac7-d0953fd9-ab6a0b2f.jpg,validate/p17/p17301639/s51481197/4bf623f2-baf13bc1-c1d95ac7-d0953fd9-ab6a0b2f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // evaluate for acute process COMPARISON: CT chest ___ 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. " e5eb2c0e-d0acb0bb-b4ec03bf-93f3e144-20fbc61a.jpg,validate/p12/p12954893/s57680161/e5eb2c0e-d0acb0bb-b4ec03bf-93f3e144-20fbc61a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Heavy retching with reported hematemesis. Evaluate for pneumomediastinum. 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. IMPRESSION: Normal chest radiograph, specifically no evidence of pneumomediastinum. " 53cf62c9-e3060699-87200eb3-84eb7707-dcdc2ef3.jpg,validate/p15/p15239201/s50997917/53cf62c9-e3060699-87200eb3-84eb7707-dcdc2ef3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis and pleural effusion s/p ___ // Assess for pleural effusion, worsening PNA Assess for pleural effusion, worsening PNA COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Mild pulmonary edema has worsened. Previous moderate left pleural effusion is substantially smaller. Heart size normal. " cdd7ee52-66082b29-febaceb1-6ced7608-1e8e8631.jpg,validate/p19/p19404187/s57780214/cdd7ee52-66082b29-febaceb1-6ced7608-1e8e8631.jpg,validation," FINAL REPORT INDICATION: Aspiration following EGD. Concern for pneumonia. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: There is still an area of increased density in the left upper lobe projecting over the anterior aspect of the second rib measuring approximately 2.9 x 2.2 cm, improved from ___. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Improving left upper lung zone consolidation compared to ___. " 26cffd48-857b34e6-d4255381-04082a07-36cd364a.jpg,validate/p19/p19875621/s56472355/26cffd48-857b34e6-d4255381-04082a07-36cd364a.jpg,validation," FINAL REPORT INDICATION: Left shoulder and chest pain, assess for pneumonia or intrathoracic process. COMPARISONS: ___. FINDINGS/IMPRESSION: Two views of the chest were obtained. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is normal in size and normal cardiomediastinal contours. " 9a6a6d63-abd04608-06182656-e9cce98c-200772b5.jpg,validate/p18/p18976991/s54097106/9a6a6d63-abd04608-06182656-e9cce98c-200772b5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: ___-year-old, intubated, followup. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 6 cm above the carina. The patient continues to be slightly rotated, but there is also an atelectasis of the right lower lung, overall unchanged in appearance. Bilateral pleural effusions are noted. The reason for the appearance of the right lower lung is unclear, and assessment with chest CT might be considered at certain point. " 6729734f-431dffaf-efca6b48-ce71e762-dfc72337.jpg,validate/p12/p12441280/s56492543/6729734f-431dffaf-efca6b48-ce71e762-dfc72337.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fall and syncope, now with headache, neck pain, and tachypnea. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. No displaced rib fracture is appreciated. The imaged thoracic vertebral body heights are maintained. IMPRESSION: No acute cardiopulmonary process. " 1e50d019-e37f4bdd-52b69a1f-4469d6f8-780c52b2.jpg,validate/p19/p19249493/s56027098/1e50d019-e37f4bdd-52b69a1f-4469d6f8-780c52b2.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Ovoid calcification seen on shoulder x-ray, question location. FINDINGS: Frontal and lateral views of the chest demonstrate the ovoid calcification projecting over the soft tissues of the axilla. This could represent a calcified node or less likely a skin lesion. The lungs are clear without infiltrate or effusion. The bony thorax is normal. The cardiac and mediastinal silhouettes are normal. " 4ff477d8-60cd0e19-076ac848-61355096-887ecb57.jpg,validate/p12/p12724735/s55662236/4ff477d8-60cd0e19-076ac848-61355096-887ecb57.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxia // hypoxia hypoxia IMPRESSION: Comparison to ___. No relevant change. Normal lung volumes. Moderate cardiomegaly. No pulmonary edema, no pleural effusions, no pneumonia. Right hemodialysis catheter in correct position. " 1f4e23d8-a776b126-47303cb9-ac25efa9-b23dfc2b.jpg,validate/p13/p13411236/s52346893/1f4e23d8-a776b126-47303cb9-ac25efa9-b23dfc2b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ yo male with alcoholic cirrhosis and treatedHCC (MELD ___) c/b portal hypertension, grade I-II varices, andcontrolled portopulmonary hypertension, who presents today forpossible liver transplantation. // preop liver txp Surg: ___ (Liver txp) TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, CT chest ___ 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. " e3a82dd7-644dd34e-68531aad-189ec836-87a0ec08.jpg,validate/p14/p14157370/s51256993/e3a82dd7-644dd34e-68531aad-189ec836-87a0ec08.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: COUGH,SMOKER IMPRESSION: There no prior chest radiographs available for review. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 3d37ea7b-8ba3916c-900091dc-690917c3-10f5405d.jpg,validate/p19/p19858494/s54968491/3d37ea7b-8ba3916c-900091dc-690917c3-10f5405d.jpg,validation," WET READ: ___ ___ ___ 9:28 PM Moderate left pleural effusion. PICC line tip at the mid SVC. Low lung volues. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Chest x-ray, ___. FINDINGS: Left PICC terminates within the lower superior vena cava. Tracheostomy tube remains in standard position. Moderate-to-large left pleural effusion appears similar compared to the prior study allowing for differences in technique and projection. There is also likely a small right pleural effusion. Bibasilar atelectasis is present, worse on the left than the right. Diffuse haziness of the imaged portion of the upper abdomen may correspond to the presence of ascites. " 3b9ff868-05e6dd27-576ebeed-315027d6-cd455d1c.jpg,validate/p10/p10320599/s58259087/3b9ff868-05e6dd27-576ebeed-315027d6-cd455d1c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with + blood cultures, h/o AVR COMPARISON: Prior exam dated ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Suture material projects over the right upper lung as on prior. Previously noted chest wall emphysema has resolved in the interval. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " d73b8a0f-03226f12-df892dcd-8a9e0425-b5d80f3d.jpg,validate/p19/p19343087/s50339653/d73b8a0f-03226f12-df892dcd-8a9e0425-b5d80f3d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with pericarditis p/w bilateral acute pleural effusions after pulling pericardial drain, now s/p bilateral chest tube placement // Assess chest tube placement and change in effusion sizes Assess chest tube placement and change in effusion sizes IMPRESSION: In comparison with the study of ___, there again are extremely low lung volumes that accentuate the enlargement of the cardiac silhouette. Bilateral chest tubes are in place and there is no evidence of pneumothorax. There is increasing indistinctness of pulmonary vessels, which could reflect some elevation in pulmonary venous pressure. Atelectatic changes are increased bilaterally at the bases, especially in the retrocardiac region. This latter opacification could well represent superimposed pneumonia in the appropriate clinical setting. " a4c45fde-3071c725-7b125b4b-e8d49a65-6a60e95f.jpg,validate/p19/p19330158/s58299126/a4c45fde-3071c725-7b125b4b-e8d49a65-6a60e95f.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY OF ___ COMPARISON: Radiograph of ___. FINDINGS: Indwelling support and monitoring devices are in standard position. Cardiomediastinal contours are stable in appearance. As compared to the previous study, there has been improvement in the degree of pulmonary edema with residual moderate edema remaining. Bilateral pleural effusions are also noted with adjacent bibasilar atelectasis. " 789e18a9-92e7af9e-7a872b75-4cb846a6-7aa376d9.jpg,validate/p15/p15403852/s58444220/789e18a9-92e7af9e-7a872b75-4cb846a6-7aa376d9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p redo AVR/MVR/VAP/trach/PEG // eval VAP eval VAP IMPRESSION: In comparison with the study of ___, there are continued low lung volumes that accentuate the transverse diameter of the heart. There has been decrease in the degree of pulmonary edema. The area of coalescence in the left hilar region is less prominent. This suggests that it it represented some asymmetric edema rather than superimposed pneumonia, though it would be difficult to unequivocally exclude pneumonia in the appropriate clinical setting. The monitoring and support devices are unchanged. " a14ff04c-73e7570f-147a6b84-5adb39d4-1155deeb.jpg,validate/p16/p16180157/s58905280/a14ff04c-73e7570f-147a6b84-5adb39d4-1155deeb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with VT on and ICD on amiodarone // evaluate for amiodarone effect evaluate for amiodarone effect IMPRESSION: In comparison with study of ___, there is little change. Continued enlargement of the cardiac silhouette with well -placed pacer leads. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Specifically, no interstitial lung " 690d20eb-0a0d54d2-e45fe31e-c7ef177a-c1547323.jpg,validate/p10/p10401318/s59074633/690d20eb-0a0d54d2-e45fe31e-c7ef177a-c1547323.jpg,validation," FINAL REPORT INDICATION: Recent pneumonia as well as a history of Hodgkin's. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: ___. FINDINGS: The left lower lobe consolidation has resolved. There is no new focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. The cardiac and hilar contours are within normal limits. Mediastinal fibrosis from prior radiation therapy is noted. IMPRESSION: Resolved left lower lobe pneumonia. " a266d92b-a2c5bfd5-4ad09245-249b8d71-352929d5.jpg,validate/p15/p15360815/s53128454/a266d92b-a2c5bfd5-4ad09245-249b8d71-352929d5.jpg,validation," WET READ: ___ ___ ___ 10:50 PM No pneumonia ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with DM___ s/p multiple I+Ds due to abscess and OM to left heel. Still spiking fevers with a cough, previously intubated. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to___. FINDINGS: There is no evidence of focal consolidation,pleural effusion,pneumothorax,or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. In the setting of osteomyelitis, there should be a low threshold for chest CT if there is concern for septic emboli. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. If there is clinical concern for septic emboli, would recommend chest CT " d26dc6a6-d9932b86-9a944b51-14820ae1-2bad9382.jpg,validate/p12/p12268481/s50521565/d26dc6a6-d9932b86-9a944b51-14820ae1-2bad9382.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fever and cough. Evaluate for pneumonia. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral chest radiograph demonstrates a new right middle lobe and left lower lobe consolidation with associated left pleural effusion. In addition, there is a mildly enlarged heart with mildly increased vascular congestion and enlargement of the azygous vein suggestive of increased patient fluid volume. There is no overt pulmonary edema. There is no pneumothorax. IMPRESSION: New bibasilar opacities, some of which may represent atelectatic changes, but in view of the patient clinical history, likely represents pneumonia. These findings were discussed with the medical house officer caring for the patient. " ecf1d196-438ef11f-41186d5e-d2b74949-d721f570.jpg,validate/p18/p18843419/s53503161/ecf1d196-438ef11f-41186d5e-d2b74949-d721f570.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with increased shortness of breath. Evaluate for fluid overload. COMPARISONS: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is mildly enlarged with a left ventricular configuration. Lung volumes are low. The lungs are otherwise clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. There is significant degenerative changes of the right acromioclavicular joint. Osseous structures are otherwise unremarkable. No radiopaque foreign body. IMPRESSION: Mild cardiomegaly. No evidence of fluid overload. " 8160b2d8-707cd4a6-ccdf361e-ac8472b8-d5e8916c.jpg,validate/p12/p12260873/s54943325/8160b2d8-707cd4a6-ccdf361e-ac8472b8-d5e8916c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hep C cirrhosis, variceal bleed s/p TIPS, found to have gastrorenal shunt, s/p occlusion of shunt, now with worsening hyperbilirubinemia. // evaluate for infection IMPRESSION: Compared to ___ radiograph, mild cardiomegaly and pulmonary vascular congestion are new, accompanied by interstitial edema and small pleural effusions. Asymmetrically distributed patchy right upper lobe opacity and confluent left lower lobe opacity are also demonstrated. The possibility of superimposed secondary process such as aspiration or infection should be considered in the appropriate clinical setting. " 994fb3e2-2f107f64-2783194c-9ec4c583-d366eb74.jpg,validate/p12/p12022180/s55128926/994fb3e2-2f107f64-2783194c-9ec4c583-d366eb74.jpg,validation," FINAL REPORT HISTORY: ___-year-old male patient found to have slightly enlarged hilum on prior chest radiographs. Study requested for evaluation of interval change. COMPARISON: Prior chest radiographs from ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The left hilum is slightly larger than expected. There has been however, no appreciable change in the left hilum since baseline study from ___. The cardiomediastinal silhouette is 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. Stable appearance of the left hilum since ___. " 233f4e0c-d2ef8351-24cf6b0c-ef228534-3797e147.jpg,validate/p12/p12708817/s57006661/233f4e0c-d2ef8351-24cf6b0c-ef228534-3797e147.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) CLINICAL HISTORY ___ year old woman with strokes // NG tube placement (2 step) NG tube placement (2 step) COMPARISON: The same day ___ FINDINGS: 2 successive chest radiographs again demonstrate positioning and advancement of the feeding tube from the lower esophagus to the region of the body of the stomach. IMPRESSION: Tube placement as described. " bf78fd31-8e427de6-e0c2a704-6675f3b1-18b33b18.jpg,validate/p17/p17871905/s55939618/bf78fd31-8e427de6-e0c2a704-6675f3b1-18b33b18.jpg,validation," 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. " b3161f05-9126b0ca-40169c43-482712e2-13ef7b2d.jpg,validate/p15/p15015008/s59396516/b3161f05-9126b0ca-40169c43-482712e2-13ef7b2d.jpg,validation," FINAL REPORT HISTORY: Cardiac arrest with intubation. FINDINGS: In comparison with a series of studies from ___, there is again hazy opacification of both hemithoraces, more prominent on the right, consistent with layering pleural effusions and compressive atelectasis. Cardiac silhouette remains at the upper limits of normal in size. Pulmonary vascularity is difficult to assess due to the overlying pleural fluid. Monitoring and support devices remain in place. " 9477fd87-a76f57ae-48b2ea03-70eba37c-76545a02.jpg,validate/p18/p18139875/s55138184/9477fd87-a76f57ae-48b2ea03-70eba37c-76545a02.jpg,validation," 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. " 3b8d09d5-d2d54c58-d1e6ae4e-0c01e7d3-58da73f8.jpg,validate/p17/p17755234/s53317472/3b8d09d5-d2d54c58-d1e6ae4e-0c01e7d3-58da73f8.jpg,validation," FINAL REPORT INDICATION: Fever and cough. Evaluation for pneumonia. COMPARISON: Right upper quadrant ultrasound ___. Chest radiograph ___. FINDINGS: PA and lateral chest radiographs. Right internal jugular dialysis catheter terminates in the right atrium, unchanged. There are small bilateral pleural effusions. Mild interstitial edema and redistribution suggest mild fluid overload. The cardiomediastinal silhouette is normal. IMPRESSION: Mild fluid overload. " f41aeadc-1c98f6eb-3093c4cf-8e0134d5-7e060d1f.jpg,validate/p14/p14209763/s50784714/f41aeadc-1c98f6eb-3093c4cf-8e0134d5-7e060d1f.jpg,validation," WET READ: ___ ___ ___ 10:44 AM A subtle lucency through the superior sternum could represent a nondisplaced sternal fracture. WET READ VERSION #1 ___ ___ ___ 10:30 AM No fracture or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with sternal bruise // r/o rib fx, ptx TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. A subtle transverse lucency through the superior sternum is suspicious for a nondisplaced sternal fracture. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. IMPRESSION: A subtle lucency through the superior sternum is suspicious for a nondisplaced sternal fracture. " 943b524f-9c0e1756-63da8b90-1b292ff7-84c925bf.jpg,validate/p10/p10039959/s51761406/943b524f-9c0e1756-63da8b90-1b292ff7-84c925bf.jpg,validation," WET READ: ___ ___ 10:09 PM No pneumonia. WET READ VERSION #1 ___ ___ 6:00 PM 1. Possible ascending aortic aneurysm measuring up to 5 cm in a patient with a tortuous aorta. 2. Subtle anterior disc space widening of a lower thoracic vertebral body may be projectional. Clinical correlation recommended for recent history of trauma or ligamentous injury. 3. No pneumonia. WET READ VERSION #2 ___ ___ 6:45 PM 1. Subtle anterior disc space widening of a lower thoracic vertebral body may be projectional. 2. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F w/chest pain, assess for occult pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are mildly hypoinflated with crowding of vasculature. No pleural effusion or pneumothorax. The aorta is tortuous. The heart, mediastinal contour and hila are otherwise unremarkable. No acute fracture. IMPRESSION: No pneumonia. " e08998df-963494e2-b70b3696-d512bc9a-9c6bbed6.jpg,validate/p11/p11194247/s50805897/e08998df-963494e2-b70b3696-d512bc9a-9c6bbed6.jpg,validation," 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. " 814151f4-415328a6-d44999b6-9b54aaf2-6c066ceb.jpg,validate/p16/p16568680/s57150756/814151f4-415328a6-d44999b6-9b54aaf2-6c066ceb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea // acute process COMPARISON: Prior study is dated ___ FINDINGS: PA and lateral views of the chest provided. The heart appears top-normal in size. There is subtle prominence of the main pulmonary artery contour. The hila appear minimally congested. The lungs are clear. No focal consolidation concerning for pneumonia. No large effusion or pneumothorax. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Top normal heart size with prominence of the main PA contour, correlate for pulmonary arterial hypertension. Possible mild hilar congestion. " e80b48f5-addaf021-ffdd1da8-60607bb2-f492cdf0.jpg,validate/p14/p14502109/s56372317/e80b48f5-addaf021-ffdd1da8-60607bb2-f492cdf0.jpg,validation," 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. " c060dc9c-2aa496c7-114e2b8c-039fb868-66553b85.jpg,validate/p12/p12109177/s55599595/c060dc9c-2aa496c7-114e2b8c-039fb868-66553b85.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with recent intubation. COMPARISON: None available. FINDINGS: Single supine radiograph of the chest demonstrates a malpositioned nasogastric tube, which is looped in the mid esophagus, with distal tip terminating in the pharynx, and directed inferiorly. An endotracheal tube terminates just above the level of the clavicular heads, approximately 7.2 cm above the level of the carina, and could be advanced approximately 2 cm for ideal positioning. The lung volumes are low. Retrocardiac opacity may be secondary to atelectasis, but lungs are otherwise clear of effusion, consolidation, or pulmonary edema. The cardiomediastinal silhouette is unremarkable. There is no pneumothorax. The stomach is distended with air. IMPRESSION: Malpositioned nasogastric tube, and high position of the endotracheal tube, as described above. NOTIFICATION: The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at 10:20 a.m. on ___, five minutes after discovery. " b920d298-7df03aa6-93699705-5a95a6af-9fc53718.jpg,validate/p17/p17517983/s52994143/b920d298-7df03aa6-93699705-5a95a6af-9fc53718.jpg,validation," 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. " 0b7e50b5-e294c033-a6ba8608-9ef1d9cf-16a24354.jpg,validate/p17/p17327592/s51857131/0b7e50b5-e294c033-a6ba8608-9ef1d9cf-16a24354.jpg,validation," 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. " a2d623cb-9551ddce-d42822f3-a896cbf5-40d06ea4.jpg,validate/p16/p16576541/s58961803/a2d623cb-9551ddce-d42822f3-a896cbf5-40d06ea4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with COPD and instability and dizziness // Pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recently ___ FINDINGS: Heart size is normal. The aorta is calcified, indicating atherosclerosis The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is bibasilar atelectasis. Unchanged fibrous scarring extending from the right hilum to the right apex. Severe upper lobe emphysema. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There is a compression deformity of a lower thoracic vertebral body with approximately ___ percent height loss, not significantly changed compared to ___. Multilevel degenerative changes of the visualized spine. IMPRESSION: No acute cardiopulmonary abnormality. Severe emphysema. " fd9b5bc1-10c12646-ebb9633a-4dd312a7-104508ba.jpg,validate/p19/p19049916/s52844020/fd9b5bc1-10c12646-ebb9633a-4dd312a7-104508ba.jpg,validation," FINAL REPORT HISTORY: Positive PPD. 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 acute cardiopulmonary disease or old tuberculous disease. " 7287a27a-b3561eef-3b56e9ba-b3874ea4-03292bc2.jpg,validate/p14/p14546998/s55953785/7287a27a-b3561eef-3b56e9ba-b3874ea4-03292bc2.jpg,validation," FINAL REPORT INDICATION: Pleuritic right-sided chest pain and shortness of breath. COMPARISON: Multiple prior studies, most recently ___. PA AND LATERAL CHEST: A left PICC has been removed. There are two percutaneous transhepatic biliary drains identified in the right upper quadrant. There is no right pleural effusion, and there is no opacity to suggest pneumonia. There is no pneumothorax. Left basilar volume loss is chronic. There is a somewhat linear nodular density identified at the right apex, projecting between the posterior fourth and fifth ribs, not clearly apparent on prior studies. This may be artifactual, though close attention to this area on followup examinations is recommended. The hilar and cardiomediastinal contours are normal. There is no pulmonary vascular congestion or edema. These findings were discussed with ___ by Dr. ___ at 2:30 p.m. on ___ by phone. " 6771934b-0e96d5dc-437d30e0-f298be8b-1bc99366.jpg,validate/p12/p12151284/s58983109/6771934b-0e96d5dc-437d30e0-f298be8b-1bc99366.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Made with a prior study from ___. CLINICAL HISTORY: Chest wall pain. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear and well inflated. There is no focal consolidation, effusion or pneumothorax. Tiny clips project over the right chest wall with asymmetric appearance of the breast soft tissue which suggests prior surgical intervention. No effusion or pneumothorax. There is calcification curvilinear along the proximal descending aorta which is stable from prior exam. Bony structures appear intact. IMPRESSION: No acute findings in the chest. " 613d9bdd-32bb3b3e-e0e722e8-955b6c29-9d1a6d35.jpg,validate/p11/p11648387/s57553492/613d9bdd-32bb3b3e-e0e722e8-955b6c29-9d1a6d35.jpg,validation," FINAL REPORT INDICATION: ___M with failure to thrive // eval for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest x-ray and chest CT from ___. . FINDINGS: Opacity at the right cardiophrenic angle is compatible with a prominent fat pad. Calcified granulomas in the right middle lobe seen on prior CT are faintly visualized. There is some associated linear opacity at the right lung base as well, unchanged from prior potentially due to atelectasis. Elsewhere, lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Unchanged right basilar opacity. Potentially atelectasis noting that infection cannot be entirely excluded. " dd42a337-70b0ff24-59bf0a18-0d62d6b4-d3321cce.jpg,validate/p16/p16977687/s53328540/dd42a337-70b0ff24-59bf0a18-0d62d6b4-d3321cce.jpg,validation," FINAL REPORT INDICATION: History: ___M with AMS // evaluate for acute process TECHNIQUE: Upright AP and lateral chest COMPARISON: Chest radiographs ___ through ___. CTA chest ___. FINDINGS: Lung volumes are low. Known severe emphysema is better seen on chest CT. Streaky opacity in the right lower lung is likely atelectasis. Interstitial abnormality most prominent at the left base likely reflects combination of atelectasis and emphysema. There is no definite evidence of pneumonia. Mild cardiomegaly is unchanged. There is chronic elevation of the right hemidiaphragm. There is no pneumothorax. IMPRESSION: Bibasilar atelectasis and severe emphysema better depicted on prior chest CT. There is no definite evidence of pneumonia. Mild cardiomegaly is stable. " 065ddc36-40f0b34e-03c84b7c-c0faadfb-2e068bab.jpg,validate/p12/p12784119/s50332332/065ddc36-40f0b34e-03c84b7c-c0faadfb-2e068bab.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with chest pain // eval for acute process TECHNIQUE: Portable AP chest COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are well-expanded. Subtle increased opacity in the right lower hemi thorax could represent an early bronchopneumonia. No edema, effusion, or pneumothorax. The heart size is normal. The mediastinum is not widened. Prominent pulmonary arteries are similar to the prior exam and may suggest sequelae of chronic pulmonary hypertension. A left posterior a lateral rib fracture is old, unchanged. IMPRESSION: 1. Subtle increased opacity in the right lower lobe could represent an early bronchopneumonia. 2. Prominent pulmonary arteries may suggest sequelae of chronic pulmonary hypertension. " 24d5157e-a708ff03-4663fd94-2e351c78-d1f7b4b5.jpg,validate/p13/p13325402/s53420046/24d5157e-a708ff03-4663fd94-2e351c78-d1f7b4b5.jpg,validation," 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. " 42ebbd12-464b30f7-1cd4a918-27e4212f-23964be7.jpg,validate/p13/p13757356/s51139543/42ebbd12-464b30f7-1cd4a918-27e4212f-23964be7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p AVR // eval for pneumo eval for pneumo IMPRESSION: The patient is now extubated and the nasogastric tube was removed. Also removed is the Swan-Ganz catheter. The mediastinal drains and chest tubes are in unchanged position. No pneumothorax. No larger pleural effusions. Minimal retrocardiac atelectasis. No pulmonary edema. Normal appearance of the cardiac silhouette. " 6b9ab29e-f0447f5d-e3a4377d-fb8e0e7f-beaea360.jpg,validate/p19/p19860681/s55318812/6b9ab29e-f0447f5d-e3a4377d-fb8e0e7f-beaea360.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: No prior studies for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs and pleural surfaces are clear. IMPRESSION: No radiographic evidence of pneumonia. " bf7ba2bc-d99420d4-21d7f72c-be971c28-a3f9ce1b.jpg,validate/p15/p15239201/s53285388/bf7ba2bc-d99420d4-21d7f72c-be971c28-a3f9ce1b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with etoh cirrhosis, admitted for AMS, intubated, no breath sounds on L. // evaluate ET tube placement, pneumo COMPARISON: ___. IMPRESSION: INTERVAL PLACEMENT OF ENDOTRACHEAL TUBE AND NASOGASTRIC TUBE IN STANDARD POSITION. CARDIOMEDIASTINAL CONTOURS ARE STABLE. LARGE LAYERING LEFT PLEURAL EFFUSION APPEARS SLIGHTLY LARGER THAN ON THE PRIOR STUDY BUT AND SPARES IS LIMITED BY POSITIONAL DIFFERENCES. WITHIN THE RIGHT LUNG, LOWER LUNG VOLUME RESULTS IN CROWDING OF BRONCHOVASCULAR STRUCTURES OF THE RIGHT LUNG BASE. " 045f4c72-0cd740e3-99462864-826137c9-2261662e.jpg,validate/p11/p11719118/s58337930/045f4c72-0cd740e3-99462864-826137c9-2261662e.jpg,validation," 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. " 6f48fd58-ef49f6cc-832f2cb2-f6354a59-ada84b89.jpg,validate/p19/p19557250/s54535058/6f48fd58-ef49f6cc-832f2cb2-f6354a59-ada84b89.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated // lines, tubes, opacity lines, tubes, opacity COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lung volumes remain low. Greater opacification in the left lower lobe is probably atelectasis. Some left pleural effusion is presumed, but it is not large. No pneumothorax. Right upper lung clear. Moderate to severe enlargement of the cardiac silhouette is stable since ___, but increased since ___, indicating continued cardiac decompensation. ET tube in standard placement. Right jugular line ends close to the superior cavoatrial junction and an esophageal drainage tube passes into the stomach and out of view. " 5e90daae-146024d4-22efb57a-0aeb3932-e7cf05bd.jpg,validate/p18/p18143490/s52744023/5e90daae-146024d4-22efb57a-0aeb3932-e7cf05bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p asc ao replacement and CT removal // r/o ptx r/o ptx IMPRESSION: In comparison with the earlier study of this date, the right chest tube has been removed and there is no definite pneumothorax. Otherwise little change. " 8dfe12b7-818b64b9-0414d931-938695ec-96793fa8.jpg,validate/p10/p10083678/s58403667/8dfe12b7-818b64b9-0414d931-938695ec-96793fa8.jpg,validation," FINAL REPORT HISTORY: Chest pain COMPARISON: ___ and CT from ___ FINDINGS: PA and lateral views of chest. The lungs are clear aside from a small nodular opacity seen best on the lateral view at the costophrenic angle. Cardiac silhouette is normal in size. There is no pleural effusion, pneumothorax or pulmonary edema. The hilar contours are normal. Clips are noted in the right upper quadrant. The trachea is again mildly deviated to the left at the thoracic inlet, but this was also present on the prior CT in ___ without associated mass lesion. IMPRESSION: No evidence of acute cardiopulmonary process. " cdd27684-001064a4-60543453-9d8816e5-3b576298.jpg,validate/p18/p18153530/s53078056/cdd27684-001064a4-60543453-9d8816e5-3b576298.jpg,validation," 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. " c364a188-ae96c773-31235440-a03d6736-9b4a6a63.jpg,validate/p19/p19667420/s50141517/c364a188-ae96c773-31235440-a03d6736-9b4a6a63.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ESRD with increased SOB, cough and anorexia. // r/o pulmonary edema versus Pneumonia TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiographs dated ___. FINDINGS: Compared to chest radiographs from ___, right-sided pleural effusion has minimally improved. Left-sided pleural effusion, with fissural fluid, appears loculated and is unchanged. Lungs are hyperinflated with flattening of the bilateral hemidiaphragms, suggestive of emphysema. There is mild central vascular congestion without overt pulmonary edema. No focal consolidation. No pneumothorax. Cardiomediastinal silhouette is stable. Left pectoral cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle, respectively. IMPRESSION: 1. Stable left pleural effusion appears loculated with fissural fluid. Minimally improved right pleural effusion. 2. No pulmonary edema. No pneumonia. 3. Hyperinflated lungs with flattening of bilateral hemidiaphragms, suggestive of emphysema. 4. No radiographic findings suggestive of pulmonary embolism, though this exam alone cannot confirm or exclude pulmonary embolism. " 6b40439a-eec83bf6-d0db7406-253c173d-4b42bd52.jpg,validate/p11/p11856988/s56689956/6b40439a-eec83bf6-d0db7406-253c173d-4b42bd52.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and anemia. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: Hyperexpansion of the lungs is again seen, compatible with COPD. The heart is mildly enlarged, increased in size since the ___ exam. The central pulmonary vessels are engorged. There is superimposed mild interstitial edema, slightly worse at the lower lung zones. There is no pneumothorax or pleural effusion. IMPRESSION: COPD with cardiomegaly and mild asymmetric interstitial edema. " 1cd75d09-3c802d4b-b5921f15-455dff10-84a2c72a.jpg,validate/p13/p13969231/s55627200/1cd75d09-3c802d4b-b5921f15-455dff10-84a2c72a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with shortness of breath // acute process? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Spinal catheters are noted. Catheter projects over the right hemi thorax. The lungs are clear without focal consolidation, effusion or pneumothorax. The heart mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " c4c72d83-ebb90083-bda7f755-df81b935-6c86721d.jpg,validate/p16/p16454913/s54294444/c4c72d83-ebb90083-bda7f755-df81b935-6c86721d.jpg,validation," WET READ: ___ ___ ___ 7:26 PM No free air under the diaphragm in this semi-upright CXR. ETT, R IJ CVL is similar position. Left basal consolidation, similar. ___. ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with pancreatic renal transplant and with tracheobronchomalacia status post tracheobronchoplasty. FINDINGS: Comparison is made to the prior study performed 14 hours earlier. The tracheostomy, feeding tube, right IJ central line are stable in position. There are persistent bilateral pleural effusions, left side worse than right. There is pulmonary vascular congestion. No free intra-abdominal gas is seen. " d56d46e2-7580b012-6ed726a8-92eb6ea5-dd9e90b9.jpg,validate/p13/p13359620/s54431719/d56d46e2-7580b012-6ed726a8-92eb6ea5-dd9e90b9.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chronic cough and known fibrosis. Question interval change. COMPARISONS: Radiographs available from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: Surgical clips project about the left lateral chest wall in the left breast, as before. The left lung shows similar mild volume loss with focal opacity at the medial left lung apex with a patchy distribution, similar to prior examinations allowing for differences in technique. The right lung remains clear. There is no pleural effusion or pneumothorax. The bony structures appear within normal limits. IMPRESSION: Similar left apical opacities. If more detailed comparison for change is needed clinically, then chest CT could be considered. " f41b9c85-c60b9de6-d86b2ee0-3e5040fd-e642109b.jpg,validate/p18/p18176683/s52548636/f41b9c85-c60b9de6-d86b2ee0-3e5040fd-e642109b.jpg,validation," 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. " 6b03df1a-703630f8-ce2c0747-2112c59b-84759b82.jpg,validate/p16/p16899484/s57162076/6b03df1a-703630f8-ce2c0747-2112c59b-84759b82.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with right upper quadrant pain radiating to the back. Tachycardia. 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. IMPRESSION: No acute cardiopulmonary process. " 4b393f05-234662dd-cfca3ec8-56982f72-55c468b8.jpg,validate/p12/p12911473/s51501983/4b393f05-234662dd-cfca3ec8-56982f72-55c468b8.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST` REASON FOR EXAM: Evaluate NG tube. Patient with basilar artery occlusion and pontine infarction. Comparison is made with prior study performed 10 hours earlier. Cardiomediastinal contours are normal. ET tube tip is in standard position, 5.2 cm above the carina. NG tube tip is seen in the stomach. New right lower lobe opacity is consistent with aspiration. Left lower lobe opacity could be due to atelectasis and/or aspiration. There is no pneumothorax or large pleural effusions. " 785f645d-0f904d56-8a7be552-7416d392-ab56260d.jpg,validate/p11/p11503464/s57033866/785f645d-0f904d56-8a7be552-7416d392-ab56260d.jpg,validation," WET READ: ___ ___ ___ 10:48 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain, evaluate for acute cardiopulmonary disease. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs from ___.. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. A suture anchor in the right humeral head is unchanged from the prior study. IMPRESSION: No acute cardiopulmonary process. " a44020f6-415f6604-1f320f7d-52736d20-ea85fe14.jpg,validate/p19/p19787365/s55058814/a44020f6-415f6604-1f320f7d-52736d20-ea85fe14.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Chest pain, shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CTA ___ FINDINGS: As before, the mediastinal structures are shifted to the right which is a chronic finding. The cardiomediastinal silhouette is unchanged. Prominence of the hila bilaterally is similar. No focal consolidation or pneumothorax is identified. Blunting of the right costophrenic angle is unchanged and no pleural effusion is otherwise identified. Linear atelectasis is seen within the left lung base. Multiple clips are again seen in the left upper quadrant of the abdomen. There are no acute osseous abnormalities demonstrated. IMPRESSION: No interval change from prior with no evidence of pneumonia. " 86588dc8-06904fda-a647333b-5587e6b1-ebec1b5a.jpg,validate/p14/p14034311/s59879501/86588dc8-06904fda-a647333b-5587e6b1-ebec1b5a.jpg,validation," FINAL REPORT PORTABLE CHEST ___, ___ COMPARISON: ___. FINDINGS: A new focal opacity has developed in the right lung base medially, partially obscuring the right hemidiaphragm. This could represent developing infection, atelectasis or aspiration. Otherwise, no relevant changes since recent study, with persistent cardiomegaly and mild pulmonary vascular congestion. " b6963e30-c5d2f27b-4ae377ca-6f593524-8cb1946a.jpg,validate/p13/p13462065/s56043635/b6963e30-c5d2f27b-4ae377ca-6f593524-8cb1946a.jpg,validation," 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. " 5b668c8a-b92a4746-f2721be2-8d5cf52a-86166fe1.jpg,validate/p12/p12541979/s54771529/5b668c8a-b92a4746-f2721be2-8d5cf52a-86166fe1.jpg,validation," FINAL REPORT HISTORY: Lymphoma, shortness of breath. History of CHF. Assess for abnormalities. COMPARISON: Chest radiograph from ___ in conjunction with CT torso from ___. FINDINGS: There is no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. There has been interval resolution of pulmonary vascular congestion since ___. IMPRESSION: No pneumonia or pulmonary vascular congestion. Telephone notification to Dr. ___ by Dr. ___ at 16:15 on ___ per request " ef6c7754-e90271a1-3d0fcf88-38045626-235dc489.jpg,validate/p12/p12291041/s56216973/ef6c7754-e90271a1-3d0fcf88-38045626-235dc489.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with CHF // worsening infiltrates or edema? COMPARISON: Radiographs from ___ IMPRESSION: Left Pacemaker and right IJ central line are unchanged in position. There has been improved aeration. There is unchanged cardiomegaly. There is improvement of the mild pulmonary edema. There are small bilateral effusions. " a524eb24-19c1dda7-d85b1d24-cafc14ac-c9970ea3.jpg,validate/p19/p19458379/s50477646/a524eb24-19c1dda7-d85b1d24-cafc14ac-c9970ea3.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs appear clear. The osseous structures are unremarkable. IMPRESSION: No evidence of acute disease. " fe7bd495-cd1ee433-25411a4e-13614d8b-00bb590c.jpg,validate/p16/p16826047/s53010349/fe7bd495-cd1ee433-25411a4e-13614d8b-00bb590c.jpg,validation," FINAL REPORT INDICATION: Evaluate right pleural effusion. COMPARISON: Chest radiograph from ___, dating back to ___. CT torso from ___. FINDINGS: PA and lateral radiographs of the chest demonstrate that the right pleural effusion, which had been drained on the ___ radiograph, has returned to the size it was on ___. In addition, there is right middle and lower lobe collapse. There is no shift of mediastinal structures. The visible lung fields are clear. There is no pneumothorax or left-sided effusion. Moderate cardiomegaly is unchanged. Pulmonary vascularity is normal. There is a right-sided chest wall port with the catheter terminating in the low SVC. IMPRESSION: Reaccumulation of moderate right pleural effusion. NOTE: Findings were communicated to Dr. ___ by Dr. ___ ___ telephone on ___ at 9:40 a.m. " 549eae45-cb9b690a-25e3fe21-2aea71d7-2ae555a9.jpg,validate/p10/p10818683/s50961597/549eae45-cb9b690a-25e3fe21-2aea71d7-2ae555a9.jpg,validation," FINAL REPORT INDICATION: Right-sided chest pain, rule out pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear and the lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. Heart is normal size. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " e3f7728a-c7a834f8-a857d4a0-d9f98076-53d85efa.jpg,validate/p13/p13567284/s50440744/e3f7728a-c7a834f8-a857d4a0-d9f98076-53d85efa.jpg,validation," WET READ: ___ ___ ___ 11:25 PM Focal silhouetting of the descending thoracic aorta with subtle increased retrocardiac opacity could represent focal infection in the proper clinical setting. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with fevers and cough. Question pneumonia. COMPARISON: None. FINDINGS: PA and lateral views of the chest. There is focal silhouetting of the descending thoracic aorta in the retrocardiac region with time subtle increased opacity in the infrahilar region. On the lateral view. . Elsewhere, the lungs are clear. There is no effusion. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: Focal silhouetting of the descending thoracic aorta with subtle increased retrocardiac opacity could represent focal infection in the proper clinical setting. " b178e9bb-a1056dc4-7287d8ec-344b1166-2044a62e.jpg,validate/p15/p15177732/s57192624/b178e9bb-a1056dc4-7287d8ec-344b1166-2044a62e.jpg,validation," FINAL REPORT INDICATION: Cough. 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. " 5c836540-7d4cf4e0-c00ca9a5-14506886-f92dfa26.jpg,validate/p13/p13820409/s50970542/5c836540-7d4cf4e0-c00ca9a5-14506886-f92dfa26.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxia, evaluation for acute process. COMPARISON: No comparison available at the time of dictation. FINDINGS: The size of the cardiac silhouette is mildly enlarged. The patient shows combination of interstitial and alveolar opacities with gradient of increasing severity from the top to the bottom of the lungs. There also are signs of blood flow redistribution and minimal Kerley B lines. Overall, the findings are strongly suggestive of pulmonary edema. Pleural effusions are not present. No other relevant findings. At the time of dictation and observation, 9:11 a.m., on ___, the referring physician, ___. ___ was paged for notification. Findings were discussed on the telephone a few minutes later. " 850d0702-d5853040-db3edb26-87f97a20-9b221fa8.jpg,validate/p13/p13707575/s51604314/850d0702-d5853040-db3edb26-87f97a20-9b221fa8.jpg,validation," FINAL REPORT INDICATION: History: ___F with RUQ and R back pain // cxr: pna?US: gallstones vs cholecystits TECHNIQUE: Chest PA and lateral COMPARISON: None. 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. " 20562a6d-f828f0d5-36f3fa26-7cd99315-92335576.jpg,validate/p17/p17925184/s53579774/20562a6d-f828f0d5-36f3fa26-7cd99315-92335576.jpg,validation," FINAL REPORT HISTORY: Left hip replacement with multiple infections, now low O2 sat, question developing pneumonia. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ at 13:41 p.m. Right subclavian PICC line is present, tip at SVC/RA junction. Heart size is at the upper limits of normal. Prominence of the main pulmonary artery is suggested. I suspect the presence of background COPD, with bullous change in the right greater than left upper zones, accounting for attenuation of vessels. There is patchy opacity in the right cardiophrenic region, greater than at the left base, unchanged compared with ___. As sugggested on the ___ CT scan, the differential includes an infectious infiltrate or focus of aspiration. Small cavitary nodules seen on the ___ CT are difficult to appreciate radiographically. IMPRESSION: 1. Severe background COPD. 2. Patchy right-cardiophrenic-greater-than-left-base opacity, is unchanged. The differential diagnosis includes a pneumonic infiltrate versus changes due to aspiration. 3. No CHF or effusion. " 58d7e06a-17227ebb-6e6caa8e-40f01a47-e3a4f56e.jpg,validate/p19/p19933545/s51280626/58d7e06a-17227ebb-6e6caa8e-40f01a47-e3a4f56e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Productive cough. PA and lateral upright chest radiographs were reviewed in comparison to ___ and CT abdomen from ___. Heart size is normal. Large hiatal hernia containing substantial portion of the stomach is redemonstrated and it might contribute to the presence of recurrent aspiration. Lungs on the other hand are essentially clear except for minimal atelectasis at the left lung base. No focal consolidations to suggest infectious process or definitive aspiration are present. There is no pleural effusion or pneumothorax. If clinically warranted, correlation with chest CT might be considered. " 73902504-55aa102c-6ad8b494-e877b5db-f4ee4e77.jpg,validate/p12/p12405184/s51554945/73902504-55aa102c-6ad8b494-e877b5db-f4ee4e77.jpg,validation," FINAL REPORT INDICATION: ___M with mild hypoxia, evaluate for pulmonary edema. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: Heart is top-normal in size. Mediastinal contours normal. There is no focal lung consolidation. No overt pulmonary edema seen. 7 mm nodular opacity at the right lung base, likely corresponds to nipple shadow. IMPRESSION: Nodular opacity at the right lung base most likely represents nipple shadow. Repeat chest radiograph with nipple markers recommended for further evaluation. No overt pulmonary edema or evidence of pneumonia. " 4b2d7a37-7eda2b3e-e292e51b-bf995cd4-2f5e18b8.jpg,validate/p10/p10347349/s58541661/4b2d7a37-7eda2b3e-e292e51b-bf995cd4-2f5e18b8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with intermitted CP // r/o occult 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. " 6a8b7e21-1d39336c-a331de15-240d8eb7-12728f6f.jpg,validate/p17/p17069014/s59773060/6a8b7e21-1d39336c-a331de15-240d8eb7-12728f6f.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Sickle cell with cough, congestion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiomediastinal silhouette and hilar contours are stable. There are areas of minor linear left basilar atelectasis. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. Mild vascular congestion is again seen. " 15783b02-8507ca2c-ffec67b7-748a3fc2-daebc717.jpg,validate/p19/p19057990/s56479968/15783b02-8507ca2c-ffec67b7-748a3fc2-daebc717.jpg,validation," WET READ: ___ ___ ___ 8:40 PM ET and NG tubes in appropriate position. The cardiomediastinal and hilar contours are normal. There is no pneumothorax or large pleural effusion. Bibasilar atelectasis is present. There is no focal consolidation concerning for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with RECENT INTUBATION. ASSESS ET TUBE PLACEMENT // PATIENT JUST INTUBATED. ASSESS ET also comment on pulmonary edema or consolidation concerning for PNA PATIENT JUST INTUBATED. ASSESS ET also comment on pulmonary edema or consolidation concerning for PNA IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Small regions of peribronchial opacification in the axillary region of the right upper lobe than right lung base could be pneumonia, perhaps due to aspiration, but diagnosis depends upon depends on clinical circumstances. Cardiomediastinal silhouette is normal. Pleural effusions small if any. ET tube in standard placement. Esophageal drainage tube ends in the midportion of the nondistended stomach. " 8e313127-b7059e97-a34989fa-8f07b62d-3901d5f3.jpg,validate/p19/p19550773/s52460058/8e313127-b7059e97-a34989fa-8f07b62d-3901d5f3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with metastatic NSCLC with previous findings concerning for pneumonia, dropping O2 sat and audible congestion. // ? change in RUL consolidation, pleural effusion IMPRESSION: In comparison to ___ chest radiograph, diffuse airspace opacities in the right lung have minimally improved in the right apex and right lung base. A large masslike opacity persists in the right mid lung, accompanied by intrathoracic lymphadenopathy and right-sided pleural thickening and worse fusion. Within the left lung, left basilar atelectasis has improved. " 6b1410ba-56a5c4c9-d7abdb1e-4ff4aaea-75660c62.jpg,validate/p11/p11087814/s56853223/6b1410ba-56a5c4c9-d7abdb1e-4ff4aaea-75660c62.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old female with increased frequency of seizures and sick contacts at daycare. 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. " 746dda01-f490de59-170cedc0-f013ebff-ce401b8a.jpg,validate/p14/p14828203/s55992201/746dda01-f490de59-170cedc0-f013ebff-ce401b8a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Persistent cough, productive, assess pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well-expanded lungs without focal consolidation, effusion, or pneumothorax. Nipple shadows project over the left and right lower lungs. Cardiomediastinal silhouette appear normal. There is slight widening of the AP diameter of the chest with upper lobe lucency, which could reflect underlying emphysema. There is a compression deformity in the upper thoracic spine seen on lateral view, which is new from prior exam. Otherwise, bones are intact. IMPRESSION: Emphysema without definite signs of pneumonia. Upper thoracic mild compression fracture, new from prior. " 3dacbb1d-c3b09461-146d44a2-b042a8ce-55562da2.jpg,validate/p10/p10781468/s56816123/3dacbb1d-c3b09461-146d44a2-b042a8ce-55562da2.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST. REASON FOR EXAM: Hypoxia, rales, assess for pneumonia. Comparison is made with prior study, ___. Mild interstitial edema is new. Cardiomegaly is stable. There is no pneumothorax. Small bilateral effusions are new. " 45926aa8-cb6f679c-626db26e-631f10b7-11f44f8d.jpg,validate/p10/p10851962/s58806773/45926aa8-cb6f679c-626db26e-631f10b7-11f44f8d.jpg,validation," FINAL REPORT HISTORY: Arrhythmia. FINDINGS: The cardiac silhouette is within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 30974841-b11e3e5f-c174b232-67d79ddf-46d49688.jpg,validate/p11/p11084812/s53844476/30974841-b11e3e5f-c174b232-67d79ddf-46d49688.jpg,validation," FINAL REPORT INDICATION: Cough and chest pain. COMPARISON: ___. TECHNIQUE: Upright AP and lateral views of the chest. FINDINGS: Study is limited due to poor penetration. Right-sided Port-A-Cath tip again resides within the proximal right atrium. The mediastinal and hilar contours are unchanged. There is no pulmonary edema, focal consolidation or pleural effusion. No pneumothorax is identified. No acute osseous abnormalities are seen. IMPRESSION: Limited study, but no acute cardiopulmonary abnormality identified. " 441b5e19-3ed2a500-dc081125-324da09d-715d9ef4.jpg,validate/p16/p16566006/s53682711/441b5e19-3ed2a500-dc081125-324da09d-715d9ef4.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, lethargy status post hospitalization for stroke. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Again, a trace left pleural effusion is not excluded. No definite focal consolidation is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. The patient is status post median sternotomy and CABG. IMPRESSION: Possible trace left pleural effusion, otherwise no acute cardiopulmonary process. " 30888f95-c62df363-808adb8b-265f4be4-d432a972.jpg,validate/p14/p14131994/s59959021/30888f95-c62df363-808adb8b-265f4be4-d432a972.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with trauma to right ribs. TECHNIQUE: AP view of the chest, additional AP view of the right-sided ribs COMPARISON: Chest radiograph ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Mild deformity of the right ninth lateral rib may reflect a nondisplaced rib fracture. IMPRESSION: Mild deformity of the right ninth lateral rib with a nondisplaced rib fracture and clinical correlation with the site of patient's tenderness is recommended. No acute cardiopulmonary process. " 1061659b-8891cc3c-16d561bc-ec98a126-34cc6bd2.jpg,validate/p19/p19372257/s59612507/1061659b-8891cc3c-16d561bc-ec98a126-34cc6bd2.jpg,validation," WET READ: ___ ___ ___ 1:33 PM New heterogeneous bilateral lower lobe opacities may represent atelectasis however are worrisome for pneumonia/aspiration pneumonia in the appropriate clinical setting. Clinical correlation is recommended. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 1:31 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with leukemia, currently with tachypnea. // Tachypnea- pneumonia? TECHNIQUE: Portable AP chest radiograph. COMPARISON: CT chest ___. FINDINGS: A right-sided Port-A-Cath terminates in the mid SVC. A left subclavian catheter terminates in the proximal SVC. There new bibasilar airspace opacities, while this may reflect atelectasis there is no appreciable volume loss and the appearances are suspicious for developing infection. No pleural effusion or pneumothorax seen. " 2b2bc385-4c8820bf-5c68ee03-741bb172-9c530f5c.jpg,validate/p15/p15584013/s51901736/2b2bc385-4c8820bf-5c68ee03-741bb172-9c530f5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough // Eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal contours are stable. Again seen is prominence of the central pulmonary arteries, suggestive of possible pulmonary arterial hypertension. No definite new areas of consolidation are identified. In comparison to the most recent examination, there is left upper lobe bronchial wall thickening. There is no large pneumothorax. Possible, trace bilateral pleural effusions are present. A right-sided chest port remains in stable position. IMPRESSION: New bronchial wall thickening in the left upper lobe may be consistent with infection/ inflammation. Definite focal consolidation is not identified. " 9447acce-dde3ce9a-206a0351-f5e6e6f3-189dbea0.jpg,validate/p12/p12706696/s51752569/9447acce-dde3ce9a-206a0351-f5e6e6f3-189dbea0.jpg,validation," FINAL REPORT HISTORY: Diastolic congestive heart failure of medication. Now with shortness of breath and chest pain. COMPARISON: Chest radiograph ___. FINDINGS: Portable semi upright frontal view of the chest. Cephalization of the pulmonary vasculature with no overt pulmonary edema appears relatively unchanged compared to the prior chest radiograph. Bilateral lower lobes opacity likely represent atelectasis and due to overlying soft tissues. There is no pleural effusion or pneumothorax. No osseous abnormality is seen. IMPRESSION: No pleural effusions. Mild pulmonary vascular congestion. " 606a53ec-9bdc1450-645a545a-4a2418db-57f71e0e.jpg,validate/p13/p13637928/s51887542/606a53ec-9bdc1450-645a545a-4a2418db-57f71e0e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of pna // ___ for pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lungs are better inflated. No evidence of pneumonia, no pulmonary edema. No larger pleural effusions. Normal size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. " 6781eb5a-c0a3adbe-f8d6593d-169cdcc9-6765ff3a.jpg,validate/p14/p14500788/s58780446/6781eb5a-c0a3adbe-f8d6593d-169cdcc9-6765ff3a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 1 week cough, initial fever, CXR on ___ no pneumonia. Cough persistent / worse, localized wheezing in bilateral lower lung field worse on right, no pleural rub. patient c/o left pleuritic chest pain. non-smoker. // r/o interim change since last CXR 5 days ago. 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. " 0ddbdda3-b4e91ac5-5b662512-b0f799da-39c44c2d.jpg,validate/p12/p12913304/s51923783/0ddbdda3-b4e91ac5-5b662512-b0f799da-39c44c2d.jpg,validation," 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. " 6620eeaf-a96fad7e-075375c5-9e23eeb9-0664f9c5.jpg,validate/p13/p13358134/s53539161/6620eeaf-a96fad7e-075375c5-9e23eeb9-0664f9c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with 5mm parafalcine SDH and T11-T12 hyperextension injury, c/o back pain now with new cough and sob // new cough, ronchi new cough, ronchi IMPRESSION: In comparison with the study of ___, there again are relatively low lung volumes that accentuate the prominence of the transverse diameter of the heart. No evidence of vascular congestion or acute focal pneumonia. The multiple pulmonary nodules throughout the lungs were much better identified on the CT scan of ___. Given the pulmonary changes and prominence of the cardiac silhouette, it would be extremely difficult to unequivocally exclude superimposed pneumonia in the appropriate clinical setting, especially in the absence of a lateral view. " dea3e134-b66a802e-b5bec049-764bc7f2-5e7e11d2.jpg,validate/p16/p16017640/s53491688/dea3e134-b66a802e-b5bec049-764bc7f2-5e7e11d2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pressure x2 days. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Minimal scarring is noted in the lung apices. Lungs are otherwise clear. No pleural effusion, focal consolidation or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " a2c79030-ebda4f26-4c9b3697-656c991a-7218a9a2.jpg,validate/p16/p16660343/s59592707/a2c79030-ebda4f26-4c9b3697-656c991a-7218a9a2.jpg,validation," WET READ: ___ ___ ___ 10:10 PM Expected tracheostomy appearence. Minimal left basilar scarring. No acute cardiopulmonary process. D/W Dr ___ ___ phone at ___, immediately after discovery. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: New tracheostomy tube, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has undergone tracheostomy. The tracheostomy tube is in expected position. No evidence of pneumothorax, pneumomediastinum or other complications. Normal size of the cardiac silhouette. No pleural effusions, no pulmonary edema. " 6e0701f6-a49eb6fa-5c9adcd3-1ba3444b-52bfc355.jpg,validate/p14/p14252529/s59227295/6e0701f6-a49eb6fa-5c9adcd3-1ba3444b-52bfc355.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cough. 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. IMPRESSION: Normal chest radiograph status post biliary surgery. " ba45d0ec-4b188296-1166ffdc-f7ab8708-0e2e5998.jpg,validate/p15/p15308477/s54387970/ba45d0ec-4b188296-1166ffdc-f7ab8708-0e2e5998.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with dyspnea. Question pneumonia. History of recently biopsied left lung base mass compatible with metastatic melanoma. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___ and ___. Left lower lobe lung mass is again noted. Margins on the current exam are less clearly delineated when compared to pre-biopsy exam, however, appear similar to prior portable exam from ___. There is increased opacity more posteriorly in the left lower lobe, potentially due to consolidation, post-biopsy changes and possible underlying small effusion. Elsewhere, the lungs are clear. Cardiomediastinal silhouette is stable. Left shoulder arthroplasty again noted. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No significant interval change since prior. " 6d947ebf-9ba19e6c-0fc44c44-fa66a95d-7b3d963c.jpg,validate/p11/p11856988/s59819793/6d947ebf-9ba19e6c-0fc44c44-fa66a95d-7b3d963c.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough and shortness of breath. Evaluate for infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate clear, well-expanded lungs. There is moderate hyperexpansion and lucency consistent with emphysema. There is no pleural effusion or pneumothorax. Minimal linear atelectasis or scar is noted in the left mid lung. The cardiac silhouette is top normal in size, the mediastinal contours are normal, with calcification of the aortic knob present. Pleural thickening or effusion is present on the left. IMPRESSION: Emphysema. Atelectasis is a non-specific finding; the examination neither suggests nor excludes the diagnosis of acute pulmonary embolus. " 66b3eaeb-99291e56-e7e5eacd-c29b7450-24e43fdb.jpg,validate/p17/p17699605/s54778546/66b3eaeb-99291e56-e7e5eacd-c29b7450-24e43fdb.jpg,validation," WET READ: ___ ___ 7:55 AM Very low lung volumes cause marked crowding of the bronchovascular structures and infection cannot be excluded. Bilateral lower lobe atelectasis. Repeat radiograph in inspiration are recommended. Right PICC ends in the upper SVC. ___ ___ 23:17. WET READ VERSION #1 ___ ___ 11:19 PM Very low lung volumes cause marked crowding of the bronchovascular structures and infection cannot be excluded. Bilateral lower lobe atelectasis. Repeat radiograph in inspiration are recommended. Right PICC ends in the upper SVC. ___ ___ 23:17. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic hepatitis, s/p 8 day ICU course, d/c CTX couple days ago. Has fever to 100.9. Looking for infectious source. // Evidence of pneumonia? infiltrate? Evidence of pneumonia? infiltrate? IMPRESSION: In comparison with the study of ___, there again are extremely low lung volumes that accentuate the enlargement of the cardiac silhouette. There is more prominence of interstitial markings that could represent pulmonary vascular congestion with basilar atelectatic changes. However, in the appropriate clinical setting, superimposed pneumonia could certainly not be excluded. " bdf9258b-f107abd1-6fa5b29e-6349ab3f-15338bf0.jpg,validate/p13/p13915085/s56545808/bdf9258b-f107abd1-6fa5b29e-6349ab3f-15338bf0.jpg,validation," WET READ: ___ ___ ___ 6:34 PM Increased opacity along the lower spine on the lateral view may represent an infiltrate in the appropriate clinical context. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Permanent pacemaker is in standard position with leads in the right atrium and right ventricle. The heart is mildly enlarged, but there is no evidence of pulmonary edema. Nonspecific area of increased opacity overlies the lower thoracic spine on the lateral view, and could potentially represent an early focus of pneumonia. No pleural effusion. IMPRESSION: Possible early basilar pneumonia, visualized only on the lateral radiograph. " 66cb3065-76d46f24-f79c8372-1d5223c1-78a4c853.jpg,validate/p18/p18391757/s58957429/66cb3065-76d46f24-f79c8372-1d5223c1-78a4c853.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with L rib pain s/p basketball injury // ? 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. IMPRESSION: No acute cardiopulmonary process. " 819423a3-a0ff2364-5a540010-c7d5a268-cc0821cd.jpg,validate/p17/p17527875/s56118958/819423a3-a0ff2364-5a540010-c7d5a268-cc0821cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS wedge resection ___ COMPARISON: Prior study from ___ FINDINGS: PA and lateral views of the chest provided. In this patient with prior right VATS wedge resection, there is a persistent right pleural effusion which is slightly decreased from prior exam. There is associated compressive right lower lobe atelectasis. The left lung remains clear. No pneumothorax is seen. The heart and mediastinal contours are stable and within normal limits. The bony structures are intact. IMPRESSION: Mild interval decrease in right pleural effusion with associated compressive right lower lobe atelectasis. " 3a5614d2-c05258c1-f58e0840-7d6a2d22-811bafc7.jpg,validate/p18/p18747069/s51546104/3a5614d2-c05258c1-f58e0840-7d6a2d22-811bafc7.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Severe COPD. AP radiograph of the chest was compared to prior study obtained a day earlier. The left PICC line tip is at the level of mid SVC. Heart size and mediastinum are unchanged in appearance. Widespread parenchymal opacities appear to be unchanged or minimally worse in the lung bases, potentially reflecting different phase of respiratory cycle. Bilateral pleural effusions are most likely present. " 728b315f-63c43110-51c81ee2-7b75472f-3ff5bfca.jpg,validate/p10/p10398981/s53624608/728b315f-63c43110-51c81ee2-7b75472f-3ff5bfca.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cirrhosis, GIB, septic shock and ARDS // eval for interval change eval for interval change IMPRESSION: Compared to chest radiographs ___ through ___. Severe widespread pulmonary consolidation has improved since ___ probably due to resolving edema or alternatively pulmonary hemorrhage, but pneumonia is unlikely tube decreased so rapidly. Pleural effusions are likely, but not large. Heart is top-normal size. ET tube and right internal jugular line are in standard placements respectively. No pneumothorax. " 73c48080-2a129232-4b84b557-e4a08814-36f5adbe.jpg,validate/p13/p13207128/s51922166/73c48080-2a129232-4b84b557-e4a08814-36f5adbe.jpg,validation," 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. " 91f818cf-81b4ce56-c742cf63-a59ab24e-e12238e4.jpg,validate/p10/p10508292/s58274534/91f818cf-81b4ce56-c742cf63-a59ab24e-e12238e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Myasthenia crisis, on vent, // assess for interval change IMPRESSION: As compared to the recent radiograph of 1 day earlier, there has not been a substantial change in the appearance of the chest. " b8a9fddb-73cc85cd-dbd7e69a-7f85a8fb-67a9e578.jpg,validate/p17/p17989167/s56782590/b8a9fddb-73cc85cd-dbd7e69a-7f85a8fb-67a9e578.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with infected nephrolithiasis s/p removal with rigors // Evidence of pneumonia Evidence of pneumonia COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: In the setting of new pulmonary vascular congestion, symmetric bibasilar interstitial abnormality is probably edema. There is no pneumothorax or appreciable pleural effusion and heart size is normal. A right jugular line ends in the upper SVC. There is no pneumothorax or mediastinal widening. " b6540bc4-a4da1139-55cf33e8-a8c7c112-33a69cdc.jpg,validate/p16/p16446440/s53506548/b6540bc4-a4da1139-55cf33e8-a8c7c112-33a69cdc.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fever and chest pain. 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. " 105455d9-1ba3e937-3dbf97d6-5c8f52d9-71029c56.jpg,validate/p10/p10188275/s58439563/105455d9-1ba3e937-3dbf97d6-5c8f52d9-71029c56.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with tracheobronchomalacia and COPD. Assess for acute changes. Comparison is made with prior study ___. Cardiomegaly and elongated aorta are unchanged. Moderate right pleural effusion has probably increased allowing the difference in positioning of the patient. Bibasilar atelectases have increased on the left. Left perihilar plate-like atelectases are new. There is no pneumothorax. " 471c8b38-8347a33b-8728aa73-3e70bf79-b0d5aebf.jpg,validate/p12/p12643916/s56898663/471c8b38-8347a33b-8728aa73-3e70bf79-b0d5aebf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with eating disorder, syncope 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. " c98f0756-3793569d-c1ddf8aa-a205fabd-dc18b40c.jpg,validate/p10/p10821027/s53144533/c98f0756-3793569d-c1ddf8aa-a205fabd-dc18b40c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: ETT placement. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient has received an endotracheal tube. The tip of the tube projects 4 cm above the carina. The tube could be advanced by 1 cm. No evidence of complications, notably no pneumothorax. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. No focal parenchymal opacities suggesting pneumonia. " 81015333-5caca01c-d5faf72f-4c3168f2-24a6f21e.jpg,validate/p12/p12674071/s55778859/81015333-5caca01c-d5faf72f-4c3168f2-24a6f21e.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with throat tightness and dyspnea. He quit smoking ___ years ago. IMPRESSION: PA and lateral chest compared to ___: Severe pulmonary fibrosis, has been progressing since ___, now severe in the mid and lower lung zones. Heart size is normal and unchanged. There has been a slight increase in fullness in the right tracheobronchial angle, which could be due to lymph node enlargement or azygous distention because of elevated central venous pressure. There are no features about this condition to elevate sarcoidosis as the likely cause, but that does not exclude the diagnosis, particularly since there appears to be adenopathy in the left hilus and perhaps AP window. I attempted to reach Dr. ___ by telephone and reached answering service instead. " ebe6a459-4a73a7c1-85c0b241-fb39a44a-246cb961.jpg,validate/p18/p18770653/s50670252/ebe6a459-4a73a7c1-85c0b241-fb39a44a-246cb961.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Frontal and lateral views COMPARISON: None. FINDINGS: Patchy left lower lobe opacity is worrisome for early /mild pneumonia. The right lung is clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Findings worrisome for early/mild left lower lobe pneumonia. " fba8b7ac-2bd1d941-6be171ce-3a2d737c-d10c3743.jpg,validate/p15/p15625104/s51443173/fba8b7ac-2bd1d941-6be171ce-3a2d737c-d10c3743.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new OGT. // Please confirm OGT placement. COMPARISON: ___ IMPRESSION: As compared to the previous image, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube is not included on the image but the side-hole projects 3-4 cm be low the gastroesophageal junction, indicating correct tube position. No complications. The pre-existing massive changes in both lungs are constant. The endotracheal tube has been slightly pulled back. " 802a6631-0ea5378c-acd3d857-ec25e16b-6abda874.jpg,validate/p17/p17925249/s50056334/802a6631-0ea5378c-acd3d857-ec25e16b-6abda874.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Right upper quadrant and rib pain on the right. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size to perhaps slightly enlarged. 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. Borderline cardiomegaly. " 79e31b4f-e4e570fd-6ae3f6a8-b93d5f98-6b10b055.jpg,validate/p19/p19252503/s57519149/79e31b4f-e4e570fd-6ae3f6a8-b93d5f98-6b10b055.jpg,validation," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with cough, R base rales. Assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, and ___. FINDINGS: The heart size is top normal, unchanged. The tortuous aorta is also unchanged. Lungs are clear without effusion, pneumothorax, or focal consolidation concerning for pneumonia. An opacity projecting over the heart on the lateral view is unchanged since ___ and is likely an extensive fat pad. IMPRESSION: No evidence of pneumonia. " ee197523-d2f7cfff-a9e6f1e3-dce9c5a6-48160bc3.jpg,validate/p13/p13412761/s50193514/ee197523-d2f7cfff-a9e6f1e3-dce9c5a6-48160bc3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough // eval for infiltrate 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. " 56d0aef6-1651504e-2e373c21-f1fd3543-3b6bef1d.jpg,validate/p16/p16260390/s51723187/56d0aef6-1651504e-2e373c21-f1fd3543-3b6bef1d.jpg,validation," FINAL REPORT HISTORY: Hypotension, to assess for lung pathology. 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. " 5f8fede2-958897d7-09bd5dbb-ca616938-1d50d974.jpg,validate/p15/p15057814/s53713146/5f8fede2-958897d7-09bd5dbb-ca616938-1d50d974.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with shortness of breath. hx of mitral regurg. 2d post-op from c-section // ?pneumonia or pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: No pleural effusion or pneumothorax. Bilateral infrahilar parenchymal opacities is probably atelectasis. There is pulmonary vascular congestion. There is mild to moderate interstitial edema. The heart is top-normal in size. IMPRESSION: Findings suggestive of volume overload/heart failure. No definite pneumonia. " 1692627f-cb5595da-87eb1991-2af0577d-997bc504.jpg,validate/p19/p19229277/s59575557/1692627f-cb5595da-87eb1991-2af0577d-997bc504.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p esohpagectomy // interval change interval change IMPRESSION: In comparison with the study of ___, there are slightly lower lung volumes. Retrocardiac opacification is again seen, consistent with volume loss in the left lower lobe and pleural fluid. Hazy opacification in the right hemithorax could reflect some layering effusion. There is evidence of pulmonary vascular congestion as well as a continued streak of atelectasis in the left mid-zone. There may be a small left apical pneumothorax which, in retrospect, may have been also present on the previous study. " f68f036e-76f35b6e-e995567f-a060653c-367b8f25.jpg,validate/p10/p10781100/s55616892/f68f036e-76f35b6e-e995567f-a060653c-367b8f25.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Focal consolidation in the left retrocardiac region with adjacent area of linear atelectasis appears unchanged since the recent study of several hours earlier. Remainder of the exam is also similar allowing for technical differences. " ac68a194-14edacda-5637f04a-2c58cfef-fcfaa7a9.jpg,validate/p13/p13276258/s54259189/ac68a194-14edacda-5637f04a-2c58cfef-fcfaa7a9.jpg,validation," FINAL REPORT INDICATION: Right upper quadrant abdominal pain and hypertension. History of metastatic renal cell carcinoma. The patient transferred emergently from MRI. COMPARISONS: Outside radiograph ___. FINDINGS: AP chest radiograph demonstrates diffuse pulmonary opacities particularly involving the right upper lobe and left lung base. These findings are markedly worsened from ___, suggesting worsening metastatic disease, though a superimposed infection is possible. The lung volumes are low. There is no pneumothorax or large pleural effusion. The heart size is normal. " e90d7a61-f9e1f13b-1b4098d9-bd4df181-bc12ddc8.jpg,validate/p15/p15957987/s57387096/e90d7a61-f9e1f13b-1b4098d9-bd4df181-bc12ddc8.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with recurrent pleural effusion and pneumothorax status post PleurX catheter placement. Assess for interval change. COMPARISON: Chest radiograph from ___ and chest CT from ___. PORTABLE FRONTAL CHEST RADIOGRAPH: An esophageal stent is in unchanged position. A left Port-A-Cath terminates in the right atrium, unchanged from prior. A left PleurX drain terminates in the medial left lung base. There is a persistent left apical pneumothorax, though it has decreased in size since the most recent prior examination. A small right pleural effusion and right basilar atelectasis appear unchanged from prior. There is overall improved aeration of the left lung base which may be secondary to reduction in the left pleural effusion or possibly decreased atelectasis. The cardiomediastinal and hilar contours are within normal limits and unchanged. IMPRESSION: 1. Interval decrease in size of left apical pneumothorax, now small. 2. Improved aeration of the left lung base either due to decrease in left pleural effusion or decreased atelectasis. " 6df387c0-28792a11-31c968a4-1a6213f9-9d66e4ac.jpg,validate/p15/p15403575/s50296488/6df387c0-28792a11-31c968a4-1a6213f9-9d66e4ac.jpg,validation," FINAL REPORT INDICATION: ___ year old man with pancreatitis, recent aspiration PNA/HCAP in setting of ileus, ?cavitary lesion seen on CXR ___ // assess presence of ?cavitary lesion TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and CT scan FINDINGS: Heterogeneous consolidation throughout the right lung Has progressed, and continues to have a nodular quality. Heterogeneous consolidation in left lower lobe is new compared to recent radiographs. Bilateral diffuse septal thickening involving the right lung to a greater degree than the left has worsened. Small pleural effusions are present bilaterally. Cardiomediastinal contours are unchanged IMPRESSION: Worsening multifocal pneumonia in the right lung, possibly due to aspiration. Atypical and opportunistic infections are also possible given the nodular component. Diffuse interstitial opacities atypical may be related to infection or coexisting edema. " 8c7c03f2-66e5fce4-631c079f-ffdca933-fb8e44e4.jpg,validate/p18/p18211216/s53400006/8c7c03f2-66e5fce4-631c079f-ffdca933-fb8e44e4.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with uterine cancer on chemotherapy, now with new cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are essentially clear except for questionable opacity projecting over the left apex, most likely representing summation of shadows. To exclude the possibility of developing infection in this location, repeated radiograph in lordotic projection is recommended. Nephrostomy is projecting over the left upper quadrant. " 1540f1fe-1f477ab0-c4509b4b-67f2e10e-1b8d3b09.jpg,validate/p17/p17800072/s58390202/1540f1fe-1f477ab0-c4509b4b-67f2e10e-1b8d3b09.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with altered mental status. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal AP and lateral views of the chest were obtained. Increased heterogenous opacity in the left lower lobe may represent infection in the appropriate clinical setting. The remainder of the lungs are clear aside from mild right basilar atelectasis. Trace pleural effusions are difficult to exclude bilaterally, with blunting of the posterior costophrenic angles on the lateral view. No pneumothorax. Cardiac and mediastinal silhouettes and hilar contours are normal. IMPRESSION: Heterogenous left lower lobe opacity may represent pneumonia in the appropriate clinical setting. Trace bilateral pleural effusions. " bdfbb5e1-e5841d8e-b7936481-e2284aae-18a19e7c.jpg,validate/p14/p14189406/s56916321/bdfbb5e1-e5841d8e-b7936481-e2284aae-18a19e7c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ___ y/o M with h/o TBI --> AMS, worsening respiratory status // Evaluate for worsening interval pulmonary or cardiac disease COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The lung volumes are low. The known perihilar parenchymal opacity on the left is of unchanged extent and severity. Unchanged platelike atelectasis at the right lung base. No pleural effusions. Mild cardiomegaly. No pneumothorax. The right PICC line is constant in position. " 3daad974-3ac43ce7-a0d13eba-661e3d8a-3658467e.jpg,validate/p15/p15143312/s59703213/3daad974-3ac43ce7-a0d13eba-661e3d8a-3658467e.jpg,validation," WET READ: ___ ___ ___ 11:38 AM Multifocal, bilateral lower lobe regions of consolidation compatible with pneumonia in the proper clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with cough, fevers // ? pneumonia TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: Multi focal opacities are identified in the lungs, specifically with perihilar and retrocardiac opacities on the left. Right basilar opacity is also noted, potentially in the lower lobe based on lateral view. Superiorly the lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Multifocal, bilateral lower lobe regions of consolidation compatible with pneumonia in the proper clinical setting. " a39e74ce-1616b824-21857514-ba0a84d2-5b29ec86.jpg,validate/p11/p11053913/s53503744/a39e74ce-1616b824-21857514-ba0a84d2-5b29ec86.jpg,validation," FINAL REPORT INDICATION: Chest pain, evaluate for acute cardiopulmonary process. COMPARISON: None. FINDINGS: The right costophrenic angle is excluded from these radiographs. The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary process. " 4652256d-e0c7a114-a8110418-4507b405-d9ad35a8.jpg,validate/p10/p10235789/s59880759/4652256d-e0c7a114-a8110418-4507b405-d9ad35a8.jpg,validation," FINAL REPORT AP CHEST, 11:06 P.M., ___ HISTORY: ___-year-old man fell with rib and intracranial injuries, now hypoxic. IMPRESSION: AP chest compared to ___, 2:34 p.m.: New opacification at the lung bases is probably atelectasis, left more severe than right. Upper lungs grossly clear. No pneumothorax or pleural effusion. Heart size is normal. " e9d1d866-3e8a7587-2cb3d59f-78cddd2f-f9b99785.jpg,validate/p10/p10423466/s55702195/e9d1d866-3e8a7587-2cb3d59f-78cddd2f-f9b99785.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: New brain lesion, question infiltrate. 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. Please note that CT is more sensitive in detecting small pulmonary nodules. " 15f169d6-0d9b3afe-eb2c7342-3d43c5e8-30967573.jpg,validate/p18/p18699523/s59643140/15f169d6-0d9b3afe-eb2c7342-3d43c5e8-30967573.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleuritic type right-sided chest pain. Evaluation for opacities. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have decreased and the size of the cardiac silhouette has minimally increased. There is no evidence of pleural effusions, and no evidence of acute or chronic lung parenchymal abnormalities. The appearence of the hilar and mediastinal contours are unchanged. " 3b58accd-f3766f11-68dbea9b-18392fa1-9eeea416.jpg,validate/p10/p10380296/s50914986/3b58accd-f3766f11-68dbea9b-18392fa1-9eeea416.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SOB // interval change, why decr breath sounds on L interval change, why decr breath sounds on L COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Lung volumes are lower today than 9 have been on prior chest radiographs. Left lower lobe is probably collapsed accompanied by moderate left pleural effusion. Since the mediastinum has widened since ___, bleeding, with or without unstable pseudoaneurysm, in both the mediastinum and pleural space may well be present. Moderate enlargement of cardiac silhouette is stable. The configuration of the aortic endo graft is unchanged. Findings of the subsequent chest radiograph available at the time of this review were reported to the clinical care team. NOTIFICATION: Dr. ___ reported the findings to Dr ___ by telephone on ___ at 10:07 AM, 20 minutes the initial page immediately after discovery of the findings. " 69dd95ae-bf4a8722-d95a924a-c2362665-ad3d25cb.jpg,validate/p10/p10393955/s50223235/69dd95ae-bf4a8722-d95a924a-c2362665-ad3d25cb.jpg,validation," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old female with chest wall pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Again seen are relatively low lung volumes. The lungs are grossly 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. " fdcf56af-aee71434-71793b68-1e3ed2da-706367d1.jpg,validate/p13/p13826980/s52334852/fdcf56af-aee71434-71793b68-1e3ed2da-706367d1.jpg,validation," 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 ___. " ccf067c3-49b92a4a-be262606-e77c524e-ca3655f1.jpg,validate/p19/p19014160/s50750189/ccf067c3-49b92a4a-be262606-e77c524e-ca3655f1.jpg,validation," 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, focal consolidation or pneumothorax is present. There are no acute osseous abnormalities, including no displaced fractures. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture is seen. If there is continued concern, a dedicated rib series can be obtained. " 96879d30-9cd77041-803a9c02-3b9f2af0-a9c13e7f.jpg,validate/p14/p14073122/s56434470/96879d30-9cd77041-803a9c02-3b9f2af0-a9c13e7f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness COMPARISON: CT chest ___, and CXR ___ FINDINGS: There is no focal consolidation, effusion, or pneumothorax. Hyperexpanded lungs and attenuation of pulmonary vessels in the upper lobes are compatible with mild centrilobular emphysema as seen on the prior CT chest. The cardiomediastinal silhouette is normal. No free air below the diaphragms seen. IMPRESSION: No acute intrathoracic process. Mild emphysema. " 8f83fe63-98271055-6d72e86b-6e82e1e5-50434fe5.jpg,validate/p15/p15388421/s51465340/8f83fe63-98271055-6d72e86b-6e82e1e5-50434fe5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with esophagectomy c/b leak // r/o pulm edema, ptx, pleural effusion, pna, pls perform as close to 5 AM as possible r/o pulm edema, ptx, pleural effusion, pna, pls perform as close to 5 AM as possible IMPRESSION: In comparison with the study of ___, the patient has taken a slightly better inspiration, which most likely is responsible for the slight improvement in the opacification at the right base consistent with a combination of atelectatic changes and pleural fluid. Right chest tube remains in place and there is no definite pneumothorax. Left basilar opacification is consistent with pleural fluid and volume loss in the left lower lobe. Otherwise little change. " 39f163a6-e3c3d37b-dea835d0-09555abd-36c3292a.jpg,validate/p15/p15199994/s52012049/39f163a6-e3c3d37b-dea835d0-09555abd-36c3292a.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with ___'s disease, seizures, and dysphagia with NG tube potentially out of place, assess position. COMPARISONS: ___. FINDINGS: Nasogastric tube courses into the stomach, curls back upon itself, and terminates in the proximal body. The lungs are well expanded with linear atelectasis, but no focal consolidation and perhaps trace pleural effusion on the left. The cardiomediastinal contours are unremarkable. Multiple old rib fractures are seen bilaterally. IMPRESSION: Nasogastric tube curled within the stomach as before. " fa342168-edb15ec6-c563b4ba-615a8586-02030b0d.jpg,validate/p12/p12498222/s59869128/fa342168-edb15ec6-c563b4ba-615a8586-02030b0d.jpg,validation," 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. " 4cee23a3-9a838075-97192d17-d8df7e81-2c1b7d45.jpg,validate/p10/p10972707/s53362586/4cee23a3-9a838075-97192d17-d8df7e81-2c1b7d45.jpg,validation," FINAL REPORT INDICATION: Left jaw tingling as well as mid substernal chest heaviness. Evaluate for acute process. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest were acquired. Compared to the prior radiographs from ___, there is new mild right cardiac enlargement as well as engorgement of the superior mediastinal vasculature, without evidence of interstitial pulmonary edema. No focal consolidations are seen. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: New mild right cardiac enlargement and prominence of the superior mediastinal vasculature could relate to a right-sided cardiac process, for which further evaluation with an echocardiogram may be performed. Findings and recommendation were discussed with Dr. ___ by Dr. ___ ___ via telephone at 4:05 p.m. on the day of the study. " ac1b5e4a-fad96c19-6bb6db21-e2ef2f0f-8b5b9b0d.jpg,validate/p13/p13821814/s57932582/ac1b5e4a-fad96c19-6bb6db21-e2ef2f0f-8b5b9b0d.jpg,validation," FINAL REPORT HISTORY: Febrile neutropenia. COMPARISON: ___, ___. FINDINGS: PA and lateral chest radiographs were obtained. The lungs are well expanded. There is no focal consolidation or pneumothorax. Bilateral pleural effusions are small. The cardiac and mediastinal contours are normal. A right-sided PICC line has been removed since the prior exam. IMPRESSION: Bilateral small pleural effusions. " 0aa111a4-9a4a60de-572fb9f4-d655719b-318eb851.jpg,validate/p19/p19453522/s54155014/0aa111a4-9a4a60de-572fb9f4-d655719b-318eb851.jpg,validation," FINAL REPORT HISTORY: Cirrhosis and pleural effusion. Evaluate for interval change in the pleural effusion. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph without recurrence of pleural effusion. " dcdc908d-8f4a46cf-0dff1d17-7bf04375-a24a33a8.jpg,validate/p13/p13989850/s53791685/dcdc908d-8f4a46cf-0dff1d17-7bf04375-a24a33a8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary abscess, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes, borderline size of the cardiac silhouette. No pneumonia. No pleural effusions. No pulmonary edema. Normal aspect of the hilar and mediastinal structures. " 3932c26b-7ecd577e-1bd501d7-2fca2617-56c9bce8.jpg,validate/p10/p10706648/s58892567/3932c26b-7ecd577e-1bd501d7-2fca2617-56c9bce8.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever, cough, shortness of breath and fatigue. 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. The bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " 2db48c53-2e91e030-73f53916-68c3c3fb-bb6187b6.jpg,validate/p14/p14198038/s52164094/2db48c53-2e91e030-73f53916-68c3c3fb-bb6187b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough. History of tobacco abuse. // assess for infiltrate TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiographs dated ___. FINDINGS: There is no focal consolidation, effusion, or pneumothorax. Mild left basilar atelectasis. Mediastinum, hila and pleural surfaces are unremarkable. Heart size is normal. Mild unfolding and tortuosity of the thoracic aorta. Moderate-sized hiatal hernia containing possible retained oral contrast in the dependent portion is noted. IMPRESSION: 1. No evidence of pneumonia. Mild left basilar atelectasis. 2. Moderate size hiatal containing probable retained oral contrast. " 39f05b5d-07795b5b-5aaffa18-30527771-06506477.jpg,validate/p13/p13693730/s58313525/39f05b5d-07795b5b-5aaffa18-30527771-06506477.jpg,validation," 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. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities seen. Several ossific densities are noted about the right acromioclavicular joint, likely the sequela of previous injury. Mild degenerative changes are also noted involving the left acromioclavicular joint and within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 83442373-fb4391ae-7904dc07-1e4b37f7-f05e398e.jpg,validate/p11/p11708364/s53948969/83442373-fb4391ae-7904dc07-1e4b37f7-f05e398e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with POD___ s/p lap hernia repair w/ vasovagal event // any radiographic findings of cardiopulmonary pathology COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. Borderline size of the cardiac silhouette. Atelectasis at the left lung bases. No pneumonia, no pulmonary edema. There might be a minimal right pleural effusion. " b453fcc4-96aae899-ee963497-3c37f879-d7182af9.jpg,validate/p19/p19132474/s58860802/b453fcc4-96aae899-ee963497-3c37f879-d7182af9.jpg,validation," 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. " 7609c265-c0d5c750-4df31598-97759661-7a5d3985.jpg,validate/p17/p17927957/s57825932/7609c265-c0d5c750-4df31598-97759661-7a5d3985.jpg,validation," WET READ: ___ ___ ___ 9:13 PM Nasogastric tube tip projects over left upper quadrant, likely within the stomach. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:37 P.M. ___ HISTORY: ___-year-old woman with SBO and high nasogastric tube output. Check tube position. IMPRESSION: AP chest compared to ___: Nasogastric tube ends in the mid stomach. An elliptical opacity projecting over the right mid lung is either atelectasis or small amount of fluid in the minor fissure. Small band of atelectasis crosses the left lower lung. Heart size is top normal or minimally enlarged. Lungs are clear. There is no pleural effusion elsewhere. " 2404c212-a16717a7-5f61fc7f-747667c1-ed817a00.jpg,validate/p13/p13855132/s56427095/2404c212-a16717a7-5f61fc7f-747667c1-ed817a00.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxic resp failure // interval change; consider diuresis/extubation interval change; consider diuresis/extubation IMPRESSION: In comparison with the study ___ ___, the monitoring and support devices are essentially unchanged. Cardiac silhouette remains mildly enlarged with moderate pulmonary edema. Continued left effusion with volume loss in the lower lobe. The right hemidiaphragm is more sharply seen, though there is still residual fluid with basilar atelectasis. " 823e4217-3e8e4835-db73ea40-bb07e51e-b664e5bd.jpg,validate/p17/p17647154/s50915793/823e4217-3e8e4835-db73ea40-bb07e51e-b664e5bd.jpg,validation," FINAL REPORT INDICATION: ___-year-old female status post chest tube removal. COMPARISON: ___. The patient has been extubated and a nasogastric tube, mediastinal drain, and bilateral chest tubes have been removed. A right IJ sheath extends into the upper SVC, though prior pulmonary arterial catheter is absent. There are bilateral pleural effusions, small to large moderate in size, which are new. There is also a new moderate right apical pneumothorax, measuring approximately 3.5 cm at the apex and extending to the fifth rib posteriorly. There is no left pneumothorax. There is no pneumomediastinum or pneumopericardium. Hilar and cardiomediastinal contours are unremarkable. There is bibasilar atelectasis. There is no evidence of pneumonia. IMPRESSION: 1. Interval extubation and removal of chest tubes and mediastinal drains. 2. New 3.5 cm moderate right apical pneumothorax. 3. New bilateral pleural effusions with associated atelectasis. ___ was informed of these findings at 9:30 a.m. on ___ via phone by Dr. ___. " c6dd05c3-d7e57594-b387edc3-fe1d54be-bfd5f6f4.jpg,validate/p11/p11528413/s51450305/c6dd05c3-d7e57594-b387edc3-fe1d54be-bfd5f6f4.jpg,validation," 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. " c3ccd392-f72ad233-a9b3d7a5-e6c3ab3e-527681d2.jpg,validate/p17/p17413636/s56657549/c3ccd392-f72ad233-a9b3d7a5-e6c3ab3e-527681d2.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: ___-year-old female with low sats/cough. COMPARISON: None. FINDINGS: Single frontal view of the chest was obtained. Relative increased opacity at the right lung base could be due to underlying infection or aspiration. If the patient is able, PA and lateral views would be helpful for further evaluation. Left lung clear. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Increased opacity at the right lung base could be due to atelectasis, although underlying consolidation due to infection not excluded. If patient able, repeat dedicated PA and lateral views would be helpful for further evaluation. " 8ab5a4dc-0f8769ec-2462b91f-728e4181-18e70058.jpg,validate/p12/p12486660/s50629216/8ab5a4dc-0f8769ec-2462b91f-728e4181-18e70058.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Mild degenerative spurring is noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 15ce1e40-41553e4c-39a67b20-39fb3fde-4c2a9507.jpg,validate/p16/p16997368/s52706607/15ce1e40-41553e4c-39a67b20-39fb3fde-4c2a9507.jpg,validation," FINAL REPORT CLINICAL HISTORY: COPD, admitted with exacerbation. CHEST, PA AND LATERAL COMPARISON: Outside chest ___, 10:00 a.m. The heart and mediastinum are normal. The lung fields are clear. Costophrenic angles are sharp. No acute infiltrates present. The kyphoscoliosis is seen. There has been no significant change since the prior chest x-ray. " d7f45831-31e2fa19-d80264dc-c8b6908f-b129eaff.jpg,validate/p16/p16289699/s56219982/d7f45831-31e2fa19-d80264dc-c8b6908f-b129eaff.jpg,validation," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old male with shortness of breath and wheeze, history of inferior MI and reactive airway disease. Question effusion. FINDINGS: Single portable view of the chest is compared to previous exam from ___. When compared to prior, there has been interval increase in size of the right-sided pleural effusion. Right upper lung and left lung remain clear. Triple-lead pacing device is again noted. Cardiac silhouette remains difficult to assess given size of effusion. Osseous and soft tissue structures are grossly unchanged. IMPRESSION: Interval enlargement of the right-sided pleural effusion. Otherwise, no change. " 4ff5a6f5-eb55e0c1-ceefeb01-0d5eedd1-72c51a23.jpg,validate/p15/p15762119/s56743758/4ff5a6f5-eb55e0c1-ceefeb01-0d5eedd1-72c51a23.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Left-sided thoracocentesis, known very small left-sided pneumothorax. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The known small left pneumothorax is still not visible. The pre-existing rib changes as well as the cardiomegaly with mild fluid overload and the changes in both humeral heads are constant. " b951c94c-bc3a2b3d-c15c74b6-e0fe9200-ce5cf253.jpg,validate/p15/p15906640/s54746882/b951c94c-bc3a2b3d-c15c74b6-e0fe9200-ce5cf253.jpg,validation," WET READ: ___ ___ ___ 9:57 PM Retrocardiac opacity is concerning for pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Retrocardiac opacity, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has developed a new retrocardiac opacity that could be early pneumonia or atelectasis. Unchanged size of the cardiac silhouette. Unchanged position of the Port-A-Cath. No pulmonary edema. No pleural effusions. " a26c9959-96ddc93d-7576d633-7fe51ea0-7e9f6ab8.jpg,validate/p15/p15485853/s58920797/a26c9959-96ddc93d-7576d633-7fe51ea0-7e9f6ab8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man sp thoracotomy for retained hemothorax // ptx TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 8 hours earlier IMPRESSION: Bibasilar atelectasis have markedly worsened on the right. Bilateral effusions are stable. There is no pneumothorax. Mild to moderate pulmonary edema is unchanged. Cardiac size cannot be evaluated. Widening mediastinum is unchanged. Lines and tubes are in unchanged standard position " 5d6164d7-057e6159-87aaabfb-2eb594a0-1cdf7904.jpg,validate/p17/p17642642/s53595190/5d6164d7-057e6159-87aaabfb-2eb594a0-1cdf7904.jpg,validation," 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. " c0388ad7-0df56f2c-4958a37e-70da90d9-16591dc5.jpg,validate/p15/p15188685/s59810511/c0388ad7-0df56f2c-4958a37e-70da90d9-16591dc5.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Intubated patient. Patient has meningitis. Comparison is made with prior study, ___. Cardiac size is top normal. The aorta is tortuous. Bibasilar opacities larger on the left side are a combination of pleural effusion and atelectasis. There is no pulmonary edema or pneumothorax. Line and tubes are in standard position. " 1d9fea9f-11986dc0-a52657a3-313ae255-5b0ad06f.jpg,validate/p15/p15657398/s51296119/1d9fea9f-11986dc0-a52657a3-313ae255-5b0ad06f.jpg,validation," FINAL REPORT HISTORY: An ___-year-old female with cough and fever. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The heart size is within normal limits. The mediastinal contours are within normal limits. The lungs demonstrate airspace opacity in the left base with small left pleural effusion. There is no pneumothorax. IMPRESSION: Left basal consolidation compatible with pneumonia with a small left parapneumonic effusion. " b7605da1-11fc2a92-7ce4fea0-d5e717ce-c7e4301f.jpg,validate/p10/p10203225/s56389180/b7605da1-11fc2a92-7ce4fea0-d5e717ce-c7e4301f.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with past pulmonary embolism. Pre-V/Q scan, radiograph. COMPARISON: Radiograph of the chest dated ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate pulmonary vascular enlargement, right greater than left, corresponding to enlargement of the right pulmonary artery. The heart is mildly enlarged. There is scarring at the bilateral apices. There is no pneumothorax, consolidation, or pleural effusion. There are multiple well-healed old right sided rib fractures. IMPRESSION: Enlarged pulmonary arteries, right greater than left. " dcc8f723-2cf81b95-e24bf7ca-4fadbd9b-889029fc.jpg,validate/p10/p10924565/s56160441/dcc8f723-2cf81b95-e24bf7ca-4fadbd9b-889029fc.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with LLL mass and endobronchial lesion s/p bronch with biopsy on ___ // eval for pneumothorax TECHNIQUE: Portable chest radiograph COMPARISON: None available. FINDINGS: There is ill-defined hazy opacification noted in the left retrocardiac region. Given recent endobronchial biopsy in this region, this may represent edema vs. bleeding or both. There is atelectasis at the right lung base. There are no pleural effusions or pneumothorax. Cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Ill-defined hazy opacity in the left retrocardiac region, which may represent post-biopsy bleeding vs. edema. 2. No pneumothorax. " 75fdbd05-8220c8ea-b634dffd-fe4faa66-193559b1.jpg,validate/p19/p19946917/s50058033/75fdbd05-8220c8ea-b634dffd-fe4faa66-193559b1.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with history of positive PPD with night sweats. FINDINGS: PA 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 radiographic evidence of active tuberculosis. " f8805834-53e2bd3e-5dd3b39f-9f9d5ab6-685dafe9.jpg,validate/p19/p19551039/s50105768/f8805834-53e2bd3e-5dd3b39f-9f9d5ab6-685dafe9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, L pleuritic pain // r/o pna COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pleural effusions, no pulmonary edema. No pneumothorax. The ribcage appears unremarkable. " b9570a3b-7733eeb9-fd95e265-519e1210-7c769aac.jpg,validate/p17/p17748848/s55256296/b9570a3b-7733eeb9-fd95e265-519e1210-7c769aac.jpg,validation," 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. " f56fed8e-c37ce724-f79fe55c-14c787e9-fd5c8e5f.jpg,validate/p16/p16560117/s54798309/f56fed8e-c37ce724-f79fe55c-14c787e9-fd5c8e5f.jpg,validation," FINAL REPORT HISTORY: Infection. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are mildly hyperexpanded but clear. There is no pleural effusion or pneumothorax. The heart is moderately enlarged with post CABG changes. IMPRESSION: No acute intrathoracic process. " c5bdb663-eac3094c-a6ad2831-3add3302-1ea29c9c.jpg,validate/p17/p17995948/s58026314/c5bdb663-eac3094c-a6ad2831-3add3302-1ea29c9c.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: None available. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: The cardiac silhouette is moderately enlarged and is slightly exaggerated by AP technique. The mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Moderate-to-severe cardiomegaly without evidence of pulmonary edema or congestion. No focal consolidation worrisome for pneumonia. " 5637271e-a7273a2d-cb1fcca3-b2c09e03-6fb71a9c.jpg,validate/p19/p19262736/s56956276/5637271e-a7273a2d-cb1fcca3-b2c09e03-6fb71a9c.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hypoxia evaluate for interval change. TECHNIQUE: Frontal view of the chest. COMPARISON: ___. FINDINGS: A right PICC has been retracted and ends in the upper superior vena cava. Right lower lobe collapse has improved. Left lower lobe collapse has worsened. Parenchymal opacities are unchanged on the right and worse on the left. Mild pulmonary vascular congestion is also unchanged. The cardiac and mediastinal contours are stable. IMPRESSION: 1. Improved right lower lobe collapse. New left lower lobe collapse. 2. Parenchymal opacities are unchanged on the right and worse on the left. 3. Retraction of the PICC, now terminating in the upper superior vena cava. " 7865bb2e-958d064b-2b092fad-b597c7b8-41a6a2a2.jpg,validate/p10/p10913302/s53591858/7865bb2e-958d064b-2b092fad-b597c7b8-41a6a2a2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hx of pneumo removed chest tube ___ // evaluate pneumo? TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There is no evident pneumothorax. There are low lung volumes. Mild vascular congestion is stable. Bibasilar atelectasis larger on the right side are minimally increased on the right. Right chest wall subcutaneous emphysema has improved. Right port a cath tip is in the cavoatrial junction. Cardiomediastinal contours are unchanged. There appears to be a small right pleural effusion " 9ae1103d-5221b3eb-3e5bf812-f9142dad-b2597350.jpg,validate/p12/p12885823/s51584768/9ae1103d-5221b3eb-3e5bf812-f9142dad-b2597350.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of Crohn's disease, evaluation, cough, fever, wheezing. COMPARISON: No comparison available at the time of dictation. FINDINGS: A parenchymal opacity with peribronchial location and air bronchograms is seen in the lingula. In light of the clinical presentation of the patient, this abnormality represents pneumonia. At the time of observation and dictation, the referring physician, ___. ___ was paged for notification, 11:36 a.m., on ___, and the findings were subsequently discussed over the telephone. There is no evidence of pleural effusion or other complication. The lung parenchyma looks otherwise normal. Normal aspect of the heart and the mediastinum. " e5375a16-8332a777-853f7b2d-a52b5f3b-00c24599.jpg,validate/p13/p13446510/s50161368/e5375a16-8332a777-853f7b2d-a52b5f3b-00c24599.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R pneumothorax s/p pigtail // compare to prior COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the extent of the right pneumothorax has decreased. The pneumothorax is 3-4 mm wide, there is no evidence of tension. No change in position of the right pigtail catheter and of the right pectoral Port-A-Cath. " 005e83aa-06d68b30-f230b4fb-e6b0a2c0-e0335db0.jpg,validate/p17/p17219587/s54099904/005e83aa-06d68b30-f230b4fb-e6b0a2c0-e0335db0.jpg,validation," WET READ: ___ ___ ___ 12:35 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness, evaluate for pneumonia. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: None. FINDINGS: A right total shoulder prosthesis is noted. A rounded calcific density measuring approximately 5 mm overlying the left sternoclavicular joint is consistent with a granuloma. There is no focal consolidation, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Slight density posterior to the right hemidiaphragm may represent mild pleural thickening or a tiny right effusion. IMPRESSION: Possible tiny left pleural effusion. " 286593f1-f11c4633-542da550-b9bc54f4-340cf58a.jpg,validate/p11/p11668433/s54123139/286593f1-f11c4633-542da550-b9bc54f4-340cf58a.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Brain injury, intubated patient. Comparison is made with prior study performed a day earlier. Mild cardiomegaly is stable. ET tube is in standard position. NG tube tip is out of view below the diaphragm. Large bilateral pleural effusions with associated atelectasis are likely unchanged, allowing the difference in positioning of the patient. " dae539d7-9790d72e-9c8fe75b-2a46de7e-95f48fa3.jpg,validate/p13/p13621809/s50061714/dae539d7-9790d72e-9c8fe75b-2a46de7e-95f48fa3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old woman with R MCA stroke, c/f acute MI, persistent cough // ?PNA COMPARISON: CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY ___. IMPRESSION: Previous mild pulmonary edema is unchanged. Heart is top-normal or mildly enlarged, unchanged, but small pleural effusions are new. No pneumothorax. No pulmonary consolidation. " 0116939b-6160dd9b-1cd67a35-121cdb18-cb5ae954.jpg,validate/p11/p11026100/s57132618/0116939b-6160dd9b-1cd67a35-121cdb18-cb5ae954.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with rigors, fever, rule out air under diaphragm or other pulmonary process. COMPARISON: ___ at 5:41 a.m. FINDINGS: Left lower lobe opacity has resolved rapidly consistent with atelectasis. There is no new consolidation. Mediastinal and cardiac contours are top normal. There is no pleural effusion or pneumothorax. CONCLUSION: There is no evidence of pneumonia. " fbefb0fd-ddecd20c-dcfa7e20-bad57b45-b271d316.jpg,validate/p10/p10589679/s54345538/fbefb0fd-ddecd20c-dcfa7e20-bad57b45-b271d316.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with one week history of diffuse body pains, weakness, and arthralgias. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. There is subtle opacification at the bilateral lung apices, suggestive of scarring which was better evaluated on the prior CT chest dated ___. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are identified. There is no free air under the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 5c105742-95fa1fb9-006e484b-f9873e59-b8fc12da.jpg,validate/p11/p11801344/s50398172/5c105742-95fa1fb9-006e484b-f9873e59-b8fc12da.jpg,validation," FINAL REPORT HISTORY: Cough and fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are within normal limits. The lungs are clear and the pulmonary vasculature normal. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormalities are demonstrated. IMPRESSION: No acute cardiopulmonary process. " 0a6a3c4e-bc7e2f53-52fe87c2-927ddbc1-fe2eb569.jpg,validate/p15/p15345462/s52468354/0a6a3c4e-bc7e2f53-52fe87c2-927ddbc1-fe2eb569.jpg,validation," WET READ: ___ ___ ___ 12:28 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M w/chest pain and fever, please eval for pna, mediastinal widening // ___M w/chest pain and fever, please eval for pna, mediastinal widening 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. IMPRESSION: No acute cardiopulmonary abnormality. " ce9bf375-e929ef5e-6b5b6f76-d30f67dc-6f1965d6.jpg,validate/p12/p12878814/s57587494/ce9bf375-e929ef5e-6b5b6f76-d30f67dc-6f1965d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CTs // CT placement TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: Lung volumes have improved when compared to the prior study. There is unfolding of the right pigtail catheter where it enters the pleural space. There is improved aeration of the right lung however there is residual airspace opacity possibly reflecting re-expansion pulmonary edema. Scattered air bronchograms are noted. The left lung is relatively clear with patchy areas of airspace opacity in the left base. The left-sided pigtail catheter is similar in appearance when compared to the prior study. A tunneled right intern middle jugular catheter terminates near the cavoatrial junction. No pneumothorax seen. IMPRESSION: Improved aeration of the right lung and decreased in the right pleural effusion. " 1387a41a-df496dee-432507bb-eea46f65-ad05d361.jpg,validate/p16/p16159749/s50937178/1387a41a-df496dee-432507bb-eea46f65-ad05d361.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST: REASON FOR EXAM: Recent Influenza infection. expiratory wheeze at right base. There are faint opacities in the lower lobes bilaterally. These could be due to recent influenza infection. There is no evidence of lobar pneumonia, pneumothorax or pleural effusion. The lungs are hyperinflated. There are moderate-to-severe degenerative changes in the thoracic spine. " 81ae071b-4d39c4b3-9342ee5e-01c49732-1c216a88.jpg,validate/p19/p19232186/s51130213/81ae071b-4d39c4b3-9342ee5e-01c49732-1c216a88.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion, arrythmia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy. Heart size is normal. Mediastinal and hilar contours are unremarkable, and the pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " 361db4f9-e3508af4-1e934e10-92c49ee4-88aea458.jpg,validate/p15/p15811084/s55956821/361db4f9-e3508af4-1e934e10-92c49ee4-88aea458.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man POD___ s/p lap esophagectomy w fever // intrathoracic infection, interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the a esophageal drain was removed. The other monitoring and support devices, in particular the right chest tube, are in unchanged position. Areas of atelectasis at both the right and the left side persist. There is no evidence of pneumothorax. Moderate cardiomegaly. Contrast material is visualized in the upper abdomen. " fb714c15-1471d4a9-030b28ff-d18b12be-52d0da34.jpg,validate/p10/p10952022/s54150595/fb714c15-1471d4a9-030b28ff-d18b12be-52d0da34.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Port-A-Cath placement assessment. AP and lateral radiograph of the chest were reviewed in comparison to ___. The Port-A-Cath catheter mid portion is looping within the jugular vein, most likely kinking giving its position and appearance on the AP view. Dedicated neck view might be beneficial for precise assessment. Heart size and mediastinum are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. " a82ece1e-98c580ca-95a6ee3c-d2baa5c9-7378e7f7.jpg,validate/p19/p19528443/s55655777/a82ece1e-98c580ca-95a6ee3c-d2baa5c9-7378e7f7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with recent endoscopy presenting with worsening abdominal pain diffusely. // Please assess for consolidation, effusion or free air under the diaphragm TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No definite focal consolidation is seen. There is minor left base atelectasis. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. Re- demonstrated is partially imaged cervical spine hardware. No evidence of free air is seen beneath the diaphragm. IMPRESSION: No acute cardiopulmonary process. No evidence of free air beneath the diaphragm. " d25f4093-d200d67d-7d3fe295-861d0616-4fa395fa.jpg,validate/p16/p16576075/s57354108/d25f4093-d200d67d-7d3fe295-861d0616-4fa395fa.jpg,validation," FINAL REPORT INDICATION: Sepsis, question pneumonia, ET tube placement. COMPARISONS: None. TECHNIQUE: Single portable chest radiograph are provided. FINDINGS: An ET tube is situated 5.3 cm from the carina. An NG tube courses below the diaphragm with the tip at the pylorus. The heart is enlarged with a left ventricular configuration. There is a layering right pleural effusion. No pneumothroax. IMPRESSION: 1. ET tube and NG tube in appropriate position. 2. Moderate cardiomegaly. 3. Right pleural effusion. " 5afa855a-ee8ad10d-c5d77a24-c65c63b4-faafd1ba.jpg,validate/p15/p15915757/s56303651/5afa855a-ee8ad10d-c5d77a24-c65c63b4-faafd1ba.jpg,validation," FINAL REPORT INDICATION: Chest pain. 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. An opacity projecting just medial to the cardiophrenic border may represent a diaphragmatic hernia or paraspinal abnormality. IMPRESSION: No acute cardiopulmonary process. An opacity projecting just medial to the right cardiophrenic border may represent a diaphragmatic hernia or paraspinal abnormality. If no cause for patient's chest pain is found, recommend further work up for this finding. These findings were emailed to the ___ nurses by Dr. ___ at 814am on ___. " 8dde2193-97e7ad56-135f42fc-31e3808a-9cff413b.jpg,validate/p12/p12156923/s59818105/8dde2193-97e7ad56-135f42fc-31e3808a-9cff413b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with prolonged hospital course, pleural effusions, pulm edema, increasing o2 requirements // eval for changes, cxr stat now eval for changes, cxr stat now IMPRESSION: Comparison to ___. No relevant change is seen. Extensive bilateral parenchymal opacities, reflecting multifocal pneumonia, are stable in extent and severity. The position of the left and right chest tubes as well as of the right PICC line are also stable. Moderate cardiomegaly persists. No larger pleural effusions. " 58971723-038a33ae-b59077ae-435774fb-a98ba698.jpg,validate/p15/p15040368/s58224479/58971723-038a33ae-b59077ae-435774fb-a98ba698.jpg,validation," FINAL REPORT STUDY: Chest radiograph. INDICATION: Thoracic pain left side. To evaluate. TECHNIQUE: Two views of the chest were obtained. COMPARISON: None. REPORT: The cardiomediastinal silhouette is unremarkable. The central pulmonary arteries are prominent but probably just within normal limits. Minimal thickening of the right paratracheal stripe is identified but no additional convincing evidence of lymphadenopathy. Visualized osseous structures are normal. The lung parenchyma appears grossly normal. CONCLUSION: No acute cardiopulmonary finding is evident. " 1a1ded5b-eea8f2de-e3ea7d41-6a8c58be-58d44109.jpg,validate/p15/p15023390/s59295016/1a1ded5b-eea8f2de-e3ea7d41-6a8c58be-58d44109.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with cough productive of green sputum // r/o infiltrate COMPARISON: Chest radiographs ___ and ___. Findings IMPRESSION: Slight increase in size in the small areas of peribronchial infiltration in the left lung base look more like atelectasis than pneumonia. Right lung and left upper lung are clear. There is no pleural effusion or evidence of central lymph node enlargement. Heart is normal size. Chronic scoliosis is moderate to severe, unchanged. " 6b99d620-c3069349-b2110612-eaeb3143-b97840ff.jpg,validate/p19/p19172342/s52570403/6b99d620-c3069349-b2110612-eaeb3143-b97840ff.jpg,validation," FINAL REPORT REASON FOR EXAM: COPD flair, low-grade fevers and back pain. Cardiac size is top normal. The aorta is tortuous. There are bibasilar atelectasis. There is no evidence of pneumonia, CHF, pneumothorax with pleural effusion. " ac138ae0-fda21e3e-dca993be-65396580-ecf56037.jpg,validate/p19/p19728795/s54737195/ac138ae0-fda21e3e-dca993be-65396580-ecf56037.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pacemaker, check lead positioning. COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Left chest wall AICD is again seen with single lead extending to the region the right ventricle. Lung volumes are low limiting assessment. The heart appears normal in size. The hila appear engorged. There is probable mild interstitial pulmonary edema. No large effusion or signs of pneumonia or pneumothorax. Mediastinal contour is within normal limits. Bony structures are intact. IMPRESSION: As above. " ff755115-40753853-16fab826-8f47504d-8672bad6.jpg,validate/p13/p13749827/s55838783/ff755115-40753853-16fab826-8f47504d-8672bad6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p moped accident, bilateral SAH, 6th rib fx, L orbital fx. // Evaluate L 6th rib fx, eval for PNA TECHNIQUE: Chest, two views including lateral. COMPARISON: Chest x-ray from ___ at 11:19. Targeted view of chest CT from ___. FINDINGS: The ___ CT showed a fracture of the posteromedial left sixth rib. On the current chest x-ray, this is very subtly visible as minimal cortical offset. No significant displacement is detected on the available views. There is increased retrocardiac opacity consistent with left lower lobe collapse and/or consolidation and a small left effusion. There is subsegmental atelectasis at the right lung base. No CHF. No obvious pneumothorax. Compared with ___ at 11:19, I doubt overt interval change. No new infiltrate identified. IMPRESSION: Increased retrocardiac opacity, similar to ___. Differential diagnosis includes atelectasis and/or a pneumonic infiltrate. Small left pleural effusion is similar to the prior study. Probable atelectasis at the right base, not significantly changed. As seen on the current study, the posterior medial sixth rib fracture appears only very minimally displaced, in keeping with findings on the ___ CT scan. " 8ea328c3-87ea66fd-6484f357-029f65b6-1fdb3d36.jpg,validate/p19/p19011388/s59841754/8ea328c3-87ea66fd-6484f357-029f65b6-1fdb3d36.jpg,validation," FINAL REPORT CLINICAL HISTORY: Orogastric tube placed, check position. CHEST: The tip of the orogastric tube is not included on the film, but must lie within the abdomen, likely within the stomach. The tip of the Swan-Ganz catheter lies within the left lower pulmonary artery. The tip of the aortic balloon lies just below the aortic knob. Position of the endotracheal tube is unchanged. No failure is seen. Some areas of atelectasis are present. IMPRESSION: Orogastric tube lies within the abdomen. " 9a9d78cc-6acc8ad0-6c59bd07-556c4f28-62dc8f15.jpg,validate/p17/p17165725/s50809163/9a9d78cc-6acc8ad0-6c59bd07-556c4f28-62dc8f15.jpg,validation," FINAL REPORT PORTABLE CHEST FILM, ___ AT 3:56 CLINICAL INDICATION: ___-year-old with necrotizing pneumonia, evaluate for change. Comparison is made to the patient's previous study dated ___ at 3:02. Portable AP upright chest film on ___ at 3:56 is submitted. IMPRESSION: 1. Right internal jugular central line has its tip in the superior vena cava. A right PICC line has its tip in the proximal SVC. A feeding tube is seen coursing below the diaphragm with the tip not identified. 2. There is bilateral interstitial abnormality which likely reflects mild interstitial pulmonary edema. A right pleural effusion remains. The heart is stably enlarged which may reflect cardiomegaly, although pericardial effusion cannot be excluded. The aorta is calcified, consistent with atherosclerosis. Focal patchy opacity at the right base may represent an area of confluent edema or possibly pneumonia or atelectasis. Clinical correlation is advised. No pneumothorax is appreciated. " d08f0f1c-8b68a02d-09b3e42b-418ac935-b302082c.jpg,validate/p10/p10024982/s59608895/d08f0f1c-8b68a02d-09b3e42b-418ac935-b302082c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p cardiac arrest this morning // interval change TECHNIQUE: Portable, AP supine radiograph view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: ETT in standard position. Left cardiac pacemaker device is unchanged. Median sternotomy wires and multiple mediastinal clips are unchanged. Heart remains moderate to severely enlarged. Lung volumes remain low. Moderate edema persists, with interval increased opacity in the right upper lobe; this asymmetric edema can be seen in the setting of mitral regurgitation. No large pleural effusion. No pneumothorax. IMPRESSION: Moderate edema with new asymmetric increased edema in the right upper lobe which can be seen in the setting of mitral regurgitation. Correlate with clinical history. " 96ce8abd-471204d7-3be48990-b3783625-d9bb9298.jpg,validate/p16/p16564743/s55554013/96ce8abd-471204d7-3be48990-b3783625-d9bb9298.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with headache, fevers, chills, nausea x 5 days TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lung volumes are low with streaky opacity in the retrocardiac region most likely reflective of atelectasis. No pleural effusion or pneumothorax is present. No acute osseous abnormalities demonstrated. IMPRESSION: Streaky retrocardiac opacity, likely atelectasis in the setting of low lung volumes. " 93a7f566-755cce97-aaa9a91f-36ede0ba-8bd3d8d7.jpg,validate/p13/p13233424/s53889038/93a7f566-755cce97-aaa9a91f-36ede0ba-8bd3d8d7.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pressure and shortness breath. STUDY: PA AND LATERAL CHEST RADIOGRAPH COMPARISON: ___. FINDINGS: The heart size is top normal. The mediastinal and hilar contours are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 76e2b002-64bef2ab-759faa8b-17670d43-ac387b88.jpg,validate/p18/p18812673/s58954061/76e2b002-64bef2ab-759faa8b-17670d43-ac387b88.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman hx sarcoidosis s/p treatment, present with bilateral pleuritic chest pain. // ?cause of pain COMPARISON: ___. IMPRESSION: Mild scoliosis with subsequent asymmetry of the ribcage. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of pulmonary edema, pneumonia or pleural effusions. No fibrosis. No micronodularity of the lung parenchyma. " 094df106-4dc40b0e-6fec378b-f6a51b5e-291e549d.jpg,validate/p10/p10159319/s52712730/094df106-4dc40b0e-6fec378b-f6a51b5e-291e549d.jpg,validation," FINAL REPORT INDICATION: ___-year-old female status post right hemiarthroplasty with continued oxygen requirement. COMPARISONS: Chest radiograph from___ ER from ___. FINDINGS: Since most recent prior radiograph, there are now bilateral small pleural effusions and basilar opacities, likely atelectasis. There is also worsening of pulmonary edema. The cardiac silhouette remains enlarged. There is no pneumothorax or definite focal consolidation. " 62d688af-dba8ae8e-0a4742eb-bca3718c-99a45b76.jpg,validate/p11/p11098660/s56858976/62d688af-dba8ae8e-0a4742eb-bca3718c-99a45b76.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and dyspnea. History of congestive heart failure. TECHNIQUE: Chest, PA and lateral. FINDINGS: The patient is status post aortic valve replacement. The heart is mild to moderately enlarged. The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 57fda9ed-a4b67239-233860ed-cbc6bd2b-84b2b488.jpg,validate/p14/p14086847/s57561132/57fda9ed-a4b67239-233860ed-cbc6bd2b-84b2b488.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post esophagectomy, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices, including the right chest tube, are in unchanged position. The right surgical site appears unchanged as compared to the previous image. On the left, the pre-existing effusion has slightly decreased in extent but left lower lobe atelectasis is still clearly visible. Unchanged size of the cardiac silhouette. No parenchymal opacities concerning for pneumonia. No pulmonary edema. " 9ed03247-e4bf8168-aea885d1-507c75cb-cc17a822.jpg,validate/p12/p12745171/s57214731/9ed03247-e4bf8168-aea885d1-507c75cb-cc17a822.jpg,validation," WET READ: ___ ___ 11:48 PM Pulmonary vascular engorgement, without focal consolidation or pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain, L shoulder and elbow pain, difficult history. Eval for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___, ___, and ___. FINDINGS: Pulmonary vascular engorgement is unchanged, with improved interstitial lung markings compared with the prior radiograph. Mild cardiomegaly and hilar contours are unchanged. No focal consolidation or pleural effusions. IMPRESSION: Pulmonary vascular engorgement, without focal consolidation or pleural effusion. " 80ebdd2c-d387828d-89e90960-df690604-91bd8696.jpg,validate/p11/p11226572/s56558940/80ebdd2c-d387828d-89e90960-df690604-91bd8696.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough and tachycardia. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear aside from minor unchanged scarring in the lingula. IMPRESSION: No evidence of acute cardiopulmonary disease. " c548948f-3530a554-1971c56c-0b8ee21e-350d181f.jpg,validate/p17/p17396841/s57633122/c548948f-3530a554-1971c56c-0b8ee21e-350d181f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // eval for interval change eval for interval change IMPRESSION: Comparison to ___. Minimal increase in extent and severity of the pre-existing left basal parenchymal opacity. Overall decrease in volume of the right lung, with signs of mild pulmonary edema. The monitoring and support devices are stable. " f5878da9-1cba8431-48377284-d7f3e5cd-ae330820.jpg,validate/p10/p10585182/s57568467/f5878da9-1cba8431-48377284-d7f3e5cd-ae330820.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: This is a ___F with history of sCHF with EF of ___% and history of infiltrating ductal carcinoma s/p partial mastectomy and chemo and RTX, as well as history of asthma and multiple PNA in the past ___ years who presents with hypoxia and tachypnea // evaluate for change in pulmonary edema and any consolidation evaluate for change in pulmonary edema and any consolidation IMPRESSION: Compared to prior chest radiographs ___. The large area of consolidation in the right upper lobe developed between ___, along with a similar area in the perihilar left lung and worsened subsequently. Both areas were still abnormal on ___ when the patient also had mild pulmonary edema elsewhere in the lungs. Subsequently edema has improved, and so has the consolidation, particularly in the perihilar left lung. The sequence of changes is extremely unusual ; I do not think these areas of recurrent pneumonia as referenced. Perhaps these are areas of lung injury from radiation or drug toxicity and have an lower threshold for edema than the rest of the lungs. Pattern is not consistent with pulmonary alveolar proteinosis or malignancy. Moderate cardiomegaly is chronic. Small bilateral pleural effusions are still present. There is no pneumothorax or mediastinal widening. Supraclavicular central venous infusion catheter ends in the low SVC. " 5e47db76-1dec7b22-51b67456-0e293f68-7bcd954b.jpg,validate/p18/p18651563/s51979672/5e47db76-1dec7b22-51b67456-0e293f68-7bcd954b.jpg,validation," FINAL REPORT PORTABLE CHEST FILM, ___ AT 4:36 INDICATION: ___-year-old with fever, concern for pneumonia, evaluate for change. COMPARISON: ___ at 19:01. Portable semi-erect chest film ___ at 4:36 is submitted. IMPRESSION: 1. Right internal jugular central line continues to have its tip in the distal SVC. There is worsening airspace disease involving both the lungs, but more confluent in the left mid and lower lung than the right base and right upper lung. These findings are concerning for multifocal pneumonia, although could represent an atypical presentation of severe pulmonary edema. Clinical correlation is advised. There are likely small layering effusions, left greater than right. No pneumothorax. Overall cardiac and mediastinal contours remain unchanged. " cd796ed6-db20639f-b97e31c7-faa654db-4831ec5d.jpg,validate/p18/p18232511/s55585884/cd796ed6-db20639f-b97e31c7-faa654db-4831ec5d.jpg,validation," FINAL REPORT AP CHEST 7:44 A.M. ___ HISTORY: Evaluate cardiopulmonary process. IMPRESSION: AP chest compared to ___: Since ___, following extubation, lung volumes have decreased and greater opacification at the lung bases, particularly the right indicates worsening atelectasis. Left lower lobe atelectasis was severe prior to extubation, unchanged, though there is an increase in small left pleural effusion. Severe cardiomegaly is chronic. Pulmonary vascular congestion has worsened in the lung apices, but I don't see pulmonary edema. Right PIC line ends in the mid SVC. No pneumothorax. " fbf5f5ce-67e2f521-d0507fac-3c95a4f2-1661218f.jpg,validate/p10/p10150465/s59953574/fbf5f5ce-67e2f521-d0507fac-3c95a4f2-1661218f.jpg,validation," FINAL REPORT INDICATION: ___F with fatigue, sob s/p admission for pancreatitis // eval for pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " d9782dd2-a838d1a4-08ba6734-0ecd6485-51c66000.jpg,validate/p10/p10963981/s52294386/d9782dd2-a838d1a4-08ba6734-0ecd6485-51c66000.jpg,validation," FINAL REPORT INDICATION: Dobhoff insertion. COMPARISON: Radiograph ___. TECHNIQUE: Frontal chest radiograph. IMPRESSION: The Dobbhoff catheter appears to terminate within the stomach. Posterior spinal fixation hardware is again demonstrated. A right PICC terminates at the lower SVC. " 1f93a89e-8c901258-7538b6c7-58204b29-62c4a08a.jpg,validate/p19/p19926301/s58960487/1f93a89e-8c901258-7538b6c7-58204b29-62c4a08a.jpg,validation," FINAL REPORT HISTORY: Fever. TECHNIQUE: AP upright and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The lungs are markedly hyperinflated with significant elevation of the left hemidiaphragm similar, with overlying atelectasis. Streaky linear opacities in the mid and lower right lung are increased from the previous examination but their appearance is more suggestive of a chronic process. There is mild blunting of the posterior right costophrenic angle, which may be due to a small pleural effusion or pleural thickening. Cardiac silhouette and mediastinal contours are unchanged. IMPRESSION: Increased mid and lower right lung streaky opacities are more suggestive of a chronic pulmonary process. Comparison with any priors since ___ and continued follow-up. Mild blunting of the posterior right costophrenic angle, small pleural effusion vs pleural thickening. " 4cfccdcb-122eefe2-ccd1cbbd-c93635de-eda3823c.jpg,validate/p10/p10075925/s51010496/4cfccdcb-122eefe2-ccd1cbbd-c93635de-eda3823c.jpg,validation," WET READ: ___ ___ ___ 5:06 AM New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly. No focal consolidation. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with ___ edema, evaluate for fluid overload. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs back to ___. FINDINGS: Mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema are new compared with the prior study. Mild cardiomegaly has increased compared with the immediate prior study. There is no pleural effusion, pneumothorax, or focal consolidation. The cardiomediastinal contour is stable The osseous structures and upper abdomen are unremarkable. IMPRESSION: New mild pulmonary vascular congestion with mild to moderate interstitial pulmonary edema and increased mild cardiomegaly. No focal consolidation. " 416f6151-87a88bbe-60965288-46ae97ef-c02f5158.jpg,validate/p10/p10781100/s51829652/416f6151-87a88bbe-60965288-46ae97ef-c02f5158.jpg,validation," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of altered mental status. COMPARISON: None. FINDINGS: Single frontal view of the chest was obtained. The lungs are relatively hyperinflated. Minimal left base atelectasis is seen. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal. The aorta is calcified. IMPRESSION: No acute cardiopulmonary process. No focal consolidation. " 3a134866-2fd8e9ad-9ffc18e4-b57a2ca9-813c18cd.jpg,validate/p13/p13166211/s51299592/3a134866-2fd8e9ad-9ffc18e4-b57a2ca9-813c18cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic breast cancer, malignant pleural effusion with worsening hypoxia, hemoptysis // ? pulm edema, change in pleural effusion, DAH ? pulm edema, change in pleural effusion, DAH IMPRESSION: Comparison to ___. The pre-existing widespread bilateral opacities and consolidations, accompanied by bilateral pleural effusions, are stable in extent and severity. No new parenchymal changes. Stable size of the cardiac silhouette with moderate retrocardiac atelectasis. " 87942770-035c44b5-a8ea95d8-a600c446-076a4cb4.jpg,validate/p12/p12679065/s54209221/87942770-035c44b5-a8ea95d8-a600c446-076a4cb4.jpg,validation," 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. " fb696f2c-acbbe04c-7c18a211-83821e7b-fd4be003.jpg,validate/p17/p17846223/s51913245/fb696f2c-acbbe04c-7c18a211-83821e7b-fd4be003.jpg,validation," FINAL REPORT INDICATION: ___M with confusion // eval for pnaCT head: eval for ICH TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 0fb5f86a-0bd79931-094c1843-6122d406-58c06484.jpg,validate/p11/p11838364/s59303771/0fb5f86a-0bd79931-094c1843-6122d406-58c06484.jpg,validation," 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. " ac6588c0-2c302f4d-b59533cb-3359beca-3f344286.jpg,validate/p14/p14766138/s52279206/ac6588c0-2c302f4d-b59533cb-3359beca-3f344286.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with hypotension into the ___ this a.m. and bilateral lower extremity pain. Question vascular congestion or infection. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Previously identified right-sided PICC line is no longer visualized. There is a focal opacity seen in the left mid lung and adjacent to the hilum, potentially due to focal infiltrate. Opacity obscuring the right heart border is less conspicuous on the current exam. Elsewhere, the lungs are clear and there is no effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. IMPRESSION: Focal opacity in the left mid lung, potentially due to infiltrate. Recommend repeat after treatment to document resolution. " 0733a761-43669ecf-4ced3fd3-e66a2fb8-93a62e4e.jpg,validate/p10/p10450632/s51666336/0733a761-43669ecf-4ced3fd3-e66a2fb8-93a62e4e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with tachycardia, overdose. Question pneumothorax. COMPARISON: None. FINDINGS: Single portable view of the chest. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is normal. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " e999829a-74a32a61-75d42b0a-6b315536-e4881c95.jpg,validate/p11/p11730422/s55297096/e999829a-74a32a61-75d42b0a-6b315536-e4881c95.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p L thoracotomy with LLLsup seg wedge and lingular wedge, hemothorax ___ // check interval change check interval change COMPARISON: Chest radiographs since ___, most recently postoperatively ___ through ___. IMPRESSION: Extensive heterogeneous consolidation that developed in the right lung on ___ has progressed, consistent with edema or extensive pneumonia. The large residual left pleural collection and consolidation and volume loss in the postoperative left lung are unchanged. 3 left thoracostomy tubes in place. Contour of the upper mediastinum is now obscured. NOTIFICATION: Dr. ___ reported the findings to DR ___ by telephone on ___ at 11:48 AM, 1 minutes after discovery of the findings. " e3976438-48d491b7-741d00cc-76763073-cfc3d950.jpg,validate/p18/p18447299/s59428844/e3976438-48d491b7-741d00cc-76763073-cfc3d950.jpg,validation," FINAL REPORT INDICATION: History: ___F with s/p LIJ placement // eval LIJ placement TECHNIQUE: Frontal view of the chest COMPARISON: None FINDINGS: Left Internal jugular venous catheter terminates in upper SVC. Linear opacity in left mid lung is likely atelectasis or scarring. No consolidation, pneumothorax, or large pleural effusion is identified. Cardiac silhouette is borderline enlarged. IMPRESSION: Left internal jugular venous catheter terminates in upper SVC. " 6c561553-2e85e0f1-24ba5afd-c5cb4ab5-fb944d5a.jpg,validate/p12/p12350123/s50174183/6c561553-2e85e0f1-24ba5afd-c5cb4ab5-fb944d5a.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain, DOE // Eval for volume overload TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion or pneumothorax. There is no pulmonary edema. The cardiomediastinal silhouette is within normal limits. Hypertrophic changes are noted in the spine. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 0fdeddf6-38d49b6d-63143b49-554d1df7-2c0b9ac7.jpg,validate/p13/p13687044/s54091915/0fdeddf6-38d49b6d-63143b49-554d1df7-2c0b9ac7.jpg,validation," FINAL REPORT AP CHEST, 4:29 A.M., ___ HISTORY: ___-year-old man with diffuse alveolar hemorrhage, shock and right ventricular failure. IMPRESSION: AP chest compared to ___: No appreciable right pleural effusion with pigtail pleural catheter still present at the base of the right lung. No pneumothorax. Right basal consolidation which developed during the course of ___ has improved, probably due to resolution of a component of atelectasis. There is worsening opacification at the base of the left lung, either pneumonia or hemorrhage. Moderate cardiomegaly is longstanding. No pneumothorax. Course of the transjugular Swan-Ganz catheter is little uncertain, but it probably ends in a small branch of the right descending pulmonary artery, no less than 4 cm beyond standard positioning. Right jugular introducer ends low in the SVC. Left PIC line can be traced as far as the left brachiocephalic vein, but the tip is indistinct. ET tube in standard placement. MICU housestaff notified by telephone at 9 a.m. " a3c531ef-c050965c-7a55e8ab-2479cae5-90cae462.jpg,validate/p10/p10283452/s52548733/a3c531ef-c050965c-7a55e8ab-2479cae5-90cae462.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with end-stage renal disease, prerenal transplant evaluation code ___, assess for cardiopulmonary abnormalities. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding similar study ___ ___. The heart size is normal. No configurational abnormalities identified. 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 apical area. Skeletal structures of the thorax grossly within normal limits. In comparison with the next previous study of ___, no significant interval change can be identified. IMPRESSION: Stable normal chest findings, no evidence of cardiovascular or pulmonary abnormalities. " 0b0c26e3-10e11439-05f28120-29316d91-1ec0e575.jpg,validate/p11/p11625962/s52668617/0b0c26e3-10e11439-05f28120-29316d91-1ec0e575.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph dated ___. CLINICAL HISTORY: ___ y/o male with symptomatic anemia, also with cough and sputum as well as rhonchi. Assess for pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. Interstitial pulmonary edema is again noted superimposed on known chronic interstitial lung disease. Heart and mediastinal contours appear grossly stable. There is no new superimposed consolidation, large effusion or pneumothorax. " 3a35532f-3445242b-f7276556-4b835834-8784e395.jpg,validate/p17/p17290566/s52912567/3a35532f-3445242b-f7276556-4b835834-8784e395.jpg,validation," FINAL REPORT INDICATION: Left effusion, to assess for interval change. TECHNIQUE: AP semi-upright portable radiograph of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Right internal jugular catheter terminates at the superior cavoatrial junction. Right costophrenic sulcus is excluded from the image. Lungs are low in volume. Aside from atelectasis at the right lung base, the right lung is well aerated. The left lung is slightly better aerated than on the prior study with minimal decrease in left pleural effusion though some of it appears to be collected in a nondependent location, perhaps within the major fissure. Mild cardiomegaly is noted and slightly decreased from the prior study. Median sternotomy wires as before. IMPRESSION: Overall likely unchanged to minimally decreased left pleural effusion, with a portion collecting in a non-dependent fashion, perhaps within the major fissure. " ca1ede18-d17d0d35-ff4edabf-4b995522-e943adf2.jpg,validate/p10/p10758011/s57080991/ca1ede18-d17d0d35-ff4edabf-4b995522-e943adf2.jpg,validation," FINAL REPORT INDICATION: Atrial fibrillation and overexertion. COMPARISONS: Chest radiograph ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Severe degenerative changes are noted in the right shoulder with joint space loss, likely reflecting chronic rotator cuff injury. The left shoulder has mild degenerative changes. IMPRESSION: 1. No acute cardiopulmonary process. 2. Severe degenerative changes in the right shoulder. " 3aa9ee81-08355b5d-713a3a03-6cd20281-6222326c.jpg,validate/p10/p10361930/s59928548/3aa9ee81-08355b5d-713a3a03-6cd20281-6222326c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with TBM s/p stent placement on ___, DMI, presenting with N/V, hyperglycemia and new productive cough, with PNA and likely DKA, with respiratory failure. // Please assess for placement of ETT TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: As compared to the prior study there is no substantial change in the NG tube placement terminating most likely in the stomach. The ET tube tip is 5 cm above the carinal. A left pleural effusion is moderate. There is interval additional progression of bibasal consolidations. There is also interval development of interstitial edema. Left perihilar opacity most likely reflect additional focus of infection as well. No definitive pneumothorax is seen. " 5c668058-2e7e7922-0202a532-0af6fa1d-a9c53e1b.jpg,validate/p14/p14137711/s52892576/5c668058-2e7e7922-0202a532-0af6fa1d-a9c53e1b.jpg,validation," WET READ: ___ ___ 8:34 PM Since the prior study, there is no change in positioning of the right sided pleural catheter with heterogeneous opacification of the right lung base, likely a combination of atelectasis and fluid. There is slight kinking of the mid course of the catheter, and correlation with catheter output is recommended. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hemothroax and chest tube in place // interval change interval change COMPARISON: Chest radiographs ___ IMPRESSION: Small right basal pleural effusion remains, pigtail pleural drainage catheter unchanged. No pneumothorax. Mild right basal atelectasis stable. Left lung clear. Heart size normal " a4a48c71-f167fff4-c1ef194f-4724f5fa-eb3399be.jpg,validate/p18/p18406213/s53701556/a4a48c71-f167fff4-c1ef194f-4724f5fa-eb3399be.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pelvic abscess now intubated for hypoxemic respiratory failure // ? interval change in bilateral consolidations ? interval change in bilateral consolidations COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous pulmonary edema has resolved, but the moderate right pleural effusion has increased. Heart size normal. ET tube in standard placement. Right jugular line ends in the right atrium. Transesophageal drainage tube passes into the stomach and out of view. No pneumothorax. " f39bfa9b-38b45c5c-30564877-9850d408-8ad55a96.jpg,validate/p15/p15328320/s52282175/f39bfa9b-38b45c5c-30564877-9850d408-8ad55a96.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p extubation // acute process? acute process? IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tubes have been removed. The left hemidiaphragm is now a sharply seen and there is no substantial atelectasis in the retrocardiac region. No evidence of acute focal pneumonia. " c520e3cf-c1fc5e1e-30849b0d-1b52a69e-502cad9a.jpg,validate/p17/p17298236/s58414403/c520e3cf-c1fc5e1e-30849b0d-1b52a69e-502cad9a.jpg,validation," FINAL REPORT INDICATION: Right rib pain, assess for fracture. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISONS: Chest radiograph, most recently ___. FINDINGS: Lungs are clear overall, though slight obscuration of the left costophrenic sulcus is seen which may be due to atelectasis, though pneumonia cannot be fully excluded. There is no right-sided pleural effusion or pneumothorax. The heart is top normal in size with normal cardiomediastinal silhouette. No displaced rib fractures are seen. IMPRESSION: No displaced rib fractures, but right ribs are incompletely imaged on this radiograph. Left basal opacity likely atelectasis, though in the setting of infectious symptoms pneumonia should be considered. This was discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. " c26adfce-76a340af-8e88cda2-5dec76b8-549a1a34.jpg,validate/p14/p14129886/s56115754/c26adfce-76a340af-8e88cda2-5dec76b8-549a1a34.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with chest pain. 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. " 5e89fb5c-60291239-7885a826-24d354d3-2f161ad2.jpg,validate/p16/p16646670/s50408804/5e89fb5c-60291239-7885a826-24d354d3-2f161ad2.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with concern for pathologic fx of left distal femur. // fractures?CXR: preopSecond read: please eval for metastatic lesions, pathologic fx TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are low leading to crowding of the bronchovascular structures. Mild bibasilar atelectasis is noted. The heart is top-normal in size. Mild central vascular congestion is seen. There is no large pleural effusion, pneumothorax, or leak lobar consolidation. Partially imaged vertebral fusion hardware is noted. IMPRESSION: Low lung volumes with mild pulmonary vascular congestion. " 61d7ff68-0c62ed6e-f30fe780-d0002ebb-a751e1fa.jpg,validate/p14/p14921632/s58936237/61d7ff68-0c62ed6e-f30fe780-d0002ebb-a751e1fa.jpg,validation," 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. " e370eff8-f4c9c95a-1298bbc7-287319bc-386f6dd0.jpg,validate/p16/p16644826/s56400044/e370eff8-f4c9c95a-1298bbc7-287319bc-386f6dd0.jpg,validation," FINAL REPORT HISTORY: Acute short of breath, question edema. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___. There is hyperinflation, suggesting background COPD. There is moderately severe cardiomegaly, with prominence of the right mediastinal soft tissues. There is a small left effusion with underlying collapse and/or consolidation and a small right effusion. There is upper zone redistribution, without other evidence of CHF. The patient is apparently status post right mastectomy, with right axillary clips. IMPRESSION: 1. COPD and stable cardiomegaly. 2. New small left effusion with underlying collapse and/or consolidation. Possibility of a pneumonic infiltrate cannot be excluded. 3. Upper zone redistribution, without other evidence of CHF. Mild diffuse prominence of the interstitial markings is noted, while this could relate to mild interstitial edema, it is less pronounced than on the earlier film and may represent background parenchymal scarring. 4. Subsegmental atelectasis at the left base and small right effusion similar to prior. 5. Prominence of the right paratracheal soft tissues apparently reflects mediastinal lymphadenopathy. This is also reflected in loss of the right supraclavicular companion shadow. This is better depicted on a chest CT from ___. The pulmonary nodules seen on the CT are not readily apparent radiographically, though may be related to opacity seen at the right base laterally. 6. Status post right mastectomy with right axillary clips. " 9f0d4f3d-5391b3b0-4935f3ac-9e322076-f3127b1c.jpg,validate/p15/p15128994/s53981287/9f0d4f3d-5391b3b0-4935f3ac-9e322076-f3127b1c.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with positive blood cultures and fever. Rule out pneumonia. COMPARISON: Multiple prior chest radiographs, most recently from ___. FINDINGS: Frontal and lateral views of the chest were obtained. Large bore left subclavian catheter terminates in the right atrium. The heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " be1f80c8-648acc4f-25bf4e9c-21b28c6a-6e3680bd.jpg,validate/p16/p16074678/s57108150/be1f80c8-648acc4f-25bf4e9c-21b28c6a-6e3680bd.jpg,validation," WET READ: ___ ___ ___ 8:21 AM 1. Cardiomegaly 2. Low lung volumes 3. Transesophageal tube terminates in the region of the stomach 4. ETT stable WET READ VERSION #1 ___ ___ 9:12 PM 1. Cardiomegaly 2. Low lung volumes 3. Transesophageal tube terminates in the region of the stomach 4. ETT stable ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sepsis s/p bowel surgery // NG tube placement NG tube placement IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube extends well into the stomach with the side port distal to the esophagogastric junction. The other monitoring and support devices are essentially unchanged. " 2703e882-b2ce95eb-3bf9118c-803602cc-a115da34.jpg,validate/p13/p13227504/s55737746/2703e882-b2ce95eb-3bf9118c-803602cc-a115da34.jpg,validation," FINAL REPORT HISTORY: ___-year-old female status post motor vehicle collision, now with left-sided chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. No acute displaced rib fracture is visualized. IMPRESSION: No acute cardiopulmonary process or displaced rib fracture. " 826e408c-16345121-0498567c-fe0f2d10-19912cf5.jpg,validate/p16/p16061352/s56847949/826e408c-16345121-0498567c-fe0f2d10-19912cf5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with autoimmune hepatitis and pleural effusion now with hypoxia. // Eval for PNA, pulm edema, worsening effusion. Eval for PNA, pulm edema, worsening effusion. COMPARISON: Prior chest radiographs ___ through ___ at 04:20. IMPRESSION: Moderately severe pulmonary edema has improved, moderate to large left pleural effusion has increased. . Heart size partially obscured by left pleural effusion is at least mildly enlarged. Mediastinal veins are still engorged. Left lower lobe still atelectatic. No pneumothorax. " 9dc5414c-f2b03f62-36e66c1f-5b0a134c-0480fc82.jpg,validate/p19/p19272439/s56639079/9dc5414c-f2b03f62-36e66c1f-5b0a134c-0480fc82.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality identified. IMPRESSION: No acute cardiopulmonary process. " ba03c508-36724115-afb90d6d-315cdcae-c6487448.jpg,validate/p15/p15451291/s58409003/ba03c508-36724115-afb90d6d-315cdcae-c6487448.jpg,validation," FINAL REPORT INDICATION: ___Fwith symptoms concerning for ACS vs PE, recent unarmed assault with worsening headache // Acute cardiopulmonary process, acute intracranial process TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___. FINDINGS: Heterogeneous consolidation predominately involving the right middle lobe and to a lesser degree the adjacent right lower lobe is new compared to ___ radiograph. Linear right basilar opacities are also new. The left lung is clear. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax. No acute osseous abnormality is identified. IMPRESSION: Right middle and lower lobe consolidation, concerning for acute pneumonia. Followup radiographs in 4 weeks following treatment is recommended to assess for full resolution. NOTIFICATION: Findings were emailed to the ED QA nurse by Dr.___ at 10:55am on ___. " b1a46962-8f6ea740-4a1b51a1-7db678fc-c7cde0b7.jpg,validate/p16/p16826765/s53176607/b1a46962-8f6ea740-4a1b51a1-7db678fc-c7cde0b7.jpg,validation," 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. " 008b0537-b257a837-b9e56cc2-9f393eb2-45ef816a.jpg,validate/p11/p11148683/s55621399/008b0537-b257a837-b9e56cc2-9f393eb2-45ef816a.jpg,validation," WET READ: ___ ___ ___ 5:09 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with CP // cardiac workup COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Heart size is top normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " debcecea-42df1574-ecc1262c-55f073d2-ae1c3c6a.jpg,validate/p11/p11856988/s57788851/debcecea-42df1574-ecc1262c-55f073d2-ae1c3c6a.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old male with productive cough and shortness of breath. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. There are bibasilar linear opacities suggestive of atelectasis versus scar, similar to prior. The lungs are hyperinflated, but clear of new region of consolidation. Cardiac silhouette is enlarged, but stable in configuration. Osseous and soft tissue structures are unchanged. IMPRESSION: No definite acute cardiopulmonary process. " 7d23008a-d191a15a-09a28efd-3950dabb-baa23f1a.jpg,validate/p13/p13117765/s59860241/7d23008a-d191a15a-09a28efd-3950dabb-baa23f1a.jpg,validation," FINAL REPORT HISTORY: ___ year old woman with pulmonary nodules, s/p RUL wedge biopsy. pneumothorax? COMPARISON: Exam compared to ___, ___. TECHNIQUE: Chest x-ray in 2 projections. FINDINGS: Minimal right apical pneumothorax. Mediastinal structure and trachea are shift to the right. A right chest tube was positioned and its tip is positioned in the posterior-inferior right lung field. There is an incomplete atelectasis of the lingula with bilateral pleural effusion more evident on the left lung field. IMPRESSION: Small right apical pneumothorax Placement of right chest tube Subactelectasis of the lingula Bilateral pleural effusion " a28810ae-62817671-cee252b1-38fb3073-bc8c9cef.jpg,validate/p14/p14614404/s54826793/a28810ae-62817671-cee252b1-38fb3073-bc8c9cef.jpg,validation," FINAL REPORT HISTORY: Pneumothorax with prior pigtail, now with positive pressure ventilation. FINDINGS: In comparison with the study of earlier in this date, there is increased hazy opacification on the left, consistent with layering pleural effusion that may appear worse due to a change in patient position. Previous rib and scapular fractures are seen. However, there is no evidence of acute pneumothorax. " a03302f5-2a29978b-99c25e8d-7c644dd0-6db661cd.jpg,validate/p14/p14001756/s51337668/a03302f5-2a29978b-99c25e8d-7c644dd0-6db661cd.jpg,validation," WET READ: ___ ___ ___ 9:56 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with chest pressure, shortness of breath, evaluate for an acute process. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. A portable AP upright chest film ___ at ___ is submitted. IMPRESSION: 1. Cardiac and mediastinal contours are within normal limits. Lungs appear well inflated without evidence of focal airspace consolidation, pleural effusions, pulmonary edema or pneumothorax. No acute bony abnormality appreciated. " a6911389-03e1533e-5ad8489d-7f05b925-03b1fd63.jpg,validate/p19/p19988669/s59390014/a6911389-03e1533e-5ad8489d-7f05b925-03b1fd63.jpg,validation," 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. " b7a5fee5-c9255f86-f1baf0cf-bdc24577-26111c73.jpg,validate/p15/p15289580/s55385947/b7a5fee5-c9255f86-f1baf0cf-bdc24577-26111c73.jpg,validation," FINAL REPORT HISTORY: Multiple myeloma with atrial fibrillation, to assess for congestion. FINDINGS: In comparison with the study of ___, the cardiac silhouette is slightly more prominent. There is increased opacity at both bases that could reflect mild elevation of pulmonary venous pressure and atelectatic changes. " 98bf78e9-e989cc5a-c0b7dc6d-5369d971-8a4f06ea.jpg,validate/p18/p18938959/s52127356/98bf78e9-e989cc5a-c0b7dc6d-5369d971-8a4f06ea.jpg,validation," 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. " ca3ce8f5-2d838a45-c4f7888c-821f179d-771bb418.jpg,validate/p12/p12348779/s58725344/ca3ce8f5-2d838a45-c4f7888c-821f179d-771bb418.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG. PA and lateral upright chest radiographs were reviewed in comparison to ___. The heart size and mediastinum are stable in appearance. Post-sternotomy wires are unremarkable. Left pleural effusion has decreased in size, small to moderate, associated with atelectasis. Minimal left apical pneumothorax cannot be excluded. No right pneumothorax is seen. " e9d5bb61-1c25ca69-0c6653a7-03e138bc-e2a455b1.jpg,validate/p12/p12448098/s53779165/e9d5bb61-1c25ca69-0c6653a7-03e138bc-e2a455b1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pneumonia and worsening sx // ?change in infiltrates TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is increasing left parahilar opacification, with air bronchograms. The right lower lobe patchy opacification is persistent. The linear opacification in the right mid lung represents atelectasis. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Increasing left parahilar opacification and right lower lobe patchy opacification, representing multifocal pneumonia. " caedc923-4c65a76b-b7b1050f-542c245c-8098f9e2.jpg,validate/p12/p12385889/s52843413/caedc923-4c65a76b-b7b1050f-542c245c-8098f9e2.jpg,validation," FINAL REPORT HISTORY: History of ALL and GVHD, heavily immunosuppressed, now with fever and cough. Evaluate for pneumonia. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. A preliminary was provided by Dr. ___ to Dr. ___ at ___ on ___. " 5d54a839-1c5f5156-cb890477-5adcd37d-49d6fda5.jpg,validate/p10/p10297774/s56034443/5d54a839-1c5f5156-cb890477-5adcd37d-49d6fda5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with sCHF exacerbation, IABP in place // pulmonary edema, pleural effusion, IABP position pulmonary edema, pleural effusion, IABP position COMPARISON: Chest radiographs ___. IMPRESSION: Tip of the IABP is approximately a cm from the apex of the aortic arch. Swan-Ganz catheter ends in the right descending pulmonary artery, approximately 4 cm beyond standard placement. Transvenous right ventricular pacer defibrillator lead unchanged in position, tip projecting over the apex of a dilated right ventricle. Tip of the right atrial lead partially obscured. Moderate cardiomegaly stable. Mild interstitial edema is new. Pleural effusions small if any. No pneumothorax " 64d95fbc-e14bdd00-aae7dce1-39ce50d1-65ff82eb.jpg,validate/p11/p11407180/s55950738/64d95fbc-e14bdd00-aae7dce1-39ce50d1-65ff82eb.jpg,validation," FINAL REPORT HISTORY: PICC placement. COMPARISON: Same day examination 3 hours prior. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: The right-sided PICC is much more clearly visualized on this examination. The tip appears to terminate in the right atrium 7 cm caudal to the carina. The remainder of the exam is unchanged with redemonstration of bibasilar atelectasis and small bilateral effusions. IMPRESSION: Right PICC terminating in the right atrium. If positioning of the tip in the lower SVC is desired, catheter must be pulled back by 4 cm. Preliminary results were conveyed to ___ of the IV team over the telephone by Dr. ___ at 3:40 p.m. on ___ at the time of initial review. Final results indicating necessity to pull back of a total of 4 cm was conveyed over the telephone to ___ by Dr. ___ at 4:31 p.m. on ___ at time of attending readout. " 82ef297a-5963ad85-e10e8cec-152f3413-c8ea4262.jpg,validate/p11/p11760978/s57982537/82ef297a-5963ad85-e10e8cec-152f3413-c8ea4262.jpg,validation," FINAL REPORT HISTORY: Chest pain and hemoptysis. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is not engorged. Ill-defined focal opacities within the right upper lobe are concerning for pneumonia. Streaky left lower lobe opacity is also likely present, and could reflect an addition area of infection. Minimal blunting of the costophrenic angles may suggest trace bilateral pleural effusions. No pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Focal opacities within the right upper lobe and streak left lower lobe opacity are concerning for pneumonia. Probable small bilateral pleural effusions. Followup radiographs after treatment are recommended to ensure resolution of this finding. " b0be3c5f-423bc1e3-0bf20afd-29c9c338-4d4ada62.jpg,validate/p14/p14546527/s53127434/b0be3c5f-423bc1e3-0bf20afd-29c9c338-4d4ada62.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of pleural effusion, pre kidney transplant clearance needed // rule out cardiopulmonary abnormalities TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Hammer dialysis catheter tip is most likely in the right atrium or even in the right ventricle. Cardiomegaly is moderate and unchanged. Mediastinum is stable. Lungs are clear. Minimal linear atelectasis at the left lower lung as demonstrated. No appreciable pleural effusion or pneumothorax is seen. Coronary artery stents are present. " 94264b0b-cc5497b4-9dc120e1-8195f2b4-78cbb977.jpg,validate/p18/p18394695/s50057221/94264b0b-cc5497b4-9dc120e1-8195f2b4-78cbb977.jpg,validation," FINAL REPORT HISTORY: Questionable lung nodule on chest x-ray from ___, patient underwent for CT. Re-evaluate lung nodules/opacities. COMPARISON: ___. FINDINGS: The right mid lung nodular opacity persists, not significantly changed in size since ___, but new since ___. The chronic right upper lobe collapse with bronchiectasis demonstrates increased lucency compared with prior. Left mid lung chronic scarring is unchanged. Mediastinal and hilar calcified nodes are consistent with prior granulomatous disease as well as multiple calcified granulomas all of which are unchanged. There has been interval enlargement of the cardiomediastinal silhouette compared with ___, which could represent cardiomegaly or pericardial effusion. No pleural effusion or pneumothorax is present. Metallic fragments overlying the left ___ and 2nd ribs are unchanged. IMPRESSION: 1. Persistent right mid lung nodular opacity is not significantly changed from recent CXR; however, further evaluation by a chest CT is recommended as it was not present on earlier studies. 2. Increased lucency in chronically collapsed right upper lobe raises the possibility of a chronic cavitary process for which CT would also be helpful to evaluate. 3. Interval enlargement of the cardiomediastinal silhouette could be related to cardiomegaly or pericardial effusion. NOTIFICATION: Dr. ___ was paged and called at her office; however, she was not available, so the findings were reported to the Critical Results Dashboard by Dr. ___ at 16:30 on ___. " b8e2137d-f3fd5bd7-9a90cc4a-1585f2d8-4281ea98.jpg,validate/p14/p14886127/s51491172/b8e2137d-f3fd5bd7-9a90cc4a-1585f2d8-4281ea98.jpg,validation," WET READ: ___ ___ ___ 9:48 PM 1. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ALL on high dose steroids with worsening cough // interval change, r/o PNA interval change, r/o PNA IMPRESSION: IN COMPARISON WITH THE STUDY OF ___, THERE IS LITTLE CHANGE. CARDIAC SILHOUETTE IS WITHIN NORMAL LIMITS AND THERE IS NO VASCULAR CONGESTION, PLEURAL EFFUSION, OR ACUTE FOCAL PNEUMONIA. THE TIP OF THE LEFT PICC LINE IS IN THE MID SVC. " 3fc233a9-d842785a-757ec25c-7da9da5c-3199940e.jpg,validate/p18/p18068560/s52652228/3fc233a9-d842785a-757ec25c-7da9da5c-3199940e.jpg,validation," FINAL REPORT INDICATION: ___ year old man with lung cancer, hemoptysis // eval for interval change in L lung COMPARISON: Radiographs from ___ IMPRESSION: Support lines and tubes are unchanged in position. Cardiomediastinal silhouette is within normal limits. There are again seen bilateral pleural effusions, left greater than right. Left retrocardiac opacity is seen. Atelectasis at the lung bases are also present. There is also prominence of the pulmonary interstitial markings consistent with pulmonary edema. Overall, the findings appear stable. " 588dac74-f16864b1-9b66750f-f7992440-60454ec9.jpg,validate/p18/p18121111/s58427719/588dac74-f16864b1-9b66750f-f7992440-60454ec9.jpg,validation," WET READ: ___ ___ ___ 12:09 PM Interval pull back of the ET tube, which now terminates 2.9 cm above the carina. Otherwise stable exam.--___ WET READ VERSION #___ ___ ___ ___ 9:41 PM Interval pull back of the ET tube, which now terminates 2.9 cm above the carina. Otherwise stable exam.--___ ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with hemoptysis, history of lung cancer in the right apical lung status post bronchoscopy and intubation. TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position. COMPARISON: Radiographs from ___ and CT from ___. FINDINGS: Endotracheal tube in now terminates centrally in the trachea, approximately 2.9 cm from the carina. There is a right central venous line terminating in the lower SVC. Pulmonary opacities are unchanged including a right upper lobe cavity. The heart size is normal. IMPRESSION: Appropriate repositioning of the trachea centrally. " c7d89de8-4cc17cec-f44d1623-81ffa309-2476cc94.jpg,validate/p10/p10610461/s52315234/c7d89de8-4cc17cec-f44d1623-81ffa309-2476cc94.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with abnml portable fiml - pls compare and eval right hilum // see below see below IMPRESSION: Heart size is top-normal. Mediastinum is unremarkable with no abnormality corresponding to the findings seen on the previous chest radiograph seen. The most likely reflect tortuosity of the ascending aorta. Lungs are clear. There is no pleural effusion or pneumothorax. " 14961f53-228d294d-625e6fce-fda30bb8-3c70477b.jpg,validate/p15/p15200162/s55403814/14961f53-228d294d-625e6fce-fda30bb8-3c70477b.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain, history of dissection 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 size is normal. The mediastinal contours are normal. The patient is status post median sternotomy, and surgical clips project over the right axilla. IMPRESSION: No acute cardiopulmonary process. " 915b0204-02bc06f0-0f9cd179-f612b4a4-09ac0e3c.jpg,validate/p12/p12935888/s56500921/915b0204-02bc06f0-0f9cd179-f612b4a4-09ac0e3c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and wheezing, history of rheumatoid arthritis. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-described opacities at the lung bases are no longer visible. Besides a moderately enlarged cardiac silhouette and tortuosity of the thoracic aorta, the chest radiograph performed today is normal. No pleural effusions. No lung nodules or masses. As requested, the referring physician ___. ___ was paged for notification and the findings were discussed over the telephone at 11:36 a.m., on the ___ ___. " dbb4bf36-5c7c441a-ba23c76c-bd925c6f-d5598bb6.jpg,validate/p15/p15154432/s59355163/dbb4bf36-5c7c441a-ba23c76c-bd925c6f-d5598bb6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p intubation // eval for level of ETT eval for level of ETT COMPARISON: Comparison to ___ at 03:33 FINDINGS: Portable supine chest radiograph ___ at 21:34 is submitted. IMPRESSION: Endotracheal tube has its tip 2.5 cm above the carina. Nasogastric tube and left internal jugular central line are unchanged in position. The heart remains stably enlarged. Lung volumes are low with worsening perihilar edema and persistent left lower lobe collapse. There are likely layering effusions. No pneumothorax, although the sensitivity to detect pneumothorax is diminished given supine technique. " 4a44cd8f-5af261b8-f102d0ae-46c64137-599c59ab.jpg,validate/p13/p13652475/s56570236/4a44cd8f-5af261b8-f102d0ae-46c64137-599c59ab.jpg,validation," FINAL REPORT HISTORY: Patient with blast cells on blood count. Evaluate for mediastinal mass TECHNIQUE: PA and lateral chest radiographs. COMPARISON: None available. FINDINGS: The lungs are well expanded. There is minimal retrocardiac subsegmental atelectasis, confirmed in the lateral view, but no focal opacities concerning for pneumonia. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiographic examination. " 7d43230d-a4c27b2e-e9fdf560-1edb1621-ea0c9ca8.jpg,validate/p10/p10562811/s58591819/7d43230d-a4c27b2e-e9fdf560-1edb1621-ea0c9ca8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Cough, chest pain with breathing. TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiographs dated ___. FINDINGS: Lungs are clear without focal consolidation, effusion, or pneumothorax. There is no central vascular congestion or overt pulmonary edema. Mediastinum, hila and pleural surfaces are unremarkable. Heart size normal. IMPRESSION: No acute intrathoracic process. " 3ba444f0-9342d330-569bb619-5771ab88-a8fee26d.jpg,validate/p13/p13357148/s59869033/3ba444f0-9342d330-569bb619-5771ab88-a8fee26d.jpg,validation," WET READ: ___ ___ 6:41 AM An endotracheal tube ends in the upper thoracic trachea. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with CPR, intubated, // pneumo?E ETT? TECHNIQUE: Single AP view COMPARISON: Chest radiograph ___ FINDINGS: Lung volumes are significantly decreased. An endotracheal tube ends the upper thoracic trachea 7 cm above the carina and just distal to an area of apparent focal tracheal stenosis. There is no focal consolidation. Linear atelectasis is present in the left lower lobe. With The cardiomediastinal silhouette is within normal limits. Pulmonary vascular congestion is mild. IMPRESSION: 1. An endotracheal tube ends in the upper thoracic trachea, 7 cm above the carina. No pneumothorax. 2. Mild pulmonary vascular congestion. " 0087898e-a539bb9c-5e9f07b6-a56d1884-6578f0e0.jpg,validate/p19/p19352450/s55977368/0087898e-a539bb9c-5e9f07b6-a56d1884-6578f0e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with symptoms and signs of chf, including dyspnea and new orthopnea and edema // assess for signs of chf assess for signs of chf IMPRESSION: In comparison with the study of ___, there again is enlargement of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia. " 03318d76-d0969f8e-6509e60d-b2df8f5b-d4386a07.jpg,validate/p14/p14206119/s51842233/03318d76-d0969f8e-6509e60d-b2df8f5b-d4386a07.jpg,validation," FINAL REPORT HISTORY: Chest tube on waterseal, to assess for pneumothorax. FINDINGS: In comparison with the study of ___, with the chest tube on waterseal, there is no definite pneumothorax. The nasogastric tube and endotracheal tube have been removed. There is some increased opacification at the left base laterally, most likely related to atelectasis. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. " 473b252b-e67e3c57-e0ee2af5-ea1499a6-77716f49.jpg,validate/p19/p19491045/s53299166/473b252b-e67e3c57-e0ee2af5-ea1499a6-77716f49.jpg,validation," FINAL REPORT EXAM: Chest single semi-erect AP portable view. CLINICAL INFORMATION: Severe tachycardia. COMPARISON: ___. FINDINGS: Single frontal semi-erect AP portable view of the chest was obtained. There are prominent bilateral predominantly perihilar opacities which may be due to severe pulmonary edema/ARDS, possible multifocal infection. There is blunting of the costophrenic angles and small pleural effusions are not excluded. The cardiac silhouette is likely top normal to mildly enlarged, although not well assessed due to right lung base opacities. Aortic knob is calcified. No evidence of pneumothorax is seen. IMPRESSION: Extensive perihilar opacities raise concern for severe pulmonary edema/ARDS, possible multifocal infection. Blunting of the costophrenic angles, small pleural effusions not excluded. " 5cc003f3-5da09434-c3cb1e3c-78b29146-d668daa7.jpg,validate/p11/p11984732/s58771235/5cc003f3-5da09434-c3cb1e3c-78b29146-d668daa7.jpg,validation," FINAL REPORT AP CHEST, 8:07 A.M. ___ HISTORY: A ___-year-old woman with critical aortic stenosis and pulmonary edema after balloon valvuloplasty. IMPRESSION: AP chest compared to ___, 11:06 p.m.: Mild pulmonary edema has changed in distribution, but not in severity. Appearance of the right lower lobe is most consistent with dependent atelectasis and edema. Left lower lobe remains severely atelectatic. With the chin down, position of the ET tube, 2.5 cm from the carina is acceptable. Moderate cardiomegaly is chronic. Some pleural effusion is presumed, but not substantial. Right PIC line can be traced as far as the low SVC where the tip is obscured by the upper enteric drainage tube passing into the stomach and out of view. Transvenous right atrial and right ventricular pacer leads are in their expected positions. " e80f9afe-33e6f7c6-09765fbc-1c6b4d51-90862f52.jpg,validate/p17/p17637467/s57535131/e80f9afe-33e6f7c6-09765fbc-1c6b4d51-90862f52.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain, assess pneumothorax. FINDINGS: Portable AP upright chest radiograph obtained. There are calcified breast implants noted bilaterally, partially obscuring the lung bases. There is no clear sign of pneumonia or CHF. No pneumothorax is seen. The heart is top normal in size. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Calcified breast implants slightly obscure the lung bases. No pneumothorax. " b0ef1396-3adf5144-6fbcfced-3646c408-7fc01eea.jpg,validate/p14/p14760908/s56718840/b0ef1396-3adf5144-6fbcfced-3646c408-7fc01eea.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with left frontal intracranial hemorrhage. Question ET tube positioning. COMPARISON: ___. FINDINGS: Single frontal view of the chest demonstrates ET tube with tip extending to 3.4 cm above the carina. An enteric tube extends to the stomach, although the tip could be further distally placed by 4-5 cm to secure better seating. The cardiomediastinal silhouette is within normal limits. Allowing for mildly decreased lung volumes, the lungs are clear. There is no pneumothorax, pleural effusion, or pulmonary vascular congestion. IMPRESSION: Normal ET tube position. Consider placing NG tube more distally by 4-5 cm. No acute cardiopulmonary process. " d501780d-67954844-4ea8e4ce-4916d471-9d90d8f5.jpg,validate/p13/p13840464/s50129145/d501780d-67954844-4ea8e4ce-4916d471-9d90d8f5.jpg,validation," FINAL REPORT HISTORY: Cardiac surgery, to assess for widened mediastinum. FINDINGS: In comparison with the study of ___, there is little change. No evidence of increasing widening of the mediastinum. Huge enlargement of the cardiac silhouette persists without appreciable vascular congestion, again suggesting underlying cardiomyopathy. " 16ead83d-5df6f8a7-50ec9a19-f790583f-2ecba7aa.jpg,validate/p13/p13048446/s53994824/16ead83d-5df6f8a7-50ec9a19-f790583f-2ecba7aa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hepatitis C and chronic abdominal pain with fever. // fever work up COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No evidence of pleural effusions on the frontal and lateral radiograph. No pneumonia, no pulmonary edema. " b9f41476-765ad2e5-d33212d9-ab36f013-79f36199.jpg,validate/p15/p15878063/s53700262/b9f41476-765ad2e5-d33212d9-ab36f013-79f36199.jpg,validation," WET READ: ___ ___ ___ 1:31 PM Right clavicular fracture better seen on dedicated clavicle films. Nodular opacity projecting over the anterior right second rib. This could be due to degenerative changes at the second costochondral junction or due to underlying parenchymal nodule. Repeat films including lordotic view suggested non urgently. Compression deformity in the upper lumbar spine, age indeterminate. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with R shoulder pain after fall // assess for injury TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is a focal opacity projecting over the right anterior second rib. Lungs are otherwise clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Right clavicular fractures better seen on dedicated images. Upper lumbar compression deformity is noted. Surgical clips noted in the right upper quadrant suggesting prior cholecystectomy. IMPRESSION: Right clavicular fracture better seen on dedicated clavicle films. Nodular opacity projecting over the anterior right second rib. This could be due to degenerative changes at the second costochondral junction or due to underlying parenchymal nodule. Compression deformity in the upper lumbar spine, age indeterminate. NOTIFICATION: Repeat chest x-ray including lordotic view suggested non urgently. " fdf5df57-647aac82-6102fa03-69cc54ec-27058806.jpg,validate/p10/p10963981/s53260619/fdf5df57-647aac82-6102fa03-69cc54ec-27058806.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with multiple stable medical issues now with rising white count // Any evidence of PNA? TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiographs dated ___. FINDINGS: Compared to chest radiographs from ___, bibasilar opacities and pulmonary edema have resolved. Spinal fusion hardware largely obscures the the right infrahilar, perihilar and paratracheal regions. Lung volumes are low and exaggerate heart size, mildly enlarged, unchanged. No focal consolidation. No pleural effusion. No pneumothorax. Mediastinal and hilar contours are stable. Left PIC line tip is not well seen though likely terminates in the lower SVC. A right IJ central line tip terminates in the lower SVC. Enteric tube descends below the diaphragm and out of the field-of-view. IMPRESSION: 1. No evidence of pneumonia. 2. Resolved pulmonary edema and bibasilar atelectasis. 3. Stable mild cardiomegaly. " 6bd7b518-19ce43bf-52b17192-0653e823-a264a1b9.jpg,validate/p15/p15442180/s58761487/6bd7b518-19ce43bf-52b17192-0653e823-a264a1b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p full treatment for PNA, aspiration risk with tube feeds running (strict NPO), NSTEMI with CHF now diuresed, now with bronchial breath sounds in left base. // infiltrate? pleural effusion? infiltrate? pleural effusion? IMPRESSION: Comparison to ___. Decrease in extent of the pre-existing parenchymal opacities. Unchanged moderate right and small left pleural effusion. The lung bases is better ventilated. However, the patient still shows evidence of mild pulmonary edema. Borderline size of the cardiac silhouette is unchanged. The course of the feeding tube is stable. " a0938436-d22e9396-a43b33c1-f534a104-f01d8ddb.jpg,validate/p11/p11222100/s52748066/a0938436-d22e9396-a43b33c1-f534a104-f01d8ddb.jpg,validation," FINAL REPORT INDICATION: ___M with abd pain after endoscopy. // eval for free air TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. There is no free air below the diaphragm. IMPRESSION: No acute cardiopulmonary process. No free intraperitoneal air. " f58fe198-80d8975f-af62744e-20b699ac-8f4cedd2.jpg,validate/p17/p17209077/s59884308/f58fe198-80d8975f-af62744e-20b699ac-8f4cedd2.jpg,validation," FINAL REPORT HISTORY: Kidney transplant with reduced breath sounds on the right. FINDINGS: In comparison with the study of ___, the patient has taken a much better inspiration. There is no evidence of acute pneumonia, vascular congestion, or pleural effusion. " 2a20039b-06657a88-91c65739-ba93d119-1ed84b19.jpg,validate/p15/p15287471/s57858718/2a20039b-06657a88-91c65739-ba93d119-1ed84b19.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with respiratory failure, bilateral effusions, evaluation for interval change. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: ET tube ends 3.7 cm above carina. The feeding tube is in adequate position below the diaphragm. Left-sided PICC line is in mid SVC. Bilateral moderate pleural effusion with bibasilar atelectasis is unchanged. Right upper lobe decreased opacity could reflect improvement of the lung process versus modification in ventilation parameters. Pulmonary edema is mild to moderate and unchanged. Mediastinal and cardiac contours are normal. There is no pneumothorax. CONCLUSION: 1. Tube and lines are in adequate position. 2. Slight improvement in right upper lobe opacity. This could reflect improvement of the lung process versus change in ventilation parameters. 3. Moderate pleural effusions are unchanged. " aa97ed28-c4d5c48d-0dc7645f-e44371d5-74206f28.jpg,validate/p12/p12722192/s56235939/aa97ed28-c4d5c48d-0dc7645f-e44371d5-74206f28.jpg,validation," 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. " 7c92c271-b483a753-ef2b3f80-804f19ba-48ef83eb.jpg,validate/p10/p10169796/s52881375/7c92c271-b483a753-ef2b3f80-804f19ba-48ef83eb.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with history of epilepsy and episode today concerning for seizure. The patient with sinus symptoms, chest congestion, and occasional cough. Evaluate for pneumonia. COMPARISON: Multiple chest radiographs, the latest from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show an opacity in the lingula. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. Clips are noted in the left upper quadrant are unchanged. IMPRESSION: Lingular opacity could represent pneumonia or atelectasis. These findings were communicated to the ED QA nurses via email at 11:41 pm on ___. " 1d325763-0ee55684-41db8af7-ad156460-9a5ac986.jpg,validate/p12/p12514721/s55902129/1d325763-0ee55684-41db8af7-ad156460-9a5ac986.jpg,validation," FINAL REPORT HISTORY: Non-small cell lung cancer in right lower lobe, had prior pneumothorax with biopsy on ___; has neck pain and headaches since; possible subcutaneous emphysema. Evaluate for pneumothorax and subcutaneous emphysema. COMPARISON: Chest radiograph from ___ in conjunction with CT chest from ___. FINDINGS: There is no evidence of pneumothorax or subcutaneous emphysema. In the right upper lung there is a 7 mm nodular opacity which was not clearly present on the most recent prior chest radiograph or chest CT. Additionally, there is a ___ 6 mm nodular opacity in the left mid lung which may correlate to a nodule seen on the most recent CT. A metallic marker is seen within the right lower lung nodule, not significantly changed from prior. The cardiomediastinal silhouette is stable. No pleural effusions are present. A hiatal hernia is again noted. IMPRESSION: 1. No pneumothorax or subcutaneous emphysema. 2. Right upper lung and left mid lung nodules, one possibly seen on prior CT. Recommend short-term follow up chest x-ray. If persistent, consider a chest CT, if warranted clinically, to assess for possible metastases. Findings discussed with Dr ___ by Dr ___ at 15:45 on ___ via phone. " 79962df8-e995d237-0acb8964-d83264d2-ed018303.jpg,validate/p14/p14828203/s55558581/79962df8-e995d237-0acb8964-d83264d2-ed018303.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with h/o multi lobar pneumonia 2 months ago // evaluate for resolution of pneumonia COMPARISON: Chest radiographs since ___ most recently ___ IMPRESSION: Previous consolidation in the right middle lobe has improved. Lungs are essentially clear of the multi focal abnormality present on ___, probably viral or mycoplasma pneumonia. Hyperinflation is consistent with either emphysema or small airway obstruction. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Moderately severe compression of an upper thoracic vertebral body which developed between ___ and ___ is unchanged. Mild gaseous distention of the mid esophagus is a recurrent feature and while it could be normal in a patient of this age might indicate swallowing dysfunction. Clinical correlation advised. " ce8d2728-761a24dd-1ccf59fc-bda7dc27-4a91e4dd.jpg,validate/p12/p12006413/s53325314/ce8d2728-761a24dd-1ccf59fc-bda7dc27-4a91e4dd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with endocarditis now intubated // Please assess placement of ET tube Please assess placement of ET tube IMPRESSION: In comparison with the study of ___, the endotracheal tube is approximately 5.5 cm above the carina. The other monitoring and support devices are stable, as is the cardio mediastinal silhouette. No evidence of acute focal pneumonia or vascular congestion. Mild blunting of the costophrenic angles is seen bilaterally. " ad8e0b09-1d048287-39be906e-65394285-a4de0708.jpg,validate/p12/p12181636/s59313123/ad8e0b09-1d048287-39be906e-65394285-a4de0708.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man S/P removal and replacement of LINX device and reduction of HH // check interval change check interval change COMPARISON: ___ IMPRESSION: Heart size and mediastinum is stable. ___ an X devise is in place. Lungs are clear. There is no pleural effusion or pneumothorax. " 33159e0a-07f63abb-a2e4da7e-00233e5c-7fdb488a.jpg,validate/p11/p11593760/s55044894/33159e0a-07f63abb-a2e4da7e-00233e5c-7fdb488a.jpg,validation," FINAL REPORT INDICATION: Epigastric and substernal pain, evaluate for cardiopulmonary process. COMPARISONS: None. PA AND LATERAL VIEWS OF THE CHEST: A left side pacemaker is noted with wires terminating in the right atrium and right ventricle. There is mild interstitial edema compatible with mild volume overload. The heart size is top normal. There is no pneumothorax, pleural effusion or focal airspace consolidation. An eventration is noted in the right hemidiaphragm. Aortic calcifications and degenerative changes of the cervical spine are appreciated. IMPRESSION: Minimal volume overload. " db04f686-953c540c-bf9ae941-d2499d69-aa3af8c3.jpg,validate/p10/p10915432/s51283606/db04f686-953c540c-bf9ae941-d2499d69-aa3af8c3.jpg,validation," FINAL REPORT HISTORY: Positive Gram stain on sputum culture, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the tracheostomy tube and left subclavian catheter remain in standard position. No evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " c82ab04d-0e944624-6a5a123a-f807f02b-a4f96b0c.jpg,validate/p13/p13875890/s50715470/c82ab04d-0e944624-6a5a123a-f807f02b-a4f96b0c.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old woman s/p PICC placement. CXR to confirm placement of PICC. // CXR to confirm placement of PICC. CXR to confirm placement of PICC. IMPRESSION: AP chest compared to ___ through ___ at 14:18. Left PIC line ends in the mid SVC. Tracheostomy tube in standard position. Nasogastric drainage tube ends in the distal stomach. Bilateral perihilar consolidation has improved on the right, worsened slightly on the left. The shift may indicate that some of this is pulmonary edema. Left pleural effusion is small. No pneumothorax. Heart size normal. " b94db79a-ebc44a07-be42079b-3fe36b3c-ce1d4e75.jpg,validate/p19/p19768190/s51918429/b94db79a-ebc44a07-be42079b-3fe36b3c-ce1d4e75.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of submassive PE, pulmonary hypertension. // any infiltrates? any infiltrates? 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. " 46310f4b-d80ba54a-6af22b8c-810f7056-47442bc2.jpg,validate/p10/p10083754/s59125232/46310f4b-d80ba54a-6af22b8c-810f7056-47442bc2.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___ year old with multiple myeloma // s/p auto transplant with intermittent low grade fevers, evaluate for PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ and ___ FINDINGS: No evidence of pneumonia. There is mild pectus excavatum. Linear atelectatic changes are seen at the left lung base. No pleural effusions or pneumothorax. A right subclavian catheter is unchanged in position. The cardiopericardial silhouette is unremarkable. IMPRESSION: No evidence of pneumonia. Reviewed with Dr. ___. " eaa42187-895dc78a-c071bfc8-93afd12b-858c2898.jpg,validate/p12/p12410201/s55664838/eaa42187-895dc78a-c071bfc8-93afd12b-858c2898.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: PA and lateral views of the chest. Findings: The patient is status post median sternotomy and CABG. Heart size is normal. Mediastinal and hilar contours are unchanged with mild calcification noted at the aortic arch. Pulmonary vasculature is normal and the lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. There are mild degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 579415cd-41a796f5-63d91b1e-74d3b940-5595d784.jpg,validate/p19/p19405326/s59902758/579415cd-41a796f5-63d91b1e-74d3b940-5595d784.jpg,validation," FINAL REPORT HISTORY: Shortness of breath COMPARISON: ___ FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs. The cardiac, hilar, mediastinal contours are normal. No pleural abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 51315f4b-febac73a-31544011-4a8bc123-9c3d8feb.jpg,validate/p12/p12502220/s55519216/51315f4b-febac73a-31544011-4a8bc123-9c3d8feb.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. COMPARISONS: Radiographs from ___, and CT from ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: There is again a three-lead pacemaker/ICD device with leads terminating in the right atrium, right ventricle, and coronary sinus. The cardiac, mediastinal and hilar contours appear unchanged including mild-to-moderate cardiomegaly and moderate unfolding of the thoracic aorta. Similar to prior findings, there is upper zone redistribution of pulmonary vasculature and peribronchial cuffing suggesting a state of very mild vascular congestion. There is no definite pleural effusion or pneumothorax. There has been little if any change. IMPRESSION: Stable appearance of the chest. " fcea157b-2a621e42-f91db983-ddb3681e-ced2dbd5.jpg,validate/p17/p17086932/s58882164/fcea157b-2a621e42-f91db983-ddb3681e-ced2dbd5.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with acute dyspnea, left lower lobe congestion and productive cough. Assess for pneumonia. COMPARISONS: ___. FINDINGS: Increased opacification with obscuration of the right and left heart borders and dense consolidation on the lateral is compatible with multifocal right middle and lingular pneumonia. Concomitant mild vascular congestion is also seen. Heart and mediastinum are normal. IMPRESSION: Multifocal pneumonia with mild vascular congestion. Follow up radiograph in ___ weeks is recommended to assess for radiographic improvement. Findings were discussed with Dr. ___ by Dr. ___ at ___ on ___. " d2097d93-a324b282-bdaef314-9874ca9a-9840c757.jpg,validate/p18/p18554479/s57476859/d2097d93-a324b282-bdaef314-9874ca9a-9840c757.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left sided chest pain, leukocytosis // pls eval for PNA, pt was asked to give better inspiratory effort TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ at 17:40 FINDINGS: Lingular opacity demonstrated on the prior study is not as well seen on the current study and may have been due to atelectasis. No definite focal consolidation is seen. Mid lung linear atelectasis/scarring is seen. . No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Lingular opacity demonstrated on the prior study is not as well seen on the current study and may have been due to atelectasis. No definite focal consolidation is seen " 8a07dcb3-d4c3ac2f-2b9a202a-615e3348-9b81f4b5.jpg,validate/p13/p13715870/s57885697/8a07dcb3-d4c3ac2f-2b9a202a-615e3348-9b81f4b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man POD8 Redo MVR // evaluate R apicalPTX evaluate R apicalPTX IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with mild vascular congestion and atelectatic changes at the left base. The previously described pneumothorax on the right is less prominent on the current study. Monitoring and support devices remain in place. " e92ebf9d-ff2fd7fe-50fe9a8c-03389988-8f493ef1.jpg,validate/p19/p19302735/s51230087/e92ebf9d-ff2fd7fe-50fe9a8c-03389988-8f493ef1.jpg,validation," FINAL REPORT INDICATION: Relapse CLL with increased cough. COMPARISONS: CT of the chest from ___. Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: A small left pleural effusion and left-sided atelectasis are unchanged. There is no new opacity to suggest pneumonia. There is no pulmonary edema, right pleural effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Post-surgical changes from a prior CABG are present. Left-sided Port-A-Cath is noted with the tip in the upper right atrium. IMPRESSION: Unchanged left pleural effusion. No evidence of pneumonia. Results were discussed with Dr. ___ at 12:10 p.m. on ___ via telephone, 5 minutes after the findings were discovered. " 7433ac7a-be3854ee-11115621-1de2794b-b47cb244.jpg,validate/p15/p15745033/s54988418/7433ac7a-be3854ee-11115621-1de2794b-b47cb244.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with multiple myeloma and productive cough. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest imaging: Findings are equivocal regarding the possibility of a small basal pneumonia, seen on the lateral view projected over the descending aorta. I would recommend oblique views to see if this is a real finding. Upper lungs are clear. Heart is mildly enlarged, but there is no vascular plethora or edema or significant pleural effusion. " 6bbfdc55-c31dc0e2-b104d5b7-24a23e90-8361f955.jpg,validate/p14/p14325424/s51500277/6bbfdc55-c31dc0e2-b104d5b7-24a23e90-8361f955.jpg,validation," 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. " 482837bc-93bd95f6-9113b687-b8e4f9f1-7eff59d7.jpg,validate/p14/p14413724/s57962838/482837bc-93bd95f6-9113b687-b8e4f9f1-7eff59d7.jpg,validation," FINAL REPORT INDICATION: ___M with fever and cough // r/o acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___ chest x-ray and ___ chest CT. FINDINGS: Patient is status post partial right upper lobe resection with subsequent volume loss in the right hemi thorax. Irregular interstitial markings at the right lung base on the frontal view abutting the diaphragm likely chronic based on changes on prior chest CT. There is no focal consolidation worrisome for pneumonia nor effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 41f958b2-cd580590-0d984da9-bc9191b3-77dcea93.jpg,validate/p17/p17653729/s59274781/41f958b2-cd580590-0d984da9-bc9191b3-77dcea93.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with ETT, pulm edema, bl pleural effusions // pls eval for interval changes COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Moderate right pleural effusion mild interstitial pulmonary edema, top-normal heart size and mediastinal vascular engorgement all unchanged since ___. ET tube and right PIC line are in standard placements. Left basal pleural pigtail drainage tube still in place. No pneumothorax. " dbb5a255-162eaa67-1d0e3eb2-288e2a59-79847c02.jpg,validate/p17/p17549101/s53300809/dbb5a255-162eaa67-1d0e3eb2-288e2a59-79847c02.jpg,validation," FINAL REPORT HISTORY: Chest pain, question pneumonia. CHEST, TWO VIEWS. COMPARISON: No previous chest x-rays on PACS record for comparison. There are slightly low inspiratory volumes. Allowing for this, heart size is borderline or slightly enlarged. No CHF. Minimal bibasilar atelectasis. No effusion. Probable eventration of the right hemidiaphragm. Possible slight wedging of the mid thoracic vertebral body, question T8. Mild T-spine degenerative change is noted. IMPRESSION: No acute pulmonary process identified. " 022905ba-30a221aa-5ef3fe06-e47ef416-4048cbac.jpg,validate/p12/p12454785/s58847357/022905ba-30a221aa-5ef3fe06-e47ef416-4048cbac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p whipple // please eval ETT placement IMPRESSION: Since ___, an endotracheal tube is been placed, in standard position. Feeding tube has been exchanged for a nasogastric tube, terminating below the diaphragm. Lung volumes are low, accentuating cardiomediastinal contours. Bibasilar atelectasis is demonstrated as well as a possible small left pleural effusion. Postoperative changes are observed in the upper abdomen. " eb814f5e-e5d348f5-cbf8e57f-a68b36b2-000a6092.jpg,validate/p13/p13826562/s56374351/eb814f5e-e5d348f5-cbf8e57f-a68b36b2-000a6092.jpg,validation," FINAL REPORT HISTORY: Fever. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. Mildly increased right lung peribronchial markings are in keeping with known history of radiation therapy. The lungs are otherwise clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Mildly increased right lung peribronchial markings, consistent with known history of radiation therapy. " d91c8050-f7ca1f2d-a8002283-04366dbe-17fccc87.jpg,validate/p19/p19950252/s57709543/d91c8050-f7ca1f2d-a8002283-04366dbe-17fccc87.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and fever, rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia. No pulmonary edema. Normal size of the cardiac silhouette. No pleural effusions. Normal aspect of the hilar and mediastinal structures. " eb70d1a9-f265fa44-625ed086-123f4837-1be1433c.jpg,validate/p17/p17202399/s52596569/eb70d1a9-f265fa44-625ed086-123f4837-1be1433c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with fever, hypotension // eval for pna COMPARISON: ___ and ___ FINDINGS: The lungs are hyperinflated suggesting COPD in the appropriate clinical setting. 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. Left hemidiaphragm is mildly elevated. IMPRESSION: Hyperinflated, clear lungs. No acute intrathoracic process. " 46e2f613-563a5684-66318017-af08a9de-75f8d5ec.jpg,validate/p16/p16497039/s54347125/46e2f613-563a5684-66318017-af08a9de-75f8d5ec.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with polytrauma. Question interval change. COMPARISON: Multiple prior studies dating back to ___. FINDINGS: Single frontal view of the chest demonstrates interval improved aeration in the right lung base. There is persistent dense retrocardiac opacity compatible with atelectasis or consolidation. A small left pleural effusion may be present. Upper lungs are well aerated. The left subclavian approach central venous catheter is stable in position with tip in the upper SVC. Osseous injuries are better delineated on prior CT dated ___. IMPRESSION: Improved right lower lobe aeration. " 20096568-62abbd31-59b33115-413e1788-3132bb75.jpg,validate/p15/p15299171/s59151354/20096568-62abbd31-59b33115-413e1788-3132bb75.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ___ No prior radiographs for comparison. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs and pleural surfaces are clear. There are no pleural effusions or acute skeletal findings. IMPRESSION: No radiographic evidence of pneumonia. " 16a6fd10-31f4dcd1-20230178-e7315472-bb6a25f0.jpg,validate/p12/p12152670/s58312611/16a6fd10-31f4dcd1-20230178-e7315472-bb6a25f0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with bibasilar rales, episodic PND // ? CHF TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: Some thickened septal lines are seen in the lower lungs, compatible with early phase pulmonary edema. Lungs are otherwise clear and the pulmonary vasculature is not particularly dilated or plethoric. Lungs are hyperinflated and the diaphragm is flattened consistent with air trapping and/or emphysema. Incidental note is made of well-healed right eighth and ninth rib fractures. IMPRESSION: Minimal pulmonary edema. Chronic moderate cardiomegaly. COPD " dc0ab49e-ab63ed2d-bf9f3464-64414684-d33f3adb.jpg,validate/p12/p12025665/s51014597/dc0ab49e-ab63ed2d-bf9f3464-64414684-d33f3adb.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. 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. " ad068dc1-d4322317-a26620e6-d24cb4e9-15887303.jpg,validate/p19/p19616273/s58414233/ad068dc1-d4322317-a26620e6-d24cb4e9-15887303.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male 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. Cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 87995080-ea852276-848bc0aa-f85a841b-10da8a77.jpg,validate/p10/p10804747/s51123732/87995080-ea852276-848bc0aa-f85a841b-10da8a77.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hemodynamic instability, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is improvement with reduction in extent of the right pleural effusion and increasing lung volumes, likely reflecting improved ventilation. However, extent of a minimal left pleural effusion and of a relatively large left lower lobe atelectasis is constant. No newly appeared parenchymal opacities. Unchanged size of the cardiac silhouette. Unchanged right PICC line. " a1eed35c-391a03ce-af45918f-1a8fdb0f-06b1d7e1.jpg,validate/p12/p12773009/s59041828/a1eed35c-391a03ce-af45918f-1a8fdb0f-06b1d7e1.jpg,validation," 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. " 14651f3d-694dcf17-0bd96548-ff16a8c5-f708dbd0.jpg,validate/p12/p12327925/s59277744/14651f3d-694dcf17-0bd96548-ff16a8c5-f708dbd0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever, coughing // evaluate for pneumonia evaluate for pneumonia IMPRESSION: Compared to chest radiographs ___. Right hemidiaphragm is chronically elevated. The mass, right midlung noted, documented on chest CT ___. Lungs clear of pneumonia. Heart size normal. No pleural effusion. " 840966c1-3d6f283c-da3068d1-5c1c7bbe-cd91137a.jpg,validate/p18/p18174666/s52411932/840966c1-3d6f283c-da3068d1-5c1c7bbe-cd91137a.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: New ICD placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. The biventricular pacer defibrillator has its leads in expected locations, although of note is that the right ventricular lead appears to be higher than on the prior imaging, although on the lateral view it follows the expected course within the right ventricle. There is no evidence of pneumothorax. Heart size and mediastinum are stable in appearance. Lungs are clear. " 555c4a80-969ce658-76b5aac3-0fcc8c45-7cc9d512.jpg,validate/p19/p19453522/s53756982/555c4a80-969ce658-76b5aac3-0fcc8c45-7cc9d512.jpg,validation," FINAL REPORT INDICATION: New right subclavian line placement. Please assess. COMPARISON: Comparison is made to chest radiograph performed the same day. FINDINGS: Single portable chest radiograph demonstrates interval placement of right subclavian line terminating at the cavoatrial junction. No pneumothorax or pleural effusion identified. Otherwise, the examination is unchanged. There is redemonstration of vague opacification projecting over the left hemithorax with no clear anatomical relationship and may represent increased soft tissue density due to patient's positioning. IMPRESSION: New right subclavian venous line without pneumothorax or pleural effusion. Stable opacification projecting over the left hemithorax of unclear etiology, possibly increased due to patient positioning. " 7c491adc-1feb9e60-6577d78d-11e04887-885601a7.jpg,validate/p17/p17237809/s53278352/7c491adc-1feb9e60-6577d78d-11e04887-885601a7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ___-year old right-handed man with a past medical history of CAD s/p CABG, sCHF (EF ___%), PVD s/p stents on Aspirin, HTN and afib on Coumadin, left CEA who presents with a right IPH with IVE. // interval change interval change IMPRESSION: ET tube tip is 6 cm above the carinal. Left PICC line tip is at the level of mid SVC. Heart size is enlarged. Left lung base was not included in the field of view. No pulmonary edema demonstrated. No appreciable right pleural effusion is seen. No pneumothorax. " 12c897f8-64dac996-5ab0fa74-df4376fe-9c6ed67f.jpg,validate/p16/p16788522/s53344312/12c897f8-64dac996-5ab0fa74-df4376fe-9c6ed67f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with abdominal pain, BRBPR, Hx of perforated viscous // upright chest: evaluate for abdominal free air TECHNIQUE: AP, portable views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are decreased, leading to crowding of the bronchovascular structures. Linear, bibasilar atelectasis is seen. Otherwise, there is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette are unchanged in appearance. Calcifications are noted at the aortic arch. No free air is seen beneath the right hemidiaphragm. IMPRESSION: Low lung volumes with bibasilar atelectasis. No free intraperitoneal air. " 0bfb85a2-fe62f571-fb0c092b-b592a4d6-60a8b4ff.jpg,validate/p19/p19720782/s51067581/0bfb85a2-fe62f571-fb0c092b-b592a4d6-60a8b4ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with h/o small cell lung cancer s/p radiation and severe emphysema presenting with dyspena, treating for COPD exacerbation, CXR on admission with ?fluid in the right major fissure. // Evaluate for interval change, particularly of the right major fissue and note of fluid on prior CXR. TECHNIQUE: Portable semi upright chest radiograph COMPARISON: ___ FINDINGS: Since the prior study the pseudotumor (fluid in the major fissure) on the right has resolved. Post treatment changes including elevation of the right hilus and coarse interstitial changes indicative of radiation fibrosis are again noted, a chronic finding. Obscuration of the right hemidiaphragm is likely a function of atelectasis and a small pleural effusion. The left lung is largely clear. Heart size and mediastinal contours are stable. Heavily calcified aortic arch is again noted. IMPRESSION: 1. Resolution of fluid in the right major fissure. 2. Small right pleural effusion and right basilar atelectasis. 3. Chronic treatment-related changes in the right lung. " 8e1f4766-c0852f98-8c4c8db6-57182af8-99ec6bb1.jpg,validate/p11/p11888614/s56650370/8e1f4766-c0852f98-8c4c8db6-57182af8-99ec6bb1.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with left-sided chest pain and shortness of breath. COMPARISON: ___. PA AND LATERAL CHEST RADIOGRAPH: Mediastinal and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion, or pneumothorax. " 5cc3f729-9c51ff22-dfb6daf2-4f4b6f74-67739c95.jpg,validate/p16/p16528352/s57392928/5cc3f729-9c51ff22-dfb6daf2-4f4b6f74-67739c95.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with right-sided chest tube and with concern for lung trapping. Portable AP radiograph of the chest was reviewed in comparison to ___. The right pigtail catheter is in place. There is no interval increase in pleural effusion. The aeration of the right upper lung is preserved but there is unchanged right lower lung opacities that might potentially reflect area of atelectasis. Left upper lung is clear. Right lung is demonstrated. The left lung base demonstrates minimal opacity worrisome for interval development of small effusion/atelectasis. " 9b8e9916-23b22736-3437096c-8ffc30f1-0077ccd8.jpg,validate/p18/p18714570/s51029250/9b8e9916-23b22736-3437096c-8ffc30f1-0077ccd8.jpg,validation," FINAL REPORT INDICATION: Patient with fever and chills. 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. " d0c9ae3c-a39ecca7-f7da6e6f-8cd0f5cf-fcfe3a56.jpg,validate/p12/p12347720/s59471770/d0c9ae3c-a39ecca7-f7da6e6f-8cd0f5cf-fcfe3a56.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Persistent cough. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: The patient is status post sternotomy. The cardiac, mediastinal and hilar contours appear stable. There is similar mild-to-moderate relative elevation of the right hemidiaphragm. The lungs appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute disease. " 2ddce13a-bd57dcfa-99430ae5-9490cb63-6daaf8de.jpg,validate/p17/p17457075/s55375309/2ddce13a-bd57dcfa-99430ae5-9490cb63-6daaf8de.jpg,validation," 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. " e876e616-425d73e5-e7110098-4256cf22-d1ea420a.jpg,validate/p17/p17716210/s53145515/e876e616-425d73e5-e7110098-4256cf22-d1ea420a.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath and cough. COMPARISON: Chest radiograph dated ___. FINDINGS: Frontal and lateral chest radiograph demonstrates well expanded and clear lungs. There is no focal consolidation, pleural effusion, or pulmonary edema. There is no pneumothorax. The cardiomediastinal and hilar contours are within normal limits. There is re- demonstration of thoracic spine stimulator in standard position. IMPRESSION: No pneumonia. " 3f10fc90-f9c1f74d-16178253-226f96e8-45822e14.jpg,validate/p11/p11184688/s59373833/3f10fc90-f9c1f74d-16178253-226f96e8-45822e14.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with cough, tachycardia // Eval for pneumonia COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Multiple overlying EKG leads limit the assessment. The heart is markedly enlarged as on prior. Bilateral ground-glass opacities likely reflect pulmonary edema though superimposed pneumonia difficult to exclude. No large effusions or pneumothorax seen. Bony structures appear intact. IMPRESSION: Marked cardiomegaly with mild-to-moderate pulmonary edema. Difficult to exclude a superimposed pneumonia. " 30a0b396-2b634a5c-279221a6-087bb6ba-bd9d39ed.jpg,validate/p10/p10046679/s51410749/30a0b396-2b634a5c-279221a6-087bb6ba-bd9d39ed.jpg,validation," FINAL REPORT INDICATION: ___M afib on coumadin, erectile dysfxn (s/p implant), CLL, severe COPD, ___ ___ for ab pain CT w pneumoperitoneum s/p ex lap, sigmoid resection and end colostomy for stercoral perforation // eval for CHF TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The ET tube terminates 3.1 cm above the carina. The enteric tube terminates in the stomach. The lung volume is small. No pulmonary edema. Increased pulmonary vascular marking is likely exaggerated by small lung volume. Left lower lobe atelectasis has increased. Left pleural effusion is mild. Cardiomediastinal silhouette is unchanged. IMPRESSION: 1. The ET tube terminates 3.1 cm above the carina. The enteric tube terminates in the stomach. 2. Worsening left lower lobe atelectasis and left pleural effusion. Otherwise stable chest radiograph. " ec3d1dee-c2278d11-dbf2f08c-3a06dafd-312e31aa.jpg,validate/p16/p16426000/s55910164/ec3d1dee-c2278d11-dbf2f08c-3a06dafd-312e31aa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right first rib resection and entry intro pleural space. // Please assess size of right sided pneumothorax Please assess size of right sided pneumothorax IMPRESSION: In comparison with the study of ___, there has been resection of the right first rib with a a resulting small apical pneumothorax. Otherwise, little change and no evidence of pneumonia or vascular congestion. " 90228898-3077540a-83ca4851-ebf876f9-64a41ad9.jpg,validate/p18/p18031120/s52968077/90228898-3077540a-83ca4851-ebf876f9-64a41ad9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiomyopathy, severe vol overload // eval PA catheter placement, interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate to large cardiomegaly is stable. Fluid overload has resolved. Retrocardiac atelectasis have minimally increased. There is no pneumothorax. Right Swan-Ganz catheter and pacer are in unchanged standard position " fb2b301e-c7239d8d-d6eb7f45-2e36806a-304d2682.jpg,validate/p16/p16492376/s51850330/fb2b301e-c7239d8d-d6eb7f45-2e36806a-304d2682.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with OSA AF chronic anticoagulation, with 3 week Hx of URI Sx; examination notable for subtle 'accentuation' of breath sounds L posterior base // please assess cardiopulmonary architecture please assess cardiopulmonary architecture COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " a044dfab-8ff64a00-7cb7dc75-873a6a63-02079b14.jpg,validate/p17/p17685971/s53863021/a044dfab-8ff64a00-7cb7dc75-873a6a63-02079b14.jpg,validation," FINAL REPORT HISTORY: Patient with asthma, assess for evidence of right or left heart failure. COMPARISON: ___ FINDINGS: Frontal and lateral chest radiographs were obtained. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. There is stable leftward tracheal deviation, unchanged from prior study. The heart size is normal. The mediastinal and hilar contours are within normal limits. IMPRESSION: 1. No radiographic evidence for acute cardiopulmonary process. 2. Stable leftward tracheal deviation, likely reflective of right thyroid lobe enlargement. " 7cd3b3b5-f8611b8f-c8b8af69-bf657e87-0e098719.jpg,validate/p17/p17624308/s51192948/7cd3b3b5-f8611b8f-c8b8af69-bf657e87-0e098719.jpg,validation," FINAL REPORT HISTORY: Left-sided chest pain. TECHNIQUE: Frontal and lateral views chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 36511a6b-02f0a55f-f8587e48-98856b27-c571817a.jpg,validate/p10/p10142639/s51984612/36511a6b-02f0a55f-f8587e48-98856b27-c571817a.jpg,validation," FINAL REPORT INDICATION: Three months of exertional substernal chest pain as well as shortness of breath and diaphoresis. Assess for pneumothorax or evidence of aortic dissection. COMPARISON: Cardiac CT 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. Surgical clips are seen in the right upper abdominal quandrant. IMPRESSION: No acute cardiac or pulmonary process. " a2266ac3-70cd3000-df442038-072dccab-a9f5a5e8.jpg,validate/p16/p16052022/s59650409/a2266ac3-70cd3000-df442038-072dccab-a9f5a5e8.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with GBM with failure to thrive. Question pneumonia. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Right chest wall port is seen with catheter tip in the proximal right atrium. Biapical scarring is seen, right greater than left, unchanged. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits noting superior retraction of the hila. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 537c2d5e-5f66ed47-dd10c195-6751db58-7b06edf6.jpg,validate/p16/p16074663/s54410717/537c2d5e-5f66ed47-dd10c195-6751db58-7b06edf6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cirrhosis and worsening altered mental status TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Minimal atelectasis is seen in the lung bases. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " c38def76-144cddcf-72f3c88c-f4bb57a9-1793c272.jpg,validate/p18/p18908795/s51174384/c38def76-144cddcf-72f3c88c-f4bb57a9-1793c272.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with R-CT; waterseal cxr showed worsening PTX so CT back to suction. // Please obtain morning of ___ to eval interval change of PTX COMPARISON: ___, 05:15 IMPRESSION: As compared to the previous radiograph, the right chest tube is now on suction. There is unchanged evidence of a and approximately 3 cm right apical pneumothorax that has not substantially changed since the previous examination. Unchanged minimal right pleural effusion with minimal atelectasis. Normal appearance of the cardiac silhouette and of the left lung. " a9533550-1718bb5a-7860c8b5-9d1bd8e3-2d23f424.jpg,validate/p18/p18666022/s57296566/a9533550-1718bb5a-7860c8b5-9d1bd8e3-2d23f424.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: NG tube placement TECHNIQUE: Single frontal chest radiograph COMPARISON: ___ 06:13 FINDINGS: NG tube tip terminates in the distal stomach. Slightly improved aeration of the lungs. Large free peritoneal air is re- demonstrated. No other relevant change. IMPRESSION: NG tube tip terminates in the distal stomach. Otherwise no relevant change from recent prior. " 8250ea9c-cf56f041-772a3dae-79adacd1-7a201760.jpg,validate/p11/p11581156/s51351158/8250ea9c-cf56f041-772a3dae-79adacd1-7a201760.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with esophageal cancer, s/p R pleurodesis ___; evaluate for interval change. COMPARISON: Chest radiograph dated ___. FINDINGS: The right Port-A-Cath appears intact and ends at the cavoatrial junction. The patient has a neoesophagus. The tip of the right chest tube is in the right hemithorax. Bilateral moderate-to-large pleural effusions, with apparent interval re-accumulation of pleural fluid on the right and interval improvement on the left. Cardiomegaly. No pneumothorax. IMPRESSION: Progression of right pleural effusion. Improvement of left pleural effusion. " 74b4461f-72c65180-c0bfeab1-809c7920-1d9a5c0f.jpg,validate/p14/p14767018/s50394302/74b4461f-72c65180-c0bfeab1-809c7920-1d9a5c0f.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman s/p aRDS, ___, acute liver injury // eval interval change TECHNIQUE: Portable chest COMPARISON: Portable chest radiograph dated ___ FINDINGS: In comparison with the chest radiograph obtained 2 days prior, all opacities and pulmonary edema have improved, now mild. Heart size is mildly enlarged, but stable. No focal consolidations or pleural effusions. An ET tube terminates 3.7 cm above the carina. An NG tube passes into the stomach with a side port approximately at the GE junction. A right-sided IJ central venous catheter and a right-sided PICC terminate in the mid SVC. IMPRESSION: Interval improvement in bilateral opacities and pulmonary edema, now mild. " a129084b-c15b684e-3d66410f-2bb29ca3-91d02299.jpg,validate/p18/p18688402/s57721872/a129084b-c15b684e-3d66410f-2bb29ca3-91d02299.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with syncope and shortness of breath. Evaluate for acute cardiopulmonary process. COMPARISON: Multiple prior chest radiographs, most recently ___. FINDINGS: Frontal and lateral views of the chest were obtained. Severe cardiomegaly and cardiomediastinal contours are stable. The lungs appear clear. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body. IMPRESSION: Chronic severe cardiomegaly. " b3a54e31-884cb144-ace95caa-925a6126-00680280.jpg,validate/p13/p13567471/s56768420/b3a54e31-884cb144-ace95caa-925a6126-00680280.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with severe COPD and worsening respiratory distress. Assess for pneumonia. COMPARISON: Chest radiographs ___, ___, ___, ___. TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: Right PICC tip is in the mid SVC. Sternotomy wires are intact. Mild vascular engorgement with normal heart size, no pleural effusion, mediastinal vein dilatation, or pulmonary edema. No new focal opacity or pneumothorax. Prior hyperinflated lung volumes are now mildly decreased with new mild right lower lobe atelectasis. IMPRESSION: New mild right lower lobe atelectasis. No pneumonia. " 0d83c6fd-4cee7197-0e9d6747-9a4d5fac-eabae2cc.jpg,validate/p14/p14336401/s51683909/0d83c6fd-4cee7197-0e9d6747-9a4d5fac-eabae2cc.jpg,validation," FINAL REPORT INDICATION: ___F with ? Free air, recent ___, outpatient X ray // Eval for Free Air TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ FINDINGS: The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Free intraperitoneal air is seen below the diaphragm. No acute osseous abnormalities identified. IMPRESSION: Free intraperitoneal air NOTIFICATION: Findings were known the ED physician at time of dictation, CT scan had already been ordered. " 9c1da3f0-50c5e5f4-eb14185a-6fc05f90-5628907c.jpg,validate/p10/p10892301/s53879559/9c1da3f0-50c5e5f4-eb14185a-6fc05f90-5628907c.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain and shortness of breath, question infection. COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded. There is an equivocal opacity seen posteriorly in the lower lungs, probably in the right lower lobe and not necessarily changed; pneumonia or atelectasis could be considered. The cardiomediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present. IMPRESSION: Vague right lower lobe opacity, not specific but potentially pneumonia in the appropriate setting. " eb55c64d-aca2754f-fc1f803d-385297d5-38d2c22a.jpg,validate/p13/p13494014/s50717254/eb55c64d-aca2754f-fc1f803d-385297d5-38d2c22a.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with hypotension. Question infection. COMPARISON: Radiograph dated ___. CT dated ___ and ___. FINDINGS: Single frontal view of the chest demonstrates a right pectoral Port-A-Catheter with tip terminating in the lower SVC or upper atrium. Multiple pulmonary nodules are better appreciated on prior cross-sectional studies. A dominant left hilar mass has begun to grow after earlier remission. Worse left hemidiaphragm elevation is explained by phrenic nerve impingement. There is no confluent consolidation, pneumothorax, or large pleural effusion. Prominent epicardial fat pad likely contributes to slight blunting of the left costophrenic angle. IMPRESSION: 1. No evidence for acute infection. 2. Growing left suprahilar mass and growing right lung nodules due to progressive metastatic lung cancer; probable left phrenic nerve dysfunction. 3. Right sided central infusion port ends at the superior cavoatrial junction as before. " a4fa06c1-9f1c4f10-f1ed284a-195e386e-343ce25b.jpg,validate/p14/p14065397/s55086211/a4fa06c1-9f1c4f10-f1ed284a-195e386e-343ce25b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new desat and hypotension // New desat and hypotension New desat and hypotension IMPRESSION: Compare to prior chest radiographs, ___ and ___. Mild cardiomegaly, mediastinal and pulmonary vascular engorgement are new indicating cardiac decompensation. No pleural effusion or pneumothorax. " 18d257a8-20acbb5c-dd22fe0f-d574d20a-cbf417ac.jpg,validate/p17/p17877811/s50333724/18d257a8-20acbb5c-dd22fe0f-d574d20a-cbf417ac.jpg,validation," WET READ: ___ ___ ___ 2:19 PM Bilateral upper lobe regions of consolidation compatible with pneumonia in the proper clinical setting. Repeat will be necessary after treatment to document resolution to exclude underlying lesion. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with dyspnea, cough // r/o PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Focal areas of consolidation projecting over the mid lungs bilaterally, localizing to the upper lobes based on the lateral view. Lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Bilateral upper lobe regions of consolidation compatible with pneumonia in the proper clinical setting. Repeat will be necessary after treatment to document resolution to exclude underlying lesion. " fceeb315-9a83b1f7-7e0d020a-6b502484-fd476677.jpg,validate/p14/p14696549/s58437176/fceeb315-9a83b1f7-7e0d020a-6b502484-fd476677.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath. COMPARISON: ___. Chest CT from earlier ___. FINDINGS: PA and lateral views of the chest. There has been no significant interval change. Again seen is significant lucency in the right midlung compatible with loculated pneumothorax as characterized by chest CT from earlier the same day. The cardiomediastinal silhouette is stable noting an enlarged tortuous aorta and cardiomegaly. No acute osseous abnormality detected. IMPRESSION: No significant interval change since CT scan performed earlier the same day more clearly delineated loculated right-sided pneumothorax. Other findings as above and as detailed and CT chest report " 056c99de-b84bdf06-bd92bed1-fdff7b6d-d85ad13d.jpg,validate/p14/p14951077/s56147001/056c99de-b84bdf06-bd92bed1-fdff7b6d-d85ad13d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with hx of AML with +DOE // ? infection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Chronic bilateral apical scarring and mediastinal fibrosis leading to upward retraction of bilateral hilar structures. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions. Right Port-A-Cath ends in the right atrium. No pneumothorax. IMPRESSION: No evidence of pneumonia. Right Port-A-Cath terminates in the right atrium. " 0b8e951a-9b9a44fc-3b1b492b-0aa50d40-8d6bd903.jpg,validate/p18/p18280086/s55180358/0b8e951a-9b9a44fc-3b1b492b-0aa50d40-8d6bd903.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new oxygen requirement, tachypnea // eval for pna, pulm edema COMPARISON: Chest x-ray from ___ at ___ FINDINGS: There is increased upper zone redistribution, consistent with mild fluid overload/ CHF. Again seen is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. Hazy density adjacent to this could represent a small left effusion. There is patchy opacity at the right lung base, which is more pronounced on the current examination, with minimal blunting of the right costophrenic angle. IMPRESSION: 1. CHF, more pronounced on the current film, with small bilateral effusions. 2. Left lower lobe collapse and/or consolidation and increased patchy opacity at the right base. While this could relate to the presence of CHF, the possibility of an associated infectious infiltrate cannot be excluded. " 6e12d874-e8267105-7fcf3a3b-bf752fdc-635c8bcd.jpg,validate/p17/p17096578/s57569940/6e12d874-e8267105-7fcf3a3b-bf752fdc-635c8bcd.jpg,validation," WET READ: ___ ___ ___ 1:23 AM Possible right middle lobe pneumonia in the appropriate clinical context. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, SOB // eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___ FINDINGS: The cardiac silhouette is mildly enlarged, similar to prior examination. In the right infrahilar region, there is a patchy opacity, in the appropriate clinical context, which may represent a right middle lobe pneumonia. There is no pleural effusion or pneumothorax. IMPRESSION: Possible right middle lobe pneumonia in the appropriate clinical context. " f1494f16-1637ec00-19dbd889-d8f5f12e-7e22ca4a.jpg,validate/p11/p11958553/s51359291/f1494f16-1637ec00-19dbd889-d8f5f12e-7e22ca4a.jpg,validation," FINAL REPORT HISTORY: Esophagectomy. FINDINGS: In comparison with study of ___, there are continued low lung volumes. There is a small-to-moderate pneumothorax on the right. Nasogastric tube extends to just below the level of the carina. Opacification at the right base consistent with some combination of atelectasis and effusion, and there are atelectatic changes at the left base as well. Subcutaneous gas is seen along the lower right chest and upper right abdomen. IMPRESSION: Small-to-moderate right pneumothorax postoperatively. This information has been telephoned to Dr. ___. " 2a88c248-9691eefa-5a9adf5f-3c0a17b4-da5784ee.jpg,validate/p13/p13085034/s53669729/2a88c248-9691eefa-5a9adf5f-3c0a17b4-da5784ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with persistent cough // 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. " 29b2e213-57fc5001-8baa1c35-0faeabea-8c8fb9c3.jpg,validate/p15/p15709365/s52328776/29b2e213-57fc5001-8baa1c35-0faeabea-8c8fb9c3.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: History of prior right ___ and ___ rib fractures and small right pneumothorax, followup. COMPARISON: ___. Heart size and mediastinum are stable. No appreciable pneumothorax is demonstrated on the current examination. Lungs are essentially clear with resolution of left lower lobe opacity. No pleural effusion or pneumothorax is seen. No definitive rib fractures are present, but if clinically warranted, correlation with dedicated rib views might be considered. " 03cd8116-ebd1c79b-db1aafe0-d08f41cf-b5fc0167.jpg,validate/p15/p15841005/s55870822/03cd8116-ebd1c79b-db1aafe0-d08f41cf-b5fc0167.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with cp. Assess for cardiopulmonary 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. Limited view of the abdomen demonstrates small amount of air within the stomach. IMPRESSION: No acute cardiopulmonary process. " ee8e3b3a-1a76dda2-f163818d-4c5c5650-a1955a82.jpg,validate/p17/p17302022/s53519568/ee8e3b3a-1a76dda2-f163818d-4c5c5650-a1955a82.jpg,validation," FINAL REPORT HISTORY: Amiodarone, to assess for toxicity. FINDINGS: In comparison with study of ___, there has been effective clearing of the basilar opacifications. No evidence of acute focal pneumonia or vascular congestion. No evidence of interstitial prominence or hepatic or splenic opacification, which would be radiographic manifestations of amiodarone toxicity. " e9f7ec3e-f6153b3d-93c0625d-c91fc240-fe823c85.jpg,validate/p16/p16276199/s55107612/e9f7ec3e-f6153b3d-93c0625d-c91fc240-fe823c85.jpg,validation," WET READ: ___ ___ ___ 11:17 PM Normal chest radiograph. No displaced rib fracture. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Rib pain status post assault with abdominal pain. Assess for cause of rib pain. COMPARISON: Chest radiograph ___. FINDINGS: Frontal on lateral chest radiograph demonstrates well expanded and clear lungs.No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: Normal chest radiograph. No displaced rib fracture. " ce8d05b8-d78c72b9-b66e6d3d-bd6fb962-c3da61f7.jpg,validate/p10/p10728720/s54792083/ce8d05b8-d78c72b9-b66e6d3d-bd6fb962-c3da61f7.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Fevers and 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. No pleural effusion or pneumothorax is seen. The gallbladder clips are noted consistent with prior cholecystectomy. " 4b9dbb8d-eadbe25d-75e7b24e-cd6eb7ae-1453bdb7.jpg,validate/p13/p13687044/s52199324/4b9dbb8d-eadbe25d-75e7b24e-cd6eb7ae-1453bdb7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary hypertension, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant, with the exception of the Swan-Ganz catheter that has been removed. The right pleural pigtail catheter is in unchanged position. Unchanged moderate cardiomegaly without signs of overt pulmonary edema. No pleural effusions. No pneumonia. " 62ee9aab-8621fda2-55b3b0de-dbac217d-58c2a2b7.jpg,validate/p16/p16183583/s50749959/62ee9aab-8621fda2-55b3b0de-dbac217d-58c2a2b7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated // Please confirm OGT placement and ETT placement TECHNIQUE: AP view of the chest COMPARISON: Multiple priors most recent on ___ FINDINGS: Endotracheal tube terminates 6.4 cm above the carina. A left-sided PICC is in stable position. Enteric tube descends below the field of view. Lung volumes are low, as before. The cardiomediastinal and hilar contours are stable. Bibasilar opacities are again demonstrated, not increased from the prior exam and are suggestive of atelectasis. There is no large pleural effusion or pneumothorax. IMPRESSION: Endotracheal tube terminates 6.4 cm above the carina. Persistent bibasilar opacities suggest atelectasis however could represent infection in appropriate setting. " 07611a54-eaac9025-5500b0ba-68cc172b-de985b39.jpg,validate/p11/p11844680/s56863676/07611a54-eaac9025-5500b0ba-68cc172b-de985b39.jpg,validation," FINAL REPORT INDICATION: Fever and leukocytosis. COMPARISONS: None. FINDINGS: PA and lateral views of the chest show no consolidation, pulmonary edema, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " dd6367b0-29557368-4cb94b2a-98d042ff-3bd216a8.jpg,validate/p19/p19479385/s59616703/dd6367b0-29557368-4cb94b2a-98d042ff-3bd216a8.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 12:03 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: Fevers. Evaluate for possible pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. There are atherosclerotic calcifications at the aortic knob. Apparent post-surgical hardware is visualized in the mid-thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 394e6f51-2c916227-1efac6e2-209cfc51-1ef88e9d.jpg,validate/p19/p19730987/s54623601/394e6f51-2c916227-1efac6e2-209cfc51-1ef88e9d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with DCIS s/p masectomy presenting with syncopal episode // 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. " fa8a9cec-f0b2b8b3-c80af858-bfb95c15-e90e2562.jpg,validate/p10/p10972354/s55996534/fa8a9cec-f0b2b8b3-c80af858-bfb95c15-e90e2562.jpg,validation," FINAL REPORT INDICATION: Patient with history of pneumonia. Assess for resolution. COMPARISONS: Chest radiograph of ___ and CT chest of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothorax. Biapical pleural scarring is apparent. Several calcified mediastinal and hilar lymph nodes are noted. Hilar and mediastinal silhouette is otherwise unremarkable. Heart size is normal. There is no pleural effusion. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process, no pneumonia. " 20c86d82-36f6a6b4-949d72e2-d8e1150c-a088a0a4.jpg,validate/p19/p19670384/s51945842/20c86d82-36f6a6b4-949d72e2-d8e1150c-a088a0a4.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with fever for 3 days, s/p renal xplant ___ on immunosuppressants, evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The heart is top-normal in size. There is no focal consolidation. There is no pneumothorax or pleural effusion. Bilateral shoulder prostheses are present. IMPRESSION: No evidence of pneumonia. " 1097655b-9f690af5-6cc45124-c56f661a-27c1098b.jpg,validate/p11/p11676845/s57418627/1097655b-9f690af5-6cc45124-c56f661a-27c1098b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with syncope x2 this AM // ?infection ?edema COMPARISON: CT C-spine ___ FINDINGS: Single frontal view of the chest provided. There is a mild atelectasis of the left lung base. Blunting of the right costophrenic angle could be due to a trace right pleural effusion. No focal consolidation, or pneumothorax. There is prominent superior right mediastinal contour, likely from the tortuosity of great vessels as seen on the C-spine CT of the same day. The cardiac silhouette is normal. Imaged bones are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild atelectasis of the left lung base and possible trace right pleural effusion. " 1c5c9a9b-e7bea597-c5692e4d-fc24a1ce-66d41b82.jpg,validate/p12/p12818469/s57810578/1c5c9a9b-e7bea597-c5692e4d-fc24a1ce-66d41b82.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent multifocal PNA in ___ presents to___ clinic for F/U. She also has positive AFB culture in 1 sample with 3 negative AFB smears // F/U PNA F/U PNA IMPRESSION: Comparison to ___. The pre-existing multifocal pneumonia has completely cleared. No new parenchymal opacities are visualized. No scars. No pleural effusion. No lymphadenopathy. Normal size of the cardiac silhouette. " 5d24aa13-17afdccc-8e14db94-4105fb05-c42fee40.jpg,validate/p11/p11842879/s50406737/5d24aa13-17afdccc-8e14db94-4105fb05-c42fee40.jpg,validation," WET READ: ___ ___ ___ 5:33 PM Since the study of ___ there is new opacity obscuring the left heart border with air bronchograms. This is concerning for pneumonia. The remaining lung fields are clear. There is no pleural effusion. There is a enteric contrast in partially visualized loops of bowel in the upper abdomen. ___ to ___ at 5:25 pm, ___, by phone, 5 minutes after discovery. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with dermatomyositis s/p EGD with back pain and rigors. Comparison is made with prior studies, chest x-ray ___. New large opacity in the left hemithorax with obscuration of the left cardiac border is consistent with a large area of consolidation (pneumonia and atelectasis). The right lung is clear. There is mild elevation of the left hemidiaphragm. Contrast is seen in the colon. There is no pneumothorax or effusion. Cardiac size cannot be evaluated. " 45fa61d1-1340b5a2-162a7140-548bf71a-3e9fa9c3.jpg,validate/p15/p15297415/s56799291/45fa61d1-1340b5a2-162a7140-548bf71a-3e9fa9c3.jpg,validation," 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. " 6f050392-4cd9fcc1-d4aa35b0-359a1ae6-7071c692.jpg,validate/p11/p11655432/s59247304/6f050392-4cd9fcc1-d4aa35b0-359a1ae6-7071c692.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with Hx of TB, scrofula, ?cough COMPARISON: ___ and CT chest from ___. FINDINGS: PA and lateral views of the chest provided. There is biapical pleural parenchymal scarring 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. " 3d0856a9-e1565f49-4a634cb4-6fb8672a-1cd33f38.jpg,validate/p17/p17826428/s58772651/3d0856a9-e1565f49-4a634cb4-6fb8672a-1cd33f38.jpg,validation," FINAL REPORT AP CHEST, 10:05 P.M., ___ HISTORY: ___-year-old woman with a poor baseline mental status and new fever to 103 Fahrenheit. Question aspiration or other pneumonia. IMPRESSION: AP chest compared to ___ and ___: Lung volumes are lower on the current study which serves to exaggerate pulmonary vascular caliber and the abnormal background interstitium of the lungs present on prior studies. Heart size is top normal. Mediastinal veins may be dilated. I would recommend repeat conventional radiographs as soon as feasible to see if the vascular abnormalities and interstitial edema are genuine, and to evaluate the left lung apex, which shows greater opacity medially than the right. All of these findings could be artifacts of low lung volume. " c534000b-ec2659a7-f471ce6a-82ce22e0-3714a671.jpg,validate/p18/p18726747/s59020006/c534000b-ec2659a7-f471ce6a-82ce22e0-3714a671.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with intermittent chest pain at sternum worsened with palpation // rule out fracture rule out fracture IMPRESSION: Comparison to ___. No relevant change has occurred. Normal size of the cardiac silhouette. Minimal tortuosity of the descending aorta. No pleural effusions. No pneumonia, no pulmonary edema. No abnormalities of the chest wall. " 6ab06f5e-86ba9399-a41679f2-a71daf07-199c204b.jpg,validate/p13/p13758036/s57983215/6ab06f5e-86ba9399-a41679f2-a71daf07-199c204b.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain, evaluate for pneumothorax. COMPARISON: None. FINDINGS: PA and lateral chest radiographs are provided. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 44247882-d9de3292-4aed2a05-b8f2e6cf-960854dc.jpg,validate/p15/p15117526/s50550135/44247882-d9de3292-4aed2a05-b8f2e6cf-960854dc.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with congestive heart failure after colectomy and ongoing diuresis. Portable AP radiograph of the chest was reviewed in comparison to ___. The right internal jugular line was removed. The pacemaker defibrillator leads are in unchanged position. Heart size is unchanged. Substantially enlarged pulmonary arteries bilaterally are redemonstrated. They are also demonstrated on the CT chest from ___. Minimal bibasal atelectases are present. No pleural effusion or pneumothorax is seen. " 60118037-89a238cc-00db911f-ab3ef3b7-88798e17.jpg,validate/p19/p19822093/s57070352/60118037-89a238cc-00db911f-ab3ef3b7-88798e17.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with possible PICC removal. Single view ok. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Right PICC tip in the mid SVC. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is. Punctate calcified granuloma is seen in the peripheral aspect of the left mid lung field, unchanged. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is demonstrated. IMPRESSION: Right PICC tip in the mid SVC. No acute cardiopulmonary abnormality. " 61042ac2-4616b877-d07ab1b0-b9881e2e-6b8eb285.jpg,validate/p11/p11751321/s54022427/61042ac2-4616b877-d07ab1b0-b9881e2e-6b8eb285.jpg,validation," FINAL REPORT INDICATION: Fever. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size remains mildly enlarged. The aorta is unfolded. Previously noted nasogastric tube has been removed. The pulmonary vascularity is not engorged. Elevation of left hemidiaphragm is stable. There is mild associated linear atelectasis in the left lower lobe. Right lung is clear. No focal consolidation, pleural effusion or pneumothorax is present. Mild degenerative changes of the thoracic spine are present. Partially imaged is cervical spinal fusion hardware. IMPRESSION: Elevation of left hemidiaphragm with associated left lower lobe atelectasis. No evidence for pneumonia. " 8471a13d-574b5402-fce62496-ec91cfc9-10163895.jpg,validate/p15/p15367414/s56187085/8471a13d-574b5402-fce62496-ec91cfc9-10163895.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cabg and pericardial window // eval for effusion or infiltrate eval for effusion or infiltrate IMPRESSION: In comparison with the study of ___, there again are substantial linear atelectatic changes at both bases. Patient has taken a much better inspiration. Continued enlargement of the cardiac silhouette with pacer device in unchanged position. No definite vascular congestion. " 023e52e2-38c61f35-9b2c8697-d5db9a63-673776d2.jpg,validate/p17/p17165725/s50080674/023e52e2-38c61f35-9b2c8697-d5db9a63-673776d2.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Sepsis, suspected new consolidation. COMPARISON: ___. The patient continues to be intubated. The NG tube tip is in the stomach. The right central venous line tip is at the level of superior SVC. There is slight interval improvement of pulmonary edema which is still present, mild. Bilateral pleural effusions and bibasilar consolidations are unchanged. Overall, no definitive evidence of new infectious process in the lungs can be seen on the current radiograph. " a77b035e-8b5a63d5-cd887120-d3acf7e7-e5ae1ca4.jpg,validate/p10/p10394530/s53738159/a77b035e-8b5a63d5-cd887120-d3acf7e7-e5ae1ca4.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient treated with amiodarone for atrial fibrillation. PA and lateral upright chest radiographs were reviewed in comparison to ___. The heart size is normal. The mediastinum is normal. The lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary process. No radiographic evidence of acute process. " 6d923403-0e05d06c-5c7a0f25-344b58a5-16a642f9.jpg,validate/p16/p16233087/s58381321/6d923403-0e05d06c-5c7a0f25-344b58a5-16a642f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with anemia // enlarging hemothorax? IMPRESSION: Since the prior radiograph of 1 day earlier, a moderate left pleural effusion has slightly increased in size with adjacent worsening opacification of the left lung base. No other relevant changes. " 941e5f6c-c752e5f6-a9aa628d-e7c54d29-3761571e.jpg,validate/p19/p19455517/s58588862/941e5f6c-c752e5f6-a9aa628d-e7c54d29-3761571e.jpg,validation," FINAL REPORT HISTORY: Cirrhosis and ataxia with weakness. COMPARISON: None. FINDINGS: AP upright and lateral chest radiographs were obtained. The lungs are well expanded and clear without pleural effusion or pneumothorax. The heart is top-normal in size with normal cardiomediastinal and hilar contours. IMPRESSION: No acute intrathoracic process. " dfce4bfe-27082ce3-5c50a206-9ae52cf5-8a811b47.jpg,validate/p18/p18799590/s53679185/dfce4bfe-27082ce3-5c50a206-9ae52cf5-8a811b47.jpg,validation," 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. " 04cd12d5-20f85a5a-f9ebac55-dc1b695d-1751ee74.jpg,validate/p11/p11580750/s56579735/04cd12d5-20f85a5a-f9ebac55-dc1b695d-1751ee74.jpg,validation," WET READ: ___ ___ ___ 8:28 PM Interval removal of right subclavian catheter. Left PICC courses along expected location of superior vena cava into the low superior vena cava; tip is not clearly seen on this study. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Assess position of PICC after CVL removal. Comparison is made with prior study performed the same day earlier in the morning. Left PICC tip is at the cavoatrial junction. Cardiac size is top normal, accentuated by the projection. Left lower lobe atelectasis is unchanged, otherwise the lungs are clear. There is no pneumothorax or large pleural effusions. The aorta is tortuous. " 0d50e981-6267ce4c-ac18fd7c-0994a93b-c0e635ec.jpg,validate/p13/p13365915/s57854794/0d50e981-6267ce4c-ac18fd7c-0994a93b-c0e635ec.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: Portable AP upright chest radiograph provided. The lungs are clear. No focal consolidation, effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. " af862bc4-dd12e83a-75509337-4e62a25f-20ed4b87.jpg,validate/p17/p17396841/s58673800/af862bc4-dd12e83a-75509337-4e62a25f-20ed4b87.jpg,validation," FINAL REPORT EXAMINATION: AP CHEST INDICATION: ___ year old man with NSTEMI, CHF exacerbation c/b DAH, intubated and paralyzed // eval for interval change eval for interval change IMPRESSION: Compared to chest radiographs ___ through ___. Residual heterogeneous pulmonary opacification has improved since earlier in the day. This could be pulmonary edema but the asymmetric and somewhat peripheral distribution raise possibility of other diagnoses including pulmonary hemorrhage. Clinical correlation advised. Cardiac silhouette is obscured, probably not substantially changed, top-normal size. Pleural effusions are presumed, but not appreciable. No pneumothorax. ET tube, Swan-Ganz catheter, esophageal drainage tube are unchanged in standard placements. " 716ef6d5-650100e6-1cd73451-1d6bcbc5-96537c3e.jpg,validate/p13/p13875890/s54812754/716ef6d5-650100e6-1cd73451-1d6bcbc5-96537c3e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tumor resection // serial exam serial exam IMPRESSION: Compared to chest radiographs ___ through ___. Previous moderate pulmonary edema has improved. Residual consolidation in the right lower lung and left midlung could be largely pneumonia. Heart size is normal. No pleural effusion. No pneumothorax. ET tube in standard placement. Nasogastric drainage tube is sharply folded in the stomach pain should be evaluated clinically to make sure it is functioning properly. " c8bf8c39-636dd353-53a6f56d-33b61a5e-fc6922e7.jpg,validate/p18/p18367177/s50785932/c8bf8c39-636dd353-53a6f56d-33b61a5e-fc6922e7.jpg,validation," FINAL REPORT HISTORY: Possible hemoptysis TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Aorta is unfolded. Mediastinum and hilar contours are otherwise normal. The lungs are hyperinflated with flattening of the diaphragms, suggestive of underlying COPD. The pulmonary vascularity is normal. Previously noted lingular abnormality has nearly completely resolved. A small right pleural effusion is likely present. No new areas of focal consolidation is present. There is no pneumothorax. No acute osseous abnormality is seen. IMPRESSION: Previously noted lingular opacity has nearly completely resolved. Small right pleural effusion. Hyperinflation of lungs suggestive of underlying COPD. " 855697af-dca10a60-9fc1d32b-bfaa5bcd-c84b8bef.jpg,validate/p15/p15167597/s57392725/855697af-dca10a60-9fc1d32b-bfaa5bcd-c84b8bef.jpg,validation," 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. " 7d02af73-d06f6498-5805fed8-b2158eb7-a1dd182b.jpg,validate/p18/p18092465/s54134704/7d02af73-d06f6498-5805fed8-b2158eb7-a1dd182b.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The lung volumes are low. There is no pleural effusion or pneumothorax. The lungs appear clear. Crowding of basilar lung markings on the lateral view is probably due to low lung volumes. The bony structures appear within normal limits. IMPRESSION: No definite evidence of acute cardiopulmonary disease. " 88f22844-28e01840-b53f0d95-48bfa28b-3205b9f5.jpg,validate/p10/p10900387/s51431946/88f22844-28e01840-b53f0d95-48bfa28b-3205b9f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o s/p arrest on mechanical ventilation // et tube, pulmonary infiltrate COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. The lung volumes have slightly increased, potentially indicating improved ventilation. The extent of the retrocardiac atelectasis, however, has slightly increased. Signs of pulmonary edema are less severe than on the previous image. No evidence of pneumothorax. " 138518c8-eabae87e-30f2909f-5dd0ae15-5693155b.jpg,validate/p19/p19204138/s56512557/138518c8-eabae87e-30f2909f-5dd0ae15-5693155b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with SOB // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: A mild background generalized interstitial abnormality is identified. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Scoliosis is noted centered within the mid thoracic spine. IMPRESSION: Age-indeterminate mild generalized background interstitial abnormality. " 57fcb300-2f2efa29-1190ea7e-e4448d27-32e60e2e.jpg,validate/p13/p13212908/s53529792/57fcb300-2f2efa29-1190ea7e-e4448d27-32e60e2e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been no significant interval change. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. Mild degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 0a3c3bfc-8712c49a-4dc89eb4-85957663-fa6327dd.jpg,validate/p16/p16813817/s50385317/0a3c3bfc-8712c49a-4dc89eb4-85957663-fa6327dd.jpg,validation," FINAL REPORT INDICATION: History: ___F with left sided chest pain // eval for CHF/pneumonia 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. " 8b5c727d-fade0ca3-ca5dae0e-370494a8-fbf91a8e.jpg,validate/p13/p13903059/s56322281/8b5c727d-fade0ca3-ca5dae0e-370494a8-fbf91a8e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with productive cough // concerned 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 hyperinflated but clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 4abd2c90-f3456392-a82cb76a-d4d542d1-96798837.jpg,validate/p14/p14546998/s55133728/4abd2c90-f3456392-a82cb76a-d4d542d1-96798837.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fevers and leukocytosis // r/o pna IMPRESSION: As compared to ___ radiograph, lung volumes are low, accentuating cardiomediastinal contours and resulting and crowding of bronchovascular structures. New patchy and linear bibasilar opacities are worse on the right than the left. Differential diagnosis includes atelectasis, aspiration and developing infectious pneumonia. Short-term followup radiographs with improved inspiratory level may be helpful in this regard. " 091b1336-a7497c35-8d9acbb9-a3e5733f-c139993e.jpg,validate/p15/p15040921/s52954417/091b1336-a7497c35-8d9acbb9-a3e5733f-c139993e.jpg,validation," 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 unchanged. There is no mediastinal widening. There is no pleural effusion or pneumothorax. The lungs appear clear. Slight degenerative changes are similar along the thoracic spine. There has been no significant change. IMPRESSION: No evidence of acute disease. " fe755159-23fde26e-8a3f499c-3e4c641b-d5440166.jpg,validate/p11/p11104911/s51705498/fe755159-23fde26e-8a3f499c-3e4c641b-d5440166.jpg,validation," FINAL REPORT HISTORY: Altered mental status. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: There are low lung volumes with associated bronchovascular crowding. No mass or opacity is seen in the lungs. There is no large pleural effusion or pneumothorax. The cardiomediastinal silhouette is enlarged, stable from prior exam. IMPRESSION: Low lung volumes. No acute cardiopulmonary process. " 12464d21-dee00210-def18b2a-5756ee53-d588b98c.jpg,validate/p16/p16386802/s52627560/12464d21-dee00210-def18b2a-5756ee53-d588b98c.jpg,validation," FINAL REPORT HISTORY: Weakness. Evaluate for CPD/infiltrate. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. There is mild hyperinflation of the lungs. There is however no focal consolidation, pleural effusion or pneumothorax. There is kyphosis of the thoracic spine and there is a probable small hiatal hernia. IMPRESSION: No acute cardiopulmonary process. " 166ae919-79cff3bd-928f97ba-b01358d4-d1042186.jpg,validate/p12/p12307852/s50341885/166ae919-79cff3bd-928f97ba-b01358d4-d1042186.jpg,validation," 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. " f7e8621f-e9025e69-dacf4ea4-1570f373-2d9210e2.jpg,validate/p11/p11468192/s51014625/f7e8621f-e9025e69-dacf4ea4-1570f373-2d9210e2.jpg,validation," FINAL REPORT HISTORY: Neck swelling and abscess. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 27fbc0f5-f5e40ae4-8edad725-30e8221f-95ecfbaa.jpg,validate/p12/p12773009/s59199393/27fbc0f5-f5e40ae4-8edad725-30e8221f-95ecfbaa.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CLL/SLL // worsening dyspnea, concerning for re-accumulation of pleural effusion, please re-evaluate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Moderate left pleural effusion with overlying atelectasis. The right lung is clear. No pneumothorax identified. The size and appearance of the cardiac silhouette is unchanged. IMPRESSION: Interval increase in size of the left pleural effusion, now moderate in extent. " cbd65bf7-a0773ca2-d3b24e4d-a10fd837-d73dfd1e.jpg,validate/p15/p15368249/s52689454/cbd65bf7-a0773ca2-d3b24e4d-a10fd837-d73dfd1e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman POD1 from long TFN with intermittent hypoxemia // eval for fluid status, consolidation eval for fluid status, consolidation IMPRESSION: Comparison to ___. No relevant change is seen. Small platelike scar in the right lung. Borderline size of the heart. Mild elongation of the descending aorta. No pneumonia, no pulmonary edema, no pleural effusions. " 81fbfa64-ba008a13-d148bd00-e1eecd66-ef9a1c40.jpg,validate/p11/p11051429/s53729726/81fbfa64-ba008a13-d148bd00-e1eecd66-ef9a1c40.jpg,validation," FINAL REPORT HISTORY: Abdominal pain and brief episode of hypotension. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: There is mild cardiomegaly which is unchanged. The aorta remains tortuous. The mediastinal and hilar contours are similar, with fullness at the right paratracheal stripe which again may reflect tortuous vessels. Clips in the lower neck indicate prior thyroidectomy. The pulmonary vascularity is not engorged. There is no focal consolidation, pleural effusion or pneumothorax. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 2fd2fd6d-85fef890-53987e16-518ce16c-6122e060.jpg,validate/p12/p12971318/s56262479/2fd2fd6d-85fef890-53987e16-518ce16c-6122e060.jpg,validation," FINAL REPORT HISTORY: Positive PPD. TECHNIQUE: Frontal and lateral chest 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 is normal in size. Mediastinal contours are normal. IMPRESSION: No radiographic evidence for acute cardiopulmonary or chronic granulomatous disease. " cda4663d-b7fe1448-13295102-f55f34f3-db55f0d5.jpg,validate/p16/p16896516/s58547252/cda4663d-b7fe1448-13295102-f55f34f3-db55f0d5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Tibia and fibula fractures, preop assessment. FINDINGS: AP upright and lateral views of the chest are provided. The lungs are hyperinflated, though clear. Patient is rotated to her left. No effusion or pneumothorax. No focal consolidation or signs of pulmonary edema. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Hyperinflated lungs without superimposed acute pathology. " fda5807c-b272947a-460c3d14-061337ca-4e7a46ab.jpg,validate/p19/p19557745/s52015620/fda5807c-b272947a-460c3d14-061337ca-4e7a46ab.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with new AFib and shortness of breath concerning for CHF. COMPARISON: AP portable upright radiograph of the chest, ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Lungs are clear and well inflated bilaterally with no focal consolidation, lesions, masses, pleural effusion, or evidence of pneumothorax. The cardiomediastinal silhouette is within normal limits. The pleural surfaces are unremarkable. Minimal degenerative changes of the thoracic spine is seen. There is no evidence of vascular congestion, pulmonary edema. Nipple markers were placed in order to disambiguate round opacities overlying lateral lung fields which were seen in the first image. IMPRESSION: No evidence of CHF. " ef158fff-64d9269d-22b0b953-a459e024-9ff13ec8.jpg,validate/p15/p15648678/s58608243/ef158fff-64d9269d-22b0b953-a459e024-9ff13ec8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough/SOB x 1.___ mos // r/o PNA COMPARISON: ___ and ___ chest radiograph FINDINGS: Heart is upper limits of normal in size with left ventricular configuration. Upper zone vascular redistribution is accompanied by slight vascular indistinctness and minimal peribronchial cuffing. There are no confluent areas of consolidation and no pleural effusions are evident. Multilevel degenerative changes are again demonstrated in the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion with minimal interstitial edema. No evidence of pneumonia. " 4fdd557d-b527c89a-905374a9-0d151c89-109d90b7.jpg,validate/p13/p13382386/s50394293/4fdd557d-b527c89a-905374a9-0d151c89-109d90b7.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is upper limits of normal. Mediastinal silhouette and hilar contours are normal. No acute osseous abnormality is identified. There is no free air under the diaphragm. IMPRESSION: No acute intrathoracic process. " 2b94fd61-f1efc31d-654bc9e8-e5ee6936-69161bee.jpg,validate/p12/p12455922/s57592227/2b94fd61-f1efc31d-654bc9e8-e5ee6936-69161bee.jpg,validation," 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. " 43f9b49d-f7392434-19db9e33-4c61f007-64a4bcd8.jpg,validate/p14/p14383658/s51173612/43f9b49d-f7392434-19db9e33-4c61f007-64a4bcd8.jpg,validation," FINAL REPORT AP CHEST, 8:02 A.M., ___ HISTORY: ___-year-old woman with MRSA pericarditis and left pleural effusion following drainage of both. IMPRESSION: AP chest compared to ___: Left pleural effusion is minimal if any. Diameter of the cardiac silhouette has decreased since ___, not appreciably changed since ___ following insertion of pericardial drainage catheter still in place. Lung volumes are quite low, and consolidation at the base of the left lung which became evident after drainage of most of the pleural effusion could be either atelectasis or pneumonia responsible for serosal infection. Mediastinal venous engorgement suggests elevated central venous pressure or volume. Clinical correlation advised. Right jugular line ends in standard position. No pneumothorax. " 64a6b213-8aacd2d5-71c6036b-8b088f24-2104a0bb.jpg,validate/p11/p11962173/s52477149/64a6b213-8aacd2d5-71c6036b-8b088f24-2104a0bb.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 6:48 AM INDICATION: Fever, postop. Evaluate for acute process. COMPARISON: None. FINDINGS: The lung volumes are slightly low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. There is pulmonary venous congestion without evidence of interstitial edema. The lungs are clear. The heart size is top normal. The mediastinal contours are normal. There are no pleural abnormalities. Surgical clips are seen in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiac or pulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: Fever, postop. Evaluate for acute process. COMPARISON: None. FINDINGS: The lung volumes are slightly low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. Fullness in the lower pole of the right hilum could be due to overlapping vessels. When feasible a repeat frontal view should be obtained at full inspiration. There is pulmonary venous congestion without evidence of interstitial edema. The lungs are clear. The heart size and mediastinal contours are normal. There are no pleural abnormalities. Surgical clips are seen in the right upper quadrant of the abdomen. IMPRESSION: No clear evidence of acute cardiac or pulmonary process. Suggest repeat CXR at full inspiration to re-evaluated right hilum. " 42e4abde-a6cb7d69-e926a24d-74ff6cb5-2ebe7a26.jpg,validate/p13/p13561687/s51523033/42e4abde-a6cb7d69-e926a24d-74ff6cb5-2ebe7a26.jpg,validation," FINAL REPORT INDICATION: Patient with fever and history of cancer with chemo. Evaluate for pneumonia or any other acute process. COMPARISON: Multiple prior chest radiographs, most recent on ___ and ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: A 10 mm calcified granuloma is again noted in the right upper lobe. Linear bilateral lower lobe opacities are re-identified and likely representative of scarring. Otherwise, the lungs are clear with no evidence of consolidation. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. No fractures are identified. IMPRESSION: No evidence of acute cardiopulmonary process. " 185c2f10-95c572e5-fe9c4b31-f035f0b4-a53693ba.jpg,validate/p17/p17858377/s53473013/185c2f10-95c572e5-fe9c4b31-f035f0b4-a53693ba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dementia, syncope, evaluation for pneumonia or acute process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the left PICC line has been removed. Otherwise, there is no relevant change. Moderate cardiomegaly with enlargement of the left ventricle, moderate tortuosity of the thoracic aorta. No pleural effusions. No pulmonary edema. No pneumonia. No pneumothorax. " 3231f90f-9a8b4fe8-5b2ea4ed-b0bc0bd4-5e7944ea.jpg,validate/p11/p11487605/s55643458/3231f90f-9a8b4fe8-5b2ea4ed-b0bc0bd4-5e7944ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever, chills, and increasing SOB, c/f pneumonia // pneumonia? TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are normal. Heart size is top-normal, unchanged. IMPRESSION: No evidence of pneumonia. " ddf34104-0342c143-d35aa363-3440a4f5-6b3b44c0.jpg,validate/p19/p19017919/s52689063/ddf34104-0342c143-d35aa363-3440a4f5-6b3b44c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p tiss AVR/CABG // eval for effusion/ptx s/p Left CT drainage eval for effusion/ptx s/p Left CT drainage COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous large left pleural effusion has been substantially evacuated, will new left pleural drainage catheter in place. No appreciable pneumothorax. Aside from mild linear atelectasis, will left lung is well expanded. Contour of the right lung base suggests is small right subpulmonic pleural effusion. Postoperative cardiomediastinal silhouette normal and unchanged. Tracheostomy tube midline. Right PIC line ends in the mid SVC. " ae39f4d0-b0da3b02-52929cd2-b6698aad-a681fd22.jpg,validate/p14/p14312560/s59332489/ae39f4d0-b0da3b02-52929cd2-b6698aad-a681fd22.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, gastrointestinal bleed, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of focal parenchymal opacities indicative of pneumonia. The orogastric tube has been removed. Unchanged borderline size of the cardiac silhouette without pulmonary edema. The lateral radiograph reveals a minimal pleural effusion bilaterally, restricted to the dorsal parts of the costophrenic sinus. " 22d5dbb7-5ff6ff5d-0ec386f0-8665459e-e0b36928.jpg,validate/p15/p15133460/s50205527/22d5dbb7-5ff6ff5d-0ec386f0-8665459e-e0b36928.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Weight loss and cough, tobacco use, rule out malignancy. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a right infrahilar pneumonia has completely resolved. The current image shows no evidence for the presence of parenchymal lung disease, in particular no evidence for pulmonary edema, pneumonia, or lung nodules or masses. Normal size of the cardiac silhouette. Minimal tortuosity of the thoracic aorta. No pneumothorax. " 61f74e6a-2cf168a7-bfad8d1d-323ada96-8c42c424.jpg,validate/p12/p12841802/s50979975/61f74e6a-2cf168a7-bfad8d1d-323ada96-8c42c424.jpg,validation," FINAL REPORT INDICATION: Patient with anxiety, seeking inpatient treatment. Pre-placement evaluation. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ through ___.. FINDINGS: Frontal and lateral radiographs of the chest demonstrate hyperexpanded, clear lungs. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No acute cardiopulmonary process. " 84658c01-6d8e8e77-c8c2e84a-90324ddd-0f9a5dc7.jpg,validate/p13/p13604162/s50572065/84658c01-6d8e8e77-c8c2e84a-90324ddd-0f9a5dc7.jpg,validation," FINAL REPORT HISTORY: Line placement. FINDINGS: In comparison with the study of earlier in this date, the monitoring and support devices are essentially unchanged. There are still low lung volumes without definite vascular congestion. Cardiomegaly persists. Retrocardiac opacification is again consistent with substantial volume loss in the left lower lobe and possible small pleural effusion. " 7593d914-da628490-ea20bc8d-c7d30ac1-c58da51b.jpg,validate/p10/p10784899/s54407274/7593d914-da628490-ea20bc8d-c7d30ac1-c58da51b.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with cough and fever. Question infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Linear opacity is again seen at the right lung base laterally, suggestive of atelectasis. The lungs are clear of consolidation suspicious for pneumonia, effusion, or pulmonary vascular congestion. Cardiac silhouette is enlarged but stable in configuration compared to prior. Atherosclerotic calcifications noted in the ascending aorta. No acute osseous abnormality is identified. Degenerative changes are seen at the shoulders bilaterally. IMPRESSION: No acute cardiopulmonary process. Cardiomegaly. " 4aa72aee-87d80ec8-5e7d8be1-5b3803ce-5cddc555.jpg,validate/p19/p19997293/s58790429/4aa72aee-87d80ec8-5e7d8be1-5b3803ce-5cddc555.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph dated ___. CLINICAL HISTORY: Spinal abscess, respiratory failure, complete heart block, assess for pneumonia or pulmonary edema. FINDINGS: Semi-upright portable AP view of the chest was provided. The patient is intubated with the tip of the endotracheal tube poorly visualized. The NG tube courses inferiorly though the tip is not clearly visualized. Left upper extremity PIC line is in unchanged and appropriate position. Midline sternotomy wires and spinal fixation hardware again noted with skin ___ along the body wall. There are bilateral pleural effusions with bibasilar opacities which could represent either atelectasis or pneumonia, or a combination. The mid upper lungs appear well aerated. Overall, heart size is difficult to assess due to patient rotation, though appears grossly unchanged. Bony structures are intact. IMPRESSION: Bilateral pleural effusions appear slightly increased with associated lower lung opacities which could represent atelectasis and/or pneumonia. " 6d6bafde-be43fe0d-accb82c1-c258de20-1eaebe58.jpg,validate/p16/p16295129/s52420482/6d6bafde-be43fe0d-accb82c1-c258de20-1eaebe58.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. 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. " c8c05294-5ba4a15e-4e460925-67581710-c6181a6e.jpg,validate/p16/p16573945/s54125256/c8c05294-5ba4a15e-4e460925-67581710-c6181a6e.jpg,validation," WET READ: ___ ___ ___ 6:49 PM 1. Mild pulmonary vascular congestion without frank interstitial edema or pleural effusions. 2. Moderate cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with hx of CABG, vertebrobasilar stenosis, carotid stenosis w/ two episodes of dizziness lasting 10 minutes. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Median sternotomy wires are noted, intact. Heart size is moderately enlarged, but stable. Pulmonary vascular congestion is mild. No frank interstitial edema. Bibasal opacities likely reflect a component of atelectasis. No convincing signs of pneumonia. No large pleural effusion. Osseous structures are intact. IMPRESSION: 1. Mild pulmonary vascular congestion without frank interstitial edema or pleural effusions. 2. Moderate cardiomegaly. " c6cb9927-8fb47e40-5fbccd44-1e70e056-4d112541.jpg,validate/p17/p17982586/s58556445/c6cb9927-8fb47e40-5fbccd44-1e70e056-4d112541.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with right apical PTX and pleural effusion s/p chest tube clamping. please schedule CXR for 3pm on ___ // eval for interval change in pleural effusion and PTX COMPARISON: Chest chest x-ray from ___ at 09:44 FINDINGS: Compared with earlier the same day, I doubt significant interval change. Again seen is a small right apical pneumothorax as well as a probable small loculated pneumothorax at the right lung base. Allowing for technical differences, the pneumothoraces do not appear significantly changed. IMPRESSION: Right-sided pneumothoraces, without significant change compared with earlier the same day. " e3fa73ad-182c7ede-3a1f3afd-8cdb50a5-eb134b70.jpg,validate/p19/p19792705/s59531079/e3fa73ad-182c7ede-3a1f3afd-8cdb50a5-eb134b70.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with shortness of breath. COMPARISON: PA and lateral chest radiograph ___. PORTABLE AP CHEST RADIOGRAPH: The cardiac silhouette is mildly more prominent compared to the most recent prior examination. Background chronic pulmonary changes are noted. Opacification at bilateral lung bases appears slightly more prominent on today's study but this may actually reflect overlying soft tissues versus mild edema, atelectasis or infectious process. Recommend a true PA and lateral for further evaluation, particularly if clinical symptoms persist. " eb84785b-d2734e30-66fb4936-35a6a89e-35400436.jpg,validate/p15/p15904475/s52125821/eb84785b-d2734e30-66fb4936-35a6a89e-35400436.jpg,validation," FINAL REPORT HISTORY: ___ -year-old female with history of pulmonary edema, now with shortness of breath. Evaluation for CHF. COMPARISON: Comparison is made to radiographs of the chest from ___ and ___. This study is read in conjunction with CT of the torso from ___. FINDINGS: AP and lateral views of the chest demonstrate stable moderate cardiomegaly. The mediastinal contours are unchanged. Pulmonary vascular engorgement and bibasilar hazy opacification is consistent with mild pulmonary edema. No large pleural effusion is identified. There is no focal consolidation or evidence of pneumothorax. IMPRESSION: Stable moderate cardiomegaly, with mild pulmonary edema. " 541ecc99-33451a1b-432c59a6-b21bdf48-0889698d.jpg,validate/p13/p13269330/s50646474/541ecc99-33451a1b-432c59a6-b21bdf48-0889698d.jpg,validation," FINAL REPORT HISTORY: Chest tube placement for malignant pleural effusion, to assess for re-accumulation. FINDINGS: In comparison with study of ___, there is increasing opacification at the left base, consistent with worsening pleural effusion. This is difficult to assess, because of the change in patient's position. No acute focal pneumonia. " 4316a5d8-509d3e3b-c043b320-2b6d6b1a-82da8600.jpg,validate/p12/p12707756/s59088564/4316a5d8-509d3e3b-c043b320-2b6d6b1a-82da8600.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute mitral regurgitation and new balloon pump // evaluate balloon pump placement evaluate balloon pump placement IMPRESSION: In comparison with the study ___ ___, there is an placement of an IABP with its tip approximately 1.5 cm below the transverse arch of the aorta. It could be pulled back approximately 1 cm. There is a a right IJ Swan-Ganz catheter tip in the right pulmonary artery. The little change in the bilateral pulmonary opacifications. " 1ee0b414-ecd8d6d5-533b655a-ea998820-2a108f92.jpg,validate/p19/p19161635/s55097483/1ee0b414-ecd8d6d5-533b655a-ea998820-2a108f92.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided. Lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. The imaged bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Normal chest radiograph. " 498a9a15-3d5f9868-0ec4654f-a0c5264c-753bb9bd.jpg,validate/p13/p13235049/s51772004/498a9a15-3d5f9868-0ec4654f-a0c5264c-753bb9bd.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with shortness of breath and cellulitis. COMPARISON: ___. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in an upright position. FINDINGS: Lung volumes are low. There is pulmonary vascular prominence. No focal consolidation, pleural effusion, or pneumothorax is appreciated on this single frontal view. Deformity of the right humerus is again noted, partially imaged. " 71046850-1274b7c7-65b03710-f7a037df-9262b1f1.jpg,validate/p17/p17219726/s58200277/71046850-1274b7c7-65b03710-f7a037df-9262b1f1.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Syncope. 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. " 08247625-5a65032d-b1929a4a-71d31175-94c65f9c.jpg,validate/p16/p16046758/s52359277/08247625-5a65032d-b1929a4a-71d31175-94c65f9c.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with metastatic non-small cell lung cancer and right-sided Pleurx catheter for recurrent effusion, now with shortness of breath, evaluate for interval change. COMPARISON: ___. FINDINGS: A right-sided chest tube remains in place, though the tip has now moved inferiorly into the costophrenic sulcus. A large right-sided effusion is not significantly changed compared with ___. Minimal aerated right lung is similar in appearance, as is chronic collapse of the right upper lobe. A moderate-to-large sized left pleural effusion has increased in the interim, with adjacent atelectasis of the basal segments of the left lower lobe. IMPRESSION: Only a small amount of residual aerated lung is present in the right chest. On the left, an effusion has increased in size, resulting in collapse of the basal segments of the left lower lobe. " 612f7370-dd3ea8d8-722e1d75-6d00476e-8433e51d.jpg,validate/p12/p12811128/s51282868/612f7370-dd3ea8d8-722e1d75-6d00476e-8433e51d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. FINDINGS: Both lungs are well expanded without opacities concerning for pneumonia. Heart size, mediastinal and hilar contours are normal. There is no pleural abnormality. IMPRESSION: No pneumonia. " de396d74-5a5803b7-dc8051d5-d914f619-28cba731.jpg,validate/p10/p10635380/s54269695/de396d74-5a5803b7-dc8051d5-d914f619-28cba731.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with loc and lactate elevation. // pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___ FINDINGS: The lungs are stably hyperinflated. The cardiomediastinal silhouette and pulmonary vasculature are unremarkable and unchanged since the prior examination. Again noted is scarring in the right upper lobe, unchanged since the prior examination. There is no focal consolidation. No large pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic abnormality. " 54572f31-0f7f1e22-bde7b852-c503688e-0d20408d.jpg,validate/p10/p10326429/s50390069/54572f31-0f7f1e22-bde7b852-c503688e-0d20408d.jpg,validation," FINAL REPORT AP CHEST, 10:11 A.M., ___ HISTORY: ___-year-old woman with hypoxia after vomiting, question aspiration. IMPRESSION: AP chest compared to ___, 8:59 a.m. Asymmetry in opacification of the lungs persists. Left is relatively clear. The right shows edema, and there is a small right pleural effusion, layering posteriorly. It is possible that these are changes due to aspiration, but asymmetric distribution of edema is another possibility, sometimes due to patient positioning. Heart is mildly enlarged, but shifted leftward, without obvious cause. No pneumothorax. Relative elevation of the left hemidiaphragm is presumably due to eventration, but could reflect left upper quadrant pathology such as splenomegaly. Right PIC line ends in the mid SVC. Upper mediastinal widening has been present since at least ___, presumably due to fat deposition. " 9b172aba-19309b08-bfbcb9f3-174ca501-f4db7375.jpg,validate/p10/p10326773/s56971723/9b172aba-19309b08-bfbcb9f3-174ca501-f4db7375.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with sputum production and poor oxygentation // ?pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Mild to moderate pulmonary edema persists. Also persistent and overall unchanged is a focal parenchymal opacity in the middle lobe, blunting the contour of the right hemidiaphragm and likely accompanied by a small pleural effusion. The finding could reflect pneumonia or aspiration. Mild cardiomegaly with left lower lobe atelectasis persists. No pneumothorax. The monitoring and support devices are constant. " e7a35f4c-2087d134-bcdc47f3-53587660-72477440.jpg,validate/p17/p17454111/s56661569/e7a35f4c-2087d134-bcdc47f3-53587660-72477440.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size remains mildly enlarged. The mediastinal and hilar contours are stable. No focal consolidation, pleural effusion or pneumothorax is seen. The pulmonary vasculature is normal. Minimal streaky opacity in the left lung base may reflect scarring or subsegmental atelectasis. No acute osseous abnormalities are demonstrated. Remote bilateral rib fractures are again noted. Mild degenerative changes are seen in the imaged thoracic spine as well as within both acromioclavicular joints. IMPRESSION: No acute cardiopulmonary process. " 5b347d8a-e1bc4945-19db07d2-481125ac-7def097d.jpg,validate/p19/p19359802/s53447110/5b347d8a-e1bc4945-19db07d2-481125ac-7def097d.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with pulmonary hypertension. COMPARISON: Chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are stable, with moderate cardiomegaly. Mild pulmonary edema is noted. Enlarged hila and right atrium relate to pulmonary hypertension. No pulmonary consolidation, pleural effusion, or pneumothorax is seen. Severe compression of a mid thoracic vertebral body is unchanged. IMPRESSION: Moderate cardiomegaly. Pulmonary HTN and mild edema. " 4ac10d3a-d5cb8bae-a2bcd646-f70c10b9-3b4dea1f.jpg,validate/p12/p12704304/s59874645/4ac10d3a-d5cb8bae-a2bcd646-f70c10b9-3b4dea1f.jpg,validation," WET READ: ___ ___ 11:23 PM Low lung volumes. No evidence of acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with episode of confusion, concern for subacute infection, evaluate for occult infection. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dating back to ___. FINDINGS: Low lung volumes cause bronchovascular crowding and bibasilar platelike atelectasis. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable. IMPRESSION: Low lung volumes. No evidence of acute cardiopulmonary process. " a76537a4-e9e3e546-d2210297-3bd04687-575941b7.jpg,validate/p16/p16154462/s58058632/a76537a4-e9e3e546-d2210297-3bd04687-575941b7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Positive PPD. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. No evidence of active or non-active TB. Normal size of the cardiac silhouette. Normal appearance of the lung parenchyma. " 273d3805-5cd905c5-45bbcb50-d0769a4d-55f7fbec.jpg,validate/p16/p16454913/s59345024/273d3805-5cd905c5-45bbcb50-d0769a4d-55f7fbec.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Sacral decubitus, nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph from ___, there is no relevant change. Tip of the nasogastric tube is still not visible on the current image. Unchanged moderate cardiomegaly, and bilateral pleural effusions as well as signs of fluid overload and right parenchymal opacities. " bd020307-c5cbc445-d6927b79-c8e8f30e-fe8a1755.jpg,validate/p16/p16296993/s51542524/bd020307-c5cbc445-d6927b79-c8e8f30e-fe8a1755.jpg,validation," FINAL REPORT CHEST, SINGLE AP UPRIGHT PORTABLE VIEW. CLINICAL INFORMATION: ___ year old female with dyspnea. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. The cardiac silhouette remains mildly enlarged. The aorta is calcified and tortuous. There are relatively low lung volumes with bibasilar atelectasis. No definite focal consolidation, large pleural effusion, or evidence of pneumothorax is seen. Again, there are lung volumes. IMPRESSION: Low lung volumes, as before. Mild bibasilar atelectasis. Otherwise, no significant interval change. " 853fede5-8fde08ac-c3bc7391-d07fe326-ca0d5934.jpg,validate/p15/p15970909/s59840967/853fede5-8fde08ac-c3bc7391-d07fe326-ca0d5934.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia // eval for acute process eval for acute process COMPARISON: Chest radiographs ___ through ___. IMPRESSION: The volume of the right lower lobe has partially recovered, but that region is narrow densely consolidated, concerning for pneumonia. Atelectasis at the left lung base is less severe than the right and has also improved. The upper lungs are clear. The heart is top-normal size. Pleural effusions are presumed, but not large. No pneumothorax. No pulmonary edema. " c75e8807-2d6929f5-f3eb3683-2cd84fb9-890068cc.jpg,validate/p14/p14508643/s57935306/c75e8807-2d6929f5-f3eb3683-2cd84fb9-890068cc.jpg,validation," FINAL REPORT HISTORY: Nausea, vomiting, diarrhea, faint right lower lobe. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. MRCP ___. FINDINGS: The heart size is mildly enlarged but unchanged. The aortic knob is calcified. Mediastinal and hilar contours are within normal limits. The pulmonary vascularity is not engorged. The lungs are hyperinflated with flattening of the diaphragms compatible with COPD. No focal consolidation, pleural effusion or pneumothorax is identified. Diffuse demineralization the osseous structures is noted. Clips in the right upper quadrant of the abdomen are present. On the lateral view, rounded calcifications within the upper abdomen are within a tortuous splenic artery. IMPRESSION: No acute cardiopulmonary abnormality. " da9f025b-14da581e-7a95c5f3-7aa72d72-a5e858d6.jpg,validate/p15/p15619921/s52229495/da9f025b-14da581e-7a95c5f3-7aa72d72-a5e858d6.jpg,validation," FINAL REPORT PORTABLE CHEST; ___ HISTORY: ___-year-old female with dyspnea. COMPARISON: ___. FINDINGS: Single portable view of the chest. The degree of pulmonary vascular engorgement is unchanged. The left greater than right pleural effusions are not significantly changed. The cardiomediastinal silhouette is stable. Median sternotomy wires and mediastinal clips are again seen. IMPRESSION: No significant interval change. Bilateral left greater than right effusions with pulmonary vascular congestion. " 2f97f519-55be0627-b22bb086-f4ddf52d-b075d13c.jpg,validate/p15/p15558349/s51699276/2f97f519-55be0627-b22bb086-f4ddf52d-b075d13c.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs, two views. FINDINGS: Moderate enlargement of the cardiac silhouette has increased substantially since ___. Severe distension of mediastinal veins is disproportionate compared to mild pulmonary vascular congestion, pointing toward right heart failure or hemodynamically significant pericardial effusion. Lungs are clear and there is no pleural effusion. IMPRESSION: Worse cardiomegaly and/or pericardial effusion. Suggest echocardiography. Dr ___ paged at 8:30AM. " 30349dcf-e684ce62-305d80fe-b136411f-a31ca9b9.jpg,validate/p12/p12878461/s57560316/30349dcf-e684ce62-305d80fe-b136411f-a31ca9b9.jpg,validation," 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. " c8b95c4e-1ab26289-9107ecb6-6e70a749-ec02c584.jpg,validate/p16/p16826047/s51435164/c8b95c4e-1ab26289-9107ecb6-6e70a749-ec02c584.jpg,validation," FINAL REPORT HISTORY: Right pleural effusion with Pleurx catheter in place. FINDINGS: In comparison with study of ___, despite the right Pleurx catheter in place, there is still a substantial layering pleural effusion with compressive atelectasis at the right base. The left lung is essentially clear at this time. Continued enlargement of the cardiac silhouette with minimal if any vascular congestion. No acute focal pneumonia on the left. " 985a8941-51179348-3cdac3ab-4777b61f-f32841b0.jpg,validate/p15/p15606211/s56011207/985a8941-51179348-3cdac3ab-4777b61f-f32841b0.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with leg swelling // chf TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no lobar consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Mild coarsening of the interstitial markings is noted. The heart is mildly enlarged and there is mild central pulmonary vascular congestion. Calcifications are seen at the aortic arch. A chronic distal right clavicular fracture is noted. IMPRESSION: Mild cardiomegaly and central pulmonary vascular congestion. " ba3754aa-3a86672f-4152f550-0bc89593-fdfc9cd8.jpg,validate/p11/p11291823/s59203202/ba3754aa-3a86672f-4152f550-0bc89593-fdfc9cd8.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 3 EXAMS INDICATION: ___ year old man with recurrent aspiration causing hypoxemic respiratory failure now requiring NGT placement // Assess NGT placement. This will be performed in a two-step process requiring two films. Assess NGT placement. This will be performed in a two-step p IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube has been removed and replaced with a Dobhoff tube that extends to the upper to mid portion of the stomach. There is increasing opacification at the right base with obscuration of the hemidiaphragm, consistent with collapse of the right lower lobe and possibly a portion of the middle lobe. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion. Again the possibility of superimposed aspiration is difficult to exclude, especially in the absence of a lateral view. " f5bcfc72-3fd533a5-b7a2fc55-c29e9ac1-3c19a7af.jpg,validate/p16/p16249146/s58296356/f5bcfc72-3fd533a5-b7a2fc55-c29e9ac1-3c19a7af.jpg,validation," WET READ: ___ ___ ___ 4:31 PM 1. Large hiatal hernia. 2. Bilateral small pleural effusions with associated bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT INDICATION: Patient with abdominal pain and vomiting. Evaluate. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal AP and lateral chest radiograph. FINDINGS: A large hiatal hernia, better seen in subsequent CT, has increased in size from prior exam. Bilateral small pleural effusions are seen with asscoaited atelectasis. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax. No rib fracture is identified. IMPRESSION: 1. Large hiatal hernia. 2. Bilateral small pleural effusions with associated bibasilar atelectasis. " 89744f9c-1aec34f6-40b99e76-3c7f84ca-baaa5a11.jpg,validate/p16/p16944227/s55763245/89744f9c-1aec34f6-40b99e76-3c7f84ca-baaa5a11.jpg,validation," FINAL REPORT INDICATION: Lung mass, short of breath. COMPARISON: Chest radiograph, ___, and chest CT ___. These studies are reference studies from___ and have been scanned into PACS for comparison. PA AND LATERAL VIEWS OF THE CHEST: Patient is status post median sternotomy and CABG. The heart size is top normal. There has been interval opacification of the right upper lobe, likely resulting from post-obstructive atelectasis due to the presence of the right upper lobe mass. Small left pleural effusion appears slightly increased in size compared to the prior study. The right lung is grossly clear. There is no pneumothorax. No acute osseous abnormality is visualized, though mild degenerative changes of the thoracic spine are present. IMPRESSION: New opacification of the right upper lobe likely representing postobstructive collapse due to the presence of the right upper lobe lung mass. Small left pleural effusion appears slightly increased in size compared to the prior study. " 34bc91d9-82510d9d-962f510e-713fce6d-ad549147.jpg,validate/p17/p17989027/s54017050/34bc91d9-82510d9d-962f510e-713fce6d-ad549147.jpg,validation," 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. " 6ff01218-f6214aed-b3ff96cd-75b69e5f-9bcb66f5.jpg,validate/p15/p15630626/s59060545/6ff01218-f6214aed-b3ff96cd-75b69e5f-9bcb66f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever, neutropenic // ?pneumonia COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Due to a severe pectus excavatum deformity, opacity in the right cardiophrenic recess is more likely reflective of epicardial fat. No convincing evidence for pneumonia or CHF. No large effusion or pneumothorax. The heart appears mildly enlarged. Bony structures are intact. Mediastinal contour is normal. IMPRESSION: No acute findings. Opacity in the right cardiophrenic recess likely represents epicardial fat in the setting of a severe pectus excavatum deformity. Mild cardiomegaly. " ffa74a7d-f1992a04-7ba91036-79310464-7a8aa3a3.jpg,validate/p15/p15026237/s59587249/ffa74a7d-f1992a04-7ba91036-79310464-7a8aa3a3.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart size is top normal. The hilar and mediastinal contours are within normal limits. The patient is post-median sternotomy. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: No acute intrathoracic process. " f0f4d6a8-d9b13385-06afa3ac-27b632df-bed53503.jpg,validate/p13/p13767558/s56326397/f0f4d6a8-d9b13385-06afa3ac-27b632df-bed53503.jpg,validation," FINAL REPORT HISTORY: 3 day history of cough, status post kidney transplant on chronic immunosuppressive therapy. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The patient is status post median sternotomy and CABG. The heart size is top normal, unchanged. Mediastinal and hilar contours are unchanged, and there is no pulmonary vascular congestion. Linear scarring in the left lung base is re- demonstrated as is scarring within the lung apices. No focal consolidation, pleural effusion or pneumothorax is seen. There are multilevel degenerative changes in the thoracic spine, but no acute abnormalities are seen within the osseous structures. IMPRESSION: No acute cardiopulmonary abnormality. " 175143b0-1b2439a2-77fea834-308c46d5-0d60fdca.jpg,validate/p18/p18804886/s51145284/175143b0-1b2439a2-77fea834-308c46d5-0d60fdca.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with sob // infiltrate? 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. " 282842f4-b0edb857-29012e5d-d534688a-6d1b2f65.jpg,validate/p14/p14683932/s57503447/282842f4-b0edb857-29012e5d-d534688a-6d1b2f65.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with dyspnea. Please evaluate for acute cardiopulmonary process. 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. IMPRESSION: No acute cardiopulmonary process. " 7210d313-1fae7147-541b2194-0eaa5ccb-83110ac8.jpg,validate/p12/p12016108/s51505608/7210d313-1fae7147-541b2194-0eaa5ccb-83110ac8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Altered mental status, question pneumonia. FINDINGS: AP upright and lateral views of the chest are provided. A right pleural effusion is small and unchanged. The lungs remain clear without evidence of pneumonia or CHF. Cardiomediastinal silhouette is stable. A right PICC line has been removed. No pneumothorax. A ureteral stent is partially visualized in the upper abdomen. IMPRESSION: Stable small right pleural effusion. " 8ae85558-fc4fa33e-88c82470-d077c594-45226e8d.jpg,validate/p10/p10667727/s55517979/8ae85558-fc4fa33e-88c82470-d077c594-45226e8d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F intubated, staph bacteremia, CHF, RV failure, intubated // eval placement of NG tube eval placement of NG tube COMPARISON: Comparison to ___ at 09:43 FINDINGS: Portable semi-erect chest film ___ at 16:52 IMPRESSION: Right internal jugular central line and endotracheal tube are unchanged in position. Nasogastric tube is seen coursing below the diaphragm with the tip not identified. There are bilateral layering effusions with associated bibasilar airspace disease suggestive of compressive atelectasis. No pneumothorax is seen. No pulmonary edema. Overall cardiac and mediastinal contours are stable. " ce61bfe7-34107e1c-5fa67a4a-cf396d5c-24329108.jpg,validate/p17/p17421663/s56303279/ce61bfe7-34107e1c-5fa67a4a-cf396d5c-24329108.jpg,validation," 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. " b61a10c5-79e1b7c3-65653284-2c6138a4-f26748c7.jpg,validate/p10/p10699336/s51701994/b61a10c5-79e1b7c3-65653284-2c6138a4-f26748c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M s/p MCC, arrest x 2 w/ ROSC, s/p cric w/ TBI, C5-6 fractures with vert dissection, T3 vertebral fracture, mediastinal hematoma, R ___, ___ and L ___th rib fractures, bilateral hemothoraces, R orbital fracture, R zygomatic fracture // interval change interval change COMPARISON: Prior chest radiographs ___. IMPRESSION: Previous asymmetric pulmonary edema has cleared and mediastinal venous engorgement has resolved. Mild bibasilar atelectasis increased on the left, stable on the right. Pleural effusions small if any. No pneumothorax. ET tube is in standard placement, though it is noted that the diameter of the tube is less than half the tracheal lumen. Esophageal drainage tube is looped in the hypopharynx before passing below the diaphragm, and should be repositioned. Left subclavian line ends at the origin of the SVC. RECOMMENDATION(S): Esophageal drainage tube is looped in the hypopharynx before passing below the diaphragm, and should be repositioned. " 10172d63-ab604817-75b06338-cd203616-b7fef1b7.jpg,validate/p17/p17517983/s56461205/10172d63-ab604817-75b06338-cd203616-b7fef1b7.jpg,validation," FINAL REPORT INDICATION: Right-sided chest wall pain status post mechanical fall, here to evaluate for pneumothorax or rib fracture. COMPARISON: Chest radiograph last performed on ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are decreased from the prior study. 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 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. No displaced rib fractures are detected. IMPRESSION: No pneumothorax or displaced rib fractures. " 14a4b945-8095de52-f10c48af-196f6021-9d880382.jpg,validate/p10/p10670085/s51017432/14a4b945-8095de52-f10c48af-196f6021-9d880382.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Acute chest pain. Portable AP radiograph of the chest was reviewed in comparison to ___. The heart size is enlarged, unchanged. Sternal plates are unchanged as well as the appearance of the replaced aortic valve. Lungs are essentially clear. There is no pleural effusion or pneumothorax. " d7e150ab-fb7cb1e7-629ff48a-71439887-66e9cc46.jpg,validate/p19/p19231238/s58976957/d7e150ab-fb7cb1e7-629ff48a-71439887-66e9cc46.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, in a patient with a history of CHF. Evaluate for pulmonary edema versus pneumonia. COMPARISON: Chest radiographs from ___, ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate moderate cardiomegaly, which is likely unchanged but accentuated by lower lung volumes compared to prior radiographs. There is also results in bronchovascular crowding. There is mild vascular congestion. The left hemidiaphragm is obscured, consistent with a retrocardiac opacity, which may be due to a small left pleural effusion. There is no pneumothorax. IMPRESSION: 1. Retrocardiac opacity, new since ___. This may represent a small left pleural effusion. 2. Moderate cardiomegaly. 3. Mild vascular congestion. NOTIFICATION: These findings were discussed via telephone by Dr. ___ ___ with Dr. ___ at ___ on ___, upon initial review. " f34c83eb-e788c9fc-b1cedf10-16edb79b-6153577e.jpg,validate/p17/p17643710/s55659320/f34c83eb-e788c9fc-b1cedf10-16edb79b-6153577e.jpg,validation," 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. " 06b31862-c5012826-42d5d3d6-24faa96d-98e6b5b4.jpg,validate/p11/p11234592/s57145991/06b31862-c5012826-42d5d3d6-24faa96d-98e6b5b4.jpg,validation," 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. " 0e177252-affaf887-456420f6-a40ba638-90c32170.jpg,validate/p13/p13721087/s50939307/0e177252-affaf887-456420f6-a40ba638-90c32170.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Severe heart failure, multiple central lines, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of mild-to-moderate fluid overload and massive cardiomegaly. None of the two findings has further increased in extent and severity. Unchanged alignment of sternal wires, unchanged overall monitoring and support devices. No new parenchymal opacities. No larger pleural effusions. " fa2974c7-10be63f1-6df28362-e9e754d8-23447f3e.jpg,validate/p12/p12571564/s55874008/fa2974c7-10be63f1-6df28362-e9e754d8-23447f3e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with hypoxia. Systolic murmur. COMPARISON: None. FINDINGS: AP and lateral views of the chest. There are streaky left greater than right bibasilar opacities. Elsewhere the lungs are clear without large effusion or pulmonary vascular congestion. Blunting of the posterior costophrenic angles may be due to trace effusions. There is also suggestion of a hiatal hernia. The cardiac silhouette is enlarged. No acute osseous abnormalities detected. IMPRESSION: Cardiomegaly. Mild bibasilar opacities, potentially due to atelectasis noting infection is not totally excluded. Probable hiatal hernia. " 3b244aee-aa22c198-5b08d2dd-4158a87e-233478e0.jpg,validate/p13/p13859181/s55532787/3b244aee-aa22c198-5b08d2dd-4158a87e-233478e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with septic shock s/p VF arrest with neurologic devastation // evaluate for interval change COMPARISON: Chest radiographs ___ IMPRESSION: Moderate bilateral pleural effusion and severe left lower lobe atelectasis worsened between ___ and ___, subsequently stable. Pulmonary vascular congestion suggests mild cardiac decompensation or volume overload. The heart is mildly enlarged. ET tube and right internal jugular line are in standard placements and a nasogastric tube is looped in the stomach. No pneumothorax. " 05d40202-44850edb-4bb78133-c6ee9968-f3a5f837.jpg,validate/p13/p13306609/s59886816/05d40202-44850edb-4bb78133-c6ee9968-f3a5f837.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with seizure TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: CT chest ___, chest radiograph ___. FINDINGS: Cardiac silhouette size is moderately enlarged, increased compared to the previous examination. Aortic knob is calcified. There is mild pulmonary vascular congestion. Patchy opacities are noted in the lung bases, likely areas of atelectasis. Trace left pleural effusion is likely present. No pneumothorax is identified. Moderate multilevel degenerative changes are seen in the thoracic spine. Patient is status post thyroidectomy with clips noted in the neck. IMPRESSION: Increased moderate cardiomegaly with mild pulmonary vascular congestion and bibasilar patchy opacities, likely atelectasis. Trace left pleural effusion. " 41e4698e-8de6d179-5b2cc7af-5c3be6a1-2b92d937.jpg,validate/p14/p14505540/s52710864/41e4698e-8de6d179-5b2cc7af-5c3be6a1-2b92d937.jpg,validation," FINAL REPORT INDICATION: Femur fracture POD 4 with cough and fever. COMPARISON: ___. FINDINGS: Frontal radiograph of the chest demonstrates stable moderate enlargement of the cardiac silhouette and tortuosity of the thoracic aorta. There is new retrocardiac opacity which likely reflects a combination of a small effusion and atelectasis. Mild pulmonary edema is new. No right pleural effusion. No pneumothorax. IMPRESSION: New fluid overload with mild pulmonary edema, a small left pleural effusion and a stable moderate cardiomegaly NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 9:54 AM, 10 minutes after discovery of the findings. " 64d85c31-09b058e9-42fc9f4f-e978fec9-572567d7.jpg,validate/p19/p19599303/s58579176/64d85c31-09b058e9-42fc9f4f-e978fec9-572567d7.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with cough and wheeze, 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. " 4aa47d76-c5378300-5cbc3f00-7236992d-929bf89c.jpg,validate/p10/p10354193/s53284921/4aa47d76-c5378300-5cbc3f00-7236992d-929bf89c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with R chest wall pain // eval PTX, effusion COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Best seen on the lateral projection is airspace consolidation in the right lower lobe in which is concerning for pneumonia. There may be associated tiny pleural effusion. There is mild elevation of the right hemidiaphragm. Left lung is clear. No signs of edema or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Right lower lobe pneumonia with associated small pleural effusion. " d7cc3aee-a6884e0d-27431fd2-2e4faa2e-734d056b.jpg,validate/p17/p17755234/s54897297/d7cc3aee-a6884e0d-27431fd2-2e4faa2e-734d056b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Acute renal failure, worsening dyspnea. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is worsening of the changes. The signs indicative of fluid overload have substantially increased, so that currently the patient is in moderate pulmonary edema, with newly appeared bilateral pleural effusions. In addition, the increased parenchymal opacity in the right perihilar areas, with subtle air bronchograms, has increased in density. No other changes. Constant size and shape of the cardiac silhouette. At the time of observation and dictation, the referring physician ___. ___, covered by Dr. ___, was paged for notification, 9:55, on ___. " b6e20c0e-6fc4732f-29997e04-d005792b-4c5bc7e6.jpg,validate/p13/p13560495/s52326439/b6e20c0e-6fc4732f-29997e04-d005792b-4c5bc7e6.jpg,validation," WET READ: ___ ___ ___ 3:12 AM 1. Mild prominence of the right atrial border may be related to patient positioning however small pericardial effusion of the differential. 2. Hypoinflated lungs with bibasilar atelectasis. 3. No definite pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Cough and shortness of breath. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrates hypoinflated lungs with bibasilar, left greater than right atelectasis. Lower lung volumes compared to prior radiograph could potentially accentuate the right heart border and increased prominence of the pulmonary vascularity. Mediastinal contour and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. IMPRESSION: 1. Increased prominence of right heart border and pulmonary vascularity compared to ___ chest radiograph, possibly due to accentuation by lower lung volumes, especially since cardiac echo was normal in ___. Repeat chest radiograph with improved inspiratory level could be performed for confirmation. Alternatively, it if cardiovascular symptoms or signs are present, repeat echo could be performed 2. No pneumonia. NOTIFICATION: The updated findings were discussed by Dr. ___ with ___ QA nurses via email on ___ at 10:03 AM. " 4a1850ea-702accff-69e06497-b51a7963-3399be8e.jpg,validate/p17/p17006872/s57124453/4a1850ea-702accff-69e06497-b51a7963-3399be8e.jpg,validation," FINAL REPORT INDICATION: Evaluation of the patient with pneumothorax for interval change. COMPARISON: Chest radiograph from ___ at ___. FINDINGS: There is a moderate right pneumothorax, stable in comparison to prior study from the day before. Otherwise, the left lung appears well expanded. There are no focal consolidations. The cardiomediastinal silhouette is normal with no significant leftward shift. There is mild left diaphragmatic depression. Osseous structures are grossly normal. IMPRESSION: Stable right pneumothorax. " e31bc6bd-00ba4ce1-5cebf9b5-1dcb0079-780d79f8.jpg,validate/p18/p18732974/s57570244/e31bc6bd-00ba4ce1-5cebf9b5-1dcb0079-780d79f8.jpg,validation," WET READ: ___ ___ ___ 11:15 AM Again seen bibasilar opacities, more consolidative on the right, possibly slightly increased on the left, concerning for worsening aspiration and/ or infection. Small bilateral pleural effusions. Re- demonstrated mild central pulmonary vascular congestion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever and cough // eval pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Bibasilar opacities are again seen, more consolidative on the right and possibly slightly increased on the left, which could be due to worsening aspiration and/or infection. Blunting of the costophrenic angles could relate to atelectasis or small pleural effusions. Mild central pulmonary vascular congestion is re- demonstrated. The cardiac and mediastinal silhouettes are stable. No pneumothorax is seen. IMPRESSION: Again seen bibasilar opacities, more consolidative on the right, possibly slightly increased on the left, concerning for worsening aspiration and/ or infection. Small bilateral pleural effusions. Re- demonstrated mild central pulmonary vascular congestion. " c9e8b898-093c08a0-29bd70d2-f66bb65e-f52f90d9.jpg,validate/p19/p19454512/s58586939/c9e8b898-093c08a0-29bd70d2-f66bb65e-f52f90d9.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: There is persistent elevation of the right hemidiaphragm with adjacent atelectasis. Diffuse intersitial opacities have decreased since the last study, correlating with improving interstitial lung disease. An opacity in the left mid lung zone correlates to an area of intersitial abnormality on the chest CT obtained on the same day and is stable since the prior evaluation in ___. No pleural effusion. Patient is status post cholecystectomy. IMPRESSION: No evidence of acute cardiopulmonary process. " b9b2698d-2f53abf6-c1153dd2-977e529b-d28f0a0d.jpg,validate/p19/p19778971/s52357441/b9b2698d-2f53abf6-c1153dd2-977e529b-d28f0a0d.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Empyema, status post removal of chest tube and worsening respiratory status. Comparison is made with prior study performed a day earlier. Cardiomediastinal contours are stable. Large bibasilar opacities, a combination of pleural effusion and atelectasis have increased on the right. Left perihilar consolidation consistent with pneumonia is unchanged. Patient has known emphysema. There is no pneumothorax. Right PICC tip is in the mid-to-lower SVC. " b5256d17-e0728fef-1de8ccfc-a8ffe569-e83120d9.jpg,validate/p18/p18988595/s53368808/b5256d17-e0728fef-1de8ccfc-a8ffe569-e83120d9.jpg,validation," FINAL REPORT HISTORY: Hypertension, headache. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The patient is status post median sternotomy and CABG. Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. There is no pleural effusion or pneumothorax. Mild degenerative changes are present within the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " eafd2040-1aa43524-d7225dfc-88b1478b-8b1a3c0a.jpg,validate/p17/p17491585/s57724375/eafd2040-1aa43524-d7225dfc-88b1478b-8b1a3c0a.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and shortness of breath. COMPARISON: Chest radiograph from ___. AP AND LATERAL CHEST RADIOGRAPH: This examination is limited secondary to significant soft tissue attenuation and arms-down technique on the lateral view. Lung volumes are extremely low obscuring the lower lobes. Bibasilar opacities likely reflect atelectasis. Pulmonary vasculature appears engorged, but there is no overt interstitial edema. No definite pleural effusion is identified. Mediastinal contours are within normal limits on this AP chest radiograph. IMPRESSION: Extremely low lung volumes limiting evaluation. Likely bibasilar atelectasis with some mild pulmonary vascular congestion. Dedicated PA and lateral radiographs are recommended when patient is clinically able for further assessment. " 57d1ae2a-6d636e9c-fe811c78-baf7fc56-c5d3e9e0.jpg,validate/p19/p19980241/s58237304/57d1ae2a-6d636e9c-fe811c78-baf7fc56-c5d3e9e0.jpg,validation," WET READ: ___ ___ ___ 11:00 PM Small left pleural effusion and minor a left lower lung atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LATERAL) INDICATION: ___-year-old man with pyelonephritis status-post per acute nephrostomy and ceftriaxone x11d, now with worsening flank pain; evaluate for acute cardiopulmonary process. TECHNIQUE: PA and lateral radiograph views of the chest were obtained. COMPARISON: PA and lateral chest radiograph dated ___. FINDINGS: Stable bilateral lower lung volumes. The small left pleural effusion is new. There is minor atelectasis of the left lung base. No pneumothorax, focal consolidation, or pulmonary edema. Stable appearance of the mediastinum and hila. The heart size is normal. IMPRESSION: Small left pleural effusion and minor left lower lung atelectasis. " b19691b2-1988b602-c8dad44b-f43c16d7-3a64bb36.jpg,validate/p19/p19995320/s52961551/b19691b2-1988b602-c8dad44b-f43c16d7-3a64bb36.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: ___-year-old man with hypoxia, new SVT, assess for acute intrathoracic process. FINDINGS: PA and lateral views of the chest were obtained. The lungs are clear without focal consolidation, effusion, or pneumothorax. The heart size is within normal limits. The aorta is slightly unfolded. No signs of CHF. No effusion. Bony structures appear intact. No free air below the right hemidiaphragm. Clips in the upper abdomen noted. IMPRESSION: No acute findings in the chest. " adfdd9be-a1b0c03f-ea24f97a-350ad80b-18eae6e6.jpg,validate/p13/p13137769/s52279110/adfdd9be-a1b0c03f-ea24f97a-350ad80b-18eae6e6.jpg,validation," FINAL REPORT INDICATION: Delirium and cough. Assess for pneumonia. COMPARISON: None. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: Lung volumes are slightly low. There is generalized faint interstitial abnormality bilaterally. Apparent mediastinal widening may be artifactual due to lordotic positioning. The heart is not enlarged. There is no pleural effusion or pneumothorax. There is mild bibasilar atelectasis. IMPRESSION: 1. Generalized interstitial abnormality bilaterally may reflect history of COPD. There is no convincing evidence of pneumonia. 2. Apparent widening of the mediastinum is likely artifactual due to lordotic positioning. " 3986b5b0-3bc7d34d-9b144db0-db48ad91-c60454b3.jpg,validate/p12/p12110495/s59950832/3986b5b0-3bc7d34d-9b144db0-db48ad91-c60454b3.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with increased shortness of breath, question pneumonia. COMPARISON: AP and lateral chest radiographs from ___. FINDINGS: There is no focal consolidation or pneumothorax. There is increased prominence and cephalization of the pulmonary vascular markings consistent with pulmonary edema. The heart is enlarged but stable compared to prior study. Prominence of the left hilum likely represents enlarged pulmonary artery and thus pulmonary hypertension. There is calcification of the aortic knob. There is stable blunting of the left costophrenic angle likely due to chronic pleural thickening. There are also pleural plaques seen indicative of asbestos-related pleural disease. Incidental note is made of an azygos fissure. A two-lead right-sided pacemaker in stable position without complication. IMPRESSION: 1. Pulmonary edema with stable cardiomegaly. 2. Prominent pulmonary artery likely related to pulmonary hypertension 3. Stable asbestos-related pleural disease and blunting of the left costophrenic angle likely due to pleural thickening. " 576732ea-6b31404b-20528f6f-8c2453c9-b41ca0df.jpg,validate/p16/p16384483/s58580203/576732ea-6b31404b-20528f6f-8c2453c9-b41ca0df.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F DMI w/ DKA Afib RVR w/ L groin necrotizing soft tissue infection // interval change IMPRESSION: In comparison to previous study of 1 day earlier, the patient has been extubated. Lung volumes remain low. Pulmonary vascular congestion is accompanied by mild interstitial edema. Interval slight improved aeration at both bases with residual atelectasis predominantly at the left base, accompanied by small pleural effusion. " 6a2227f6-1af5054f-6ecbc704-d4aaed99-b501e7a8.jpg,validate/p18/p18242864/s59489087/6a2227f6-1af5054f-6ecbc704-d4aaed99-b501e7a8.jpg,validation," WET READ: ___ ___ 8:24 AM Moderate pulmonary edema. No evidence of pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old female with chest pain and shortness of breath. Evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is moderate cardiomegaly with indistinctness of the pulmonary vasculature, consistent with moderate pulmonary edema. Pleural effusions are small, if any. No evidence of pneumothorax. IMPRESSION: Moderate pulmonary edema. No evidence of pneumothorax. " d9a87211-eef3d11f-11eab8c8-63f96a61-2a87657f.jpg,validate/p16/p16537897/s57449451/d9a87211-eef3d11f-11eab8c8-63f96a61-2a87657f.jpg,validation," 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. " 217229ac-825d1b01-c20b00a7-ffb3aa4f-f34c8788.jpg,validate/p17/p17482988/s55133619/217229ac-825d1b01-c20b00a7-ffb3aa4f-f34c8788.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman, non-verbal, with NGT replacement // please assess position please assess position IMPRESSION: In comparison with the study of ___, this and placement of a nasogastric tube that extends to the distal stomach. The left hemidiaphragm is not as sharply seen, consistent with volume loss in the left lower lobe and small effusion. No evidence of acute focal pneumonia or vascular congestion. " 4304ed46-25f74f6a-c19ed44e-e4bc8514-74dff548.jpg,validate/p10/p10326215/s51261438/4304ed46-25f74f6a-c19ed44e-e4bc8514-74dff548.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right lung mass, s/p bronch with bx // ___ year old woman with right lung mass, s/p bronch with bx, eval for PTX ___ year old woman with right lung mass, s/p bronch with bx, IMPRESSION: In comparison with the earlier study of this date, following the right right-sided procedure there is no evidence of pneumothorax. The right mid zone mass is again seen. . The left lung is clear. " 0319c3ac-7d0dccaf-072d4cb2-f5890de9-c2412e70.jpg,validate/p19/p19622209/s54605701/0319c3ac-7d0dccaf-072d4cb2-f5890de9-c2412e70.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R TKR, unable to wean O2 post-op, portable CXR inconclusive, please evaluate for infectious process // evaluate for infectious process evaluate for infectious process IMPRESSION: A in comparison with the earlier study of this date, the patient has taken a slightly better inspiration. Continued blunting of the left costophrenic angle consistent with postoperative volume loss in the lower lobe and small pleural effusion. Continued enlargement of the cardiac silhouette without definite vascular congestion or acute focal pneumonia. " 6fafcd8d-67ac12fa-a3ce56a6-3557b61f-1fa1d58a.jpg,validate/p11/p11932181/s52153858/6fafcd8d-67ac12fa-a3ce56a6-3557b61f-1fa1d58a.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea, recent left upper lobectomy. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post left upper lobectomy with significant volume loss again seen on the left with suggestion of interval increase in volume loss as compared to the prior study. No definite pleural effusion is seen. In the visualized left lower lung field, there is a patchy opacity likely present on the prior study and most likely relates to underlying volume loss, although a superimposed infection is not entirely excluded. The right lung is clear. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are grossly stable. Surgical clips in the upper quadrant are from presumed prior cholecystectomy. IMPRESSION: Status post left upper lobectomy with left-sided volume loss which is increased as compared to the prior study. " 5356bd16-617d1aa1-d002b3d5-c6e90dcc-a19aa156.jpg,validate/p19/p19271682/s55658177/5356bd16-617d1aa1-d002b3d5-c6e90dcc-a19aa156.jpg,validation," FINAL REPORT INDICATION: ___M with hx of lung cancer on chemo (day 1 with Carboplatin and Taxotere started ___) and radiation, DM, HTN, ESRD on HD (T/R/___) p/w nausea, dry heaves // eval for PNA TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. PET-CT from ___. FINDINGS: Increased interstitial markings are seen throughout the lungs with more conspicuous right basilar opacity compared to prior. The right-sided pleural effusion is not dramatically changed since prior. Known right upper lobe pulmonary nodule is better seen on prior CT scan, partially visualized on the lateral. Cardiomediastinal silhouette is unchanged. Left chest wall port is again noted. No acute osseous abnormalities identified. IMPRESSION: Increased interstitial markings throughout the lungs may represent mild edema. Persistent right sided pleural effusion with more conspicuous right basilar opacity which could represent atelectasis versus superimposed infection. Please correlate clinically. " ab9403a5-c4921857-66e527ee-6eab3839-3b9771d7.jpg,validate/p15/p15426827/s53327209/ab9403a5-c4921857-66e527ee-6eab3839-3b9771d7.jpg,validation," FINAL REPORT INDICATION: Evaluation for pneumonia in a patient with significant respiratory secretions. COMPARISON: Multiple chest radiographs, the most recent of ___. UPRIGHT PA AND LATERAL VIEWS OF THE CHEST: Opacity in the right lower lung is consistent with right middle lobe collapse. Otherwise, the lungs are clear without focal opacity, vascular congestion, pleural effusions, or pneumothorax. The bones and soft tissues are unremarkable. IMPRESSION: Right middle lobe collapse. " 0ac6f975-aeca2ece-ab86bbf9-47ff1e7e-ded00590.jpg,validate/p15/p15823696/s51240251/0ac6f975-aeca2ece-ab86bbf9-47ff1e7e-ded00590.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hematemesis // ? esophageal perforation, rupture ? esophageal perforation, rupture IMPRESSION: Compared to prior chest radiographs, most recently ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . No pleural effusion or mediastinal widening or pneumomediastinum. " 5a8e8ff5-8ce2baf5-f3c8706f-273bcc53-1b6d0c37.jpg,validate/p14/p14951077/s50310792/5a8e8ff5-8ce2baf5-f3c8706f-273bcc53-1b6d0c37.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AML currently neutopenic with chills // ? PNA TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Multiple chest radiographs, most recent ___. Chest CT with contrast ___ FINDINGS: Right infusion port catheter terminates at the cavoatrial junction, unchanged. There is a possible consolidation in the right upper lobe that is partially obscured by the right clavicle, for which follow-up chest radiograph with lordotic views is recommended. Biapical scarring is unchanged. Heart size is normal. Mediastinal and hilar contours are normal. IMPRESSION: Possible, small right upper lobe consolidation, partially obscured by the right clavicle. Recommend follow-up chest radiograph in ___ weeks with lordotic views for further evaluation. RECOMMENDATION(S): Follow-up chest radiograph in ___ weeks with lordotic views. " f94930a8-7714351a-ff6dd7af-d9558919-2a330fd7.jpg,validate/p19/p19932242/s51762127/f94930a8-7714351a-ff6dd7af-d9558919-2a330fd7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with myeloma, cough // Pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous examination, there is a newly developed middle lobe pneumonia. The pneumonia is ill-defined an shows multiple air bronchograms. Otherwise the lung parenchyma is unremarkable. Normal size of the cardiac silhouette. No pleural effusions. At the time of dictation and observation, the referring physician was paged, ___, 13:23. Findings were discussed ___ min later over the telephone. " d08ecf08-e2d33be0-3ba15bac-6f1e6096-5fd4682e.jpg,validate/p17/p17709825/s53414186/d08ecf08-e2d33be0-3ba15bac-6f1e6096-5fd4682e.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Question fluid overload. FINDINGS: There is a small left pleural effusion. Lung volumes are low with some volume loss in the left lower lung. There is minimal pulmonary vascular redistribution, but no overt pulmonary edema. No pneumothorax is visualized. " c463a7d0-c453f63e-121a2153-5a1c9475-9558fed0.jpg,validate/p13/p13891491/s53894356/c463a7d0-c453f63e-121a2153-5a1c9475-9558fed0.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypotension, assess for pneumonia. FINDINGS: Supine portable AP view of the chest provided. The heart remains mildly enlarged. There is limited evaluation due to low lung volumes. Subtle left lower lung opacity is seen projecting behind the heart, which could represent early pneumonia. A lateral view would be helpful to confirm. Otherwise, the lungs appear clear without evidence of effusion or pneumothorax. The mediastinal contour is stable. Bony structures are intact. IMPRESSION: Limited exam due to low lung volumes. Mild cardiomegaly is stable. Possible left lower lobe opacity which could represent pneumonia and correlation with lateral view would be helpful to confirm. " cfa2b164-e6a72195-1e95f9c1-efc768f0-591279dc.jpg,validate/p17/p17959674/s55243435/cfa2b164-e6a72195-1e95f9c1-efc768f0-591279dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute tachycardia and hypoxia // evaluate for any worsening interstitial process evaluate for any worsening interstitial process IMPRESSION: Comparison to ___. Normal lung volumes. Minimal increase in severity of pre-existing predominantly micronodular and interstitial parenchymal opacities, notably at the right lung basis. No pleural effusions. Borderline size of the heart. Stable correct position of the right PICC line. There appears to be an old right clavicular fracture. " 50eb4ad0-5d6400c7-be43ccda-643402a2-6a84194c.jpg,validate/p10/p10007326/s59442660/50eb4ad0-5d6400c7-be43ccda-643402a2-6a84194c.jpg,validation," FINAL REPORT INDICATION: Abdominal pain and hematemesis, here to evaluate for pneumomediastinum. COMPARISON: No prior study is available. FINDINGS: PA and lateral radiographs of the chest demonstrate clear lungs 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. There is no evidence of pneumomediastinum. The trachea is midline. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary pathology, specifically no evidence of pneumomediastinum. " 8bb293a7-70bf12cd-5c07f811-4940d849-d9aa8eb5.jpg,validate/p15/p15403852/s58813443/8bb293a7-70bf12cd-5c07f811-4940d849-d9aa8eb5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with seizures // Assess for consolidation Assess for consolidation IMPRESSION: Compared to ___ at 20:40. Lung volumes remain exceedingly low. Left lower lobe is airless, either collapsed or densely consolidated. Atelectasis is somewhat less severe in the right lower lobe. Previous mild edema has improved. Cardiomegaly is moderate. Tracheostomy tube midline. Dual channel dialysis catheter ends in the right atrium. " d7eed379-e931e1de-55665061-845a660c-e07f703c.jpg,validate/p15/p15734658/s51630496/d7eed379-e931e1de-55665061-845a660c-e07f703c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with 2 weeks dyspnea on exertion, tachycardia, history of chronic eosinophilic pneumonia TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Previously noted nodular opacities primarily in an upper lobe distribution seen on CT are not clearly present on the current radiograph. Linear opacity in the left lower lobe is new, and may reflect chronic eosinophilic pneumonia. No new focal consolidation is otherwise present. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities seen. IMPRESSION: Linear opacity in the left lower lobe is new and may reflect an area of chronic eosinophilic pneumonia. Previously noted upper lobe predominant nodular opacities on CT are not clearly present on the current radiograph. " 42ae0c6c-7b1098fb-961404c7-0f003264-354d885a.jpg,validate/p13/p13473495/s52412265/42ae0c6c-7b1098fb-961404c7-0f003264-354d885a.jpg,validation," FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old male with chest pain. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: ___. FINDINGS: Redemonstration of moderate-to-severe cardiomegaly is noted. There is pulmonary vascular congestion consistent with edema. There is vague increased opacity at the left costophrenic angle which may reflect atelectasis versus a small pleural effusion. Redemonstration of a left subclavian venous stent is again noted. There is no evidence of pneumoperitoneum. Osseous structures are unchanged. IMPRESSION: 1. Opacity at left costophrenic angle likely reflects atelectasis vs. pleural fluid. 2. Pulmonary edema. " 389859cd-723f7ae7-d03ce5a9-93dbd7be-60b4c9a4.jpg,validate/p16/p16019229/s51208625/389859cd-723f7ae7-d03ce5a9-93dbd7be-60b4c9a4.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient with prior effusion and new shortness of breath. COMPARISON: Prior chest radiograph from ___ and abdominal CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal silhouette is stable. Lungs are well expanded and clear. No focal consolidations concerning for pneumonia are identified. There are small bilateral pleural effusions. There is no pneumothorax. On the lateral view, there is opacification of an extrapleural mass. This finding was not identified on prior CT examination and could well be an artifact of overlying structures. Remaining osseous structures are intact. IMPRESSION: Small bilateral pleural effusions. " 2d97776e-af3fdcd9-c91d3d41-61fd8891-d92d27c2.jpg,validate/p10/p10755736/s57261221/2d97776e-af3fdcd9-c91d3d41-61fd8891-d92d27c2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with rectal cancer and crytogenic organizing pneumonia with hypoxia // interval change of pneumonia? interval change of pneumonia? IMPRESSION: Comparison ___. No relevant change in extent and severity of the massive bilateral parenchymal opacities. No pleural effusions. Stable size of the cardiac silhouette, stable position of the right PICC line. " 4b24ea54-7b7002f6-06b60fa8-844ab712-40900b04.jpg,validate/p12/p12289464/s59436548/4b24ea54-7b7002f6-06b60fa8-844ab712-40900b04.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Right internal jugular vascular sheath remains in place. Small left apical pneumothorax is in retrospect unchanged since the prior radiograph, but previously reported small right apical pneumothorax is no longer evident. Cardiomediastinal contours are stable in appearance. Lucency adjacent to left cardiomediastinal contour may reflect postoperative pneumopericardium. Pulmonary vascular congestion is accompanied by persistent mild pulmonary edema. Improving left retrocardiac atelectasis and adjacent small left pleural effusion. " 966b03e1-b2a01275-567d58ca-34b2eeda-f0e01382.jpg,validate/p15/p15472839/s58507744/966b03e1-b2a01275-567d58ca-34b2eeda-f0e01382.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pulmonary nodules, chest mass and emphysema and smoking with increasing pain in the chest, assessment for infection. COMPARISON: ___ and CTA of the chest from ___. Heart size is normal. Mediastinum is normal. The lungs are clear within the limitations of this study technique resolution. No definitive chest mass is identified on the current study, and comparison with outside imaging where the chest mass will be visible is required. No pleural effusion or pneumothorax is seen. " 027e6040-195a4059-60300165-e4b05a51-e5bb9e31.jpg,validate/p16/p16497039/s58594979/027e6040-195a4059-60300165-e4b05a51-e5bb9e31.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with polytrauma, a new NG tube placement. COMPARISON: Same day earlier exam at 10:46 a.m. FINDINGS: Single frontal view of the chest demonstrates ET tube with tip 3.8 cm from the carina. A left subclavian approach central venous catheter has tip in the mid SVC. A left basal approach chest catheter is similar in position. A new enteric tube has tip terminating in the proximal stomach and side port likely in the region of GE junction, with moderate air distention of the stomach, consistent with ineffective decompression. The tube should be advanced by approximately 10 cm. The cardiomediastinal silhouette is little changed since preceding exam. Lung volumes are low, with similar appearance of perihilar vascular prominence. Retrocardiac opacity is compatible with atelectasis. Moderate air distension of the stomach is similar as before. IMPRESSION: Interval placement of feeding tube with tip in the proximal stomach, which should be advanced by at least 10 cm to achieve effective gastric decompression. Otherwise, no relevant change since preceding exam several hours ago. Findings reported to Dr. ___ at 4:30 pm on ___ via phone by Dr. ___. " 3a3a1198-3a437a1b-469b09be-326dcc68-73f40530.jpg,validate/p12/p12568708/s56562205/3a3a1198-3a437a1b-469b09be-326dcc68-73f40530.jpg,validation," WET READ: ___ ___ ___ 3:11 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with a history of cirrhosis, presenting for evaluation of progressively worsening altered mental status and weakness. Denies recent trauma. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is interval improvement in the previously seen left upper lobe and left lower lobe opacities consistent with gradual resolution of infection or aspiration. A subtle opacity is also seen within the right upper lobe which may have been present on the prior radiograph in ___, and therefore an underlying parenchymal lesion cannot be excluded. There is no appreciable pleural effusion or pneumothorax. Plate-like atelectasis is noted at the left lung base. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities identified. IMPRESSION: Substantial but partial improvement in the left mid and lower lobe opacities consistent with gradual resolution of an underlying infectious process. Subtle right upper lobe opacity may have been present since ___, and CT chest should be obtained to exclude an underlying parenchymal nodule. RECOMMENDATION(S): CT chest for further evaluation of possible multifocal pneumonia and co-existing right upper lobe nodule. NOTIFICATION: Updated findings and recommendation were telephoned to Dr. ___ by ___ on ___ at 9:40AM, approximately 20 minutes after attending readout. " bf172046-b51a4644-4b36cabc-786d2c2e-e6499413.jpg,validate/p13/p13687044/s59456154/bf172046-b51a4644-4b36cabc-786d2c2e-e6499413.jpg,validation," FINAL REPORT EXAM: Chest, AP upright portable view. CLINICAL INFORMATION: Respiratory distress, history of COPD, CHF. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. There is a moderate right pleural effusion; underlying consolidation is not excluded. The left lung is grossly clear aside from possible mild pulmonary vascular congestion. The cardiac silhouette remains enlarged. There is no left pleural effusion or evidence of pneumothorax. IMPRESSION: Moderate right pleural effusion, underlying consolidation is not excluded. Possible minimal pulmonary vascular congestion. Persistent cardiac silhouette enlargement. " 5a7bc05f-a7e0ea05-9dde9cd4-818b6835-705816e7.jpg,validate/p16/p16202865/s53418734/5a7bc05f-a7e0ea05-9dde9cd4-818b6835-705816e7.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after mitral valve replacement. PA and lateral upright chest radiographs were reviewed in comparison to ___. Cardiomegaly is moderate to large associated with bilateral pleural effusions and bibasal atelectasis. Small amount of apical pneumothorax is noted on the right. No left appreciable pneumothorax is noted. There is no evidence of pulmonary edema. " 0495e47b-4261fd67-28703354-a2da4ad6-7d24fa7f.jpg,validate/p16/p16455067/s52956417/0495e47b-4261fd67-28703354-a2da4ad6-7d24fa7f.jpg,validation," FINAL REPORT HISTORY: Known left lower lobe pneumonia with worsening hypoxia. TECHNIQUE: PA and lateral chest radiograph, 3 views. COMPARISON: ___. FINDINGS: Cardiomediastinal silhouette and hilar contours are stable. Heterogeneous opacities in the lingula and left lower lung are worse compared to prior exam with silhouetting of the left hemidiaphragm and left heart border. Right lung is clear. There is no pleural effusion or pneumothorax. IMPRESSION: Progressive lingular and left lower lobe pneumonia. " 0a28939d-97871311-8ee33dfb-19d787e2-50eab3a4.jpg,validate/p10/p10781100/s56307835/0a28939d-97871311-8ee33dfb-19d787e2-50eab3a4.jpg,validation," FINAL REPORT INDICATION: ___M with cough // acute process? TECHNIQUE: AP and lateral views of the chest. COMPARISON: Multiple prior exams dating back to ___ with most recent from ___. FINDINGS: There is persistent left basilar opacity likely due to scarring given persistence dating back to ___. The lungs are otherwise clear. There is trace left pleural effusion improved since most recent prior. The cardiomediastinal silhouette is within normal limits. Tortuous descending thoracic aorta is noted. Hypertrophic changes are seen in the spine. No acute osseous abnormalities identified. IMPRESSION: Persistent left lung base linear opacity suggestive of scarring given persistence. Trace left effusion. " 8fcc5126-d8306966-0159fb56-cffd973f-d3c512b7.jpg,validate/p10/p10913302/s54064777/8fcc5126-d8306966-0159fb56-cffd973f-d3c512b7.jpg,validation," FINAL REPORT PA AND LATERAL CHEST DATED ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are within normal limits and without change. Lung volumes remain low. Bibasilar lung opacities have rapidly improved, with residual opacity most prominent in the right lower lobe retrocardiac region. Additional residual linear opacities are also demonstrated. No new areas of consolidation are present, and there are no definite pleural effusions. " f2080890-63276bae-ed691c26-80c81777-10ac940e.jpg,validate/p13/p13801091/s55425326/f2080890-63276bae-ed691c26-80c81777-10ac940e.jpg,validation," FINAL REPORT AP CHEST, 10:39 A.M., ___ HISTORY: CABG. Rule out pneumothorax. IMPRESSION: AP chest compared to earlier postoperative chest radiograph, ___: The lungs are well expanded and clear. The cardiomediastinal and hilar silhouettes are normal. There is no appreciable pleural effusion, or evidence of pneumothorax. " 8f88b191-fecff59c-e44981bd-aa650ac9-e655bc0b.jpg,validate/p19/p19151721/s58246289/8f88b191-fecff59c-e44981bd-aa650ac9-e655bc0b.jpg,validation," FINAL REPORT AP CHEST, 5:15 A.M., ___ HISTORY: A ___-year-old woman with respiratory failure. Is there improvement in edema or pleural effusion. IMPRESSION: AP chest compared to ___: Previously collapsed right upper lobe has substantially re-expanded, except for the anterior segment. Small left pleural effusion stable. Severe cardiomegaly has increased. Right jugular line ends at the origin of the right brachiocephalic vein, left jugular line ends in the mid to low SVC. No pneumothorax. " 1c89de3e-c3dd3730-eeaee2b4-71f66a7e-765cd34c.jpg,validate/p19/p19739493/s56793943/1c89de3e-c3dd3730-eeaee2b4-71f66a7e-765cd34c.jpg,validation," 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. " d95e7956-24580347-8a27bba6-7e2a8b05-9ffe137d.jpg,validate/p16/p16863231/s50759559/d95e7956-24580347-8a27bba6-7e2a8b05-9ffe137d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with weakness // evidence of pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs remain hyperinflated. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No pulmonary edema is seen. IMPRESSION: No focal consolidation to suggest pneumonia. " 470be1d2-4d2a1c8d-d7be15a1-765c0d7c-019bc25e.jpg,validate/p18/p18719719/s50964544/470be1d2-4d2a1c8d-d7be15a1-765c0d7c-019bc25e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Palpitations, assess pulmonary edema. FINDINGS: PA and lateral views of the chest are provided. There is an AICD in unchanged position. Sternotomy wires and mediastinal clips are again noted. Lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with an unfolded thoracic aorta again noted. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 28557ee5-2a9485e8-960945bc-54b8eeab-2cd73512.jpg,validate/p15/p15874317/s53319219/28557ee5-2a9485e8-960945bc-54b8eeab-2cd73512.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old female with fevers and chills, rule out pneumonia. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Battery pack and pacemaker leads terminate in appropriate and unchanged position. No pleural effusion or pneumothorax. The lungs are clear of any focal opacities concerning for infectious process. Tortuous calcified aortic knob is again noted. IMPRESSION: No evidence of acute intrathoracic process. " 9c6c387f-d47dc366-88169dd2-2a6b6a88-4f87546f.jpg,validate/p18/p18688402/s57504510/9c6c387f-d47dc366-88169dd2-2a6b6a88-4f87546f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with gastrointestinal bleeding after intubation and an extubation. AP radiograph of the chest was compared to ___. Cardiomegaly is severe. Mediastinum is stable. Bilateral pleural effusions are noted, left more than right. There is no evidence of pneumothorax. " c196b3bb-bcd91ea7-281386ee-07f5c07f-248121c3.jpg,validate/p12/p12695944/s56521814/c196b3bb-bcd91ea7-281386ee-07f5c07f-248121c3.jpg,validation," WET READ: ___ ___ 2:14 AM Hyperinflated lungs with flattening of the diaphragm, compatible with COPD. No focal consolidation identified. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with right-sided chest/back pain // please evaluate for acute abnormality TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lungs are hyperinflated with mild flattening of the diaphragm, compatible with COPD. No focal consolidation is identified. There is again tortuosity of the thoracic aorta. No evidence of pulmonary edema or pleural effusion. No pneumothorax. The heart size is unchanged. Wedge compression fracture of low thoracic vertebral body is better seen on lateral view. IMPRESSION: Hyperinflated lungs with flattening of the diaphragm, compatible with COPD. No focal consolidation identified. " c31028d3-c4045e8d-cd95fdc5-8edc26ec-760d65ec.jpg,validate/p16/p16092070/s55672549/c31028d3-c4045e8d-cd95fdc5-8edc26ec-760d65ec.jpg,validation," FINAL REPORT HISTORY: Pacer. FINDINGS: In comparison with the study of ___, there has been placement of a dual-channel pacemaker device with leads in the appropriate position in the region of the right atrium and apex of the right ventricle. There are atelectatic changes at the left base, but no evidence of pneumothorax. " cea3ecc8-aa531d80-d157f684-6ffd58c0-85b2fa69.jpg,validate/p19/p19135566/s51061893/cea3ecc8-aa531d80-d157f684-6ffd58c0-85b2fa69.jpg,validation," WET READ: ___ ___ ___ 7:53 PM Increased opacification of the bilateral lung bases with blunting of the costophrenic angles suggests worsening small pleural effusions on the left greater than the right and underlying atelectasis from 18:43. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent hip fracture, progressive hypoxia, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is now evidence of bilateral pleural effusion with subsequent areas of atelectasis at both lung bases. The size of the cardiac silhouette has moderately increased. There is no evidence of overt pulmonary edema. The course of the nasogastric tube is unremarkable, overinflation of the stomach is present in unchanged manner. A nasogastric tube is in situ. " d3a7d782-42e56dbc-f038be62-8e43979e-62d4ce7a.jpg,validate/p16/p16887254/s59991222/d3a7d782-42e56dbc-f038be62-8e43979e-62d4ce7a.jpg,validation," FINAL REPORT HISTORY: Status post arch aneurysm repair, line position, status post change over wire. CHEST, SINGLE AP PORTABLE VIEW. Compared with earlier the same day (7:27 a.m.), the right IJ sheath has been converted to a right IJ central line, with tip over distal most SVC. No pneumothorax is detected. Otherwise, I doubt significant interval change. " 08a43ce3-067dae02-c0be6549-9777ec41-6dc80c15.jpg,validate/p16/p16247826/s52182684/08a43ce3-067dae02-c0be6549-9777ec41-6dc80c15.jpg,validation," WET READ: ___ ___ ___ 10:05 AM Esophageal catheter coils in esophagus and is directed upwards. Needs repositioning. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube. COMPARISON: No comparison available at the time of dictation. FINDINGS: The patient has received a nasogastric tube. The tube is coiled in the middle third of the esophagus and requires repositioning. Borderline size of the cardiac silhouette with mild elevation of the left hemidiaphragm and mild fluid overload. No pneumonia, no pleural effusions. " e43fec22-df55599d-14fa301e-0a225696-45fc7912.jpg,validate/p13/p13049990/s53430234/e43fec22-df55599d-14fa301e-0a225696-45fc7912.jpg,validation," FINAL REPORT CLINICAL INFORMATION: ___-year-old male with chest pain and dyspnea. COMPARISON: ___. TECHNIQUE: AP portable chest radiograph. FINDINGS: Much of the chest is obscured by overlying leads. The lungs are clear without pleural effusion, or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal. There is no osseous abnormality. IMPRESSION: No acute chest pathology. " a59b81f6-ea16ee6e-1280e297-fad88468-1c3c7e4b.jpg,validate/p12/p12724643/s54887824/a59b81f6-ea16ee6e-1280e297-fad88468-1c3c7e4b.jpg,validation," FINAL REPORT HISTORY: Asthma with shortness of breath. FINDINGS: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Of incidental note is a dense opacification seen in the left upper quadrant, apparently similar to a posterior collection relative to the stomach that could represent a diverticulum with residual barium. " 59960dd5-b514d231-3e9247db-c5669685-7d20fad5.jpg,validate/p18/p18692222/s55320438/59960dd5-b514d231-3e9247db-c5669685-7d20fad5.jpg,validation," 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. " ce4f3800-b042cc63-37f859cf-06e82a41-be351c46.jpg,validate/p18/p18818476/s59578359/ce4f3800-b042cc63-37f859cf-06e82a41-be351c46.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain and questionably wide mediastinum on outside hospital study. Evaluation for mediastinal widening. COMPARISON: Comparison is made to radiograph of the chest from ___ obtained at an outside hospital (___). Comparison is made to multiple radiographs, dating back to ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are relatively well expanded, with some atelectasis and either pleural scarring or a prominent epipericardial fat pad on the left. There is no evidence of pleural effusion on the right, and no pneumothorax, pulmonary edema or focal air space consolidation is seen. The cardiomediastinal contours are unremarkable. The heart size is mildly enlarged. There is no specific evidence of mediastinal widening. IMPRESSION: Normal mediastinum. Left basilar atelectasis and possible left pleural scarring, along with mild cardiomegaly. No acute cardiopulmonary process. " dd5226c7-3ecb9e07-7b592d7a-b4242a1b-fd070858.jpg,validate/p16/p16497039/s59937127/dd5226c7-3ecb9e07-7b592d7a-b4242a1b-fd070858.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with rib fracture with a chest tube on waterseal. AP radiograph of the chest was reviewed in comparison to ___ obtained 04:55 a.m. After placement of the chest tube on waterseal, there is minimal interval increase in left pleural effusion. There is no pneumothorax. Right lower lung atelectasis is redemonstrated. ET tube tip and left subclavian line are in unchanged position. " 86001495-07be6142-7922beb4-1bca53db-0f5bb1fb.jpg,validate/p16/p16458160/s56843258/86001495-07be6142-7922beb4-1bca53db-0f5bb1fb.jpg,validation," 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 " 2ec30e82-e442f0b3-7475ad49-602cfb75-d9261d13.jpg,validate/p12/p12278812/s58871375/2ec30e82-e442f0b3-7475ad49-602cfb75-d9261d13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Pacemaker for MRI. // Please evaluate patient's Pacemaker for MRI. Please evaluate patient's Pacemaker for MRI. IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Transvenous right atrial right ventricular pacer leads are continuous from the left pectoral generator following their expected courses. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 3c1bc617-6c5b7e42-4b502723-97cd1560-2ac60c3a.jpg,validate/p11/p11899569/s53119026/3c1bc617-6c5b7e42-4b502723-97cd1560-2ac60c3a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PTX, subq emphysema s/p CT placement // please eval for resolving PTX please eval for resolving PTX IMPRESSION: Comparison to ___. Stable apical 7-8 mm right-sided pneumothorax. The right chest tube is in stable position. Normal size of the heart. Elongation of the descending aorta. Stable air collection in the soft tissues. " da15a1ab-3636f89a-ef7c17b7-dba8eef8-dcf66c43.jpg,validate/p16/p16935781/s51634765/da15a1ab-3636f89a-ef7c17b7-dba8eef8-dcf66c43.jpg,validation," FINAL REPORT INDICATION: Metastatic breast cancer with fever and leukocytosis. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Left-sided Port-A-Cath tip terminates within the proximal right atrium. The cardiac, mediastinal, and hilar contours are within normal limits. Pulmonary vascularity is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. Right apical scarring appears unchanged. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. " 9f3dff81-03b9ef97-26ba617f-392f33e1-786a2d7f.jpg,validate/p12/p12179804/s50817786/9f3dff81-03b9ef97-26ba617f-392f33e1-786a2d7f.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with new-onset dizziness, ataxia, and vomiting. COMPARISON: None available. 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. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " ce3af6d3-6b70d061-e54a90dd-31892ba1-6382cf68.jpg,validate/p15/p15335912/s50034387/ce3af6d3-6b70d061-e54a90dd-31892ba1-6382cf68.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Altered mental status and cough. FINDINGS: AP upright and lateral views of the chest were provided. Thoracic kyphosis and scoliosis limits evaluation. The lungs appear clear without focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures appear grossly intact. " c05aa1e8-ed9a9cfc-6c9337e0-0d53c30b-388ee6cf.jpg,validate/p13/p13381744/s55571313/c05aa1e8-ed9a9cfc-6c9337e0-0d53c30b-388ee6cf.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with lung cancer presents with fever and cough. COMPARISON: PA and lateral chest radiograph, ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: Projecting over the anterior aspect of the ___ right rib along the midclavicular line in the right upper lung is an ill-defined heterogenous opacity approximately 2.1 x 3.0 cm, more readily visible now than it was on ___. The lungs are otherwise clear. Cardiomediastinal silhouette is normal. Pleural surfaces are unremarkable. Adenopathy is not appreciated on this study. IMPRESSION: Likely, small, right upper lung pneumonia. " a4da95ab-80ffa976-2e79bee8-69fe63dc-8aca3bc0.jpg,validate/p19/p19371747/s57924863/a4da95ab-80ffa976-2e79bee8-69fe63dc-8aca3bc0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F difficult intubation, s/p c3-c6 laminectomy, c/b sever facial edema post op. // Dobhoff placement - will need multiple films. IMPRESSION: Serial chest radiographs for performed to document feeding tube placement, with the first image demonstrating the feeding tube in the proximal intrathoracic esophagus, the second demonstrating the tube terminating in the distal thoracic esophagus, in the third demonstrating positioning in the distal stomach. Exam is otherwise remarkable for interval resolution of a patchy right basilar opacity since ___ radiograph. " 4f113886-a3834c3c-e1958f7b-18ae3890-0269a49d.jpg,validate/p13/p13478067/s58702845/4f113886-a3834c3c-e1958f7b-18ae3890-0269a49d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SOB // heart size? IMPRESSION: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Sequela of previous surgery are seen in the left hemithorax. No acute pneumonia, vascular congestion, or pleural effusion. " 1ae9998f-61dd5d52-96da5dec-714bb05a-a9b4c8a0.jpg,validate/p14/p14018555/s51247529/1ae9998f-61dd5d52-96da5dec-714bb05a-a9b4c8a0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MVA now unresponsive // PNA, cardiopulm process PNA, cardiopulm process IMPRESSION: In comparison with the study of ___ the endotracheal tube and nasogastric tube and pacer leads are essentially unchanged. Blunting of the left costophrenic angle again suggests small pleural effusion with mild atelectatic changes. The right lung is clear and there is no evidence of vascular congestion. " f3a441a0-523fd110-21ccf221-c0d1335f-671dc4cd.jpg,validate/p15/p15456456/s54540487/f3a441a0-523fd110-21ccf221-c0d1335f-671dc4cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with breast CA, pleural effusions, s/p R Pleurex ___ // pleurex placement, change in pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiac size cannot be evaluated. Large bilateral pleural effusions are present with associated adjacent atelectasis. New left perihilar consolidation could be atelectasis or pneumonia. Right port a cath tip is in the cavoatrial junction. There is no evident pneumothorax. Catheters project in the upper abdomen and right lower hemi thorax IMPRESSION: Allowing the difference in positioning of the patient large bilateral pleural effusions are stable. Left perihilar opacities could be atelectasis or pneumonia. ___, MD " defdee6f-3a360322-a24e133e-c0f015f5-5ea33cbc.jpg,validate/p11/p11868667/s56951730/defdee6f-3a360322-a24e133e-c0f015f5-5ea33cbc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo F w/ chest pain concerning for PEs // ___ yo F w/ chest pain concerning for PEs TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Pulmonary edema has almost completely resolved. Moderate cardiomegaly is a stable. There are low lung volumes. Pacer leads are in standard position. There is no pneumo thorax or effusions IMPRESSION: Resolved pulmonary edema " c306ee89-6b8a8aaf-5176d35d-80e0c2df-dbdb6cf2.jpg,validate/p13/p13562596/s51533172/c306ee89-6b8a8aaf-5176d35d-80e0c2df-dbdb6cf2.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with altered mental status. COMPARISON: Chest radiograph from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: Lung volumes are low resulting in bronchovascular crowding. However, no confluent consolidation is identified to suggest pneumonia. Pulmonary parenchyma appears similar to prior examination of ___. There is no overt interstitial edema or large pleural effusion. Mediastinal and hilar contours are within normal limits. Mild cardiomegaly is unchanged from prior. IMPRESSION: No acute cardiopulmonary process " 590b7fca-987b515e-313d4fc3-f8c5f406-12d86ec9.jpg,validate/p16/p16581153/s57971392/590b7fca-987b515e-313d4fc3-f8c5f406-12d86ec9.jpg,validation," FINAL REPORT HISTORY: Hypertension and chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Mild cardiomegaly is unchanged from ___ with mild tortuosity of the thoracic aorta. Mediastinal and hilar contours are unremarkable. There is no pulmonary vascular congestion or interstitial edema. Lung volumes are low but are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Mild cardiomegaly unchanged from ___ without fluid overload. " 26501c5c-f2496746-df8bc129-e7eb896b-b5d1de3c.jpg,validate/p14/p14394983/s57722108/26501c5c-f2496746-df8bc129-e7eb896b-b5d1de3c.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph, ___, ___. Chest CT, ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear. The pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 75e05434-a551823f-a9d190eb-f23a8cfc-7cd3001c.jpg,validate/p17/p17983451/s58202176/75e05434-a551823f-a9d190eb-f23a8cfc-7cd3001c.jpg,validation," WET READ: ___ ___ ___ 2:52 PM No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with nausea and EKG changes, evaluate for CHF or pneumonia. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs from ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Median sternotomy wires and mediastinal clips are noted. IMPRESSION: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. " 9117b1ea-10e20b20-23583395-0c12a6ce-a2ddc964.jpg,validate/p12/p12405140/s55220622/9117b1ea-10e20b20-23583395-0c12a6ce-a2ddc964.jpg,validation," WET READ: ___ ___ 3:38 AM Portable frontal supine radiograph of the chest demonstrates the ET tube ending 1.7 cm above the carina. An NG tube extends below the diaphragm and into the stomach. Compared to the prior chest radiograph, there has been interval increase in widespread bilateral patchy opacities greater on the left than the right likely representing aspiration given the clinical situation. No pleural effusion or pneumothorax. Stable cardiomediastinal contours. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with drowning, ett // ? ett placement COMPARISON: Outside hospital chest radiograph dated ___ at 12:55 and outside hospital CT torso dated ___ at 1:15. FINDINGS: Portable frontal supine radiograph of the chest demonstrates the ET tube ending 1.7 cm above the carina and could be pulled back slightly. An NG tube extends below the diaphragm and into the stomach. Compared to the prior chest radiograph, there has been interval increase in widespread bilateral patchy opacities greater on the left than the right likely representing aspiration given the clinical situation. No pleural effusion or pneumothorax. Stable cardiomediastinal contours. " 695fc88d-9045bd3c-deb964e2-28bfc679-c976f8b6.jpg,validate/p11/p11235666/s59631979/695fc88d-9045bd3c-deb964e2-28bfc679-c976f8b6.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with chest pain, s/p fall, assess for fractures, effusion, consolidation TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: The lungs are mildly hyperinflated with flattening of the diaphragms, unchanged in appearance since prior examination. Lungs are otherwise clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. There are intact median sternotomy wires. A left anterior chest wall pacemaker device lead tips are in the right atrium and right ventricle. Limited assessment of the osseous structures are notable for chronic left rib deformities and chronic mid left clavicular fracture. IMPRESSION: 1. No acute cardiopulmonary process. 2. Although no acute fracture or other bone abnormality is seen, conventional chest radiographs are not appropriate for detection or characterization of chest cage lesions. Any focal findings should be clearly marked and imaged with either bone detail views or CT scanning. 3. Hyperinflated lungs suggestive of emphysema and chronic obstructive pulmonary disease. " f1d9343f-9e161699-26a0946c-5d4e7016-613e238a.jpg,validate/p11/p11547745/s50661444/f1d9343f-9e161699-26a0946c-5d4e7016-613e238a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxia // pulmonary edema pulmonary edema IMPRESSION: Compared to prior chest radiographs since ___ most recently ___ through ___. Moderate pulmonary edema unchanged since ___. Moderately severe left lower lobe atelectasis stable. Heart size top-normal. Pleural effusions are presumed, but not large. No pneumothorax. Right jugular line ends in the low SVC. " 401f21e9-b881432f-c33c78fa-e4f17b2f-845fdfcf.jpg,validate/p18/p18283471/s59543451/401f21e9-b881432f-c33c78fa-e4f17b2f-845fdfcf.jpg,validation," FINAL REPORT HISTORY: Left lower lobe pneumonia, to assess for resolution. FINDINGS: In comparison with the study of ___, the areas of increased opacification have essentially cleared. Continued hyperexpansion of the lungs consistent with chronic pulmonary disease. " 2a6251dc-2b24d484-2bdae3d9-4929e4d0-45706844.jpg,validate/p14/p14262623/s58070770/2a6251dc-2b24d484-2bdae3d9-4929e4d0-45706844.jpg,validation," FINAL REPORT HISTORY: Fall, assess for pneumothorax. COMPARISON: ___. FINDINGS: Two views were obtained of the chest. The lungs are well expanded and clear without pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal contours. No displaced rib fractures are identified. Right humeral postsurgical changes are better seen on the dedicated shoulder radiographs. IMPRESSION: No acute intrathoracic process. " 0df4e176-5b6d60f4-196d150e-14c19633-3dffb3b9.jpg,validate/p15/p15877362/s54184287/0df4e176-5b6d60f4-196d150e-14c19633-3dffb3b9.jpg,validation," WET READ: ___ ___ ___ 12:58 PM 1. No pneumothorax identified. 2. Significant interval improvement of asymmetric vascular engorgement and indistinct pulmonary vasculature, right greater than left. 3. Hyperinflated lungs. WET READ VERSION #1 ___ ___ ___ 9:24 AM Significant interval improvement in vascular crowding and indistinct pulmonary vasculature, right greater than left, compared to ___. Unchanged air lucency between the left cardiac silhouette and medial left lung, which may reflect a persistent small medial left pneumothorax. WET READ VERSION #2 ___ ___ 9:57 AM 1. Significant interval improvement in vascular crowding and indistinct pulmonary vasculature, right greater than left, compared to ___. 2. Unchanged area of lucency between the left cardiac silhouette and medial left lung, which may reflect a persistent small medial left pneumothorax. 3. Heterogeneous area of opacification at the right lung base likely represents vascular crowding or atelectasis, less likely aspiration or pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Frontal chest radiograph. INDICATION: ___F s/p fall ?medial pneumothorax on previous XR please eval for interval growth. TECHNIQUE: Single frontal view of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: AP upright and lateral views the chest provided demonstrate clear well expanded lungs that focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette appears within normal limits. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " a4737c55-1192337d-385652fb-3a58df9f-c8ef919d.jpg,validate/p15/p15568805/s57723954/a4737c55-1192337d-385652fb-3a58df9f-c8ef919d.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with seizure. Evaluate for infectious process. TECHNIQUE: Portable AP frontal chest radiograph was obtained. COMPARISON: Chest radiographs from ___, ___ and ___. FINDINGS: Lung volumes are low causing accentuation of the bronchovascular structures and cardiac silhouette. No focal consolidation, pleural effusion or pneumothorax seen. There is no overt pulmonary edema. IMPRESSION: Low lung volumes. " d021519f-408119d1-5e824d66-73f65727-e87f7c76.jpg,validate/p16/p16739492/s54395117/d021519f-408119d1-5e824d66-73f65727-e87f7c76.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Lung cancer, now with bilateral lower extremity swelling, question CHF. FINDINGS: PA and lateral views of the chest were obtained. There is a left arm PICC line with tip residing in the expected location of the superior vena cava. Clips are noted projecting over the left chest. A left pleural effusion is again noted with left basilar consolidation, possibly representing atelectasis and essentially unchanged from prior exam. Right lung remains clear. There is mild cephalization, which is compatible with mild congestive heart failure. Mediastinal contour is unremarkable. Bony structures appear unremarkable and intact. IMPRESSION: Unchanged left basilar effusion/consolidation. Mild cephalization, likely indicating mild degree of failure. PICC line appropriately positioned. " 6f50d523-0c71ec64-3bc17775-969ab4c9-2743b42a.jpg,validate/p11/p11567329/s51068735/6f50d523-0c71ec64-3bc17775-969ab4c9-2743b42a.jpg,validation," FINAL REPORT INDICATION: History: ___M with sob, pls eval for pna // History: ___M with sob, pls eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph " fb5d0918-dec0dbe5-269fdeae-12a9f592-681a2d82.jpg,validate/p17/p17033324/s55908357/fb5d0918-dec0dbe5-269fdeae-12a9f592-681a2d82.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with chronic bronchitis, fall, infectious workup TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___, CT torso ___ FINDINGS: Heart size is mildly enlarged. The mediastinal and hilar contours unremarkable. Pulmonary vasculature is not engorged. Streaky opacities in the lung bases may reflect bronchial wall thickening and bronchitis. No focal consolidation, pleural effusion or pneumothorax is seen. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: Streaky bibasilar opacities may reflect bronchial inflammation or infection, without focal consolidation. " a1b37d92-afac868e-a026c656-d3b1d6e0-c456be70.jpg,validate/p18/p18946180/s50228960/a1b37d92-afac868e-a026c656-d3b1d6e0-c456be70.jpg,validation," FINAL REPORT INDICATION: ___F with chest tightness. TECHNIQUE: Chest PA and lateral COMPARISON: None. 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. " 4074faa6-dc70b7a0-9c1dcbe2-1c1e5b01-fb182818.jpg,validate/p17/p17846379/s58274475/4074faa6-dc70b7a0-9c1dcbe2-1c1e5b01-fb182818.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:57 AM 1. Right lower lobe opacity concerning for pneumonia. 2. Abnormality in the right lateral lung, either represents a skinfold or possible pneumothorax, suggest repeat chest radiograph with repositioning to better assess. ______________________________________________________________________________ FINAL REPORT INDICATION: Myelodysplastic syndrome and MS, now with delirium, rule out pneumonia. COMPARISON: Chest radiograph on ___ and ___. FINDINGS: One portable upright AP view of the chest. A right lower lobe opacity is concerning for pneumonia. There is also an area in the right lateral lung that may represent either a skinfold or possible pneumothorax. The left lung is clear. There is no pleural effusion. Cardiac, mediastinal and hilar contours are normal. A right internal jugular line ends in the upper SVC. IMPRESSION: 1. Right lower lobe opacity concerning for pneumonia. 2. Abnormality in the right lateral lung, either represents a skinfold or possible pneumothorax, suggest repeat chest radiograph with repositioning to better assess. These findings were discussed with Dr. ___ at 11:15am on ___ by telephone. " a5e8306c-d98da940-959e77fa-1ae9304f-c23e2fa0.jpg,validate/p17/p17631528/s52848056/a5e8306c-d98da940-959e77fa-1ae9304f-c23e2fa0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with met Rectal Ca receiving chemotherapy // Is port in correct location Is port in correct location IMPRESSION: A comparison study of ___, the patient has taken a better inspiration. No evidence of pneumonia, vascular congestion, or pleural effusion. The configuration of the left Port-A-Cath is essentially unchanged. " 9123dcd3-b7e8dc21-e2df6e2c-d8cb0f5c-1a5e99a6.jpg,validate/p13/p13854184/s56001925/9123dcd3-b7e8dc21-e2df6e2c-d8cb0f5c-1a5e99a6.jpg,validation," FINAL REPORT HISTORY: SIADH and cough. FINDINGS: In comparison with the study of ___, the patient has taken a much better inspiration. The cardiac silhouette is within upper limits of normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 296812ac-2e440de6-9400526b-80e07a7d-e4c58d1d.jpg,validate/p19/p19528638/s51960147/296812ac-2e440de6-9400526b-80e07a7d-e4c58d1d.jpg,validation," WET READ: ___ ___ 5:11 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with proximal leg weakness. Eval for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs of ___ and ___. FINDINGS: Heart size, mediastinal, and hilar contours are normal. Lungs are hyperinflated, however clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Hyperinflated lungs. " 8b891db9-df843e2c-42a7d776-907ce41a-6d829f15.jpg,validate/p19/p19621765/s50588811/8b891db9-df843e2c-42a7d776-907ce41a-6d829f15.jpg,validation," FINAL REPORT INDICATION: Pain after a colonoscopy. Evaluate for free air. COMPARISON: 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 mediastinal contours are normal. Atherosclerotic calcifications are noted along the aortic arch. The cardiac silhouette is normal. There is no free air below the hemidiaphragms. IMPRESSION: 1. No acute cardiopulmonary process. 2. No free air below the hemidiaphragms. " e7b0aad6-569e6b7d-3edda4ce-97f556fc-36e305d5.jpg,validate/p12/p12303032/s56825272/e7b0aad6-569e6b7d-3edda4ce-97f556fc-36e305d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with hypoxia // ?pna COMPARISON: None. FINDINGS: PA and lateral views of the chest provided. Elevated right hemidiaphragm with right basilar atelectasis/scarring noted. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. No signs of pneumonia or edema. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. Atelectasis and scarring at the right lung base with elevated right hemidiaphragm. " 5b74e91d-bdfadf11-7b063b5b-b014bffb-38999389.jpg,validate/p15/p15957987/s58859331/5b74e91d-bdfadf11-7b063b5b-b014bffb-38999389.jpg,validation," FINAL REPORT HISTORY: Bilateral effusions and left apical pneumothorax. FINDINGS: In comparison with study of ___, there is little change. The bilateral chest tubes remain in place and there is no change in the left apical pneumothorax or the opacification at the right base. Slightly lower lung volumes. " 96aee13d-4d324593-af589fd1-3b0969b2-db6b6976.jpg,validate/p17/p17676327/s59993665/96aee13d-4d324593-af589fd1-3b0969b2-db6b6976.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT // NGT placement? NGT placement? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Transesophageal drainage tube ends in the mid stomach. ET tube in standard placement. Moderately severe bibasilar consolidation is probably atelectasis since it has varied considerably over the past 3 days, more severe now than previously. Heart is moderately enlarged, unchanged. Severe widening of the mediastinum could ___ a variety of abnormalities including adenopathy and a dilated aorta, either aneurysm or dissection, but it could also be due to a combination of distended mediastinal veins and benign fat deposition. If there is concern for active mediastinal condition, CT scanning with contrast is recommended, and if the aorta is suspect, with cardiac gating. " 01c05ac4-431c9e95-b3e2dc46-18e3eca4-0e73dd4c.jpg,validate/p13/p13235049/s52282262/01c05ac4-431c9e95-b3e2dc46-18e3eca4-0e73dd4c.jpg,validation," FINAL REPORT AP CHEST, 7 P.M. ON ___ HISTORY: Liver failure and pulmonary hypertension. Check ET tube. IMPRESSION: AP chest compared to ___ at 11:07 a.m.: With the chin down, the position of the new endotracheal tube, no less than 18 mm from the carina, is acceptable. Mild pulmonary edema has worsened. Heart is moderately enlarged. New opacification at the base of the left lung could be atelectasis or asymmetric edema. Aspiration or even pneumonia not excluded. Small pleural effusion is new or increased. No pneumothorax. " a6fd215a-708ed13d-c2bb9862-5e1512f3-feb85eec.jpg,validate/p12/p12293983/s57538028/a6fd215a-708ed13d-c2bb9862-5e1512f3-feb85eec.jpg,validation," FINAL REPORT INDICATION: History: ___F with cough + syncope yesterday. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The heart size is normal. The hilar mediastinal contours are normal. 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 focal consolidations concerning for pneumonia identified. " f0920e88-d3dc38f7-a4fcb5c5-cca87011-ad54d307.jpg,validate/p10/p10863418/s51973859/f0920e88-d3dc38f7-a4fcb5c5-cca87011-ad54d307.jpg,validation," 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. " 08f953d2-970a1202-b9c09d49-7d2d27db-5c1b68d2.jpg,validate/p14/p14827673/s57434953/08f953d2-970a1202-b9c09d49-7d2d27db-5c1b68d2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atypical anterior chest pain, normal EKG; prior pneumonia ___; DM // rule out cardiopulmonary abnormalities rule out cardiopulmonary abnormalities IMPRESSION: ___ ___ ___ the study of ___, the patient has taken a better inspiration. Cardiac silhouette remains enlarged without vascular congestion. The areas of heterogeneous opacification on the right are no longer present and there is no evidence of acute pneumonia at this time. " bc3a33e0-def0a3b1-db3c1e7d-7b408282-facc2c01.jpg,validate/p18/p18130172/s58191449/bc3a33e0-def0a3b1-db3c1e7d-7b408282-facc2c01.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with right chest pain for multiple months. // Eval chest pain 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. " 731cb92a-bf509b9f-b6a1b3f5-491347eb-a2168529.jpg,validate/p16/p16480579/s54737108/731cb92a-bf509b9f-b6a1b3f5-491347eb-a2168529.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p LLL // check interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the left apical pneumothorax is no longer visible. Also resolved are the multiple air-fluid levels, described in the previous report. Neither the frontal border lateral radiograph of today's image show presence of pleural effusions. Per normal size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. No pneumonia. Minimal left lower lobe atelectasis. A 4-5 mm rounded structure at the right lung bases probably reflects the nipple, it should receive attention on the next followup, the structure projects over the dorsal parts of the tenth rib. " ca85780f-4337809a-c7a50598-62399701-5d328b34.jpg,validate/p18/p18194653/s53288574/ca85780f-4337809a-c7a50598-62399701-5d328b34.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right ventricular failure, patient on ecmo, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the coiling of one of the two esophageal devices is present in unchanged manner. The other monitoring and support devices are also unchanged. Moderate cardiomegaly that is unchanged, likely associated to small pleural effusions, right more than left. Mild pulmonary edema. Atelectasis at the lung bases, but no evidence of new parenchymal opacities. " e226ea14-d03afc99-478cc1c8-2eef86b2-419000f3.jpg,validate/p10/p10842371/s56148807/e226ea14-d03afc99-478cc1c8-2eef86b2-419000f3.jpg,validation," WET READ: ___ ___ ___ 8:34 PM Equivocal rounded opacity over right lung base is likely summation of superimposed structures. No definite consolidation. Slight blunting of right costophrenic angle is compatible with a small pleural effusion. - ___ p_________________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Hepatitis C, assessment before hemodialysis initiation. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size and mediastinum are unremarkable. Lungs are essentially clear. Minimal pleural thickening in the right costophrenic angle is noted. No overt infection is currently seen. " afc55225-8329ad2f-df5e10a2-b22015bb-6ab6fd5c.jpg,validate/p15/p15623256/s55911215/afc55225-8329ad2f-df5e10a2-b22015bb-6ab6fd5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, chest pain // Assess for pneumonia TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. Spinal osteophytes are present, extensive. " e8fd420d-9f96c7c2-7c3cef6d-d612c8b3-f27c47f6.jpg,validate/p17/p17517983/s52415164/e8fd420d-9f96c7c2-7c3cef6d-d612c8b3-f27c47f6.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with gastroparesis. COMPARISON: Multiple prior exams, most recently chest radiographs of ___. 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. " 11368cfc-136abb8a-7991c04e-844737ab-8065334f.jpg,validate/p13/p13633584/s50146807/11368cfc-136abb8a-7991c04e-844737ab-8065334f.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: A ___-year-old female with generalized weakness and shortness of breath. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Chest radiograph from ___ and ___. FINDINGS: There is no significant interval change compared with prior chest radiograph from ___. Lung volumes are low. The heart size is mildly enlarged but unchanged. The mediastinal contours are similar with tortuosity of the thoracic aorta and diffuse atherosclerotic calcifications again noted. There is no pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. Numerous remote fractures of the left-sided ribs and left distal third clavicle are re- demonstrated. IMPRESSION: No evidence of acute cardiopulmonary process. Numerous remote fractures of the left-sided ribs and left distal third clavicle are re- demonstrated. " 8cb9a1a0-6b183c4c-83ade8ac-06d4effe-95dc7abb.jpg,validate/p10/p10998936/s54167675/8cb9a1a0-6b183c4c-83ade8ac-06d4effe-95dc7abb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with fever, neutropenia. // ___F with fever, neutropenia. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Lungs remain hyperinflated. Patchy medial left base opacity, increased since the prior study, could be due to atelectasis, aspiration, or pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Persistently hyperinflated lungs may be due to COPD. Patchy medial left base opacity, increased since the prior study, and could be due to atelectasis, aspiration, or pneumonia. " 86d6319d-22e06897-0469d513-378f1a31-a401bc3c.jpg,validate/p17/p17239737/s51169794/86d6319d-22e06897-0469d513-378f1a31-a401bc3c.jpg,validation," 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. " b3d9c438-efde4a55-9f6d39ed-5e541658-5a16f8c8.jpg,validate/p17/p17673690/s53351801/b3d9c438-efde4a55-9f6d39ed-5e541658-5a16f8c8.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: sickle cell pain crisis with cough. FINDINGS: Comparison is made to prior study from ___. There has been placement of a right IJ central line with distal lead tip in the mid SVC. Lungs are clear and there is improved aeration since the prior study. There are no pneumothoraces. Heart size is normal. " 00a481e0-604434ea-64941c88-e9205e69-81cb7793.jpg,validate/p13/p13139773/s59686695/00a481e0-604434ea-64941c88-e9205e69-81cb7793.jpg,validation," WET READ: ___ ___ 7:22 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M with left sided chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No acute cardiopulmonary abnormality. " 154db5b0-d545cdb5-dad94d3f-6f8dc6aa-173c7a9f.jpg,validate/p19/p19780620/s51015708/154db5b0-d545cdb5-dad94d3f-6f8dc6aa-173c7a9f.jpg,validation," WET READ: ___ ___ ___ 3:45 PM Nasogastric tube with distal tip in the stomach and side-port at the expected location of the gastroesophageal junction. Advancing the tube by 5 cm is recommended ______________________________________________________________________________ FINAL REPORT EXAMINATION: Portable upright radiograph INDICATION: ___ year old man with NGT placement. // Please evaluate for NGT location. TECHNIQUE: Portable upright chest radiograph COMPARISON: Chest radiograph from ___. FINDINGS: Nasogastric tube terminates in the body of the stomach with side-port near the estimated location of the gastroesophageal junction. Post pyloric Dobhoff tube is seen coursing into the jejunum with distal tip out of view. Other support lines, left pleural effusion, and left lower lobe opacification are unchanged. IMPRESSION: Nasogastric tube with side-port at the expected location of the gastroesophageal junction. Advancing the tube by 5 cm is recommended. NOTIFICATION: The wet read was discussed with Dr. ___, M.D. by ___, M.D. on the telephone on ___ at 2:00 PM, at the time of discovery of the findings. " 46b8711b-92fecfb5-011599c8-63970c84-2ac6ba32.jpg,validate/p15/p15354006/s59335606/46b8711b-92fecfb5-011599c8-63970c84-2ac6ba32.jpg,validation," FINAL REPORT INDICATION: Cough and low oxygen saturations in office today. Decreased breath sounds at bases bilaterally, no wheeze, rales, rhonchi. Evaluate for pneumonia versus effusion versus other cause. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion or pneumothorax is present. Heart size, mediastinal and hilar contours are normal. Lungs remain stably hyperinflated with unchanged scarring at the apices. Moderate hiatal hernia is unchanged. Mild scoliosis is unchanged. IMPRESSION: 1. No evidence of pneumonia. 2. Stable moderate hiatal hernia. NOTIFICATION: Page sent to Dr. ___ by Dr. ___ at 2:45 p.m. on ___ per request. " 11b3ba3c-faef8fa0-65ee7ffc-81e321ca-0f8f4d32.jpg,validate/p14/p14627594/s51935783/11b3ba3c-faef8fa0-65ee7ffc-81e321ca-0f8f4d32.jpg,validation," FINAL REPORT INDICATION: History: ___F with weakness TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lung volumes are low. Streaky opacities in lung bases likely reflect bibasilar atelectasis. Otherwise, there is no focal consolidation, pleural effusion or pneumothorax. The aortic knob is calcified. The heart size is top normal with left ventricular predominance. IMPRESSION: Bibasilar atelectasis. " 2979be74-0245b2bc-bf20901c-3de56063-f8ce8aa5.jpg,validate/p14/p14565909/s54522745/2979be74-0245b2bc-bf20901c-3de56063-f8ce8aa5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with intubation TECHNIQUE: Portable chest x-ray. COMPARISON: AP radiograph from 6 hours prior FINDINGS: Lung volumes are low. The cardiac silhouette is borderline enlarged. In the interim, the patient has been intubated. The tip of the endotracheal tube extends into the right mainstem bronchus. Atelectasis in the left lung base is noted. Crowding of bronchovascular structures is demonstrated without overt pulmonary edema. No pleural effusion or pneumothorax is present. Hypertrophic changes are seen in the thoracic spine. IMPRESSION: Right mainstem bronchial intubation. NOTIFICATION: The findings were discussed with ___, RN by ___ ___, M.D. on the telephone on ___ at 9:42 AM, 5 minutes after discovery of the findings. " 3f27cc5a-355abec3-39c4f89f-3be781fe-76ce13f2.jpg,validate/p14/p14716808/s57354809/3f27cc5a-355abec3-39c4f89f-3be781fe-76ce13f2.jpg,validation," 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. " 8a298cc1-078cc4b4-0df59712-3ade6839-be836c44.jpg,validate/p14/p14371035/s58104379/8a298cc1-078cc4b4-0df59712-3ade6839-be836c44.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with NMO and urosepsis, intubated. // interval change COMPARISON: Radiographs from ___ IMPRESSION: There is no interval change. Support lines and tubes are unchanged in position. Cardiomediastinal silhouette is within normal limits. There is again seen atelectasis versus early infiltrate at the lung bases. Small left-sided pleural effusion is seen. No pneumothoraces are identified. " cf707ff8-ce0954d9-117ecc00-856ccfe9-396c7225.jpg,validate/p16/p16617005/s54199216/cf707ff8-ce0954d9-117ecc00-856ccfe9-396c7225.jpg,validation," FINAL REPORT EXAMINATION: Portable upright chest x-ray INDICATION: ___ year old man with VAP and fluid overload // mucus plug, VAP, pulmonary edema TECHNIQUE: Portable upright chest x-ray COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: In comparison ___ study multifocal airspace consolidation of the right lung continues to improve as well as improvement of the left lung though a infrahilar opacity persists. Moderate pleural effusion appears stable and a right pleural effusion is minimal. Again seen is a right central venous catheter with the tip terminating in the mid SVC. IMPRESSION: Multifocal airspace consolidation with improvement of the right upper and left upper lobes with stable bilateral pleural effusions. " 732318cd-10ce1b12-7b569013-85dabc6a-e3745109.jpg,validate/p18/p18784363/s53939598/732318cd-10ce1b12-7b569013-85dabc6a-e3745109.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with dyspnea, chest pain and back pain. Evaluate for acute process. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: Lung volumes are mildly decreased with crowding of the central bronchovascular structures. There is a left lung opacity concerning for pneumonia. The heart is normal in size, and there is no pleural effusion or pneumothorax. IMPRESSION: Left lung opacities concerning for pneumonia. " 44aa5051-e4be2657-65dc8dfe-91e32574-94526282.jpg,validate/p16/p16514111/s57887224/44aa5051-e4be2657-65dc8dfe-91e32574-94526282.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SOB and ___F last night. // pna? COMPARISON: ___ ___. IMPRESSION: As compared to the previous radiograph, there is a decrease in lung volumes, reflecting a lesser inspiratory effort. The signs indicative of resolving pulmonary edema are constant. Also constant is the slightly denser lung zone at the right lung basis and the small right pleural effusion. Unchanged moderate cardiomegaly with elongation of the descending aorta. " 283b2bb0-034fd7b3-54f39fa6-7266bf4b-a2f02987.jpg,validate/p15/p15172735/s54208174/283b2bb0-034fd7b3-54f39fa6-7266bf4b-a2f02987.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough, chills. COMPARISON: None available. FINDINGS: PA and lateral images through the chest demonstrates clear lungs bilaterally. The cardiomediastinal contours are within normal limits. There is no pleural effusion or pneumothorax. Visualized osseous structures demonstrate no acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " 5377d0f2-d2d14e4d-3e446279-52883c08-ef7da57b.jpg,validate/p15/p15782217/s59637321/5377d0f2-d2d14e4d-3e446279-52883c08-ef7da57b.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, orthopnea, bibasilar crackles and lower extremity edema. Concern for congestive heart failure. Also, history of asthma. Evaluate for evidence of CHF. COMPARISON: Chest radiograph ___, ___ and ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: Lung volumes are low with vascular crowding and prominent interstitial markings suggesting mild interstitial edena. There is no focal airspace opacity. Cardiomegaly is moderate. There is mild atelectasis at the left base. No large pleural effusion or pneumothorax is detected. Left rib fractures are chronic. IMPRESSION: Low lung volumes, moderate cardiomegaly, and mild pulmonary edema in the setting of CHF. " 68a893b1-d841e9b3-c592fd4c-e80b55a5-71075672.jpg,validate/p10/p10823359/s51511155/68a893b1-d841e9b3-c592fd4c-e80b55a5-71075672.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with right basal ganglia bleed // New NGT placement. please assess placement TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to previous radiograph done ___ FINDINGS: nasogastric tube in situ with the tip in the mid stomach. The cardiomediastinal shadow is unchanged. No new areas of airspace consolidation. No pulmonary edema. IMPRESSION: Nasogastric tube in situ in the appropriate position " 734dd65c-90775978-da11d33a-231a27ef-5c2dc910.jpg,validate/p18/p18443326/s56131092/734dd65c-90775978-da11d33a-231a27ef-5c2dc910.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Likely right-sided ischemic stroke. Evaluate for pulmonary edema. TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Heart size is normal. Cardiomediastinal silhouette is unremarkable. There is a central pulmonary vascular engorgement with moderate interstitial pulmonary edema. A right subclavian approach Port-A-Cath tip terminates in the right atrium. There is a small right-sided pleural effusion with increased density at the right base. There is no pneumothorax. Bones are diffusely demineralized. IMPRESSION: Pulmonary vascular congestion with moderate interstitial pulmonary edema and small right-sided pleural effusion. A confluent opacity at the right lung base may be secondary asymmetrical edema, though infection should also be considered in the appropriate clinical setting. Short-term followup radiographs after diuresis may be helpful in this regard, if warranted clinically. . " 67e9844a-3770c428-2d61e9d6-24c98c5a-02b688ea.jpg,validate/p14/p14865329/s50663584/67e9844a-3770c428-2d61e9d6-24c98c5a-02b688ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with post-op cervical fusion // eval for acute apthology COMPARISON: ___ IMPRESSION: AS COMPARED TO THE PREVIOUS RADIOGRAPH, THE LUNG VOLUMES HAVE INCREASED, LIKELY REFLECTING IMPROVED VENTILATION. MINIMAL CROWDING OF VASCULAR STRUCTURES AT THE LUNG BASES AND NEWLY APPEARED RETROCARDIAC ATELECTASIS. NO PNEUMOTHORAX. ENDOTRACHEAL TUBE IS IN UNCHANGED POSITION. THE NASOGASTRIC TUBE SHOWS A NORMAL COURSE. NO PLEURAL EFFUSIONS. NEWLY IMPLANTED CERVICAL EFFUSION. . " 72393f58-3de64497-fa2b8f3c-8caf7e2a-45a8e745.jpg,validate/p10/p10374990/s50367671/72393f58-3de64497-fa2b8f3c-8caf7e2a-45a8e745.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pulm edema/effusions, hx of chylothorax // interval change of effusions interval change of effusions COMPARISON: Comparison to prior study dated ___ at 05:40 FINDINGS: Portable upright chest radiograph ___ at 08:12 is submitted. IMPRESSION: Left PICC line unchanged in position. TAVR and seen. Hardware overlying the upper thoracic spine. Since ___, there is improving aeration in the lungs. There continue be layering small bilateral effusions with residual patchy opacities suggestive of atelectasis. No evidence of pulmonary edema. No obvious pneumothorax. Multiple old left-sided rib fractures. " 0e905807-ba576b28-e8b91fab-92e3de39-1ba1c06d.jpg,validate/p11/p11459120/s53962571/0e905807-ba576b28-e8b91fab-92e3de39-1ba1c06d.jpg,validation," FINAL REPORT INDICATION: History of COPD, now with bibasilar rales. Evaluate for pulmonary edema versus pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. There is a widespread interstitial abnormality, likely secondary to mild pulmonary edema. Moderate cardiomegaly is not significantly changed. Aortic calcifications are noted. Mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Multilevel degenerative changes of the thoracolumbar spine are noted. There is a left-sided pacemaker with right atrial and right ventricular leads. There is also re-demonstration of left shoulder hardware. IMPRESSION: 1. Findings suggestive of mild interstitial pulmonary edema. 2. Moderate cardiomegaly, not significantly changed. " efa61bb7-19839b14-3e72a5d1-36526bb7-00991c22.jpg,validate/p13/p13229615/s56190188/efa61bb7-19839b14-3e72a5d1-36526bb7-00991c22.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe COPD p/w respiratory distress, most likely COPD exacerbation. Clinical picture not consistent with PNA, but CXR read as possible right lung opacity. // Pneumonia? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum as well as appearance of the lungs including severe emphysema is unchanged. No interval development of pleural effusion, pneumothorax or new consolidations demonstrated. " 52490f78-866024a8-71b65b0d-bf35bfeb-5556c66d.jpg,validate/p19/p19103751/s58966657/52490f78-866024a8-71b65b0d-bf35bfeb-5556c66d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with Multiple myeloma. New onset of SOB // New onset SOB 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. RECOMMENDATION(S): The findings were discussed by Dr. ___ ___ ___ on the telephone on ___ at 4:29 PM, 120 minutes after discovery of the findings. " 53ac5e4b-01b9181e-c0701b8f-7c4b1733-ba7b7dbc.jpg,validate/p17/p17988248/s53362062/53ac5e4b-01b9181e-c0701b8f-7c4b1733-ba7b7dbc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Non-small cell lung cancer, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a new right pleural effusion, occupying approximately one-third of the right hemithorax and blunting the costophrenic sinus. The effusion extends to the level of the minor fissure. In addition, relatively large areas of atelectasis are seen on the right. No change in appearance of the left lung. The patient has been extubated in the interval. The cardiac silhouette is unchanged. " 7117effc-d58f3655-bf56aa06-92a461ff-23fe4551.jpg,validate/p17/p17653729/s50344427/7117effc-d58f3655-bf56aa06-92a461ff-23fe4551.jpg,validation," FINAL REPORT INDICATION: ___ year old F with atrial fibrillation, peripheral vascular disease , CVA, dementia, two recent hospitalizations and a general decline, presenting from rehab with possible pneumonia. TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Since prior, lung volumes are slightly lower. Borderline size of cardiac silhouette is unchanged. Mediastinal and hilar borders are stable. There are no focal consolidations to suggest pneumonia. There is no pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: Mild decrease in lung volumes, no evidence of pneumonia or pulmonary edema. " 16cd7fad-a1d17346-5d085a17-e8f23189-3c65e64a.jpg,validate/p16/p16560053/s59680663/16cd7fad-a1d17346-5d085a17-e8f23189-3c65e64a.jpg,validation," FINAL REPORT HISTORY: An ___-year-old male with shortness of breath. Evaluate effusion. COMPARISON: Preoperative chest radiograph ___, postoperative chest radiographs ___. FINDINGS: IMPRESSION: Postoperative widening of the cardiomediastinal silhouette has not changed since ___. If there is a pericardial effusion it is not hemodynamically sufficient to distend mediastinal veins. Pulmonary vasculature is engorged, although improved and there is no appreciable pulmonary edema. Bilateral pleural effusions are small but unchanged. No pneumothorax. " ac883b1f-7ae1566b-7409b9b6-6a6ba7e5-b575080a.jpg,validate/p12/p12054589/s53874011/ac883b1f-7ae1566b-7409b9b6-6a6ba7e5-b575080a.jpg,validation," FINAL REPORT AP CHEST, 7:48 A.M., ___ HISTORY: Fluid overload, question interval change. IMPRESSION: AP chest compared to ___ and ___: Previous mild pulmonary edema has improved, moderate right pleural effusion is stable, small left pleural effusion is new, heart size remains top normal, mediastinal vascular engorgement has decreased. Tip of the endotracheal tube with the chin down is only at the upper margin of the clavicles, no less than 7.5 cm above the carina and should be advanced 3 cm for more secured seating when the chin elevates. Swan-Ganz catheter ends in the right pulmonary artery. Dr. ___ paged at 11:50 a.m. " 85d65941-557baa2c-a1a97aff-fd5f68bb-967e8f6b.jpg,validate/p16/p16753046/s53428075/85d65941-557baa2c-a1a97aff-fd5f68bb-967e8f6b.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female with left arm and chest pain, rule out cardiopulmonary process. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are clear of focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable, noting surgical clips in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 608c5cf8-0e1342b6-ce1d31a5-ac3557ca-da694bf1.jpg,validate/p13/p13353252/s53683300/608c5cf8-0e1342b6-ce1d31a5-ac3557ca-da694bf1.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Streaky left base retrocardiac opacity is seen, which may be due to atelectasis. No definite new focal consolidation is seen. There is no large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable, as are the hilar contours. No overt pulmonary edema is seen. IMPRESSION: No significant interval change. Streaky retrocardiac opacities may be due to atelectasis. " dc0c90b2-41abf27e-d7d3cfee-ef73991d-2f0b0009.jpg,validate/p10/p10491172/s51870686/dc0c90b2-41abf27e-d7d3cfee-ef73991d-2f0b0009.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with copd exacerbation and acute head / chest congestion, not improving w/ azithromycin // r/o pneumonia 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, pleural effusion or pneumothorax. Mild scarring at the right base, unchanged. Mediastinal and hilar contours, including prominence of the pulmonary arteries, are unchanged. Heart size is normal. IMPRESSION: No evidence of pneumonia. Hyperinflated lungs are suggestive of emphysema. " 58a862dc-2b757f90-0757758f-1d4f8c7c-bf1fc05e.jpg,validate/p10/p10987724/s51183349/58a862dc-2b757f90-0757758f-1d4f8c7c-bf1fc05e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness, history of cancer // eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph and CT chest ___ FINDINGS: Cardiac silhouette size is normal. The aorta remains mildly tortuous. Mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. Two masses in the right lung, one within the right middle lobe, and a second within the right lower lobe appear grossly unchanged compared to the previous examinations. Severe emphysema seen in the left upper lobe unchanged. Subsegmental atelectasis is noted in the left lung base. No new focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Re- demonstration of two right lung masses, grossly unchanged from the previous CT. Left upper lobe severe emphysema. No new focal consolidation to indicate pneumonia. " e043273b-8ad9d58a-0227342b-f2840627-4676ac11.jpg,validate/p11/p11329913/s53837061/e043273b-8ad9d58a-0227342b-f2840627-4676ac11.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Questionable small nodular opacity seen on the lateral view overlying the anterior T9 vertebral body, most likely due to overlapping structures. Resolution of this finding with shallow oblique radiographs from the lateral projection should be obtained, and shown to a radiologist to confirm technical adequacy. // Questionable small nodular opacity seen on the lateral view overlying the anterior T9 vertebral body, most likely due to overlapping structures. Resolution of this finding with shallow oblique radiographs from the lateral COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre described rounded prevertebral opacity is no longer visualized. In the interval, minimal pleural effusions have newly occurred. No other relevant changes are seen. " c1a92cf2-0ac43f41-7e37000d-c0d48025-04d3b7b9.jpg,validate/p15/p15294749/s52510492/c1a92cf2-0ac43f41-7e37000d-c0d48025-04d3b7b9.jpg,validation," 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 appear normal. Atherosclerotic calcification along the aortic knob is noted. The imaged osseous structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " db6a9cd4-68eb728e-6a0d1235-83e294ea-0a141107.jpg,validate/p19/p19972786/s50478782/db6a9cd4-68eb728e-6a0d1235-83e294ea-0a141107.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // predischarge eval COMPARISON: Chest radiograph ___ FINDINGS: Moderate retrocardiac atelectasis is unchanged. A moderate-to-large left pleural effusion is unchanged. Hilar contours are normal. The heart is moderately enlarged unchanged from ___. Patient is status post median sternotomy. The wires are properly aligned and intact. A left central venous line ends in the mid SVC unchanged from prior. IMPRESSION: 1. A moderate to large left pleural effusion is unchanged from ___. 2. Left central venous line ends in the mid SVC unchanged from prior. 3. Moderate retrocardiac atelectasis is unchanged from ___. " e016e385-82689555-d95ac098-bb7c9978-8428632a.jpg,validate/p18/p18978846/s52144583/e016e385-82689555-d95ac098-bb7c9978-8428632a.jpg,validation," FINAL REPORT INDICATION: History of lymphoma, query masses or acute process. COMPARISON: Chest radiograph, ___. FINDINGS: The cardiomediastinal contours are stable allowing for differences in patient positioning. There is a new small left pleural effusion, and there may also be a small right pleural effusion. There is no pneumothorax. Continued indistinctness of pulmonary hila with increased interstitial markings is consistent with interstitial pulmonary edema. IMPRESSION: New small left pleural effusion with a probable small right pleural effusion and mild vascular congestion. " 56534250-bef7f6a1-41651718-8d40c44f-d90feaa2.jpg,validate/p19/p19507787/s50242325/56534250-bef7f6a1-41651718-8d40c44f-d90feaa2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent pneumonia and/or atelectasis and also segmental LLL PE on CTA in late ___, all in the setting of ___ ___ // Assess for radiographic clearing of bilateral lower lobe consolidations seen in ___ ___ for radiographic clearing of bilateral lower lobe consolidations seen in ___ IMPRESSION: In comparison with study ___ ___, the patient has taken a much better inspiration. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Minimal atelectatic streak at the left base. " 3e374d07-2b385265-26da6cd6-e66fe169-02d863bb.jpg,validate/p15/p15233042/s53118856/3e374d07-2b385265-26da6cd6-e66fe169-02d863bb.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with congestive heart failure and COPD. Portable AP radiograph of the chest was reviewed in comparison to ___. Post-sternotomy wires are redemonstrated with the upper ones being displaced and potentially broken. The cardiomediastinal silhouette is unchanged, including moderate cardiomegaly. No appreciable interstitial edema, pleural effusion, or pneumothorax is seen. " e9a06137-9ac241ef-c7a2c79a-a1858a67-8caf26eb.jpg,validate/p12/p12310399/s58900923/e9a06137-9ac241ef-c7a2c79a-a1858a67-8caf26eb.jpg,validation," FINAL REPORT INDICATION: Status post pacemaker placement. TECHNIQUE: Frontal lateral chest radiographs. COMPARISON: CTA chest dated ___ FINDINGS: A right-sided dual lead pacemaker is noted with tips overlying the expected location of the right atrium and right ventricle. The cardiac silhouette is normal. There is no focal consolidation, pneumothorax, or pleural effusion. Osseous structures demonstrate bridging osteophytes over multiple levels in the thoracic spine suggesting DISH. " e57ff56f-20d12a46-92e9c0a5-04b7de66-3ff67b20.jpg,validate/p13/p13688556/s54659107/e57ff56f-20d12a46-92e9c0a5-04b7de66-3ff67b20.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with several episodes syncope, palpitations over prior month COMPARISON: Prior study from ___ FINDINGS: PA and lateral views of the chest provided. Spinal hardware projects over the lower T-spine and upper lumbar spine and is only partially 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. IMPRESSION: No acute intrathoracic process. " 88782c36-b33cd797-016c19b8-fa72149b-eb7f09f0.jpg,validate/p14/p14176612/s59666846/88782c36-b33cd797-016c19b8-fa72149b-eb7f09f0.jpg,validation," 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. " 9d99d3f9-f44fda16-1f381494-9c77b03d-ca8e153f.jpg,validate/p16/p16019229/s59802175/9d99d3f9-f44fda16-1f381494-9c77b03d-ca8e153f.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Question air leak after chest tube placement. Comparison is made with prior study performed 6 hours earlier. Left pigtail catheter has been pulled back. There is less catheter inside the pleural space and there is less looping of the catheter at the tip. Extensive multifocal bilateral pneumonia is unchanged. Other lines are tubes are in unchanged position. Right chest tube is new. There is no evident pneumothorax. The small right pleural effusion has improved. Cardiomediastinal contours are unchanged. " 48a0bfa9-b0e805ea-5eacb445-df97e458-e73d4725.jpg,validate/p14/p14011614/s54263027/48a0bfa9-b0e805ea-5eacb445-df97e458-e73d4725.jpg,validation," FINAL REPORT HISTORY: ___-year-old female smoker with Crohn's, presents with new cough after recent hospitalization. Assess for pneumonia. COMPARISON: None. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: New ill-defined opacity obscuring the left heart border is consistent with lingular pneumonia. Left subclavian tip is in low SVC. No additional focal opacity or pleural effusion. No pneumothorax. The heart size, mediastinal contour and hila are normal without lymphadenopathy. IMPRESSION: New lingular pneumonia. " 7e6e5cfa-d817f73e-77dba32b-87e78555-e5c9d906.jpg,validate/p14/p14997223/s53200231/7e6e5cfa-d817f73e-77dba32b-87e78555-e5c9d906.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: There is chronic blunting of the right costophrenic angle along with right lateral pleural thickening, findings similar to the prior exam. This maybe related to the patient's previous loculated pleural effusion and pleurodesis. There is no evidence of pneumonia or pneumothorax. Cardiac silhouette is normal in size. Elevation of the right hemidiaphragm is unchanged. IMPRESSION: No substantial interval change from prior with no acute cardiopulmonary process. Chronic blunting of the right costophrenic angle and right lateral pleural thickening, likely related to the patient's history of pleurodesis and pleural effusion. " 3e493528-3deaa1ec-3c17c400-4d0d1f1d-e309132d.jpg,validate/p10/p10998936/s59354747/3e493528-3deaa1ec-3c17c400-4d0d1f1d-e309132d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with myelodysplastic syndrome and fever, considered neutropenic by BMT // acute intrathoracic process? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are hyperinflated without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal in size. Mediastinal contours are unremarkable. Hilar contours are unremarkable. Partially imaged is a coarse calcification projecting over the soft tissue lateral to the right humeral head, likely represents calcific tendinosis. IMPRESSION: Hyperinflated lungs without focal consolidation. " 3ed76d30-e69a9cac-d26cca2a-6e1bed67-3193830c.jpg,validate/p11/p11522912/s58083606/3ed76d30-e69a9cac-d26cca2a-6e1bed67-3193830c.jpg,validation," FINAL REPORT HISTORY: Tracheostomy with new infiltrate. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in satisfactory position. Stable enlargement of the cardiac silhouette, in part due to prominent pericardial fat pad seen on prior CT of ___. There is evidence of elevated pulmonary venous pressure. Increased opacification at the right base is consistent with pleural effusion and volume loss in the adjacent lower lung. Less prominent similar changes are seen on the left. In the appropriate clinical setting, supervening pneumonia would have to be considered. Marked gastric distention is again noted in the upper abdomen, as on the previous study. " 3556b168-827fe50f-4120c355-ffae51b3-8f0057ff.jpg,validate/p12/p12009813/s56595611/3556b168-827fe50f-4120c355-ffae51b3-8f0057ff.jpg,validation," 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. " d1d3e945-02b8ecd1-5a2be55f-84f351fe-7c5fdfc2.jpg,validate/p11/p11104709/s53258541/d1d3e945-02b8ecd1-5a2be55f-84f351fe-7c5fdfc2.jpg,validation," FINAL REPORT INDICATION: History of metastatic melanoma, now with difficulty swallowing solids and liquids. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent CT of the torso dated ___ and most recent radiographs of the chest dated ___. FINDINGS: A left hilar and left infrahilar opacity corresponds to known lesions seen on CT examination of ___. No new focal consolidation is seen to suggest pneumonia. No pleural effusion or pneumothorax is present. The heart size is normal. There is mild tortuosity of the aorta. IMPRESSION: 1. Known left perihilar as seen on prior CT examination. Other smaller lesions seen by CT are not well appreciated on this examination. 2. No evidence of acute superimposed intrathoracic process. " ed93bd90-891b2c13-3a894f1b-feb1bac2-dadcf742.jpg,validate/p10/p10208178/s56678122/ed93bd90-891b2c13-3a894f1b-feb1bac2-dadcf742.jpg,validation," FINAL REPORT HISTORY: Chest pain, evaluate for pneumonia. COMPARISON: CTA chest from ___. FINDINGS: An upright portable radiograph of the chest was obtained. The base of the right hemithorax is obscured by an overlying pacemaker. The dual leads extend to the expected positions of the right atrium and ventricle. The patient is status post bilateral shoulder arthroplasties. A left base/retrocardiac opacity may represent consolidation. There may also be a small left pleural effusion. Additionally, there is a superimposed central pulmonary vascular engorgement. The cardiomediastinal contour is enlarged, as on prior exam. There is no pneumothorax. IMPRESSION: 1. Left base/retrocardiac opacity, which may represent consolidation as well as a small left pleural effusion. 2. Central pulmonary vascular engorgement " 0551dd78-89ad5e67-5dace524-dc0e1544-b9dff480.jpg,validate/p15/p15700497/s51963541/0551dd78-89ad5e67-5dace524-dc0e1544-b9dff480.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p exp lap with SBR desat and O2 req, tachy // aspiration? edema? TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: There are bibasilar opacities, greater on the left which may reflect atelectasis. Aspiration however cannot be excluded. No pleural effusion or pneumothorax identified. The size the cardiac silhouette is enlarged. A density projects over the lower mediastinum is likely reflective of a hiatal hernia. A small amount free air is noted beneath the right hemidiaphragm. IMPRESSION: 1. Bibasilar opacities are likely reflective of atelectasis, however aspiration should be considered in the proper clinical context. 2. Small amount of free air under the right hemidiaphragm. 3. Suspected hiatal hernia. " 5399001e-2325aad2-1fd4ba6c-47301a01-36e66c83.jpg,validate/p16/p16050305/s50915118/5399001e-2325aad2-1fd4ba6c-47301a01-36e66c83.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with asthma, pneumonia ___, ongoing shortness of breath // follow up pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ with the most recent dated ___. FINDINGS: There is moderate cardiomegaly which is stable. The mediastinal silhouette is widened and stable. There is elevation of the left hemidiaphragm with no evidence of previously seen left lower lobe pneumonia which is likely secondary to a persistent consolidation to base and likely represents a left lower lobe atelectasis. . There is no evidence of focal consolidations, pulmonary edema, or pleural effusion. Again seen is a moderate hiatal hernia which is stable. IMPRESSION: 1. Elevation of left hemidiaphragm with persistent consolidation of the left lung base in the setting of a cleared pneumonia likely represents left lower lobe atelectasis. 2. No evidence of acute on chronic heart disease. " 8eea3b0f-96a875cd-399e44d5-c67ada7c-c18dd006.jpg,validate/p15/p15664962/s53279195/8eea3b0f-96a875cd-399e44d5-c67ada7c-c18dd006.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o breast cancer // r/o metastatic disease COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing pleural effusions have completely resolved. Moderate scoliosis of the thoracic spine. Borderline size of the cardiac silhouette with mild elongation of the descending aorta. Several smaller millimetric nodular structures on the frontal radiograph are not visualized on the lateral radiograph and likely reflect vascular shadows. No pneumonia, no pneumothorax, no atelectasis. " 87831f3a-f3d86c9e-6f006aad-89cb1ff3-b908f93e.jpg,validate/p13/p13006587/s56010928/87831f3a-f3d86c9e-6f006aad-89cb1ff3-b908f93e.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough, fever, and knee pain. Evaluate for pneumonia. COMPARISONS: None. FINDINGS: The heart is of normal size with normal cardiomediastinal contours. The pulmonary vasculature is unremarkable. Linear opacity overlying the lower thoracic vertebral bodies on lateral view is most compatible with atelectasis, but pneumonia cannot be excluded in the correct clinical setting. No diffuse pulmonary abnormality is present. No pleural effusion or pneumothorax. Osseous structures are unremarkable. No radiopaque foreign body. IMPRESSION: Streaky linear opacity overlying the lower thoracic vertebral bodies, most compatible with atelectasis, although atypical pneumonia cannot be excluded in the correct clinical setting. " a3885053-a88c80d9-f548506d-4348e9d0-7f0adcf7.jpg,validate/p13/p13437934/s58108087/a3885053-a88c80d9-f548506d-4348e9d0-7f0adcf7.jpg,validation," FINAL REPORT INDICATION: Cough and hypoglycemia. Evaluate for infection. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: There is diffuse increased interstitial markings, most consistent with mild pulmonary edema. At the right base, there is an ill-defined opacity, which may be related the edema, though a superimposed infection is difficult to exclude. There are small bilateral pleural effusions. There is no pneumothorax. The mediastinal contours are normal. The heart is mildly enlarged, and unchanged from the prior exam. IMPRESSION: 1. Mild pulmonary edema. 2. More focal opacity at the right base may be related to the edema, though an infection cannot be excluded in the proper clinical setting. 3. Small bilateral pleural effusions. 4. Mild cardiomegaly. " 24eae785-6c9d7e64-b61e2540-8279ae85-1aa85b10.jpg,validate/p19/p19837909/s54418628/24eae785-6c9d7e64-b61e2540-8279ae85-1aa85b10.jpg,validation," FINAL ADDENDUM ADDENDUM Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state throat foreign body sensation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with likely food impaction // evaluate for acute process COMPARISON: Prior study from ___ and CT torso 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. No radiopaque foreign body is seen. IMPRESSION: No acute intrathoracic process. " 83a477bf-169b283f-c707a1ed-90805070-c900af05.jpg,validate/p10/p10905644/s55050228/83a477bf-169b283f-c707a1ed-90805070-c900af05.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. Question acute process. COMPARISON: None available. FINDINGS: Frontal and lateral views of the chest demonstrate slightly decreased lung volumes, accentuating a prominent cardiac silhouette. There is minimal interstitial prominence without definite evidence to suggest frank edema. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No definite evidence of acute cardiopulmonary process. Minimal interstitial prominence without frank edema. " a024f000-0ed36642-c029a162-89806810-0b9a9278.jpg,validate/p14/p14508231/s55606151/a024f000-0ed36642-c029a162-89806810-0b9a9278.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain, syncope // eval for acute process TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Anterior cervicothoracic hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " 084e0d27-d1cb8421-d8d795cf-99948cf9-6ea2a492.jpg,validate/p19/p19635768/s51401379/084e0d27-d1cb8421-d8d795cf-99948cf9-6ea2a492.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Lungs appear hyperexpanded with apical lucency gradient. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Emphysema. No pneumonia or pulmonary edema. " eb1ce65a-d397ee85-691fe6cc-f258b884-a9da3a38.jpg,validate/p10/p10429729/s57457019/eb1ce65a-d397ee85-691fe6cc-f258b884-a9da3a38.jpg,validation," FINAL REPORT HISTORY: Status post transbronchial biopsies of right lower lobe mass, rule out pneumothorax. COMPARISON: ___. FINDINGS: The right hilus is enlarged. A string of opacities projecting over the right upper lobe simulates chain suture material. There is no focal consolidation, hemorrhage, pleural fluid, or pneumothorax. Cardiac silhouette and mediastinal contours are normal. IMPRESSION: Status post biopsy of right lower lobe mass, without pneumothorax. Findings were discussed by phone with Dr. ___ ___ IP. " c64b5d22-510ae2bb-acae6962-89ebba7c-d9ddb90f.jpg,validate/p12/p12724735/s58517996/c64b5d22-510ae2bb-acae6962-89ebba7c-d9ddb90f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with GPC bacteremia, low blood pressures // eval pneumonia TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: There is persistent cardiomegaly with prominence of the pulmonary vasculature consistent with pulmonary vascular congestion. A tunneled right internal jugular dialysis catheter is unchanged in position. No pneumothorax. No consolidation seen. There is deformity of the left lateral chest wall, stable when compared to the prior study. Small left-sided pleural effusion. Interval improvement in the linear opacities of the right lung base. " 914e030c-8fe649a7-7b058bf2-e1d1b9ce-372a765e.jpg,validate/p12/p12361982/s56873538/914e030c-8fe649a7-7b058bf2-e1d1b9ce-372a765e.jpg,validation," 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. " 7c51a285-e0154ff3-a0edf803-770662fd-7729ccb5.jpg,validate/p18/p18049473/s55762639/7c51a285-e0154ff3-a0edf803-770662fd-7729ccb5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F ESRD HD dependent // volume status TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Tear E hilar and lower lobe opacities appear to be unchanged, reflecting still present pulmonary edema although infectious process is still a possibility. Bilateral pleural effusion is noted, most likely left more than right. There is no pneumothorax. " 1df646ba-6a19b819-1d9a5cc3-f662d3f4-1f8c3151.jpg,validate/p14/p14483422/s55599009/1df646ba-6a19b819-1d9a5cc3-f662d3f4-1f8c3151.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___ as well as a prior CT torso dated ___. CLINICAL HISTORY: Non-small cell lung cancer, status post fall, assess for rib fracture. FINDINGS: PA and lateral views of the chest are provided. There is a left paramediastinal mass which is better assessed on the prior CT, compatible with known primary lung cancer. The lungs are otherwise clear, though changes from known emphysema are noted. No pleural effusion is seen. Overall cardiomediastinal contour appears unchanged from prior CT. Bony structures are intact. Of note, no displaced rib fractures are seen. A wedge deformity of the upper thoracic spine is stable. IMPRESSION: Stable mediastinal prominence compatible with known left paramediastinal mass. Emphysema. No acute injury is seen. Please refer to subsequent CT chest for additional details. " e837e144-5c181c43-50d8abf1-3757e8a9-a0b84116.jpg,validate/p17/p17105437/s56566445/e837e144-5c181c43-50d8abf1-3757e8a9-a0b84116.jpg,validation," FINAL REPORT INDICATION: Cough, pneumonia. COMPARISON: No prior study available for comparison. FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. Minimal faint opacity in the right lower lung likely reflects atelectasis. No opacification concerning for pneumonia identified. No definitive pleural effusion evident. No evidence of pneumothorax is seen. Degenerative changes are seen along the spine. IMPRESSION: No acute intrathoracic process. " d0605c56-4a8b5868-7a5c77d0-dcdc673d-5873c7d9.jpg,validate/p19/p19248321/s52471626/d0605c56-4a8b5868-7a5c77d0-dcdc673d-5873c7d9.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain // eval for CHF/pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: THE LUNGS ARE HYPERINFLATED. 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. " 3a21dcbf-478508c9-d878b06c-6b4a3e6e-13396157.jpg,validate/p15/p15373430/s52247013/3a21dcbf-478508c9-d878b06c-6b4a3e6e-13396157.jpg,validation," WET READ: ___ ___ ___ 3:43 AM New small left pleural effusion. Otherwise unremarkable exam. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with fever // ? pna TECHNIQUE: PA and lateral images of the chest. COMPARISON: Bifid, ___ and ___. FINDINGS: The lungs are well expanded and clear. There is a small left pleural effusion, new from prior exam. There is no right pleural effusion. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: New small left pleural effusion. Otherwise unremarkable exam. " 9b8d2d26-31fcb81a-ed96c830-22d74ebd-6becb199.jpg,validate/p10/p10866397/s58234978/9b8d2d26-31fcb81a-ed96c830-22d74ebd-6becb199.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with shortness of breath. // r/o pneumothorax, pulm edema or pna TECHNIQUE: PA and lateral views the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified noting an minimal lower thoracic dextroscoliosis. IMPRESSION: No acute cardiopulmonary process. " 4c0a2ceb-2ba23856-b1b680eb-e804f9f2-395a16a4.jpg,validate/p10/p10665320/s51943526/4c0a2ceb-2ba23856-b1b680eb-e804f9f2-395a16a4.jpg,validation," 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. " 7fcf0743-35873efd-c4a05f77-ad6c0627-cf14c968.jpg,validate/p19/p19291199/s51750569/7fcf0743-35873efd-c4a05f77-ad6c0627-cf14c968.jpg,validation," FINAL REPORT HISTORY: Pleural effusion. FINDINGS: In comparison with the study of ___, there is again large right pleural effusion, with a changed appearance that most likely reflects different position of the patient. There are extensive atelectatic changes involving the lower right lung. Little change in the bilateral hilar adenopathy. In the appropriate clinical setting, supervening pneumonia would have to be considered. " 6408c280-17911830-a2c76bc1-fbf929ac-519de1ac.jpg,validate/p15/p15388421/s53970915/6408c280-17911830-a2c76bc1-fbf929ac-519de1ac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p thoracentesis // r/o pneumothorax r/o pneumothorax IMPRESSION: In comparison with the study of earlier in this date, there has been a left thoracentesis with decrease in the amount of pleural fluid at the base. Specifically, no evidence of post procedure pneumothorax. Otherwise little change. " f181ffeb-421d6074-dbb643c4-f214a2d2-30b8b5c5.jpg,validate/p19/p19551627/s57958195/f181ffeb-421d6074-dbb643c4-f214a2d2-30b8b5c5.jpg,validation," WET READ: ___ ___ ___ 8:39 AM Nasogastric tube terminates in the stomach. Otherwise, no significant interval change in appearance of the chest since the prior study. WET READ VERSION #1 ___ ___ 8:33 PM Nasogastric tube terminates in the stomach. Otherwise, no significant interval change in appearance of the chest since the prior study. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ SDH s/p NGT re-placement // Confirm NGT placemet Confirm NGT placemet IMPRESSION: The nasogastric tube extends at least to the mid body of the stomach, where it crosses the lower margin of the image. Little change otherwise from the study of earlier in this date. " 33783e50-e5f31553-be0e9695-40a748ea-5322c8f8.jpg,validate/p15/p15368003/s54917966/33783e50-e5f31553-be0e9695-40a748ea-5322c8f8.jpg,validation," FINAL REPORT HISTORY: IJ placement. FINDINGS: In comparison with the earlier study of this date, the right IJ catheter has been pulled back so that the tip lies in the mid-to-lower SVC. Otherwise, little overall change. " 25876159-3031ccec-5c9d1f34-e1d29426-e0076496.jpg,validate/p16/p16233695/s59697051/25876159-3031ccec-5c9d1f34-e1d29426-e0076496.jpg,validation," WET READ: ___ ___ 8:58 AM Minimal left lower lobe atelectasis. No convincing evidence of pneumonia. WET READ VERSION #1 ___ ___ ___ 9:11 PM Minimal left lower lobe atelectasis. No convincing evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with history of dementia, s/p fall who has cough and leukocytosis. // Question of pneumonia COMPARISON: No comparison IMPRESSION: The lung volumes are low. Minimal retrocardiac atelectasis. No evidence of pneumonia. No pleural effusions. Borderline size of the cardiac silhouette. Tortuosity of the descending aorta. " 2386d449-ff60da90-15b0f79f-2a63ae3d-146cb799.jpg,validate/p13/p13473495/s56929753/2386d449-ff60da90-15b0f79f-2a63ae3d-146cb799.jpg,validation," FINAL REPORT INDICATION: History of congestive heart failure and renal failure, now with chest pain during dialysis. COMPARISON: Chest radiograph, last performed on ___. TECHNIQUE: Upright AP and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are low. The cardiac silhouette is moderately enlarged, but stable from the prior study. The mediastinal and hilar contours are not significantly changed from the prior radiograph allowing for patient rotation on the current examination. No significant pleural effusion or pneumothorax is detected. A small amount of fluid is noted in the right minor fissure. Mild pulmonary edema is present. A right dual-chamber dialysis catheter is in position with the tip terminating at the cavoatrial junction or proximal right atrium. The visualized upper abdomen is gasless. IMPRESSION: Mild pulmonary edema. Moderate cardiomegaly. " c2a36365-a9010cef-82478bbf-a914787d-f1e129e9.jpg,validate/p10/p10727938/s50687422/c2a36365-a9010cef-82478bbf-a914787d-f1e129e9.jpg,validation," FINAL REPORT INDICATION: History of cough for one month. Smoking history. Status post assault tonight. COMPARISONS: None. FINDINGS: The re is a mild diffuse interstitial abnormality, which is of uncertain etiology and chronicity. The abnormality is more pronounce in the right lung. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Mild diffuse interstitial abnormality, which may be chronic, although an acute atypical infection cannot be excluded. " f3761e61-a4422b9e-9410c9b5-ba20a583-4e308fad.jpg,validate/p16/p16861367/s53601808/f3761e61-a4422b9e-9410c9b5-ba20a583-4e308fad.jpg,validation," FINAL REPORT INDICATION: Large subarachnoid hemorrhage. Evaluation of ET tube placement. COMPARISON: None. FINDINGS: The ET tube terminates 5.5 cm above the carina. The NG tube tip is in the stomach and the side hole is at the level of the GE junction and can be advanced 5 cm for better positioning. Fibrosis and scarring in the lung bases bilaterally is seen. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. " b9d2d6a5-14049aac-f025b71d-049c89d5-09e286a6.jpg,validate/p12/p12278812/s57263594/b9d2d6a5-14049aac-f025b71d-049c89d5-09e286a6.jpg,validation," FINAL REPORT HISTORY: Evaluation of pacemaker and lead placement. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple chest radiographs the most recent on ___. FINDINGS: A left-sided pacemaker is seen in place with two pacing leads terminating over the right atrium and proximal right ventricle. No evidence of pacer lead fracture. The lungs are clear. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax. IMPRESSION: Appropriate lead placement with no evidence of complication. " a738c011-e5f5982f-5682e953-c5aaf054-4d78d387.jpg,validate/p10/p10953161/s54580935/a738c011-e5f5982f-5682e953-c5aaf054-4d78d387.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain to back // Please eval for aortic dissection TECHNIQUE: 2 portable views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated but clear without focal consolidation or large effusion. Cardiac silhouette is within normal limits. The thoracic aorta is somewhat tortuous with atherosclerotic calcifications at the arch. Of note, there is an unusual contour of the undersurface of the aortic arch with slightly medial lies atherosclerotic calcifications which do indeed raise possibility of dissection. Right chest wall dual lead pacing device is again seen. IMPRESSION: Abnormal contour to the region of the aortic arch with possibly medialized atherosclerotic calcifications. CTA is suggested to exclude the possibility of dissection- which had already been ordered. NOTIFICATION: Findings discussed with Dr. ___ at approximately 18:30 on ___. " ccc14c49-a90256fd-f0521fdc-226cd615-bdb12d21.jpg,validate/p14/p14199690/s50560919/ccc14c49-a90256fd-f0521fdc-226cd615-bdb12d21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever to 101.1 // r/o acute pulmonary process TECHNIQUE: Chest single view COMPARISON: ___ 04:57 FINDINGS: Sternotomy. Enteric tube tip is in the proximal to mid stomach. Right PICC line tip is in the low SVC. Shallow inspiration. Increased heart size, pulmonary vascularity, stable. Bibasilar opacities, likely atelectasis. Left perihilar opacity stable. IMPRESSION: Stable exam " c6302370-9ef2527b-6077a16f-5aa06e69-d9c5ac5a.jpg,validate/p17/p17613076/s59378618/c6302370-9ef2527b-6077a16f-5aa06e69-d9c5ac5a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with left breast cellulitis and chest pain. Evaluate for free air, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Low lung volumes. Heart size is at the upper limits of normal and unchanged. Again seen is a right upper mediastinal contour abnormality compatible with previously characterized cyst. The mediastinal and hilar contours are otherwise normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Multilevel degenerative changes of the visualized thoracolumbar spine. Right neck surgical clips. IMPRESSION: No acute cardiopulmonary abnormality. " 1a10d7fd-ee921bb6-1f182729-a7d63055-84487a87.jpg,validate/p12/p12464244/s59613855/1a10d7fd-ee921bb6-1f182729-a7d63055-84487a87.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right rib pain // evaluate for bony abnormality and/or lung infection evaluate for bony abnormality and/or lung infection IMPRESSION: Compared to chest radiographs ___ through ___. Lungs are fully expanded and clear. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. No obvious chest wall abnormality. RECOMMENDATION(S): 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. " 98aee5e5-165d5f0b-33109e23-3080e5a6-92a25824.jpg,validate/p13/p13279382/s59668997/98aee5e5-165d5f0b-33109e23-3080e5a6-92a25824.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with aspiration, ill-appearing TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and CABG. The lung volumes are low. Heart size is normal. The aorta is mildly tortuous and diffusely calcified. The mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Streaky linear opacities are seen in both lung bases, more pronounced on the left, and likely reflect areas of atelectasis or scarring. No focal consolidation, pleural effusion or pneumothorax is present. Elevation of the left hemidiaphragm appears chronic. Multiple remote right-sided rib fractures are again demonstrated. There has been prior resection of the distal right clavicle. Moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " e560ab72-0c3fe50f-cdcfd2b1-9182cf9d-f64d015a.jpg,validate/p12/p12006266/s54818669/e560ab72-0c3fe50f-cdcfd2b1-9182cf9d-f64d015a.jpg,validation," FINAL REPORT HISTORY: Air leak after right chest tube placement, evaluate pneumothorax _____ chest tube. CHEST, SINGLE AP PORTABLE VIEW. A left-sided chest tube is present. No discrete pneumothorax is identified. No left-sided effusion is seen. There is upper zone re-distribution and on the right, there is hazy opacity consistent with right lower lobe collapse and/or consolidation and possible effusion. Probable upper zone re-distribution. Increased retrocardiac density. Compared with ___ at 8:36 a.m., the pigtail catheter at the left base is new and the left effusion has resolved. The right-sided findings are slightly worse. The CHF findings may be slightly improved. " 08a8deab-aa27ad50-256fe6f1-21da6275-363a878d.jpg,validate/p10/p10410641/s57802287/08a8deab-aa27ad50-256fe6f1-21da6275-363a878d.jpg,validation," FINAL REPORT PORTABLE CHEST COMPARISON: ___ chest x-ray. FINDINGS: Pigtail pleural catheters remain in place bilaterally. Small bilateral apical lateral pneumothoraces have slightly decreased in size since the prior study. Small left pleural effusion is again demonstrated. " 4d422fb0-f04f7a1b-c00838bb-f5a1eb40-57ec4c63.jpg,validate/p10/p10646009/s52065791/4d422fb0-f04f7a1b-c00838bb-f5a1eb40-57ec4c63.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old female with fever and cough TECHNIQUE: Chest PA and lateral COMPARISON: CTA abdomen and pelvis ___ FINDINGS: Tip of the right Port-A-Cath terminates in the upper SVC. Left lung volume is slightly lower than the right. No focal consolidation to suggest lobar pneumonia. Streaky right lung base opacity likely represents atelectasis. Note is made of a lobulated hyperdense structure projecting over the lower thoracic spine on the lateral view, and over the left heart border on the frontal view, which corresponds to a calcified pleural plaque. Cardiomediastinal contours are normal. No subdiaphragmatic free air. No acute osseous abnormalities identified. IMPRESSION: No evidence of focal pneumonia. " 40ed1291-2cb648ac-31573ee5-c46fbbe1-1fcb14a9.jpg,validate/p11/p11958913/s52572579/40ed1291-2cb648ac-31573ee5-c46fbbe1-1fcb14a9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with CP;SOB;hx of asthma and CHF // r/o pulm path r/o pulm path IMPRESSION: In comparison with the study of ___, there is little change. Again there is enlargement of the cardiac silhouette with tortuosity of the aorta. No vascular congestion or acute focal pneumonia. " d5345ec0-04c0f8c8-5dce2ecc-07dcb94d-1d68630a.jpg,validate/p16/p16756848/s51436887/d5345ec0-04c0f8c8-5dce2ecc-07dcb94d-1d68630a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 3 weeks cough // right/o pneumonia COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. The only abnormality is a minimal thickening of the minor fissure, better appreciated on the lateral than on the frontal radiograph. No evidence of pneumonia or pulmonary edema. No pleural effusions. " 9a6179de-6e1ee640-734e55d9-e89246e7-ae0d60a5.jpg,validate/p15/p15199994/s56392721/9a6179de-6e1ee640-734e55d9-e89246e7-ae0d60a5.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with history of aspiration pneumonia, now with fever, has right upper lobe opacity on latest chest examination, unclear if pneumonia versus pneumonitis pneumonia. FINDINGS: AP single view of the chest was obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of ___. The on previous examination described hazy parenchymal densities in the lateral aspect of the right upper lobe persist and may even have increased slightly. There are no other new abnormalities present. The previously described multiple old right-sided rib fractures and pleural scar formations on the left base remain unchanged. Observed multiple semi-linear lines traversing the upper thorax bilaterally. They should not be confused with a pneumothorax but most likely represent skin folds in this patient examined in semi-erect recumbent position. IMPRESSION: Right upper lobe hazy ground-glass densities persist. Differential diagnosis between pneumonitis and aspiration pneumonia cannot be decided on this portable single view examination, but must be supported by clinical findings. " 725146c6-250b84a7-c733ff18-493e7602-6e47d9ae.jpg,validate/p15/p15432819/s52172774/725146c6-250b84a7-c733ff18-493e7602-6e47d9ae.jpg,validation," FINAL REPORT AP CHEST, 8:31 A.M., ___ HISTORY: ___-year-old woman with critical aortic stenosis, aortic regurgitation and mitral regurgitation. Dyspnea. Question pulmonary edema. IMPRESSION: AP chest compared to ___: Previous pulmonary edema, resolved, has not recurred. Severe cardiomegaly is chronic. Small right pleural effusion, is comparable to ___. No pneumothorax. Lungs grossly clear. " 51e6fa47-8a5175a3-3fbf676f-d653bd14-ebf17abc.jpg,validate/p17/p17506723/s52828093/51e6fa47-8a5175a3-3fbf676f-d653bd14-ebf17abc.jpg,validation," WET READ: ___ ___ ___ 9:29 AM Dobbhoff in stomach. Left subclavian CVL tip in upper to mid SVC. Bilateral lower lobe heterogeneous opacities, slightly improved since previous examination, consistent with pneumonia. WET READ VERSION #1 ___ ___ ___ 1:10 AM Dobbhoff in stomach. Left subclavian CVL tip in upper to mid SVC. Bilateral lower lobe heterogeneous opacities, slightly improved since previous examination, consistent with pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff placement // dob hoff placement TECHNIQUE: Lower chest and upper abdomen for top off placement COMPARISON: ___. IMPRESSION: The job off tube tip is in the distal stomach/ proximal duodenum. Bilateral lower lobe infiltrates are slightly less dense on today's study left subclavian line tip is in the SVC. The film is centered too low to assess the ET tube " 368b49a6-21fa0594-0dfdb9c4-3aa6c93f-0e95925b.jpg,validate/p18/p18656167/s53700576/368b49a6-21fa0594-0dfdb9c4-3aa6c93f-0e95925b.jpg,validation," 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. " 935a0e39-3ff432e5-5171a109-763c1e89-66cf05e7.jpg,validate/p17/p17477304/s52675641/935a0e39-3ff432e5-5171a109-763c1e89-66cf05e7.jpg,validation," FINAL REPORT INDICATION: History: ___M with left -sided weakness (?chronicity), cough, altered mental status// evaluate for acute process TECHNIQUE: AP upright and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is mildly enlarged. There is perihilar haziness and vascular indistinctness compatible with mild pulmonary edema. New bilateral pleural effusions are small in size. Bibasilar airspace opacities may reflect atelectasis. Infection is not completely excluded. No pneumothorax is identified. A rugger ___ appearance of the imaged thoracic spine is compatible with renal osteodystrophy. IMPRESSION: Mild pulmonary edema with small bilateral pleural effusions. Bibasilar airspace opacities may reflect atelectasis although infection is not excluded in the correct clinical setting. " 42e3ea52-1b65eae2-981db3c0-82efd588-aaa7c9c6.jpg,validate/p15/p15196754/s51396592/42e3ea52-1b65eae2-981db3c0-82efd588-aaa7c9c6.jpg,validation," 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. " e431f14a-5f6982c1-03fafd29-97682319-37573d4e.jpg,validate/p19/p19262736/s58365837/e431f14a-5f6982c1-03fafd29-97682319-37573d4e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with persistent hypoxia of unknown etiology // interval change interval change IMPRESSION: In comparison with the study of ___, the right hemidiaphragm is not sharply seen. This could reflect developing pleural fluid or merely a more supine position of the patient. Bibasilar atelectatic changes are again seen, though there is not these right lower lobe collapse that was noted on the study of ___. Although it is difficult to identify any focal consolidation, the possibility of developing pneumonia would be difficult to exclude in the appropriate clinical setting. The cardiac silhouette is within normal limits. Mild indistinctness of pulmonary vessels is consistent with some elevation of pulmonary venous pressure. " 775d2460-2e512c6f-0f376b09-18bac183-7fcb5b08.jpg,validate/p17/p17078350/s55813459/775d2460-2e512c6f-0f376b09-18bac183-7fcb5b08.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with NASH cirrhosis, hepatic hydrothorax s/p thoracentesis. // pleural effusion, pneumothorax COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the extent of the right pleural effusion has decreased. The effusion is better appreciated on the lateral than on the frontal radiograph. Subsequent parenchymal opacities at the right lung base, associated to the pleural effusion and likely atelectatic in origin, show several air bronchograms. No new parenchymal opacities. Normal diameter of the cardiac silhouette. No pneumothorax. " 7f7b1c8a-97a57df6-bca9e69c-ea3bf24f-e9d349b5.jpg,validate/p11/p11276090/s59892248/7f7b1c8a-97a57df6-bca9e69c-ea3bf24f-e9d349b5.jpg,validation," FINAL REPORT INDICATION: Chills, sweats, and nausea. History of alcoholic cirrhosis. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. A vague interstitial prominence in the upper lungs may indicate slight fluid overload but there is no focal opacity. IMPRESSION: Findings that may indicate minimal fluid overload but otherwise unremarkable examination without convincing evidence for pneumonia. " 6c068cef-98b214c4-40bcd9b4-fbb3cb14-218e0c0e.jpg,validate/p16/p16334734/s57373067/6c068cef-98b214c4-40bcd9b4-fbb3cb14-218e0c0e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman partially self-d/c'ed RIJ TLC // line position? IMPRESSION: In comparison to ___ radiograph, a right internal jugular catheter has been withdrawn several cm, now terminating in the right brachiocephalic vein. Stable cardiomegaly accompanied by worsening interstitial edema and slight increase in small right pleural effusion. Small left pleural effusion adjacent left lower lobe atelectasis have slightly improved. No other relevant change. " 9cf74394-47bfc6d1-ae882a6f-ef3ac022-ab2c695e.jpg,validate/p10/p10156618/s53750226/9cf74394-47bfc6d1-ae882a6f-ef3ac022-ab2c695e.jpg,validation," FINAL REPORT INDICATION: History: ___F with 2 days of left upper back pain worse with movement and inspiration // r/o acute proccess such as fracture or pna TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: The heart is not enlarged. The aorta is minimally unfolded. The cardiomediastinal silhouette is otherwise within normal limits. No CHF, focal infiltrate, gross effusion, or pneumothorax is detected. Minimal degenerative change in the thoracic spine could be present. On the available images, there is suggestion of mild right convex curvature in the thoracic spine, but this could be positional. Otherwise, limited assessment of osseous structures is grossly unremarkable. No vertebral body compression or obvious rib fracture is identified. Incidental note is made of nonvisualization of the left clavicular companion shadow. IMPRESSION: 1. No acute pulmonary process identified. 2. Possible mild right convex curvature and minimal degenerative changes in the thoracic spine. Limited assessment of osseous structures is otherwise grossly unremarkable. 3. No free air seen seen beneath the diaphragm. No dilated loops of bowel seen in the visualized portion of the upper abdomen. 4. Nonvisualization of the left clavicular companion shadow. Clinical correlation to assess for any supraclavicular lymphadenopathy is requested. RECOMMENDATION(S): Nonvisualization of the left clavicular companion shadow. Clinical correlation to assess for any supraclavicular lymphadenopathy is requested. " 771fa57a-464fb063-942e88ea-e0d88564-21bcb7ed.jpg,validate/p18/p18696269/s56384573/771fa57a-464fb063-942e88ea-e0d88564-21bcb7ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AMS and new hypoxia. // Please eval for pneumonia, esp. aspiration. Please eval for pneumonia, esp. aspiration. IMPRESSION: In comparison with the study of ___, there are slightly lower lung volumes. Continued enlargement of the cardiac silhouette with tortuosity of the aorta. No evidence of acute focal pneumonia or vascular congestion. Continued osteopenia of the thoracic spine with loss of height of what appears to be the L1 vertebral body. " c4efdc75-e530b9a4-d90669f7-09372cc7-0d4445ca.jpg,validate/p12/p12492854/s55226866/c4efdc75-e530b9a4-d90669f7-09372cc7-0d4445ca.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left radiating arm pain in the ulnar distribution // Please assess for nodules or cavitating lesions TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There relatively low lung volumes and mild basilar atelectasis. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. No significant interval change. Please note that chest CT is more sensitive in detecting small pulmonary nodules. " 385a852a-c200f4f5-dd525e8a-fbedba34-4e4f9a7d.jpg,validate/p13/p13569749/s58300647/385a852a-c200f4f5-dd525e8a-fbedba34-4e4f9a7d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with confusion and decreased p.o. intake. Hypoglycemia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Linear opacity seen in the right mid lung in the retrocardiac region similar to prior suggestive of atelectasis versus scarring. Elsewhere, the lungs are clear without consolidation or pulmonary vascular congestion. Cardiac silhouette is enlarged but stable in configuration. No acute osseous abnormality is identified. Atherosclerotic calcification is seen at the aortic arch. Hypertrophic changes noted in the spine. IMPRESSION: No acute cardiopulmonary process. " ad1f9859-b7eca239-5b05243a-2820e2b4-e7be0749.jpg,validate/p13/p13031024/s57862956/ad1f9859-b7eca239-5b05243a-2820e2b4-e7be0749.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. Evaluate for pneumonia or pneumothorax. COMPARISON: None available. TECHNIQUE: Frontal AP and lateral chest radiograph. FINDINGS: The lungs are well expanded without focal opacities. The heart appears mildly enlarged but the cardiomediastinal and hilar contours are otherwise normal. There is no pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly. No evidence of pneumonia. " e74257a3-feae2b16-f7c4ff50-daf1e9f2-3e2947a6.jpg,validate/p10/p10380296/s58489660/e74257a3-feae2b16-f7c4ff50-daf1e9f2-3e2947a6.jpg,validation," WET READ: ___ ___ ___ 12:09 PM 1. The mediastinum is wide, and an aortic stent graft is in place. No priors are available for comparison at this time, however comparison to prior studies would be helpful for assessment of any potential changes in the appearance of the mediastinum. 2. Small left pleural effusion. 3. No focal consolidation. 4. Cardiomegaly. Wetread point 1 was discussed with Dr. ___ by Dr. ___ ___ telephone at 12:07pm on ___, 5 minutes after discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with SOB, confusion // eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The mediastinum is wide, and an aortic stent graft is in place. Cardiac silhouette appears enlarged. The lung volumes are low, which results in bronchovascular crowding. There is a small left pleural effusion. No focal consolidation or pneumothorax. IMPRESSION: 1. The mediastinum is wide, and an aortic stent graft is in place. No priors are available for comparison at this time, however comparison to prior studies would be helpful for assessment of any potential changes in the appearance of the mediastinum. If there is high concern for mediastinal hemorrhage, CT scan is recommended. 2. Small left pleural effusion. 3. No focal consolidation. 4. Cardiomegaly. NOTIFICATION: Wetread point 1 was discussed with Dr. ___ by Dr. ___ ___ telephone at 12:07pm on ___, 5 minutes after discovery. " a742313d-41974402-dc6dec53-ef041097-d1b5fdff.jpg,validate/p11/p11855285/s52892936/a742313d-41974402-dc6dec53-ef041097-d1b5fdff.jpg,validation," FINAL REPORT INDICATION: History: ___M with oral bleed, possible aspiration. // PNA? Aspiration? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Left pectoral pacemaker and its 2 leads are in unchanged positions. There is no consolidation, pneumothorax, or pleural effusion. Severely enlarged cardiac silhouette is similar to before. IMPRESSION: No radiographic evidence of pneumonia. " 20dec91d-9282cf6d-13edd2d4-c1407688-e8926b0d.jpg,validate/p13/p13774492/s53091663/20dec91d-9282cf6d-13edd2d4-c1407688-e8926b0d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hyoercapbic resp failure // eval interval change eval interval change COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Hyperinflation is demonstrated. Minimal bibasal atelectasis are noted but overall no substantial change since previous examination demonstrated. " 151f24b7-32148790-0a7244ef-b41b01aa-d825a1ed.jpg,validate/p17/p17137598/s56671628/151f24b7-32148790-0a7244ef-b41b01aa-d825a1ed.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dyspnea, CP // r/o acute process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There is persistent elevation of the right hemidiaphragm with overlying atelectasis. Left basilar atelectasis/ scarring is again seen. No new focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. There is persistent anterior wedging of a mid thoracic vertebral body, stable. IMPRESSION: No acute cardiopulmonary process. Persistent elevation the right hemidiaphragm with overlying atelectasis. " 11e1fceb-8f9c62d3-9f81d729-4b965e06-a3443200.jpg,validate/p13/p13295971/s58577032/11e1fceb-8f9c62d3-9f81d729-4b965e06-a3443200.jpg,validation," FINAL REPORT INDICATION: History: ___F s/p fall several days ago now with worsening R sided pleuritic CP // eval for rib fx, PNA, PTX TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The heart size overall is top normal, but there is left ventricular enlargement. The mediastinal and hilar contours are unremarkable. There is no pneumothorax. Small bilateral pleural effusions are noted, larger on the left, with bibasilar atelectasis. There is no focal consolidation concerning for pneumonia. No displaced rib fractures are noted. IMPRESSION: 1. Small bilateral pleural effusions, larger on the left, with adjacent atelectasis. No focal consolidation concerning for pneumonia. 2. Left ventricular enlargement. " 2ffa17c3-d9a1b752-f8fb9125-03ea7055-33ca76c0.jpg,validate/p10/p10882818/s55023655/2ffa17c3-d9a1b752-f8fb9125-03ea7055-33ca76c0.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old man with bladder cancer, on chemotherapy, who now presents with fever and cough; evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT scouts and cross-sectional images dated ___. FINDINGS: The lungs remain hyperinflated with slight increased AP diameter of the chest, unchanged. Subtle increased opacity in the right infrahilar region on only the frontal view may represent overlap of superimposed structures or atelectasis; however, aspiration and/or early bronchopneumonia cannot be excluded in the appropriate clinical situation. The left lung is clear. No pleural effusion, edema, or pneumothorax. The heart is normal. The mediastinum is not widened. Biapical mild pleural thickening/scarring is unchanged. Mild atelectasis and/or scarring at the left costophrenic angle is also unchanged. Dextroconvex scoliosis of the lower thoracic spine is unchanged. Degenerative changes in the thoracic spine are unchanged. IMPRESSION: 1. Subtle increased opacity in the right infrahilar region probably reflects superimposed normal structures and/or atelectasis. However, early bronchopneumonia cannot be excluded in the appropriate clinical situation. 2. Hyperinflated lungs with widening of AP diameter compatible with history of chronic pulmonary disease. " 3a728d55-ada5df5f-222e0b9c-a3a02db1-443b3cc5.jpg,validate/p10/p10282467/s54267240/3a728d55-ada5df5f-222e0b9c-a3a02db1-443b3cc5.jpg,validation," 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. " 8bd0980a-4bd425ac-ad30a3bc-648826de-f3c62b6f.jpg,validate/p11/p11958303/s57952770/8bd0980a-4bd425ac-ad30a3bc-648826de-f3c62b6f.jpg,validation," WET READ: ___ ___ ___ 8:59 PM Similar apparent of the right lung to exams from ___, suggestive of probable recurrence of previously seen right upper and middle lobe collapse. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with small cell lung ca being managed on chemo and rad tx, known collapsed lung on R, here with 2 day hx of lightheadedness // eval for worsening of collapsed lung TECHNIQUE: PA and lateral images of the chest. . COMPARISON: Comparison is made with chest radiographs from ___, ___, ___ ___ and CT chest from ___. FINDINGS: A right chest wall port is again noted. There is recurrent right upper lobe collapse secondary to obstructing right hilar mass. Tented appearance of the right hemidiaphragm is also noted. Emphysematous changes are noted in the lungs. The lungs are otherwise clear. No pneumothorax is seen. The cardiomediastinal silhouette is otherwise unremarkable. IMPRESSION: Right upper lobe collapse secondary to right hilar mass. " 8690114b-fa7703b7-f544cc85-892a6fda-b9b5333c.jpg,validate/p18/p18052701/s56640643/8690114b-fa7703b7-f544cc85-892a6fda-b9b5333c.jpg,validation," 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. " 87d0cf1a-67257ed5-466927f7-8f035992-2c74ae7b.jpg,validate/p16/p16108772/s53964210/87d0cf1a-67257ed5-466927f7-8f035992-2c74ae7b.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: An ___-year-old man with shortness of breath, rule out acute pulmonary process. IMPRESSION: PA and lateral chest compared to ___: Previous mild pulmonary edema has resolved. Lungs are clear. Generally large and tortuous thoracic aorta chronically unchanged. Chronic mild cardiomegaly also stable. No pulmonary edema. Healed right posterior rib fractures are chronic. " 11be98b2-7052d8aa-9ffc7efa-4da69d5d-161e7544.jpg,validate/p19/p19279626/s55655365/11be98b2-7052d8aa-9ffc7efa-4da69d5d-161e7544.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Abdominal pain, assess for free air. FINDINGS: PA and lateral views of the chest were provided. There is no free air below the right hemidiaphragm. The lungs appear clear bilaterally. Cardiomediastinal silhouette appears normal. No effusion or pneumothorax is seen. The bony structures are intact. IMPRESSION: No acute abnormalities, no free air below the right hemidiaphragm. " 510d7589-3be68fbe-bf531929-ab2e2cf6-a332b90c.jpg,validate/p10/p10188275/s50388822/510d7589-3be68fbe-bf531929-ab2e2cf6-a332b90c.jpg,validation," WET READ: ___ ___ ___ 8:20 AM Low lung volumes, mild cardiomegaly, and mild central pulmonary vascular congestion and interstitial edema. Streaky bibasilar airspace opacities are similar from ___, and likely represent atelectasis. Multifocal linear atelectasis is also noted predominately within the left lower lobe. No large pleural effusion. WET READ VERSION #1 ___ ___ ___ 6:52 PM Low lung volumes, mild cardiomegaly, and mild central pulmonary vascular congestion and interstitial edema. Streaky bibasilar airspace opacities are similar from ___, and likely represent atelectasis. Multifocal linear atelectasis is also noted predominately within the left lower lobe. No large pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea. Hx of diastolic heart failure, tracheobronchomalacia with tracheoplasty. // evidence of pulmonary edema, PNA, cardiomegaly? COMPARISON: ___. IMPRESSION: As compared to the previous image, no relevant change is seen. Metallic foreign body projects over the midline. Platelike atelectasis at the left lung bases. Moderate cardiomegaly. Old minimal scarring at the right upper lobe basis. Status post right partial rib resection. No acute abnormalities. " 233b0f17-7ca01198-d666e7a6-6f0501b4-c2c98501.jpg,validate/p15/p15530265/s54810370/233b0f17-7ca01198-d666e7a6-6f0501b4-c2c98501.jpg,validation," FINAL REPORT INDICATION: ___F PET-avid LUL s/p LUL bisegmentectomy s/p chest tube removal // Interval change. Please complete at 4 pm. TECHNIQUE: AP and lateral portable chest radiograph COMPARISON: ___ from earlier today FINDINGS: There has been interval removal of the left chest tube. No discrete pneumothorax identified. Chain sutures project over the left lung apex. The right upper lung zone volume loss with upward retraction of the hilum. No focal consolidation, or pleural effusion. The size and appearance of the cardiac silhouette is unchanged. IMPRESSION: Interval removal of the left chest tube. No discrete pneumothorax identified. " 7ad3d2cd-c53d3f5e-69469123-5a463db4-9339da72.jpg,validate/p19/p19700168/s54221244/7ad3d2cd-c53d3f5e-69469123-5a463db4-9339da72.jpg,validation," FINAL REPORT INDICATION: Status post fall with bilateral lower extremity weakness, evaluate for abnormalities TECHNIQUE: Chest AP and lateral. COMPARISON: Chest radiograph from ___. FINDINGS: Lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Included upper abdomen is unremarkable. Osseous structures are grossly intact. IMPRESSION: No evidence of acute cardiopulmonary process. " b540ca29-a4fd52b8-658c23a5-4244f7f9-30a3380f.jpg,validate/p15/p15199994/s54701642/b540ca29-a4fd52b8-658c23a5-4244f7f9-30a3380f.jpg,validation," FINAL REPORT COMPARISONS: ___ to ___. INDICATION: ___-year-old man with ___'s disease, seizures, and fever, choked on food this morning. FINDINGS: Left lower lobe micronodular opacities are new since yesterday. A small right effusion may be present. The left costophrenic angle is unchanged. No pneumothorax is present. The cardiac and mediastinal contours are normal. Multiple stable old posterior rib fractures. IMPRESSION: Rapid development of left lower lobe opacities more compatible with aspiration rather than infection. " d9c4d7cc-30d5e31f-c5c67262-23d3c53d-5b15497e.jpg,validate/p19/p19461413/s55071754/d9c4d7cc-30d5e31f-c5c67262-23d3c53d-5b15497e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alcoholic cirrhosis, rectal bleeding, s/p intubation // interval change? interval change? IMPRESSION: Compared to chest radiographs ___ through ___. Lung volumes remain very low, exaggerating mild pulmonary edema. Bibasilar consolidation could be atelectasis and edema or concurrent pneumonia, unchanged since ___. Pleural effusions are small if any. Heart size normal. No pneumothorax. Left PIC line ends in the upper right atrium. " af04a09b-901de177-aba181b3-c35363da-2b4d7d30.jpg,validate/p14/p14450311/s59716754/af04a09b-901de177-aba181b3-c35363da-2b4d7d30.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right axillary chest pain, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the previously placed right internal jugular vein catheter has been removed. There is unchanged moderate cardiomegaly with tortuosity of the thoracic aorta, but without evidence of pulmonary edema. No pleural effusions. No pneumonia. No pneumothorax. " 11bcffc7-e7af9fd9-28ff7842-07278147-8d3a58bd.jpg,validate/p10/p10110764/s52561350/11bcffc7-e7af9fd9-28ff7842-07278147-8d3a58bd.jpg,validation," FINAL REPORT HISTORY: OG tube placement. FINDINGS: In comparison with study of earlier in this date, there is little overall change in the appearance of the orogastric tube. The side hole is close to the esophagogastric junction and should be pushed forward several cm. There are lower lung volumes with bibasilar atelectatic changes and mild hazy opacification of the lower lungs raising the possibility of layering pleural effusions. " a63788d0-7619a852-acb2ac6f-4dfde5c7-f4a62fd2.jpg,validate/p15/p15746885/s57119093/a63788d0-7619a852-acb2ac6f-4dfde5c7-f4a62fd2.jpg,validation," FINAL REPORT CLINICAL INDICATION: Fluid overload. Evaluate for infiltrate and edema. COMPARISON: Chest x-ray ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Bilateral diffuse prominent interstitial markings, perivascular cuffing and cephalization consistent with mild pulmonary edema. No pleural effusion or pneumothorax. The mediastinal contours are normal. There is mild cardiomegaly, stable since ___. IMPRESSION: Mild pulmonary edema, slightly increased since ___. Stable mild cardiomegaly. " 2ed5371a-2c630f79-75ec65f8-f927bc5d-1551d00f.jpg,validate/p16/p16256871/s52425079/2ed5371a-2c630f79-75ec65f8-f927bc5d-1551d00f.jpg,validation," WET READ: ___ ___ ___ 6:41 PM linear lucency projecting over distal right clavicle. correlate with history of trauma to that site vs artifact. mediastinum not widenend. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Coronary artery disease, status post multiple stents, feeling lightheaded. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are 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 stable and unremarkable. No overt pulmonary edema is seen. Degenerative changes are partially seen along the spine. A linear lucency through the distal right clavicle is may be artifactual given patient history. IMPRESSION: No acute cardiopulmonary process. Linear lucency through the distal right clavicle may be artifactual given patient's history; correlate clinically. " a49df741-c0ea6229-abbee566-1a0fdce7-03d1ec0c.jpg,validate/p18/p18121111/s54679112/a49df741-c0ea6229-abbee566-1a0fdce7-03d1ec0c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hemoptysis, vent depenedence // eval itnerval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there has been no substantial change in the right upper lobe cavitary lesion and surrounding opacification, position of tubes and lines and widespread opacities, predominantly involving lower lobes, that might in fact represent gradual slowly progressing infectious process . There is no evidence of pulmonary edema. No increase in pleural effusion or development of pneumothorax demonstrated. " c6f7678d-134aae7c-9890617f-2822de34-8405916b.jpg,validate/p13/p13129822/s50149428/c6f7678d-134aae7c-9890617f-2822de34-8405916b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cp // r/o 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. " bbcedfed-0fa48c05-618a5f01-e286fcca-0682c23f.jpg,validate/p11/p11154374/s51931249/bbcedfed-0fa48c05-618a5f01-e286fcca-0682c23f.jpg,validation," WET READ: ___ ___ 2:03 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with fall, R shoulder pain // eval for traumatic injury 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. No compression deformity of the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 2568ba0f-46164485-40e4646a-83f49823-081956ed.jpg,validate/p16/p16019229/s56665968/2568ba0f-46164485-40e4646a-83f49823-081956ed.jpg,validation," FINAL REPORT HISTORY: Chest tube removal, to assess for pneumothorax. FINDINGS: In comparison with the study of ___, there is little change. No evidence of pneumothorax. Continued low lung volumes with opacifications, predominantly involving the left hemithorax. " 9aea405b-593685ed-0553caf4-12e3ef67-ee0a87c2.jpg,validate/p19/p19430776/s57364177/9aea405b-593685ed-0553caf4-12e3ef67-ee0a87c2.jpg,validation," FINAL REPORT HISTORY: Nasogastric tube placement. FINDINGS: In comparison with the earlier study of this date, there has been placement of a nasogastric tube that extends to the body of the stomach. The side hole appears to be just distal to the esophagogastric junction. Diffuse bilateral pulmonary opacifications persist. " 4b2e4984-32a9e1e0-a25664a6-46106eca-92a66571.jpg,validate/p19/p19174686/s53563841/4b2e4984-32a9e1e0-a25664a6-46106eca-92a66571.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ESRD // new evaluation for kidney transplant assess for cardiopulmonary abnormalities new evaluation for kidney transplant assess for cardiopulmon COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Pulmonary hyperinflation suggests emphysema. There are no focal pulmonary abnormalities. Heart is borderline enlarged, but improved since earlier examinations and there is no pulmonary vascular engorgement or edema. 's " 3d142fed-96f23ff1-3ce235a5-b49c4c5b-695632a3.jpg,validate/p18/p18601472/s52772751/3d142fed-96f23ff1-3ce235a5-b49c4c5b-695632a3.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with dyspnea. COMPARISON: CT chest done earlier today ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pulmonary edema, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary pathology. " 120a57f4-e3ccdb9d-3b5a4674-5016a151-b29ad510.jpg,validate/p16/p16232857/s59702874/120a57f4-e3ccdb9d-3b5a4674-5016a151-b29ad510.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT, repositioned // ?ETT position IMPRESSION: Endotracheal tube has been repositioned compared to ___ radiograph, with tip now terminating at the carina as directed towards the right main bronchus. Exam is otherwise similar to the recent radiograph. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ the telephoneon ___ at 8:49 AM, 10 minutes after discovery of the findings. " a5014845-caa045ba-6063ab6e-2cd1a9c0-5e720d17.jpg,validate/p18/p18160228/s50668930/a5014845-caa045ba-6063ab6e-2cd1a9c0-5e720d17.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with abdominal distention/pain! // evaluate for free air under diaphragm TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest 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 is no pneumoperitoneum. IMPRESSION: No pneumoperitoneum. " b99d5269-c1b39433-b5dcaabf-be634349-74224e90.jpg,validate/p10/p10745810/s54023094/b99d5269-c1b39433-b5dcaabf-be634349-74224e90.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The lungs are hyperexpanded, consistent with COPD. The cardiomediastinal silhouette is normal. A chronic wedge compression fracture is noted in the mid thoracic spine, unchanged from prior exams. IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable mid thoracic compression fracture. " 3b9d5f72-6aae7f1a-659fabe9-3c422725-45d68293.jpg,validate/p12/p12118473/s56820655/3b9d5f72-6aae7f1a-659fabe9-3c422725-45d68293.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with parkinsonian disorder, pacemaker, non responsive episode this morning, elevated troponin above baseline TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph FINDINGS: Left-sided pacer device is noted with leads terminating in the right atrium, right ventricle, and coronary sinus, unchanged. Mild to moderate cardiomegaly is similar. Dense atherosclerotic calcifications of the thoracic aorta are present. Mild pulmonary edema is improved compared to the previous study. Calcified pleural pleural plaques are re- demonstrated. No focal consolidation is noted. Small bilateral pleural effusions are decreased compared to the prior study. No acute osseous abnormality is detected. IMPRESSION: 1. Mild pulmonary edema with trace bilateral pleural effusions. 2. Calcified pleural plaques compatible with prior asbestos exposure. " e0ea2bdf-34ab9664-96053c2a-14d05c3c-72e4cb8d.jpg,validate/p19/p19826437/s54845999/e0ea2bdf-34ab9664-96053c2a-14d05c3c-72e4cb8d.jpg,validation," FINAL REPORT INDICATION: ___M with n/v and hematemesis with BRB // r/o perforation, pneumomediastinum TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: Normal chest x-ray. " 2b46b87e-3b9d60d9-e5bf3cef-cf8b0c9d-18e2b54e.jpg,validate/p14/p14565909/s52008509/2b46b87e-3b9d60d9-e5bf3cef-cf8b0c9d-18e2b54e.jpg,validation," FINAL REPORT INDICATION: ___F with visual hallucinations, chest pain // eval for consolidation TECHNIQUE: Frontal 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. " 66b3a346-614d2566-c7fb18ad-44f90e85-b203f7b6.jpg,validate/p10/p10952022/s54350002/66b3a346-614d2566-c7fb18ad-44f90e85-b203f7b6.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with fever status post chemo and radiation treatment today. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The patient is rotated to the left. The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation, pulmonary edema, pleural effusion or pneumothorax. A left chest wall Port-A-Cath ends at the level of the upper SVC. IMPRESSION: No acute cardiopulmonary pathology. " 88e2b142-dbc487ba-c252a081-80be6904-d972e084.jpg,validate/p10/p10049334/s54625686/88e2b142-dbc487ba-c252a081-80be6904-d972e084.jpg,validation," 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. " fee7200d-c1be30d8-6223ae08-098ed8e8-a11564cb.jpg,validate/p12/p12947494/s51996489/fee7200d-c1be30d8-6223ae08-098ed8e8-a11564cb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // Please repeat CXR to re-evaluate for pulmonary process TECHNIQUE: Portable supine radiograph COMPARISON: Chest radiograph on ___. FINDINGS: Opacities overlying the left mid and lower lung are increased from the prior examination and are consistent with aspiration or rapidly progressing pneumonia. The right hemithorax remains clear. There is no evidence of pneumothorax. IMPRESSION: Increased opacity of the left mid and lower lung worrisome for aspiration or rapidly progressing pneumonia. " ef7c15e6-9da7de48-51a1ecd9-22ae367c-2e885910.jpg,validate/p15/p15451291/s59777152/ef7c15e6-9da7de48-51a1ecd9-22ae367c-2e885910.jpg,validation," 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. " fe8c6a13-f98b2fa4-a2586621-8fbd7971-42ee856e.jpg,validate/p15/p15343855/s59615668/fe8c6a13-f98b2fa4-a2586621-8fbd7971-42ee856e.jpg,validation," WET READ: ___ ___ 9:14 AM 1. No specific findings to suggest pulmonary sarcoidosis. 2. Clear lungs. 3. Mild to moderate dextro convex scoliosis of the lower thoracic spine. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with ?erythema nodosum // eval for sarcoid TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lumbar fixation hardware is partially imaged. There is a mild dextro convex scoliosis of the thoracic spine. Heart size and mediastinal contours are normal. The lungs are well inflated and clear. There is no mediastinal or hilar lymphadenopathy. Osseous structures are intact. IMPRESSION: 1. No specific findings to suggest pulmonary sarcoidosis. 2. Clear lungs. 3. Mild to moderate dextro convex scoliosis of the lower thoracic spine. " c3552c14-610f9d03-12fd19c1-d9309782-af870f1f.jpg,validate/p15/p15782217/s54170665/c3552c14-610f9d03-12fd19c1-d9309782-af870f1f.jpg,validation," FINAL REPORT HISTORY: Prior pneumonia, to assess for resolution. FINDINGS: In comparison with the study of ___, the patchy opacification at the right base has effectively cleared. Continued enlargement of the cardiac silhouette with tortuosity of the aorta. No pleural effusion or vascular congestion. " 3dfb6563-df39e1c8-9fcd8451-0c85f5e5-1773f4f5.jpg,validate/p15/p15964158/s51797341/3dfb6563-df39e1c8-9fcd8451-0c85f5e5-1773f4f5.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___. COMPARISON: Study of one day earlier. FINDINGS: Endotracheal tube and nasogastric tube remains in standard position. Previously visualized aspirated barium in the right bronchial tree is no longer apparent. Bilateral layering pleural effusions are likely unchanged allowing for positional differences, with persistent adjacent atelectasis. " 9603fa2f-c5a6c998-74001b07-404b4670-0d19b07c.jpg,validate/p11/p11549602/s50511741/9603fa2f-c5a6c998-74001b07-404b4670-0d19b07c.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with thoracic spine osteomyelitis and epidural abscess. COMPARISON: ___. CHEST, AP: Endotracheal and nasogastric tubes have been removed. Right internal jugular catheter terminates at the cavoatrial junction. Left PICC ends in the mid SVC. Again seen are right lower lobe consolidative opacities and a moderate right pleural effusion. Left lower lobe atelectasis has increased. There is mild central venous congestion and interstitial edema. Mild cardiomegaly is unchanged. There are thoracotomy defects in the lateral right seventh and eighth ribs. Fusion hardware is noted in the mid thoracic spine. IMPRESSION: 1. Right lower lobe pneumonia and effusion. 2. ETT and NGT removal, with increased left lower lobe atelectasis. 3. Mild pulmonary edema. " 1a52ff49-11f0b536-bc18dad9-0f3d0774-ee2da104.jpg,validate/p14/p14159095/s53683074/1a52ff49-11f0b536-bc18dad9-0f3d0774-ee2da104.jpg,validation," FINAL REPORT HISTORY: Fever and cough recently returned from ___. 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 and mediastinal contours are unremarkable. IMPRESSION: No acute intrathoracic process. " 524af695-4552a76c-9e3174b9-0d5295a9-15b8e7f2.jpg,validate/p14/p14707390/s53807666/524af695-4552a76c-9e3174b9-0d5295a9-15b8e7f2.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and lethargy. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___. Chest radiograph ___. FINDINGS: A new moderate to large right pleural effusion is demonstrated with associated right basilar opacification. Patchy left basilar opacity is also demonstrated. Peripheral increased interstitial markings likely reflect underlying chronic interstitial lung disease, as assessed on the previous CT. There is no pneumothorax or pulmonary vascular congestion. Heart size is difficult to determine given the presence of the left pleural effusion. Mediastinal contours are unremarkable with calcification of the aortic knob. Right hilar enlargement is suggestive of underlying lymphadenopathy. There are multilevel degenerative changes in the thoracic spine. IMPRESSION: 1. New moderate to large right pleural effusion. 2. Right basilar opacification could reflect pneumonia, atelectasis, or aspiration. Followup imaging after treatment are recommended to ensure resolution and exclude underlying malignancy. Milder opacification within the left lung base may reflect atelectasis or chronic interstitial abnormality. 3. Chronic interstitial lung disease, better assessed on previous CT. " 62e3e15d-bc3aab26-5a0e1a63-3b047b2b-706a6ff6.jpg,validate/p10/p10362716/s56332200/62e3e15d-bc3aab26-5a0e1a63-3b047b2b-706a6ff6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with weakness. Evaluate for pneumonia. TECHNIQUE: AP upright and lateral chest radiographs COMPARISON: ___ FINDINGS: Since the prior study, there has been decrease in lung volumes and redemonstration of coarse interstitial markings. Cardiomediastinal silhouette is mildly enlarged and there is no new focal parenchymal consolidation. No evidence of large pleural effusion or pneumothorax. Aside from general osteopenia, there is no acute osseous finding. IMPRESSION: No significant interval change from ___, with no evidence of new pneumonia. " 13a27197-2f296fa4-b4db9767-64f794e5-f7b1665c.jpg,validate/p14/p14265178/s54208597/13a27197-2f296fa4-b4db9767-64f794e5-f7b1665c.jpg,validation," FINAL REPORT HISTORY: Chest pain and history of congestive heart failure. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Mild to moderate cardiomegaly is unchanged. The aorta remains calcified, with the mediastinal and hilar contours appearing otherwise unremarkable. There is no pulmonary vascular engorgement. Lungs are clear. Hyperinflation of lungs with flattening of the diaphragms suggests COPD. No pleural effusion or pneumothorax is identified. There are mild degenerative changes in the thoracic spine. Clips are seen within the upper abdomen. Widening of the left acromioclavicular joint suggest prior trauma. IMPRESSION: No acute cardiopulmonary abnormality. Hyperinflation of lungs suggestive of COPD. " 1a49dbf1-edba1566-efbfd3c5-925eb82d-b3deecb6.jpg,validate/p19/p19785715/s52189953/1a49dbf1-edba1566-efbfd3c5-925eb82d-b3deecb6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Weakness, assess pneumonia. FINDINGS: PA and lateral views of the chest were obtained demonstrating sternotomy wires. The lungs are hyperinflated and clear. No focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 3a0732de-ce5addbd-ec41716a-5f2d8fe5-3d90f071.jpg,validate/p17/p17848508/s56644182/3a0732de-ce5addbd-ec41716a-5f2d8fe5-3d90f071.jpg,validation," FINAL REPORT HISTORY: Intermittent chest pain. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 62716f69-0a07d5c5-2f8833af-4da7933b-696070a4.jpg,validate/p17/p17805551/s58392748/62716f69-0a07d5c5-2f8833af-4da7933b-696070a4.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with lightheadedness after bowel movement and memory loss. COMPARISON: ___. 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. No acute osseous abnormality is identified. There is no free air under the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 2eecd590-06c2b0c9-71c96551-4d31a743-a863ae9f.jpg,validate/p10/p10459005/s53757655/2eecd590-06c2b0c9-71c96551-4d31a743-a863ae9f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain, history of CHF // any evidence of fluid overload? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and CABG. Dual lead left-sided AICD is stable in position. The cardiac silhouette remains enlarged. Mediastinal and hilar contours are stable. No overt pulmonary edema is seen. There may be a trace right pleural effusion. No focal consolidation is seen. IMPRESSION: Possible trace right pleural effusion. Persistent cardiomegaly. No pulmonary edema. " 25cfda6b-6c348a2a-80707c91-0ff30d97-593ce0c1.jpg,validate/p18/p18551287/s50220647/25cfda6b-6c348a2a-80707c91-0ff30d97-593ce0c1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory distress // evaluate for pulm edema evaluate for pulm edema COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Since ___ there has been some progression in the dramatic changes that developed between ___ and previous study. Cardiomegaly is mild, and mediastinal venous engorgement minimal. Upper lobe vascular redistribution is clear. There is some contribution of moderate right pleural effusion and mild pulmonary edema. In addition there is probable consolidation in the lower lobes. Whether this is pneumonia or collapse is radiographically indeterminate. Lateral chest radiograph would be helpful, CT scanning would be diagnostic. RECOMMENDATION(S): Lateral chest radiograph would be helpful, CT scanning would be diagnostic. " 1ce28d4f-73cf9700-08fc39bb-8c15baca-1d2e5fd7.jpg,validate/p16/p16108772/s50908079/1ce28d4f-73cf9700-08fc39bb-8c15baca-1d2e5fd7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with recent pneumonia // eval for resolution of LLL opacity TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, there is increased aeration of bilateral lung bases.There is no focal consolidation. There is no effusion or vascular congestion. No pneumothorax. Mild cardiomegaly, unchanged. Tortuous aorta and prominent innominate artery, similar to prior. Severe scoliosis, unchanged. IMPRESSION: Increased aeration at the bilateral lung bases. No pneumonia. " bc6cc8fc-1361b1fa-7e5ae379-1fa8dc61-baebed2c.jpg,validate/p19/p19966115/s53002796/bc6cc8fc-1361b1fa-7e5ae379-1fa8dc61-baebed2c.jpg,validation," WET READ: ___ ___ ___ 11:40 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with history ___ ___'s who presented to ED after syncopal vs mechanical fall, no c/o headache and right knee pain // intracranial hematoma?Right knee injury? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are hypoinflated. In comparison to the prior examination, the cardiomediastinal silhouette appears stable. The pulmonary vasculature is mildly indistinct, though not significantly changed since prior examination. No definite pneumothorax or pleural effusion is noted. IMPRESSION: No acute intrathoracic process. " 96c0444b-460a7bd2-a1359056-5c96fbf9-588b4cc4.jpg,validate/p16/p16384483/s57190673/96c0444b-460a7bd2-a1359056-5c96fbf9-588b4cc4.jpg,validation," WET READ: ___ ___ 12:56 AM Side port of the NG tube is below the GE junction, with the tip in the stomach. Otherwise no significant change since chest radiograph earlier today. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with necrotizing fasciitis with new NG tube placement // please eval for NGT placement please eval for NGT placement IMPRESSION: Compared to prior chest radiographs, ___ through ___:55. Mild pulmonary edema and moderate cardiomegaly unchanged. Moderate left lower lobe atelectasis improved since ___, stable since ___. No pneumothorax. Left internal jugular line ends at the thoracic inlet. Esophageal drainage tube ends in the upper portion of a nondistended stomach. " 8a37a401-1b19ff90-e6aac369-d60743d4-adfe1555.jpg,validate/p10/p10361930/s57512641/8a37a401-1b19ff90-e6aac369-d60743d4-adfe1555.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with diabetic ketoacidosis and ARDS and respiratory failure. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 4.5 cm above the carina. The NG tube passes below the diaphragm terminating in the stomach. The right internal jugular line tip is at the level of mid SVC. There is interval progression of widespread parenchymal opacities, in particular in the lower lobes, which are multifocal and might be concerning for multifocal pneumonia/ARDS. Pulmonary edema would be less likely. " 1716247f-abba9e77-02d6fde3-e3cf31fd-06e329d9.jpg,validate/p16/p16050305/s50915118/1716247f-abba9e77-02d6fde3-e3cf31fd-06e329d9.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with asthma, pneumonia ___, ongoing shortness of breath // follow up pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ with the most recent dated ___. FINDINGS: There is moderate cardiomegaly which is stable. The mediastinal silhouette is widened and stable. There is elevation of the left hemidiaphragm with no evidence of previously seen left lower lobe pneumonia which is likely secondary to a persistent consolidation to base and likely represents a left lower lobe atelectasis. . There is no evidence of focal consolidations, pulmonary edema, or pleural effusion. Again seen is a moderate hiatal hernia which is stable. IMPRESSION: 1. Elevation of left hemidiaphragm with persistent consolidation of the left lung base in the setting of a cleared pneumonia likely represents left lower lobe atelectasis. 2. No evidence of acute on chronic heart disease. " 248f97e1-4561721b-eb71c6e4-24faa91e-dabdff6a.jpg,validate/p12/p12727118/s58274479/248f97e1-4561721b-eb71c6e4-24faa91e-dabdff6a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph from ___. CLINICAL HISTORY: Chest pain. 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 findings in the chest. " cf39fba3-fbe2090c-544be3c8-acaff988-0b4ac537.jpg,validate/p17/p17002760/s51212589/cf39fba3-fbe2090c-544be3c8-acaff988-0b4ac537.jpg,validation," 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. " 4f7e7ecd-b26980f7-38f9b412-e4036772-13e14953.jpg,validate/p11/p11899569/s54119576/4f7e7ecd-b26980f7-38f9b412-e4036772-13e14953.jpg,validation," FINAL REPORT INDICATION: ___ year old man with R 10th rib fx and PTX, subQ emphysema s/p CT placement 5 days ago // please eval for resolution PTX COMPARISON: Radiographs from ___ IMPRESSION: The previously seen tiny right apical pneumothorax has resolved. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There is subcutaneous emphysema along the chest wall. " e41b9b43-a31d8e44-ea1b8a0c-92416a84-4e913fb9.jpg,validate/p16/p16560117/s51447967/e41b9b43-a31d8e44-ea1b8a0c-92416a84-4e913fb9.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Followup pneumonia. Comparison is made with prior study ___. Enlarged cardiomediastinal silhouette is stable. Small pleural effusions have markedly decreased. Aside from small left lower lobe atelectasis, the lungs are clear. There is no pneumothorax. Patient is status post CABG. Sternal wires are aligned. " 2e00f879-285b7bf7-45ad88c4-bcb4a076-7afbd1f2.jpg,validate/p10/p10286475/s50358987/2e00f879-285b7bf7-45ad88c4-bcb4a076-7afbd1f2.jpg,validation," WET READ: ___ ___ 7:30 PM 1. ET tube 6.5 cm from the carina. Enteric tube terminates in the stomach. 2. Large bilateral pleural effusions. Lateral aspect of right hemi thorax omitted from view. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with sp intubation // eval tube position TECHNIQUE: Portable supine AP chest COMPARISON: Chest radiographs ___ through ___. CTA chest ___ FINDINGS: The lateral aspect of the right hemi thorax is omitted from view. ET tube is in the upper thoracic trachea approximately 6.5 cm from the carina. Enteric tube courses through the esophagus terminating in the stomach. There are large bilateral layering pleural effusions. Retrocardiac opacity likely due to atelectasis although superimposed consolidation would be possible. Also be due to The heart is obscured by pleural effusion. There is no evidence of large pneumothorax within the limitations of this study. IMPRESSION: 1. ET tube 6.5 cm from the carina. Enteric tube terminates in the stomach. 2. Large bilateral pleural effusions. Lateral aspect of right hemi thorax omitted from view. " bee0594a-ea9c879e-a4e349c9-dd88a26b-7008f419.jpg,validate/p15/p15805011/s50920412/bee0594a-ea9c879e-a4e349c9-dd88a26b-7008f419.jpg,validation," 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 prominence of the central pulmonary vasculature which may be due to mild pulmonary vascular congestion without overt pulmonary edema. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Mild pulmonary vascular congestion. " e2d899ec-7496436e-720d94ce-35f1660e-cb82c621.jpg,validate/p12/p12097647/s51310335/e2d899ec-7496436e-720d94ce-35f1660e-cb82c621.jpg,validation," WET READ: ___ ___ ___ 10:47 PM Nasogastric tube tip ends in the esophagus, proximal to the large hiatal hernia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with hiatal hernia, NG tube placement // eval NG tube placement TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiographs dated ___ and ___. FINDINGS: There are low lung volumes, which results in bronchovascular crowding. There is no focal consolidation, pleural effusion, or pneumothorax. There is bibasilar atelectasis. Heart remains enlarged. Large hiatal hernia again seen. A nasogastric tube tip ends in the esophagus, proximal to the hiatal hernia. IMPRESSION: Nasogastric tube tip ends in the esophagus, proximal to the large hiatal hernia. RECOMMENDATION(S): Advancement of nasogastric tube. NOTIFICATION: These findings were discussed with Dr. ___ By Dr. ___ ___ telephone at approximately 930pm on ___, at the time of discovery. " 1bd3f8e5-70dca2c5-6053e925-8e3d38c4-24ce8376.jpg,validate/p16/p16323470/s51868436/1bd3f8e5-70dca2c5-6053e925-8e3d38c4-24ce8376.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with s/p fall obvioius wrist deformity, pain ttp in the hips knee and femur // eval for fracture x rayseval for ICH for ct head eval c spine for C-spine TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Costochondral calcification is noted at multiple levels. No definite focal consolidation is seen. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous. The lungs remain hyperinflated. Degenerative changes noted at the right glenohumeral joint, not fully assessed. IMPRESSION: Hyperinflated lungs. No definite focal consolidation. " 324d5453-dcd8ffef-051e56dd-d496b6c6-aa8c7c2f.jpg,validate/p14/p14462563/s54645811/324d5453-dcd8ffef-051e56dd-d496b6c6-aa8c7c2f.jpg,validation," FINAL REPORT INDICATION: ___ year old man with ESRD s/p transplant now with chills and fatigue // evaluate for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs since ___. FINDINGS: The lungs are clear. The hila and pulmonary vasculature are normal. No pleural effusion or pneumothorax. The left hemidiaphragm is chronically elevated due to eventration, unchanged since ___. The heart size is normal and unchanged. The mediastinum is normal. IMPRESSION: No pneumonia. " f93300ec-06b7513f-f79f2b23-5ec07285-227ba9ee.jpg,validate/p17/p17435854/s54697182/f93300ec-06b7513f-f79f2b23-5ec07285-227ba9ee.jpg,validation," FINAL REPORT INDICATION: Patient with shortness of breath, who is a smoker. COMPARISONS: Chest radiograph ___ ___. 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. " 50a45523-39bc5da2-dc6782cc-c358b524-6d3bc78b.jpg,validate/p11/p11900721/s54936907/50a45523-39bc5da2-dc6782cc-c358b524-6d3bc78b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with cirrhosis, presents with AMS // eval for acute process, portal vein thrombosis COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Metallic coils project over the right upper quadrant. Interstitial opacities likely reflect mild interstitial edema. The heart is stable though top-normal in size. No large effusion or pneumothorax. No convincing signs of pneumonia. Mediastinal contour appears stable and normal. Bony structures are intact. IMPRESSION: Findings suggestive of mild interstitial edema. " e61c28c9-f649fc62-a1098aed-2d5f91db-cd4023a3.jpg,validate/p11/p11581370/s58049069/e61c28c9-f649fc62-a1098aed-2d5f91db-cd4023a3.jpg,validation," FINAL REPORT INDICATION: ___ year old man with coughing // ? coughing 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 cardiopulmonary process. NOTIFICATION: The findings were discussed by Dr. ___ with ___ on the telephoneon ___ at 12:51 PM, 10 minutes after discovery of the findings. " d3c92148-eb196c30-bb78b817-b3f1ecf0-225b8d05.jpg,validate/p18/p18533644/s55057423/d3c92148-eb196c30-bb78b817-b3f1ecf0-225b8d05.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 2:49 PM IMPRESSION: Stable cardiomegaly with small bilateral pleural effusions with associated atelectasis. Slightly worse pulmonary edema. ______________________________________________________________________________ FINAL REPORT HISTORY: An ___-year-old female with shortness of breath. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: A pacer unit projects over the left chest with a lead in the coronary sinus. Severe cardiomegaly persists. Small bilateral pleural effusions are present with underlying atelectasis. There is no pneumothorax. Pulmonary edema is slightly worse. IMPRESSION: Stable cardiomegaly with small bilateral pleural effusions with associated atelectasis. Slightly worse pulmonary edema. " 3dc6795c-91576279-11c71aa8-a933aacf-43b050b7.jpg,validate/p16/p16992997/s50839913/3dc6795c-91576279-11c71aa8-a933aacf-43b050b7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with scant crackles in Left upper/mid lung field // ?pneumonia ?pneumonia IMPRESSION: In comparison with study of ___, the Port-A-Cath has been removed. Otherwise, little change. Marked scoliosis of the thoracolumbar spine is noted. No evidence of cardiomegaly, vascular congestion, or pleural effusion. Although not well seen on the lateral view, there is a moderate hiatal hernia noted on the frontal projection. " 9370fbd2-011ef5f9-b83bf757-c4f2692d-d4bffd7f.jpg,validate/p17/p17788370/s50160928/9370fbd2-011ef5f9-b83bf757-c4f2692d-d4bffd7f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion s/p pigtail placement // assess pleural effusions, chest tube assess pleural effusions, chest tube IMPRESSION: Compared to chest radiographs since ___, most recently ___. Orientation of the right basal pigtail pleural drainage catheter has changed. There is probably still some right pleural effusion, even fissural, but not a large volume. It is possible is she is developing an pneumonia in the axillary region of the right midlung. Careful followup is advised. Pulmonary vascular congestion has definitely increased and there is new mild pulmonary edema. Heart size is normal but larger today than it was on ___. No pneumothorax. Left PIC line ends in the mid SVC. " f68c0262-d20eb0b5-7128ce5c-60b41f6c-1d94cf10.jpg,validate/p15/p15884351/s57078070/f68c0262-d20eb0b5-7128ce5c-60b41f6c-1d94cf10.jpg,validation," FINAL REPORT INDICATION: ___M with SOB, productive cough, pls eval for pna vs edema // TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Prior left PICC is no longer visualized. Previously seen right-sided pleural effusion has near completely resolved. Hazy right greater than left basilar opacities on the frontal may be due to atelectasis and there is no definite correlate on the lateral view. Lungs are otherwise clear. The cardiomediastinal silhouette is stable. No acute osseous abnormalities identified. IMPRESSION: Hazy right greater than left basilar opacities on the frontal view potentially due to atelectasis has no definite correlate is seen on the lateral. " 31a8d662-3754f2c2-f34935f8-912c2a15-1c0d05b3.jpg,validate/p15/p15676084/s59482132/31a8d662-3754f2c2-f34935f8-912c2a15-1c0d05b3.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with intrathoracic anastomosis after minimally invasive esophagectomy, followup. PA and lateral upright chest radiographs were reviewed in comparison to ___. The NG tube tip terminates at the level of mid esophagus. The epidural catheter is in place. The right chest tube is in place. There is no appreciable pneumothorax and there is minimal amount of right pleural effusion demonstrated. Air-fluid level in the neoesophagus is at the mid level of the chest. " ec79562b-efb9baee-4ea45952-35999ab9-7e315def.jpg,validate/p10/p10550621/s55470119/ec79562b-efb9baee-4ea45952-35999ab9-7e315def.jpg,validation," WET READ: ___ ___ ___ 7:47 PM Right basilar opacity is worse than on ___ and likely represents atelectasis and effusion. Supervening pneumonia cannot be excluded (per ___ ___, pt has no fever or white count, has chronic cough). Left lung is clear. Heart difficult to evaluate. Mild pulmonary vascular engorgement. -___ d/w ___ by phone 7:45pm ___. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Lung cancer, atrial fibrillation, evaluation for acute changes. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right-sided pleural effusion has substantially increased in extent. It now occupies about one-third of the right hemithorax and leads to subsequent right basal atelectasis. Moderate cardiomegaly and no signs of overt pulmonary edema. Clips projecting over the liver. No pneumothorax. " 03f93729-607921a0-df52310e-e263c854-85c23f18.jpg,validate/p16/p16384649/s54757979/03f93729-607921a0-df52310e-e263c854-85c23f18.jpg,validation," FINAL REPORT HISTORY: Chest pain and shortness of breath. Evaluate for 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. Surgical clips are seen in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 48d757c2-20f627dc-beb906af-17ace7bf-358c0fdf.jpg,validate/p18/p18230852/s50732350/48d757c2-20f627dc-beb906af-17ace7bf-358c0fdf.jpg,validation," FINAL REPORT INDICATION: ___M with sob // R/O PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: ___ FINDINGS: The lungs remain clear focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. Old healed right lateral rib fracture is again noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 224933b4-b16a4bda-6626da6e-78f4d638-7aa9e31e.jpg,validate/p15/p15111021/s55502959/224933b4-b16a4bda-6626da6e-78f4d638-7aa9e31e.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Dyspnea and anemia. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. Opacity in the right upper lung appears similar to slightly increased while opacities in the left lower lung have partly resolved. Elsewhere the lungs remain clear without new areas of opacification. There is no pleural effusion or pneumothorax. IMPRESSION: Persistent, similar to slightly increased, opacity in the right upper lung suggesting acute infection, although otherwise improved. " c24ad42f-83369ef5-4f93076a-ff20030f-60ec2347.jpg,validate/p19/p19850525/s59763750/c24ad42f-83369ef5-4f93076a-ff20030f-60ec2347.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ M PMHx of ESRD on HD (TThS), a fib on coumadin, sCHF (EF ___% ___), AS and anemia // Eval for pulm edema/effusions/volume overload Eval for pulm edema/effusions/volume overload IMPRESSION: Compared to prior chest radiographs since ___ most recently ___. Mild pulmonary edema has worsened accompanied by increasing small pleural effusions and stable severe cardiomegaly. Dual channel left trans jugular dialysis catheter ends close to the superior cavoatrial junction. Transvenous right atrial right ventricular leads are continuous from the left pectoral generator. No pneumothorax " 7feda1dd-ff4f1f6e-e46b83d1-d5bf28f4-5b81851d.jpg,validate/p16/p16476559/s53813903/7feda1dd-ff4f1f6e-e46b83d1-d5bf28f4-5b81851d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with increase SOB // r/o PNA exacerbation of CHF COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. The heart remains markedly enlarged. There is mild pulmonary edema noted, new from prior. Patient is slightly rotated to the left. Mediastinal contour stable. No pneumothorax. No large effusion. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Marked cardiomegaly with mild pulmonary edema. " bd9c6b97-f1a886a2-cbb9100c-8df17fc1-0de7eb08.jpg,validate/p11/p11155222/s54941510/bd9c6b97-f1a886a2-cbb9100c-8df17fc1-0de7eb08.jpg,validation," FINAL REPORT HISTORY: Cough and fever. COMPARISON: Chest radiograph on ___. 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. " 223321e3-ffc996b3-8e801efa-83dbd2e4-ee373cb4.jpg,validate/p12/p12493668/s56755167/223321e3-ffc996b3-8e801efa-83dbd2e4-ee373cb4.jpg,validation," WET READ: ___ ___ ___ 10:24 PM A right pleural pigtail catheter is again noted with continued improvement in the pleural effusion at the right lung base. There is now placement of a second right pleural pigtail catheter more superiorly. There is unchanged appearance of a moderate loculated effusion at the apex and small on laterally. There is multi focal atelectasis on the right. Apparent improvement in the left pleural effusion may be positional versus true resolution. No pneumothorax. Right PICC in unchanged position. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new (second) R sided chest tube placement. // Please eval for pneumothorax, chest tube placement Please eval for pneumothorax, chest tube placement COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Second pleural drainage tube has been inserted since ___ in the right upper chest, with its tip against the mediastinum. There may have been some decrease in moderate right pleural effusion, but there is are still substantial apical and basal loculations. The base of the right lung is probably consolidated, due to atelectasis or infection. Left lung shows increased vascular congestion and borderline edema. Heart is normal size. There is no left pleural abnormality or right pneumothorax. New right PIC line can be traced as far as the low SVC, but the tip is indistinct. " 12b44909-9e0a1525-d4d2cc78-df5ff1e5-ef3c1de8.jpg,validate/p19/p19348515/s59021672/12b44909-9e0a1525-d4d2cc78-df5ff1e5-ef3c1de8.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man with right pleural effusion status post drainage with small pneumothorax. FINDINGS: Comparison is made to previous study from ___. There is again seen a very tiny right apical pneumothorax. There are areas of consolidation with lucency at the right base, likely representing loculated pleural fluid. There is volume loss in the right side as well. A small left-sided pleural effusion is seen. Healed right-sided rib fractures are present. The heart size is within normal limits. Median sternotomy wires are present. Overall, there has been no appreciable change. " 7b24c84d-7a078283-437aac06-8bd94b8a-aaf48c6d.jpg,validate/p15/p15069337/s58946926/7b24c84d-7a078283-437aac06-8bd94b8a-aaf48c6d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hemoptysis // Please eval for pneumonia, masses, bronchiectasis COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Lungs are well inflated. A faint opacity projecting over the lateral aspect of the right upper lobe is new. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. IMPRESSION: A faint opacity projecting over the lateral aspect of the right upper lobe is concerning for pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:24 PM, 15 minutes after discovery of the findings. " cf083263-78b29e8b-fea01a6d-ee39d556-cdd3b785.jpg,validate/p12/p12570311/s58452422/cf083263-78b29e8b-fea01a6d-ee39d556-cdd3b785.jpg,validation," FINAL REPORT INDICATION: Seizures, assess for acute process. COMPARISONS: Chest radiograph ___. FINDINGS: Lung volumes are low but slightly improved from the prior examination with bibasilar atelectasis. Ventricular shunt tubing courses to the right hemithorax after which it is not well followed. Cardiomediastinal silhouette is poorly assessed due to low lung volumes but appears unremarkable. No pneumothorax is seen. IMPRESSION: No acute intrathoracic process. " 26c8cfe0-a7afb7f6-1dcbaef8-4c1ad372-341acf54.jpg,validate/p16/p16036071/s57171225/26c8cfe0-a7afb7f6-1dcbaef8-4c1ad372-341acf54.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with drug overdose, s/p extubation, now with resp distress // interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. There is mild over distension of the stomach and an increase in extent of the retrocardiac atelectasis with air bronchograms, likely emphasized by the lower lung volumes. No new parenchymal opacities. No pulmonary edema. Normal size of the cardiac silhouette. " db7cc8ea-a1fa9beb-238119f5-92293f2e-39973bf6.jpg,validate/p12/p12553538/s52311526/db7cc8ea-a1fa9beb-238119f5-92293f2e-39973bf6.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with new onset of pancytopenia. COMPARISON: ___ and chest x-ray from earlier the same day at 7:53 a.m. from the ___. CT abdomen and pelvis from ___. FINDINGS: AP and lateral views of the chest. Low lung volumes are again noted. Dense retrocardiac opacity is likely due in part to known hiatal hernia present on prior CT abdomen from ___. There is also a small right-sided pleural effusion. Engorged pulmonary vasculature is compatible with vascular congestion. Posterior and posterolateral right rib fractures affecting ribs 7 and 8 appear old. Additional right lateral rib fractures are not well characterized. Deformity of the proximal left humerus is compatible with prior fracture. IMPRESSION: Pulmonary vascular congestion and small-to-moderate right pleural effusion. Dense retrocardiac opacity is compatible with large hiatal hernia seen on prior exam. " 436f5c1c-ef7ce959-02f7d0a5-85b9eb66-926a60cd.jpg,validate/p15/p15100936/s50946011/436f5c1c-ef7ce959-02f7d0a5-85b9eb66-926a60cd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Lung mass, status post intervention, evaluation for pneumothorax. FINDINGS: There is a status post mediastinoscopy. The rounded mass in the right upper lobe is in unchanged position. There currently is no evidence of pneumomediastinum or pneumothorax. A tubular structure projects over the upper parts of the trachea but could be located outside the patient. No parenchymal opacities. No pleural effusions. " 923f7fa7-1755a8a9-4d0aa346-7e042f35-bc7c77ae.jpg,validate/p18/p18317586/s51916527/923f7fa7-1755a8a9-4d0aa346-7e042f35-bc7c77ae.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Epigastric and chest pain radiating to the back. 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 are no pleural effusions or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary disease. " eb62aab1-d9f87521-7efa99d7-549efe62-0e6107df.jpg,validate/p12/p12292383/s53424613/eb62aab1-d9f87521-7efa99d7-549efe62-0e6107df.jpg,validation," WET READ: ___ ___ ___ 6:40 PM similar chest radiographs to ___ with biventricular pacer and cardiomegaly. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Progressive dyspnea on exertion. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is mildly enlarged, unchanged. Biventricular pacer is in unchanged location. Lung volumes are relatively low. Bibasilar areas of atelectasis are redemonstrated. No pleural effusion or pneumothorax is seen. No evidence of acute process has been demonstrated as compared to the prior radiograph. " 0f8ff557-d10c62a6-7c2f7c69-6b4e0214-8ea95215.jpg,validate/p17/p17081205/s53957506/0f8ff557-d10c62a6-7c2f7c69-6b4e0214-8ea95215.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with alcoholic hepatitis and possible volume overload // Pulm edema? TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: Right PICC line terminates in lower SVC. The lung volume is small. Bilateral lower lobe opacification has increased, likely worsening atelectasis. Pulmonary vascular markings are unchanged. Bilateral mild pleural effusion is new compared to ___. No pneumothorax. The cardiomediastinal silhouette is normal and unchanged. IMPRESSION: 1. No overt pulmonary edema. 2. Bilateral pleural effusion, right worse than left. " b96fcc66-9c6eb2ef-33de19ed-235f00e4-bb5d3ccd.jpg,validate/p11/p11485993/s52951442/b96fcc66-9c6eb2ef-33de19ed-235f00e4-bb5d3ccd.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with persistent hypotension and leukocytosis, evaluate for pneumonia or pulmonary edema. TECHNIQUE: Single upright AP chest radiograph COMPARISON: Multiple prior chest radiographs dating back to ___ and recent CT of the abdomen pelvis dated ___. FINDINGS: Areas of increased opacification overlying the right lung. Could be postsurgical. Not of typical appearance for pneumonia, however given the significant underlying architectural distortion of the right lung this may represent an infectious process in the proper clinical setting. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable. IMPRESSION: Interval increase in irregular opacification of the right lung which may represent an infectious process superimposed on markedly abnormal underlying lung architecture in the proper clinical setting. " 0bdc1037-2bec12b9-39a5fe7e-784fbf58-b9be279d.jpg,validate/p12/p12365988/s56568116/0bdc1037-2bec12b9-39a5fe7e-784fbf58-b9be279d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with syncope // eval for acute process COMPARISON: ___ and prior CT abdomen pelvis from ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. Since the prior exam there is improved aeration at the lower lungs. There is only mild residual basilar atelectasis on the left. There is a retrocardiac gas filled structure which corresponds with known hiatal hernia. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: Mild left basal atelectasis. Hiatal hernia. Otherwise unremarkable. " 5b4fcc10-cad2a317-0d9ea3f7-07c6f765-92ab5b70.jpg,validate/p10/p10692417/s56923898/5b4fcc10-cad2a317-0d9ea3f7-07c6f765-92ab5b70.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Right shoulder pain, nausea, history of breast cancer. COMPARISON: ___. FINDINGS: There is persistent prominence of the right hilum with hilar lymphadenopathy seen on chest CT from ___. Minimal left basilar atelectasis/scarring is again seen. There is no new focal consolidation. No large pleural effusion, though a trace left pleural effusion is difficult to exclude posteriorly. No evidence of pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Stable prominence of the right hilum in this patient with known right hilar lymphadenopathy. Possible trace posterior effusion. No new focal consolidation. " ba3d66da-8d03af03-c1be3259-af73a5fc-0be4a58e.jpg,validate/p12/p12850832/s57272354/ba3d66da-8d03af03-c1be3259-af73a5fc-0be4a58e.jpg,validation," FINAL REPORT HISTORY: Prior right lower lobe pneumonia. FINDINGS: In comparison with the study of ___, there is no evidence of acute focal pneumonia or vascular congestion or pleural effusion. The slight impression on the lower cervical trachea on the right seen previously is not apparent at this time. " 006a8bd5-ce90cfc4-06592011-859f8d73-993ac2bd.jpg,validate/p10/p10382464/s50316187/006a8bd5-ce90cfc4-06592011-859f8d73-993ac2bd.jpg,validation," FINAL REPORT HISTORY: Status post placement of a pacemaker, rule out pneumothorax. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: Redemonstrated is the unchanged position of a dual-chamber subclavian pacemaker seen in place, with leads identified within the right atrium and right ventricle. Note that the prior report mistakenly described the pacemaker lead to be within the left atrium. There is stable moderate cardiomegaly. Mild bilateral pulmonary edema is noted. There is no focal consolidation, pneumothorax, or pleural effusion seen. The mediastinal contours are grossly normal. No bony abnormalities are detected. IMPRESSION: Unchanged position of a dual-chamber pacemaker with leads in the right atrium and right ventricle. No evidence of associated pneumothorax. Moderate cardiomegaly. " 201d9a47-314a2d84-0153c7a4-5c0758e5-7453386c.jpg,validate/p15/p15160486/s50730601/201d9a47-314a2d84-0153c7a4-5c0758e5-7453386c.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. Question pneumonia. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral views. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is a large bulging opacity in the posterior lower right hemithorax which suggests a large loculated pleural effusion. A more free flowing portion of the effusion has also increased more anteriorly with possible patchy coinciding atelectasis. A suspicious nodule persists in the right upper lung. Possibly a right upper lung nodule has increased, but change could be better appreciated by comparing with CT if needed. The left lung remains clear with no effusion. The bones are probably demineralized to some extent. IMPRESSION: Findings suggestive of a large recurrent partly loculated effusion in the right lower hemithorax. Suspicious nodule in the right upper lobe, potentially increased somewhat. " 9ae2258c-fa1daa73-7ceb02a8-2d248042-458ebe47.jpg,validate/p11/p11356345/s50926471/9ae2258c-fa1daa73-7ceb02a8-2d248042-458ebe47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with left shoulder pain status post pedestrian struck 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. " 5d8cdccf-f1214e55-cb9f03c1-0a932e07-948d9080.jpg,validate/p19/p19015076/s58444843/5d8cdccf-f1214e55-cb9f03c1-0a932e07-948d9080.jpg,validation," FINAL REPORT ___-year-old female with history of AFib, presenting with syncope. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No pleural effusion or pneumothorax. Soft tissue calcification in the left shoulder is unchanged from ___. Additional calcifications are noted in the right axilla. IMPRESSION: No evidence of acute intrathoracic process. " 687618ed-43b306e2-2504c0e3-e428ebe0-a37702b8.jpg,validate/p14/p14541551/s56028029/687618ed-43b306e2-2504c0e3-e428ebe0-a37702b8.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with stroke, NG tube repositioning. COMPARISON: ___ at 8:08 a.m. (one hour ago). FINDINGS: Portable AP radiograph is obtained through the mid chest and upper abdomen. In comparison to the study of one hour prior the tip of the NG tube is minimally advanced, but still remains at the level of the diaphragm with the side hole in the lower esophagus. Surgical clips are noted in the upper abdomen. No significant changes compared to the prior study. IMPRESSION: Nasogastric tube tip is at the level of the diaphragm with the side hole clearly seen in the lower esophagus. The tube needs to be advanced further. " bb92c0ab-3f2958e3-4fae4b79-830dee46-363c257a.jpg,validate/p15/p15308781/s53761423/bb92c0ab-3f2958e3-4fae4b79-830dee46-363c257a.jpg,validation," WET READ: ___ ___ 2:59 PM 2.3 x 2.1 cm rounded opacity projecting over the posterior mid thorax best seen on the lateral view, not identified on frontal view, difficut to discern whether osseous or pulmonary(lesion). Recommend nonemergent chest CT for further evaluation. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Substernal chest pressure. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. On the lateral view, projecting over the posterior mid thorax, there is a 2.3 x 2.2 cm rounded opacity, difficult to discern whether osseous or pulmonary (lesion). Recommend non-emergent chest CT for further evaluation. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is identified. IMPRESSION: No focal consolidation to suggest pneumonia. No evidence of pneumothorax. 2.3 x 2.2 cm rounded opacity projecting over the posterior mid hemithorax, approximately at the level of the mid thoracic spine, difficult to truly discern whether osseous or pulmonary. Recommend chest CT for further evaluation. " 48640c68-71119afa-7bba6544-a3c87717-f0ac99cf.jpg,validate/p18/p18169233/s51641214/48640c68-71119afa-7bba6544-a3c87717-f0ac99cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with chest pain. TECHNIQUE: Semi-upright AP view of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Cardiac silhouette size is normal. Atherosclerotic calcifications are demonstrated at the aortic knob. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. Assessment of the medial left lung apex is somewhat obscured by overlying soft tissue from the patient's neck and chin. There is no acute osseous abnormality. Multiple clips project over the gastroesophageal junction. IMPRESSION: No acute cardiopulmonary abnormality. " 2ac905b5-a988529e-56981572-0f07115b-b6c5993f.jpg,validate/p17/p17254594/s55291825/2ac905b5-a988529e-56981572-0f07115b-b6c5993f.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with suboxone and heroin overdose, possible Tylenol overdose, with cough and possible aspiration. COMPARISON: No prior radiographs are available for comparison. FINDINGS: AP and lateral views of the chest were obtained. There are bilateral confluent opacifications in the dependent areas of the lower lungs posteriorly. Patchy opacifications in the mid and upper lungs are also noted. There is some upper mediastinal widening and hilar prominence likely due to vascular distention but lymphadenopathy could appear similar. Heart size is top normal and there is no pleural effusion or pneumothorax. CONCLUSION: Bilateral lower lobe dependent consolidation, which could be due to clinically suspected aspiration, but infection and edema may have a similar appearance radiographically. Multifocal patchy opacities in the mid and upper lungs could represent coexisting pulmonary edema or additional sites of aspiration. Followup radiographs after treatment are recommended to ensure resolution. The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at ___, 5 minutes after the finding was discovered. " 10027dbc-6faa85a7-2dd307c2-50ed9e54-0e3afbb2.jpg,validate/p19/p19794689/s57354749/10027dbc-6faa85a7-2dd307c2-50ed9e54-0e3afbb2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with A-fib w/ RVR // R/o pneumonia vs pulmonary edema R/o pneumonia vs pulmonary edema IMPRESSION: No comparison. Moderate cardiomegaly. Atelectasis at both the left and the right lung basis. No pulmonary edema no pleural effusions. No pneumothorax. " c27973b5-2c8dff4a-9ea0325f-e51a2d65-889aa224.jpg,validate/p10/p10207476/s57618599/c27973b5-2c8dff4a-9ea0325f-e51a2d65-889aa224.jpg,validation," 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. " 9590b976-c4f498c8-614bb320-23df9350-7b99240d.jpg,validate/p14/p14244279/s59765778/9590b976-c4f498c8-614bb320-23df9350-7b99240d.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain. Evaluate for mediastinal widening or pneumothorax. COMPARISON: ___ and CT ___. FINDINGS: A frontal upright view of the chest was obtained portably. The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Blunted right costophrenic angle likely reflects pleural scarring. There is minimal left basilar atelectasis. Heart size is normal. Mediastinal silhouette and hilar contours are normal. No displaced rib fracture is seen. No free air under the diaphragm. Partially imaged in anterior cervical spinal fusion hardware. IMPRESSION: No acute intrathoracic process. " a0a263fc-bbdbbb0a-2a0b9f9c-1588b9d9-72e12b48.jpg,validate/p14/p14496622/s53930821/a0a263fc-bbdbbb0a-2a0b9f9c-1588b9d9-72e12b48.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with leukocytosis // eval for PNA eval for PNA 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. " ddec252c-3f9ec350-365b28f8-8d0ddf99-27144619.jpg,validate/p16/p16799832/s59314165/ddec252c-3f9ec350-365b28f8-8d0ddf99-27144619.jpg,validation," WET READ: ___ ___ ___ 7:54 AM Stable appearance of the chest, including a right paramediastinal/perihilar mass, moderate right pleural effusion, and moderate cardiomegaly. WET READ VERSION #1 ___ ___ ___ 7:25 PM Stable appearance of the chest, including a right paramediastinal/perihilar mass, moderate right pleural effusion, and moderate cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with known aggressive neuroendocrine tumor, pleural effusion, new o2 requirement. // assess for pulmonary edema COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The large paramediastinal and right hilar mass is constant. Mild to moderate right pleural effusion. Unchanged appearance of the normal left lung and of the left heart contour. " f54f9369-3bd49e96-d599e186-40f80e65-46f8783f.jpg,validate/p14/p14836874/s50308863/f54f9369-3bd49e96-d599e186-40f80e65-46f8783f.jpg,validation," 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. " ab8480ad-b464bbc1-98f4287d-9472c996-1f9ec1e3.jpg,validate/p18/p18039866/s56710845/ab8480ad-b464bbc1-98f4287d-9472c996-1f9ec1e3.jpg,validation," 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. " b76755d8-bf755774-fd2135f8-7658feb2-454b8ac0.jpg,validate/p19/p19197903/s51567024/b76755d8-bf755774-fd2135f8-7658feb2-454b8ac0.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with history of known interstitial pulmonary fibrosis with possible left lower lobe opacity on outside radiographs. COMPARISON: Chest radiographs from ___ as well as CT chest ___. FINDINGS: There is a new patchy opacity in the left lower lobe which partly obscures the left hemidiaphragm. Otherwise, extensive fibrosis appears unchanged. Evidence of prior wedge resection is again noted at the level of the lingula. There is no pneumothorax. Cardiac silhouette appears stable. Osseous structures are grossly unremarkable. IMPRESSION: 1) New left lower lobe opacity suggestive of left lower lobe pneumonia. Followup CXR recommended in 4 weeks after therapy to ensure resolution. 2) Similar appearance of interstitial pulmonary fibrosis. " 6d232f60-cf42d5f5-908802f2-cd7c46b6-b862a9a5.jpg,validate/p12/p12913304/s58917710/6d232f60-cf42d5f5-908802f2-cd7c46b6-b862a9a5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with left lung procedure and PTX // PTX eval change- please do immediately after procedure. Patient in RCU PTX eval change- please do immediately after procedure. Pati IMPRESSION: In comparison with the study of ___, there are now fiducial seeds in place on the left. Following the procedure, there is a small to moderate apical pneumothorax. Otherwise, little change. " ef76ec5a-8a03346a-c530e2ea-eee305bc-f40e9a68.jpg,validate/p16/p16251011/s58004088/ef76ec5a-8a03346a-c530e2ea-eee305bc-f40e9a68.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post ammonia ingestion. 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. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. No pneumoperitoneum. " 210618d2-5faab91c-a30c5f5a-319e5f0f-4ab1d3ff.jpg,validate/p14/p14809300/s56421518/210618d2-5faab91c-a30c5f5a-319e5f0f-4ab1d3ff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the pre-existing pleural effusion on the right has completely resolved. There is no re-expansion edema or other parenchymal abnormality. The fiducial marker in the right apex is in constant position. Healing right basal lateral rib fracture. Normal appearance of the cardiac silhouette. Mild tortuosity of the descending aorta. " 5c0f393d-3bc781a6-dc5e2373-d5eedac2-18b09654.jpg,validate/p13/p13177245/s51078419/5c0f393d-3bc781a6-dc5e2373-d5eedac2-18b09654.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with fever, SOB // Eval for infiltrate TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: Patchy lingular opacity is seen which could be due to atelectasis versus infectious process in the appropriate clinical setting. Perihilar peribronchial thickening is noted. The right lung is clear. The lungs are relatively hyperinflated, suggesting chronic obstructive pulmonary disease. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable. IMPRESSION: Patchy lingular opacity, atelectasis versus infection. Left perihilar peribronchial wall thickening. " 746cde7e-03952e23-15e803b3-30d8eaab-d6356dc7.jpg,validate/p16/p16500918/s53182342/746cde7e-03952e23-15e803b3-30d8eaab-d6356dc7.jpg,validation," FINAL REPORT INDICATION: ___F with fall from standing. on Coumadin. Reports pain in the left hand and left knee // eval for ICH, fracture/dislocation TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right chest wall dual lead pacing device is again seen with lead tips in the right atrium and right ventricle. Mitral valve replacement and median sternotomy wires are again noted. The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " a03ac33d-fe835365-82973c3a-0bf2e738-fbb8a2f1.jpg,validate/p16/p16662264/s58623741/a03ac33d-fe835365-82973c3a-0bf2e738-fbb8a2f1.jpg,validation," WET READ: ___ ___ 7:17 PM RML opacity has become more confluent with a new right effusion. a small left sided ill-defined opacity slightly obscures the cardiac apex and is concerning for an addtional focus of infection likely within the lingula. a small left effusion may also be present. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Renal transplant with multifocal pneumonia with new left-sided pleuritic chest pain. REFERENCE EXAM: Chest x-ray from ___ and CT from ___. FINDINGS: Again seen is the right middle lobe infiltrate. There is also left lingular infiltrate that is slightly increased in conspicuity compared to prior. There are small bilateral pleural effusions that have increased compared to prior. The patchy upper lobe infiltrate seen on CT is not as well visualized on the chest x-ray. IMPRESSION: Bilateral pneumonia with increased effusion. " 345e42de-a74487a9-6d80450a-ade60d72-c325df7f.jpg,validate/p16/p16609016/s56088519/345e42de-a74487a9-6d80450a-ade60d72-c325df7f.jpg,validation," FINAL REPORT INDICATION: ___ year old man with chronic pul fibrosis s/p cardiac surgery. Evaluate interstitial lung disease. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___, ___. FINDINGS: Compared to ___, minimal residual pulmonary edema is seen. Small residual left pleural effusion is likely. Compared to preop radiograph on ___, previously seen fibrosing interstitial lung disease account for bilateral opacities. The heart size is normal and unchanged. The mediastinal and hilar contours are unchanged. Right jugular catheter is in right atrium, unchanged from prior. No pneumothorax seen. Sternotomy wires are aligned and intact. Aortic calcification is unchanged. IMPRESSION: Improving pulmonary edema. Similar extent of pulmonary fibrosis. " aec3a526-de1b2204-e70f6257-d21b7f0e-7a8d655e.jpg,validate/p14/p14760908/s51294227/aec3a526-de1b2204-e70f6257-d21b7f0e-7a8d655e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: PICC line placement. COMPARISONS: Prior radiographs from ___ and scout from chest CT performed on ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: A left-sided PICC line terminates in the upper superior vena cava. 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. PICC line terminating in the superior vena cava. " 652155ca-cf055a80-e075315f-53731fdb-dccc71f0.jpg,validate/p16/p16030116/s57668483/652155ca-cf055a80-e075315f-53731fdb-dccc71f0.jpg,validation," FINAL REPORT HISTORY: ARDS with intubation. FINDINGS: In comparison with study of ___, there has been a dramatic change in the appearance of the lungs with diffuse bilateral pulmonary opacifications consistent with the clinical diagnosis of ARDS. There has been placement of an endotracheal tube with its tip approximately 2.4 cm above the carina. " 53e15d6a-3a12ba93-a18a18f4-e09c19bd-0de5c527.jpg,validate/p16/p16595826/s59281673/53e15d6a-3a12ba93-a18a18f4-e09c19bd-0de5c527.jpg,validation," FINAL REPORT INDICATION: Fevers. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral. COMPARISON: None. FINDINGS: The cardiac and mediastinal silhouettes are within normal limits. Calcifications of the mitral valve anulus are noted. There is no definite focal pulmonary opacity, pleural effusion, or pneumothorax. Atelectasis/scarring is seen at both costophrenic angles. Slightly increased lung markings are likely chronic changes. Surgical clips seen in the lower neck are probably from prior thyroid or parathyroid surgery. Severe degenerative changes and post fracture morphology of the right shoulder are noted. IMPRESSION: Chronic changes; no evidence of consolidation or acute cardiopulmonary process. " 6ac6c88a-e585f498-adc49b21-7e3b7e2c-930a0b4d.jpg,validate/p16/p16253574/s55869776/6ac6c88a-e585f498-adc49b21-7e3b7e2c-930a0b4d.jpg,validation," FINAL REPORT INDICATION: Followup pneumothorax. COMPARISON: Chest radiographs, ___, CT cervical spine ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is a small subpulmonic left pleural effusion. There is no pneumothorax or right pleural effusion. New linear atelectasis is present in the left mid lung. Multiple left rib fractures are again seen. IMPRESSION: 1. No pneumothorax. 2. New small left pleural effusion. " df0b3f6b-ca4255ab-9e3978f1-a6512c8f-caa3dca4.jpg,validate/p16/p16644826/s56356557/df0b3f6b-ca4255ab-9e3978f1-a6512c8f-caa3dca4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of lung cancer and breast cancer, COPD, chronic heart failure, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a decrease in lung volume and a newly appeared parenchymal opacity at the right lung base that could reflect pneumonia. In addition, there is increased retrocardiac atelectasis and moderate fluid overload that has newly appeared. Moderate cardiomegaly. No pneumothorax. The presence of a small right pleural effusion cannot be excluded. At the time of observation and dictation, 8:24 a.m., the ___, the referring physician ___. ___ was paged for notification. " a667914c-325c0ae8-7f1a37c1-81aa25d4-3f0add5c.jpg,validate/p18/p18202111/s56740072/a667914c-325c0ae8-7f1a37c1-81aa25d4-3f0add5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with leukocytosis TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ chest radiograph and ___ chest CT FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Nodular opacities within the lingula and left lower lobe are similar in appearance when compared to the prior chest radiograph accounting for differences in technique. Additional patchy opacity within the left lung base is not significantly changed in the interval, and may reflect a combination of atelectasis and or scarring. No new focal consolidation, pleural effusion or pneumothorax is identified. Percutaneous gastrostomy catheter is partially imaged. IMPRESSION: Relatively similar appearance of left basilar rheumatoid nodules. No new focal consolidation identified. " 7e7cbd10-f4b93082-aff10eba-3940f73d-99e7d317.jpg,validate/p17/p17173704/s59244583/7e7cbd10-f4b93082-aff10eba-3940f73d-99e7d317.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with cough and scattered rhonchi, evaluate for pneumonia. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is within normal limits. No typical configurational abnormalities identified. The thoracic aorta is mildly widened and elongated but no local contour abnormalities or wall calcifications are seen. No mediastinal abnormalities are identified. 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 can be identified on the frontal view. Comparison is made with two previous chest examinations dated ___ and ___. There are no new pulmonary abnormalities. The heart size is stable. Mild widening and elongation of the thoracic aorta existed already earlier and is unchanged. IMPRESSION: Stable chest findings, no evidence of acute infiltrates. " 2ff65b57-a6b9c973-bcce629b-268f2927-e04b1c46.jpg,validate/p18/p18911407/s56458162/2ff65b57-a6b9c973-bcce629b-268f2927-e04b1c46.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with cough, fevers // pneumonia?pre-op TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: The lungs are relatively well inflated, with bibasilar atelectasis. Biapical pleural thickening is again noted. The cardiomediastinal silhouette is unremarkable. There is no focal consolidation concerning for pneumonia. No pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 67f8ebd8-3b20fab7-4958aedf-a2d25104-ae96a6d3.jpg,validate/p14/p14916430/s57990847/67f8ebd8-3b20fab7-4958aedf-a2d25104-ae96a6d3.jpg,validation," WET READ: ___ ___ ___ 9:22 PM Cardiomegaly with central pulmonary vascular congestion. Mild edema. Persistent left retrocardiac opacity likely reflecting severe atelectasis but underlying infection cannot be excluded. Unchanged small bilateral pleural effusions. ______________________________________________________________________________ FINAL REPORT AP CHEST 5:36 P.M. ___ HISTORY: ___-year-old woman with alcoholic hepatitis, increasing white count and pleural effusion. IMPRESSION: AP chest compared to ___: Severe consolidation at the base of the left lung which worsened from ___ to ___ has not cleared. Could be either persistent lobar collapse or pneumonia. Moderate to severe cardiomegaly and mediastinal and pulmonary vascular engorgement indicate persistent cardiac decompensation, but there is no pulmonary edema. An ___-mm wide elliptical opacity projecting over the right mid lung and the seventh posterior rib could be a new, acute lung nodule, as such infectious. Feeding tube is looped in the upper stomach, which is moderately distended with air and fluid. " 6bfe69d7-3a29768c-be0594e7-4eab8e43-6aacb6ab.jpg,validate/p18/p18978545/s51948948/6bfe69d7-3a29768c-be0594e7-4eab8e43-6aacb6ab.jpg,validation," FINAL REPORT CLINICAL HISTORY: Smoking history, weight loss. CHEST The heart and mediastinum are normal. The lung fields are clear. Costophrenic angles are sharp. No lung masses are identified. IMPRESSION: Chest clear. " f95cf278-cda30cc1-b6a46b22-bd66dc2d-ca10a23b.jpg,validate/p14/p14244279/s52166465/f95cf278-cda30cc1-b6a46b22-bd66dc2d-ca10a23b.jpg,validation," FINAL REPORT INDICATION: ___M with chest pressure, dyspnea // Evaluate for penumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is stable. Tortuosity of the descending thoracic aorta is again noted. Anterior cervical fixation hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " de37590d-4e509fe1-0b405bad-e681503c-7d7dce95.jpg,validate/p13/p13180695/s51339045/de37590d-4e509fe1-0b405bad-e681503c-7d7dce95.jpg,validation," FINAL REPORT INDICATION: ___F with stemi, fever // ? pna COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: The heart is mildly enlarged and there are prominent mitral annular calcifications. Prominent soft tissue density abuts the upper right mediastinum. Small hazy opacity is present in the left lung base. Coarse interstitial lung markings appear chronic. No pleural effusion or pneumothorax. Distal right clavicle fracture appears chronic. IMPRESSION: 1. Small left base opacity may represent pneumonia or aspiration. 2. Prominent soft tissue density abutting the upper right mediastinum may represent tortuosity of vessels or thyroid lesion. A paramediastinal mass is thought less likely. Additional imaging may be obtained as clinically warranted. 3. Mild cardiomegaly. " 5091e9e6-2f9c6245-3333766b-6d3dbeaa-88a2d67d.jpg,validate/p15/p15937283/s52911499/5091e9e6-2f9c6245-3333766b-6d3dbeaa-88a2d67d.jpg,validation," FINAL REPORT HISTORY: Weakness and hypotension, assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are somewhat low in volume with right lower lung opacity, slightly less conspicuous than the prior study. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are unchanged with multiple coronary stents noted. IMPRESSION: Slightly decreased conspicuity of right lower lung opacity, which again likely reflects atelectasis, though infection remains a consideration. " 584f18ec-1c6605a8-5ea3aa51-0db860d3-1bd8d908.jpg,validate/p10/p10161112/s53763289/584f18ec-1c6605a8-5ea3aa51-0db860d3-1bd8d908.jpg,validation," FINAL REPORT HISTORY: Female status post left upper lobe sleeve lobectomy. Assess for interval change. COMPARISON: Chest radiograph ___; ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Stable subcutaneous emphysema. Persistent left fluidopneumothorax with stable small pneumothorax and moderate interval increase in left-sided fluid. No signs of tension. Right lung is fully expanded and clear without pleural effusion or pneumothorax. Heart size is obscured by fluid. Right mediastinal contour and hila are normal. No bony abnormality. IMPRESSION: Left fluidopneumothorax with stable small pneumothorax and moderate interval increase in fluid. No radiographic evidence of tension. Results were conveyed via telephone to Dr. ___ by Dr. ___ on ___ at 11 a.m. within 15 minutes of observation of findings. " 31090045-27bdf65e-a66ecdbe-c1a3eff0-41dea32d.jpg,validate/p10/p10305417/s54244448/31090045-27bdf65e-a66ecdbe-c1a3eff0-41dea32d.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Rear-ended MVC, complaining of 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. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. " e940b8d9-877d4a66-c6c9a2c2-1575f126-960cf778.jpg,validate/p15/p15672432/s50496862/e940b8d9-877d4a66-c6c9a2c2-1575f126-960cf778.jpg,validation," 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. " d51178db-8e5d5f75-8afb61a9-021839a4-3397dcd5.jpg,validate/p18/p18719447/s55897404/d51178db-8e5d5f75-8afb61a9-021839a4-3397dcd5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p multiple R VATS wedge resections, s/p chest tube pull // eval for interval change, perform exam 2:30 pm COMPARISON: ___, 10:57 IMPRESSION: As compared to the previous radiograph, the right chest tube has been removed. There is no evidence for pneumothorax. Postoperative atelectasis at the right lung bases persist. The right Port-A-Cath is in unchanged position. Unchanged appearance of the left lung and of the cardiac silhouette. " ba1e5ed2-4d9949da-bf37197c-79c279d1-cc487f32.jpg,validate/p18/p18103848/s51581524/ba1e5ed2-4d9949da-bf37197c-79c279d1-cc487f32.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SOB and desats on being supine // Assess for resolution of pulmonary edema, Assess for resolution of pulmonary edema, IMPRESSION: Compared to prior chest radiographs ___ through ___. Moderately severe pulmonary edema has improved in the right lung, not in the left. Moderate cardiomegaly stable. Small moderate bilateral pleural effusions are unchanged. No pneumothorax per Right PIC line has been repositioned or replaced and now ends in the mid SVC. " 1844bf7a-2015050f-7d6f389a-df292f11-d8d2d7a4.jpg,validate/p11/p11862800/s56748204/1844bf7a-2015050f-7d6f389a-df292f11-d8d2d7a4.jpg,validation," WET READ: ___ ___ 11:02 PM IMPRESSION: 1. No evidence of acute disease including no evidence for pleural effusion. 2. Soft tissue density in the lower mediastinum suspected to represent a hiatal hernia but not entirely characterized; it is difficult to exclude an aneurysm. If more remote prior radiographs are not available to show stability of this appearance, then characterization should be considered with chest CT when clinically appropriate. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH HISTORY: Question pleural effusion on the left. COMPARISONS: Earlier radiographs from the same day. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is mildly enlarged. The patient is status post coronary artery bypass graft surgery. The aortic arch is calcified. There is again an expansile soft tissue opacity along the lower mediastinum immediately above the thoracic inlet. Mild to moderate relative elevation of the right hemidiaphragm compared to the left is noted. There is no evidence for pleural effusion or pneumothorax. The lungs appear clear. The bones are probably demineralized to some degree. IMPRESSION: 1. No evidence of acute disease including no evidence for pleural effusion. 2. Soft tissue density in the lower mediastinum suspected to represent a hiatal hernia but not entirely characterized; it is difficult to exclude an aneurysm. If more remote prior radiographs are not available to show stability of this appearance, then characterization should be considered with chest CT when clinically appropriate. " 35d9f1f6-b2fc2328-84cc3335-89adf41a-64c9a939.jpg,validate/p13/p13730797/s50216000/35d9f1f6-b2fc2328-84cc3335-89adf41a-64c9a939.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG // predischarge eval COMPARISON: Chest x-ray from ___ at 12:46 FINDINGS: Status post sternotomy. Mild prominence the cardiomediastinal silhouette is unchanged and compatible with recent surgery. There is continued s patchy retrocardiac opacity, consistent with left lower lobe collapse and/or consolidation, with slight elevation left hemidiaphragm and a small left effusion, all similar to the prior film. There is focal opacity in the right cardiophrenic region, likely in the right lower lobe posteriorly. No gross right effusion. No CHF. There is thin linear density at the extreme upper left lung apex, though it does not follow the usual curvilinear course the lung this typically seen with a small pneumothorax . IMPRESSION: 1. Left lower lobe collapse and/or consolidation and small left effusion is unchanged. 2. Focal opacity in the right cardiophrenic region, likely in the right lower lobe is more pronounced on the current examination. While this may represent atelectasis, in the appropriate clinical setting, the differential diagnosis could include a focal infiltrate. 3. Density at left lung apex, equivocal for tiny pneumothorax. Clinical correlation is requested. If clinically indicated, a repeat frontal view of the chest, taken at end-expiration of the respiratory cycle may help for further assessment. " b0baaeb8-625d489d-89c7e14e-04105805-3909a298.jpg,validate/p11/p11494804/s50477897/b0baaeb8-625d489d-89c7e14e-04105805-3909a298.jpg,validation," FINAL REPORT INDICATION: ___M with fever, tachy // PNA? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Prior right PICC is no longer seen. There are small bilateral pleural effusions. Low lung volumes are seen with crowding of the bronchovascular markings however there is no superimposed consolidation. The cardiomediastinal silhouette is within normal limits. Hypertrophic changes noted in the spine. Multiple presumably biliary stents are identified as well as surgical clips in the abdomen. IMPRESSION: Small bilateral pleural effusions. No superimposed consolidation. " a76dd204-132e7b55-aa3d3792-a8f7205d-c0305f8b.jpg,validate/p17/p17979567/s59187891/a76dd204-132e7b55-aa3d3792-a8f7205d-c0305f8b.jpg,validation," FINAL REPORT AP CHEST, 10:36 A.M., ___. HISTORY: ___-year-old man after NG tube placement. IMPRESSION: AP chest compared to ___: Examination centered in the low mediastinum excludes the lung apices. Shows an upper enteric drainage tube ending in the stomach, clear lower lungs, normal heart size, and no appreciable pleural effusion. " d9836ba2-3a35f2a0-3da0fd1f-0b156d46-ab609224.jpg,validate/p11/p11366266/s57480176/d9836ba2-3a35f2a0-3da0fd1f-0b156d46-ab609224.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p ___'s, SBR, now with increased SOB // compare to prior chest x-rays for interval change compare to prior chest x-rays for interval change IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal or mildly enlarged with pulmonary vascular congestion. Little change in the residual opacification in the upper zones. Blunting of the costophrenic angles is noted. Central catheter is in unchanged position. There is an impression on the lower cervical trachea on the right, which could represent a thyroid mass. " cbcf8e21-b6663d20-435ad044-2302b89c-fd39b153.jpg,validate/p11/p11595727/s51032545/cbcf8e21-b6663d20-435ad044-2302b89c-fd39b153.jpg,validation," FINAL REPORT INDICATION: ___F with left arm pain/swelling, evaluate for mass.. 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. There is no evidence of an apical mass. IMPRESSION: Normal chest radiograph. No evidence of an apical mass. " 50521ce0-62fd51d4-7faab450-6c7ed300-220e2049.jpg,validate/p10/p10027957/s59195693/50521ce0-62fd51d4-7faab450-6c7ed300-220e2049.jpg,validation," FINAL REPORT INDICATION: ___F with sepsis, neck stiffness // eval ? PNA TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without consolidation, effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " f86445ea-4d897df0-b2f92870-39ae34ab-1a4646d7.jpg,validate/p15/p15974937/s50032807/f86445ea-4d897df0-b2f92870-39ae34ab-1a4646d7.jpg,validation," FINAL REPORT INDICATION: Right-sided chest pain. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, which accentuate bronchovascular markings. There is no pleural effusion or pneumothorax. Subtle lung base opacities are noted. Remoted left sided rib fractures are redemonstrated. IMPRESSION: Subtle lung base opacities may represent atelectasis, developing infection not excluded in the appropriate clinical setting. " 8c0fe065-c9d284f1-9d80b5f4-03ee4c05-43f8e6ab.jpg,validate/p18/p18388773/s55499928/8c0fe065-c9d284f1-9d80b5f4-03ee4c05-43f8e6ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M s/p MVC, high speed Tbone with central C-spine, t-spine TTP, mild chest TTP // eval ? traumatic injury TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lordotic positioning. Slightly low inspiratory volumes. The heart is not enlarged. Aorta is slightly unfolded. There is mild patchy opacity at the left base, which could represent atelectasis or early changes due to aspiration. Otherwise, no focal infiltrate identified. No CHF, effusion, or pneumothorax detected. Mild irregularity of the right second rib laterally is noted, but could represent an old injury. Otherwise, visualized ribs are grossly unremarkable. Note is made of nonvisualization of the supraclavicular companion shadow as well as soft tissue opacity in the adjoining fat. IMPRESSION: Small patchy opacity at the left lung base, question atelectasis or focus of aspiration. Mild irregularity of the right second rib laterally. Unless there is focal tenderness in this area, this likely represents an old, healed fracture. Otherwise, no acute pulmonary process identified. Mild unfolding of the aorta noted. Opacity in the left supraclavicular fat and effacement of the left clavicular companion shadow. Correlation with physical exam to exclude supraclavicular lymphadenopathy or other soft tissue mass cannot location is requested. Please note that this examination is not adequate for evaluation of the cervical or thoracic spine. In addition, correlation with specific sites of chest wall tenderness may also be helpful for assessment. RECOMMENDATION(S): Opacity in the left supraclavicular fat and effacement of the left clavicular companion shadow. Correlation with physical exam to exclude supraclavicular lymphadenopathy or other soft tissue mass cannot location is requested. " 4d143add-ca8c732b-8a510649-ed442d67-09393a21.jpg,validate/p19/p19244907/s53000725/4d143add-ca8c732b-8a510649-ed442d67-09393a21.jpg,validation," FINAL REPORT INDICATION: ___F with ?infection // evidence of pneumonia . COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE PA and lateral view of the chest. FINDINGS: Cardiomediastinal silhouette is within normal limits. No CHF, focal infiltrate, pleural effusion, or pneumothorax is detected. There is no pleural effusion or pneumothorax. Hazy density over both lower lungs relates to the patient's bilateral breast prostheses. The upper portion of an IVC filter and question a balloon from a G-tube are noted. Compared with ___, the tracheostomy tube and left subclavian PICC line have been removed. The previously seen left base left lung base opacity has resolved. IMPRESSION: No evidence of pneumonia. " d5e1c59e-57269948-e6eb4ff0-e6210aea-14dd035e.jpg,validate/p17/p17992323/s50689561/d5e1c59e-57269948-e6eb4ff0-e6210aea-14dd035e.jpg,validation," FINAL REPORT INDICATION: History: ___M with severe n/v/d, TTP with guarding in ruq and b/l lq pls eval for appy and cholecys and panc // History: ___M with severe n/v/d, TTP with guarding in ruq and b/l lq pls eval for appy and cholecys and panc TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are hyperinflated and demonstrate mild interstitial changes raises which raises concern for emphysema. No focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. There is no free air beneath the hemidiaphragms. IMPRESSION: No acute intrathoracic process. Hyperinflated lungs with associated mild interstitial changes is concerning for emphysema. No intra-abdominal free air. " 97fc304b-1239e3fc-97ae2751-8bf39574-990cbb03.jpg,validate/p11/p11214611/s52654828/97fc304b-1239e3fc-97ae2751-8bf39574-990cbb03.jpg,validation," FINAL REPORT INDICATION: ___ year old man with esophageal adenocarcinoma, here with worsening dysphagia // R/o pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: No recent prior radiographs FINDINGS: Right-sided prepectoral Port-A-Cath in situ with the tip seen in the distal SVC. Evidence of previous gastric pull-through. Air-fluid level seen in the distal stomach (intrathoracic). The density projecting over the lower vertebral bodies is presumed to be a fluid-filled stomach. There is attenuation of the cervical esophagus with shift to the left in keeping with known peritracheal adenopathy. Widening of the right paratracheal stripe in keeping with paratracheal adenopathy. Chronic, healed right-sided rib fractures. No airspace consolidation. No pleural effusions. No pulmonary edema. IMPRESSION: Attenuation of the cervical trachea secondary to peritracheal lymph nodes as known. No new areas of airspace consolidation to suggest pneumonia. This preliminary report was reviewed with Dr. ___, ___ radiologist. " b90143dd-2713f871-8904bcde-9136e6cc-abd9e104.jpg,validate/p11/p11018127/s52036210/b90143dd-2713f871-8904bcde-9136e6cc-abd9e104.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and phlegm // pneumonia? IMPRESSION: As compared to ___ radiograph, nonspecific left retrocardiac opacities have partially cleared. No new areas of consolidation are identified to suggest a new source of infection, but standard PA and lateral radiographs may be helpful for more complete assessment of the lungs if clinical suspicion for pneumonia persists. " cb47ee4c-76240b6a-49058587-6a9bfc1c-43a5d041.jpg,validate/p19/p19213525/s51882037/cb47ee4c-76240b6a-49058587-6a9bfc1c-43a5d041.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires are noted. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " ec4ac550-668f9a20-f8ebacf0-154039b5-abb2fea8.jpg,validate/p11/p11439189/s50775219/ec4ac550-668f9a20-f8ebacf0-154039b5-abb2fea8.jpg,validation," FINAL REPORT INDICATION: ___ year old man with new ETT. // ETT placement COMPARISON: Radiographs performed on ___ at 11:32. IMPRESSION: There is an endotracheal tube whose tip is 5 cm above the carina. There is a feeding tube whose side port is above the GE junction and this could be advanced 10 cm for more optimal placement. Heart size is within normal limits. There is a left retrocardiac opacity. There are bilateral pleural effusions. There is atelectasis at the lung bases. There is no overt pulmonary edema or pneumothoraces. " 191b4dc0-4c247fed-1da220d1-e4f4e2b3-0209692b.jpg,validate/p14/p14997223/s53846944/191b4dc0-4c247fed-1da220d1-e4f4e2b3-0209692b.jpg,validation," FINAL REPORT EXAM: Chest, AP semi-erect upright and lateral views. CLINICAL INFORMATION: ___-year-old female with shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. A feeding tube is seen coursing below the level of the diaphragm on the left, inferior aspect not seen. The patient is rotated slightly to the left. There is a large area of right-sided opacification likely representing combination of large right pleural effusion with possible overlying atelectasis, underlying consolidation not excluded. There is likely a small left pleural effusion. No new evidence of pneumothorax is seen. Cardiac silhouette is difficult to accurately assess due to the large right pleural effusion. IMPRESSION: 1. Large right pleural effusion with likely some degree of underlying atelectasis, underlying consolidation not excluded. Likely small left pleural effusion. 2. Feeding tube is seen coursing below the level of the diaphragm, although inferior aspect not visualized. " 9add5f1c-00fad956-44bc9a74-f5b20158-ed6e86f8.jpg,validate/p19/p19045978/s56350708/9add5f1c-00fad956-44bc9a74-f5b20158-ed6e86f8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Stroke, evaluation for pneumonia or other acute process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes remain low. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. No pneumonia. No pneumothorax. " 230cca02-9108adab-4528c795-ca315711-f274b8e3.jpg,validate/p16/p16421524/s56683350/230cca02-9108adab-4528c795-ca315711-f274b8e3.jpg,validation," WET READ: ___ ___ ___ 7:57 PM Stable small right apical pneumothorax. No other change. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with right PTX, s/p removal CT with recurrent PTX on post pull film. // ? interval change. Please do standing expiratory film. COMPARISON: ___, 14:59. IMPRESSION: As compared to the previous radiograph, the current expiratory film shows an unchanged dimension of the known right apical lateral pneumothorax. The diameter of the pneumothorax is approximately 1-2 cm. There is no evidence of tension. Unchanged appearance of the heart and the left lung. " 027969d1-f7d560b8-c8685425-e138b808-9762932d.jpg,validate/p11/p11614157/s59766269/027969d1-f7d560b8-c8685425-e138b808-9762932d.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient status post MVC, increased oxygen demands, on bed rest. FINDINGS: An AP single view of the chest has been obtained with patient in very recumbent position. Comparison is made with the portable supine chest examination ___ ___ performed in the department's emergency unit. The heart size remains unchanged. The appearance of the thoracic aorta is unremarkable. Again high positioned diaphragms indicative of poor inspiratory effort during examination. Crowded appearance of the pulmonary vasculature present. In addition, one has the impression of a plethora of the pulmonary vessels without evidence of perivascular haze or pleural effusion. This may be the result of patient's bed rest and post-trauma fluid treatment. Local discrete parenchymal infiltrates cannot be identified on this portable chest examination. If possible have repeat exam with standard views in PA and lateral projection with patient in upright position. This would be optimal to evaluate for possible pneumonic infiltrates. No pneumothorax is seen on this portable examination. " f1eb2e4e-f8c42508-31715abe-58a0ed7e-ca7cb00a.jpg,validate/p14/p14857506/s55134426/f1eb2e4e-f8c42508-31715abe-58a0ed7e-ca7cb00a.jpg,validation," WET READ: ___ ___ ___ 11:45 PM Dobhoff ends in stomach. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Dobbhoff tube. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a Dobbhoff tube. The course of the tube is unremarkable, the tip of the tube is projecting over the middle parts of the stomach. No evidence of complications, notably no pneumothorax. Otherwise, the radiograph is unchanged. " d23c7e80-f2fba825-0e21eb10-7448b340-c2ae3437.jpg,validate/p19/p19310285/s51905387/d23c7e80-f2fba825-0e21eb10-7448b340-c2ae3437.jpg,validation," FINAL REPORT HISTORY: ___-year-old man status post tracheal resection. Evaluate for interval change. COMPARISON: Multiple prior radiographs of the chest dated ___ through ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate well-expanded clear lungs. The mediastinal and hilar contours are unchanged. No pneumothorax, pleural effusion or consolidation. IMPRESSION: No pneumothorax. No acute cardiopulmonary process. " a12362ae-797ae841-6115e812-b709b6e7-9c2e30dc.jpg,validate/p18/p18828209/s53463984/a12362ae-797ae841-6115e812-b709b6e7-9c2e30dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ngt placement // comfirm ngt placement TECHNIQUE: Chest single view COMPARISON: ___. IMPRESSION: The NG tube tip is in the stomach with the proximal port at the GE junction. The large bore catheter with tip in the cavoatrial junction is unchanged. There is increased vascular plethora with patchy areas of alveolar infiltrate that have increased compared to prior the heart is globular in configuration the overall impression is that of increased CHF " 04993a82-00166bca-110f5ef9-bc440728-e9404b34.jpg,validate/p13/p13805536/s53372668/04993a82-00166bca-110f5ef9-bc440728-e9404b34.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with recent colonoscopy and BRBPR, syncope. Evaluate for acute cardiopulmonary process. TECHNIQUE: Single upright portable AP chest radiograph 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. Overlying EKG leads are present. IMPRESSION: No acute intrathoracic findings. " ed18c399-e286fc22-5f192076-89f502d9-3ef8f6e3.jpg,validate/p19/p19206717/s50304647/ed18c399-e286fc22-5f192076-89f502d9-3ef8f6e3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with COPD exacerbation, impending respiratory failure TECHNIQUE: Semi-upright AP view of the chest COMPARISON: CT trachea ___ and chest radiograph ___ FINDINGS: Heart size is mildly enlarged. Mediastinal and hilar contours appear unchanged with enlargement of the pulmonary arteries, better assessed on the previous CT, compatible with pulmonary arterial hypertension. There is upper zone vascular redistribution without overt pulmonary edema. Chronic interstitial opacities are again noted predominantly along the periphery and lung bases with bronchiectasis also noted in the lower lobes. Patchy ill-defined opacities are re- demonstrated in both lower lung fields as well as within the upper lobes bilaterally, more so on the right. Overall, the findings within the left lung base and left upper lobe appear minimally improved, with the opacities in the right lung base perhaps slightly worse. Small bilateral pleural effusions are likely present. No pneumothorax is demonstrated. Remote left-sided rib rib fractures are again seen. IMPRESSION: Patchy ill-defined opacities within both upper lobes, more so on the right, as well as within both lung bases, findings concerning for superimposed infection on a background of chronic interstitial abnormality and bronchiectasis. Small bilateral pleural effusions. " 41e7f685-fe36fb26-b7ccbef4-4a75fe1e-2b65cdbf.jpg,validate/p18/p18754895/s56892167/41e7f685-fe36fb26-b7ccbef4-4a75fe1e-2b65cdbf.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough. COMPARISONS: ___. FINDINGS: PA and lateral chest radiographs were obtained and slightly limited by body habitus. The lungs are well inflated and clear. No focal consolidation, effusion, pneumothorax is present. The cardiac and mediastinal contours are normal. The right hemidiaphragm remains higher than the left. IMPRESSION: No acute cardiopulmonary process. " 715937c3-1aed6e28-cfcd5598-7eada8f2-c5019053.jpg,validate/p18/p18283471/s59274481/715937c3-1aed6e28-cfcd5598-7eada8f2-c5019053.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: Portable AP chest radiograph, ___. INDICATION: ___-year-old with cough and fevers. FINDINGS: PA and lateral chest radiographs were obtained for this exam. Direct comparison was made to the immediate preceding film on ___. Cardiac size is normal. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is crowded vasculature with perivascular densities in the left lower lung zone. IMPRESSION: Left lower lung zone perivascular densities. In the appropriate clinical setting this is consistent with a bronchopneumonic infection. Recommend followup in two weeks after treatment to document resolution. " 827f96fc-f222a802-8513aad2-d19f56fe-d256c362.jpg,validate/p10/p10705688/s55025955/827f96fc-f222a802-8513aad2-d19f56fe-d256c362.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough. Evaluate for pneumonia. EXAMINATION: PA and lateral chest radiographs. COMPARISONS: ___ and ___. FINDINGS: Well-expanded lungs are clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal. There is mild marginal spurring involving the visualized thoracolumbar spine. IMPRESSION: No acute cardiopulmonary process. " 784f0c17-80ab63d4-7f6a424c-c71d4c56-e1c5a33c.jpg,validate/p12/p12061930/s50723970/784f0c17-80ab63d4-7f6a424c-c71d4c56-e1c5a33c.jpg,validation," 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. " b114093a-74a57f9c-0a07e582-4581b2cc-aa59922b.jpg,validate/p13/p13998587/s57377248/b114093a-74a57f9c-0a07e582-4581b2cc-aa59922b.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Intracranial hemorrhage. TECHNIQUE: Chest, AP and lateral. COMPARISON: CT from ___. 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. " 97bf7996-1ab34a30-b6d76339-f8ff80e8-432a2e6e.jpg,validate/p18/p18897036/s50445073/97bf7996-1ab34a30-b6d76339-f8ff80e8-432a2e6e.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever and cough. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The heart size is within normal limits. The mediastinal contours and hilar contours are normal. The lung volumes are slightly low with minimal basilar atelectasis, but there is no frank consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 0521bc2e-7040e8e2-94130dd1-f6dd4c99-f8854114.jpg,validate/p11/p11828962/s59880799/0521bc2e-7040e8e2-94130dd1-f6dd4c99-f8854114.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after discontinuation of ___ chest tubes on the left. AP and lateral radiographs of the chest were reviewed in comparison to ___. The left pleural effusion appears to be unchanged. There is no appreciable pneumothorax demonstrated. There is no evidence of right substantial pleural effusion or pneumothorax. The heart size and mediastinum are stable. Right PICC line tip is at the level of low SVC. " 57a2a4bb-f9cbac16-93c8460c-76e2ee36-3b62b5fd.jpg,validate/p15/p15154281/s58371143/57a2a4bb-f9cbac16-93c8460c-76e2ee36-3b62b5fd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. Comparison is made with a prior chest radiograph dated ___. CLINICAL HISTORY: Schizophrenia, currently reports of not feeling well, cloudy with increased somnolence and twitching, question pneumonia. FINDINGS: PA and lateral views of the chest are obtained. Low lung volumes somewhat limit evaluation. Likely mild atelectasis or bronchovascular crowding accounts for subtle opacities in the lower lungs. There is no definite sign of pneumonia, CHF, pleural effusion, or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. Subtle opacities in the lower lungs likely atelectasis or bronchovascular crowding. If needed, a repeat study with more optimized inspiratory effort may be performed to confirm. " 96e3f4eb-13f7dadb-65cc8cb1-4e4edc3c-52517eb5.jpg,validate/p19/p19296519/s50559017/96e3f4eb-13f7dadb-65cc8cb1-4e4edc3c-52517eb5.jpg,validation," 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. " 6907e2de-85cc5d3e-539c829e-bc55ac40-d58ca3cc.jpg,validate/p15/p15672432/s59624707/6907e2de-85cc5d3e-539c829e-bc55ac40-d58ca3cc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chf, hiv possible viremia with dyspnia and increased resp rate // Pneumonia? Edema? Pneumonia? Edema? COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lungs are mildly hyperinflated, but clear. Heart is normal size. Pulmonary vasculature is more distended today than on ___ probably in indication of borderline left ventricular left heart dysfunction, but there is no pulmonary edema, consolidation, or pleural effusion. No pneumothorax. " 831ec78e-4c654a68-ed0e1f5a-3906a38a-cc5bfdc0.jpg,validate/p14/p14420248/s53576842/831ec78e-4c654a68-ed0e1f5a-3906a38a-cc5bfdc0.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Asthma and latent tuberculosis. Persistent cough with blood. On dialysis. TECHNIQUE: Chest, AP and lateral. COMPARISON: ___. FINDINGS: A dialysis catheter has been removed. The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 99e1a1e4-dfe76a9c-7fe2953a-e4c6c820-b7168e1a.jpg,validate/p17/p17719829/s59004197/99e1a1e4-dfe76a9c-7fe2953a-e4c6c820-b7168e1a.jpg,validation," FINAL REPORT INDICATION: ___M with cough // eval pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 8537d664-0dbb489f-176568ea-7d7f95bb-34ecfec8.jpg,validate/p15/p15877600/s52667245/8537d664-0dbb489f-176568ea-7d7f95bb-34ecfec8.jpg,validation," FINAL REPORT INDICATION: Chest pain, here to evaluate for pneumonia or evidence of cardiomyopathy. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral upright 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. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The visualized upper abdomen is unremarkable. No displaced rib fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 2d602632-2976539c-8e870178-5094c535-f998c2fe.jpg,validate/p13/p13934074/s56740073/2d602632-2976539c-8e870178-5094c535-f998c2fe.jpg,validation," FINAL REPORT INDICATION: Chest and shoulder pain. COMPARISON: None available. FINDINGS: Frontal lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs. No focal consolidation, pleural effusion, or pneumothorax is seen. The visualized upper abdomen is unremarkable. IMPRESSION: Normal chest radiograph. " cf4db307-285b736d-0b9d2c6e-bda4cfd6-d4c243db.jpg,validate/p13/p13494098/s55625342/cf4db307-285b736d-0b9d2c6e-bda4cfd6-d4c243db.jpg,validation," 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. " 79ff04fa-87dcf9ae-691ab9df-9bef256d-eee46410.jpg,validate/p14/p14749066/s54821126/79ff04fa-87dcf9ae-691ab9df-9bef256d-eee46410.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Perihilar opacities are seen, raising concern for pulmonary edema. However, there are also increased opacities at the right perihilar and right infrahilar/right basilar regions, right greater than left, which could relate to fluid overload; however, superimposed multifocal infectious process is not excluded. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac silhouette is enlarged. There appears to be mild prominence of the main pulmonary artery which may be due to a component of underlying pulmonary hypertension. The aortic knob is calcified. IMPRESSION: Perihilar, infrahilar, and bibasilar opacities may be due to fluid overload, but superimposed multifocal infectious process is not excluded. Recommend repeat after diuresis. There may also be subtle opacity at the right upper lobe. Enlarged cardiomediastinal silhouette. " 3e6bf777-34314795-325169af-c7748acf-c4fc2c78.jpg,validate/p12/p12551724/s50968591/3e6bf777-34314795-325169af-c7748acf-c4fc2c78.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy and CABG. Mild enlargement of the cardiac silhouette is unchanged. The aortic knob is calcified. Mediastinal and hilar contours are similar. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. Moderate degenerative changes are seen within the thoracic spine peer IMPRESSION: No acute cardiopulmonary abnormality. " f7d140ae-11b44bf4-ce0ec2db-bf059369-9c7f893a.jpg,validate/p15/p15003878/s55982972/f7d140ae-11b44bf4-ce0ec2db-bf059369-9c7f893a.jpg,validation," FINAL REPORT INDICATION: Status post surgery, intubated, please evaluate for pneumothorax. COMPARISON: Chest radiograph and CT torso on ___. FINDINGS: One portable semi-erect AP view of the chest. Compared to most recent chest radiograph, the mediastinum is more widened. Given the patient's manubrium fracture, this is concerning for a mediastinal bleed. Endotracheal tube ends 5 cm from the carina. There are low lung volumes and new right mid lung linear opacity probably representing atelectasis. No evidence of pneumonia. No pleural effusions. No pneumothorax. Increased vascular congestion. IMPRESSION: 1. Increased widening of mediastinum is concerning for mediastinal bleed given the patient's history of trauma and manubrium fracture. 2. New right mid lung atelectasis. These findings were discussed with Dr. ___ ___ at 1 p.m. on ___ by telephone. " 8dddabcb-43db2d6c-262b76b1-2eb4f6a8-412fba56.jpg,validate/p11/p11877234/s56384134/8dddabcb-43db2d6c-262b76b1-2eb4f6a8-412fba56.jpg,validation," FINAL REPORT INDICATION: Chest pain and shortness of breath. COMPARISONS: Chest radiograph ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The lungs are hyperinflated, consistent with a history of COPD. Enlargement of the cardiac silouhette is stable. Atherosclerotic calcifications are noted in the aortic arch. An implanted AICD is unchanged in position. A compression deformity in the lower thoracic spine is also unchanged in appearance. No new compression deformities are noted. IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable hyperinflation, consistent with COPD. " 2d378a11-795b6c96-e0cabc86-0d58be75-b7cdb4de.jpg,validate/p17/p17061894/s56196709/2d378a11-795b6c96-e0cabc86-0d58be75-b7cdb4de.jpg,validation," FINAL REPORT INDICATION: ___F with cough // eval for infiltrate TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: The lungs are well expanded and clear where not obscured by overlying leads. The cardiomediastinal silhouette is within normal limits. Mild atherosclerotic calcifications seen at the aortic arch. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 7914556a-264969c7-ad68ea70-37afac59-fc324c1a.jpg,validate/p15/p15227491/s58097290/7914556a-264969c7-ad68ea70-37afac59-fc324c1a.jpg,validation," WET READ: ___ ___ 10:37 AM ET tube has been withdrawn and now ends 3.1 cm above the carina. Otherwise there is no significant change from prior. WET READ VERSION #1 ___ ___ 7:39 PM ET tube has been withdrawn and now ends 3.1 cm above the carina. Otherwise there is no significant change from prior. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___F s/p colonoscopy complicated by perforation, s/p ex lap with right hemicolectomy with primary anastamosis, also found to have colovaginal vistula, unable to be extubated due to sedation. Now Extubated s/p neg ex lap // eval ET tube COMPARISON: Chest radiographs ___ through ___ at 15:51. IMPRESSION: Large bilateral pleural effusions, right greater than left, increased since ___:51. Endotracheal tube has been withdrawn, now in standard placement. Left lower lobe has been collapse for several days. Right lower lobe collapse is presumed. Heart is at least moderately enlarged. Mild pulmonary edema is probably present, but exaggerated by overlying pleural effusion. No pneumothorax. " 6c358567-2da853ca-497719fa-02435563-b7df96db.jpg,validate/p14/p14947837/s53512432/6c358567-2da853ca-497719fa-02435563-b7df96db.jpg,validation," FINAL REPORT INDICATION: Clearance for MRI. Question of pulmonary stent. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. There is no radiopaque stent seen. IMPRESSION: No acute cardiopulmonary process. No radiopaque stent seen. " 7d6dcf8b-14a8c820-6cd24188-ac60aa05-dea5d3cc.jpg,validate/p14/p14717200/s57922163/7d6dcf8b-14a8c820-6cd24188-ac60aa05-dea5d3cc.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: NG tube placement. REFERENCE EXAM: ___ at ___. FINDINGS: The ET tube continues to be slightly high, at the thoracic inlet. NG tube tip is off the film, at least in the stomach. There continue to be low lung volumes with pulmonary vascular re-distribution. There are new/increased opacities in both lower lungs. While this could be due to volume loss, early infiltrate cannot be excluded. " 8e356ed6-d5b88256-bf5a4f53-36d19069-3b956797.jpg,validate/p14/p14729260/s55045804/8e356ed6-d5b88256-bf5a4f53-36d19069-3b956797.jpg,validation," FINAL REPORT AP CHEST, 4:09 P.M., ___ HISTORY: A ___-year-old woman here for an allograft transplant, now has worsening lower extremity edema and acute dyspnea. IMPRESSION: AP chest compared to ___: Moderate cardiomegaly has improved, and previous pulmonary edema has resolved. Mediastinal caliber is normal, and the mild dilatation of upper lobe pulmonary vasculature is less pronounced. All findings point to improved cardiac function. A supraclavicular dual-channel dialysis catheter ends in the right atrium. If there is a bilateral lower extremity edema, the explanation might lie in the inferior vena cava or both femoral veins. " 86b30a0d-54904a7c-0b4a29f9-3b950034-79b5d4d8.jpg,validate/p10/p10033552/s56492208/86b30a0d-54904a7c-0b4a29f9-3b950034-79b5d4d8.jpg,validation," FINAL REPORT HISTORY: ___-year-old female postop day #1 from appendicitis, now with fevers. COMPARISON: Chest radiograph dated ___. FINDINGS: Upright AP and lateral radiographs of the chest show perihilar fullness and prominent indistinct vascularity most suggestive of mild to moderate pulmonary edema. No focal consolidation is identified convincing for pneumonia. There is no pleural effusion or pneumothorax. The cardiac, mediastinal and hilar contours appear stable. IMPRESSION: Findings suggesting pulmonary edema. No focal consolidation convincing for pneumonia. " c5a96845-8c653257-8ac55ae3-a6d1a9fb-b1ecea3f.jpg,validate/p14/p14419091/s53739862/c5a96845-8c653257-8ac55ae3-a6d1a9fb-b1ecea3f.jpg,validation," WET READ: ___ ___ 7:37 PM No acute cardiopulmonary process. Nodular opacity projecting over the anterior right fifth rib, potentially within the bone or lung parenchyma. Shallow oblique should be performed to further localize. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with new afib, now resolved // acute process? TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear of consolidation, large effusion, or vascular congestion. There is a somewhat nodular opacity projecting over the anterior right fifth rib. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted within the aortic arch. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. Nodular opacity projecting over the anterior right fifth rib, potentially within the bone or lung parenchyma. Shallow oblique should be performed to further localize. " 9790840e-cabbc08f-140234f0-2250015d-882b73d3.jpg,validate/p16/p16312465/s50690069/9790840e-cabbc08f-140234f0-2250015d-882b73d3.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with multiple myeloma, baseline examination for clinical trial. 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 remains unchanged and is within normal limits. No configurational abnormality is identified. Thoracic aorta unchanged and within normal limits. A right-sided Port-A-Cath system exists as before seen to terminate in the mid portion of the SVC. No pneumothorax is present. The pulmonary vasculature is not congested. No evidence of acute pulmonary infiltrates is present, and the pleural sinuses are free. No pneumothorax in the apical area. IMPRESSION: Stable chest findings. No evidence of cardiac enlargement, pulmonary congestion, or acute infiltrates. " aeab07ab-6cc40bfb-d6924157-03d33e21-2e7227a0.jpg,validate/p17/p17770586/s56315582/aeab07ab-6cc40bfb-d6924157-03d33e21-2e7227a0.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with rad/median nerve sx on L // acute process, 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. " ec2ca2fe-178891b9-59dd748c-6f690c14-8f03b071.jpg,validate/p14/p14611780/s51341881/ec2ca2fe-178891b9-59dd748c-6f690c14-8f03b071.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath, pneumonia diagnosed at outside location 2 days ago per Dr. ___. COMPARISON: ___. TECHNIQUE: Frontal radiographs of the chest were obtained. FINDINGS: Pacer hardware overlies the left mid and lower chest, limiting evaluation of this region. No lateral view was obtained. Subtle hazy opacity is seen over the right mid lung. No pleural effusion or pneumothorax is detected on this frontal view. Dual-chamber pacer leads, mediastinal clips and sternal wires are seen. Cardiomegaly is again noted. IMPRESSION: Persistent cardiomegaly with hazy opacity in the right mid lung, concerning for pneumonia. " e6ef9444-74f2bf2c-7d0b7e4c-496f0d42-5ceba025.jpg,validate/p16/p16620451/s59248466/e6ef9444-74f2bf2c-7d0b7e4c-496f0d42-5ceba025.jpg,validation," 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. " 5db3d7ed-43cac62a-ec9827e7-870d55c3-215d50da.jpg,validate/p10/p10532853/s59259138/5db3d7ed-43cac62a-ec9827e7-870d55c3-215d50da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis s/p VATS yesterday. // Interval change? Interval change? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Since ___ following tracheal extubation common aeration of both lung bases has worsened, presumably atelectasis. Right pneumothorax has almost resolved, apical and basal pleural drain still in place. Severe cardiomegaly is chronic and pulmonary vasculature is engorged, but there is no edema. " 2c82e111-fe0b4fd8-d2a25c06-ad776381-0b8740b9.jpg,validate/p16/p16403386/s52750447/2c82e111-fe0b4fd8-d2a25c06-ad776381-0b8740b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman, intubated, possible history of aspiration, thick secretions // please assess for evidence of aspiration or consolidation TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: The ET tube is 3.7 cm above the Carina. NG tube tip is in the stomach. Lung volumes are slightly low. There is slight increase in interstitial markings with possible early infiltrate in the right lower lobe and right upper lobe the right-sided infiltrates have increased compared to prior IMPRESSION: Possible early infiltrates on the right. Recommend followup " 66af4bcd-cc162b97-84f7ddfe-8b6731b0-86dfc85a.jpg,validate/p14/p14014950/s57361332/66af4bcd-cc162b97-84f7ddfe-8b6731b0-86dfc85a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mv repair // r/o inf, eff r/o inf, eff IMPRESSION: In comparison with the study of ___, the right IJ sheath has been removed. Little overall change in the appearance of the heart and lungs with large pleural effusions, more prominent on the left, vascular congestion, and cardiomegaly. There may be slight decrease in the right pneumothorax. " dfedc9cc-2dcc2be5-14fb2252-0f857f44-1a2f01e6.jpg,validate/p15/p15003878/s59424963/dfedc9cc-2dcc2be5-14fb2252-0f857f44-1a2f01e6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post motor vehicle accident, difficult extubation. COMPARISON: ___, 5:53 a.m. FINDINGS: As compared to the previous radiograph, the patient has been extubated. In addition, the right chest tube has been removed. There is currently no evidence of pneumothorax. The lung volumes have slightly increased. Moderate cardiomegaly and bilateral areas of atelectasis, the presence of small bilateral pleural effusions cannot be excluded. No newly appeared opacities, no pneumonia, no pulmonary edema. " 32334f7a-86348329-44298472-9a8ae55a-7de120d5.jpg,validate/p17/p17339556/s57481441/32334f7a-86348329-44298472-9a8ae55a-7de120d5.jpg,validation," WET READ: ___ ___ ___ 10:59 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with epigastric and chest pain // Eval for acute CP process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiac silhouette and pulmonary vasculature are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. There is no free air below the diaphragm. Again seen is dextroscoliosis of the thoracic spine. IMPRESSION: No acute intrathoracic process. " f9f8a897-2346b998-6136c40b-44909523-e3257b27.jpg,validate/p17/p17894121/s54708616/f9f8a897-2346b998-6136c40b-44909523-e3257b27.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with tracheobronchomalacia and asthma, s/p renal transplant, with cough and shortness-of-breath, evaluate for pneumonia COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. In comparison to prior study, there is little change. Lungs are clear. Mild cardiomegaly is stable. Of note, the ___ and ___ sternotomy wires are fractured, but not displaced. IMPRESSION: No acute pneumonia. " a94d9831-a8166ef3-ef18ad55-c8682d23-30c35657.jpg,validate/p10/p10427568/s57132908/a94d9831-a8166ef3-ef18ad55-c8682d23-30c35657.jpg,validation," FINAL REPORT EXAMINATION: Radiograph. INDICATION: ___M with chest pain. Assess etiology appear 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 acute cardiopulmonary process. " f634995c-b384b7ec-e6c0c41c-13c5efea-4f29eb8c.jpg,validate/p12/p12379467/s50784904/f634995c-b384b7ec-e6c0c41c-13c5efea-4f29eb8c.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: The patient with history of non-Hodgkin's lymphoma and asthma, complaining of shortness of breath, wheezing, and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Right-sided Port-A-Cath is seen terminating in the mid-to-lower SVC. There is slight prominence of the interstitial markings bilaterally which may be due to minimal fluid overload. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Mild interstitial edema. " 4e24a9f5-4c314a43-62b58b7c-29f1bbf7-3fcb26a1.jpg,validate/p12/p12244625/s59717184/4e24a9f5-4c314a43-62b58b7c-29f1bbf7-3fcb26a1.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fall, striking the left occiput. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is normal. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. " eb2476eb-92fc9b7d-44aebf13-67d07277-64531ea2.jpg,validate/p19/p19028690/s55086195/eb2476eb-92fc9b7d-44aebf13-67d07277-64531ea2.jpg,validation," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Radiographs available from ___ and ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The patient is slightly rotated. The heart size is normal. The hilar and mediastinal contours are within normal limits. There has been interval increase in central pulmonary vessel prominence and interstial opacities, representing mild edema. Increased linear atelectasis at the left base is seen. There is no pneumothorax or large pleural effusion. No free intrabdominal air is detected on this upright study. IMPRESSION: Mild interstial edema. " bbba683c-db20673f-7fcce6e4-19eb42b4-0d11403d.jpg,validate/p18/p18866492/s50820319/bbba683c-db20673f-7fcce6e4-19eb42b4-0d11403d.jpg,validation," 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. " ef83808a-46609089-d7c03652-5cb57364-63ea02f6.jpg,validate/p15/p15510911/s50985208/ef83808a-46609089-d7c03652-5cb57364-63ea02f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F, PMH of anxiety/depression presenting after MVC versus tree sustaining multiple injuries, including C6-7 transverse process fracture associated with hematoma, right ICA dissection, bilateral PTX with extensive RUL pulmonary contusions/lacerations s/p bilateral pigtail placement, C7-T3 spinous process fractures, T1-6 transverse process fractures, right 2nd rib head fracture, IVH with layering in dependent ___ ventricle, liver I, IV, V lacerations, extensive R facial laceration s/p repair by Plastics and right mid clavicle fracture. // right chest tube to water seal-?pneumoright chest tube to water seal-?pneumoPLEASE DO AT NOON IMPRESSION: Comparison to ___. A millimetric left apical pneumothorax persists. The left pigtail catheter is in unchanged position. Stable position of the right pigtail catheter. Minimal retrocardiac atelectasis. No cardiomegaly. The other monitoring and support devices are in stable correct position. " 862db64c-30cc4c42-40e16508-1eacbb8d-d674d8c6.jpg,validate/p17/p17464246/s56086633/862db64c-30cc4c42-40e16508-1eacbb8d-d674d8c6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of melanoma // Please evaluate disease status Please evaluate disease status IMPRESSION: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Specifically, no evidence of skeletal or pulmonary metastases. " 08197bb7-299b7e3b-22f3cf64-11ddb29e-7dbddc3d.jpg,validate/p13/p13742877/s54713399/08197bb7-299b7e3b-22f3cf64-11ddb29e-7dbddc3d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: New onset palpitations, question pneumonia. FINDINGS: PA and lateral views of the chest provided. The lungs are hyperinflated. There is tiny nodular vague opacity in the right lung base which could represent a very early pneumonia. In addition, there is left basilar linear density which is stable and likely represents scarring. No effusion or pneumothorax is seen. There is no sign of CHF. The cardiomediastinal silhouette is stable with atherosclerotic calcification along the aortic knob. Bony structures are intact. IMPRESSION: Subtle nodular opacity in the right lung base is concerning for an early pneumonia. Recommend followup to resolution. Hyperinflated lungs likely reflect COPD. " 7750702d-1c707d39-b485179b-6dfa14bc-c5ba7a04.jpg,validate/p13/p13917981/s55930538/7750702d-1c707d39-b485179b-6dfa14bc-c5ba7a04.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain cough // 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. " a7ae4b37-151bba1f-da593275-15ee5895-6957a08d.jpg,validate/p17/p17445535/s56766207/a7ae4b37-151bba1f-da593275-15ee5895-6957a08d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with C.diff and DRESS syndrome with evolving leukocytosis // eval for PNA eval for PNA IMPRESSION: In comparison with the study of ___, there is little change. Again there are low lung volumes with elevation of the right hemidiaphragmatic contour. However, no acute pneumonia, vascular congestion, or pleural effusion. " c786e854-cd2ab441-7a0efb44-95d01c19-b6764d8b.jpg,validate/p15/p15485853/s51049365/c786e854-cd2ab441-7a0efb44-95d01c19-b6764d8b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with tracheobronchomalacia after stent removal with purulent secretions noted on bronchoscopy. AP radiograph of the chest was reviewed in comparison to ___. ET tube is in place with its tip terminating 3 cm above the carina. The right central venous line (Port-A-Cath catheter) terminates at the cavoatrial junction. Cardiomediastinal silhouette is unchanged with cardiomegaly and dilated mediastinum. Left basal opacity appears to be slightly more pronounced than on the prior study, concerning for progression of atelectasis or infectious process, especially given the provided history of purulent secretions. Right lower lung linear opacities are unchanged. The NG tube tip is in the stomach. " dfe0e835-824e81ee-65504031-f4573774-10657f37.jpg,validate/p12/p12559662/s50607742/dfe0e835-824e81ee-65504031-f4573774-10657f37.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with COPD and mental status change and cough and shortness of breath. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Lungs are hyperinflated but clear of focal consolidation or effusion. There is no pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Hyperinflation without acute cardiopulmonary process. " 5d5e1a8b-a3e8b921-3ae3a62f-61af15f9-d789425e.jpg,validate/p16/p16162271/s55474387/5d5e1a8b-a3e8b921-3ae3a62f-61af15f9-d789425e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Portable supine chest view was reviewed in comparison with prior chest radiographs through ___ to ___. A CT torso study from ___ was also concurrently reviewed. IMPRESSION: Large right upper lung mass-like consolidation, bulky right hilus and widened right paratracheal stripe from a known large lung mass and paratracheal and right hilar lymphadenopathy associated with postobstructive right upper lung atelectasis is unchanged. Mild right lower lung atelectasis is new. Left lower lung atelectasis is unchanged. Right-sided PICC line ends at lower SVC. Heart is normal. " db285784-927d476d-ad6b0fc9-388a7b6f-d7e74e2f.jpg,validate/p15/p15002645/s55499543/db285784-927d476d-ad6b0fc9-388a7b6f-d7e74e2f.jpg,validation," FINAL REPORT INDICATION: ___M with bipolar disorder p/w 4d SOB cough, and now several hours of CP // any evidence of pneumonia? any acute process? TECHNIQUE: PA and lateral views of the chest. ___. FINDINGS: The lungs remain clear. There is no consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 81c091f6-6e10c0d3-61370f57-5446deef-f2867bcd.jpg,validate/p13/p13225183/s53453083/81c091f6-6e10c0d3-61370f57-5446deef-f2867bcd.jpg,validation," FINAL REPORT HISTORY: Status post BiV pacemaker. Confirm lead placement. COMPARISON: ___. FINDINGS: AP and lateral radiographs of the chest demonstrate a newly placed left chest wall pacemaker with the leads terminating in the right ventricle and coronary sinus. Compared to the prior radiograph, there has been interval resolution of a right lower lobe pneumonia. The lung volumes are slightly decreased compared to the prior radiograph, and there is mild bibasilar atelectasis. The heart, mediastinal and hilar contours are normal. No pleural abnormality is detected. IMPRESSION: Interval placement of left chest wall pacemaker with leads in the right ventricle and coronary sinus. " f43a6997-33342776-88393462-601dc182-279050ae.jpg,validate/p13/p13224377/s56665830/f43a6997-33342776-88393462-601dc182-279050ae.jpg,validation," 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 ___. " eff25c86-8796bc21-7945d2fb-38727425-616ee3ec.jpg,validate/p19/p19826220/s54441429/eff25c86-8796bc21-7945d2fb-38727425-616ee3ec.jpg,validation," WET READ: ___ ___ 9:58 AM 1. Increased right perihilar micronodules may represent worsening sarcoid, however infection is also a possibility. 2. Increased bilateral hilar prominence consistent with lymphadenopathy. *** ED URGENT ATTENTION *** WET READ VERSION #1 ___ ___ ___ 2:51 AM 1. Increased right perihilar airspace opacification concerning for pneumonia. 2. Stable bilateral hilar prominence consistent lymphadenopathy. *** ED URGENT ATTENTION *** WET READ VERSION #2 ___ ___ 4:13 AM 1. Increased right perihilar airspace opacification concerning for pneumonia. 2. Stable bilateral hilar prominence consistent with lymphadenopathy. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with dyspnea. Evaluate for acute process. TECHNIQUE: Portable upright chest radiograph COMPARISON: ___ FINDINGS: There is again bilateral hilar enlargement, compatible with lymphadenopathy, which has worsened since the prior radiograph, more so in the right. Increasing micronodular opacities in the right upper and lower lung may represent worsening sarcoid, less likely superimposed pneumonia. Elevation of the right hemidiaphragm is unchanged. No large pleural effusion or pneumothorax. Heart size is normal. IMPRESSION: 1. Increased right perihilar micronodules may represent worsening sarcoid, however infection is also a possibility. 2. Increased bilateral hilar prominence consistent with lymphadenopathy. " 80652884-9fbda465-e8a5fcd1-29a29445-d11e8e4a.jpg,validate/p16/p16635089/s52806186/80652884-9fbda465-e8a5fcd1-29a29445-d11e8e4a.jpg,validation," FINAL REPORT INDICATION: History: ___F with fevers // eval pna TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Patient is rotated. Allowing for differences in technique, cardiomegaly and diffuse pulmonary vascular congestion is stable. There is no focal consolidation, large pleural effusion, or pneumothorax. IMPRESSION: Stable cardiomegaly and pulmonary vascular congestion. No evidence of pneumonia. " c9f299c9-7a4e782e-01e6e2e5-9eebb017-36f8a079.jpg,validate/p11/p11804719/s59685872/c9f299c9-7a4e782e-01e6e2e5-9eebb017-36f8a079.jpg,validation," 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. " ae584259-32842349-e6ff9abf-72c5fb65-47970178.jpg,validate/p13/p13053009/s59466311/ae584259-32842349-e6ff9abf-72c5fb65-47970178.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with > ___ years of chronic cough, former smoker // eval for infiltrates, parenchymal disease 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 " 25d1899e-a7fe6533-d9e09c06-676d8225-c184138c.jpg,validate/p10/p10933807/s55801454/25d1899e-a7fe6533-d9e09c06-676d8225-c184138c.jpg,validation," 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. " fb14218b-ff1056a4-9a4f87e5-374a7331-aadd452c.jpg,validate/p15/p15226778/s55420950/fb14218b-ff1056a4-9a4f87e5-374a7331-aadd452c.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with increasing cough, evaluate for pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiac, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 9da0c207-a0708e50-95ad4811-471596e3-12aa54e8.jpg,validate/p14/p14171423/s50117863/9da0c207-a0708e50-95ad4811-471596e3-12aa54e8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right lower lobe segmental PE // interval changes interval changes IMPRESSION: In comparison with the study of ___, there are improved lung volumes, but otherwise little change. Central catheter an pacer lead are in unchanged position. Continued enlargement of the cardiac silhouette with elevated pulmonary venous pressure. Bilateral pleural effusions with basilar atelectasis again seen. Little overall change in the patchy areas of opacification, especially in the right perihilar region, which have been attributed to consolidation. " 81a8cfa1-d306e5fb-5801b3a9-d797782b-fb9df60b.jpg,validate/p17/p17535980/s50261083/81a8cfa1-d306e5fb-5801b3a9-d797782b-fb9df60b.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cough. Question pneumonia. TECHNIQUE: Chest, AP upright and lateral. COMPARISON: ___. FINDINGS: Chin flexion obscures each medial lung apex. Lung volumes are low. Within the limitations of technique, the cardiac, mediastinal and hilar contours are probably within normal limits. There is no pleural effusion or pneumothorax. The visualized lung fields appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 6fb38af3-5b4aba2e-74fb6382-3d85bb79-0d647c64.jpg,validate/p18/p18719314/s56800126/6fb38af3-5b4aba2e-74fb6382-3d85bb79-0d647c64.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with massive PE, ARF, ileus. // Interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild-to-moderate cardiomegaly is a stable. Lines and tubes are in unchanged standard position. Diffuse bilateral opacities with largest consolidation in the right perihilar region are unchanged. There is no pneumothorax large pleural effusions Dobhoff tube tip isout of view, below the diaphragm. " 637ba177-b33b7ed7-2ba757a2-afbdf422-0ff29687.jpg,validate/p12/p12584492/s57633913/637ba177-b33b7ed7-2ba757a2-afbdf422-0ff29687.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG // eval for ptx - chest tube on water seal eval for ptx - chest tube on water seal IMPRESSION: In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. With the left chest tube on water seal, there is no evidence of pneumothorax. Retrocardiac opacification is consistent with some volume loss in the left lower lobe. Probable mild pneumomediastinum. The right lung is essentially clear. " 541636c3-18ecc8da-a3f6640d-9d83ea98-ccbdbe90.jpg,validate/p10/p10952156/s55116785/541636c3-18ecc8da-a3f6640d-9d83ea98-ccbdbe90.jpg,validation," FINAL REPORT HISTORY: Atrial fibrillation. TECHNIQUE: Supine AP view of the chest. COMPARISON: ___. FINDINGS: The right internal jugular central venous catheter tip terminates in the mid SVC. The lung volumes are low. The heart size remains moderately enlarged. The aorta is tortuous and calcified. Widening of the mediastinum is likely related to supine positioning and elevated venous pressures which is mild. There is no focal consolidation, large pleural effusion or large pneumothorax on this supine study. No acute osseous abnormalities detected. IMPRESSION: 1. Right internal jugular central venous catheter tip in the mid SVC. No large pneumothorax identified. 2. Elevated venous pressures. " d6267093-2106ea38-82b58420-1bc8916b-c14d1495.jpg,validate/p18/p18655830/s50008625/d6267093-2106ea38-82b58420-1bc8916b-c14d1495.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dm1, esrd, found to have severe cad, now planning cabg // preop for cabg, any acute process/infection? preop for cabg, any acute process/infection? IMPRESSION: In comparison with the study of ___, the cardiac silhouette is essentially within normal limits with no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " b08dee3d-64123370-78aeb9f3-dafdfc3d-4fe077be.jpg,validate/p16/p16342554/s53223503/b08dee3d-64123370-78aeb9f3-dafdfc3d-4fe077be.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with fall. COMPARISON: ___ and ___. FINDINGS: AP and lateral views of the chest. The lungs are clear without consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. There is a chronic mild compression deformity of the lower thoracic vertebral body. IMPRESSION: No acute cardiopulmonary process. " fdbb92a9-2c30e75c-a52eda33-d3583dc0-5cf4620a.jpg,validate/p17/p17679569/s54912756/fdbb92a9-2c30e75c-a52eda33-d3583dc0-5cf4620a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p tracheoplasty // interval change interval change IMPRESSION: In comparison with the study of ___, there is little overall change. Areas of atelectasis are again seen in the right mid zone with elevation of the right hemidiaphragmatic contour and probable small effusion. The left lung is clear. The PICC line again extends to the lower SVC and the cervical fusion device is seen. " 71e5fc40-aeaf34a1-9f7e9b31-5ee96d40-00167fe3.jpg,validate/p16/p16879269/s51210310/71e5fc40-aeaf34a1-9f7e9b31-5ee96d40-00167fe3.jpg,validation," 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. " 3a1c302c-c27b64f7-9ce1d41e-f63debc6-9420d78b.jpg,validate/p18/p18940953/s59710297/3a1c302c-c27b64f7-9ce1d41e-f63debc6-9420d78b.jpg,validation," FINAL REPORT CLINICAL HISTORY: Pre-op for above-knee amputation. Previous left below-knee amputation. History of diabetes, coronary artery disease. CHEST The heart is enlarged. Increased opacity is again noted in the left lower lobe, is now somewhat denser than it was on the prior chest x-ray and therefore pneumonic consolidation becomes more likely. Some failure is likely present. IMPRESSION: Increased densities right lower lobe possibly caused by pneumonia. " 9fa70e36-edc1c8f9-c259bdeb-54468918-37d5c837.jpg,validate/p18/p18456328/s56108157/9fa70e36-edc1c8f9-c259bdeb-54468918-37d5c837.jpg,validation," 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. " d8d8694e-17cc993b-b4f58913-b9e3fb88-1228c6c0.jpg,validate/p12/p12174157/s54722873/d8d8694e-17cc993b-b4f58913-b9e3fb88-1228c6c0.jpg,validation," 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. " 6a83b24c-67c3269a-c2c1b295-6bde13b8-b9bab43c.jpg,validate/p10/p10750092/s51178141/6a83b24c-67c3269a-c2c1b295-6bde13b8-b9bab43c.jpg,validation," FINAL REPORT AP CHEST, 10:36 P.M., ___ HISTORY: Tracheostomy and PEG. IMPRESSION: AP chest compared to ___, 5:37 a.m. There is a new tracheostomy tube, turned to the left, tip facing the left tracheal wall. There is no pneumothorax or mediastinal widening. Small right pleural effusion is new. Heart size is normal. Thoracic aorta is tortuous, but not focally dilated. Right subclavian line ends low in the SVC. " 1f2abd87-40721bfc-0c52357f-8ae1bed2-cb484431.jpg,validate/p14/p14359057/s53067344/1f2abd87-40721bfc-0c52357f-8ae1bed2-cb484431.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with urosepsis requring intubation // acute process acute process COMPARISON: Chest radiographs ___ through ___ at 20:06. IMPRESSION: Small to moderate left pleural effusion is slightly larger, explaining return of the mediastinum toward the midline. There is also still some atelectasis in the left lower lobe. Transient edema in the right lower lung has improved. Heart size is normal. ET tube and right subclavian line are in standard placements a nasogastric tube passes below the diaphragm and out of view. No pneumothorax. " 00ff741b-6cad0eed-8f0c4623-fd6499eb-51418e4e.jpg,validate/p15/p15219971/s55525501/00ff741b-6cad0eed-8f0c4623-fd6499eb-51418e4e.jpg,validation," FINAL REPORT INDICATION: Cough. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: Since the prior exam, the lung volumes are lower. With new increased interstitial markings at the bilateral bases, this may represent new interstitial lung disease. There is no focal consolidation. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Lower lung volumes and basilar interstitial opacities may represent new interstitial lung disease. Recommend further characterization with a high-resolution chest CT. Results were discussed with Dr. ___ at 4:30 PM on ___ via telephone by Dr. ___ ___ minutes after the findings were discovered. " 401c1107-62b1f29e-6939c5c8-a4c38021-fc5a12f5.jpg,validate/p14/p14010324/s58953249/401c1107-62b1f29e-6939c5c8-a4c38021-fc5a12f5.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with presyncope, volume overload // Eval for cardiopulmonary process 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. " 817412a0-5d8d1860-72ca1032-db562415-08ffffa6.jpg,validate/p15/p15649651/s52212827/817412a0-5d8d1860-72ca1032-db562415-08ffffa6.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Cough after right transbronchial biopsy. There is no evidence of pneumothorax or pleural effusion. Cardiac size is normal. There are innumerable small lung nodules, unchanged from prior study, ___. Minimal increase in density of the medial right lower lobe could be hemorrhage due to recent intervention. " aec68407-ba040f1f-520cca21-abb3e279-3928ef9e.jpg,validate/p17/p17427285/s52384570/aec68407-ba040f1f-520cca21-abb3e279-3928ef9e.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with pleural effusion // evaluate for pneumonia/infiltrate s/p thoracentesis.Can do CXR at ___ Am on ___ thanks TECHNIQUE: Chest PA and lateral COMPARISON: No prior study for comparison. FINDINGS: The medial right hemidiaphragm is obscured by a moderate sized right pleural effusion. There is homogeneous opacification of the lung parenchyma below the right minor fissure due to right middle and right lower lobe collapse. There is decreased vascularity of the right upper lung when compared to the left side. The right perihilar region also appears more full and this could represent a central mass compressing the right pulmonary vasculature and bronchi resulting in hypoperfusion of the right upper lung and collapse of the right middle and lower lobes. The left lung is well-expanded and there is increased vascularity of the left lower lung likely secondary to physiologic increase in left lung perfusion. The heart is normal sized. A left Port-A-Cath tip terminates in the upper right atrium. There is no pneumothorax seen. IMPRESSION: 1. Right middle and right lower lobe collapse could be due to an obstructing right hilar mass. Recommend follow-up chest CT with IV contrast for further evaluation. 2. Persistent moderate size right pleural effusion. 3. No complications nor pneumothorax status post thoracentesis RECOMMENDATION(S): Recommend follow-up chest CT with IV contrast for further evaluation of suspected right hilar mass. " 6e87c959-24dfa50c-d3d91e0a-70a0dfad-96865517.jpg,validate/p14/p14727722/s57049495/6e87c959-24dfa50c-d3d91e0a-70a0dfad-96865517.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with HIV and end-stage renal disease, severe diffuse abdominal pain. Evaluate for free air. COMPARISON: CT chest from ___ and chest radiograph from ___. CHEST, AP AND LATERAL: A hemodialysis catheter terminates at the cavoatrial junction. Mild cardiomegaly is unchanged. The aorta is tortuous and unfolded. There is increased prominence of the mediastinal silhouette, with distention of the azygos and central veins. No pleural effusions or pneumothorax. No free air under the diaphragm. IMPRESSION: 1. Mild volume overload. 2. No pneumoperitoneum. " 8f68ce7d-c1c09c23-1b282668-867b88f2-9f616933.jpg,validate/p12/p12788432/s54362559/8f68ce7d-c1c09c23-1b282668-867b88f2-9f616933.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a patient status post Type A aortic dissection repair. COMPARISON: Chest radiographs dating back to ___, most recently from ___. FINDINGS: A bedside AP radiograph of the chest demonstrates enlarging moderate bilateral pleural effusions and worsening bibasilar atelectasis. The lungs are otherwise clear. Mild enlargement of the cardiomediastinal contours is unchanged. There is no pneumothorax or pulmonary edema. The right internal jugular Swan-Ganz catheter sheath remains in place. The sternal cerclage wires are intact. IMPRESSION: Enlarging moderate bilateral pleural effusions and bibasilar atelectasis. " aa823b05-86948cc9-1c2ba865-71da2806-db2a5e0f.jpg,validate/p12/p12902491/s59831664/aa823b05-86948cc9-1c2ba865-71da2806-db2a5e0f.jpg,validation," FINAL REPORT INDICATION: Status post V-fib arrest with trach and PEG in place, here to evaluate position of lines and tubes. COMPARISON: No prior studies available. TECHNIQUE: Portable supine frontal radiograph of the chest. FINDINGS: A tracheostomy tube projects over the trachea in appropriate position on this single view. A left pectoral pacemaker with a single lead terminating in the right ventricle is present. The inspiratory lung volumes are decreased. There is opacification of the right lower lung zone obscuring the right heart border and right hemidiaphragm, suggesting a small right pleural effusion. There is probable elevation of the right hemidiaphragm with air-filled colon projecting over the expected right lung base. The left lung is relatively clear with streaky retrocardiac opacification most compatible with atelectasis. No pneumothorax is detected. The cardiac silhouette is incompletely evaluated due to right basilar opacification but is likely mildly enlarged. The mediastinal contours are prominent in part related to unfolding of the thoracic aorta. The aortic knob is partially calcified. IMPRESSION: Right pleural effusion with possible elevation of the right hemidiaphragm and air-filled colon projecting over the expected right lung base beneath the elevated hemidiaphragm. " 389e1a6c-13e08eee-69f0ca71-fc8543fd-b81fb751.jpg,validate/p18/p18889316/s54464271/389e1a6c-13e08eee-69f0ca71-fc8543fd-b81fb751.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with developmental delay. Symptoms of cough for two to three weeks. Posterior lower bilateral thoracic pain. Decreased breath sounds and dullness to percussion. Evaluation for bibasilar pneumonia. COMPARISON: No prior chest radiographs are available for comparison. FINDINGS: PA and lateral views of the chest were obtained. The lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no evidence of focal consolidation, pulmonary edema or pleural effusion. CONCLUSION: No acute cardiopulmonary disease. " 6769e61f-b9bc8dca-8791fc0f-96b58a70-02e2ec21.jpg,validate/p11/p11585755/s55213100/6769e61f-b9bc8dca-8791fc0f-96b58a70-02e2ec21.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Aortic graft, status post motor vehicle accident, evaluation for mediastinal changes. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Moderate enlargement of the cardiac silhouette. Mild tortuosity of the thoracic aorta. An aneurysmal dilatation of the aorta cannot be detected. There is no pleural effusion, no left mediastinal widening and no apical cap that could suggest an acute aortic injury. However, given the lack of previous comparisons, short-term radiographic followup should be performed and the images should be re-evaluated accordingly. Status post sternotomy. Mild increase in diameter of the hilar pulmonary vessels. No substantial atelectasis. No lung nodules or masses. " bb46fd25-0ef7a244-51d4fd2c-2cfe9b6b-b42abbcc.jpg,validate/p13/p13299285/s50796869/bb46fd25-0ef7a244-51d4fd2c-2cfe9b6b-b42abbcc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recent pleural effusion, likely sympathetic, and tachypnea // Please eval interval change TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: There is a right Port-A-Cath, and a left IJ, both of which terminate in the lower SVC. The patient is status post median sternotomy and CABG, with sternotomy wires that appear intact and appropriately aligned. There is a dobhoff tube which courses below the diaphragm, however the tip is not visualized on this image. There are surgical clips in the right upper quadrant. There are bilateral pleural effusions, right worse than left, with fluid in the horizontal fissure, which appears to have worsened in comparison to the prior chest radiograph. 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. Right Port-A-Cath, left IJ, and dobhoff left tube in appropriate position. 2. Worsening bilateral pleural effusions, right worse than left. " 7a40a3cd-0269b39e-5785fda2-a7c56076-ceb2062b.jpg,validate/p16/p16014948/s56909851/7a40a3cd-0269b39e-5785fda2-a7c56076-ceb2062b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cp // r/o infiltrate 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. " f5a8a808-5ebdf79c-060b89e9-97b50616-6b38885a.jpg,validate/p15/p15970909/s51571553/f5a8a808-5ebdf79c-060b89e9-97b50616-6b38885a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever s/p ex lap // ? PNA, interval change ? PNA, interval change COMPARISON: Chest radiograph ___. IMPRESSION: New consolidation at the base of the right lung could be atelectasis alone. Nevertheless aspiration could be responsible and this area should be followed for the possibility of developing pneumonia. Heart size top-normal. Pleural effusion small if any. Upper lungs clear. " 60cef032-0bf38c61-dfae4717-e031b83c-8e1b2703.jpg,validate/p10/p10410774/s53135044/60cef032-0bf38c61-dfae4717-e031b83c-8e1b2703.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with new O2 requirement // r/o pulmonary congestion, other acute process TECHNIQUE: Frontal view of the chest COMPARISON: ___ chest radiograph FINDINGS: Moderate bilateral pleural effusions and bibasilar atelectasis are increased compared to 1 day ago. Mild pulmonary edema is increased. Cardiac silhouette is obscured by bibasilar opacities, however grossly appear similar to before. IMPRESSION: Increased pulmonary edema and bilateral pleural effusions compared to 1 day ago. NOTIFICATION: The findings were discussed with ___ N.P. by ___, M.D. on the telephone on ___ at 5:26 PM, 30 minutes after discovery of the findings. " cf4213c5-6c774cc3-b26bf079-5c774f5f-a3845b1f.jpg,validate/p11/p11607177/s53899060/cf4213c5-6c774cc3-b26bf079-5c774f5f-a3845b1f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p VAD w/increased chest tube output IMPRESSION: Allowing for differences in technique and projection, there has not been a substantial change the appearance of the chest since the recent study performed a few hours earlier. " 491c33c1-c886676e-80d8b1b2-6e75c246-51e51d45.jpg,validate/p15/p15353701/s56250664/491c33c1-c886676e-80d8b1b2-6e75c246-51e51d45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with significant mitral regurgitation // eval pulmonary edema IMPRESSION: In comparison to prior radiograph of 1 day earlier, an asymmetrical pattern of pulmonary edema has slightly worsened, accompanied by increased moderate right pleural effusion. Remainder of exam is unchanged. " adf0bd10-a03b694e-14a22db3-a3b6eabe-9b804ad2.jpg,validate/p16/p16391106/s59119386/adf0bd10-a03b694e-14a22db3-a3b6eabe-9b804ad2.jpg,validation," FINAL REPORT INDICATION: 1 month of chest tightness with history of COPD TECHNIQUE: Frontal lateral chest radiographs COMPARISON: ___ FINDINGS: The heart remains stably enlarged. The aorta is tortuous. There is no focal consolidation, pneumothorax, or effusion. The pulmonary vasculature is normal. The lungs are mildly hyperinflated. There also moderate degenerative changes of the thoracic spine. IMPRESSION: Mild COPD. No acute cardiopulmonary abnormality. " 5e250ab6-d58d8e44-e717ff2d-08d566f0-b85e9388.jpg,validate/p13/p13174810/s55521426/5e250ab6-d58d8e44-e717ff2d-08d566f0-b85e9388.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post trauma, patient with tracheostomy and pneumothoraces. Comparison is made with prior study performed 9 hours earlier. Small left apical pneumothorax is unchanged allowing the difference in the positioning of the patient. Small right pneumothorax previously described is not seen in this examination. Right PICC, right chest tube, tracheostomy tube, and enteric tube remain in unchanged position. Multiple surgical clips are in the right apex. Multifocal opacities located in the periphery of the right upper lobe and lower lobes bilaterally are grossly unchanged. Small right pleural effusion is unchanged. Sternal wires are aligned. " cdd6887e-85932430-cc6f9d63-b4335126-bff86229.jpg,validate/p15/p15964158/s59683671/cdd6887e-85932430-cc6f9d63-b4335126-bff86229.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Perforated sigmoid diverticulitis, assessment for pneumothorax. FINDINGS: As compared to the previous radiograph, the patient has a right chest tube. An air-fluid level is seen on the right, suggesting the presence of intrapleural air. However, the apical pneumothorax line, seen on the previous radiograph, no longer visible on the current image. The nasogastric tube has been removed, but the left PICC line remains in situ. Changed appearance of the cardiac silhouette. Mild decrease in extent of the pleural effusion. The atelectasis at the left lung base and in the retrocardiac areas is unchanged. " ef04d1f0-5a039a3e-a90100fa-43ef64e4-ff5c08af.jpg,validate/p13/p13292409/s52520955/ef04d1f0-5a039a3e-a90100fa-43ef64e4-ff5c08af.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asthma s/p bronchial thermoplasty RLL // ptx TECHNIQUE: Plain film COMPARISON: ___. FINDINGS: Is portable upright AP chest radiograph shows new subsegmental atelectasis at the right lung base and right pericardiac region and unchanged linear scar at the left lung base. Although the overall cardiac size remains within normal limits, the left heart border has lost its concavity and there is some mild redistribution of pulmonary blood flow to the upper lobes without haziness or edema. Several small, sub cm, calcified lymph nodes are seen in the right perihilar region and these are new. No pneumothorax is seen status post thermoplasty. IMPRESSION: Redistribution of pulmonary blood flow to the upper lobes without current edema. Subsegmental atelectasis at the right base and right middle lobe and a calcified right perihilar lymph nodes are new compared to the patient's previous studies from ___. " e2367dd3-027e7c77-46b40399-a7f046b3-d68b21df.jpg,validate/p10/p10307557/s55473383/e2367dd3-027e7c77-46b40399-a7f046b3-d68b21df.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old male was intubated with multiple extremity injuries. FINDINGS: Comparison is made to previous study from ___. There is an endotracheal tube whose distal tip is 5.5 cm above the carina at the level of clavicles. There is a right IJ line with the distal lead tip in the proximal SVC, stable. There is a feeding tube whose distal port is below GE junction. There are no pneumothoraces. There is prominence of the pulmonary interstitial markings without signs for overt pulmonary edema. " 996d668c-c8927e28-5a923fed-6f734002-08ff7938.jpg,validate/p19/p19171679/s51223553/996d668c-c8927e28-5a923fed-6f734002-08ff7938.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with vomiting and wrenching and abdominal pain. Free air under the diaphragm? IMPRESSION: PA and lateral chest compared to ___: Low lung volumes exaggerate heart size which is probably normal, and crowd pulmonary vasculature, particularly at the lung bases, but lungs are probably clear. There is no pleural effusion or evidence of central adenopathy and no free subdiaphragmatic gas. " 628fa4af-4437f574-41d94d8d-07632f9a-99d6fc4b.jpg,validate/p17/p17429491/s52751133/628fa4af-4437f574-41d94d8d-07632f9a-99d6fc4b.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with lung cancer s/p chest tube. // Please assess for interval changes. TECHNIQUE: Single view at ___ 9:05 AM COMPARISON: ___ at 20:56 FINDINGS: The large left-sided paramediastinal mass again is noted as well as the pigtail catheter in the left base. There has been no re-accumulation of the pleural effusion. Slight lucency is seen capping the left lung apex but no pleural line is identified to suggest a definite pneumothorax. The right lung has no acute disease. The heart is not enlarged. The osseous structures are normal for age. IMPRESSION: No change " 66d13817-333439e1-2134a531-fed0a9cb-579956fd.jpg,validate/p18/p18465343/s51903210/66d13817-333439e1-2134a531-fed0a9cb-579956fd.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with pleuritic chest pain and cough // eval pna TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Blunting of the left costophrenic angle on the lateral view suggests chronic pleural thickening rather than small effusion. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " dd4b2fdc-7085af0b-48af8fdb-a4cd0c96-0592a019.jpg,validate/p12/p12448098/s53740832/dd4b2fdc-7085af0b-48af8fdb-a4cd0c96-0592a019.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with one month of productive cough with history of abnormal chest radiograph. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest are obtained. The lungs are well expanded and clear. No evidence of pulmonary nodules are seen. There is no pneumothorax, pleural effusion or pulmonary edema. The cardiomediastinal silhouette is unremarkable. CONCLUSION: No evidence of pulmonary nodules. No acute cardiopulmonary disease. The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at 16:45, five minutes after discovery was made. " 2c9cc51c-fdaf47d9-240afd9f-7d348b1b-30af9e4b.jpg,validate/p14/p14508231/s54306233/2c9cc51c-fdaf47d9-240afd9f-7d348b1b-30af9e4b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with headache, neck pain, left face pain, recently started coumadin 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 apart for minimal subsegmental atelectasis in the right middle lobe. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " ef2fac28-9522cd57-821f83c9-a6d59582-6b93d566.jpg,validate/p14/p14422845/s57331092/ef2fac28-9522cd57-821f83c9-a6d59582-6b93d566.jpg,validation," WET READ: ___ ___ ___ 9:31 AM Lung volumes are slightly lower. Stable positioning of right IJ catheter. Apparent increase in size of collection in the right hemithorax as well as the loculated collection of the apex could be related to positioning. Interval removal of surgical drain. Otherwise stable appearance of the chest. WET READ VERSION #1 ___ ___ ___ 6:45 PM Lung volumes are slightly lower. Stable positioning of right IJ catheter. Apparent increase in size of collection in the right hemithorax as well as the loculated collection of the apex could be related to positioning. Interval removal of surgical drain. Otherwise stable appearance of the chest. WET READ VERSION #2 ___ ___ ___ 9:28 AM Lung volumes are slightly lower. Stable positioning of right IJ catheter. Apparent increase in size of collection in the right hemithorax as well as the loculated collection of the apex could be related to positioning. Interval removal of surgical drain. Otherwise stable appearance of the chest. ______________________________________________________________________________ FINAL REPORT INDICATION: Post right upper lobectomy and right middle lobectomy. Increased oxygen requirement. COMPARISON: Radiographs from ___. TECHNIQUE: Frontal upright chest radiograph. FINDINGS: The lung volumes are lower in comparison to the prior examination from ___ at 8:53. Again seen is a large right middle and upper zone gas/fluid collection and a subpleural loculated collection or lesion along the right lateral superior hemithorax, minimally changed since the 8:53 examination. Mild superimposed pulmonary edema appears stable. The hilar mediastinal contours are unchanged. There has been interval removal of an epidural catheter. The right IJ catheter again terminates at the mid to upper SVC. IMPRESSION: 1. Large gas/fluid collections within the right mid to upper zone appear stable since the ___ examinations. 2. Unchanged background mild pulmonary edema. " 48a9ae4b-e0042749-c995f53e-d4e6473f-820f71d4.jpg,validate/p10/p10900387/s52150607/48a9ae4b-e0042749-c995f53e-d4e6473f-820f71d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old man with fevers // Eval for PNA TECHNIQUE: Single AP view of the chest. COMPARISON: Comparison is made to radiographs the chest from ___. FINDINGS: Left basilar opacity has improved since the prior study, with similar appearance of bilateral interstitial opacities. Medial right lung base opacity is likely atelectasis. The cardiomediastinal silhouette is unchanged. There is no pneumothorax or large pleural effusion. IMPRESSION: 1. Right basilar opacity, likely atelectasis, has slightly increased; and left basilar opacity has improved since the prior study. 2. Bilateral interstitial opacities persist, most likely edema, however PCP pneumonia could be considered in the appropriate clinical setting, as it can have a similar radiographic appearance. " 9b6eb222-51209cea-34167579-ccab363b-100bd975.jpg,validate/p17/p17284612/s59492119/9b6eb222-51209cea-34167579-ccab363b-100bd975.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with lethargy TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Moderate enlargement of the cardiac silhouette is again noted with a left ventricular predominance. The aorta remains tortuous. The mediastinal and hilar contours are otherwise grossly unchanged. The pulmonary vasculature is not engorged. Patchy atelectasis is noted in the lung bases. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities demonstrated. IMPRESSION: Patchy opacities in the lung bases, likely atelectasis. " 6671b7b8-922f905d-c48e9203-a17ea8d0-0dabdbb4.jpg,validate/p18/p18729394/s56673950/6671b7b8-922f905d-c48e9203-a17ea8d0-0dabdbb4.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with upper abdominal pain. COMPARISON: ___. FINDINGS: Chest, PA and lateral. There is minimal linear opacity in the left lower lobe. The lungs are otherwise clear. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Sternal cerclage wires are intact. IMPRESSION: Linear opacity in the left lower lobe likely represents atelectasis. " 0397ba7c-14cf7014-8311e8b4-08c6b575-89ddaae9.jpg,validate/p15/p15147932/s51143538/0397ba7c-14cf7014-8311e8b4-08c6b575-89ddaae9.jpg,validation," WET READ: ___ ___ 3:42 PM free air. ___, ___ paged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Chest pain, question mediastinal pathology, free air. COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Evidence of free air is seen beneath the diaphragms, right greater than left. There are relatively low lung volumes and minimal bibasilar atelectasis. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Evidence of pneumoperitoneum raising concern for bowel perforation. Dr. ___, was paged at 3:40 p.m. at the time of discovery. Through ED dashboard, the ED team is aware of free air under the diaphragms. Dr. ___ ___ this at 3:45pm. " 31ff71ed-eb4d7a99-d0edacb6-1274d24b-9e98641d.jpg,validate/p16/p16508811/s58582715/31ff71ed-eb4d7a99-d0edacb6-1274d24b-9e98641d.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: New cough. Cardiomediastinal contours are normal. The lungs are grossly clear. There is no evidence of pneumonia, CHF, pneumothorax or pleural effusion. The mitral annulus is calcified. IMPRESSION: No evidence or pneumonia. " b2747de1-e0fa20ab-3d5743a7-6b4dd451-bbc993a3.jpg,validate/p19/p19960115/s54452365/b2747de1-e0fa20ab-3d5743a7-6b4dd451-bbc993a3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia, intubated, pulmonary edema // ? interval change ? interval change COMPARISON: Previous chest radiographs ___ through ___. IMPRESSION: Severe right lower lobe atelectasis, accompanied by moderate right pleural effusion on change since ___. Vascular congestion and borderline edema in the left lung and probable small left pleural effusion also unchanged. Moderate cardiomegaly unchanged since ___. ET tube and left subclavian line are in standard placements. Transesophageal drainage tube passes into the stomach and out of view. No pneumothorax. " dbb63c78-ea4d85d3-0c7f957b-e3bf2deb-3243caa7.jpg,validate/p15/p15938425/s51450769/dbb63c78-ea4d85d3-0c7f957b-e3bf2deb-3243caa7.jpg,validation," FINAL REPORT HISTORY: Left calf pain and chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest CTA and chest radiograph. FINDINGS: Heart size is mildly enlarged, unchanged. Mediastinal and hilar contours are within normal limits. The patient is status post median sternotomy with multiple mediastinal clips noted anteriorly. Pulmonary vascularity is normal. The lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. Clips are re- demonstrated within the right upper quadrant of the abdomen compatible with prior cholecystectomy. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary abnormality. " 178f0ddc-400b5cc3-066b7b7d-42d1fa25-c23191f5.jpg,validate/p19/p19751455/s54979667/178f0ddc-400b5cc3-066b7b7d-42d1fa25-c23191f5.jpg,validation," FINAL REPORT INDICATION: ___ year old man with NSCLC s/p photodynamic therapy. // evaluate for NG tube placement COMPARISON: RADIOGRAPHS FROM ___ IMPRESSION: There has been placement of a feeding tube whose distal tip is poorly seen; however, it is at least within the distal body of the stomach. Endotracheal tube is unchanged in position. There is again seen airspace opacities worse within the lung bases, right worse than left. There is improved aeration of the consolidation within the left upper lobe. Heart size is within normal limits. There is again seen left apical pleural thickening, unchanged. " 5f90a4ea-57e4a309-30dbdc90-40ef9742-e1b121c8.jpg,validate/p19/p19648992/s57614362/5f90a4ea-57e4a309-30dbdc90-40ef9742-e1b121c8.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fatigue, back 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. No displaced fracture is identified. IMPRESSION: No acute cardiopulmonary process. " de862544-2b2b4720-11fba17b-b84b2a9f-a8f340b6.jpg,validate/p18/p18895628/s54103436/de862544-2b2b4720-11fba17b-b84b2a9f-a8f340b6.jpg,validation," 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. " beaae5c1-8c2b1095-a83be50d-a90401b9-08efe82c.jpg,validate/p16/p16881590/s50510122/beaae5c1-8c2b1095-a83be50d-a90401b9-08efe82c.jpg,validation," 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. " 3184cec6-7f456285-a6f28742-839e541f-5356bd4f.jpg,validate/p19/p19994730/s55355225/3184cec6-7f456285-a6f28742-839e541f-5356bd4f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fever, anemia, questionable adenopathy. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. The hilar and mediastinal contours are unremarkable. Normal lung structure without evidence of adenopathy, lung nodules, pulmonary edema, or pulmonary infection. Normal size of the cardiac silhouette. " eaddbf5f-885df1ba-e14b8f6c-d92a1f59-861d2b9e.jpg,validate/p17/p17547651/s53278136/eaddbf5f-885df1ba-e14b8f6c-d92a1f59-861d2b9e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman desats POD2 band removal // r/o pna r/o pna IMPRESSION: In comparison with the study of ___, there are lower lung volumes following surgery. On the right there are atelectatic changes at the bases and possible small effusion. Slightly larger effusion with atelectatic changes at the bases seen on the left. No evidence of pulmonary vascular congestion or definite consolidation, though pneumonia in the lower lung could be considered in the appropriate clinical setting. " 1186d10f-850bfbb8-c359be3c-0a1acd2e-c0a62492.jpg,validate/p13/p13052287/s51315618/1186d10f-850bfbb8-c359be3c-0a1acd2e-c0a62492.jpg,validation," 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. " 1555b64c-960e553f-e5dd6c38-ab80e768-b7a0e791.jpg,validate/p12/p12702896/s50417631/1555b64c-960e553f-e5dd6c38-ab80e768-b7a0e791.jpg,validation," 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: 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. " f6fee01a-d213c15c-bf6343a9-c4dd7e1c-74526f0b.jpg,validate/p17/p17574863/s59694801/f6fee01a-d213c15c-bf6343a9-c4dd7e1c-74526f0b.jpg,validation," WET READ: ___ ___ ___ 10:02 PM Feeding tube passes below the diaphragm into the expected region of the stomach and is then coiled on itself with tip above the diaphragm projecting over expected region of the mid-distal esoph. This requires repositioning. Findings of this and the most recent prior radiography were discussed with Dr. ___ at 9pm on ___ via tel. ___ ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post liver transplant, confirm readjustment of nasogastric tube. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the feeding tube now passes below the diaphragm into the expected region of the stomach. Then the tube is coiled on itself with its tip above the diaphragm, projecting over the expected region of the mid distal esophagus. This tube position needs to be revised. A telephone information was given at the time of the wet read. " 4c4ff406-8451ea39-1d1c6f56-dc536009-432cae6b.jpg,validate/p15/p15432819/s58664775/4c4ff406-8451ea39-1d1c6f56-dc536009-432cae6b.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph ___, ___. Chest CT ___. FINDINGS: PA and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are stable. Again visualized is an aortic CoreValve replacement. Chronic elevation of the right hemidiaphragm is seen. There is no pleural effusion or pneumothorax. Lungs are well expanded and clear. Exaggerated kyphosis of the thoracic spine with degenerative changes is noted. IMPRESSION: No acute cardiopulmonary process. " 4fc10631-c9d1180a-310a1826-afbbd6fb-2032dbf4.jpg,validate/p15/p15287755/s58534623/4fc10631-c9d1180a-310a1826-afbbd6fb-2032dbf4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with palpitations // pna? pna? IMPRESSION: Comparison to ___. The radiograph shows no relevant change. Borderline size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pleural effusions. No pneumothorax. The hilar and mediastinal contours are unremarkable. " bcd89cd3-3a048af6-dddb099d-12d0ed14-37053aa4.jpg,validate/p19/p19372257/s53276621/bcd89cd3-3a048af6-dddb099d-12d0ed14-37053aa4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pna and pulm edema // evaluate intubated pt evaluate intubated pt IMPRESSION: As compared to ___, the bilateral pleural effusions have slightly decreased in extent. As a consequence, the bilateral basilar atelectasis are also decreased. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices. " 6f16a9f6-59070c28-150ae39a-5a766290-385a40c3.jpg,validate/p12/p12928643/s55136712/6f16a9f6-59070c28-150ae39a-5a766290-385a40c3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with fever // eval infiltrate. COMPARISON: Same day lateral radiograph. Chest PA and lateral radiograph dated ___. FINDINGS: AP radiograph of the chest. Again visualized are multiple metallic densities likely consistent with shrapnel/bullet fragments. Pleural thickening at the left lung base, stable. There is no effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute intrathoracic process. " 88dd4b9d-f5dc2b18-5e9e6141-943b90b2-39b71300.jpg,validate/p18/p18767957/s56415175/88dd4b9d-f5dc2b18-5e9e6141-943b90b2-39b71300.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with weakness // 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. " 54e28620-35df4726-a920ea61-3dc32f62-63def7ea.jpg,validate/p15/p15132645/s51689009/54e28620-35df4726-a920ea61-3dc32f62-63def7ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with positive quantiferon gold // r/o any evidence of active TB COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette. Mild elongation of the thoracic aorta. No pleural effusions. No pneumonia, no evidence of active or known active TB. " 6bf80889-8f64a62e-5d06d91d-92e6bc98-939a7292.jpg,validate/p11/p11192888/s54578371/6bf80889-8f64a62e-5d06d91d-92e6bc98-939a7292.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough // pna? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ and ___. FINDINGS: A left-sided dual lead pacemaker is in stable, appropriate position. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Right and left lower lobe opacities (left greater than right) are concerning for infection. There may be a small left pleural effusion. No pneumothorax is seen. IMPRESSION: Bilateral lower lobe opacities, concerning for multifocal pneumonia. Element of interstitial edema is present, re-assess after diuresis. NOTIFICATION: Findings communicated to Dr. ___ at 18:34 on ___ by Dr. ___ via telephone. " f3d45333-fee0e28a-9b02a09b-33cb8cb4-4ffeaf75.jpg,validate/p17/p17747028/s50873873/f3d45333-fee0e28a-9b02a09b-33cb8cb4-4ffeaf75.jpg,validation," 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. " a4f19f99-7db27f28-7a208f12-542cc831-2bab9276.jpg,validate/p14/p14589120/s56812100/a4f19f99-7db27f28-7a208f12-542cc831-2bab9276.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain, weakness // ?ACS 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. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 5692823d-56395e47-5617743f-191e73c7-2a4dcb1a.jpg,validate/p18/p18014061/s53823123/5692823d-56395e47-5617743f-191e73c7-2a4dcb1a.jpg,validation," 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. " 86bf2bd4-bc116bff-33e27f6a-e24575c2-30886a08.jpg,validate/p15/p15259138/s53008225/86bf2bd4-bc116bff-33e27f6a-e24575c2-30886a08.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of breast cancer after surgery and chemotherapy, currently with progressive dyspnea. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size is normal. Mediastinum is normal. Lungs are essentially clear within the limitations of the study technique. There is no pleural effusion or pneumothorax. Surgical clips are projecting over the left hemithorax related to recent breast surgery. The right breast clips are seen as well, findings most likely consistent with breast reconstruction. " e74cbcf2-ad05d03b-bde252bc-aebde87f-e4678f15.jpg,validate/p14/p14755254/s50561953/e74cbcf2-ad05d03b-bde252bc-aebde87f-e4678f15.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PMH of CHF, pneumonia, recently completed abx. // Please eval for pulmonary edema, resolving pneumonia Please eval for pulmonary edema, resolving pneumonia IMPRESSION: In comparison with the study of ___, there again is substantial enlargement of the cardiac silhouette with worsening pulmonary vascular congestion. No definite acute focal pneumonia, though this would be difficult to unequivocally exclude in the appropriate clinical setting, especially in the absence of a lateral view. Monitoring and support devices are unchanged. " 45a57544-0c7b47e1-d0a998b3-e4dc94e4-a8dcdcd2.jpg,validate/p15/p15245907/s52896243/45a57544-0c7b47e1-d0a998b3-e4dc94e4-a8dcdcd2.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. Question pneumonia. COMPARISONS: CT torso from ___ as well as radiographs from ___. TECHNIQUE: Chest, AP upright view. FINDINGS: Similar moderate relative elevation of the right hemidiaphragm suggests a hernia of Bochdalek type. A gastrostomy tube appears unchanged. There are no pleural effusions or pneumothorax. Patchy left basilar opacity suggests minor atelectasis. IMPRESSION: No definite evidence of acute disease. " 3c24d0a7-f5b91f2b-4d244932-eb710f36-e3a75ecf.jpg,validate/p12/p12278812/s52936529/3c24d0a7-f5b91f2b-4d244932-eb710f36-e3a75ecf.jpg,validation," FINAL REPORT HISTORY: Pacer. FINDINGS: No previous images. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Mild blunting of the left costophrenic angle is seen. There is a dual-channel pacemaker device in place with the leads extending to the right atrium and region of the apex of the right ventricle. No evidence of pneumothorax. " 4a664821-04997628-88f2799e-9c21f9cb-d372b6d6.jpg,validate/p17/p17439964/s59704849/4a664821-04997628-88f2799e-9c21f9cb-d372b6d6.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old male transferred and intubated TECHNIQUE: Portable chest radiograph COMPARISON: Outside facility chest radiograph ___ at 15:50, chest CT ___ FINDINGS: The endotracheal tube terminates 4.1 cm above the carina. Enteric tube seen with tip past the GE junction although side port is likely in the distal esophagus. Known right lung mass occupying a majority of the right midlung is better assessed by recent chest CT performed earlier on the same date. There is new right basilar atelectasis medially. Mild interstitial pulmonary edema. There is a blunting of the right lateral costophrenic angle in part due to prominent extrapleural fat although underlying effusion is possible. No sizable pleural effusion on the left. No pneumothorax. Cardiomediastinal contours are unchanged. Heart size may be minimally enlarged. No acute osseous abnormalities identified. IMPRESSION: 1. Endotracheal tube terminates 4.1 cm above the carina. 2. Enteric tube tip likely just past the GE junction with side-port in the distal esophagus. 3. Mild interstitial edema. 4. Right lung mass, better assessed by same-day CT. " fc2e0be1-c206f9f0-e4462574-d84b834c-58f33dd4.jpg,validate/p14/p14219343/s53361141/fc2e0be1-c206f9f0-e4462574-d84b834c-58f33dd4.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, evaluate for pulmonary edema TECHNIQUE: Single AP upright view of the chest. COMPARISON: Chest x-ray from ___ FINDINGS: There is interval improvement in moderate interstitial and alveolar edema. There are small persistent bilateral pleural effusions. The cardiomediastinal silhouette and hilar contours are unchanged. A left chest pacemaker and leads are in unchanged positions. There is no pneumothorax. IMPRESSION: 1. Interval improvement in interstitial and alveolar edema with persistent but improving bilateral pleural effusions. 2. Unchanged position of a left-sided pacemaker with intact pacer wires. " aee13000-8d572d36-486b3633-d228d2b9-1cdef521.jpg,validate/p12/p12452974/s50834829/aee13000-8d572d36-486b3633-d228d2b9-1cdef521.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT 15:07 CLINICAL INDICATION: Elevated white count, question pneumonia. Comparison is made to the patient's previous study dated ___. PA and lateral views of the chest, ___ at 15:07 are submitted. IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm and positioned within the stomach. There are several mildly dilated small bowel loops with air-fluid levels in the left upper quadrant, which could represent an ileus or obstruction. Correlation with the patient's clinical presentation is advised. Lungs remain well inflated without evidence of focal airspace consolidation, pleural effusions, pneumothorax or pulmonary edema. Incidental note is made of bilateral saline breast implants. " ab0b6dd7-eb1eecc6-f19a6a06-9003dc59-c0297b05.jpg,validate/p13/p13734687/s55347115/ab0b6dd7-eb1eecc6-f19a6a06-9003dc59-c0297b05.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with pneumonia. IMPRESSION: PA and lateral chest compared to ___: Region of peribronchial infiltration in the infrahilar right lung has improved. Some of this is due to greater lung volumes, but there may have been pneumonia. Lungs elsewhere are unremarkable. There is no evidence of central lymph node enlargement. Thickening of the right lateral pleural sulcus is probably chronic. Heart size is normal. Left pleural surface is unremarkable. " 212c0ddd-6dd0974b-066ae423-409aa157-860ec31e.jpg,validate/p15/p15448346/s57880266/212c0ddd-6dd0974b-066ae423-409aa157-860ec31e.jpg,validation," FINAL REPORT INDICATION: Bruising over the pacer area. Assessment of leads. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate stable positioning of left-sided pacer and three leads. Prosthetic aortic valve is again noted. The cardiomediastinal silhouette is stable. There is no pneumothorax or large pleural effusion. IMPRESSION: Stable cardiac pacer and lead positioning. " c75d87b0-ed83eac5-8c49d8f2-5d2bfa39-0a412c21.jpg,validate/p13/p13117868/s54767292/c75d87b0-ed83eac5-8c49d8f2-5d2bfa39-0a412c21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stroke and seizure // assess for infection, aspiration COMPARISON: No comparison IMPRESSION: Status post valvular replacement and sternotomy. Right pectoral pacemaker in correct position. Borderline size of the cardiac silhouette with retrocardiac atelectasis but no evidence of pneumonia, pulmonary edema, or pleural effusion. " 2ef0680d-ea5290b9-018bcfd1-3b3a603e-18b1b373.jpg,validate/p18/p18514987/s50924608/2ef0680d-ea5290b9-018bcfd1-3b3a603e-18b1b373.jpg,validation," WET READ: ___ ___ ___ 3:28 AM Hypoinflated lungs with right lower lobe atelectasis. No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Wheezing and shortness of breath. Assess for pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral chest radiograph demonstrates hypoinflated lungs with crowding of vasculature. Heterogeneous opacity partially obscuring the right heart border is consistent right middle lobe pneumonia. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: Right middle lobe pneumonia. NOTIFICATION: The updated findings were discussed by Dr. ___ with ___ QA nurses via email on ___ at 9:56 AM. " 6f3e6a70-d668067e-ef1af264-922ebef4-5b7a1d02.jpg,validate/p19/p19385620/s54438387/6f3e6a70-d668067e-ef1af264-922ebef4-5b7a1d02.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p ___ esophagectomy // assess for interval change assess for interval change IMPRESSION: In comparison with study of ___, there is again evidence of extensive cardiac surgery with intact midline sternal wires. Esophagectomy is again noted. No evidence of residual pneumothorax. No pneumonia, vascular congestion, or pleural effusion. " 17ac16d1-2e772a23-daddb57c-45f39ecf-b0677706.jpg,validate/p15/p15154432/s53174019/17ac16d1-2e772a23-daddb57c-45f39ecf-b0677706.jpg,validation," 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 // interval assessment interval assessment COMPARISON: Comparison to ___ at 04:53 FINDINGS: Portable semi-erect chest radiograph ___ at 04:59 is submitted. IMPRESSION: Tracheostomy tube continues to have its tip 1.2 cm above the carina. A right internal jugular central line has its tip in the distal SVC. The heart remains stably enlarged. There is a layering left effusion with retrocardiac consolidation suggestive of compressive lower lobe atelectasis, although pneumonia should also be considered. There has been interval appearance of mild perihilar edema. No obvious pneumothorax. " 73632233-e9355edd-04174ec5-4c7144c8-72bc2ffc.jpg,validate/p12/p12829862/s50946948/73632233-e9355edd-04174ec5-4c7144c8-72bc2ffc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS wedge // check interval change, increased O2 requirements check interval change, increased O2 requirements IMPRESSION: Comparison to ___. Unchanged postoperative appearance of the right lung. Postoperative parenchymal opacities are seen in the right perihilar and right basal areas. Gas collection in the right lateral soft tissues are stable. No pneumothorax. Elevation of the right hemidiaphragm and mild bilateral pleural effusions are visualized. No change in appearance of the heart and of the left lung. " 32e91515-55af5140-b0cc47e6-8edc241d-baf465cd.jpg,validate/p13/p13854372/s52346524/32e91515-55af5140-b0cc47e6-8edc241d-baf465cd.jpg,validation," FINAL REPORT EXAM: CHEST FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: ___-year-old female with history of pulmonary fibrosis with increased oxygen requirements. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. Diffuse increased interstitial markings are grossly similar to prior, consistent with patient's pulmonary fibrosis, with possible of overlying edema. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable compared to ___ and ___. The patient is rotated in position. There is severe compression of an upper lumbar spine vertebral body, also seen on the prior study from ___. " a62fb481-549aa58b-d59653a9-02f0f934-d3b33620.jpg,validate/p19/p19771635/s55329416/a62fb481-549aa58b-d59653a9-02f0f934-d3b33620.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atypical chest pain. // Is there pulmonary or vascular pathology? Is there pulmonary or vascular pathology? IMPRESSION: In comparison with the study of ___, there is little change. Cardiac silhouette is at the upper limits of normal in size. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " efaaf97a-91a66e72-46656da4-a97f3eae-91e618b7.jpg,validate/p14/p14027430/s52703993/efaaf97a-91a66e72-46656da4-a97f3eae-91e618b7.jpg,validation," 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. " 91f8fe99-1fad1653-89ce5f2c-e77316b1-2b8e867f.jpg,validate/p10/p10862731/s57105789/91f8fe99-1fad1653-89ce5f2c-e77316b1-2b8e867f.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with hyponatremia and confusion for the past two days. COMPARISON: Chest radiograph, ___. FINDINGS: The cardiomediastinal and hilar contours are stable, with moderate calcification of the thoracic aorta. The lungs are clear without consolidation, pleural effusion or pneumothorax. Mild bibasal atelectasis is seen. IMPRESSION: No acute cardiopulmonary pathology. " d4c5a94f-f1d3a7a4-5ff7e463-91804785-d49c447b.jpg,validate/p14/p14637100/s55017642/d4c5a94f-f1d3a7a4-5ff7e463-91804785-d49c447b.jpg,validation," FINAL REPORT AP CHEST 10:23 P.M. ON ___ HISTORY: CHF or nephrotic syndrome. IMPRESSION: AP chest compared to ___ and ___: Moderately severe pulmonary edema has worsened. Bibasilar opacification in the lungs could be dependent edema and atelectasis or concurrent pneumonia. Severe enlargement of the cardiac silhouette is longstanding. Small bilateral pleural effusions are presumed. No pneumothorax. " 830e7a84-6aef81f3-4bda5599-a0a64901-28051033.jpg,validate/p16/p16260927/s57314902/830e7a84-6aef81f3-4bda5599-a0a64901-28051033.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman s/p pancreatic biopsy yesterday with RUQ pain presenting for evaluation for free air (upright). TECHNIQUE: Portable upright AP radiograph view of the chest. COMPARISON: None. FINDINGS: The lungs are well-expanded. Streaky opacities in the left lower lung are consistent with mild atelectasis. There may be a small lung nodule at the right second anterior interspace. No focal consolidation, edema, or pneumothorax. The heart is mild-to-moderately enlarged. The mediastinum is not widened. No subdiaphragmatic free air on this upright image. The partially imaged bowel gas pattern is nonspecific. No acute osseous abnormality. Bilateral prior shoulder tendon repairs are again seen. IMPRESSION: 1. No subdiaphragmatic free air. 2. Atelectasis. 3. Mild-to-moderate cardiomegaly. 4. Possible small right pulmonary nodule at the right second anterior interspace. Recommend conventional chest radiograph to further assess. RECOMMENDATION(S): Conventional chest radiograph to reassess possible right pulmonary nodule. " cb3adb02-77232066-e459ff13-d0095967-639e0c20.jpg,validate/p15/p15709718/s50818545/cb3adb02-77232066-e459ff13-d0095967-639e0c20.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with SOB // ? infiltrate COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Multiple overlying EKG leads are present limiting assessment. Lung volumes are low. There is mild hilar congestion without frank pulmonary edema. Small bilateral pleural effusions are likely present. The heart is mildly enlarged. No definite pneumothorax is seen. Bony structures appear grossly intact. IMPRESSION: Pulmonary congestion and cardiomegaly with small bilateral pleural effusions. " 059c0a91-b3ab08cc-d25f5e2f-3ca79e0b-c7e7fb41.jpg,validate/p11/p11883857/s56750309/059c0a91-b3ab08cc-d25f5e2f-3ca79e0b-c7e7fb41.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with Quantiferon gold positive, assessment for any potential signs of active or chronic tuberculosis. COMPARISON: ___. Heart size is mildly enlarged, unchanged since the prior study. Mediastinum is stable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No abnormality demonstrated that might potentially be attributed to active or chronic tuberculosis. " 684967b4-5f96120f-2e91079a-e799c1b0-f436fd03.jpg,validate/p16/p16609004/s59811519/684967b4-5f96120f-2e91079a-e799c1b0-f436fd03.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with c/o weight loss. // Assess for pulmonary abnormalities, signs of TB Assess for pulmonary abnormalities, signs of TB IMPRESSION: Comparison to ___. No relevant change is noted. Moderate overinflation, moderate scoliosis. Moderate elongation of the descending aorta. No pulmonary edema. No pneumonia, no pleural effusions. No suspicious lung nodules or masses. " da5a53df-3791246a-66b1405d-7aa7af14-e6bc1683.jpg,validate/p16/p16108772/s58051417/da5a53df-3791246a-66b1405d-7aa7af14-e6bc1683.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough and dyspnea. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged including tortuosity of the aorta and borderline cardiomegaly. There is a mild interstitial abnormality suggestive of pulmonary vascular congestion. Patchy opacities are present at both lung bases, not specific although most suggestive of atelectasis. There is no definite pleural effusion or pneumothorax. IMPRESSION: Findings suggesting mild vascular congestion. In the appropriate clinical setting, atypical pneumonia could also be considered. Also, although it is difficult to exclude focal pneumonia at the lung bases, patchy basilar opacities with low lung volumes could also be seen with atelectasis. " d632294a-2b85225c-613460f4-dc3e81df-65aa2740.jpg,validate/p15/p15498178/s56078345/d632294a-2b85225c-613460f4-dc3e81df-65aa2740.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with emphysema with brownish prod cough // eval pna COMPARISON: Prior CT chest from ___. FINDINGS: PA and lateral views of the chest provided. A peripheral nodular opacity in the left upper lobe is again seen measuring approximately 2.6 x 2.6 cm, better assessed on recent CT. Underlying fibrotic lung disease is noted. A similar pattern of lower lung opacities is seen compared with recent prior exam likely reflecting emphysema/ fibrosis. No large effusion or pneumothorax. Cardiomediastinal silhouette stable. Bony structures intact. IMPRESSION: 2.6 cm mass in the left upper lobe is concerning for a neoplasm. Extensive underlying emphysema/fibrosis. " 725b1c9f-a8fa3082-0b2d1268-565d5a3a-d3d5d2d4.jpg,validate/p16/p16454295/s59203216/725b1c9f-a8fa3082-0b2d1268-565d5a3a-d3d5d2d4.jpg,validation," FINAL REPORT INDICATION: Kidney and pancreas transplant. Evaluate for infiltrate. COMPARISON: ___ at 4:49 a.m. FINDINGS: Right IJ central venous line ends in the low SVC. ET tube ends 3.3 cm from the carina in appropriate position. An enteric tube ends in the stomach. Previously seen at least moderate pulmonary edema has decreased. No large pleural effusions. No pneumothorax. Cardiomediastinal and hilar contours are stable. IMPRESSION: Decrease in pulmonary edema. " 576824e0-ec63abac-c077f4bf-23d8c1f9-bab16b38.jpg,validate/p16/p16741854/s52010510/576824e0-ec63abac-c077f4bf-23d8c1f9-bab16b38.jpg,validation," CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________ FINAL REPORT INDICATION: History of recurrent effusions, please evaluate status post PleurX placement and post-thoracoscopy. COMPARISONS: Chest radiographs from ___, ___, ___ and ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: There is a new left-sided PleurX catheter with interval improvement of the loculated left pleural effusion. There is a small left basilar pneumothorax. There is a stable left apical density which may represent pleural fluid and/or thickening. Calcified pleural plaques are likely related to prior asbestos exposure. The heart and mediastinal contours appear to be stable with aortic calcifications. There appears to be slight interval worsening of diffuse bilateral pulmonary edema compared to the prior exam. IMPRESSION: Small left basal pneumothorax at the site of the Pleur-X catheter. Slight interval worsening of the bilateral pulmonary edema. Findings were discussed with Dr. ___ by Dr. ___ by telephone at ___:___p on the day of the exam. " 7762a490-72a57fe6-e226b3ca-5ef64d74-322912d5.jpg,validate/p17/p17800072/s59710801/7762a490-72a57fe6-e226b3ca-5ef64d74-322912d5.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cirrhosis, presenting with chest pain 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. The lungs appear clear. IMPRESSION: No evidence of acute disease. IMPRESSION: No evidence of acute disease. " 66206646-3e181055-abd34652-7704502e-d5880194.jpg,validate/p11/p11738518/s54039312/66206646-3e181055-abd34652-7704502e-d5880194.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with need to confirm picc placement // picc placement picc placement IMPRESSION: In comparison with the study of ___, the left subclavian PICC line again extends to the mid portion of the SVC. No change in the appearance of the heart and lungs. " bc0f1282-d93f37f9-1a269d3a-67f38da9-89b5f5e5.jpg,validate/p17/p17846379/s57960491/bc0f1282-d93f37f9-1a269d3a-67f38da9-89b5f5e5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: AP upright portable chest view was read in comparison with prior chest radiographs through ___ with the most recent from ___. FINDINGS: The endotracheal tube ends 8 cm above the carina just above the level of clavicle. Consider advancing ETT by 1.5-2 cm for a better seating. Right internal jugular line terminates at upper SVC. Since ___, mild bilateral pulmonary edema has improved. Since ___, mild-to-moderate right pleural effusion and associated lower lung atelectasis has improved and small left pleural effusion is unchanged. Heart size, mediastinal and hilar contours are normal. IMPRESSION: Since ___, mild pulmonary edema and mild-to-moderate right pleural effusion associated with lower lung atelectasis has improved whereas small left pleural effusion is unchanged. " 66699917-cb10f39d-c6837ebc-ae3846ad-868b4f6c.jpg,validate/p11/p11648387/s56026305/66699917-cb10f39d-c6837ebc-ae3846ad-868b4f6c.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain, CF // Pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CT ___. . FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear without focal consolidation concerning for pneumonia. Pulmonary vascularity is within normal limits. The upper abdomen is unremarkable. These is no acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " cf374fb9-bbf8d2a0-05d73eae-e2bd9368-525039fe.jpg,validate/p19/p19748258/s54709881/cf374fb9-bbf8d2a0-05d73eae-e2bd9368-525039fe.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with fatigue and dizziness evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Right chest wall pacing leads and in the right atrium and right ventricle, unchanged. The heart is top-normal in size. Prominence of the left mediastinum is unchanged and may represent pulmonary artery enlargement. The lungs are grossly clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of pneumonia. " 1d172d77-77f28a2f-7986c843-b7b0c91e-2f124ed0.jpg,validate/p11/p11472206/s54115428/1d172d77-77f28a2f-7986c843-b7b0c91e-2f124ed0.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph from ___. CLINICAL HISTORY: Shortness of breath. FINDINGS: PA and lateral views of the chest were provided. Midline sternotomy wires are noted. There is a nasogastric tube terminating in the left upper quadrant. The heart is mildly enlarged. The lungs appear clear. Bony structures are intact. IMPRESSION: Appropriately positioned nasogastric tube. Mild cardiomegaly. Otherwise, normal. " 4512db26-98c5ab36-5cf248c4-d00a5f1e-8af43dac.jpg,validate/p13/p13049990/s53299977/4512db26-98c5ab36-5cf248c4-d00a5f1e-8af43dac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with non-productive cough, HIV positive (last CD4 greater than 500 in ___), evaluate for intrathoracic pathology to explain cough? 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. " 43e31247-41137f00-c7d5f758-b7896ef8-9811bb66.jpg,validate/p16/p16442467/s54327503/43e31247-41137f00-c7d5f758-b7896ef8-9811bb66.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison with an outside hospital CT of the torso performed earlier today. HISTORY: ___-year-old male with left pneumothorax and left rib fractures, assess interval increase in the known left pneumothorax. FINDINGS: Fracture of the left sixth rib is again seen. There is a small residual left apical pneumothorax. Overall, there is minimal change from prior exam. Cardiomediastinal silhouette is stable. No large effusion is seen. IMPRESSION: Small left pneumothorax, minimally increased from prior exam. Left sixth rib fracture redemonstrated. " 6c238910-b8360687-97a67a91-9eedab64-4dbe8004.jpg,validate/p14/p14916430/s57443959/6c238910-b8360687-97a67a91-9eedab64-4dbe8004.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiographs dated ___. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Mild lingular atelectasis is noted. The heart is moderately enlarged, unchanged from prior examination. Mediastinal contours are normal. Redemonstrated are multiple vertebral compression deformities of the thoracic spine, similar as compared to the prior examination. No acute bony abnormality is detected. IMPRESSION: 1. No radiographic evidence for acute cardiopulmonary process. 2. Multiple stable vertebral compression deformities within the thoracic spine. " ec49c7cc-ead03f22-5a22a7c4-5392c5af-dad07a82.jpg,validate/p15/p15625104/s59888992/ec49c7cc-ead03f22-5a22a7c4-5392c5af-dad07a82.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with L lung disease / whiteout, R lung congestion // eval interval changes TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube has been exchanged by a tracheostomy with its tip currently 4.3 cm above the carinal. The tip of the tracheostomy is slightly impinging the left tracheal wall and should be readjusted. There is no substantial change in the widespread opacification of the left hemothorax with element of atelectasis. Right upper lobe opacity appears to be slightly increased. Right pleural effusion is at least moderate. " 411b6487-d8e98871-4f4cca87-327090d0-f8720915.jpg,validate/p15/p15485426/s51078695/411b6487-d8e98871-4f4cca87-327090d0-f8720915.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleuritic pain/fever // cough, pleurisy cough, pleurisy IMPRESSION: In comparison with the study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Again there is relative " d0288e00-e268772f-10136cfb-3e4d0fc4-6e710b6e.jpg,validate/p17/p17860352/s59855052/d0288e00-e268772f-10136cfb-3e4d0fc4-6e710b6e.jpg,validation," FINAL REPORT EXAMINATION: Chest for radiographs INDICATION: ___ year old woman with dyspnea, aspiration pna // assess consolidations, assess for pulmonary edema TECHNIQUE: Chest PA COMPARISON: Multiple priors chest radiographs FINDINGS: Low lung volumes. Persistent left lower lobe atelectasis and possible small bilateral effusions. No pneumothorax This preliminary report was reviewed with Dr. ___, ___ radiologist. IMPRESSION: As above " 76c83013-f426e967-9c0e9df2-99e326b5-5c245aaa.jpg,validate/p19/p19791816/s56872909/76c83013-f426e967-9c0e9df2-99e326b5-5c245aaa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with h/o A fib, HTN, lymphoma, cerebellar stroke, new-onset seizures in Augsut without clear source admitted to ED in status epilepticus. Resolved with lorazepam x4mg, PPF. Admitted to ICU for neurologic monitoring // interval changes? COMPARISON: Prior chest radiographs dating between ___ and ___ as well as prior chest CT of ___ IMPRESSION: Support and monitoring devices remain in standard position. The cardiomediastinal contours are similar to the prior study. Extensive calcified pleural plaques are again demonstrated involving the right hemi thorax more than the left. Worsening left retrocardiac opacity could reflect atelectasis or developing infectious pneumonia and is accompanied by a small left pleural effusion. " e1cb361b-46a09cac-b4848d07-678edf4b-08839ab6.jpg,validate/p16/p16771184/s59260571/e1cb361b-46a09cac-b4848d07-678edf4b-08839ab6.jpg,validation," 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. " ece88034-2e43e3e5-4e0ca4fe-e29393e1-bf14eb02.jpg,validate/p12/p12723922/s55664973/ece88034-2e43e3e5-4e0ca4fe-e29393e1-bf14eb02.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with small-bowel obstruction// ? NGT position TECHNIQUE: Portable AP view of the chest COMPARISON: ___ chest radiograph at 05:02 FINDINGS: There has been interval placement of an enteric tube with tip in the stomach. Left-sided AICD device is noted with leads in unchanged positions. Cardiac silhouette size remains mildly enlarged. The mediastinal and hilar contours are similar. Mild pulmonary vascular congestion persists. There is streaky atelectasis in the lung bases without focal consolidation. No pleural effusion or pneumothorax is present. Right shoulder arthroplasty and lumbar spine fusion hardware are incompletely assessed. IMPRESSION: Enteric tube tip in the stomach. " e7f5702a-962e0e08-3f0e8830-f969228b-f8b87db2.jpg,validate/p15/p15938425/s54810849/e7f5702a-962e0e08-3f0e8830-f969228b-f8b87db2.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with coronary artery disease status post CABG with paroxysmal AFib, presents with atrial fibrillation. Question pneumonia. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Cardiac silhouette is enlarged but stable in configuration. Median sternotomy wires are again noted. The lungs are clear of consolidation, effusion, or pulmonary vascular congestion. No acute osseous abnormalities are noted. Surgical clips identified in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 7a15860b-470dcb69-7ce6bb37-0d9b40a7-4bd6991d.jpg,validate/p17/p17724257/s56881708/7a15860b-470dcb69-7ce6bb37-0d9b40a7-4bd6991d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ M with ESRD s/p transplant in ___, CAD s/p CABG, DM c/b neuropathy, CHF with EF ___%, hyperparathyroidism s/p resection of ___ glands on ___ sent in by PCP after found to be in acute on chronic renal failure with Cr 7.2 (from 4.3 on ___). // Please assess for rib fractures (recent compressions), and pulmonary edema, evidence of decompensating heart failure COMPARISON: Chest x-ray from ___. FINDINGS: Compared with ___, no definite change is detected. The cardiomediastinal silhouette is grossly unchanged. Sternotomy wires again noted. Platelike atelectasis at the left base with an elevated left hemidiaphragm is again noted, though with gas now seen beneath the left hemidiaphragm, with in the gastric fundus. No CHF or frank consolidation is identified. No gross effusion. Minimal blunting of both costophrenic angles posteriorly could be new. No displaced rib fractures are detected on these lung-technique films. Correlation with any specific site of symptoms and, if indicated, dedicated rib radiographs could help for further assessment. No pneumothorax is detected. IMPRESSION: 1. Possible slight blunting of both costophrenic angles posteriorly, which could be new. Otherwise, I doubt significant interval change. 2. No displaced rib fracture detected. Please see comment above. " 88e81f62-a3866133-3fe6b5b0-dcb217ee-01d2d52e.jpg,validate/p15/p15619921/s58989408/88e81f62-a3866133-3fe6b5b0-dcb217ee-01d2d52e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with small PTX // reeval PTX IMPRESSION: As compared to the previous radiograph from earlier today, bilateral pleural effusions have apparently increased in size, particularly on the right. Both effusions appear to be partially layering on this semi upright radiograph. Previously noted small right apical pneumothorax is no longer visualized, but positional differences may limit the detection of small pneumothoraces. " 81f35cca-8483582f-cda44193-44f4d44e-2baf5a1e.jpg,validate/p19/p19121781/s50074386/81f35cca-8483582f-cda44193-44f4d44e-2baf5a1e.jpg,validation," FINAL REPORT HISTORY: Three days of cough. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiac silhouette is top normal. There is no pleural effusion or pneumothorax. There is no pulmonary edema. IMPRESSION: No evidence of acute cardiopulmonary process. " 52cf6d1d-d432bdb5-b79e3b14-765f4e0c-a9bf148b.jpg,validate/p19/p19353175/s58870109/52cf6d1d-d432bdb5-b79e3b14-765f4e0c-a9bf148b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough, x-ray earlier today recommended another x-ray due to poor positioning on latera. COMPARISON: Prior exam performed earlier today. FINDINGS: PA and lateral views of the chest provided. Eventration of the right hemidiaphragm again noted. The lungs appear clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette appears normal. Bony structures appear intact. Prominent anterior osteophytes in the thoracic spine likely account for prevertebral opacity. IMPRESSION: No acute findings. Prominent anterior osteophytosis in the thoracic spine likely accounts for prevertebral opacity seen on prior imaging study. " 99831696-75a866c4-0e2b74da-dae31617-79209208.jpg,validate/p18/p18871802/s58167141/99831696-75a866c4-0e2b74da-dae31617-79209208.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M 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. " 2838401e-68f717f3-a159f535-69173412-ec5a7e8d.jpg,validate/p15/p15195922/s56524331/2838401e-68f717f3-a159f535-69173412-ec5a7e8d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Hypoxia. COMPARISONS: None. TECHNIQUE: Chest, portable AP upright. FINDINGS: Although perhaps exaggerated by AP portable technique, the heart is relatively prominent in size for age with a globular appearance. The lungs appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: Mildly prominent heart size for age although potentially exaggerated by technique; follow-up standard PA and lateral radiographs may be useful to reassess when feasible. No evidence of acute disease. " 3d865e47-42eab299-97bafac4-bbd97344-fc5cc7f9.jpg,validate/p16/p16135813/s51370362/3d865e47-42eab299-97bafac4-bbd97344-fc5cc7f9.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with ?new brain mass // ?infection TECHNIQUE: Chest PA and lateral IMPRESSION: As compared to ___ radiograph, appearance of the chest is similar with no new areas of consolidation to suggest the presence of pneumonia. " df38dc24-44a7a0ae-12d0930e-a67fb018-c519bc3e.jpg,validate/p13/p13225587/s58516997/df38dc24-44a7a0ae-12d0930e-a67fb018-c519bc3e.jpg,validation," FINAL REPORT INDICATION: Intraparenchymal hemorrhage, question pneumonia or fluid overload. COMPARISON: Chest radiograph from ___ at ___. FINDINGS: Three views of the chest. There are interstitial opacities in the right lung, which may represent diffuse multifocal pneumonia or aspiration. Given differences in technique, this appears similar to prior study. No pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: Likely multifocal pneumonia or aspiration in the right lung. " af2bcaa9-f4ad11d5-24d7cb72-a54fbacc-e4dd0aa3.jpg,validate/p14/p14280310/s56920231/af2bcaa9-f4ad11d5-24d7cb72-a54fbacc-e4dd0aa3.jpg,validation," 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. " 41b4706d-342746d9-817b69d2-8592d3d5-5a348fd9.jpg,validate/p14/p14113035/s53794908/41b4706d-342746d9-817b69d2-8592d3d5-5a348fd9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cardiac arrest // ?interval worsening COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous examination. The monitoring and support devices are in unchanged normal position. The pre-existing perihilar opacity on the left is minimally improved but still clearly visible. No evidence of pulmonary edema. No pleural effusions. No pneumothorax. " 3baa7990-f2336c48-5bb28312-4b1b3efb-c9b29e9a.jpg,validate/p11/p11966397/s58616087/3baa7990-f2336c48-5bb28312-4b1b3efb-c9b29e9a.jpg,validation," 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. " 7921e2fe-b2c4aeff-017ce709-712dedb9-b4fb4d38.jpg,validate/p13/p13193136/s51545983/7921e2fe-b2c4aeff-017ce709-712dedb9-b4fb4d38.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest tightness. FINDINGS: PA and lateral views of the chest provided demonstrate a dual-lead pacemaker with leads extending into the region of the right atrium and right ventricle, unchanged and intact in appearance. The lungs appear clear and hyperinflated with upper lobe lucency and flattened diaphragms suggesting underlying emphysema. No signs of pneumonia or CHF. Cardiomediastinal silhouette is stable and normal. No acute bony abnormalities are seen. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 5243c28e-34e2109a-6bdf4cc1-a9100624-b96f1743.jpg,validate/p13/p13325402/s57589679/5243c28e-34e2109a-6bdf4cc1-a9100624-b96f1743.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ESRD ___ HTN s/p deceased donor kidney transplant in ___ (on tacro and prednisone, baseline Cr 2.5-3.0), CVA, seizure d/o on Keppra and postpartum CM who p/w SOB and ___ ___ acute dHF exacerbation as well as acute on chronic anemia. Symptoms improving with diuresis, now on room air and approaching euvolemia. // Assess for interval change in pulmonary edema TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is enlarged, unchanged. The aortic knob is prominent, unchanged. Lungs are overall clear with no evidence of pulmonary edema. No pleural effusion or pneumothorax is appreciated although small amount of pleural fluid cannot be excluded. " 7069e05e-745802f2-7715c356-57f7e116-27e885f6.jpg,validate/p12/p12468629/s58929664/7069e05e-745802f2-7715c356-57f7e116-27e885f6.jpg,validation," FINAL ADDENDUM Updated finding and recommendations discussed with Dr. ___ (ED) by phone at 9:23am on ___. ______________________________________________________________________________ FINAL REPORT HISTORY: Hip fracture. Evaluate for cardiopulmonary process. COMPARISON: CXR ___ and CT ___. FINDINGS: Frontal supine views of the chest were obtained. Low lung volumes results in bronchovascular crowding, but a small right pleural effusion is larger than on ___, pulmonary vasculature less distinct, there are new septal lines due to increased interstitial pulmonary edema. The heart is enlarged, similar to ___. A fractured uppermost median sternotomy wire is unchanged. A tubular opacity still present at the lower pole of the right hilus could be a vessel or a nodule. Repeat conventional chest radiographs should be taken after resolution of cardiac decompensation to see if Chest CT is neeeded for clarification. IMPRESSION: Mild pulmonary edema. Need to follow possible right lower lobe lung nodule. " dbd5e32e-550bcc39-c1cf82c8-a475d285-1fcf2887.jpg,validate/p10/p10021487/s50316375/dbd5e32e-550bcc39-c1cf82c8-a475d285-1fcf2887.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with rib fracture, evaluate for rib fractures. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate healing right-sided rib fractures. There is increase in the air component within a large air-fluid collection under an elevated right hemidiaphragm consistent with known necrotic right lobe of the liver. The lungs are otherwise clear with right more than left basilar atelectasis, and a large right pleural effusion. The cardiac silhouette and mediastinal contours are normal. IMPRESSION: 1. Poor visualization of right-sided rib fractures. If there is further question regarding these, repeat dedicated views are recommended. 2. Large air-fluid level within the necrotic right lobe of the liver, and elevation of the right hemidiaphragm with right base atelectasis and small pleural effusion. " 12285719-e63fa906-acf048d3-94311f2c-5e78ffee.jpg,validate/p18/p18515014/s51509987/12285719-e63fa906-acf048d3-94311f2c-5e78ffee.jpg,validation," FINAL REPORT HISTORY: Dehydration with basilar crackles. FINDINGS: No previous images. There are relatively low lung volumes that most likely account for the prominence of the transverse diameter of the heart. Dense calcification of the mitral annulus is seen. No definite vascular congestion, pleural effusion, or acute focal pneumonia. " ef5d1971-6f672ac0-ab664841-488bfab3-6f38d14d.jpg,validate/p17/p17767787/s52583609/ef5d1971-6f672ac0-ab664841-488bfab3-6f38d14d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea // ?PNA COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Hilar congestion is again noted with improvement in pulmonary edema. Bilateral pleural effusions are small and appears slightly improved. Basilar compressive atelectasis is present. Heart size is top-normal. Mediastinal contour is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Overall there is interval improvement with mild residual hilar congestion and small bilateral pleural effusions. Top-normal heart size. " c0f11ebe-74893726-bc3d3e20-ea4b5c98-9f823e90.jpg,validate/p17/p17297649/s55876474/c0f11ebe-74893726-bc3d3e20-ea4b5c98-9f823e90.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with heart failure. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded, with prominent bilateral interstitial markings and Kerley B lines, compatible with interstitial edema. There is no pneumothorax, pleural effusion, or focal airspace opacity. The cardiomediastinal silhouette is stable in appearance, and a dual-lead pacemaker device is unchanged in position. The aorta is tortuous, with mild atherosclerotic calcifications. Enlargement of the bilateral hila is similar in appearance, compatible with known pulmonary arterial hypertension. Mild bibasilar atelectasis is noted. IMPRESSION: Interstitial pulmonary edema, increased since the prior study. Stable mild cardiomegaly. " d06596cc-e984b733-9f6a35cc-5179acc5-792c06d6.jpg,validate/p12/p12006266/s54145098/d06596cc-e984b733-9f6a35cc-5179acc5-792c06d6.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Question edema. The patient presents with increased lower extremity edema and history of congestive heart failure. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The heart is moderately enlarged. There is similar mild unfolding of the thoracic aorta. The mediastinal and hilar contours appear unchanged. As before, the minor fissure appears slightly thickened. Depicted on the lateral view is a moderate subpulmonic effusion with associated opacity, probably due to atelectasis, likely unchanged. There is no pneumothorax. Right-sided rib deformities appear unchanged. Moderate anterior osteophytes are noted throughout the thoracic spine. The right shoulder demonstrates severe degenerative changes including complete effacement of the glenohumeral joint with subchondral sclerosis and prominent marginal osteophyte formation. IMPRESSION: Persistent moderate right-sided pleural effusion; otherwise unremarkable. " 42c3f465-4d4a0374-ea321cfb-6a7952a9-89795d3c.jpg,validate/p17/p17977232/s53618406/42c3f465-4d4a0374-ea321cfb-6a7952a9-89795d3c.jpg,validation," FINAL REPORT HISTORY: Tachycardia and cough, assess for cardiopulmonary process. COMPARISON: None. FINDINGS: Two views were obtained of the chest. While no discrete abnormality is seen on the frontal view, there is a vague retrocardiac opacity. On the lateral mild increase in opacification of the posterior lower lungs suggests left lower lobe pneumonia. There is no pleural effusion or pneumothorax. The heart is top-normal in size with normal mediastinal and hilar contours. IMPRESSION: Vague opacity on the lateral view could reflect left lower lobe pneumonia. " 35f042cf-069f706a-03848019-19737f83-a6414f6e.jpg,validate/p15/p15653759/s57513933/35f042cf-069f706a-03848019-19737f83-a6414f6e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic gastric cancer with right pleural effusion on admission s/p pigtail catheter with drainage, removed on ___. // eval interval change, reaccumulation eval interval change, reaccumulation IMPRESSION: In comparison with the study of ___, there is increased opacification in the lower portion of the right hemithorax, consistent with re-accumulation of a layering pleural effusion with compressive basilar atelectasis. Less prominent effusion and atelectasis seen on the left. Port-A-Cath again extends to the right atrium. " 57e75002-8921d0e1-6d925d8e-9940bcf5-e382a0a8.jpg,validate/p16/p16617891/s55238781/57e75002-8921d0e1-6d925d8e-9940bcf5-e382a0a8.jpg,validation," 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. " c66adf3d-92b590b7-58098170-fabd41ff-9fe62ebe.jpg,validate/p16/p16777182/s53601105/c66adf3d-92b590b7-58098170-fabd41ff-9fe62ebe.jpg,validation," FINAL REPORT INDICATION: ___F with cough // eval for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process, no evidence of pneumonia. " eb0df44a-ba88acdb-2047d2cd-f8629b6f-5fd0e98c.jpg,validate/p15/p15190257/s59892756/eb0df44a-ba88acdb-2047d2cd-f8629b6f-5fd0e98c.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs. INDICATION: ___ year old man with decompensated cirrhosis. Eval for infiltrate, fluid. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ and ___. FINDINGS: There is been interval development of bilateral lower lobe predominant airspace opacities with cephalization likely representing pulmonary edema and vascular congestion. Overall the appearance is unchanged from ___. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable. Imaged upper abdomen is unremarkable. IMPRESSION: Interval development of bilateral lower lobe predominant airspace opacities favoring pulmonary vascular congestion and edema, similar in appearance to ___ but new compared to ___. This study was reviewed with Dr. ___, ___ radiologist. " 50ca584b-f859bda7-fd523d01-28a67cc1-ac2b5c55.jpg,validate/p11/p11052935/s53884408/50ca584b-f859bda7-fd523d01-28a67cc1-ac2b5c55.jpg,validation," FINAL REPORT INDICATION: Recent diagnosis of pneumonia, worsening symptoms. COMPARISON: Chest CT ___, PET-CT ___, chest radiograph ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. Hyperinflation of lungs with emphysematous changes , most pronounced within the lung apices is again demonstrated. Ill-defined patchy opacity within the right lower lobe appears slightly improved when compared to the prior study, but persists. Additionally, continued patchy ill-defined opacity within the left lower lobe is not significantly changed in the interval. No pleural effusion or pneumothorax is identified. There is no pulmonary vascular engorgement. Scarring within the left upper lobe is stable. There is no pneumothorax. Multilevel degenerative changes of the thoracic spine are redemonstrated. IMPRESSION: Slight interval improvement in ill-defined patchy opacity within the right lower lobe likely representing pneumonia. Patchy opacity in the left lower lobe may be reflective of atelectasis, though infection in this region also cannot be excluded, but appears relatively unchanged compared to the prior study. " 9730f165-4ba8828b-d3282d1e-6feb9b23-aa2bd9ff.jpg,validate/p14/p14421594/s54687501/9730f165-4ba8828b-d3282d1e-6feb9b23-aa2bd9ff.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with bibasilar rhochi // Eval for acute process, attn to PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Increased interstitial markings, particularly at the lung bases suggest chronic interstitial lung disease similar as compared to the prior study. Minor basilar atelectasis is seen. There is no new focal consolidation. No large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Chronic lung disease without definite focal consolidation to suggest pneumonia. " 029566d4-ed8b41ff-5ede7559-3d7f39d1-e2cd7e88.jpg,validate/p17/p17292893/s54436929/029566d4-ed8b41ff-5ede7559-3d7f39d1-e2cd7e88.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with sob // eval for ptx 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. " 91e0ee5a-2f8b0ef1-1780894f-32247137-ec4ef988.jpg,validate/p10/p10983866/s50732129/91e0ee5a-2f8b0ef1-1780894f-32247137-ec4ef988.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with fever, question pneumonia. COMPARISON: Chest radiograph on ___ and CT chest on ___. FINDINGS: PA and lateral views of the chest. Again seen is the biapical calcified scarring compatible with prior granulomatous disease and emphysematous changes involving mainly the apices. Mild chronic interstitial changes are seen in the lower lobes bilaterally, better assessed on the prior CT. There is an opacity in the left lower lobe which may represent a superimposed pneumonia. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette is normal. The median sternotomy wires and mediastinal clips are stable. Clips are seen in the right upper quadrant. There is no free air. The osseous structures appear unremarkable. IMPRESSION: Left lower lobe opacity concerning for pneumonia. " 9081b062-9e711153-0bdfa06e-bbda36e0-39c37d09.jpg,validate/p16/p16517237/s56758617/9081b062-9e711153-0bdfa06e-bbda36e0-39c37d09.jpg,validation," FINAL REPORT AP CHEST, 4:30 A.M., ___. HISTORY: A ___-year-old man with a stroke, question interval changes. IMPRESSION: AP chest compared to ___: Left PIC line has been withdrawn to the mid SVC. I doubt there is pulmonary edema. Moderate-to-severe cardiomegaly is chronic. No appreciable pleural effusion. ET tube in standard placement. Upper enteric drainage tube would need to be advanced 8 cm to move all the side ports into the stomach. No pneumothorax. " 8e406ed2-cc436cd4-977ecfaf-daa07959-fc2f1e68.jpg,validate/p17/p17561108/s57185861/8e406ed2-cc436cd4-977ecfaf-daa07959-fc2f1e68.jpg,validation," FINAL REPORT AP CHEST X-RAY INDICATION: Patient with aortic valve repair. Rule out pneumothorax. COMPARISON: ___. FINDINGS: Since the previous exam, the patient has been extubated. The nasogastric tube, the Swan-Ganz and the mediastinal catheter have also been removed. The pneumopericardium has regressed. There is probably a small left-sided apical pneumothorax that is less than 3 mm. Small bilateral pleural effusion. Bibasilar atelectasis. Stable enlarged mediastinal and cardiac contours. CONCLUSION: The tubes have been removed. There is a minimal left apical pneumothorax. " 5bc4ec21-acb43a4d-4e05873a-e43f7b42-cd182ec8.jpg,validate/p14/p14338126/s53572656/5bc4ec21-acb43a4d-4e05873a-e43f7b42-cd182ec8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: AM Evaluation // Post-op patient IMPRESSION: As compared to ___ chest radiograph, cardiomegaly is accompanied by worsening edema, and apparent enlargement of bilateral pleural effusions, now large on the left and moderate on the right with adjacent bibasilar atelectasis and or consolidation. Diffuse haziness of the upper abdomen is suggestive of ascites, and there is likely anasarca present as well. " 5bc4c07b-60d9033d-18dd2f2d-0b49e42c-30200ac7.jpg,validate/p13/p13968418/s59482018/5bc4c07b-60d9033d-18dd2f2d-0b49e42c-30200ac7.jpg,validation," FINAL REPORT INDICATION: Epigastric pain. Evaluate for free air. 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. There is no free air under the diaphragm. IMPRESSION: 1. No acute cardiac or pulmonary process. 2. No free air under the diaphragm. " 0045a283-9dda0951-4b21809c-a280181d-a64dc06a.jpg,validate/p14/p14371035/s52598293/0045a283-9dda0951-4b21809c-a280181d-a64dc06a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with periurostomy herniation p/w recurrent SBO. // Nasogastric tube positioning Nasogastric tube positioning IMPRESSION: In comparison with the study of earlier in this date, the nasogastric tube has advanced to the upper to mid portion of the stomach with the tip pointing downward. Nevertheless, in the it should be pushed forward at least several cm for most effective positioning. Little change in the appearance of the heart and lungs. " e4ab162e-21b26966-72979f19-358fc1d8-b1f6ce1b.jpg,validate/p18/p18614958/s59235376/e4ab162e-21b26966-72979f19-358fc1d8-b1f6ce1b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with CABG on ___, nonweightbearing and leg swelling and shortness of breath. Evaluation for pulmonary edema. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrates stable cardiomegaly with median sternotomy wires and vascular clips overlying the left cardiomediastinal border. There has been interval removal of right internal jugular central venous catheter. The degree of pulmonary vascular congestion appears similar compared to prior chest radiograph. There is blunting of the bilateral costophrenic angles, representing small bilateral pleural effusions. There is no pneumothorax. No focal consolidations are present within the lungs. IMPRESSION: No acute cardiopulmonary process with stable appearance of pulmonary vascular congestion and small bilateral pleural effusions. " 8ce0b116-d9c59da2-522cd357-d1100ae1-91ec8660.jpg,validate/p13/p13471464/s52461112/8ce0b116-d9c59da2-522cd357-d1100ae1-91ec8660.jpg,validation," FINAL REPORT HISTORY: Dyspnea and atrial fibrillation. TECHNIQUE: Portable AP view of the chest. COMPARISON: None. FINDINGS: There are small to moderate size bilateral pleural effusions, right greater than left. This is obscures the cardiac silhouette making assessment of the cardiac silhouette size difficult. The patient is somewhat rotated. There is diffuse calcification of the trachea and bronchi. No pulmonary vascular congestion is seen. No pneumothorax is clearly present. Bibasilar airspace opacities likely reflect compressive atelectasis, but infection or aspiration are not completely excluded. Moderate cervical lumbar spine, convex to the right is noted. IMPRESSION: Somewhat limited study due to patient rotation. Small to moderate size bilateral pleural effusions with bibasilar opacities likely reflecting compressive atelectasis. Infection and aspiration at the lung bases however cannot be excluded. " bf494af4-58716511-874baae6-22c6fc39-d61315b4.jpg,validate/p14/p14338126/s52556075/bf494af4-58716511-874baae6-22c6fc39-d61315b4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: post-extubation // pulmonary congestion TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: There has been interval removal of the endotracheal tube. Lung volumes remain low. There is persistent left lower lobe atelectasis. There are airspace opacities at both the right and left bases, this is nonspecific in appearance but could reflect pulmonary edema or infection. There is increased aeration, projected on the right side when compared to the prior study. Given the relatively rapid improvement, pulmonary edema is considered more likely. A right-sided subclavian catheter terminates in the mid SVC. A nasoenteric tube is in-situ, the tip is not visualized in this study but lies below the left hemidiaphragm. Prominence of the hila and pulmonary vasculature consistent with fluid overload. IMPRESSION: Interval improvement in the airspace opacities bilaterally, most suggestive of resolving pulmonary edema. " eba7a535-8115fea9-eae89d1b-ce6539da-abe356ba.jpg,validate/p13/p13751863/s54773888/eba7a535-8115fea9-eae89d1b-ce6539da-abe356ba.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with hyperglycemia and altered mental status. STUDY: PA and lateral chest radiograph. COMPARISON: ___ chest radiograph and PET-CT from ___. FINDINGS: A left-sided Port-A-Cath tip terminates at the lower SVC. The heart size is within normal limits. The mediastinal and hilar contours are normal. The lungs are clear of lobar consolidation with plate-like atelectasis or scarring along the major fissure than in the lower lateral lung zones bilaterally. Blunting of the right costophrenic angle likely represents a small-to-moderate pleural fluid versus thickening. There is no pneumothorax. There is no change from prior exams. IMPRESSION: No radiographic evidence of pneumonia; probable small-to-moderate right pleural effusion versus thickening which is unchanged. " 1385cf8b-06437690-90173c74-552bf1f2-145baf18.jpg,validate/p10/p10046679/s54480315/1385cf8b-06437690-90173c74-552bf1f2-145baf18.jpg,validation," FINAL REPORT HISTORY: Asthma. FINDINGS: In comparison with study of ___, there is little overall change and no evidence of acute cardiopulmonary disease. There is hyperexpansion of the lungs with flattening of the hemidiaphragms consistent with chronic pulmonary disease. There is continued enlargement of the cardiac silhouette without vascular congestion or pleural effusion. No evidence of acute focal pneumonia. " 032295b3-3cc8b64d-cc8c9f56-5be66e38-bf8fb817.jpg,validate/p11/p11607177/s55843267/032295b3-3cc8b64d-cc8c9f56-5be66e38-bf8fb817.jpg,validation," FINAL REPORT INDICATION: History: ___M with cough, LVAD // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: Severe cardiomegaly is unchanged. Left axillary device with associated leads is unchanged in position. The left ventricular assist device is partly imaged. There is a small left pleural effusion but no right pleural effusion or pneumothorax. Mild pulmonary edema is present. There is no focal consolidation concerning for pneumonia. IMPRESSION: 1. Mild pulmonary edema with small left pleural effusion. No pneumonia. 2. Stable severe cardiomegaly. " 9808adcd-7cd5c509-8999c753-8a01cfff-15d8cdec.jpg,validate/p13/p13216215/s59829503/9808adcd-7cd5c509-8999c753-8a01cfff-15d8cdec.jpg,validation," FINAL REPORT AP CHEST, 7:44 A.M., ___ HISTORY: ___-year-old man with high inflammatory markers. Suspect pneumonia. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Lungs are mildly hyperinflated but clear of any focal abnormality to suggest pneumonia. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 9c8ac568-1844d60d-2fc4be7f-4b94d283-9602cd75.jpg,validate/p12/p12521370/s53944090/9c8ac568-1844d60d-2fc4be7f-4b94d283-9602cd75.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple myeloma, pathologic cervical fracture, fever to 103, no cough or SOB // ?pneumonia, aware that patient had CXR in past 24 hours, CXR very rotated making findings unclear therefore we are repeating CXR ?pneumonia, aware that patient had CXR in past 24 hours, CXR COMPARISON: Chest radiographs ___. IMPRESSION: Lung volumes remain very low, but on this examination patient positioning is less rotated, giving a reasonable view of all of the lungs except for the infra hilar right lower lobe where there could be consolidation. Lungs otherwise are clear although the pulmonary vasculature remains engorged. Widening of the supra cardiac mediastinum suggests venous distention, probably due to volume overload. Heart is mildly enlarged. Pleural effusions small if any at all. No pneumothorax. " 5904d07f-71abc76c-ec437cd6-a1139580-b98c8e4a.jpg,validate/p19/p19845120/s51297752/5904d07f-71abc76c-ec437cd6-a1139580-b98c8e4a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ male admitted with GI bleed on ___ which was thought to be ___ AVM s/p IR coiling which has subsequently been complicated by ischemic colitis and ongoing lower GI bleed now s/p lap->open R colectomy on ___ extubated on ___ reintubated on ___, lue dvt., whose major issues are continued GI bleeding and respiratory insuffiency, AF and renal failure. // monitor pleural effusion COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube and a right internal jugular vein catheter are unchanged. There is considerable on going volume loss of the left lung, with shift of the mediastinal and cardiac structures to the left and an increase in extent of left atelectasis. On the right, no relevant change is seen. No pneumothorax. No larger right pleural effusion. " 5e5f8305-24a495c9-89fb7f6f-ab730177-bbc4dbd2.jpg,validate/p16/p16454913/s56296904/5e5f8305-24a495c9-89fb7f6f-ab730177-bbc4dbd2.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient on hemodialysis and intubated. Comparison is made with prior study, ___. Large bilateral pleural effusions, larger on the right side, are probably unchanged allowing the difference in positioning of the patient. Bibasilar atelectases, larger on the left side, are stable. Cardiomegaly is obscured by the pleuroparenchymal abnormalities. Lines and tubes are in unchanged standard position. Mild-to-moderate pulmonary edema is stable. " 7db300a9-8f66e34c-56685f33-fcd48279-3cd7ce3a.jpg,validate/p18/p18135822/s54935367/7db300a9-8f66e34c-56685f33-fcd48279-3cd7ce3a.jpg,validation," FINAL REPORT INDICATION: Epigastric abdominal pain, evidence of perforation. COMPARISON: Chest radiograph ___; ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Lungs are well expanded and clear. There is no pneumoperitoneum. IMPRESSION: No acute cardiopulmonary process. No pneumoperitoneum. " da86426e-9ab12d0d-cb8c2ec3-51968bb2-70f16c9e.jpg,validate/p13/p13989807/s58318482/da86426e-9ab12d0d-cb8c2ec3-51968bb2-70f16c9e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p CABG- CTs d/c'd // evaluate for pneumothorax TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate to severe cardiomegaly is stable. Widening mediastinum has improved. There is minimal vascular congestion. If any there is a small left effusion. There is probably small left pneumothorax. Retrocardiac atelectasis has increased. Sternal wires are aligned. . " 1d4897dd-e28077d2-07f02268-bbfb9e34-9ccef409.jpg,validate/p17/p17290849/s57921274/1d4897dd-e28077d2-07f02268-bbfb9e34-9ccef409.jpg,validation," FINAL REPORT INDICATION: Cough. COMPARISON: ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There are no focal consolidations concerning for pneumonia. The lungs are symmetrically well expanded. There is no pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 84676836-8aeeae0d-0f54b6d1-e1915da4-4fe6285d.jpg,validate/p17/p17446941/s50693892/84676836-8aeeae0d-0f54b6d1-e1915da4-4fe6285d.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and sarcoidosis. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: Heart size is mildly enlarged but unchanged. Multiple calcified mediastinal and hilar lymph nodes are again demonstrated. Superior hilar retraction with scarring in the lung apices are compatible with chronic changes from sarcoidosis. Blunting of the costophrenic angles bilaterally is compatible with small bilateral pleural effusions, as seen on the prior study. Lungs are hyperinflated. No new focal consolidation is identified. There is no pneumothorax. No pulmonary vascular congestion is identified. The right humeral head prosthesis is partially imaged. Calcified breast implants are re- demonstrated. IMPRESSION: No significant interval change from the prior exam with chronic findings compatible with sarcoidosis. Small bilateral pleural effusions. No new focal opacity. " 8ffcb895-65104879-59d2146a-45db3a9f-8ce3c5c5.jpg,validate/p12/p12643916/s56898663/8ffcb895-65104879-59d2146a-45db3a9f-8ce3c5c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with eating disorder, syncope 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. " 909976a8-8afcc08f-53ac0148-510c7801-79056dce.jpg,validate/p17/p17548885/s51487035/909976a8-8afcc08f-53ac0148-510c7801-79056dce.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest pain. There is mild cardiomegaly. The lungs are clear. There is no pneumothorax, pleural effusion, pneumonia or CHF. " 23212450-182137a2-759f5954-bb94bfb2-bb513357.jpg,validate/p12/p12175804/s50839295/23212450-182137a2-759f5954-bb94bfb2-bb513357.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___ y.o. woman with multiple medical problems most notable for hypertension, severe COPD on 4L NC, dCHF, iron deficiency anemia presenting with exertional dyspnea, hematochezia, and abdominal pain. TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___, PET-CT ___ FINDINGS: Cardiac silhouette size remains mildly enlarged with prominent epicardial fat pad. Mediastinal and hilar contours are unchanged with atherosclerotic calcifications noted at the aortic knob. Lungs are hyperinflated with mild emphysematous changes again noted within the upper lobes. There is mild upper zone vascular redistribution without frank pulmonary edema. Patchy opacities in the lung bases likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: Mild bibasilar atelectasis. Mild emphysema. Mild pulmonary vascular congestion. " 31ff3d04-0e4cacb3-9b71a1a5-fce12d84-256917f0.jpg,validate/p10/p10541305/s59891703/31ff3d04-0e4cacb3-9b71a1a5-fce12d84-256917f0.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP, recvent URI // 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 and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 940a0a48-9356e448-61bc5a0c-b68716d5-99003075.jpg,validate/p11/p11224611/s56665882/940a0a48-9356e448-61bc5a0c-b68716d5-99003075.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o sarcoidosis, recent SOB; // assess for active disease assess for active disease IMPRESSION: In comparison with the study of ___, there is little change. There is substantial elevation of the right hemidiaphragmatic contour, but no evidence of pneumonia, vascular congestion, or pleural effusion. Specifically, no evidence of hilar adenopathy or interstitial prominence to radiographically suggest sarcoidosis. " 92afaf0a-1599ea5d-299de00c-663008be-231fd983.jpg,validate/p16/p16508811/s53708518/92afaf0a-1599ea5d-299de00c-663008be-231fd983.jpg,validation," FINAL REPORT INDICATION: Fever and cough, status post renal transplant. History of smoking. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There are new opacities in the superior segment of the left lower lobe and in the right lower lobe, most consistent with multifocal pneumonia. No pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are normal. IMPRESSION: New multifocal pneumonia in the right and left lower lobes. These findings were discussed with Dr. ___ by Dr. ___ at 1:45 p.m. on ___ by telephone at the time of discovery. " 354b415a-1bcfa629-7cbc1f26-2a1071a2-bec97f2f.jpg,validate/p16/p16074700/s56142651/354b415a-1bcfa629-7cbc1f26-2a1071a2-bec97f2f.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No definite focal consolidation to suggest pneumonia. " 258f49f2-0ff30eda-fd431a82-10d4af8b-bddd0828.jpg,validate/p10/p10667727/s53874681/258f49f2-0ff30eda-fd431a82-10d4af8b-bddd0828.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, SOB, AMS // flash pulm edema flash pulm edema IMPRESSION: In comparison with the study of ___, there is again extensive hazy opacification throughout most of the right hemithorax, consistent with large layering pleural effusion and compressive atelectasis. Less prominent changes are seen on the left. In the appropriate clinical setting, superimposed pneumonia would have to be considered. The right IJ catheter is unchanged. There is now an endotracheal tube in place with its tip approximately 4 cm above the carina. Nasogastric tube extends well into the stomach the for passing below the lower margin of the image. " c0ea55f3-c0ec0470-254b3c64-b4e6fc44-c7ff354d.jpg,validate/p15/p15297941/s50079581/c0ea55f3-c0ec0470-254b3c64-b4e6fc44-c7ff354d.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old man with chest congestion, fever and expiratory wheezes. Evaluate for pneumonia. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. " 5ef3b52e-a102da92-6e4e92bd-93c1ce7e-ae4d61a8.jpg,validate/p12/p12466049/s50666238/5ef3b52e-a102da92-6e4e92bd-93c1ce7e-ae4d61a8.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: AP view of the chest. COMPARISON: ___ and ___. FINDINGS: Lung volumes are low. The heart size is top normal. Mediastinal contours are unchanged. There is mild pulmonary vascular engorgement, but this is improved compared to the prior study. No definite pleural effusions are seen. No pneumothorax is seen. Minimal bibasilar patchy opacities may reflect atelectasis. No acute osseous abnormalities are detected. IMPRESSION: Mild pulmonary vascular congestion, improved compared to the most recent exam, and mild bibasilar atelectasis. " 3d5ab314-5a749c3c-81777a54-a4aca66a-879a32c6.jpg,validate/p10/p10852143/s56286443/3d5ab314-5a749c3c-81777a54-a4aca66a-879a32c6.jpg,validation," FINAL REPORT HISTORY: Patient status post IPAA for UC, now with fever, eval for pneumonia or other respiratory process. COMPARISON: None available. FINDINGS: Frontal and lateral chest radiographs were obtained. Multiple areas of oapcity are present in the right lower lobe. The cardiac silhouette is mildly enlarged with small bilateral pleural effusions but no overt pulmonary edema. Mediastinal and hilar contours are stable. There is no pneumothorax. IMPRESSION: 1. Multisegmental pneumonia in the right lower lobe. 2. Mild cardiomegaly with small bilateral pleural effusions. Dr.___ ___ findings with Dr.___ ___ telephone at 1:40pm on ___. " 527b72bd-b4e8aa4c-e23200b1-8d44beeb-00583a22.jpg,validate/p13/p13450012/s55091731/527b72bd-b4e8aa4c-e23200b1-8d44beeb-00583a22.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with temperature to 102.5STAT CXR to look for etiology of temp/source of infection. // STAT CXR to look for etiology of temp/source of infection. TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph ___ FINDINGS: Bilateral low lung volumes. Cardiac size is top normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary abnormality or evidence of pneumonia " c2199ebd-889bd9db-a889f016-e0070a60-34479974.jpg,validate/p14/p14185804/s55873795/c2199ebd-889bd9db-a889f016-e0070a60-34479974.jpg,validation," FINAL REPORT HISTORY: Fever and cough. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Mild bibasilar atelectasis is present. There is no focal consolidation, pleural effusion or pneumothorax. No acute osseous abnormalities are detected. IMPRESSION: Mild bibasilar atelectasis. " 3e45713e-fdfe7571-fc3b868f-0652cf3f-cae269b8.jpg,validate/p15/p15245907/s55601986/3e45713e-fdfe7571-fc3b868f-0652cf3f-cae269b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure. Evaluate for interval change. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from ___, ___, and ___. FINDINGS: Compared with the prior study, bilateral basal parenchymal opacities are unchanged. There has been interval worsening of the bilateral pleural effusions, now multiloculated in the bilateral lungs. Moderate cardiomegaly is stable. Constant positioning of the tracheostomy tube and left PICC line. IMPRESSION: Worsened bilateral pleural effusions, which now demonstrate multiple loculations. " a95249e2-8b23803f-3ea7aefd-194644db-7d6b66ef.jpg,validate/p14/p14395025/s50244790/a95249e2-8b23803f-3ea7aefd-194644db-7d6b66ef.jpg,validation," FINAL REPORT HISTORY: COPD with worsening cough and phlegm. Evaluate for pneumonia. COMPARISON: CT abdomen and pelvis ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The lungs are hyperinflated, consistent with COPD. There is increased opacity over the right mid and lower lung which is new from ___ and concerning for multifocal pneumonia. There is no pleural effusion or pneumothorax. A 4 mm nodule is seen in the left lower lung. The ascending aorta is tortuous. The heart is normal in size. There is prominence of the pulmonary arteries, suggesting underlying pulmonary arterial hypertension. These findings were discussed with Dr. ___ by Dr. ___ at 11:15 on ___ by telephone 5 minutes after discovery. " 9916729f-e325868c-81b1fea7-1ee4fd6a-7eb75825.jpg,validate/p16/p16528352/s58950166/9916729f-e325868c-81b1fea7-1ee4fd6a-7eb75825.jpg,validation," FINAL REPORT INDICATION: Increased oxygen requirement and chest tightness suspicious for pneumothorax. TECHNIQUE: Upright AP chest view was read in comparison with multiple prior radiographs with the most recent from ___. FINDINGS: Right-sided PICC line ends at mid SVC. A pleural pigtail catheter is present at right lung base. No significant interval changes in the chest since ___. Opacity at the right lung base which is likely atelectasis and presumed small residual effusion are stable. Left lung is clear. There is an evidence of prior median sternotomy. Sternal sutures are intact. Heart size, mediastinal and hilar contours are normal. No pneumothorax. IMPRESSION: 1. No pneumothorax. 2. Small right lung base atelectasis and presumed small right pleural effusions are unchanged. " c21a7871-cb00990c-d55cc358-5fb64305-8a159053.jpg,validate/p10/p10871684/s59894670/c21a7871-cb00990c-d55cc358-5fb64305-8a159053.jpg,validation," 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. " 2c25c346-98ebdc1e-e6c6e7a2-734d16f2-1d7d4749.jpg,validate/p17/p17374016/s51771482/2c25c346-98ebdc1e-e6c6e7a2-734d16f2-1d7d4749.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with EN, no cough // eval for sarcoidosis 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 " 88d4ce78-1a535357-e1ab1dab-250ed8ba-4a94fda9.jpg,validate/p16/p16755216/s51398298/88d4ce78-1a535357-e1ab1dab-250ed8ba-4a94fda9.jpg,validation," WET READ: ___ ___ ___ 10:29 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fall // evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The cardiomediastinal silhouette is unchanged. The lungs are clear. There is no pleural effusion or pneumothorax. Mild to moderate multilevel degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 8f4b53f5-7a9e88ec-3eca0968-931a41de-aa42cacb.jpg,validate/p11/p11005665/s53778953/8f4b53f5-7a9e88ec-3eca0968-931a41de-aa42cacb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p aortic arch replacement and chest wall reconstruction w/pleural effusion. Concern for possible hemorrhagic effusion. Hct continues to downtrend. // Assess for worsening effusion Assess for worsening effusion COMPARISON: Comparison to ___ at 11:09 FINDINGS: PA and lateral views of the chest ___ at 13:25 is submitted. IMPRESSION: Extensive postoperative changes of the left hemithorax with similar appearance to that on prior studies. Stable partially loculated left pleural effusion. The right lung remains well inflated and clear. Overall cardiac and mediastinal contours are stable status post median sternotomy. No pneumothorax. Left subclavian arterial stent remains in place. " dc718e0a-3beae8a3-43d42e39-20bfc40f-156a65de.jpg,validate/p16/p16385283/s54913260/dc718e0a-3beae8a3-43d42e39-20bfc40f-156a65de.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tachypnea and fever // r/o pneumonia, r/o pulm edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 04:___. IMPRESSION: There is interval development of severe interstitial pulmonary edema that partially obscures right lower lobe consolidation and pleural effusion. Heart size and mediastinum are stable. The azygos vein is substantially more distended which is in consistency with pulmonary edema and increased volume overload. Right internal jugular line tip is at the level of cavoatrial junction. " 5bfb6e79-a90271c3-12a79698-b32dcaf1-ecb28b9b.jpg,validate/p12/p12304672/s59234412/5bfb6e79-a90271c3-12a79698-b32dcaf1-ecb28b9b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ with a PMHx of HBV cirrhosis complicated by esophageal varices, portal HTN, who presents with hypotension, leukocytosis, ___ and evidence of decompensated cirrhosis after ureteral stent exchange, s/p CVL placemnt. // evaluate for evolving pneumothorax evaluate for evolving pneumothorax IMPRESSION: Right internal jugular line tip is at the level of mid SVC. Pacemaker leads are in the expected locations. Left pleural effusion is large. Vascular congestion is present. There is no pneumothorax. " c530b46c-3be7e3c6-28f91990-b9152ec4-2f61ea52.jpg,validate/p17/p17006872/s54189022/c530b46c-3be7e3c6-28f91990-b9152ec4-2f61ea52.jpg,validation," FINAL REPORT INDICATION: Shortening of chest tube and changed to Pneumostat prior to transfer home. Evaluation for stability of pneumothorax. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Multiple priors, most recent on ___ at 4:44 a.m. FINDINGS: The right chest tube is in stable position. There is continued decrease in the size of the right pneumothorax which now measures less than 2 mm at the apex. There is no focal consolidation or pleural effusion. The cardiomediastinal silhouette is normal. IMPRESSION: Continued decrease in size of right pneumothorax and stable positioning of chest tube. Findings were relayed to ___ by phone at 2:06 p.m. " d91ca585-fc95dfa9-6484b0cf-45d715a2-f73ade41.jpg,validate/p15/p15584013/s53449388/d91ca585-fc95dfa9-6484b0cf-45d715a2-f73ade41.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Fever, neutropenia. COMPARISON: ___. FINDINGS: Right-sided subclavian central venous catheter is again seen, unchanged in position, terminating in the low SVC. There is increased mild elevation of the left hemidiaphragm which may be due to an underlying subpulmonic effusion. The right lung is grossly clear. No pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Slight prominence of the left hilum is stable. " e645fad1-e89e85bf-109cb215-ae2f37e1-ce3368eb.jpg,validate/p12/p12594793/s51223132/e645fad1-e89e85bf-109cb215-ae2f37e1-ce3368eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p cabg // eval pulm edema and effusion eval pulm edema and effusion IMPRESSION: Comparison to ___. Improved ventilation of the retrocardiac lung regions. . The left lateral pleural adhesion is stable there is no evidence for the presence of larger pleural effusions. No pneumothorax. No pulmonary edema. Correct stable alignment of the sternal wires. " 82a36da0-3c6a8f8f-fce3ed7a-2ba22a44-1b9e4626.jpg,validate/p14/p14470386/s54198228/82a36da0-3c6a8f8f-fce3ed7a-2ba22a44-1b9e4626.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubated, edh, ___ // eval for interval change TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 7da368f4-e99e2229-bc0d1b96-486a645b-38933068.jpg,validate/p13/p13940027/s55601457/7da368f4-e99e2229-bc0d1b96-486a645b-38933068.jpg,validation," FINAL REPORT HISTORY: COPD, acute exacerbation. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated with flattening of the diaphragms and increased retrosternal clear space compatible with COPD. Blunting of the costophrenic angles posteriorly appears to be chronic, and likely relates to pleural thickening. Cardiac, mediastinal and hilar contours are unremarkable. There are is no focal consolidation. No pneumothorax is identified. The pulmonary vascularity is normal. No acute osseous abnormality is identified. Old right-sided rib fractures are again noted. IMPRESSION: COPD. No radiographic evidence for pneumonia. " deae899c-cba9c0e4-3a9e7a11-d0e321f5-ba0c1745.jpg,validate/p17/p17598516/s54516963/deae899c-cba9c0e4-3a9e7a11-d0e321f5-ba0c1745.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with sudden onset of upper abdominal and lower chest pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. No free air seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " c916a793-4895c0fa-dd254c4e-dfedc5a3-f365b732.jpg,validate/p19/p19673689/s57311177/c916a793-4895c0fa-dd254c4e-dfedc5a3-f365b732.jpg,validation," FINAL REPORT HISTORY: Chest pain, hypertension. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: There is minor mid lung atelectasis. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The aorta is tortuous. The cardiac silhouette is mildly enlarged. No overt pulmonary edema is seen. IMPRESSION: No significant interval change. " 4d9a0aad-b7b2c160-e1c60248-cd755f83-612078fc.jpg,validate/p10/p10165672/s58414364/4d9a0aad-b7b2c160-e1c60248-cd755f83-612078fc.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: A poorly-defined area of consolidation has developed in the periphery of the right upper lobe, with a somewhat rounded configuration of the consolidation and internal lucencies, which probably represent air bronchograms. No additional similar areas of consolidation are seen elsewhere in the lungs, but note is made of several thickened septal lines in the periphery of the lung bases, right greater than left. Cardiac silhouette is mildly enlarged, but stable in size, and the aorta is tortuous without change. Possible new small right pleural effusion. IMPRESSION: 1. Peripheral right upper lobe consolidation, which may represent a bacterial ""round"" pneumonia. However, considering the patient's immunocompromised status, fungal infection should also be considered, particularly if the patient is neutropenic, as well as Nocardia. Consider CT for further characterization if warranted clinically. 2. New basilar septal lines, which may reflect mild interstitial edema or an interstitial component of the infection. 3. Small right pleural effusion. Findings and recommendation communicated to the office of Dr. ___ by telephone at 9:55 a.m. on ___. " 08985fcf-9107af17-71d06ddd-bf02e209-3402e3d0.jpg,validate/p15/p15803381/s51232487/08985fcf-9107af17-71d06ddd-bf02e209-3402e3d0.jpg,validation," FINAL REPORT HISTORY: Volume overload graphics exam: ___. COMPARISON: FINDINGS: Compared to the prior study there is no significant interval change. " 567655c4-5c2f129b-12da8879-12d729a9-1ce45e56.jpg,validate/p12/p12708817/s53742230/567655c4-5c2f129b-12da8879-12d729a9-1ce45e56.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) CLINICAL HISTORY ___ year old woman with strokes // NG tube placement (2 step) NG tube placement (2 step) COMPARISON: ___ FINDINGS: Two views demonstrate placement of the feeding to, with its tip ultimately in the region of the body of the stomach. IMPRESSION: Feeding tube placement. " 53968969-0927a4ba-ed749c81-c069df6d-9ce77533.jpg,validate/p13/p13444104/s53406111/53968969-0927a4ba-ed749c81-c069df6d-9ce77533.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AML. cough/SOb, eval infiltrates // eval infiltrates eval infiltrates COMPARISON: Comparison to ___ at 16:20 FINDINGS: Portable upright chest radiograph ___ at 09:22 is submitted. IMPRESSION: Dual lead right-sided pacer is unchanged. The heart remains enlarged. There are layering bilateral effusions with bibasilar patchy opacities suggestive of partial lower lobe atelectasis, although pneumonia or aspiration should also be considered. Interval improvement but residual mild to moderate pulmonary edema. No pneumothorax. Calcified mediastinal and hilar nodes as well as a calcified mass at the right apex consistent with prior granulomatous infection. Incidental note made of left shoulder hemiarthroplasty. " 337bb7a5-6d6242dd-73ed694a-85f1ca9e-e285e522.jpg,validate/p14/p14358282/s59632009/337bb7a5-6d6242dd-73ed694a-85f1ca9e-e285e522.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, shortness-of-breath, evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. Cardiomegaly is stable. Pulmonary vasculature is normal. There is no pleural effusion. Dual pacemaker leads are in appropriate position. IMPRESSION: No acute pneumonia. " 99997840-6796cc4e-930f556f-4f0c148c-73be1e77.jpg,validate/p16/p16177830/s51060763/99997840-6796cc4e-930f556f-4f0c148c-73be1e77.jpg,validation," FINAL REPORT HISTORY: Dyspnea, chest pain x. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Right perihilar mass is again seen, similar in appearance. Slight prominence of the left hilum is stable. Evidence of right upper lobe emphysema is seen. There is no new focal consolidation. No pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Again seen right perihilar mass. No findings to suggest pneumonia or pleural effusion. " 11de8156-85275908-b6e04550-d737ba48-845d64c6.jpg,validate/p16/p16649269/s52753890/11de8156-85275908-b6e04550-d737ba48-845d64c6.jpg,validation," FINAL REPORT INDICATION: Lymphoma, nausea, vomiting, joint pain after chemotherapy on ___. COMPARISON: None. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal, and hilar contours are normal. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " ffaffd43-ceafaf30-62c85c52-c7a3e744-65cb538a.jpg,validate/p15/p15393649/s53468293/ffaffd43-ceafaf30-62c85c52-c7a3e744-65cb538a.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with shortness of breath, evaluate for pneumonia. COMPARISON: None Available. TECHNIQUE PA and lateral view of the chest. FINDINGS: The cardiomediastinal contour is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. Views of the upper abdomen are normal. IMPRESSION: No evidence of pneumonia. " 56e13df0-9bfe1fb6-c5986acd-2eb345db-f8a79b22.jpg,validate/p13/p13031024/s57440674/56e13df0-9bfe1fb6-c5986acd-2eb345db-f8a79b22.jpg,validation," 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. " b9bea654-559841fa-527179d4-44f9e185-af10c365.jpg,validate/p16/p16444272/s57865512/b9bea654-559841fa-527179d4-44f9e185-af10c365.jpg,validation," FINAL REPORT PA AND LATERAL CHEST HISTORY: ___-year-old woman with pleural effusion. IMPRESSION: PA and lateral chest compared to ___ through ___: Moderate, chronic right pleural effusion has not changed in volume compared to ___. Dependent atelectasis in the right lower lobe is stable. Moderate cardiomegaly is unchanged. Thoracic aorta is heavily calcified, including the ascending segment. There is no pulmonary edema. " c212fae6-6b0dd509-2367b2ea-25a60a29-4c42d448.jpg,validate/p19/p19642544/s52628561/c212fae6-6b0dd509-2367b2ea-25a60a29-4c42d448.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Multiple rib fractures, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing right apical pneumothorax has completely resolved. An area of lateral pleural thickening is unchanged. The displaced right clavicular fracture is constant in appearance. The rib fractures are not well visualized on today's image, with exception of the ninth right rib, and are better evaluated on the CT examination of ___. " 9b0bc8e6-f1289c1b-8bc3a6d5-97c2b463-de883201.jpg,validate/p17/p17800663/s54662168/9b0bc8e6-f1289c1b-8bc3a6d5-97c2b463-de883201.jpg,validation," 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. " be0f2bef-5bc71144-6817b6b8-7d347b06-9d115377.jpg,validate/p12/p12537194/s56883327/be0f2bef-5bc71144-6817b6b8-7d347b06-9d115377.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SOB/backpain found to R pleural effusion d/t lung ca and mets. // Trend effusion Trend effusion IMPRESSION: As a comparison to ___, 16:54. Minimal increase in extent of the pre-existing right pleural effusion. The subtotally collapsed. Apex of the right lung is in stable position. Stable position of the right chest tube. No change in appearance of the left lung and of the left heart border. " 31004a85-daac9049-6bafa914-4b224649-c185eecf.jpg,validate/p19/p19696298/s55477107/31004a85-daac9049-6bafa914-4b224649-c185eecf.jpg,validation," FINAL REPORT HISTORY: Cough, shortness of breath, edema. TECHNIQUE: Upright AP view of the chest. COMPARISON: None. FINDINGS: The heart is moderately enlarged the aorta is unfolded. There are atherosclerotic calcifications of the aortic knob. Mild pulmonary edema is demonstrated with vascular indistinctness and perihilar haziness. There is blunting of the left costophrenic angle which could suggest a trace left pleural effusion. Patchy retrocardiac opacity likely reflects atelectasis. No pneumothorax is demonstrated. There are moderate multilevel degenerative changes in the thoracic spine. IMPRESSION: Mild pulmonary edema with possible trace left pleural effusion. Retrocardiac atelectasis. " 0ccab7e7-e549dade-f49aa61a-1c20086f-2736cced.jpg,validate/p17/p17284612/s51998276/0ccab7e7-e549dade-f49aa61a-1c20086f-2736cced.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with somnolence r/o infxn, pna // r/o pna r/o pna IMPRESSION: Comparison ___. No relevant change is noted. Low lung volumes. Moderate cardiomegaly. Bilateral areas of atelectasis. No pneumonia. No larger pleural effusions P " a07b6d9e-b5215143-50c414ec-e3ac1c83-28882d62.jpg,validate/p10/p10041196/s57513869/a07b6d9e-b5215143-50c414ec-e3ac1c83-28882d62.jpg,validation," 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. " 7fdc9d0e-d018013e-a955dc4f-bc5b35f6-5f4dc14a.jpg,validate/p12/p12033460/s55948152/7fdc9d0e-d018013e-a955dc4f-bc5b35f6-5f4dc14a.jpg,validation," 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. " 17b540b2-ca6c6e8a-9c916cf4-cc751320-3734722f.jpg,validate/p12/p12270337/s54436978/17b540b2-ca6c6e8a-9c916cf4-cc751320-3734722f.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with asthma and dyspnea. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are mildly hyperexpanded. Slightly increased density over the inferior spine on the lateral view without correlate on the frontal view may represent atelectasis, but early or developing infection cannot be excluded. No pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Mildly increased opacity projecting over the spine on the lateral view may represent early or developing infection in the appropriate clinical setting. " 4e25f2e7-4ab07975-e5a9f14c-acc20f75-9fa89750.jpg,validate/p11/p11932181/s54296756/4e25f2e7-4ab07975-e5a9f14c-acc20f75-9fa89750.jpg,validation," FINAL REPORT CHEST ON ___ AT ___ HISTORY: Chest tube to waterseal. FINDINGS: Compared to the study from earlier the same day, there is no significant interval change. " 111a5488-8a7d9f76-3fae2213-30a03096-5430f835.jpg,validate/p16/p16192183/s54632759/111a5488-8a7d9f76-3fae2213-30a03096-5430f835.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough and subjective fever. 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. IMPRESSION: No evidence of acute cardiopulmonary disease. " f726169c-ce11cd47-b7010add-8d459f9f-cf63cc42.jpg,validate/p18/p18036188/s53383232/f726169c-ce11cd47-b7010add-8d459f9f-cf63cc42.jpg,validation," FINAL REPORT HISTORY: Dobbhoff check. FINDINGS: In comparison with the study of 36 minutes previously, there is no change in the appearance of the Dobbhoff tube. " 0d017b74-3273b4db-35519f64-5f5850bd-1fbeb837.jpg,validate/p18/p18612446/s57802680/0d017b74-3273b4db-35519f64-5f5850bd-1fbeb837.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with productive cough x 4 weeks // r/o CAP TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: No edema, focal consolidation, effusion, or pneumothorax. The heart is normal in size. The mediastinum is not widened. There is a small left calcified granuloma. IMPRESSION: No acute cardiopulmonary process. " e12771a8-ba418120-db4f2b50-c16cee51-19221609.jpg,validate/p14/p14359057/s50155294/e12771a8-ba418120-db4f2b50-c16cee51-19221609.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with OGT tube placement // OGT tube OGT tube COMPARISON: Chest radiographs ___ through ___ at 16:50. IMPRESSION: Moderately severe left lower lobe atelectasis has improved, reflected in return of the mediastinum to the midline. New consolidation in the right lower lung could be contralateral atelectasis or developing pneumonia. Small left pleural effusion persists. Upper lungs clear. Heart size normal. No pneumothorax. ET tube, nasogastric tube, and right subclavian line are in standard placements respectively. " 0cc344ad-f097db12-79edc6b3-d0ab11e4-5f354e32.jpg,validate/p18/p18326030/s58541790/0cc344ad-f097db12-79edc6b3-d0ab11e4-5f354e32.jpg,validation," FINAL ADDENDUM ADDENDUM 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. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alc hepatitis now s/p intubation // Eval s/p intubation Eval s/p intubation IMPRESSION: ET tube tip is 6 cm above the carinal. Large right pleural effusion has slightly increased in the interim which might potentially be related to different positioning of the patient or true increase in pleural effusion. Hemorrhagic pleural fluid cannot be excluded. A left lung is essentially clear. There is no pneumothorax. " e6a8b3cc-6fc56248-78916fbb-70624369-616e88e3.jpg,validate/p14/p14108116/s51339294/e6a8b3cc-6fc56248-78916fbb-70624369-616e88e3.jpg,validation," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Fever, cough. COMPARISON: ___. FINDINGS: There has been no significant interval change. Expansile anterior left lower rib sclerotic, is again seen. Evidence of multiple old right-sided rib fracture is again seen. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. The aorta is calcified and tortuous. The cardiac silhouette remains enlarged, but stable in configuration. IMPRESSION: No significant interval change aside from possible increase in sclerosis of the anterior lower left expansile rib. " 3d2b32e1-1236dcc8-02000d5d-09d7f7a0-79da3826.jpg,validate/p19/p19826220/s58336497/3d2b32e1-1236dcc8-02000d5d-09d7f7a0-79da3826.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with dyspnea, cough COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Overlying EKG leads are present. Lung volumes are low. Allowing for limitations, the lungs are clear. No signs of pneumonia or edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " d80eae61-55f385bf-7446cb51-94ef9754-2aa14e4d.jpg,validate/p11/p11632236/s53457187/d80eae61-55f385bf-7446cb51-94ef9754-2aa14e4d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with OLT and ESRD on HD with AMS // eval for infectious process COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The extensive bilateral but predominantly left-sided interstitial lung opacities are neither increased nor decreased in severity. They are relatively stationary since ___. Moderate cardiomegaly persists. The monitoring and support devices are in constant position. " 71eeadfe-d27d2d60-049ce5bc-9e6b332c-75294b3b.jpg,validate/p15/p15148888/s50917330/71eeadfe-d27d2d60-049ce5bc-9e6b332c-75294b3b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough x 2 weeks // rule out pneumonia rule out pneumonia IMPRESSION: In comparison with study of ___, the patient has taken a much deeper inspiration. There is suggestion of some asymmetric opacification at the right base, possibly seen posteriorly on the lateral view. In the appropriate clinical setting, this could represent an area of developing consolidation. Of incidental note, there is again evidence of a healed fracture of the distal right clavicle. " 24f76da7-670cb5f6-e06fa04c-196dbde5-2b04f0f3.jpg,validate/p17/p17892707/s57151526/24f76da7-670cb5f6-e06fa04c-196dbde5-2b04f0f3.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with lymphoma, admitted for chemotherapy, now with dyspnea. PA and lateral upright chest radiographs were reviewed in comparison to prior study obtained earlier the same day. Heart size and mediastinum are grossly stable compared to prior radiograph obtained the same day earlier as well as CT from ___. There is bilateral pleural effusion, small to moderate, substantially increased since the prior study. Mild interstitial prominence is demonstrated that might reflect mild interstitial pulmonary edema. The patient is after replacement of aortic valve. " f7d44296-00c3a240-f018e702-eb891905-a52e1c53.jpg,validate/p15/p15950211/s54731069/f7d44296-00c3a240-f018e702-eb891905-a52e1c53.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. Question pneumonia. COMPARISONS: None available. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The aorta is partly calcified with minimal unfolding. Otherwise, the mediastinal and hilar contours are unremarkable. The lungs appear clear aside from streaky left basilar opacities most suggestive of minor atelectasis or perhaps scarring. The lateral view, however shows a posterior opacity, compatible with atelectasis although infection is not excluded. The bones appear likely demineralized with mild-to-moderate degenerative changes along the mid-to-lower thoracic spine. IMPRESSION: Left basilar opacity which is compatible with atelectasis although infection is difficult to completely exclude. " 0d724949-3d74d714-248e6681-2e86c95d-3ce7d9cb.jpg,validate/p13/p13486482/s55452479/0d724949-3d74d714-248e6681-2e86c95d-3ce7d9cb.jpg,validation," FINAL REPORT PA AND LATERAL FILM ___ AT 9:27. CLINICAL INDICATION: Chest tube, assess for interval change. Comparison is made to the patient's prior study ___. Images of the chest dated ___ at 9:27 are submitted. IMPRESSION: A left-sided chest tube remains in place. Lung volumes remain low with patchy opacity at the left base likely reflecting atelectasis. Pneumonia or aspiration cannot be excluded. There is no pneumothorax. No evidence of pulmonary edema. Possible small left effusion. Acute left-sided rib fractures are difficult to appreciate on the current study. Evidence of old right-sided rib fractures. " d5e474bb-b1415a73-80005e3a-4be2826f-660db275.jpg,validate/p10/p10978131/s57118843/d5e474bb-b1415a73-80005e3a-4be2826f-660db275.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with a clinical stage 1A (T1a,N0,M0) 1.5 cm mildly FDG avid (SUV max 1.3) LUL biopsy proven adenocarcinoma s/p Robot-assist LUL lobectomy // please evaluate for interval change. please evaluate for interval change. IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the left chest tube and postsurgical changes in the left hemithorax. No definite pneumothorax. No vascular congestion or acute pneumonia. " cbab036d-7c8d4ca8-df3ce06f-e380bf43-7cc8b2c5.jpg,validate/p16/p16605694/s53983117/cbab036d-7c8d4ca8-df3ce06f-e380bf43-7cc8b2c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for 4 months, no shortness of breath or wheezes. No tobaco use // Eval cough COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. Moderate cardiomegaly with elongation of the descending aorta. And signs of mild fluid overload but no overt pulmonary edema. No pleural effusions. No pneumonia. The lateral radiograph reveals a moderate to severe scoliosis. " 2ec4ad83-1027fe3f-b74ebcc5-b3910eda-8f989beb.jpg,validate/p14/p14415891/s58281248/2ec4ad83-1027fe3f-b74ebcc5-b3910eda-8f989beb.jpg,validation," 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. " defa1ae8-680c924e-6538260a-b88bba44-c360e2fe.jpg,validate/p14/p14534470/s58277502/defa1ae8-680c924e-6538260a-b88bba44-c360e2fe.jpg,validation," FINAL REPORT HISTORY: Pleuritic chest pain. COMPARISON: ___, ___ chest radiograph, and chest CT ___, ___. FINDINGS: PA and lateral chest radiographs demonstrate a stable 11 mm nodule within the left upper lobe. The lungs are well expanded and otherwise clear. The pleural surfaces are normal. The cardiac silhouette and mediastinal contours are normal. No thoracic cage abnormality is detected. IMPRESSION: 1. No acute chest abnormality. 2. Stable left upper lobe pulmonary nodule, which is benign. These findings were discussed with Dr. ___ by phone at 2:40 p.m. " a2179cad-852b4724-1a674fc9-75b652be-70820e64.jpg,validate/p16/p16296993/s55931575/a2179cad-852b4724-1a674fc9-75b652be-70820e64.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with COPD, acute onset dyspnea today // ?infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes and mild vascular congestion. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mild to moderately enlarged. Compression of a vertebral body at the thoracolumbar junction is again noted. IMPRESSION: Low lung volumes and mild vascular congestion. Mild to moderate enlargement of the cardiac silhouette. " 221a5fdb-4f49722d-854194b3-a17ae8e4-0311de28.jpg,validate/p12/p12043836/s51494881/221a5fdb-4f49722d-854194b3-a17ae8e4-0311de28.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough and shortness of breath, question pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: There is significant enlargement of the cardiac silhouette, similar to prior study. Mild pulmonary vascular congestion is seen. There is a streaky opacity in the right mid lung. No evidence of pneumothorax or pleural effusion. IMPRESSION: New streaky opacity in the right mid lung, may be due to infection, aspiration, atelectasis. Correlate clinically. Stable moderate-to-severe cardiomegaly and mild pulmonary vascular congestion. " 531155ee-5b8190c6-2d7e2fa9-f948ca05-82e10906.jpg,validate/p17/p17755234/s59086594/531155ee-5b8190c6-2d7e2fa9-f948ca05-82e10906.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with thoracocentesis and removal of 620 cc fluid base, assess for pneumothorax. COMPARISON: ___. FINDINGS: There is no pneumothorax post-thoracocentesis. Right mild pleural effusion has significantly decreased; residual pleural effusion is small if any. Left small pleural effusion is unchanged with bibasilar atelectasis. Cardiac contour is mildly enlarged and stable. Right-sided hemodialysis catheter is unchanged in right atrium. CONCLUSION: There is no pneumothorax post-thoracocentesis. Residual right pleural effusion is small if any. " aeec30ec-f4aeac99-4b7b4c26-fa2822e4-5b49f750.jpg,validate/p13/p13411236/s56850821/aeec30ec-f4aeac99-4b7b4c26-fa2822e4-5b49f750.jpg,validation," 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 " 35e705ea-269c847b-513e295e-88e62d2f-75aa03d6.jpg,validate/p12/p12353907/s57390415/35e705ea-269c847b-513e295e-88e62d2f-75aa03d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with above // Persistent fever after treatment for right upper lobe pneumonia. Please evaluate for new infiltrate, extension Persistent fever after treatment for right upper lobe pneumonia. Please evaluate for new infiltrate, extension IMPRESSION: Comparison to ___. The pre-existing right upper lobe pneumonia has only minimally decreased. Pneumonia is still extensive than continues to be clearly visualized in the right upper lobe. No new parenchymal opacities. No pleural effusions. Normal size of the heart. " 4650ce40-92ec1d1c-456ff27a-44507db9-8f57e6b4.jpg,validate/p17/p17225132/s51658337/4650ce40-92ec1d1c-456ff27a-44507db9-8f57e6b4.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old status post spinal fusion with fevers. Evaluate for infection or atelectasis. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. AP upright and lateral views of the chest, ___ at ___ are submitted. IMPRESSION: 1. Overall cardiac and mediastinal contours are within normal limits given AP technique. Lungs are well inflated without evidence of focal airspace consolidation, pleural effusions, pulmonary edema or pneumothorax. No acute bony abnormality is appreciated. A 3 to 4 mm linear radiopaque abnormality is seen overlying the inferior edge of the left sixth lateral rib projects in the midline on the lateral view with a second linear opacity on the lateral projection as well. The imaging appearance is suggestive of surgical clips. Clinical correlation is advised. Comparison to remote studies also would be helpful. " 4d9e9305-fbf9d205-db31a44c-eba07b59-10580f48.jpg,validate/p14/p14611053/s50042310/4d9e9305-fbf9d205-db31a44c-eba07b59-10580f48.jpg,validation," FINAL REPORT HISTORY: Right-sided pulmonary embolus with new crackles. FINDINGS: In comparison with the study of ___, the patient has taken a better inspiration. There is no evidence of pneumonia, vascular congestion, or pleural effusion. Clips in the lower neck suggest previous thyroid surgery. " 07ca1a3d-1aa5149b-9c7e4007-36669470-2f2a632c.jpg,validate/p18/p18785569/s57426865/07ca1a3d-1aa5149b-9c7e4007-36669470-2f2a632c.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. Evaluate for acute process. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Single frontal portable view of the chest was obtained. The patient is rotated with respect to the film and is in lordotic position. The heart is of normal size. A large hiatal hernia is similar to prior. Lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. No radiopaque foreign body. Mild degenerative changes are present in bilateral glenohumeral joints. IMPRESSION: No acute cardiopulmonary process. " 2c61bead-6eb04a30-56aacf82-0d1a6a35-7cf18caa.jpg,validate/p12/p12459180/s57631502/2c61bead-6eb04a30-56aacf82-0d1a6a35-7cf18caa.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Altered mental status. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral views. FINDINGS: The lung volumes are low. The cardiac, mediastinal and hilar contours are probably unchanged allowing for the limitations of technique. There is no pleural effusion or pneumothorax. There are patchy opacities at both lung bases that are poorly delineated, but early pneumonia, atelectasis or even areas of slight aspiration are possible. This is all seen in the background of a mild interstitial abnormality suggesting fluid overload. IMPRESSION: Findings suggesting mild vascular congestion, although technique is limited. Patchy basilar opacities, non-specific. Repeat radiographs may be helpful in short-term follow-up to re-assess; preferably, this could be done with standard PA and lateral technique if feasible clinically. " 41812075-50c0909c-4f1c1865-ab15d054-65d60315.jpg,validate/p10/p10018205/s58629645/41812075-50c0909c-4f1c1865-ab15d054-65d60315.jpg,validation," 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 and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " e043d8d6-1553aec4-dcb4656a-479b9223-49c9dc62.jpg,validate/p15/p15103276/s57690928/e043d8d6-1553aec4-dcb4656a-479b9223-49c9dc62.jpg,validation," FINAL REPORT INDICATION: Left-sided chest pain. Assess for pneumothorax. 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 unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No pneumothorax. " aac7084c-423ebe1f-078bec5d-c0d531c6-ad072fa1.jpg,validate/p13/p13696039/s59951543/aac7084c-423ebe1f-078bec5d-c0d531c6-ad072fa1.jpg,validation," 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. " ea0b9dbd-83deb282-6929b0d7-26af3df4-27d557c2.jpg,validate/p10/p10838031/s55527488/ea0b9dbd-83deb282-6929b0d7-26af3df4-27d557c2.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Lung volumes are low. 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. " d395dfb2-72de72a5-2713a7ed-9e61fa67-4c8999b4.jpg,validate/p14/p14702613/s58420950/d395dfb2-72de72a5-2713a7ed-9e61fa67-4c8999b4.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Left-sided abdominal pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " abe5eda5-11b3e090-6c8d9417-935a6496-6f46d23f.jpg,validate/p16/p16598144/s57847925/abe5eda5-11b3e090-6c8d9417-935a6496-6f46d23f.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with fever. Question pneumonia. COMPARISON: CT chest dated ___. FINDINGS: A rounded structure in the left suprahilar region is consistent with an external pendant, and removed on repeat frontal view. The cardiomediastinal silhouette is within normal limits. The lungs are clear with the exception of trace left basilar atelectasis. There is no large effusion, vascular congestion, or pleural effusion. A subcentimeter radiodensity overlying the left posterior seventh rib is consistent with a calcified granuloma. IMPRESSION: No acute cardiopulmonary process. " 7e314030-fa3aaa6d-f929c88e-cb2b20d9-3b68cdd2.jpg,validate/p11/p11192888/s54623161/7e314030-fa3aaa6d-f929c88e-cb2b20d9-3b68cdd2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with coughing and sputum production and left sided pleuritic pain // please assess for pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Known left calcified pleural plaques. Known minimal left pleural scar. No pneumonia, no pulmonary edema. No larger pleural effusions. Normal size of the cardiac silhouette. Unchanged appearance of the right lung. " 48b885e8-e747eff7-4b6306d9-c0f39d62-9e9b3043.jpg,validate/p18/p18427812/s56184552/48b885e8-e747eff7-4b6306d9-c0f39d62-9e9b3043.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with post fall yesterday with right sided rib pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The study is limited due to the patient's chin projecting over and obscuring the apices as well as patient rotation. Within these limitations, heart size is likely top normal. The aorta is tortuous and diffusely calcified. The hilar contours are grossly unremarkable. Patchy right basilar opacity is poorly assessed on this exam, but may reflect an area of infection or atelectasis. No pleural effusion or large pneumothorax is identified. No displaced fractures are seen, but please note that assessment of the right-sided ribs is limited. IMPRESSION: Limited exam. Patchy right basilar opacity may reflect atelectasis or infection. No displaced rib fractures seen, but assessment of the right-sided ribs is limited on this study. Please note that a dedicated rib series can be obtained for further assessment. " 728f2eb9-f02b1f6b-42ecbb3f-20f6660e-a936190a.jpg,validate/p18/p18828209/s55172329/728f2eb9-f02b1f6b-42ecbb3f-20f6660e-a936190a.jpg,validation," 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. " d3b1ad92-86d6e102-fe258a09-5ad65181-787abc62.jpg,validate/p19/p19262736/s55119064/d3b1ad92-86d6e102-fe258a09-5ad65181-787abc62.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with three days of epigastric pain and guarding on abdominal exam. Evaluate lungs for infection and possibility of free subdiaphragmatic gas. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces aside from minimal thickening at the lateral aspect of the minor fissure. No free subdiaphragmatic gas. " e51f91dd-d49c98ea-7408a7ed-f90f3e82-6f5a88ab.jpg,validate/p11/p11549535/s55567429/e51f91dd-d49c98ea-7408a7ed-f90f3e82-6f5a88ab.jpg,validation," FINAL REPORT AP CHEST, 12:08 P.M., ___ HISTORY: An ___-year-old man with meningitis, acute stroke and possible seizure. Is there a mass or pneumonia. IMPRESSION: AP chest compared to ___: Lungs clear, normal cardiomediastinal and hilar silhouettes and pleural surfaces. " 872b18e4-5b472a6e-57dfdeea-ff7d7ff3-ea066a44.jpg,validate/p11/p11084812/s58820371/872b18e4-5b472a6e-57dfdeea-ff7d7ff3-ea066a44.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with polymyositis, congestive heart failure, presenting with productive cough, edema, weakness. Evaluate for infiltrate or fluid overload. COMPARISON: ___. TECHNIQUE: AP and lateral chest radiographs. FINDINGS: Lung volumes are low. There is bilateral hilar prominence with upper vascular re-distribution and diffuse interstitial thickening, but no focal opacities. Heart size is mildly enlarged although AP views are not tailored for accurate assessment of cardiac size. There is no pleural effusion or pneumothorax. IMPRESSION: Findings compatible with mild pulmonary edema. " 52b8fc71-04d7c868-3ad30ae8-6ef6f9ee-b2939ec1.jpg,validate/p14/p14321439/s57644958/52b8fc71-04d7c868-3ad30ae8-6ef6f9ee-b2939ec1.jpg,validation," FINAL REPORT HISTORY: Fever and cough. Evaluate for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 46c91c23-2a0e76b2-0dc486af-b3339026-e8e14f7f.jpg,validate/p16/p16528352/s58560012/46c91c23-2a0e76b2-0dc486af-b3339026-e8e14f7f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pleural effusion. PA and lateral upright radiographs of the chest were reviewed in comparison to ___. The patient is after median sternotomy and CABG. The heart size and mediastinum are stable. There is interval discontinuation of the right pigtail catheter with minimal amount of right pleural effusion still present. There is no pneumothorax. Lungs are well aerated with no consolidations. Bone island at the tip of the right scapula is redemonstrated. " dc67c651-42eca82e-892bd9ec-5093a9c2-336a0df0.jpg,validate/p10/p10200495/s51033338/dc67c651-42eca82e-892bd9ec-5093a9c2-336a0df0.jpg,validation," FINAL REPORT HISTORY: Bandemia without cough, to assess for pneumonia. FINDINGS: No previous images. Cardiac silhouette is within normal limits, and the lungs are free of acute pneumonia, and there is no vascular congestion. Single-channel pacer defibrillator device extends to the apex of the right ventricle. Of incidental note are multiple metallic shrapnel fragments as well as several old healed fractures. " f584a8ae-0c8aef09-bb5ee6eb-7f06228a-9b6e7c10.jpg,validate/p15/p15841005/s55870822/f584a8ae-0c8aef09-bb5ee6eb-7f06228a-9b6e7c10.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with cp. Assess for cardiopulmonary 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. Limited view of the abdomen demonstrates small amount of air within the stomach. IMPRESSION: No acute cardiopulmonary process. " 052e448b-2164ba7d-2a1a5625-94f5bdc2-34f732ab.jpg,validate/p12/p12056668/s52167064/052e448b-2164ba7d-2a1a5625-94f5bdc2-34f732ab.jpg,validation," FINAL REPORT INDICATION: Recent hiatal hernia repair and bilateral pleural effusions, please evaluate. COMPARISON: Comparison is made to chest radiograph performed ___. FINDINGS: Portable chest radiograph demonstrates slightly increased large bilateral pleural effusions. Evaluation of the cardiomediastinal and hilar silhouettes is very limited due to pleural effusions but appears grossly unchanged. No focal opacification concerning for pneumonia identified. IMPRESSION: Slight increase in large bilateral pleural effusions. " 88bbf295-740a6e64-cef105d3-f3798d26-54222298.jpg,validate/p14/p14328615/s50484782/88bbf295-740a6e64-cef105d3-f3798d26-54222298.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM, ___, AT ___. CLINICAL INDICATION: ___-year-old with drainage of pleural effusion, pneumothorax, placement of tubes. Comparison to ___ at 10:59. PA and lateral views of the chest are submitted. IMPRESSION: A single right chest tube remains in place. There continues to be an elliptical opacity in the right mid lung, which likely represents fluid loculated within the horizontal fissure. Associated basilar airspace disease is also seen, but unchanged. No pneumothorax is appreciated. There continues to be some nodularity to the lateral pleura on the right side which could reflect some loculated fluid as well. The left lung is grossly clear. Overall, cardiac and mediastinal contours are stable. No pneumothorax. " 4ef08e91-620bb8f4-c2f4c089-6182ba5d-e58932f3.jpg,validate/p15/p15426827/s51290339/4ef08e91-620bb8f4-c2f4c089-6182ba5d-e58932f3.jpg,validation," FINAL REPORT HISTORY: Alcoholic cirrhosis with nausea and vomiting, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Relatively low lung volumes, but no vascular congestion, pleural effusion, or acute focal pneumonia. " 7c666840-c2bff5d1-24847003-75ee5694-8bbf0ad0.jpg,validate/p13/p13199378/s53393390/7c666840-c2bff5d1-24847003-75ee5694-8bbf0ad0.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Altered mental status. 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 overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " bbdb16a8-22a7dc72-0602c1ab-d441bd7f-1129702d.jpg,validate/p12/p12348400/s54223421/bbdb16a8-22a7dc72-0602c1ab-d441bd7f-1129702d.jpg,validation," FINAL REPORT INDICATION: Status post right pleural biopsy. COMPARISON: Comparison is made to CT interventional procedure performed ___ and CT chest performed ___. FINDINGS: Single portable upright chest radiograph demonstrates similar appearance to ___ chest CT with severely thickened irregular pleura extending into the fissure and encasing the entire shrunken asymmetrically opacified right lung with areas of septal thickening. The left lung and pleura are clear. No pneumothorax is present. Visible cardiomediastinal and hilar contours are unremarkable. IMPRESSION: Stable examination. Dense irregular pleural thickening with diffuse increased opacification of right lung with septal thickening likely represents mesothelioma with less likely consideration given to lymphangitic spread and pleural seeding of other primary malignancy. " e084de3b-be89b11e-20fe3f9f-9c8d8dfe-4cfd202c.jpg,validate/p10/p10000032/s53189527/e084de3b-be89b11e-20fe3f9f-9c8d8dfe-4cfd202c.jpg,validation," 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. " 71e56159-4fe20b53-09b1bdbf-359f4bcd-047d7cb2.jpg,validate/p17/p17057667/s52577653/71e56159-4fe20b53-09b1bdbf-359f4bcd-047d7cb2.jpg,validation," 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. " c5e6d2ad-73afbc20-e73bd47b-aa937c8f-b80b21ab.jpg,validate/p11/p11459120/s51556348/c5e6d2ad-73afbc20-e73bd47b-aa937c8f-b80b21ab.jpg,validation," WET READ: ___ ___ ___ 9:16 AM 1. New subtle opacity within the right upper lobe is worrisome for pneumonia. Of note this is similar in location to patient's recurrent pneumonias dating back to ___. 2. Linear right lower lobe atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with cough, weakness. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___, ___, ___. CTA chest ___. FINDINGS: Frontal and lateral chest radiographs demonstrate mildly hypoinflated lungs. The left lung is clear. Within the right upper lobe there is new subtle opacity. Right lower lobe linear opacity is most consistent with linear atelectasis. No pleural effusion or pneumothorax. Stable mild cardiomegaly. Mediastinal contour and hila are otherwise unremarkable. Aortic arch calcifications are present. Left chest wall dual lead pacing device is again noted. IMPRESSION: 1. New subtle opacity within the right upper lobe is worrisome for pneumonia. Of note this is similar in location to patient's recurrent pneumonias dating back to ___. 2. Linear right lower lobe atelectasis. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:56 AM, 5 minutes after discovery of the findings. " 1bb603ea-ac2a7e42-a3d5d361-6cc437b4-1331e0bb.jpg,validate/p18/p18586624/s58950826/1bb603ea-ac2a7e42-a3d5d361-6cc437b4-1331e0bb.jpg,validation," FINAL REPORT INDICATION: Patient with cough, rule out pneumonia. COMPARISON: ___. FINDINGS: There is no pneumonia. The lungs are clear. The aorta is tortuous and stable. The cardiac contour is within normal limits. There is no pneumothorax. There is no pleural effusion. CONCLUSION: There is no radiographic evidence of pneumonia. " d6a63ce1-fa4cd434-3b378b58-f51a8b00-f6c07f33.jpg,validate/p15/p15817113/s55485650/d6a63ce1-fa4cd434-3b378b58-f51a8b00-f6c07f33.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sweats, chills. 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. " 35426ad4-2930307f-0be6120c-2e86777a-1bd5d87d.jpg,validate/p10/p10380616/s57478894/35426ad4-2930307f-0be6120c-2e86777a-1bd5d87d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with copd, tbm, s/p stent placement with persistent cough // s/p IP procedure, persistent cough COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous image. The lung volumes have increased, likely reflecting improved ventilation. The areas of scarring that pre existed are constant. No new focal parenchymal opacities. No pneumothorax of the stent placement. " e00a2221-2a1fa21f-ba9ae91c-eae46a64-4b722d13.jpg,validate/p16/p16142166/s51835013/e00a2221-2a1fa21f-ba9ae91c-eae46a64-4b722d13.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Heart failure symptoms. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is top normal. Mediastinum is unchanged. The aorta is tortuous. Lungs are essentially clear. There is no appreciable pleural effusion or pneumothorax. Lateral view demonstrates substantial calcifications of the aortic annulus and potentially aortic valve. There are no focal consolidations demonstrated. " 7de89209-097f72ff-96ec43ef-1e738afa-0811b29c.jpg,validate/p10/p10329555/s53639143/7de89209-097f72ff-96ec43ef-1e738afa-0811b29c.jpg,validation," FINAL REPORT CHEST, TWO VIEWS INDICATION: ___-year-old woman with recently drained pleural effusion complaining of chest pain, shortness of breath. Evaluate for change of effusion. Comparison is made to prior examination of ___ a portable upright chest. Again noted is a large mass involving the left upper lobe. There is a very small left pleural effusion. This is not significantly changed from the prior examination. The pulmonary vasculature does not demonstrate any evidence of pulmonary edema. There are no abnormalities in the right lung. IMPRESSION: 1. Small left pleural effusion unchanged from the film obtained immediately post-thoracentesis. 2. Large mass involving the left upper lobe. " ce531719-78a6c8a0-6db6ac35-9786e10c-8ff62104.jpg,validate/p10/p10750092/s57870796/ce531719-78a6c8a0-6db6ac35-9786e10c-8ff62104.jpg,validation," FINAL REPORT INDICATION: Pulmonary edema, assess for interval change. COMPARISONS: ___. Semi-upright portable chest radiograph was obtained. Endotracheal tube terminates 3.2 cm above the carina. Nasogastric tube is again seen with side hole at the level of GE junction. Right subclavian catheter terminates in the mid SVC. Bibasilar left greater than right atelectasis is unchanged with slight decrease in edema. A right midlung opacity is more apparent given the decreased edema and may reflect an early pneumonia. Cardiac size and tortuosity of the aorta is unchanged. IMPRESSION: Slightly decreased edema with bibasilar atelectasis and newly evident right midlung opacity which may reflect a developing pneumonia. Finding was discussed by phone with Dr. ___ by Dr. ___ at ___ on ___. " 1169bc12-67b160ee-8fdec87e-e9ce7498-171cb554.jpg,validate/p13/p13163471/s55403496/1169bc12-67b160ee-8fdec87e-e9ce7498-171cb554.jpg,validation," FINAL REPORT HISTORY: Bacteremia, to assess for pulmonary edema. FINDINGS: In comparison with the study of ___, there again are low lung volumes. Cardiac silhouette is at the upper limits of normal in size. There is some engorgement and indistinctness of pulmonary vessels, consistent with pulmonary edema, though this is less prominent than on the previous study. Right IJ catheter again extends to the level of the cavoatrial junction. " 52e296a5-0618d02e-704b62e2-4c734fe4-3af97f54.jpg,validate/p18/p18553055/s59595733/52e296a5-0618d02e-704b62e2-4c734fe4-3af97f54.jpg,validation," WET READ: ___ ___ 1:40 AM There is no large pleural effusion or pneumothorax. Aeration of the left lung is improving however there is still considerable atelectasis in the left lower lobe. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG/MVR // eval for effusion eval for effusion IMPRESSION: There is no large pleural effusion or pneumothorax. Aeration of the left lung is improving however there is still considerable atelectasis in the left lower lobe. " 8784a092-dfd8090a-fcac1aa3-d3a45f04-95b0f098.jpg,validate/p13/p13056496/s58012609/8784a092-dfd8090a-fcac1aa3-d3a45f04-95b0f098.jpg,validation," FINAL REPORT HISTORY: Dyspnea with known pericardial effusion. COMPARISON: Radiograph available from ___ and chest CT from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart is mildly enlarged, unchanged in size since ___. Again seen are fibrotic changes across the left hilum, probably relating to prior radiotherapy, unchanged over multiple prior examinations, better appreciated on the CT examination from ___. There is no pneumothorax, focal consolidation or pleural effusion. IMPRESSION: Unchanged mild cardiomegaly. Underlying pericardial effusion is better assessed with echo. No superimposed acute process. " 15742b9d-fdce65a3-9ce27709-e16a3dcc-74e5d69a.jpg,validate/p17/p17647154/s52922403/15742b9d-fdce65a3-9ce27709-e16a3dcc-74e5d69a.jpg,validation," FINAL REPORT HISTORY: Right pneumothorax, to assess for change. FINDINGS: In comparison with the study of ___, there is little change in the appearance of the small-to-moderate apical pneumothorax on the right. Bilateral pleural effusions are more prominent on the left. Continued evidence of chronic pulmonary disease without definite acute pneumonia. " fa60b308-7e5af16e-739f2656-b39711e2-a8f0b13e.jpg,validate/p18/p18391806/s56031988/fa60b308-7e5af16e-739f2656-b39711e2-a8f0b13e.jpg,validation," WET READ: ___ ___ 5:06 PM No acute intrathoracic abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with strep pharyngitis and bacterial pneumonia // ?pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " b1ab821c-e9b45a21-af18fc82-9be85fe8-f9df0811.jpg,validate/p19/p19071790/s58477532/b1ab821c-e9b45a21-af18fc82-9be85fe8-f9df0811.jpg,validation," 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. " 75c3f9a4-3105285b-7c22466f-c93f0eff-7aed04f6.jpg,validate/p13/p13553079/s51996265/75c3f9a4-3105285b-7c22466f-c93f0eff-7aed04f6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Renal transplant, cough with sputum production. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. No pneumonia. Moderate cardiomegaly with tortuosity of the thoracic aorta. No pulmonary edema. No pleural effusions. " 984b92de-95e0653d-0facdd2c-e2b5898f-b7334542.jpg,validate/p12/p12763939/s55381073/984b92de-95e0653d-0facdd2c-e2b5898f-b7334542.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post motor vehicle accident, status post traumatic diaphragmatic rupture, surveillance. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are constant. The size of the cardiac silhouette is unchanged. Unchanged appearance of the left lung and improved radiolucency of the right lung, likely reflecting improved ventilation. No acute lung changes, in particular no pneumothorax, no pleural effusion and no pneumonia. " 795690bd-289fa50b-1665560e-e908f339-2bff0f3c.jpg,validate/p11/p11745820/s55088955/795690bd-289fa50b-1665560e-e908f339-2bff0f3c.jpg,validation," FINAL REPORT INDICATION: History: ___M with cough // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrate clear lungs bilaterally. There is no focal consolidation convincing for pneumonia. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. No air under the right hemidiaphragm is identified. IMPRESSION: No opacity convincing for pneumonia. " 6b9f9916-99aae461-f8183f83-4e5f0fd9-e4f3620e.jpg,validate/p18/p18754895/s59895559/6b9f9916-99aae461-f8183f83-4e5f0fd9-e4f3620e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with epigastric abd pain, ? decreased breath sounds b/l lung bases // Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ FINDINGS: The cardiomediastinal and hilar contours are normal. There is persistent elevation of the right hemidiaphragm and streaky atelectasis at the base of the right lung. There is no focal consolidation, pleural effusion or pneumothorax. No subdiaphragmatic free air. IMPRESSION: Chronic elevation of the right hemidiaphragm with right basal atelectasis. No acute cardiopulmonary process. No large subdiaphragmatic free air. " a6038ff2-cc281df7-d393a77f-116162d6-71e6b323.jpg,validate/p14/p14225925/s59712783/a6038ff2-cc281df7-d393a77f-116162d6-71e6b323.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough. Evaluate for acute process. FINDINGS: Frontal and lateral chest radiographs demonstrate clear lungs, without pleural effusion, or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are unremarkable. IMPRESSION: Normal views of the chest. " 4ef52159-15778666-69a9cdcb-08b9c65c-d7cc7484.jpg,validate/p19/p19207168/s58297513/4ef52159-15778666-69a9cdcb-08b9c65c-d7cc7484.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent pneumonia // Follow for clearing COMPARISON: ___. IMPRESSION: As compared to the previous image, the pre-existing perihilar opacities on the right have completely resolved. There are no new opacities seen in the lung parenchyma. On going severe scoliosis with subsequent asymmetry of the ribcage. No pulmonary edema. No pleural effusions. No pneumothorax. Normal size of the heart. " 5b377a8d-49103a0f-63366d89-6f3df636-b813d265.jpg,validate/p10/p10161112/s54770297/5b377a8d-49103a0f-63366d89-6f3df636-b813d265.jpg,validation," FINAL REPORT HISTORY: NSCLC, status post sleeve resection, question interval change. CHEST, SINGLE AP PORTABLE VIEW COMPARISON: Chest x-ray from ___ at 12:24 p.m. Again seen is evidence of left-sided volume loss with elevated left hemidiaphragm and two left-sided chest tubes. There is considerable subcutaneous emphysema, but no definite pneumothorax. No gross effusion. There is patchy opacity at the left base, similar to the prior film. Clips noted over the left upper mediastinum. ? interval improvement in the degree of leftward shift of the mediastinum. On the right, the inspiratory volume is lower. There is upper zone redistribution, possible mild vascular plethora. There is elevation of the right hemidiaphragm, with atelectasis at the right base and small effusion. IMPRESSION: Lower inspiratory volumes, with suggestion of mild vascular plethora, new compared with the prior film. Extensive changes in the left chest are otherwise similar. " 8d3ecb69-725c1ce0-e0313794-e27a62f3-5733a32a.jpg,validate/p14/p14347948/s57690497/8d3ecb69-725c1ce0-e0313794-e27a62f3-5733a32a.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with right pleural effusion. Rule out pneumothorax after chest tube removal. IMPRESSION: PA and lateral chest compared to ___: There has been no change in the volume of the small-to-moderate residual right pleural effusion following removal of pigtail pleural drain. Right upper quadrant catheter unchanged in position. No pneumothorax. Right basal atelectasis mild-to-moderate, unchanged. Normal cardiomediastinal silhouette. Left lung clear. Mild cardiomegaly longstanding. " c04f1959-6d763649-3561d2d3-baf924f7-bac2214b.jpg,validate/p19/p19499595/s55609137/c04f1959-6d763649-3561d2d3-baf924f7-bac2214b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___ year old woman with acute change in mental status, h/o parkinsonism and dysphagia COMPARISON: ___ FINDINGS: AP semi upright and lateral views of the chest provided. Midline sternotomy wires again noted, the majority of which are extensively fragmented, unchanged. There is no focal consolidation concerning for pneumonia. No large effusion or pneumothorax. No signs of congestion or edema. There is a linear density in the left mid lung which could represent a focus of scarring or atelectasis. Chronic left rib deformities are again noted. No free air below the right hemidiaphragm. Clips in the right upper quadrant noted. IMPRESSION: As above. " 5d5bb343-f30024c1-70d8d330-8e28d745-213a1a5e.jpg,validate/p15/p15289901/s55937368/5d5bb343-f30024c1-70d8d330-8e28d745-213a1a5e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusion, s/p thoracentesis // s/p thoracentesis IMPRESSION: In comparison to ___ radiograph, a left pleural effusion has substantially decreased in size following recent thoracentesis with only a small residual effusion remaining and no visible pneumothorax. Persistent cardiomegaly and pulmonary vascular congestion accompanied by improving edema. No other relevant change. " 25dea37e-75f47159-17f45e94-79a1d0e8-d89eb669.jpg,validate/p11/p11877234/s52332731/25dea37e-75f47159-17f45e94-79a1d0e8-d89eb669.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with acute systolic CHF exacerbation. Question pulmonary edema. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. There are new small bilateral pleural effusions. Indistinct pulmonary vascular markings are seen. Right lung base opacity is seen medially, potentially due to atelectasis however component of infection is not excluded. Cardiac silhouette is enlarged but not likely changed from prior noting that the right heart border is not well seen. Coronary artery stent is identified. Single-lead pacing device seen with tip at the right ventricular apex. Hypertrophic changes seen in the spine as well as compression deformity of the lower thoracic vertebral body as on prior. IMPRESSION: Small effusions with mild congestion without frank pulmonary edema. Right middle lobe atelectasis versus infiltrate. Clinical correlation suggested. " ee28d946-306c755b-0a5ae4ff-44e2aa85-48eac433.jpg,validate/p19/p19519251/s59756673/ee28d946-306c755b-0a5ae4ff-44e2aa85-48eac433.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated post up. // Tube placement previous to transfer to ICU TECHNIQUE: Single AP radiograph of the chest. COMPARISON: None available. FINDINGS: The ETT is slightly too high and terminates approximately 8 cm above the carina. There is an NG tube coursing below the diaphragm with the tip in the stomach. There is mild bibasilar atelectasis. The lungs are otherwise clear. The pulmonary vasculature is normal. The cardiomediastinal silhouette is normal. There is no pleural effusion. There is no pneumothorax. IMPRESSION: 1. ETT too high, terminating approximately 8 cm above the carina. 2. Mild bibasilar atelectasis. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 9:27 AM, 2 minutes after discovery of the findings. " 65ee861f-552a4d64-4e8a8a50-8b5f647b-592caa16.jpg,validate/p13/p13485382/s51815126/65ee861f-552a4d64-4e8a8a50-8b5f647b-592caa16.jpg,validation," FINAL REPORT INDICATION: Cough and altered mental status. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There is no focal consolidation or pneumothorax. Blunting of the left costophrenic angle likely reflects a trace pleural effusion. The cardiac and hilar contours are normal. The aorta is tortuous and calcified. No pulmonary edema is noted. IMPRESSION: Trace left pleural effusion. No radiographic evidence for pneumonia. " 3a420bb9-02e39b05-2ee71937-a41451a3-ed282ca6.jpg,validate/p16/p16454913/s58264162/3a420bb9-02e39b05-2ee71937-a41451a3-ed282ca6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Diffuse alveolar opacities. Followup. COMPARISON: ___, 5:08 a.m. FINDINGS: As compared to the previous radiograph, the massive bilateral parenchymal opacities are unchanged in severity and distribution. Also unchanged is the moderate to severe cardiomegaly as well as the position of the monitoring and support devices. There is no evidence of newly appeared parenchymal changes. No pneumothorax. " 99841597-b5c25f71-19f9cf40-343cb438-43a404e6.jpg,validate/p14/p14733367/s52576050/99841597-b5c25f71-19f9cf40-343cb438-43a404e6.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Delirium. Portable AP radiograph of the chest was reviewed in comparison to ___ and CT abdomen from ___. Right pleural effusion is redemonstrated, associated with right lower lobe consolidation that appears to be slightly increased since the prior study and might reflect interval development of right lower lobe pneumonia. Cardiomegaly is severe, unchanged. The patient is in mild vascular engorgement. No pneumothorax is seen. Note is made that the left costophrenic angle was not included in the field-of-view. " 9cda3728-071bbf70-fb98c967-b55c9976-7bfd871c.jpg,validate/p12/p12736960/s53714415/9cda3728-071bbf70-fb98c967-b55c9976-7bfd871c.jpg,validation," FINAL REPORT PORTABLE CHEST, ___. COMPARISON: Radiograph of one day earlier. FINDINGS: Left internal jugular vascular catheter tip terminates in the midline position in the left brachiocephalic vein, tip of endotracheal tube terminates 5 cm above the carina, and right internal jugular central venous catheter terminates in the mid superior vena cava. Cardiomediastinal contours are stable. Rapidly improving asymmetrically distributed alveolar opacities involving the left lung to a greater degree than the right most likely represent pulmonary edema given the rapid change. Moderate left and small-to-moderate right layering pleural effusions are present, but there is no visible pneumothorax. " 69444fb9-d771008d-ff8357f8-7ef09a52-565ab816.jpg,validate/p16/p16581134/s58294615/69444fb9-d771008d-ff8357f8-7ef09a52-565ab816.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp failure, s/p ERCP for stricture // ET placement, interval change ET placement, interval change IMPRESSION: Comparison to ___. Improved lung volumes on the left with decrease of the left pre-existing atelectasis. Borderline size of the cardiac silhouette persists. Mild fluid overload but no overt pulmonary edema. No change in appearance of the right lung. " 82dd42eb-28a7d79a-ff9f9237-14a8cb4c-510565b2.jpg,validate/p18/p18763173/s57969238/82dd42eb-28a7d79a-ff9f9237-14a8cb4c-510565b2.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough. 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. " 75c4db82-a761f723-21980c55-0d32ec78-bef324d7.jpg,validate/p13/p13510413/s53837751/75c4db82-a761f723-21980c55-0d32ec78-bef324d7.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with hypoxia, wheeze, rule out pneumonia. COMPARISON: ___. FINDINGS: Small left basal atelectatic bands have slightly increased in size. The lungs are otherwise clear. There is no pleural effusion or pneumothorax. CONCLUSION: There is no evidence of pneumonia. Slight increase of the left basal atelectatic band. " 5d6d22ac-6fe262ed-55ebf2fb-5a9ad112-de38c400.jpg,validate/p19/p19151721/s53536754/5d6d22ac-6fe262ed-55ebf2fb-5a9ad112-de38c400.jpg,validation," 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. " 7eced015-c7008cc7-14f99eef-2fa9b921-1bb17d8d.jpg,validate/p19/p19685014/s52448818/7eced015-c7008cc7-14f99eef-2fa9b921-1bb17d8d.jpg,validation," FINAL REPORT INDICATION: ___-year-old female post-renal transplant with persistent cough. COMPARISON: ___. CHEST, PA AND LATERAL: There is no evidence of pneumonia or pulmonary edema. Heart size is at the upper limits of normal. No pleural effusions or pneumothorax. Note is made of right mastectomy. Scattered air-fluid levels in non-dilated loops of bowel. IMPRESSION: No acute cardiopulmonary process. " b951cc40-c9a68e82-28a66199-4667592c-c1731dff.jpg,validate/p14/p14244279/s57478290/b951cc40-c9a68e82-28a66199-4667592c-c1731dff.jpg,validation," FINAL REPORT INDICATION: History: ___M with HIV, CAD, chest pain, dyspnea // evaluate for pneumonia, acute process TECHNIQUE: PA and lateral chest COMPARISON: Chest radiographs ___ through ___ FINDINGS: The lungs are normally expanded. Faint opacity in the right lower lung is unchanged. The heart is mildly enlarged. There is no pleural effusion or pneumothorax. The mediastinal and hilar contours are normal. Peripherally calcified rounded focus projecting over the lower thoracic spine on the lateral radiograph likely correlates with large osteophytes seen on CT of the chest ___. There is partially visualized cervical fusion hardware. IMPRESSION: No acute cardiopulmonary abnormality. " d3680ffb-8eb17c65-4926e55b-36692c30-cd9800ee.jpg,validate/p11/p11937467/s56821120/d3680ffb-8eb17c65-4926e55b-36692c30-cd9800ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with confusion // Acute cardiopulm disease TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___ FINDINGS: The heart is mild-to-moderately enlarged, but stable bust prior examination. The aorta is markedly tortuous. The bilateral hila are prominent but similar appearance to the prior emanation. There is no evidence of pulmonary vascular congestion. There is mild pleural thickening at the left costophrenic angle. There is no evidence of pneumothorax or pleural effusion. There is no focal consolidation seen to suggest infection. IMPRESSION: No evidence of focal consolidation, or pneumothorax. Mild to moderate cardiomegaly is stable. " 12bc9961-ea7ed954-128b3818-b56ff708-a10db367.jpg,validate/p14/p14304873/s59737954/12bc9961-ea7ed954-128b3818-b56ff708-a10db367.jpg,validation," FINAL REPORT INDICATION: History: ___M with DOE // 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: No acute cardiopulmonary process. " a1fa9169-48920217-ab55d6e0-5b2c4ff7-8dfee7f3.jpg,validate/p16/p16428261/s57250714/a1fa9169-48920217-ab55d6e0-5b2c4ff7-8dfee7f3.jpg,validation," FINAL REPORT INDICATION: ___F with rhonci on exam and cough // R/o pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiac silhouette is top normal. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 83b9dfbc-3d932e0b-c00b24df-9a21809a-49bd5ec7.jpg,validate/p12/p12537194/s52462112/83b9dfbc-3d932e0b-c00b24df-9a21809a-49bd5ec7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with worsening SOB and back pain, found to have malignant effusion. // Has effusion resolved s/p chest tube placement Has effusion resolved s/p chest tube placement IMPRESSION: In comparison with the study of ___, there is little change in the large right pneumothorax despite the presence of a pigtail catheter. There again is a moderate right effusion with continued collapse of a trapped right lung. The left lung is essentially clear. " 7c36d5b0-e90e6944-5faa1919-f8054272-4063c35c.jpg,validate/p11/p11507904/s53524827/7c36d5b0-e90e6944-5faa1919-f8054272-4063c35c.jpg,validation," 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. " 22773090-1ded72fb-10d06a62-2a90514d-bfacc9d8.jpg,validate/p17/p17910433/s56823169/22773090-1ded72fb-10d06a62-2a90514d-bfacc9d8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p CABG // eval pulmonary edema eval pulmonary edema IMPRESSION: Left PICC line tip is at the level of lower SVC. Cardiomediastinal silhouette is unchanged including substantial enlargement of the pulmonary artery suspected on the current study. Left pleural effusion is moderate. No pneumothorax. Continues assessment of the mediastinal silhouette to exclude the possibility of mediastinal hematoma is recommended although no worsening changes demonstrated currently. " feab99fa-1b3d01e8-00019882-3760c697-b5d68c10.jpg,validate/p17/p17405009/s59348909/feab99fa-1b3d01e8-00019882-3760c697-b5d68c10.jpg,validation," FINAL REPORT INDICATION: ___F with excessive vomiting, now complaining of chest pain // pneumomediastinum? TECHNIQUE: AP and lateral views the chest. COMPARISON: None available. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. There is no pneumomediastinum. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 0aa06bbb-17758188-a4a8b905-9d0b9d5b-57d25af8.jpg,validate/p13/p13680126/s54113101/0aa06bbb-17758188-a4a8b905-9d0b9d5b-57d25af8.jpg,validation," 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. " 0af42ca0-cf113768-0ca09e17-bafa3122-80fe3845.jpg,validate/p10/p10165902/s59989831/0af42ca0-cf113768-0ca09e17-bafa3122-80fe3845.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AMS, laid flat and now ___% RA and gurgling sound // aspiration or other acute process aspiration or other acute process IMPRESSION: Compared to prior chest radiographs since ___, most recently ___ and ___. Lung volumes have not improved. There are no findings to suggest either cardiac decompensation or pneumonia. There is most likely a small right pleural effusion. Heart size is normal. No pneumothorax. " 15db48e2-01c47d25-b3d6a2c5-9789e82c-afde30a3.jpg,validate/p17/p17165725/s59405704/15db48e2-01c47d25-b3d6a2c5-9789e82c-afde30a3.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Infection, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the opacities at the right lung base surrounding the insertion site of the pigtail catheter in the right pleural space are constantly decreased in extent. Moderate cardiomegaly persists. Mild pulmonary edema. The two right-sided access lines are unchanged in appearance. No new parenchymal opacities are visible. " 616bbe56-903a3571-f5779431-247510f7-68eaca86.jpg,validate/p19/p19972786/s58798714/616bbe56-903a3571-f5779431-247510f7-68eaca86.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain . COMPARISON: Comparison is made to multiple chest radiographs dating back to ___ and abdominal and pelvic CT from ___. TECHNIQUE Frontal lateral view of the chest. FINDINGS: Moderate cardiomegaly is unchanged. Eventration of the right hemidiaphragm is noted. Blunting of the bilateral costophrenic angles, likely secondary to pleural thickening, as demonstrated on CT from ___. Bibasilar opacities, likely represent atelectasis. There is no pneumothorax. Mediastinal and hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. Chronic changes of pleural thickening at the bilateral lung bases and moderate cardiomegaly. " 81a5f9ee-28cb9ab8-47fd3ff6-22aead5e-0f263497.jpg,validate/p19/p19489906/s57560730/81a5f9ee-28cb9ab8-47fd3ff6-22aead5e-0f263497.jpg,validation," FINAL REPORT CHEST, TWO VIEWS. HISTORY: ___-year-old female with history of right pleuritic chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear of consolidation or pneumothorax. There is mild blunting of one of the posterior costophrenic angles, potentially due to trace effusion, likely on the right. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Trace probable right pleural effusion without other acute cardiopulmonary process. " 754d61f5-3be6b5a7-770c387e-38f01b45-2c4aea9c.jpg,validate/p12/p12379467/s50532122/754d61f5-3be6b5a7-770c387e-38f01b45-2c4aea9c.jpg,validation," FINAL REPORT HISTORY: Asthma and dyspnea. Evaluate for pneumonia. 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. A right-sided Port-A-Cath terminates in the lower SVC. IMPRESSION: No evidence of pneumonia. " f6d16ab3-17bdbaea-40814546-e81e700f-300e334f.jpg,validate/p11/p11686464/s52356838/f6d16ab3-17bdbaea-40814546-e81e700f-300e334f.jpg,validation," FINAL REPORT HISTORY: Fever, chills, and leukocytosis. Concern for pneumonia. COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. Findings were relayed by Dr. ___ to Dr. ___ by phone at 2:38 p.m. on ___. " d9566318-0c0952eb-c7255b64-76fc6787-9072b670.jpg,validate/p13/p13602190/s52858585/d9566318-0c0952eb-c7255b64-76fc6787-9072b670.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Weakness. 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. Bony structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary disease. " a82ca0f8-b0a48183-03832cbc-4e1803d0-46ef6b09.jpg,validate/p12/p12913035/s58460340/a82ca0f8-b0a48183-03832cbc-4e1803d0-46ef6b09.jpg,validation," FINAL REPORT PORTABLE CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: ___-year-old man with heroin overdose, question aspiration. FINDINGS: Portable AP upright chest radiograph provided. The nasogastric tube extends into the left upper quadrant, though the tip is excluded from view. There is a bat wing pattern of pulmonary edema. Right CP angle is excluded. No large effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: Pulmonary edema. NG tube courses into the left upper abdomen. " 590dd63e-8a937c46-b6924ffa-d58e0535-36389a7b.jpg,validate/p16/p16132012/s53068018/590dd63e-8a937c46-b6924ffa-d58e0535-36389a7b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ M complicated medical history (h/o DVT/PE, CMML/myelodysplastic syndrome, s/p TAC/ileostomy s/p reversal in setting of ulcerative colitis vs c diff, nephrolithiasis s/p stenting, PAD s/p R BKA due to chronic ulcer, and multiple recent prolonged hospitalizations at ___ ___ sepsis who presented as transfer from ___ to ___ MICU on ___ for septic shock, SBO, and multifocal pneumonia requiring intubation s/p pressor therapy, IV antibiotics with hospital course complicated by thrombocytopenia, ongoing leukocytosis ___ MPN, sacral decubitus ulcer s/p debridement, persistent fevers, adrenal COMPARISON: Chest x-ray from ___ at ___ FINDINGS: Compared with the prior film, the patchy opacity previously seen left mid zone is slightly improved. Retrocardiac opacity, obscuration of the left hemidiaphragm consistent with left lower lobe collapse and/or consolidation, and small left effusion are similar. The left pleural effusion could be slightly decreased in the interval. There is prominent vascular plethora presumably reflecting CHF, though the appearance raises the possibility of some background parenchymal scarring. Small focal, peripheral, patchy opacities at the right base laterally are noted, similar prior. Minimal blunting of the right costophrenic angle is consistent with a small right effusion. Cardiomediastinal silhouette is unchanged. Again seen is a left PICC line, with tip overlying the mid SVC. No pneumothorax is identified. IMPRESSION: Persistent left lower lobe collapse and/or consolidation and small left effusion, though previously seen left mid zone patchy opacity is improved. Probable CHF, which appears slightly worse. Question background parenchymal scarring. Small focal peripheral opacities at the right lung base, of uncertain etiology or significance, but unchanged compared with the prior film. These likely correspond to findings on the chest CT from ___. They presumably represent some form of infectious infiltrate. Peripheral location is suggestive of an embolic phenomenon such as septic emboli. " 70170195-8d5a11e2-0d0ca504-b6a55856-2710a174.jpg,validate/p14/p14065514/s52420161/70170195-8d5a11e2-0d0ca504-b6a55856-2710a174.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Right pectoral pacemaker. Right chest tube. No evidence of pneumothorax. Unchanged dense and slightly enlarged right mediastinal structures. Minimally more obvious is a subtle pleural density at the site of chest tube insertion. Unchanged size of the cardiac silhouette, unchanged normal appearance of the left hemithorax. " c901d8cc-d1cf458a-ff095106-6d501add-d80c71bb.jpg,validate/p12/p12685249/s51925530/c901d8cc-d1cf458a-ff095106-6d501add-d80c71bb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with alzheimers // eval NGT placement COMPARISON: ___ IMPRESSION: As compared to the previous image, the patient has received a second feeding tube. The tip of the second tube is showing an unremarkable course and projects over the pre-pyloric region. There is no evidence of complication. The endotracheal tube has been minimally advanced and is now projecting approximately 2.2 cm above the carina. The right internal jugular vein catheter is in unchanged position. No evidence of complications, notably no pneumothorax. The lung volumes remain low, with areas of atelectasis at both the right and the left lung bases. " 4b13a83c-16ee862c-b2302676-db455999-9fce1450.jpg,validate/p11/p11443083/s58165529/4b13a83c-16ee862c-b2302676-db455999-9fce1450.jpg,validation," FINAL REPORT HISTORY: Status post seizure with trauma, evaluate for interval change. COMPARISON: ___. FINDINGS: ET tube ends 3.6 cm above the carina. NG tube passes into the stomach and out of view. A new right lower lung opacity is concerning for aspiration or early pneumonia. Normal cardiomediastinal silhouette. No pleural effusion or pneumothorax. IMPRESSION: New right lower lung opacity concerning for aspiration or early pneumonia. Telephone notification to Dr. ___ by Dr. ___ at 11:00 on ___, 10 minutes after discovery. " 970c30d9-8bb291ee-409a2fb7-22c63aaa-a81fd07c.jpg,validate/p19/p19765159/s59277472/970c30d9-8bb291ee-409a2fb7-22c63aaa-a81fd07c.jpg,validation," 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 were obtained. There are small bilateral pleural effusions with overlying atelectasis. No pneumothorax is seen. The aorta is calcified. The cardiac silhouette is not enlarged. Degenerative changes are seen along the spine. IMPRESSION: Small bilateral pleural effusions. " 7a281921-870e0b7e-9016ef9a-d491f2b4-108dd768.jpg,validate/p16/p16743731/s57872724/7a281921-870e0b7e-9016ef9a-d491f2b4-108dd768.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of right hip avascular necrosis, pre-op chest radiograph. 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. Some degenerative changes are seen along the spine, though not optimally evaluated. IMPRESSION: No acute cardiopulmonary process. " 2966e535-737db538-43048338-c6b28e88-4913e51f.jpg,validate/p16/p16323470/s51868436/2966e535-737db538-43048338-c6b28e88-4913e51f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with s/p fall obvioius wrist deformity, pain ttp in the hips knee and femur // eval for fracture x rayseval for ICH for ct head eval c spine for C-spine TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Costochondral calcification is noted at multiple levels. No definite focal consolidation is seen. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. The aorta is calcified and tortuous. The lungs remain hyperinflated. Degenerative changes noted at the right glenohumeral joint, not fully assessed. IMPRESSION: Hyperinflated lungs. No definite focal consolidation. " 4d6dac84-ba172e7f-4087304a-0d1b687d-ba35732e.jpg,validate/p10/p10670085/s56598258/4d6dac84-ba172e7f-4087304a-0d1b687d-ba35732e.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with history of CABG and AVR presents with right-sided chest pain and fatigue. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Lungs are clear of confluent consolidation. Surgical chain sutures project over the right lower lung. There is no effusion. Cardiomediastinal silhouette is stable. Sternal plates again seen. Old healed right lateral rib fractures again noted. IMPRESSION: No acute cardiopulmonary process. " f9cc301f-23155d72-c16bd481-23265384-f968a280.jpg,validate/p16/p16151261/s59340274/f9cc301f-23155d72-c16bd481-23265384-f968a280.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new desaturations on trach // cardiopulmonary process cardiopulmonary process COMPARISON: Chest radiographs ___ through ___ at 04:24. IMPRESSION: Dense consolidation and volume loss in the left lower lobe removed present for several days consistent with collapse suggesting bronchial occlusion. Lungs are otherwise clear. Pleural effusion small on the left if any. Tracheostomy tube in standard position. Left PIC line ends close to the superior cavoatrial junction. No pneumothorax. " 317b7e73-9f3e0183-e077b726-88e1e432-1b42319e.jpg,validate/p13/p13398905/s53707520/317b7e73-9f3e0183-e077b726-88e1e432-1b42319e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough and SOB // r/o mass R/O MASS, COUGH SOB IMPRESSION: In comparison with the study of ___, the patient has taken a smaller inspiration. Cardiac silhouette remains within normal limits in size and there is no vascular congestion or pleural effusion. Mild basilar atelectatic changes are seen bilaterally. No definite acute focal pneumonia. " e8442fed-c6101058-64530434-a6bcda4e-4e24e260.jpg,validate/p12/p12875556/s51073858/e8442fed-c6101058-64530434-a6bcda4e-4e24e260.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Signs of overinflation. No focal parenchymal opacity suggesting pneumonia. No pleural effusions. Mild tortuosity of the thoracic aorta. Normal hilar and mediastinal contours. " bebe78d9-0597dd57-d25d7453-5afc4a50-a6162128.jpg,validate/p11/p11468192/s58115527/bebe78d9-0597dd57-d25d7453-5afc4a50-a6162128.jpg,validation," FINAL REPORT HISTORY: Sarcoid and 1 day of increasing cough. 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. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. " 1f32de47-09579dc2-962d58bd-a4983f3e-aa110944.jpg,validate/p16/p16800398/s56127893/1f32de47-09579dc2-962d58bd-a4983f3e-aa110944.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and fever. FINDINGS: In comparison with the study of ___, there is increased engorgement of pulmonary vessels consistent with worsening of pulmonary vascular congestion. Probable bibasilar atelectatic change. In the appropriate clinical setting, areas of possible coalescence could reflect a developing pneumonia. " b21e10f2-723fa582-546c850d-177480f2-2f7bd694.jpg,validate/p17/p17731851/s52126701/b21e10f2-723fa582-546c850d-177480f2-2f7bd694.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___ year old man s/p T12-L2 Open Treatment of Fracture now with peristent O2 requirement // comparison XR TECHNIQUE: AP and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The patient has been extubated in the interim since ___. The inspiratory lung volumes are very low, decreased from ___, with progressive bibasilar atelectasis. There is no large pleural effusion. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. Dilated air-filled colon is noted in the imaged upper abdomen. IMPRESSION: 1. Status post extubation with decreased lung volumes and progressive bibasilar atelectasis. 2. Dilated air-filled colon incidentally noted in the imaged upper abdomen. " 33b5389f-80f71ec6-9144e971-21d9138b-73e2b21a.jpg,validate/p13/p13040858/s53756045/33b5389f-80f71ec6-9144e971-21d9138b-73e2b21a.jpg,validation," WET READ: ___ ___ ___ 9:59 PM Basilar opacities, left greater than right which could represent either atelectasis versus infection or aspiration.. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with cough // eval for pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is increased opacity projecting over the lung bases particularly on the lateral view in the retrocardiac region. Based on the frontal there is more retrocardiac opacity than right basilar opacity. Superiorly, the lungs are clear. The cardiac silhouette is within normal limits. Chronic left lateral fourth and fifth rib fractures are noted, in part creating opacity projecting over left upper lung laterally. No acute osseous abnormalities. IMPRESSION: Basilar opacities, left greater than right which could represent either atelectasis versus infection or aspiration.. " 823cd2c8-38cbf82d-962ea4ae-682731ec-c2535468.jpg,validate/p17/p17886255/s52008125/823cd2c8-38cbf82d-962ea4ae-682731ec-c2535468.jpg,validation," FINAL REPORT EXAMINATION: PORTABLE CHEST RADIOGRAPH INDICATION: Evaluate NG tube placement. TECHNIQUE: Frontal supine chest radiograph COMPARISON: None available FINDINGS: Lungs are well-expanded, without focal opacities. Cardiomediastinal and hilar contours unremarkable. There is no pleural effusion pneumothorax. The NG tube is seen with both the tip and side port beyond the gastroesophageal junction. Dilated loop of colon is a known cecal volvulus better seen in prior CT performed at outside institution. IMPRESSION: Appropriate placement of the NG tube. Dilated loop of colon is a known cecal volvulus better seen in prior CT performed at outside institution. " b5f6659a-4d931756-c5a45414-53ef13ef-ee8c2941.jpg,validate/p19/p19912620/s59091260/b5f6659a-4d931756-c5a45414-53ef13ef-ee8c2941.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: PICC line placement. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been interval placement of a left-sided PICC line, terminating in the region of the distal-to-mid left subclavian vein, not in appropriate position. Recommend repositioning. Elevation of the right hemidiaphragm persists. No definite pleural effusion is seen. There is no focal consolidation or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Left-sided PICC terminates in the distal-to-mid left subclavian vein, in appropriate position. These findings and recommendations were discussed with nurse, ___, at 5:57 p.m. on ___ 3 minutes after discovery and 10 minutes later also discussed with Dr. ___ on ___. " 54cda78f-02b2b91f-3bb88971-ca816ad2-67865508.jpg,validate/p16/p16449190/s50871420/54cda78f-02b2b91f-3bb88971-ca816ad2-67865508.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyema s/p vats decortication // assess for pneumothorax, pleural effusion assess for pneumothorax, pleural effusion IMPRESSION: Comparison the ___. The previously placed right pigtail catheter was removed and replaced by 3 chest tubes. The chest tubes are in expected position. The amount of pleural effusion has slightly decreased there is a 4-5 mm pneumothorax without evidence of tension and air inclusions are seen in the right lateral soft tissues. Stable appearance of the left lung and of the cardiac silhouette. " 681bb33e-87350402-d605ee44-629a11e7-27541558.jpg,validate/p18/p18088542/s56169518/681bb33e-87350402-d605ee44-629a11e7-27541558.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, malaise and CP // R/o PNA COMPARISON: None available FINDINGS: Heart size is normal. Aorta is mildly tortuous. Lungs are well-expanded and clear, there is no evidence of pleural effusion. Mild scoliosis is noted. IMPRESSION: No radiographic evidence of pneumonia. " b275f679-c55b076f-cdc7965d-cbc79701-bc9c9847.jpg,validate/p10/p10735932/s51494483/b275f679-c55b076f-cdc7965d-cbc79701-bc9c9847.jpg,validation," 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. " 5e47c607-34affd22-c92f544d-a5941f4e-3e090903.jpg,validate/p12/p12764579/s57819991/5e47c607-34affd22-c92f544d-a5941f4e-3e090903.jpg,validation," FINAL REPORT FRONTAL VIEW OF THE CHEST REASON FOR EXAM: ET tube and NG tube. Comparison is made with prior study performed 10 hours earlier. ET tube was in the right main bronchus. In the followup study, the ET tube tip is 5.8 cm above the carina. There is no pneumothorax. If any, there is a small pleural effusion. NG tube tip is in the stomach. Large left lower lobe atelectasis is new. Left perihilar opacity is consistent with a large area of atelectasis. Opacity in the right mid lung at the level of the chest tube is increased, could be due to atelectasis or contusion. There are low lung volumes. Moderate cardiomegaly is stable. Findings were discussed with ___ by phone on ___ at 4:20 p.m. " c8014c22-5a03f891-a4f881a3-700ab67a-98648cfa.jpg,validate/p14/p14717200/s51042808/c8014c22-5a03f891-a4f881a3-700ab67a-98648cfa.jpg,validation," FINAL REPORT HISTORY: AIDS with pneumonia. FINDINGS: In comparison with the study of ___, there are lower lung volumes which account for the increased prominence of the cardiac silhouette. No evidence of vascular congestion or pleural effusion. There is some increased opacification at the right base medially. This could well reflect a combination of crowded pulmonary vessels and atelectasis, though in the appropriate clinical setting supervening pneumonia could not be definitely excluded. " e911cd03-237778cf-ed70819c-09e267ae-63ea74d9.jpg,validate/p10/p10229323/s53574843/e911cd03-237778cf-ed70819c-09e267ae-63ea74d9.jpg,validation," FINAL REPORT HISTORY: Intubated status post motor vehicle collision with lumbar fusion and major blood loss. COMPARISON: ___. FINDINGS: Single frontal view of the chest. Endotracheal tube terminates 4.3 cm above the carina. Right IJ central venous catheter terminates at the superior cavoatrial junction. Lumbar spine fusion construct is incompletely imaged. Heart size and cardiomediastinal contours are normal. Lung volumes are low, crowding of bronchovascular markings. Small retrocardiac opacities persist and may represent aspiration. No pleural effusion or pneumothorax. Interstitial edema has improved since the prior exam. IMPRESSION: Low lung volumes with interval improvement of interstitial edema. Small persistent retrocardiac opacities may represent aspiration. " 672b2864-38d1fefa-dfb43ad4-b1d4e0d9-5df351ff.jpg,validate/p12/p12490049/s56029581/672b2864-38d1fefa-dfb43ad4-b1d4e0d9-5df351ff.jpg,validation," FINAL REPORT INDICATION: ___F with h/a and WBC elevated // pna? 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: No evidence of pneumonia. " aaa64682-73ca9cb0-85e8a952-9b68179d-d7d89407.jpg,validate/p11/p11819641/s53752314/aaa64682-73ca9cb0-85e8a952-9b68179d-d7d89407.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with chest pain. 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. " 7c91514d-9d4e1852-7f03b649-ac453f51-107daa59.jpg,validate/p14/p14954759/s55540644/7c91514d-9d4e1852-7f03b649-ac453f51-107daa59.jpg,validation," FINAL REPORT HISTORY: Acute limb ischemia, pre-operative chest. FINDINGS: In comparison with the study of ___, there is again some enlargement of the cardiac silhouette with tortuosity of the aorta. Opacification at the left base is again consistent with a small effusion and some basilar atelectatic change. Central vascular engorgement is again noted. No evidence of acute focal pneumonia. " f8e1cd27-ef094155-fbb83b3f-7d09c58b-127effc7.jpg,validate/p11/p11508828/s55095381/f8e1cd27-ef094155-fbb83b3f-7d09c58b-127effc7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with acute CHF and NSTEMI // eval interval change eval interval change COMPARISON: Chest radiographs ___ IMPRESSION: Lung volumes have improved and previous bibasilar atelectasis and moderate pleural effusions have nearly cleared. There is the suggestion of new consolidation in the right upper lung, where there was substantial consolidation on ___ raising possibility of recurrent pneumonia, often due to aspiration. Heart is normal size. " e3581550-0c577e45-b3595f39-4a2776c2-579c24ea.jpg,validate/p19/p19065401/s55365220/e3581550-0c577e45-b3595f39-4a2776c2-579c24ea.jpg,validation," FINAL REPORT HISTORY: Bipolar disease and acute confusional state. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: AP and lateral views of the chest. A pacer is seen overlying the left anterior chest with intact leads in appropriate position. The lungs well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 038d261d-1b454928-956f78c0-3d132a70-c144c832.jpg,validate/p15/p15944472/s53387092/038d261d-1b454928-956f78c0-3d132a70-c144c832.jpg,validation," FINAL REPORT HISTORY: Male status post CABG and aortic valve replacement. Assess for pleural effusion or pneumothorax. COMPARISON: Chest radiograph ___, ___, ___, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Sternotomy wires are intact. Low lung volumes with mild bibasilar atelectasis, left greater than right and small bilateral pleural effusions. Interval decrease in vascular congestion. Aortic valve replacement noted. No pneumothorax, pulmonary edema, or new focal opacity. Heart size is top normal with normal mediastinal contour and hila. No bony abnormalities. IMPRESSION: Mild bibasilar atelectasis, left greater than right with small bilateral pleural effusions. No pneumothorax. " ef381a9d-fba1bc3b-5c548a80-3a53a256-bf2698fc.jpg,validate/p16/p16950272/s59090747/ef381a9d-fba1bc3b-5c548a80-3a53a256-bf2698fc.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with wheezing, couging up clear sputum, evaluate for resolution of left lung opacity. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Frontal and lateral views of the chest demonstrate interval resolution of a left midlung opacity. There are no new areas of consolidation to suggest pneumonia. Heart size is normal. Cardiomediastinal and hilar contours are unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: Resolution of left mid lung opacity. No evidence of pneumonia. " 192c4a84-2a9d5557-bc5d5b09-3913e8ed-3b9393f1.jpg,validate/p18/p18446519/s56797027/192c4a84-2a9d5557-bc5d5b09-3913e8ed-3b9393f1.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with fever and cough, HIV positive, 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. " ccc0ee00-fb6f3795-49feb469-eb0ee5d7-da674910.jpg,validate/p19/p19921229/s54387985/ccc0ee00-fb6f3795-49feb469-eb0ee5d7-da674910.jpg,validation," FINAL REPORT INDICATION: Found unresponsive at home. Please evaluate for position of ET tube. COMPARISONS: Chest radiograph from ___ and chest CT from ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The ET tube terminates approximately 2.6 cm from the carina. There is an enteric tube with the tip terminating below the diaphragm. The heart size is top normal. There is evidence of pulmonary vascular congestion with mild-to-moderate bilateral pulmonary edema. There appears to be interval worsening of a focal opacity overlying the mid left lung in the perihilar region. There is no pleural effusion. No pneumothorax is identified. Note is made of mild bibasilar atelectasis, and worsening right middle lobe atelectasis. IMPRESSION: 1. ET tube terminates approximately 2.6 cm above the carina. 2. Interval increase in the mild bilateral pulmonary edema. 3. There is prominence of left perihilar focal opacity concerning for infection or aspiration. " 01e59578-acccf138-5e6cdecc-7bc20e16-91e1b661.jpg,validate/p11/p11144826/s59718691/01e59578-acccf138-5e6cdecc-7bc20e16-91e1b661.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with history of hypertension, hyperlipidemia, diabetes, presenting with substernal chest pressure and nausea. TECHNIQUE: Chest -2 views. 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 silhouette remains mildly enlarged, stable. Mediastinal and hilar contours are also stable. IMPRESSION: No acute cardiopulmonary process. Persistent mild enlargement of the cardiac silhouette. " fa8b773b-fa9892a9-abc190b2-25d27d07-2b2aaa64.jpg,validate/p15/p15641930/s54055771/fa8b773b-fa9892a9-abc190b2-25d27d07-2b2aaa64.jpg,validation," FINAL REPORT CLINICAL HISTORY: Atrial fibrillation, myocardial infarct. CHEST AP: Since the prior chest x-ray, there has been some improvement in the degree of failure. The heart remains enlarged. IMPRESSION: Improving failure. " da9de99a-88589600-954a7bf7-b947b366-25d4cf16.jpg,validate/p11/p11226572/s51860612/da9de99a-88589600-954a7bf7-b947b366-25d4cf16.jpg,validation," FINAL REPORT HISTORY: Female with possible pulmonary nodule. COMPARISON: CT abdomen and pelvis with contrast, ___. Chest radiograph, ___. TECHNIQUE: Frontal and lateral chest radiographs with nipple markers. FINDINGS: Focal opacity in the left lower lobe is not from nipple shadow and on retrospective review was imaged in the CT abdomen and pelvis on ___ and likely represents atelectasis or focal scarring. No new focal opacity, pneumothorax, pleural effusion or pulmonary edema. Heart size, mediastinal contour and hila are normal. No bony abnormality. IMPRESSION: Focal opacity in the left lower lobe likely represents atelectasis or focal scarring. " a92801c1-9052d55e-30d013b6-e7c11d8f-244dfc6d.jpg,validate/p17/p17963938/s53569940/a92801c1-9052d55e-30d013b6-e7c11d8f-244dfc6d.jpg,validation," FINAL REPORT AP CHEST 4:47 A.M. ___ HISTORY: ___-year-old woman, intubated on a ventilator. IMPRESSION: AP chest compared to ___: Right PIC line ends approximately 15 mm beyond the cavoatrial junction in the right atrium. Small bilateral pleural effusions persist. Heart is mildly to moderately enlarged. Because of consistent rightward patient rotation, the right lower lobe is partially obscured. The left is probably atelectatic. No pneumothorax. Tracheostomy tube in standard placement. " bc23caca-51b929ae-4da7b1af-c98899d1-f8852212.jpg,validate/p10/p10216097/s56442522/bc23caca-51b929ae-4da7b1af-c98899d1-f8852212.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p VATS decortication with basilar ___ drain. Please perform ___ AM // Routine evaluation for PTX COMPARISON: Chest x-ray from ___ at 12:25 FINDINGS: Again seen is the drain along the base of the right lung. There is minimal atelectasis. Equivocal trace pneumothorax at the right lung apex. Previously seen lucency at right lung base is no longer visualized. New on today's exam, there is an ellipsoid opacity in the right mid zone. This is partly accounted for by the overlying scapular angle. Doubt pneumonic consolidation. Bibasilar atelectasis is slightly increased. Upper zone redistribution is also slightly more pronounced. No gross left effusion. The cardiomediastinal silhouette is enlarged, but unchanged. IMPRESSION: 1. Right lung base drain remains in place. Minimal , if any, residual pneumothorax. 2. Upper zone redistribution bibasilar atelectasis slightly increased. No overt CHF. 3. Ovoid opacity right mid lung -- question artifact due to overlying scapula. Attention to this area on followup films is requested. " 0c1952c0-113f7e72-a8c5d467-f14c60b9-786fbd0d.jpg,validate/p12/p12678475/s54460845/0c1952c0-113f7e72-a8c5d467-f14c60b9-786fbd0d.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain // eval for acute process TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified IMPRESSION: No acute cardiopulmonary process. " ef848aad-5aac5c10-a3b4da32-1f82abb3-e7c7e50b.jpg,validate/p14/p14590460/s52341907/ef848aad-5aac5c10-a3b4da32-1f82abb3-e7c7e50b.jpg,validation," FINAL REPORT HISTORY: Cough for 1 month. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is normal. The aorta remains tortuous but unchanged. The hilar contours are normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary process. " 93056eee-4afe3358-473e11a9-4bc246ec-79165bfc.jpg,validate/p19/p19969918/s50883476/93056eee-4afe3358-473e11a9-4bc246ec-79165bfc.jpg,validation," FINAL REPORT AP CHEST 10:08 P.M. ON ___ HISTORY: Recent left lower lobe pneumonia. Increased secretions. IMPRESSION: AP chest compared to ___ through ___: Right basal infrahilar opacification could be pneumonia. Upper lungs clear. Pleural effusion is small if any. Heart size normal. Tracheostomy tube in standard placement. " 1aedd083-e4b05eff-2f7949ee-22b9fede-dcc81d24.jpg,validate/p14/p14138018/s58394614/1aedd083-e4b05eff-2f7949ee-22b9fede-dcc81d24.jpg,validation," FINAL REPORT INDICATION: ___M with seizures, evaluate for pneumonia. COMPARISON: Comparison is made to multiple prior chest radiographs dating back to ___ TECHNIQUE AP upright view of the chest. FINDINGS: The lung volumes are low. No focal consolidation is seen. The cardiac silhouette is stably enlarged. Mild pulmonary vascular congestion is minimally worse Mediastinal contours unchanged. There is no pleural effusion or pneumothorax. There are median sternotomy wires and transvenous pacing leads ending in the right atrium and right ventricle IMPRESSION: No evidence of pneumonia. Borderline cardiac compensation. " b2083193-5e62c883-f16ad240-2ee7a461-b080a6fb.jpg,validate/p17/p17182744/s53938206/b2083193-5e62c883-f16ad240-2ee7a461-b080a6fb.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with Frontal Tumor // ETT in place TECHNIQUE: Portable chest radiograph COMPARISON: Multiple chest x-rays from ___ through ___ FINDINGS: The patient is now intubated, with the endotracheal tube terminating 5.5 cm above the carina when the neck is extended. Enteric tube terminates in the stomach. Right lung base atelectasis has resolved. Worsening left retrocardiac opacity, likely due to atelectasis and/or a small pleural effusion. No pulmonary edema or pneumothorax. The mediastinum, hila and heart are within normal limits. IMPRESSION: 1. Interval placement of an ETT that terminates 5.5 cm above the carina with the neck extended. 2. Right Basilar atelectasis resolved. New opacity at the left lung base, likely due to atelectasis and/or small effusion. " b14953e8-405236e6-9510f50a-704bcc04-e434d078.jpg,validate/p13/p13058213/s58071338/b14953e8-405236e6-9510f50a-704bcc04-e434d078.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with LUQ Pain, worse with inspiration, pain on rib palpation // ? rib fx vs lung infiltrate TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Overall, there has been no significant interval change. Again noted is thoracic scoliosis with relative asymmetry of the rib cage and pseudo hyperlucency of the left hand hemi thorax as compared to the right. Right hilar and infrahilar regions appear stable. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable. No focal consolidation, pleural effusion or pneumothorax is seen. Cervical spine surgical hardware is partially imaged and not well assessed on this study. IMPRESSION: No significant interval change aside from partially imaged cervical spine hardware which is not well assessed on this study. " 7f75aa4d-a77f83b2-733f7377-d1b8a349-83e69777.jpg,validate/p18/p18376342/s58156233/7f75aa4d-a77f83b2-733f7377-d1b8a349-83e69777.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Abdominal pain, upright radiograph to assess for free air. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of free air. Unchanged areas of mild atelectasis and mild peribronchial scars, notably in the lower lobe bilaterally. No pulmonary edema. No acute pneumonia. The right hemodialysis catheter is in constant position. " 60d067a6-444c75db-765a7e94-d1fe9c08-373321cc.jpg,validate/p12/p12300626/s53141027/60d067a6-444c75db-765a7e94-d1fe9c08-373321cc.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with c/o CP // ? 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. " 9b3209a1-4f4f10b6-89d60e43-ae5ca330-58720ec8.jpg,validate/p11/p11778596/s51493045/9b3209a1-4f4f10b6-89d60e43-ae5ca330-58720ec8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph dated ___. CLINICAL HISTORY: Fever, 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 seen. IMPRESSION: No acute intrathoracic process. " a10bd947-5db09f2f-976308c7-62c798e5-9c04b972.jpg,validate/p12/p12525702/s56620693/a10bd947-5db09f2f-976308c7-62c798e5-9c04b972.jpg,validation," FINAL REPORT INDICATION: ___M with CHF, CAD, asthma, s/p pacer w/ dypnea, nausea x 3 days // eval ? infiltrate, edema TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Opacity at the left costophrenic angle is compatible with a fat hernia. Left chest wall triple lead pacing device is again seen. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 4a79abaf-d34788a5-a2d78229-e5575065-10a2e6b5.jpg,validate/p14/p14699882/s53794666/4a79abaf-d34788a5-a2d78229-e5575065-10a2e6b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: ___ year old man with new onset gradual shortness of breath, no chest pain, but likely abdominal mass/hepatomegaly TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. Elevation of the right hemidiaphragm is of unknown chronicity. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. Elevation of the right hemidiaphragm, of unknown chronicity, and may be due to hepatic mass or hepatomegaly. " 86e67dc5-17a0a3f5-7c1f3fc2-0a96ce4b-97c81278.jpg,validate/p18/p18131843/s52834331/86e67dc5-17a0a3f5-7c1f3fc2-0a96ce4b-97c81278.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Altered mental status, assess pneumonia. FINDINGS: AP upright and lateral views of the chest provided. The lungs appear clear without focal consolidation, effusion or pneumothorax. The heart and mediastinal contour is stable with an unfolded thoracic aorta containing moderate atherosclerotic calcification. The bony structures are intact. IMPRESSION: No acute findings in the chest. " 368f5026-afedcfe0-6e5ea17e-5876ff01-00987d42.jpg,validate/p14/p14631064/s54225106/368f5026-afedcfe0-6e5ea17e-5876ff01-00987d42.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dysphagia, lethargy, ? aspiration pneumonia. // r/o pneumonia IMPRESSION: Since ___, a new opacity has developed in the left lower lobe, resulting in increased opacity over the lower thoracic spine on the lateral view. In the appropriate clinical setting, this may reflect a developing infectious pneumonia. Differential diagnosis includes focal aspiration and atelectasis. Cardiomegaly and tortuosity of the thoracic aorta are unchanged. . " 65c6ddef-499f47f2-fa21acb4-02354f29-039b5c94.jpg,validate/p14/p14848780/s50273703/65c6ddef-499f47f2-fa21acb4-02354f29-039b5c94.jpg,validation," FINAL REPORT EXAMINATION: Portable chest INDICATION: ___ year old woman with RLL mass s/p EBUS TBNA/TBBx // ?PTX TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Tracheostomy tube in good position. Mediastinal wires and mitral valve repair . No pneumothorax. Mild pulmonary vascular congestion. Mild cardiomegaly. Slight increase in bibasilar opacities are likely atelectasis. Underlying and interstitial disease is better seen in prior CT IMPRESSION: No pneumothorax. Mild pulmonary vascular congestion. " 49050bf0-ee17b7dc-ecede72f-232596a7-dffd825c.jpg,validate/p16/p16945691/s56941055/49050bf0-ee17b7dc-ecede72f-232596a7-dffd825c.jpg,validation," 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. " 47b13102-e97e38f0-192daa06-e8afaa53-2c13f883.jpg,validate/p13/p13048370/s50811384/47b13102-e97e38f0-192daa06-e8afaa53-2c13f883.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with thoracic pain after lifting weights. COMPARISON: None available. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is een. IMPRESSION: No acute cardiopulmonary process. " 260713fc-7b1a5aea-355259a2-d4efe2a8-3b0d09bf.jpg,validate/p13/p13284221/s55683903/260713fc-7b1a5aea-355259a2-d4efe2a8-3b0d09bf.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, worsening cough, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Signs of overinflation and bilateral apical scarring with symmetrical apical thickening. No pneumonia, no pulmonary edema. Normal hilar and mediastinal contours. " 009a6306-3ce3b57a-62699fc2-e09e33fe-ab854b43.jpg,validate/p11/p11585485/s59580036/009a6306-3ce3b57a-62699fc2-e09e33fe-ab854b43.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Moderate right pleural effusion which recurred between ___ and ___ is no larger. Left lung is clear. Right upper lung is clear. Atelectasis accommodates the chronic recurrent right pleural effusion. Heart size normal. No pulmonary edema. Left subclavian infusion port ends in the mid SVC. " 0cc68157-60b8e6fe-09be1a03-9349d55a-2f5343bc.jpg,validate/p18/p18655830/s56297438/0cc68157-60b8e6fe-09be1a03-9349d55a-2f5343bc.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain. TECHNIQUE: Chest PA and lateral. COMPARISON: Chest radiograph ___. FINDINGS: An accessed Port-A-Cath ends in the upper superior vena cava. The lungs are clear without focal consolidation, pulmonary edema, pleural effusion or pneumothorax. There are mediastinal clips and sternotomy wires. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. Compression deformity of a lower thoracic vertebral body was better seen on previous exam. IMPRESSION: No acute cardiopulmonary process. " 997b7f50-8f3e1721-afb050fb-483a493e-45fbd317.jpg,validate/p18/p18796073/s55964212/997b7f50-8f3e1721-afb050fb-483a493e-45fbd317.jpg,validation," FINAL REPORT HISTORY: Chest pressure and shortness of breath. Evaluate for acute process. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph from ___, lung volumes are decreased accentuating the cardiac silhouette and bronchovascular structures. There is no focal consolidation concerning for pneumonia. There is no large pleural effusion or pneumothorax. IMPRESSION: " 0aaa1217-f013d8fc-91f1a668-ede342a1-91933a85.jpg,validate/p13/p13078901/s59113453/0aaa1217-f013d8fc-91f1a668-ede342a1-91933a85.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shoulder pain. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Lung volumes are slightly low. Heart and mediastinal contours are stable. The pulmonary vasculature is stably prominent. IMPRESSION: Stable pulmonary vascular prominence. " 75ad6b29-2c7d8266-64392703-630195ea-871c1839.jpg,validate/p16/p16283431/s54995191/75ad6b29-2c7d8266-64392703-630195ea-871c1839.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for pneumothorax. COMPARISON: None. FINDINGS: PA and lateral views of the chest were obtained. Heart is normal in size and cardiomediastinal contour is unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 801ec803-25860633-c774d24f-6ed2008b-965de5b3.jpg,validate/p18/p18914461/s54178291/801ec803-25860633-c774d24f-6ed2008b-965de5b3.jpg,validation," 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. " 15cbfa78-439e1e31-52d04222-98899240-165c697d.jpg,validate/p16/p16742247/s57843049/15cbfa78-439e1e31-52d04222-98899240-165c697d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with PMH of HLH (s/p etoposide in remission), relapsed refractory secondary AML (s/p non-myeloablative MRD Allo SCT with FLU/BU for conditioning (D0=___, s/p DLI ___), baseline bronchiectasis, chronic pseudomonal pneumonia, who was admitted on ___ with febrile neutropenia, found to be in blast crisis, developed septic shock with FICU course, transferred to ___ for further management of pneumonia. // eval interval change, effusion, consolidation, blood eval interval change, effusion, consolidation, blood IMPRESSION: Compared to prior chest radiographs since ___, most recently ___ through ___. The asymmetric had heterogeneous opacification that has worsened in the right mid and lower lung zones since ___ is probably pneumonia. Generalized interstitial abnormality that has increased con currently is probably cardiogenic pulmonary edema. Pleural effusions are presumed, but not large. Right PIC line ends in the low SVC. ___, MD " c6a4d485-c65947dc-5a5914a1-9cf94e62-1f9905ec.jpg,validate/p17/p17135687/s58740155/c6a4d485-c65947dc-5a5914a1-9cf94e62-1f9905ec.jpg,validation," FINAL REPORT INDICATION: ___ year old man with trach, LLL abscess, and GSW to chest // interval change COMPARISON: Radiographs from ___ IMPRESSION: The nasogastric tube has been advanced since the previous study. The tip is now within the fundus of the stomach. Tracheostomy, right sided pleural catheter, and right sided central venous line are unchanged in position. There is a persistent left retrocardiac study and left lower lobe consolidation, compatible with known abscess. There are no pneumothoraces. " ffb3abbc-0cf32c0a-642bff9b-b88650db-eada8ddf.jpg,validate/p11/p11825167/s53045712/ffb3abbc-0cf32c0a-642bff9b-b88650db-eada8ddf.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with cough, evaluate for pneumonia. COMPARISON: ___. FINDINGS: PA and lateral views of the chest were obtained. The heart is normal size and cardiomediastinal contour is stable. Lungs are clear. There is no pleural effusion or pneumothorax. No pulmonary edema. IMPRESSION: No evidence of pneumonia. " 81ae5a77-a6c85e94-96645aba-eb7bf26e-905c504e.jpg,validate/p17/p17030818/s55905927/81ae5a77-a6c85e94-96645aba-eb7bf26e-905c504e.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG // eval for effusion TECHNIQUE: Chest PA and lateral COMPARISON: ___ and ___. FINDINGS: AP and lateral views of the chest. Show slightly worsened consolidation at the left lung base compared to ___. Bilateral pleural effusions are evident, not large. The the right base is clear other than a calcified pulmonary nodule seen on the preop study. Calcified aortopulmonary window node is partially obscured on the current exam. Coronary stents are visible. Right-sided central venous catheter tip is in unchanged position. Persistent IMPRESSION: Small pleural effusions and slightly increased/persistent left basilar consolidation " 549ce364-59a60f11-1ccc60b9-dd6549fd-326db2a1.jpg,validate/p13/p13787729/s55461092/549ce364-59a60f11-1ccc60b9-dd6549fd-326db2a1.jpg,validation," FINAL REPORT HISTORY: Rib fractures. FINDINGS: In comparison with the study of ___, there has been substantial decrease in the degree of right pleural effusion. Some blunting of the costophrenic angle with meniscus formation is again seen on the right. Evidence of healing about the previous rib fractures. No acute focal pneumonia or vascular congestion. " 648f5667-26856cfa-074f68b1-54dcffc6-62346fba.jpg,validate/p18/p18951987/s52039233/648f5667-26856cfa-074f68b1-54dcffc6-62346fba.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___. FINDINGS: Support and monitoring devices are unchanged in position. Slight decrease in width of cardiomediastinal contours accompanied by improvement in extent of pulmonary edema and apparent improvement of pleural effusions. " f5278240-1e211f06-522d371a-2b71b6dd-7789d5cf.jpg,validate/p15/p15225349/s59925496/f5278240-1e211f06-522d371a-2b71b6dd-7789d5cf.jpg,validation," 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. " 10b92f35-5b589b81-8213558a-5096568e-b50604de.jpg,validate/p17/p17967970/s52830384/10b92f35-5b589b81-8213558a-5096568e-b50604de.jpg,validation," 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 s/p right-sided thoracotomy with RUL resection on ___ with significant intra-operative anemia. // Please perform at 15:00 today. Chest tube unclamped due to significant R basal pneumothorax after clamp trial. Eval for change TECHNIQUE: Chest single view COMPARISON: ___ 11:05 FINDINGS: Tracheostomy. Right IJ central line tip in the low SVC. Single right chest tube. Surgical clip right axilla. Right basilar pneumothorax has mildly decreased. Small right pleural effusion is more prominent. There is tiny left pleural effusion, stable. Mildly improved right mid lung, basilar opacity. Left lung is clear. IMPRESSION: Right basilar pneumothorax has mildly decreased in size. There is small right, tiny left pleural effusions. " 16fd52f5-38db1b55-0ca2544e-03fb3a96-59c06bc3.jpg,validate/p15/p15289580/s59728949/16fd52f5-38db1b55-0ca2544e-03fb3a96-59c06bc3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with multiple myeloma being worked up for auto BMT // r/o cardiac/pulmonary dysfunction COMPARISON: Chest radiograph; ___ FINDINGS: PA and lateral views of the chest provided. Lungs are well inflated and grossly clear. No pleural effusion or pneumothorax. Hilar contours are normal. The heart is upper limit of normal. A chronic left rib fracture is unchanged. IMPRESSION: Normal chest radiograph. " 34935097-30f2af6a-00237008-207300be-27bf66b2.jpg,validate/p19/p19961925/s56801712/34935097-30f2af6a-00237008-207300be-27bf66b2.jpg,validation," 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. " a812c4ac-07b5633c-bcd1da74-7fcca493-e5c3b2dc.jpg,validate/p11/p11210828/s57540557/a812c4ac-07b5633c-bcd1da74-7fcca493-e5c3b2dc.jpg,validation," FINAL ADDENDUM ADDENDUM Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state nausea. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old female with ""acute process"". 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. Osseous structures are without an acute abnormality. Imaged upper abdomen is unremarkable. IMPRESSION: No acute intrathoracic abnormality. " 1b42d5d3-d5f9a17a-850c87e6-212ad69d-10d5e1c8.jpg,validate/p15/p15328320/s58520196/1b42d5d3-d5f9a17a-850c87e6-212ad69d-10d5e1c8.jpg,validation," FINAL REPORT INDICATION: ___F with NGT placement // evaluate NGT placement TECHNIQUE: CHEST AP. COMPARISON: Outside hospital chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pneumothorax or large pleural effusion. The lungs are adequately expanded and without focal consolidation concerning for pneumonia. An NG tube has been placed, with distal aspect in the stomach but tip not captured on the current film. Additionally, the side holes project above the GE junction. IMPRESSION: NG tube with side holes above the GE junction. Advancement by several cm is recommended for more optimal placement. " 08b3b034-c09591de-e02a0a5e-40d50333-940774f0.jpg,validate/p12/p12047822/s57005012/08b3b034-c09591de-e02a0a5e-40d50333-940774f0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hyponatremia ?SIADH // acute lung patholgy causing SIADH acute lung patholgy causing SIADH IMPRESSION: In comparison with the study of ___, the patient has taken a much poor inspiration an the chin obscures much of the upper lungs. There is stable enlargement of the cardiac silhouette with substantial unfolding of the aorta. Minimal prominence of interstitial markings could reflect some elevated pulmonary venous pressure or chronic lung disease. No definite acute focal pneumonia. " 9d1f237c-c78eac1f-0dc3638c-78e796e2-303a6632.jpg,validate/p13/p13350579/s54934621/9d1f237c-c78eac1f-0dc3638c-78e796e2-303a6632.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after bronchial stent placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable in appearance. Right upper mediastinal shift is related to post-surgical changes. Lungs are essentially clear and there is no pleural effusion or pneumothorax. " e7e6dbcd-ab411bbe-1d7ff909-445b1a30-e63d3d3a.jpg,validate/p17/p17885927/s57904607/e7e6dbcd-ab411bbe-1d7ff909-445b1a30-e63d3d3a.jpg,validation," FINAL REPORT HISTORY: Cough, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is some asymmetry with increased opacification in the left mid and lower zones. Much of this could reflect merely atelectatic changes. In the appropriate clinical setting, supervening pneumonia would have to be considered. Of incidental note is an old healed fracture of the distal right clavicle. " 43a61689-cb7d67dd-b1f0e388-09711b6c-1c60f7f1.jpg,validate/p14/p14290495/s56938469/43a61689-cb7d67dd-b1f0e388-09711b6c-1c60f7f1.jpg,validation," FINAL REPORT INDICATION: Chest tightness in the setting of anxiety, here to evaluate for pneumonia. COMPARISON: Chest radiographs dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: 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. The trachea is midline. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 81096ec0-707faa49-4e168bcd-60315508-36645720.jpg,validate/p15/p15619921/s55075565/81096ec0-707faa49-4e168bcd-60315508-36645720.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with moderate-severe pancreatitis, h/o CHF, now with decreased breath sounds bilateral lung fields, please assess size of effusions. // extent of pleural effusions IMPRESSION: As compared to ___ chest radiograph, cardiomediastinal contours are stable. Pulmonary vascular congestion and interstitial edema have improved. Small right and small to moderate left pleural effusions are again demonstrated with adjacent bibasilar atelectasis. The extent of atelectasis in left retrocardiac region has slightly improved in the interval. " 68ab4970-7981cc85-eddde62d-8fa12936-81e2ecd3.jpg,validate/p10/p10364180/s58256366/68ab4970-7981cc85-eddde62d-8fa12936-81e2ecd3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with intubation // eval ET tube COMPARISON: Prior exam from approximately 1 hr earlier. FINDINGS: AP portable supine view of the chest. There has been interval intubation with the tip of the endotracheal tube residing approximately 4 cm above the carina. Mild cardiomegaly and pulmonary interstitial edema persists. No large effusions are present. IMPRESSION: ET tube positioned appropriately. Persistent cardiomegaly and interstitial pulmonary edema. " 9ff0042b-c724e146-6d9734d8-ebf21fdf-45d638de.jpg,validate/p17/p17083980/s59205898/9ff0042b-c724e146-6d9734d8-ebf21fdf-45d638de.jpg,validation," FINAL REPORT INDICATION: ___F with unwitnessed fall // eval bleeding or fracture TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are grossly clear. There is no consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits given projection. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " ff09e0ec-9e286098-35fd5022-4391b84f-8be65212.jpg,validate/p16/p16444272/s52919371/ff09e0ec-9e286098-35fd5022-4391b84f-8be65212.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with chronic chylothorax after right chest tube and Pleurx catheter placed. Note is made that the original dictation was lost and the study was brought to our review today on ___. The left PICC line tip is at the level of cavoatrial junction. The right chest tube is in place. The patient continues to be in pulmonary edema with bilateral loculated pleural effusions. " 3bf767b7-9dc4fc07-48101b24-d3d22662-2b47a2ab.jpg,validate/p15/p15749643/s59147134/3bf767b7-9dc4fc07-48101b24-d3d22662-2b47a2ab.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with weakness // eval for PNA TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: Streaky bibasilar atelectasis is noted. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Moderate cardiomegaly may be partially projectional in nature. IMPRESSION: No evidence of acute cardiopulmonary process. " 97f112cd-ddaefd25-fdc598ac-b3e67661-23005e79.jpg,validate/p13/p13071917/s58975255/97f112cd-ddaefd25-fdc598ac-b3e67661-23005e79.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with with cp and SOB pls pna vs edema. COMPARISON: Prior CT chest from ___, chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. A retrocardiac opacity is again seen likely with representing known hiatal hernia. The lungs are clear without focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures appear intact. Focal eventration of the right hemidiaphragm is noted. IMPRESSION: Hiatal hernia re-demonstrated. No acute intrathoracic process. Please refer to subsequently performed CTA chest for further details. " 849627f1-78067389-0a1ce650-5cc173a2-ed12a9c1.jpg,validate/p11/p11009622/s51445899/849627f1-78067389-0a1ce650-5cc173a2-ed12a9c1.jpg,validation," FINAL REPORT INDICATION: Evaluate for effusion or consolidation in a patient with newly elevated LFTs. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate mild cardiac enlargement an calcification of the aortic knob, unchanged. Diffusely increased opacity is compatible with mild pulmonary edema. No definite focal consolidation, pleural effusion, or pneumothorax is seen. The visualized upper abdomen is unremarkable. IMPRESSION: Mild pulmonary edema. " 7a19107c-7609b3e9-048103cd-003b0230-804dc496.jpg,validate/p11/p11738518/s54588871/7a19107c-7609b3e9-048103cd-003b0230-804dc496.jpg,validation," FINAL REPORT INDICATION: ___F with dyspnea Evaluate for pneumonia, edema. TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates hyperexpanded clear lungs. Tiny right-sided pleural effusion. Moderate cardiomegaly. The aorta is tortuous. No pneumothorax. IMPRESSION: No pneumonia. " ae2354f5-4c24df75-fa15e69a-3b16ec79-cb7c86d8.jpg,validate/p12/p12764579/s50578624/ae2354f5-4c24df75-fa15e69a-3b16ec79-cb7c86d8.jpg,validation," FINAL REPORT HISTORY: Basilar chest tube replacement. FINDINGS: In comparison with the earlier study of this date, the basilar chest tube has been replaced with the tip close to the midline at the level of the top of the aorta. No evidence of pneumothorax. Little change in the appearance of the heart and lungs. " e44746c0-b7787b1f-e01981e3-4fca88df-a7ba3b9d.jpg,validate/p18/p18016258/s56638007/e44746c0-b7787b1f-e01981e3-4fca88df-a7ba3b9d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p STEMI with cardiogenic shock s/p Impella removal // interval change?consolidations? TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 18c04f81-57c222d9-2b148ccf-02b8e6eb-a52aacd4.jpg,validate/p18/p18019452/s57288758/18c04f81-57c222d9-2b148ccf-02b8e6eb-a52aacd4.jpg,validation," FINAL REPORT INDICATION: Evaluation for intrathoracic process. COMPARISON: Chest radiograph, ___. FINDINGS: PA and lateral views of the chest were obtained. There is no focal consolidation or congestive heart failure. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. No bony abnormalities. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 2b767696-7d268238-7dd3ef21-ae08e503-479171e4.jpg,validate/p17/p17190208/s58422485/2b767696-7d268238-7dd3ef21-ae08e503-479171e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with history notable for evacuation of acute SDH (___), coiling of ruptured ACOM aneurysm (___) s/p insertion of VP shunt, who has been hospitalized for 41 days with complex course notable for bilateral PEs, cholangitis s/p ERCP, renal failure, thigh hematoma, and recent GI bleed, now transferred to MICU for shock due to retroperitoneal bleed and respiratory failure // tubes/lines, acute intrapulmonary process tubes/lines, acute intrapulmonary process IMPRESSION: In comparison to ___, no relevant change is seen. All monitoring and support devices continue to be in correct position. The lung volumes remain low, with areas of pleural effusions, left more than right, and subsequent areas of atelectasis at both the left and the right lung bases. Moderate cardiomegaly persists. No overt pulmonary edema. " 14f3ef18-c73280dc-f89a7538-8957ce80-3c79cb2d.jpg,validate/p10/p10584015/s56555588/14f3ef18-c73280dc-f89a7538-8957ce80-3c79cb2d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with AML with severe GVHD liver on chronic IV steroids // r/o PCP PNA COMPARISON: Radiographs from ___. IMPRESSION: There is a right-sided central venous line with the distal lead tip at the cavoatrial junction. Heart size is within normal limits. Atelectasis at the left lung base is seen. There is no focal consolidation, pleural effusions, or signs for overt pulmonary edema. " 5d14eede-92722b90-26894a18-ca045a42-0509dfbc.jpg,validate/p17/p17345538/s50435430/5d14eede-92722b90-26894a18-ca045a42-0509dfbc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Lower GI bleed with hypoxia, question pulmonary edema. FINDINGS: AP upright portable chest radiograph obtained. Midline sternotomy wires are again noted. There is a right arm PICC line with its tip terminating at the level of the low SVC. Multiple overlying EKG leads are present. There is interstitial edema with left lower lobe opacity concerning for atelectasis or pneumonia. Small bilateral effusions are present. There is no pneumothorax. Overall, cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Mild pulmonary edema with small bilateral effusions and left lower lobe opacity concerning for atelectasis or consolidation. A lateral view would be helpful to further assess. " a891887b-8b4dd94d-141e9a10-771bf7dc-39eb6ae7.jpg,validate/p14/p14288958/s56019188/a891887b-8b4dd94d-141e9a10-771bf7dc-39eb6ae7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with seizures // eval for infiltrate eval for infiltrate COMPARISON: There are no prior chest radiographs available. IMPRESSION: Normal heart lungs hila mediastinum and pleural surfaces. " 9a2139d1-eb62bab9-d1cf51c8-32c7fde4-6fdd15d1.jpg,validate/p17/p17729814/s59358060/9a2139d1-eb62bab9-d1cf51c8-32c7fde4-6fdd15d1.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with ET tube in place // ETT placement TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: Endotracheal tube terminates 4 cm above the carina, in appropriate position. An NG tube terminates in the stomach with side port at the expected location the gastroesophageal junction. Lung volumes are low. Linear opacity at the right base is consistent with atelectasis. No pneumothorax or pleural effusion. IMPRESSION: 1. Endotracheal tube in appropriate position. 2. NG tube terminates in the stomach with side port at the expected location the gastroesophageal junction. " 1b7a1335-07130a4d-b7912199-5bb9361e-30ea1056.jpg,validate/p17/p17194805/s51956521/1b7a1335-07130a4d-b7912199-5bb9361e-30ea1056.jpg,validation," 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. " 528feb7c-475e2c03-5a69a34b-2c742dda-1e39b6c5.jpg,validate/p12/p12450697/s55170813/528feb7c-475e2c03-5a69a34b-2c742dda-1e39b6c5.jpg,validation," FINAL REPORT INDICATION: ___ year old woman POD4 CABG // effusion/atelectasis COMPARISON: Radiographs from ___. IMPRESSION: There is a right IJ central line with the distal lead tip in the proximal SVC. There has been worsening of the left-sided pleural effusion and bibasilar opacities. This may represent aspiration or developing pneumonia. There are no pneumothoraces. " 94c426f2-d7a3f21b-f8002265-12d3ddeb-e30a70ed.jpg,validate/p18/p18934359/s57301835/94c426f2-d7a3f21b-f8002265-12d3ddeb-e30a70ed.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with epigastric pain radiating to her flank. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Relatively low lung volumes are seen, but the lungs are clear. The cardiomediastinal silhouette is within normal limits. Mild mid thoracic dextroscoliosis is noted. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 82310ee7-bc8b5ea7-8432d7c0-8b47e16d-8e60b03b.jpg,validate/p17/p17716210/s56845519/82310ee7-bc8b5ea7-8432d7c0-8b47e16d-8e60b03b.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fevers and chills for 2 days. Question pneumonia. COMPARISON: Chest x-ray from ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. Spinal stimulator device is again noted as well as a G tube in the upper abdomen areseen. Prominent loops of bowel with air and fluid levels are seen in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. Prominent loops of bowel in the upper abdomen, clinical correlation suggested. " ba490b33-02707a1d-daac1893-b344a3cc-db6ba963.jpg,validate/p14/p14120635/s59893939/ba490b33-02707a1d-daac1893-b344a3cc-db6ba963.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with question of free air under diaphragm on AM CXR. // eval for free air under the diaphragm with CXR TECHNIQUE: Portable, semi upright AP radiograph view of the chest COMPARISON: Chest radiograph dated ___, earlier on the same day at 09:17. FINDINGS: ETT in standard position. Right PICC tip again courses superiorly into the right IJ and its tip is beyond the scope of this image. Right IJ catheter tip projects in the expected region of the low SVC. Enteric tube traverses the diaphragm into the left upper quadrant and its tip is not seen. Metallic foreign body projecting over the bronchus is unchanged. No evidence of pneumoperitoneum under the right hemidiaphragm. No significant interval change. Retrocardiac opacity consistent with atelectasis is unchanged. Lung volumes remain low. No pneumothorax. IMPRESSION: 1. No evidence of pneumoperitoneum. 2. Persistent right PICC tip coursing in the right IJ and its tip is not seen. " dbd595ac-99a8339c-e2f63195-9c4b2187-bf33c002.jpg,validate/p10/p10441044/s58744053/dbd595ac-99a8339c-e2f63195-9c4b2187-bf33c002.jpg,validation," FINAL REPORT INDICATION: Multiple rib fractures, left chest tube to suction? COMPARISON: Multiple chest x-rays, the last one ___ at 2:02 p.m. FINDINGS: Left chest tube is in unchanged position projecting at the left lung apex. Pneumothorax that is moderate and loculated inferiorly has significantly increased since prior exam. ET tube is in adequate position. Left subclavian line ends in upper SVC and right subclavian line ends in mid SVC. Right lower lung atelectasis is stable. CONCLUSION: Patient with multiple known rib fractures and left chest tube. Pneumothorax has significantly increased. Medical team in the ICU has been verbally contacted for the results. " 95879f17-313d2951-747d4063-7982c27c-361f4f25.jpg,validate/p19/p19932242/s52380885/95879f17-313d2951-747d4063-7982c27c-361f4f25.jpg,validation," WET READ: ___ ___ 4:11 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with sCHF, smoker, active wheezes, evaluate for pulm edema vs PNA. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: Opacity at the right lung base likely represents residual scar from site of prior right middle lobe pneumonia. The catheter from a right chest wall port terminates within the right atrium. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " e4e0e13e-62185251-35ccb907-98e901cf-45c0ce1b.jpg,validate/p17/p17175688/s53195277/e4e0e13e-62185251-35ccb907-98e901cf-45c0ce1b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: There is minimal left base atelectasis. No focal consolidation, pleural effusion, evidence of pneumothorax is seen. A the cardiac silhouette is not enlarged. The aorta is tortuous. There is a 2.2 cm and ovoid radiopaque structure projecting just below the medial right hemidiaphragm which is raises the appearance of a coin. Correlate for ingestion. " 39bc9aab-84ab35fe-fd580aaf-55db5928-606c256c.jpg,validate/p11/p11388787/s52145540/39bc9aab-84ab35fe-fd580aaf-55db5928-606c256c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pan // f/u pna F/U PNEUMONIA RESIDUAL CHECK RESOLUTION NO COUGH IMPRESSION: In comparison with the study of ___, there is again prominence of the left ventricle with tortuosity of the descending aorta. Some hyperinflation of the lungs suggests underlying chronic pulmonary disease. The left basilar opacification appears less prominent on the lateral view. This could well represent sequela of previous pneumonia. Coronary artery stent is again seen on the lateral view, as well as calcification in the region of the aortic valve. " d43170ee-8fcbab0e-f02a8615-7eb0352d-68ad823d.jpg,validate/p14/p14247227/s54402888/d43170ee-8fcbab0e-f02a8615-7eb0352d-68ad823d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with L1 lesion undergoing pre-op work up // pre-op CXR Surg: ___ (Lumbar lami) TECHNIQUE: AP view of the chest 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. " 215fccbc-5bfee4c8-790f1086-731af35f-d01f08af.jpg,validate/p11/p11658675/s57692436/215fccbc-5bfee4c8-790f1086-731af35f-d01f08af.jpg,validation," FINAL REPORT HISTORY: Difficulty swallowing, cough. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is normal. The mediastinal and hilar contours are unchanged, with mild calcification of the aortic knob again noted. The pulmonary vasculature is not engorged. Patchy and linear opacities in the lung bases appear progressed in the interval. No pleural effusion or pneumothorax is demonstrated. Vertebroplasty changes are noted within the mid and lower thoracic spine. Multilevel degenerative changes are present in the thoracic spine. IMPRESSION: Worsening bibasilar airspace opacities, likely reflective of atelectasis, but aspiration cannot be completely excluded. " 14e7bb66-26617b9c-0a89571c-c5773e7f-5290040f.jpg,validate/p15/p15590394/s52001750/14e7bb66-26617b9c-0a89571c-c5773e7f-5290040f.jpg,validation," FINAL REPORT INDICATION: Weakness. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. There is no focal consolidation, pleural effusion, or pneumothorax. There is mild elevation of the right hemidiaphragm, similar to MRI from ___. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " f47fa206-273df085-78966efa-c80d2344-43288218.jpg,validate/p17/p17182744/s53919637/f47fa206-273df085-78966efa-c80d2344-43288218.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with Hx rectal adenocarcinoma, CNS lymphoma enterocutaneous fistula presenting with nausea, vomiting and fever to 102 // R/O pneumonia, SBO COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Elevated right hemidiaphragm is unchanged. Lungs remain clear. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures intact. IMPRESSION: No acute intrathoracic process. " 9e69769b-5232de0c-7eea3752-a3647ff1-b640e09a.jpg,validate/p17/p17224335/s53571000/9e69769b-5232de0c-7eea3752-a3647ff1-b640e09a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p CABG/AVR in ___/ sepsis?/tamponade? // eval mediastinum eval mediastinum IMPRESSION: Comparison of ___. No relevant change. Stable extent of the bilateral pleural effusions. Moderate cardiomegaly persists. Unchanged platelike atelectasis at the level of the left hilus. The alignment of the sternal wires, the valvular replacement and the right internal jugular vein catheter are in correct position. " 95fd493f-b371c5ab-5d0918e9-5caf4614-ce8cb1eb.jpg,validate/p16/p16701608/s50900363/95fd493f-b371c5ab-5d0918e9-5caf4614-ce8cb1eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with tachycardia dementia // eval for pna TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: The lungs are hyperinflated, with flattening of the diaphragms. Blunting of the right costophrenic angle suggests a small pleural effusion. Chronic deformity of multiple right-sided ribs from prior fractures noted, with overall volume loss of the right lung as compared to the left. The cardiac silhouette is enlarged. There is subtle splaying of the carina which can be seen with left atrial enlargement. The aorta is calcified and tortuous. Evidence of a large hiatal hernia is seen. IMPRESSION: Hyperinflated lungs. Small right pleural effusion. Chronic deformity of the right-sided ribs with overall volume loss of the right lung as compared to the left. No definite focal consolidation is seen although this would be difficult to exclude at the right lung base. Cardiomegaly. Large hiatal hernia. " 336b336d-723d4a73-9887a3b1-07d08e6e-435bef81.jpg,validate/p19/p19744711/s59612514/336b336d-723d4a73-9887a3b1-07d08e6e-435bef81.jpg,validation," WET READ: ___ ___ ___ 3:48 PM Subtle left lower lobe opacity concerning for pneumonia. Lower lung platelike atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with hypoxia // eval for pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires again noted. There are scattered areas of platelike atelectasis in the mid to lower lungs. Retrocardiac opacity is noted in the left lower lobe which is concerning for an early pneumonia. No large effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: Subtle left lower lobe opacity concerning for pneumonia. Lower lung platelike atelectasis. " 00d0fb9c-43d3b9c6-11a88040-aa27ccf7-53d4eafb.jpg,validate/p19/p19965802/s50945705/00d0fb9c-43d3b9c6-11a88040-aa27ccf7-53d4eafb.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with reduction of parastomal hernia, ETT placement, NG tube placement, lung volume. COMPARISON: ___. FINDINGS: Right upper lobe complete opacification, new since yesterday, is consistent with atelectasis and possible superimposed aspiration. Considering the difference of technique from supine to semi-erect position, mild pulmonary edema has redistributed lower lung with mild atelectasis. Pleural effusion is small if any. There is no pneumothorax. ET tube ends 3.9 cm above carina. Right jugular line is in the mid SVC. NG tube is below the diaphragm. CONCLUSION: 1. Right upper lobe new consolidation is compatible with atelectasis with possibly superimposed aspiration. 2. Considering the difference of technique, mild pulmonary edema has redistributed in lower lung in this semi-erect exam. This has been discussed directly by telephone with the ICU team. " 0b8cdcd7-abfc26f0-64fc68d4-a9adeb91-a0dc3831.jpg,validate/p10/p10291967/s52957174/0b8cdcd7-abfc26f0-64fc68d4-a9adeb91-a0dc3831.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and fever. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. Mild linear opacities are noted in both lung bases, most likely reflective of subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is visualized. Degenerative changes of the acromioclavicular joints are noted bilaterally, right greater than left. IMPRESSION: Linear opacities at the lung bases most likely reflective of subsegmental atelectasis. " 7cf08a76-5ba9bce1-f3f935ee-6d666d6e-9cf7f4b0.jpg,validate/p19/p19802708/s53470427/7cf08a76-5ba9bce1-f3f935ee-6d666d6e-9cf7f4b0.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man with stage IIB (pT1N2M0S0) non-seminomatous germ cell tumor s/p R orchiectomy ___ w/ enlarging RP mass biopsied to be embryonal carcinoma now s/p EP x4 cycles. // Surveillance 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. IMPRESSION: No acute cardiopulmonary abnormality. " 2f10dbc1-06727cdd-74295790-c908dfc4-e85a084a.jpg,validate/p11/p11924401/s56577590/2f10dbc1-06727cdd-74295790-c908dfc4-e85a084a.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient with decreased breath sounds in the upper right lung. Patient with progressive nausea and history of VATS on the left. Comparison is made with prior study, ___. Cardiomediastinal contours are normal. Elevation of the left hemidiaphragm is stable. There is evidence of loss of volume in the left upper lobe. Irregular faint opacity in the left upper lobe could be postoperative changes. Ill-defined opacities in the right upper lobe and larger in the right lower lobe are new. If the patient has symptoms of infection, this would correspond to pneumonia. The left hilum is shifted towards the apex, unchanged from prior. There is no pneumothorax or pleura effusion. " 4cdb92d3-70661691-fe01a0e8-390b6f12-93cbfbf6.jpg,validate/p14/p14053297/s54831501/4cdb92d3-70661691-fe01a0e8-390b6f12-93cbfbf6.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with chest pain radiating to the right shoulder. Question infectious process. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 4356174d-e735362d-a4d895c4-5766bc5e-c99804fc.jpg,validate/p10/p10439001/s52247867/4356174d-e735362d-a4d895c4-5766bc5e-c99804fc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Dyspnea and chest pain for 24 hours. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours appear within normal limits. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 49b58abc-c42535a7-83341735-74ae0ffc-a676e966.jpg,validate/p19/p19454512/s54953697/49b58abc-c42535a7-83341735-74ae0ffc-a676e966.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with body aches // Eval for pneumonia COMPARISON: ___ and ___. FINDINGS: AP upright and lateral views of the chest provided. Chronic elevation of the right hemidiaphragm is again noted. Clips project over the right upper quadrant. There is a stable appearance of the chest with scattered reticular and ground-glass opacities which appear grossly unchanged from a prior CT from ___ suggesting a chronic inflammatory process. No large effusion or pneumothorax. An IVC filter projects over the upper abdomen. No pneumothorax. Bony structures demineralized and intact. IMPRESSION: Stable appearance of the chest as compared with a prior CT from ___ with scattered ground-glass and reticular opacities likely reflecting a chronic inflammatory process. " 3b83c36a-55550d8c-2be4d39a-28a6a124-bbdc33ed.jpg,validate/p11/p11849511/s53138360/3b83c36a-55550d8c-2be4d39a-28a6a124-bbdc33ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ F sp fall two weeks ago on L side, neg w/u, returns to OSH ___ with dyspnea, tachycardia, CT placed w return 1.3 L sero-sang-white fluid CT pulled back // confirm CT positioning TECHNIQUE: Chest PA and lateral COMPARISON: Multiple chest radiographs the most recent on ___. Chest CT on ___. FINDINGS: A chest tube is seen on the lateral view terminating just above the level of the left hemidiaphragm but it is not seen on the frontal view. Of note, view of the chest drain side ports were extra thoracic on the recent chest CT. Heart size is normal. The mediastinal contour is widened consistent with adenopathy charactereized on recent chest CT. The pulmonary vasculature is normal. Again seen is the substantial loculated left pleural effusion and collapse of the left lower lobe. There is minimal atelectasis at the right base and possibly a small right pleural effusion. There is no pneumothorax. Chest wall gas and fluid is not detected on this chest radiograph. IMPRESSION: 1. Moderate left pleural effusion and left lower lobe collapse. 2. Mild right basal atelectasis and a small right pleural effusion. " 0142789e-8e28aa3e-9aa33400-c1ee1334-69662e1f.jpg,validate/p10/p10464640/s54018353/0142789e-8e28aa3e-9aa33400-c1ee1334-69662e1f.jpg,validation," 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. " bf7b3230-247773c8-4da07a23-cb6bf354-2e81dc26.jpg,validate/p17/p17556194/s51836607/bf7b3230-247773c8-4da07a23-cb6bf354-2e81dc26.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fevers // eval for PNA IMPRESSION: Allowing for differences in technique and projection, there has not been a relevant change in the appearance the chest since recent study of ___. Specifically, there are no new areas of consolidation to suggest development of a pneumonia. " 42900eae-524b3c92-3245324a-b617c2a1-f8710a34.jpg,validate/p12/p12932052/s50021303/42900eae-524b3c92-3245324a-b617c2a1-f8710a34.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old man with shortness of breath, productive cough x1 month, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is a vague linear opacity in the left lower lung which is most compatible with atelectasis though the possibility of a very focal pneumonia is impossible to exclude. The cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. Bony structure is intact. IMPRESSION: Focus of linear opacity in the left lower lung is most compatible with atelectasis. " 3bf63132-22760ed0-9260b09c-f31c6634-c430cd87.jpg,validate/p11/p11172413/s51786683/3bf63132-22760ed0-9260b09c-f31c6634-c430cd87.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with shortness of breath increase o2 requirment setting of CHF // eval for pna vs chf COMPARISON: ___ FINDINGS: AP portable upright view of the chest. AICD is unchanged in position with lead extending to the region the right ventricle. The cardiomediastinal silhouette is unchanged with prominent heart size. There is hilar congestion and mild pulmonary edema. No large pleural effusion is seen. There is no pneumothorax. No convincing signs of pneumonia. Bony structures are intact. IMPRESSION: Cardiomegaly with mild pulmonary edema. " a8ecb7fb-d9f57c77-b5af7b4b-09ba66a9-54746051.jpg,validate/p18/p18175023/s59174552/a8ecb7fb-d9f57c77-b5af7b4b-09ba66a9-54746051.jpg,validation," 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 ___. " 6e276103-b722f8a8-0e61595c-17403ffe-c6b2f2ba.jpg,validate/p15/p15938425/s56161472/6e276103-b722f8a8-0e61595c-17403ffe-c6b2f2ba.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p fall on left side // ?rib fracture TECHNIQUE: AP portable chest radiograph COMPARISON: ___ FINDINGS: The patient is status post median sternotomy. There is new pulmonary edema. The size of the cardiac silhouette is enlarged but unchanged. No pleural effusion or pneumothorax identified. No acute displaced rib fracture identified. IMPRESSION: No acute displaced rib fracture identified. If there is persisting clinical concern, dedicated rib views could be obtained. New pulmonary edema. " 0d15e930-186200ef-d5db5a00-17d0e6b5-35cd3fb0.jpg,validate/p19/p19900111/s55350458/0d15e930-186200ef-d5db5a00-17d0e6b5-35cd3fb0.jpg,validation," 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 ___. " 4fa58b48-2ee033a9-2014023e-61cf020b-06e6409c.jpg,validate/p15/p15200162/s59777298/4fa58b48-2ee033a9-2014023e-61cf020b-06e6409c.jpg,validation," FINAL REPORT INDICATION: Chest pain and chills. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The lung volumes are normal and the lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is normal size. The mediastinal and hilar structures are unremarkable. Clips are seen in the right axilla. Sternotomy wires are noted. IMPRESSION: No acute cardiopulmonary process. " fcf87c3b-235f5497-f47f6500-bc18c9f2-661cd61b.jpg,validate/p18/p18111516/s53276326/fcf87c3b-235f5497-f47f6500-bc18c9f2-661cd61b.jpg,validation," 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. " bd439128-619c6840-45ebf010-6b49e5c5-44f73df7.jpg,validate/p17/p17662897/s55976233/bd439128-619c6840-45ebf010-6b49e5c5-44f73df7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with L sided CP s/p MVC *** WARNING *** Multiple patients with same last name! // eval for ptx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Mild right base atelectasis is seen. There is no definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. There is mild anterior wedging of a lower thoracic vertebral body of indeterminate age. No priors for comparison. IMPRESSION: Mild anterior wedging of a lower thoracic vertebral body of indeterminate age; no prior is available for comparison. Correlate clinically, including with point tenderness, to assess need for additional imaging. Mild right base atelectasis without definite focal consolidation. " 0e92f97d-f8146c6a-33b3b8fe-114ae717-8792ef04.jpg,validate/p10/p10799304/s57541964/0e92f97d-f8146c6a-33b3b8fe-114ae717-8792ef04.jpg,validation," FINAL REPORT INDICATION: ___-year-old male status post right-sided chest tube placement who presents for evaluation of interval changes. COMPARISONS: Chest radiograph from ___; ___ and ___. TECHNIQUE: Single AP portable examination of the chest. FINDINGS: There has been interval placement of a right-sided chest tube with interval improvement of the large right-sided pleural effusion. There is no pneumothorax. There again appears to be a moderate right-sided pleural effusion which appears to layer along the right lung. The left lung is unchanged. The heart size is unchanged. IMPRESSION: Interval placement of a right-sided chest tube with interval improvement of the large right-sided pleural effusion. No pneumothorax. " bb134f2f-34c5be70-400ff6a0-6f04be1a-73e07434.jpg,validate/p18/p18655830/s56297438/bb134f2f-34c5be70-400ff6a0-6f04be1a-73e07434.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain. TECHNIQUE: Chest PA and lateral. COMPARISON: Chest radiograph ___. FINDINGS: An accessed Port-A-Cath ends in the upper superior vena cava. The lungs are clear without focal consolidation, pulmonary edema, pleural effusion or pneumothorax. There are mediastinal clips and sternotomy wires. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. Compression deformity of a lower thoracic vertebral body was better seen on previous exam. IMPRESSION: No acute cardiopulmonary process. " 895efe31-b27d9ede-f3db5dac-a6cb5b0b-02bc64b7.jpg,validate/p17/p17565931/s50630280/895efe31-b27d9ede-f3db5dac-a6cb5b0b-02bc64b7.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Prior stroke and left-sided hemiplegia antiplatelet on warfarin presenting with dizziness and weakness with poor p.o. intake. TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lordotic positioning. Moderate cardiomegaly with unfolding of the thoracic aortic arch. Allowing for technical differences, the cardiomediastinal silhouette is in keeping with findings on the radiograph from ___. Upper zone redistribution, without overt CHF. Possible atelectasis at the left base. No definite consolidation. Lung volumes appear low on the frontal view due to patient positioning. No pleural effusion or pneumothorax. IMPRESSION: Cardiomegaly and upper zone redistribution, probably unchanged compared with ___. No definite consolidation. Possible atelectasis at the left base posteriorly. " 280a1744-956b9952-69a81e3d-8c635bc6-5780534d.jpg,validate/p15/p15341255/s57755624/280a1744-956b9952-69a81e3d-8c635bc6-5780534d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with legionella PNA, intubated // PNA COMPARISON: Chest x-ray from ___ at 05:42 FINDINGS: Compared with the prior film, the appearance is quite similar. Monitoring and support devices are similar to prior. However, the lower portion of the NG tube is difficult to trace on the current film due to underpenetration. Prominence of the cardiomediastinal silhouette, with sternotomy wires noted, is similar. Opacity in the right mid and lower zones hand the retrocardiac region as well as blunting of both costophrenic angles suggestive bilateral effusions is similar to prior. The right upper zone suggests some vascular plethora, though this is less pronounced in the left lung. IMPRESSION: Minimal interval change compared 1 day earlier. Lower portion of the NG tube is poorly visualized on the current film due to underpenetration. " 70fb8bae-b29e84aa-3bac7fef-583922e5-b598e760.jpg,validate/p17/p17209733/s52888465/70fb8bae-b29e84aa-3bac7fef-583922e5-b598e760.jpg,validation," FINAL REPORT INDICATION: History: ___M with hypotension, cough, L lung crack.es // evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest ___ FINDINGS: Lungs are hyperinflated. Mild bibasilar opacities likely reflect atelectasis. There is no pneumothorax or pleural effusion. Mildly enlarged cardiac silhouette is similar to prior CT from ___. Multiple old healed fractures are identified in the left ribs. IMPRESSION: No radiographic evidence of pneumonia. " b6b144da-b44854f0-203ae4b9-8b245d83-9fe666e7.jpg,validate/p12/p12797041/s55424440/b6b144da-b44854f0-203ae4b9-8b245d83-9fe666e7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough and feels weak all over TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and ___ CT chest FINDINGS: Right-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Heart size is normal. Again demonstrated is a consolidative opacity within the right perihilar and suprahilar region, unchanged from chest radiograph from ___ but new compared to the CT chest from ___. Remainder of the mediastinal and hilar contours are unchanged. Spiculated opacity within the right lung base appears new compared to the previous exam from ___, and likely present on the prior CT but increased in size. Other previously demonstrated nodules throughout the lungs appear grossly unchanged, the largest within the right lower lobe along the minor fissure. No pleural effusion or pneumothorax is present. Clips are seen in the right upper quadrant compatible prior cholecystectomy. Known osseous metastatic lesions are better assessed on the recent CT. IMPRESSION: 1. Consolidative opacity within the right perihilar region, not substantially changed in the interval. Findings again likely relate to prior radiation changes if there has been such a history. 2. Diffuse pulmonary nodules compatible with metastases including interval increase in size of at least 1 lesion in the right lower lobe. 3. Known osseous metastases are better assessed on the previous CT. " c60aea95-5bc00fec-578efaa9-9c21dd90-8add90f9.jpg,validate/p17/p17909804/s58126057/c60aea95-5bc00fec-578efaa9-9c21dd90-8add90f9.jpg,validation," FINAL REPORT INDICATION: Persisting weakness and malaise with a deep cough despite antibiotic therapy persisting for two weeks. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary vascular congestion, or pneumothorax. The heart size is normal. The cardiac, hilar and mediastinal contours are within normal limits. IMPRESSION: No acute cardiopulmonary abnormality. Findings were relayed to ___, at the office of Dr. ___ by phone at 1:22 p.m. on ___. " de3578b4-0bbaa091-665f5f09-6d4da2ad-bbce7d55.jpg,validate/p18/p18705722/s55562875/de3578b4-0bbaa091-665f5f09-6d4da2ad-bbce7d55.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Chest tightness, shortness of breath. COMPARISONS: None. TECHNIQUE: Chest, portable AP upright. FINDINGS: The patient is status post sternotomy. The heart is mild to moderately enlarged. There is upper zone redistribution of the pulmonary vascularity, which appears also prominent and indistinct suggesting mild pulmonary vascular congestion. Otherwise, the lungs appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: Findings suggesting mild pulmonary vascular congestion. " 1d34c1d5-6e9f0cb1-45adab3b-cff369b5-91d9d927.jpg,validate/p12/p12708817/s59606081/1d34c1d5-6e9f0cb1-45adab3b-cff369b5-91d9d927.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with stroke // To confirm NG tube placement (2 step) To confirm NG tube placement (2 step) COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: 2 radiographs show successive repositioning of the feeding tube from the lower esophagus to the upper stomach. Chest is not included on the study " aa14165e-e1079b24-b9cba964-3c6e56ef-083162e5.jpg,validate/p17/p17517983/s51748434/aa14165e-e1079b24-b9cba964-3c6e56ef-083162e5.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. Additional history of end-stage renal disease per patient's prior radiology report. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. When compared to prior, there appears to be slight interval progression of the pulmonary edema with more confluent opacities at the bases. Prominent extrapleural density seen on the right laterally suspicious for a small effusion. There is no definite left pleural effusion. Degree of cardiomegaly is unchanged. IMPRESSION: Interval progression of the bilateral opacities most compatible with pulmonary edema. Please note that superimposed infection cannot be excluded. " 37bd0ccf-d98fdc63-a20a230a-59d2f2b0-7999daa6.jpg,validate/p14/p14462563/s58037074/37bd0ccf-d98fdc63-a20a230a-59d2f2b0-7999daa6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with R sided weakness, difficulty ambulating // ? acute intracranial process? acute cardiopulm 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 silhouette is top-normal in size. The aorta appears somewhat on unfolded. There is eventration of the left hemidiaphragm, which is mildly elevated. . IMPRESSION: Eventration of the right hemidiaphragm, which is mildly elevated. No focal consolidation. " b210a38d-04ed6c39-2c76c078-0089fe8b-55bc76f6.jpg,validate/p16/p16476559/s52366684/b210a38d-04ed6c39-2c76c078-0089fe8b-55bc76f6.jpg,validation," FINAL REPORT INDICATION: ___ year old man with PICC // PICC placement IMPRESSION: As compared to ___ radiograph, a right PICC is demonstrated, with tip terminating in the proximal superior vena cava. There is some apparent redundancy in the catheter in the right upper extremity and axillary region. Exam is otherwise remarkable for decrease in size of right pleural effusion compared to ___ with no other relevant changes. " e168c1ab-6d32cd95-b8bc6faf-e82eccef-abf929db.jpg,validate/p14/p14556158/s58573616/e168c1ab-6d32cd95-b8bc6faf-e82eccef-abf929db.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain // r/o PNA, TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Lungs are clear. The cardiomediastinal silhouette is normal. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " e7eb567c-09ee545e-a7db1a61-eb27d753-b3ddcdcf.jpg,validate/p14/p14238836/s54841674/e7eb567c-09ee545e-a7db1a61-eb27d753-b3ddcdcf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with dyspnea. // Please evaluate for thoracic pathology. Please evaluate for thoracic pathology. IMPRESSION: Comparison to ___. The lateral chest radiograph shows no abnormalities. And asymmetry on the frontal radiograph, with a slightly denser left lung bases, as likely caused by soft tissues. Mild elongation of the descending aorta. Borderline size of the cardiac silhouette. No pneumonia, no pulmonary edema, no pleural effusions. " 4a251cb6-331a944e-cf473033-96b57947-8f0ef1a8.jpg,validate/p11/p11535886/s57931214/4a251cb6-331a944e-cf473033-96b57947-8f0ef1a8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with atrial fibrillation with bradycardia TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is mildly enlarged. The aorta is diffusely calcified. Mild interstitial pulmonary edema is re- demonstrated. Mild atelectasis is also noted at the lung bases. No focal consolidation, pleural effusion or pneumothorax is identified. Moderate multilevel degenerative changes are seen in the thoracic spine. Multiple clips are re- demonstrated in the upper abdomen. Bony structure inferior to the coracoid process on the right is again noted. The right humeral head remains high riding suggestive of underlying rotator cuff disease. IMPRESSION: Mild interstitial pulmonary edema and mild cardiomegaly, unchanged. " 57d30bb3-6adcc6b4-571c3e43-b3acd3e5-ad8703ce.jpg,validate/p14/p14620355/s58385308/57d30bb3-6adcc6b4-571c3e43-b3acd3e5-ad8703ce.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. The aorta is tortuous. Mediastinal and hilar contours otherwise are unremarkable. There is no pulmonary vascular congestion. Minimal patchy retrocardiac opacity is noted. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Minimal retrocardiac patchy opacity, likely atelectasis. " 833147e1-a35ff049-cba4bc9b-186d833e-c0b93dff.jpg,validate/p16/p16035422/s57398360/833147e1-a35ff049-cba4bc9b-186d833e-c0b93dff.jpg,validation," FINAL REPORT PORTABLE CHEST ___, ___ COMPARISON: ___ radiograph. FINDINGS: Nasogastric tube coils within the stomach with distal tip directed cephalad at approximately the GE junction level. Dr. ___ has been telephoned with this result at 3:05 p.m. on ___ at the time of discovery. Heart is upper limits of normal in size, and lungs are clear. " 71589563-19ba9373-f766ac42-969e51f0-485b2713.jpg,validate/p13/p13772123/s50950664/71589563-19ba9373-f766ac42-969e51f0-485b2713.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness and SOB and weight loss x 2 weeks. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray of ___ and ___. FINDINGS: Heart size is top normal. Lungs are hyperinflated without focal consolidation, pleural effusion, or pneumothorax. Bibasilar atelectasis is mild. Intact median sternotomy wires. The aorta is calcified and tortuous. IMPRESSION: No new focal consolidation concerning for pneumonia. " 925fe0e0-37fc9831-d6c9b22d-fc00ee33-d186a13b.jpg,validate/p12/p12730395/s58828091/925fe0e0-37fc9831-d6c9b22d-fc00ee33-d186a13b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lung cancer, admitted for rapid Aflutter, now found to have increased sputum production, worsening tachypnea // ?new consolidation ?new consolidation IMPRESSION: In comparison with the study of ___, there is little interval change. Again there is a moderate pleural effusion with possibly less intrafissural component. The left lung is essentially clear with no evidence of pulmonary edema. " 986bf336-1148164c-915d9619-391a9bf3-9dd1874c.jpg,validate/p15/p15021710/s56186002/986bf336-1148164c-915d9619-391a9bf3-9dd1874c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with rcc // s/p antibiotic, ? pneumonitis vs infection, cough s/p antibiotic, ? pneumonitis vs infection, cough IMPRESSION: Comparison to ___. The central venous access line has been removed. Seen on the lateral radiograph only is a left lower lobe parenchymal opacity with peribronchial distribution, likely reflecting pneumonia. In addition, there are several new nodular structures, for example in the space between the seventh and eighth right rib. The nodules have been documented on a previous CT from ___. " 4d73bbb4-c6f043a7-3527d5f7-9b5a50d3-1f6b470e.jpg,validate/p17/p17370561/s53822522/4d73bbb4-c6f043a7-3527d5f7-9b5a50d3-1f6b470e.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: Shortness of breath and chest pain. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Chest radiograph ___ FINDINGS: Assessment is limited due to artifact from hair. Mild cardiomegaly is unchanged from prior. The lungs are well expanded and clear. The hilar contour is unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " d3cd5449-6426d270-b2ae8ee9-e632a8bd-164e4c86.jpg,validate/p17/p17269824/s51373029/d3cd5449-6426d270-b2ae8ee9-e632a8bd-164e4c86.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with hemoptysis and SOB // nodule, PNA TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs ___, ___, ___ CT chest with contrast from ___ FINDINGS: Prior right-sided lobectomy is responsible for pleural scarring at the base of the right hemithorax and elevation of right hemidiaphragm. Left lung and pleural space are normal. Normal cardiomediastinal and hilar silhouettes. No evidence of intrathoracic infection, recurrent or new malignancy. IMPRESSION: No evidence of intrathoracic infection, recurrent or new malignancy. " ae4f09dd-f871aed3-8165305a-661a70af-14375e0d.jpg,validate/p19/p19358609/s59343870/ae4f09dd-f871aed3-8165305a-661a70af-14375e0d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with history of LUL lobectomy. intubated with PNA // ETT position, interval change ETT position, interval change IMPRESSION: In comparison with the study ___ ___, there is little change in the appearance of the heart and lungs and the monitoring and support devices " 03bc4ed9-8093727f-954a3953-74fc85ee-98468581.jpg,validate/p15/p15346117/s59439234/03bc4ed9-8093727f-954a3953-74fc85ee-98468581.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, pleural effusion on prior cxr. Please evaluate for effusion seen on prior CXR. TECHNIQUE: PA and lateral radiographs of the chest from ___. COMPARISON: ___ for FINDINGS: A right PICC line now ends in the low SVC. There is no pneumothorax. The lungs are clear. Previous pulmonary edema has resolved. The heart and mediastinum are within normal limits. IMPRESSION: Resolved pulmonary edema. Clear lungs. Right PICC line ends in low SVC. " 2cc8f7f9-6aa05788-674ed5ea-32ac5cbb-eab9c2c4.jpg,validate/p10/p10374990/s53976242/2cc8f7f9-6aa05788-674ed5ea-32ac5cbb-eab9c2c4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chylothorax, s/p chest tube placement // eval for interval change IMPRESSION: In comparison to ___ radiograph, a right pleural catheter has apparently changed in position. Small right apical pneumothorax is newly appreciated, and a small dependent right pleural effusion has slightly increased in size. No other relevant change. " 34a0db27-f23649c7-5ac0e9a3-e33bd63b-dc08e374.jpg,validate/p13/p13745545/s51276270/34a0db27-f23649c7-5ac0e9a3-e33bd63b-dc08e374.jpg,validation," 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. " 8de420f0-d3616da0-51481881-8befb72a-2db4eaa7.jpg,validate/p14/p14394983/s52501959/8de420f0-d3616da0-51481881-8befb72a-2db4eaa7.jpg,validation," FINAL REPORT HISTORY: Chest pain COMPARISON: ___ FINDINGS: PA AND LATERAL VIEWS OF CHEST: The lungs, mediastinum, pleural surfaces, and hila are all normal. No bony injury is appreciated on this nondedicated view. IMPRESSION: Normal chest x-ray. " dc70a4e5-e5faed99-4f041797-e0ea26fc-8e2bcd5f.jpg,validate/p15/p15282197/s52524775/dc70a4e5-e5faed99-4f041797-e0ea26fc-8e2bcd5f.jpg,validation," 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. " 3b45981c-22a218c1-895088c8-70cb300c-bb013a16.jpg,validate/p13/p13473495/s53400246/3b45981c-22a218c1-895088c8-70cb300c-bb013a16.jpg,validation," WET READ: ___ ___ 10:38 AM 1. Interval increase in retrocardiac opacity, which may represent atelectasis but cannot exclude aspiration or pneumonia in the right clinical setting. 2. Increase in pulmonary vascular engorgement, without frank edema. --___ WET READ VERSION #___ ___ ___ ___ 12:05 AM 1. Interval increase in retrocardiac opacity, which may represent atelectasis but cannot exclude aspiration or pneumonia in the right clinical setting. 2. Increase in pulmonary vascular engorgement, without frank edema. -___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cough and AMS // pneumonia? TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed the same day earlier in the morning IMPRESSION: Mild to moderate vascular congestion has increased. Bibasilar atelectasis have increased. If any there is a small right effusion. No other interval change from prior study. " bfab2672-a24df0b6-c212efa4-c56b045e-3d632a6f.jpg,validate/p19/p19966568/s53145635/bfab2672-a24df0b6-c212efa4-c56b045e-3d632a6f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with CP // r/o acute porocess TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac silhouette is vascular congestion. No focal consolidation is identified. There is no pleural effusion or pneumothorax. IMPRESSION: Mild vascular congestion. " 9788ccfd-562ea8d3-e7cdffd2-021cf9da-b48a0b32.jpg,validate/p12/p12043836/s56209273/9788ccfd-562ea8d3-e7cdffd2-021cf9da-b48a0b32.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right pigtail catheter placement // tube placement tube placement IMPRESSION: Insertion of an additional right-sided pigtail catheter in the pleural space. Slight decrease of the fluid accumulation on the right. No visible right pneumothorax. The previous to right chest tubes are in unchanged position. Moderate cardiomegaly. The monitoring and support devices are constant. " a1c300a4-d2cc2cc2-e07cb8d0-1931484c-39235a4d.jpg,validate/p18/p18364681/s50264063/a1c300a4-d2cc2cc2-e07cb8d0-1931484c-39235a4d.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with pleural effusion from unknown source. Scheduled for ___ when she has to return for echocardiography. Any 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 of ___ which apparently has been obtained with patient in semi-upright position. It is different and even when paying attention to AP versus PA frontal projection, the overall heart size has been reduced, apparently related to successful pericardiocentesis during the interval. Bilateral pleural effusions persist and are probably equal in size. They are now clearly blunting the lateral and posterior pleural sinuses as the patient is in upright position on the present examination. The accessible pulmonary vasculature does not show any congestive pattern, nor is there any upper zone redistribution when patient is in upright position. No pneumothorax can be identified. The heart shadow configuration is not revealing. An absence of significant left atrial enlargement is, however, noted on the lateral view and confirms the absence of any significant pulmonary vascular congestion. IMPRESSION: Findings consistent with polyserositis with pericardial and bilateral pleural effusions. The patient underwent a PA and lateral chest x-ray on ___ with images taken in upright position. Comparison with this study is identifying a now smaller heart shadow and the amount of pleural effusions has clearly increased. Further followup recommended. " cc5b1ae5-f0205a9f-e8523bec-b75f763e-8eda590b.jpg,validate/p16/p16217465/s54912103/cc5b1ae5-f0205a9f-e8523bec-b75f763e-8eda590b.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiograph INDICATION: ___ year old woman, smoker, ?COPD, with inspiratory squeak/rhonchi at right base // eval for infiltrate COMPARISON: Chest radiographs dated ___ and ___. FINDINGS: No significant interval change. The lungs are hyperinflated, with flattening of the hemidiaphragms and widening of the AP diameter, compatible provided history of chronic pulmonary disease. The lungs are clear. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The heart size is normal. Mediastinal and hilar contours are unchanged. IMPRESSION: 1. No pneumonia. 2. Hyperinflated lungs. " 5841fb36-a7b400ea-6898c3a5-e6555fd4-c4ded914.jpg,validate/p16/p16047857/s53054551/5841fb36-a7b400ea-6898c3a5-e6555fd4-c4ded914.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with altered mental status. Question acute process. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. Atherosclerotic calcifications are seen in the aortic arch. Previously seen left basilar opacity and effusion have resolved. There is no confluent consolidation to suggest pneumonia. There is no pneumothorax, vascular congestion, or pleural effusion. A subcentimeter radiodensity overlying the right third interspace is unchanged since at least ___, likely representing a calcified granuloma. There is diffuse osseous demineralization. IMPRESSION: 1. No evidence of acute cardiopulmonary process such as pneumonia. 2. Interval improvement of aeration of the left base as compared to ___. " 36987d30-7d71324a-02792290-772e3860-e54472a3.jpg,validate/p13/p13283651/s50962791/36987d30-7d71324a-02792290-772e3860-e54472a3.jpg,validation," FINAL REPORT INDICATION: Hip fracture. Preoperative study. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. Degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 1cd3b2ee-11456760-2abdbcd8-25334ed0-ac8eebb6.jpg,validate/p16/p16805727/s51846543/1cd3b2ee-11456760-2abdbcd8-25334ed0-ac8eebb6.jpg,validation," FINAL REPORT HISTORY: Cardiac history, on chronic amiodarone, to assess for fibrosis. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Single-channel pacemaker lead extends to the region of the apex of the right ventricle. Cardiac silhouette is at the upper limits of normal in size. No vascular congestion, pleural effusion, or acute pneumonia. Specifically, no evidence of interstitial changes suggestive of amiodarone toxicity. " 740a3ef2-b8ca5779-2a724928-bc8c4353-efd6600f.jpg,validate/p19/p19635953/s58010510/740a3ef2-b8ca5779-2a724928-bc8c4353-efd6600f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Repositioned PICC line. Portable AP radiograph of the chest was compared to prior study obtained the same day earlier. Currently, the position of the left PICC line is appropriate with its tip terminating at the level of mid SVC. No substantial change in the widespread parenchymal abnormality is demonstrated. " d58e54cb-2e600233-28d9ec4b-a996cad5-9e53df95.jpg,validate/p17/p17595027/s51265843/d58e54cb-2e600233-28d9ec4b-a996cad5-9e53df95.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Seizure disorder, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have slightly increased, potentially resulting from increased ventilatory pressure. There is unchanged evidence of bilateral basal opacities, with the morphology that rather suggest of atelectasis than pneumonia. However, both opacities show visible air bronchograms. The opacity on the right has minimally increased in extent. The opacity on the left is constant. Unchanged appearance of the cardiac silhouette. No pleural effusions. " b0fc3c88-772bc99b-87d98a66-29286aad-dfa69fa3.jpg,validate/p16/p16826047/s50448867/b0fc3c88-772bc99b-87d98a66-29286aad-dfa69fa3.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with pleural effusion, evaluate. TECHNIQUE: PA and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: Previous multiple loculated right pleural effusions have not changed, and the intrafissural right pleural drainage catheter is stable in position. The cardiac silhouette continues to be mildly enlarged without pulmonary edema. Tiny linear and nodular opacities have appeared in the left upper lobe since ___. IMPRESSION: Multiloculated right pleural effusion unchanged since ___. New linear and nodular opacities in the left upper lobe may represent carcinomatosis. Findings were relayed to Dr. ___ by Dr. ___ ___ following review on ___ at approximiately 11:00 via telephone. " 37a5340b-544a8058-0e8927e0-bda6ec40-087b8d72.jpg,validate/p10/p10803096/s50560926/37a5340b-544a8058-0e8927e0-bda6ec40-087b8d72.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chest pain and shortness of breath. 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. " 064e36eb-2b3afe3e-13102f71-a9c63890-59db7d49.jpg,validate/p10/p10747985/s58529779/064e36eb-2b3afe3e-13102f71-a9c63890-59db7d49.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fatigue, SOB, left sided base rales // please evaluate for pneumonia and CHF please evaluate for pneumonia and CHF COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Severe cardiomegaly, mediastinal and pulmonary venous engorgement, and mild bilateral pleural scarring are chronic. There is no pulmonary edema or pleural effusion. Lateral view shows substantial hyperinflation, chronic due to emphysema or small airway obstruction. " 1b2cb15a-58d36b96-2414ccc5-22b502f5-aaf83123.jpg,validate/p14/p14900452/s57674636/1b2cb15a-58d36b96-2414ccc5-22b502f5-aaf83123.jpg,validation," 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. " 3a115e99-76e4b12e-ab927143-e4b9f628-0d555f08.jpg,validate/p13/p13049990/s50777954/3a115e99-76e4b12e-ab927143-e4b9f628-0d555f08.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain radiating to the left shoulder with associated shortness of breath. FINDINGS: PA and lateral views of the chest provided demonstrate clear, well-expanded lungs without focal consolidation, effusion, or pneumothorax. No signs of pulmonary edema or CHF. Cardiomediastinal silhouette is normal. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " e275a88a-fe04de45-143dff0e-6ed5b915-049bfd55.jpg,validate/p11/p11129702/s51608307/e275a88a-fe04de45-143dff0e-6ed5b915-049bfd55.jpg,validation," 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. " 411a954d-91d0ba01-98b6bd83-f11b45d9-7a31c259.jpg,validate/p10/p10024982/s53158855/411a954d-91d0ba01-98b6bd83-f11b45d9-7a31c259.jpg,validation," 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. " 32fe481b-11ca6a8e-3e80c436-cc4936c7-90c3dcfc.jpg,validate/p10/p10784899/s58360753/32fe481b-11ca6a8e-3e80c436-cc4936c7-90c3dcfc.jpg,validation," FINAL REPORT INDICATION: Syncopal episode, here to evaluate for pneumonia or other acute cardiopulmonary process. COMPARISON: Multiple prior chest recently, most recently dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: No new airspace opacity, pleural effusion or pneumothorax is detected. There is no overt pulmonary edema. The pulmonary vasculature is within normal limits and unchanged. The cardiac silhouette is enlarged, but stable. Diffuse atherosclerotic calcification of the ascending aorta is redemonstrated with mild tortuosity of the thoracic aorta as before. The hilar contours are unchanged. Multilevel degenerative changes of the thoracic spine are noted. No acute, displaced rib fractures are detected. IMPRESSION: No acute cardiopulmonary process. " 88935a20-59b3aa0d-51e2f38e-1d452907-4f2e6589.jpg,validate/p13/p13826980/s51838560/88935a20-59b3aa0d-51e2f38e-1d452907-4f2e6589.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with ___ onset of seizure, altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures demonstrate no acute abnormality. Right IJ central line is no longer visualized. IMPRESSION: No acute cardiopulmonary process. " 72c68e7e-c68765f9-5cc1014d-ffe34a48-d547c451.jpg,validate/p18/p18329975/s52092283/72c68e7e-c68765f9-5cc1014d-ffe34a48-d547c451.jpg,validation," 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. " 26882e07-102997ea-e94d441a-f5eb6af2-a2e1118e.jpg,validate/p15/p15191759/s53272668/26882e07-102997ea-e94d441a-f5eb6af2-a2e1118e.jpg,validation," 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 ___. " a1d9e3e3-a8836a57-27a753f1-7720af33-92ac2e54.jpg,validate/p11/p11551927/s53929810/a1d9e3e3-a8836a57-27a753f1-7720af33-92ac2e54.jpg,validation," FINAL REPORT INDICATION: ___ year old man with acute pancreatitis // Dobhoff placement ?jejunum TECHNIQUE: AP views of the chest and upper abdomen. COMPARISON: Chest radiographs ___ through ___ FINDINGS: ET tube and right internal jugular central venous catheter remain in constant position. Multifocal bilateral airspace opacities are not significantly changed from the study 4 hr prior. The Dobbhoff tube courses below the left hemidiaphragm crossing midline terminating in the distal second portion of the duodenum. IMPRESSION: Dobbhoff tube terminates in the distal second portion of the duodenum. " 9f26307b-c7b5a379-991d4c2f-d9e3b2af-47f463d9.jpg,validate/p18/p18699523/s58237859/9f26307b-c7b5a379-991d4c2f-d9e3b2af-47f463d9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with pain at PICC line TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right PICC tip terminates in the low SVC, with tip appearing somewhat withdrawn by approximately 4.5 cm since the previous chest radiograph. Lung volumes remain low. The cardiac, mediastinal and hilar contours are unchanged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormality is detected. Cholecystectomy clips are again noted in the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " a555ef04-b2e2b1fb-3bbf15d0-0249ad6e-25e5d381.jpg,validate/p16/p16576075/s56845780/a555ef04-b2e2b1fb-3bbf15d0-0249ad6e-25e5d381.jpg,validation," FINAL REPORT INDICATION: Status post total abdominal colectomy, evaluate for progression of pneumonia. COMPARISON: ___. FINDINGS: The ET tube, NG tube, and left internal jugular catheter are in unchanged satisfactory position. Compared with prior radiograph, lung volumes have improved; however, the retrocardiac consolidation has increased. The right lung base is better expanded with no change in the right pleural effusion. No pneumothorax. " 09d85ece-00ff2798-9fc62777-2cdd2dde-98664239.jpg,validate/p14/p14377197/s59530016/09d85ece-00ff2798-9fc62777-2cdd2dde-98664239.jpg,validation," FINAL REPORT HISTORY: Intermittent chest pain with cocaine use TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: The heart size is normal. The cardiomediastinal silhouette and hilar contour is unremarkable. The lungs are clear without consolidation, effusion or pneumothorax. No acute bony abnormality is identified. IMPRESSION: No acute intrathoracic process. " 0b6b68f3-712c1918-bfbe27f0-2b8c6a0a-0d2a583c.jpg,validate/p14/p14821385/s55696190/0b6b68f3-712c1918-bfbe27f0-2b8c6a0a-0d2a583c.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: 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 lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " bcd01a2e-c1dd2f58-705389de-4b31259f-5ba84233.jpg,validate/p17/p17864200/s50132773/bcd01a2e-c1dd2f58-705389de-4b31259f-5ba84233.jpg,validation," 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. " 2a690521-9f90bf90-d5935bce-fd398221-5472b510.jpg,validate/p18/p18880979/s52796610/2a690521-9f90bf90-d5935bce-fd398221-5472b510.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with confusion x24 hr // eval for pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lungs are hyperinflated and clear. No focal consolidation, large effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Imaged bony structures are intact. Chronic left rib deformities are unchanged. No free air below the right hemidiaphragm is seen. IMPRESSION: Hyperinflated lungs, no signs of pneumonia. " 8f304464-59c287be-dd23e947-17c252b3-ce8b72e4.jpg,validate/p13/p13941266/s56397556/8f304464-59c287be-dd23e947-17c252b3-ce8b72e4.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with blood and vomit and left upper quadrant pain. Question free air. COMPARISON: No relevant comparisons available. ONE VIEW OF THE CHEST: The lungs are well expanded and show a nodule in the right lower lobe. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. An NG tube passes with its tip out of view below the diaphragm. No evidence of intraperitoneal free air is noted. IMPRESSION: No acute intrathoracic process. No evidence of intraperitoneal free air. A repeat PA and lateral radiograph with shallow obliques and nipple markers is recommended to rule out a nodule in the right lower lobe. These findings were communicated to ___ via telephone on 5:37 pm on ___. " b58f162d-d66dfe16-b214bee6-ab4eb84e-f272b574.jpg,validate/p10/p10979480/s56501439/b58f162d-d66dfe16-b214bee6-ab4eb84e-f272b574.jpg,validation," FINAL REPORT INDICATION: Fever, altered mental status, evaluate for pneumonia. COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___. FINDINGS: Portable chest radiograph demonstrates new consolidaiton in the left lowre lung, likely pneumonia. Right lower lung opacification may be atelectasis exaggerated by low lung volumes, alternatively representing a multifocal bilateral pneumonia is a consideration. Cardiac silhouette is somewhat obscured by opacification, but appears normal. Mediastinal and hilar contours are unremarkable. No pneumothorax evident. Blunting of the left costophrenic angle may represent a small pleural effusion. Posterior spinal fusion hardware identified. Tip of a right-sided central venous catheter is obscured but is seen as far as the cavoatrial junction. IMPRESSION:Left lower and possibly right lower lung pneumonia. Tip of right-sided central venous catheter obscured but seen as far as cavoatrial junction. " 36aa1cab-bd355444-76f2e2b4-5261ddc8-bf1ed5d3.jpg,validate/p19/p19776354/s58895466/36aa1cab-bd355444-76f2e2b4-5261ddc8-bf1ed5d3.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Dyspnea. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear unchanged. The lung volumes are low. Plate-like opacities at the lung bases are most consistent with minor atelectasis or scarring. There is no definite pleural effusion or pneumothorax, however. IMPRESSION: No evidence of acute disease. " bdb7bebe-9fcb88b1-0eadf631-70fa3e17-0752cf18.jpg,validate/p13/p13491843/s56204442/bdb7bebe-9fcb88b1-0eadf631-70fa3e17-0752cf18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with persistent cough, SOB. // r/o pneumonia r/o pneumonia IMPRESSION: Cardiomegaly is substantial, unchanged. There is interval improvement in bibasal consolidations. There are no focal consolidations. There is no pneumothorax. Mild interstitial prominence in the lung bases is present and might reflect nonspecific interstitial lung disease. No appreciable pleural effusion is seen. No pneumothorax seen. " ed4a7199-dea574fe-4e5cbc9e-8ec974c7-ab0dd43d.jpg,validate/p11/p11459120/s53962571/ed4a7199-dea574fe-4e5cbc9e-8ec974c7-ab0dd43d.jpg,validation," FINAL REPORT INDICATION: History of COPD, now with bibasilar rales. Evaluate for pulmonary edema versus pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. There is a widespread interstitial abnormality, likely secondary to mild pulmonary edema. Moderate cardiomegaly is not significantly changed. Aortic calcifications are noted. Mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Multilevel degenerative changes of the thoracolumbar spine are noted. There is a left-sided pacemaker with right atrial and right ventricular leads. There is also re-demonstration of left shoulder hardware. IMPRESSION: 1. Findings suggestive of mild interstitial pulmonary edema. 2. Moderate cardiomegaly, not significantly changed. " ca3fbc38-041d2396-c3065ccb-752740a5-53fa701c.jpg,validate/p17/p17396346/s57382119/ca3fbc38-041d2396-c3065ccb-752740a5-53fa701c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dCHF p/w SOB, hypoxic // e/o worsening pulm edema e/o worsening pulm edema IMPRESSION: No relevant change as compared to ___. Moderate cardiomegaly, mild to moderate pulmonary edema. Small bilateral pleural effusions. Subsequent areas of basilar atelectasis. No evidence of pneumonia. " f8860acd-d6e67bb3-01844a9d-b4d4ac05-aef0d239.jpg,validate/p10/p10717732/s58767140/f8860acd-d6e67bb3-01844a9d-b4d4ac05-aef0d239.jpg,validation," FINAL REPORT INDICATION: Confusion, rule out pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs for direct comparison made to study from ___ FINDINGS: There is moderate interstitial edema. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable. Osseous structures are grossly intact. IMPRESSION: Moderate interstitial edema. No focal consolidation. " aea3fdd2-d64eeb9f-58f72e06-6b7800b0-203b0754.jpg,validate/p19/p19241140/s57760229/aea3fdd2-d64eeb9f-58f72e06-6b7800b0-203b0754.jpg,validation," FINAL REPORT INDICATION: Chest pain, dyspnea. COMPARISONS: 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: Normal radiograph of the chest. " 2e18d257-42c5a406-e5ed4da8-e1510a73-39345cd6.jpg,validate/p11/p11315116/s53712180/2e18d257-42c5a406-e5ed4da8-e1510a73-39345cd6.jpg,validation," 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. " 8e13d439-56c1986d-ff477381-74291b38-e531e87f.jpg,validate/p12/p12006413/s50216535/8e13d439-56c1986d-ff477381-74291b38-e531e87f.jpg,validation," WET READ: ___ ___ ___:___ PM No definite evidence of a pneumothorax, however recommend repeat films with removal of the mask that is obscuring the left lung apex. ___ d/w Dr. ___ by Dr. ___ by phone at 9:___p on the day of the exam. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with s/p Epicardial Lead Placement // eval for ptx, effusions. patient currently in OR, will be going to PACU in approximately ___ minutes - please ___ ___ if there is any concern with findings COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: 3 new epicardial pacer leads project over the left paramedian chest extending roughly to level of the diaphragm. Without a lateral view, I cannot localize than. There is no pneumothorax mediastinal widening or pleural effusion. Heart size is comparable to the preprocedure study. No pulmonary edema. " c0a74eed-1d8f1e00-140a6f8f-fd7004c3-3d37b872.jpg,validate/p13/p13865370/s53039871/c0a74eed-1d8f1e00-140a6f8f-fd7004c3-3d37b872.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient recently intubated. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. The NG tube tip is in the stomach. Bibasal atelectasis are unchanged. The ET tube tip is approximately 4 cm above the carina. No pneumothorax is seen. " ee4c8ea7-32170766-6477c677-1467f8bc-4ac1d6d6.jpg,validate/p17/p17434263/s53950613/ee4c8ea7-32170766-6477c677-1467f8bc-4ac1d6d6.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with subclavian line placement. COMPARISON: ___ at 9:47 p.m. FINDINGS: A single portable frontal semi-upright view of the chest was obtained. Endotracheal tube terminates approximately 8 cm above the carina. Enteric tube is in the stomach. The right subclavian central venous catheter is directed into the right internal jugular vein and needs to be repositioned. Confluent airspace opacities are present in bilateral mid to lower lungs, likely representing aspiration or pneumonia, unchanged. Cardiomediastinal silhouette is stable. Small bilateral pleural effusions are present. There is no pneumothorax. IMPRESSION: 1. Malpositioned right subclavian line directed into the right internal jugular vein. 2. The endotracheal tube is high, given that the patient's head is up, consider advancing by at most 2 cm for optimal placement. 3. Unchanged dense bilateral mid-lower lung opacities, most consistent with aspiration or pneumonia. " 8cc0584c-07d0b0ca-aa6a8c6e-8ec5f238-5eb8bdcc.jpg,validate/p15/p15357192/s53327061/8cc0584c-07d0b0ca-aa6a8c6e-8ec5f238-5eb8bdcc.jpg,validation," FINAL REPORT EXAMINATION: The INDICATION: ___ year old man with R PTX // evaluate PTX IMPRESSION: Compared to ___, a right chest tube remains in place. A very small right apical pneumothorax is newly visible. Exam is otherwise unchanged. " 2b25c1d8-3c80c4cd-c6817453-6db65c2b-4ccf1ed1.jpg,validate/p10/p10304362/s50695204/2b25c1d8-3c80c4cd-c6817453-6db65c2b-4ccf1ed1.jpg,validation," 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. " 249f35a7-f7f38aa2-08ba62de-4a392579-4d20291a.jpg,validate/p12/p12645334/s52148508/249f35a7-f7f38aa2-08ba62de-4a392579-4d20291a.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. No definite focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac silhouette is top normal. The aorta is calcified and tortuous, stable. Mild right apical pleural thickening is seen. Deformity of the posterolateral right seventh rib is of old and again seen, was seen on the prior radiograph dating back to ___. There is evidence of DISH along the thoracic spine. IMPRESSION: Low lung volumes, but otherwise no acute cardiopulmonary process. " b31b3e50-c9b90534-20cb8d61-f3ecb954-8f2364db.jpg,validate/p19/p19601036/s55753073/b31b3e50-c9b90534-20cb8d61-f3ecb954-8f2364db.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p CABG with bilateral CT for chyle leak // eval pneumo FINDINGS: As compared to ___ chest radiograph, a left chest tube has apparently been repositioned, with side-port now external to the pleural space. Bilateral moderate size pneumothoraces are unchanged. Cardiomediastinal contours are stable. Bibasilar atelectasis has improved on the left and worsened on the right. Small pleural effusions are present bilaterally. " c5b24969-fc123fe4-654ab0de-008da1eb-843097cd.jpg,validate/p17/p17522005/s54043978/c5b24969-fc123fe4-654ab0de-008da1eb-843097cd.jpg,validation," 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. " 42a3ad68-ec276160-7185d9f1-95bf450e-daa8c580.jpg,validate/p16/p16926271/s53193962/42a3ad68-ec276160-7185d9f1-95bf450e-daa8c580.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Status post endotracheal intubation. TECHNIQUE: Chest, AP upright portable. COMPARISON: Earlier on the same evening. FINDINGS: The patient has been intubated. An endotracheal tube terminates approximately 4 cm above the carina. An orogastric tube has been passed and terminates perhaps shortly beyond the gastroesophageal junction. Findings associated with pulmonary edema appear not substantially changed. Small bilateral pleural effusions persist. IMPRESSION: Status post endotracheal intubation. Orogastric tube could be advanced somewhat if deeper seating in the stomach is desired clinically. Persistent findings associated with pulmonary edema and small pleural effusions. " 7142ccd3-bb55e64f-d3c972c6-aaf50cb0-5f218de0.jpg,validate/p15/p15152443/s51247587/7142ccd3-bb55e64f-d3c972c6-aaf50cb0-5f218de0.jpg,validation," FINAL REPORT INDICATION: History: ___M with fever // eval for infection TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: None. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. Extensive degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " bec1a2ab-ac802458-218aa263-0d78d3f0-4e8f11a2.jpg,validate/p12/p12464244/s58896974/bec1a2ab-ac802458-218aa263-0d78d3f0-4e8f11a2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with wheezing, eval edema // eval edema TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " c34bf96c-2ddbd462-16fa0419-31e5c69b-06b0ae88.jpg,validate/p11/p11250426/s51268134/c34bf96c-2ddbd462-16fa0419-31e5c69b-06b0ae88.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with cough, rule out infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___. FINDINGS: There is a left chest pacer device with associated dual leads projecting in unchanged configuration. There are low lung volumes, likely accentuating cardiac size. Within this limitation, the cardiac and mediastinal silhouette is unchanged from prior chest x-ray from ___. There is probably mild cardiomegaly. Calcified pleural plaques most conspicuous at the right lung base, unchanged from prior exam. There is diffuse, hazy right lung airspace opacity, all involving the right lower lobe most conspicuously. Additional airspace opacities involving the left lung base obscure the left hemidiaphragm. There is no overt pulmonary edema. There is no pneumothorax. There are small bilateral pleural effusions. IMPRESSION: 1. Right more than left lower lobe airspace opacities are new from prior exam, and while this appearance may represent asymmetric pulmonary edema, particularly in the setting of trace bilateral pleural effusions and mild cardiomegaly, this appearance could also represent multifocal infection. Correlate with signs/symptoms and lab findings suggestive of infection. 2. Calcified pleural plaques are unchanged. " 93c07a3f-b8d6f7c6-481b9d46-8a6ec666-14d910b2.jpg,validate/p14/p14618194/s52244426/93c07a3f-b8d6f7c6-481b9d46-8a6ec666-14d910b2.jpg,validation," WET READ: ___ ___ ___ 9:37 PM Low lung volumes. Subtle opacity in the right lung base could represent infection in the proper clinical setting. No pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypotension, acute anemia // Evidence of infection or hemorrhage? TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size is enlarged, unchanged. Mediastinum is stable. Lungs are essentially clear. There is no pleural effusion or pneumothorax. Minimal opacity in the right lung base most likely represent atelectasis but potentially can represent developing infection, attention to this area on the subsequent study is recommended " 12d65655-76ca4087-f82d30b5-5e5e521c-0d5fc074.jpg,validate/p17/p17894047/s59322982/12d65655-76ca4087-f82d30b5-5e5e521c-0d5fc074.jpg,validation," FINAL REPORT INDICATION: Dyspnea. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. The lungs show subtle interstitial opacities and at least one perihilar bronchus is thickened. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Findings suggestive of reactive airway disease. " fa1bfd50-5e82b49f-b311e362-287bcfe0-070ac12d.jpg,validate/p19/p19845120/s54410276/fa1bfd50-5e82b49f-b311e362-287bcfe0-070ac12d.jpg,validation," FINAL REPORT INDICATION: History of NG tube placement. Please check placement. COMPARISONS: Chest radiograph from ___. TECHNIQUE: Single AP portable radiograph of the chest. FINDINGS: Right PICC line terminates in the mid SVC. The NG tube appears to be coiled within the midline and must be removed for re-attempt at placement. There is a right-sided IJ which terminates in the upper SVC. Moderate left pleural effusion is persistent. There is small bibasilar atelectasis. Mild pulmonary edema is unchanged. Moderate cardiomegaly is stable. There is no evidence of pneumothorax. IMPRESSION: NG tube appears to be coiled within the midline and must be removed for re-attempt at placement. Findings were discussed with Dr. ___ by Dr. ___ by phone on the day of the exam immediately after discovery. " 21ff9e32-d956fe9b-24d085dc-d6dc36af-48840d73.jpg,validate/p18/p18971123/s56506393/21ff9e32-d956fe9b-24d085dc-d6dc36af-48840d73.jpg,validation," FINAL REPORT INDICATION: Eating disorder. COMPARISON: None. TECHNIQUE: Frontal and lateral chest radiographs. IMPRESSION: There is no acute intrathoracic process. The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. No foreign body is detected. " ab9f860b-a3a9a5da-9af1899a-097e017c-b0eb1892.jpg,validate/p10/p10886851/s52455968/ab9f860b-a3a9a5da-9af1899a-097e017c-b0eb1892.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever and wekaness, pls eval for pna, pls perform as upright chest, had recent colonoscoypy and want to also r/o free air in abd // History: ___M with fever and wekaness, pls eval for pna, pls perform as upright chest, had recent colonoscoypy and want to also r/o free air in abd TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: There are relatively low lung volumes and bibasilar atelectasis. Lateral view is slightly suboptimal due to slight patient motion and under penetration, possibly due to body habitus. No pleural effusion is seen. There is no evidence of pneumothorax. Subtle bibasilar opacities may be due to atelectasis although underlying infectious process is not excluded in the appropriate clinical setting. The cardiac silhouette is top-normal. No evidence of free air is seen beneath the diaphragms. IMPRESSION: Low lung volumes. Subtle bibasilar opacities may be due to vascular crowding and/or atelectasis, underlying consolidation is not excluded in the appropriate clinical setting. No evidence of free air beneath the diaphragms. " 89543eec-ad073375-83e29707-591a685e-66959b70.jpg,validate/p14/p14311378/s55474802/89543eec-ad073375-83e29707-591a685e-66959b70.jpg,validation," 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. " 021e5301-97b0554c-41797868-6dd235e9-b0cfcf2b.jpg,validate/p15/p15914421/s59257195/021e5301-97b0554c-41797868-6dd235e9-b0cfcf2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and ___ CTA chest FINDINGS: Left-sided Port-A-Cath is re- demonstrated with tip in the proximal right atrium, unchanged. Lung volumes remain low with moderate enlargement of the cardiac silhouette appearing unchanged. Mediastinal and hilar contours are unremarkable. Crowding of the bronchovascular structures is present though no overt pulmonary edema is seen. Linear opacities in the right upper lobe are compatible with post radiation changes. Patchy and linear opacities in the lung bases likely reflect a combination of chronic interstitial lung disease and atelectasis. No new focal consolidation is present. Elevation of the right hemidiaphragm is again noted, and a subpulmonic effusion may be present. There is no new pleural effusion or pneumothorax. No acute osseous abnormality is visualized. Clips are seen in the right axilla, and the patient is status post bilateral breast reconstruction. IMPRESSION: Low lung volumes with linear and patchy bibasilar opacities likely reflecting a combination of chronic interstitial lung disease and atelectasis. Post radiation changes in the right upper lobe, unchanged.Probable right subpulmonic effusion accounting for the right hemidiaphragmatic elevation. " c3976edb-3e45d8e7-5044259c-b2591614-de357986.jpg,validate/p13/p13031383/s57191166/c3976edb-3e45d8e7-5044259c-b2591614-de357986.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post liver transplant in ___, COPD, and chronic kidney disease, now presenting with dyspnea. COMPARISON: Chest radiograph from ___ and ___. PA AND LATERAL CHEST RADIOGRAPH: There is mild pulmonary vascular congestion without overt interstitial edema. There are new small bilateral pleural effusions. No confluent consolidation is identified. There is no pneumothorax. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: New mild pulmonary vascular congestion with new small bilateral pleural effusions. " 0f37e21b-e0ef32d5-6558f695-b18791eb-3bc948c0.jpg,validate/p15/p15007710/s53832381/0f37e21b-e0ef32d5-6558f695-b18791eb-3bc948c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mechanical fall with multiple rib fractures with questionable hemothorax. // status of ?hemothorax status of ?hemothorax TECHNIQUE: PA and lateral COMPARISON: Portable film and CT dated ___ FINDINGS: Right rib fractures best appreciated on CT are not well visualized on this plain film. Considering the change in the patient's position on prior (from supine to now upright), the pleural effusion (better characterized on prior CT) has not increased in size. No pneumothorax is seen. IMPRESSION: No change in right moderate sized pleural effusion (hemothorax on CT) " 200f424c-ee44b0c9-3e8e11b0-2419effc-616fee6a.jpg,validate/p14/p14011248/s57486990/200f424c-ee44b0c9-3e8e11b0-2419effc-616fee6a.jpg,validation," WET READ: ___ ___ ___ 5:10 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with 02 requirement // ? PNA TECHNIQUE: Chest AP and lateral COMPARISON: None. FINDINGS: Lung volumes are slightly low, resulting in bronchovascular crowding. Cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No pneumonia. " 031082d4-8729bd9f-07d425ed-1584d7d7-a21ce82b.jpg,validate/p11/p11130614/s54357924/031082d4-8729bd9f-07d425ed-1584d7d7-a21ce82b.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: None. FINDINGS: PA and lateral chest radiographs. The right heart border is partially obscured on the frontal view, which may be due to atelectasis. However, there is no correlating abnormality on the lateral view. There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. Surgical clips are noted around the expected location of the gastroesophageal junction. " c896d341-edf03858-91d98522-935d0a32-7153962f.jpg,validate/p13/p13756625/s57974285/c896d341-edf03858-91d98522-935d0a32-7153962f.jpg,validation," 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. " a1fc6e71-05923ec5-53afc0b9-5ed4073a-77dbb1cd.jpg,validate/p12/p12759187/s58610898/a1fc6e71-05923ec5-53afc0b9-5ed4073a-77dbb1cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new pacemaker placement // interval changes interval changes COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Moderate cardiomegaly has improved. Minimal pulmonary edema remains, and pleural effusions are presumed, but small. Transvenous right ventricular pacer lead follows its expected course, from the left pectoral generator, unchanged. No pneumothorax. " 57b4b156-3399cd95-b0f73b91-424fc570-c9497d10.jpg,validate/p17/p17451713/s53603379/57b4b156-3399cd95-b0f73b91-424fc570-c9497d10.jpg,validation," FINAL REPORT INDICATION: Nausea and shortness of breath. COMPARISONS: Multiple prior chest radiographs from ___ to ___. FINDINGS: PA and lateral chest radiographs again demonstrate hyperexpansion with flattened hemidiaphragms. However, there is no focal consolidation, pleural effusion, or pneumothorax. The cardiac, hilar, and mediastinal contours are normal. The heart size is normal. Accentuation of thoracic kyphosis is again seen. IMPRESSION: No acute cardiopulmonary process. " c71d13b0-8f8d58da-8e9a0a76-10c89f85-7f2a12cd.jpg,validate/p14/p14358282/s59632009/c71d13b0-8f8d58da-8e9a0a76-10c89f85-7f2a12cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, shortness-of-breath, evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Lungs are clear. Cardiomegaly is stable. Pulmonary vasculature is normal. There is no pleural effusion. Dual pacemaker leads are in appropriate position. IMPRESSION: No acute pneumonia. " 25f3a561-75ba9489-f052b061-203b9cdf-17d89a8d.jpg,validate/p16/p16901707/s53616270/25f3a561-75ba9489-f052b061-203b9cdf-17d89a8d.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with altered mental status with recent pneumonia. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. Left sided dual-lumen central venous catheter seen with distal tip in the right atrium, similar to prior. The lungs are hyperinflated. Increased interstitial markings are seen throughout the lungs similar to prior given differences in technique. More confluent consolidation is seen in the left lung, minimally improved since prior. There is now blunting of the posterior costophrenic angles suggestive of small effusions. Cardiomediastinal silhouette is enlarged but stable. No acute osseous abnormality detected. IMPRESSION: Mild interval improvement in the appearance of the left lung consolidation which persists. As mentioned on prior, followup will be necessary after treatment. Trace pleural effusions. No other change. " ab13ca4b-603354ad-8b8a5e30-a8ab5d53-021c1fe7.jpg,validate/p13/p13707062/s57915257/ab13ca4b-603354ad-8b8a5e30-a8ab5d53-021c1fe7.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST. REASON FOR EXAM: Assess cardiac lead. Left transvenous pacemaker lead terminates in standard position in the right ventricle. There is mild-to-moderate cardiomegaly. There is no pneumothorax. There is mild vascular congestion. " d3c36593-00dd6ade-24bf8878-e8a36735-7014052c.jpg,validate/p16/p16861367/s52820175/d3c36593-00dd6ade-24bf8878-e8a36735-7014052c.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with subarachnoid hemorrhage, for assessment of the ET tube. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 8 cm above the carina. The NG tube tip is in the stomach. The left subclavian line tip is at the level of mid SVC. Heart size and mediastinum are unremarkable. Substantial emphysema and bibasilar interstitial opacities/fibrosis appear to be unchanged as compared to ___. No interval increase in pleural effusion and no interval development of pneumothorax is seen. " e2812d68-e2455c59-49af9aa6-ee16070d-6a27ede6.jpg,validate/p12/p12022180/s57879742/e2812d68-e2455c59-49af9aa6-ee16070d-6a27ede6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sl enlarged hilum on previous CXR and subjective sensation of difficulty getting a full breath on left side and postprandial left shoulder pain // evaluate left lung and hilum; compare with CXRs from ___. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: Prior chest radiographs from ___ through ___. FINDINGS: There is unchanged slight prominence of the left hilum. There is no suspicious mass or nodule. There is no displaced rib fracture. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. No radiographic evidence for clinical symptoms. 2. No evidence of acute cardiopulmonary process. " 369ef00a-79e57ea9-c8461dad-e9d6056d-a1cfa889.jpg,validate/p17/p17526975/s53523580/369ef00a-79e57ea9-c8461dad-e9d6056d-a1cfa889.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Bilateral upper and lower extremity weakness. 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 disease. " 4b12c7c1-6a267d2c-3697d1be-e897231a-2663ff2b.jpg,validate/p18/p18730243/s58077554/4b12c7c1-6a267d2c-3697d1be-e897231a-2663ff2b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with ETOH cirrhosis and likely hepatorenal syndrome now with acute mental status change. ?Infectious cause // ?Consolidation COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: There is persistent effusion on the right side. There is no pneumothorax or CHF. The left lung is clear. " 4dba51fa-462d1b34-a2dc645f-beace74e-5c2470ab.jpg,validate/p16/p16307595/s57123799/4dba51fa-462d1b34-a2dc645f-beace74e-5c2470ab.jpg,validation," 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. " c5351da4-83b9da2a-d647cc23-bf008f7b-f5e5cf23.jpg,validate/p12/p12278812/s57023018/c5351da4-83b9da2a-d647cc23-bf008f7b-f5e5cf23.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pacemaker, brain tumor // check placement of pacemaker check placement of pacemaker IMPRESSION: In comparison with the study ___ ___, there is little change in the appearance of the dual-channel pacer, with leads extending to the right atrium and apex of the right ventricle. No evidence of acute pneumonia or vascular congestion. The right mid lung opacification seen previously is difficult to appreciate on the current study. " 357855ce-8674284b-145e686f-efbbc9ec-c42ae99e.jpg,validate/p18/p18605680/s57298943/357855ce-8674284b-145e686f-efbbc9ec-c42ae99e.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with aortic valve vegetation and known right lung mass with the diagnosis of inflammatory pseudotumor. Please evaluate for change in mass. COMPARISON: ___. TECHNIQUE: Two views of the chest. FINDINGS: The patient has a known right middle lobe lung lesion which appears unchanged from the prior radiographs. There is a loculated right pleural effusion, partially assessed on the PET-CT from ___. However, the overall size appears to have increased. The patient is status post median sternotomy, mitral and aortic valve replacements. The left lung is essentially clear. IMPRESSION: Unchanged right middle lobe mass. Loculated right pleural effusion, appears increased. " 082d50f8-416083f6-812e1bd0-1ca94fde-f4a81c15.jpg,validate/p17/p17244595/s54131419/082d50f8-416083f6-812e1bd0-1ca94fde-f4a81c15.jpg,validation," 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. " b4a8d89c-c64ae272-028ea1cb-6360bf22-644eb828.jpg,validate/p13/p13984946/s59099981/b4a8d89c-c64ae272-028ea1cb-6360bf22-644eb828.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Fever and cough evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is normal. There is no pleural effusion or pneumothorax. Linear right basilar opacity, consistent with atelectasis. IMPRESSION: No evidence of pneumonia. " 42fb9144-0cd336f1-4e3ecd64-a3e859ef-2647d4b0.jpg,validate/p10/p10308375/s55091382/42fb9144-0cd336f1-4e3ecd64-a3e859ef-2647d4b0.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with new-onset CHF. Tachypneic and desatting to ___%. Assess for interval change. COMPARISON: Chest radiograph ___, ___, ___. TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: Interval increase in moderate-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacity. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia. No pneumothorax or pulmonary edema. Heart size is partially obscured by the pleural parenchymal process. Mediastinal contour and hila are normal. No bony abnormality. IMPRESSION: 1. Interval increase in moderate-sized right pleural effusion. 2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings. " bfce96ef-aa7a780b-e1599961-e42aadb2-c5d5d700.jpg,validate/p18/p18666022/s52179935/bfce96ef-aa7a780b-e1599961-e42aadb2-c5d5d700.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis, recent umbilical hernia repair // assess change in free air COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Lungs are grossly clear. The volume of air in the large, persistent hydropneumoperitoneum has decreased. No pneumothorax. Small, bilateral pleural effusions are unchanged. There is no pneumothorax. Hilar and cardiomediastinal contours are normal. IMPRESSION: 1. Large hydro pneumoperitoneum has been present since ___. The volume of gas has decreased since ___. 2. Small, bilateral pleural increased from ___ to ___, subsequently stable. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:20 PM, 1 minutes after discovery of the findings. " 3adbdd49-cae325d1-6fc7abd4-4cf6e4b7-5c10bc51.jpg,validate/p14/p14619991/s58061851/3adbdd49-cae325d1-6fc7abd4-4cf6e4b7-5c10bc51.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea and wheezing. // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CT trachea ___ at 11:40. FINDINGS: Heart size is normal. Aorta is mildly tortuous. Mediastinal and hilar contours are otherwise normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities present. IMPRESSION: No acute cardiopulmonary abnormality. " e1c7861c-3a8fb0cd-ee5b9fac-598e0505-54858a5c.jpg,validate/p14/p14470386/s58476384/e1c7861c-3a8fb0cd-ee5b9fac-598e0505-54858a5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Epidural Hematoma, Found Down // routine CXR routine CXR IMPRESSION: Compared to chest radiographs ___ through ___. Severe infiltrative pulmonary abnormality continues to worsen. Relatively symmetric distribution and presence of septal lines suggests it could all be pulmonary edema. Concurrent infection or pulmonary hemorrhage cannot be excluded. Heart is normal size. Pleural effusions are likely, but not large. Right subclavian line ends in the region of the superior cavoatrial junction. Feeding tube ends in the upper stomach. " ebc3ca34-719ec9fc-f22ea59b-73c463fd-782cd818.jpg,validate/p10/p10717732/s55830882/ebc3ca34-719ec9fc-f22ea59b-73c463fd-782cd818.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___ year old woman s/p AVR/CABG // eval for pneumothoraces s/p VATs procedure COMPARISON: Chest radiograph dated ___. FINDINGS: The patient is status post AVR. A small amount of free air in the left lower hemithorax is new with suggestion of deep sulcus sign. The left internal jugular venous catheter tip position is unchanged when accounting for differences in technique and lower lung volumes. Small to moderate edema and pulmonary vascular congestion. Enlarged cardiac mediastinal silhouette overall unchanged and within limits postoperatively. A chest tube projects over the left hemithorax. Median sternotomy wires appear intact. IMPRESSION: 1. Small left basal/subpulmonic pneumothorax. 2. Mild-to-moderate volume overload. " f2114605-e88db04d-da931ba3-6390ade0-b22f3304.jpg,validate/p14/p14677035/s55161847/f2114605-e88db04d-da931ba3-6390ade0-b22f3304.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Fever, back pain, and myalgia. 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. The bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " fef81fa7-75d8ca91-07651606-538e5b40-bb00dbff.jpg,validate/p11/p11569093/s59413372/fef81fa7-75d8ca91-07651606-538e5b40-bb00dbff.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with stage IV adenocarcinoma of the lungs with new hemoptysis and tachycardia. FINDINGS: Single frontal image of the chest was obtained. Again seen is a partially collapsed right lung with increased density at the inferior border of the lung, consistent with pleural effusion versus pleural thickening. Below the inferior border of the right lung is again seen a hydropneumothorax with an air-fluid level. There again appear to be some small opacities within the partially collapsed right lung. The left lung is seen again to be clear. Cardiomediastinal silhouette is unchanged. IMPRESSION: Unchanged chest radiograph from previous imaging. " 74c8f391-02ab9065-22d10cf6-e2ccaaf9-1a714acb.jpg,validate/p16/p16458160/s52002237/74c8f391-02ab9065-22d10cf6-e2ccaaf9-1a714acb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p right decortication // check interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ through ___. FINDINGS: A left-sided single lead pacer/ICD is in unchanged, appropriate position. The heart is normal in size. Again seen is a moderate, partially loculated pleural effusion on the right as well as known right pleural thickening with multiple loculated right hydro pneumothoraces. There is persistent right lateral chest wall subcutaneous emphysema, which is decreased. The left lung is clear. A small hiatal hernia is unchanged. . IMPRESSION: 1. Moderate partially loculated right pleural effusion with known pleural thickening and multiple loculated right hydro pneumothoraces unchanged. " ff4add33-a1f6a3a1-b4529998-15fece4d-deb8ccff.jpg,validate/p12/p12530892/s55976763/ff4add33-a1f6a3a1-b4529998-15fece4d-deb8ccff.jpg,validation," 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. " fca5d102-2547ddfe-cefd8e2c-8c8f9f1e-e97ba106.jpg,validate/p19/p19028690/s55310022/fca5d102-2547ddfe-cefd8e2c-8c8f9f1e-e97ba106.jpg,validation," FINAL REPORT INDICATION: Volume overload. COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is unchanged, and appears mildly enlarged. Mediastinal and hilar contours are stable, and there is no evidence of pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes of the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 27e48dbd-e4c29111-17d87531-83dcf959-871d4fba.jpg,validate/p10/p10204908/s51583953/27e48dbd-e4c29111-17d87531-83dcf959-871d4fba.jpg,validation," FINAL REPORT HISTORY: Bilateral pneumothorax status post removal of chest tubes. COMPARISON: ___ at 6:00. FINDINGS: Again seen are moderate bilateral pneumothoraces. The right is best seen superolaterally. The left is present medially and laterally. The pigtail catheters have been removed. There is volume loss at both bases. NGT and PICC line are unchanged. IMPRESSION: Moderate bilateral pneumothoraces. " bc4c6034-e8650cd4-d716fcfb-7dfd507b-6e72e2b7.jpg,validate/p11/p11990968/s58341253/bc4c6034-e8650cd4-d716fcfb-7dfd507b-6e72e2b7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with c/o prod cough and thoracic pain with fever/chills // ? PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac silhouette is top-normal. IMPRESSION: No acute cardiopulmonary process. " 5d483dff-875292b3-d7b69079-496c53ca-57249aa8.jpg,validate/p11/p11308133/s52460251/5d483dff-875292b3-d7b69079-496c53ca-57249aa8.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with high oxygen requirement. COMPARISON: Comparison is made with chest radiograph from ___. FINDINGS: Two frontal images of the chest demonstrate improvement in the bibasilar lung opacities since previous imaging with complete resolution. There is no pleural effusion visualized, but the left costophrenic angle is not completely imaged. There is no pneumothorax. Cardiomediastinal silhouette is unchanged from prior imaging. IMPRESSION: Improvement in bilateral basilar lung opacities since prior imaging. Otherwise, unchanged chest radiograph. " 412d9833-31749d84-6be94ba4-ea788225-50498201.jpg,validate/p18/p18456006/s57301297/412d9833-31749d84-6be94ba4-ea788225-50498201.jpg,validation," FINAL REPORT HISTORY: Increased oxygen requirement. FINDINGS: In comparison with the study of ___, the cardiac silhouette remains enlarged and there is again indistinctness of mildly engorged pulmonary vessels consistent with elevated pulmonary venous pressure. No definite acute focal pneumonia. " 6e17139b-99d33d9a-f82f85e2-2a6b50d6-97dfd3b1.jpg,validate/p14/p14607686/s51308500/6e17139b-99d33d9a-f82f85e2-2a6b50d6-97dfd3b1.jpg,validation," 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. " 03d45510-d6a9e761-43462657-488a2254-96feb845.jpg,validate/p13/p13512048/s51603122/03d45510-d6a9e761-43462657-488a2254-96feb845.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with ankle fracture // evaluate for CHF 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. " d15c2b06-6e513816-570a95ba-73bd83d6-91114b46.jpg,validate/p11/p11861017/s57184508/d15c2b06-6e513816-570a95ba-73bd83d6-91114b46.jpg,validation," FINAL REPORT INDICATION: ___ year old man with trach, pneumonia in the past // ? pneumonia COMPARISON: ___ IMPRESSION: Tracheostomy and left-sided PICC line are unchanged in position. There has been adjustment of the right-sided chest tube which appears to have been pulled out. The tip now projects over the right perihilar region. There is cardiomegaly which is stable. There is a left retrocardiac opacity. There is consolidation at the right base which is slightly worse. There is prominence of pulmonary interstitial markings likely related to pulmonary edema. No definite pneumothoraces are seen. " 1ff4ea7c-25b647d7-2a9a432c-a03da797-def28e98.jpg,validate/p10/p10429629/s59828326/1ff4ea7c-25b647d7-2a9a432c-a03da797-def28e98.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with VAP // evaluate for interval change evaluate for interval change IMPRESSION: Compared to chest radiographs ___ through ___. Bilateral infrahilar consolidation, moderate on the left and mild on the right has not changed appreciably since ___, after improving on the right between ___ and ___. Since there is persistent leftward mediastinal shift, I think most of the left lower lobe abnormality is due to atelectasis. Borderline vascular engorgement is exaggerated by low lung volumes, as is top-normal heart size. ET tube an transesophageal drainage tube are in standard placements. Right PIC line ends in the right atrium, approximately 2.5 cm below the estimated location of the superior cavoatrial junction. No pneumothorax. Pleural effusion small if any. " 61fd80f6-c4efd8e2-3e903ce5-1746222f-77d43648.jpg,validate/p14/p14814693/s57151728/61fd80f6-c4efd8e2-3e903ce5-1746222f-77d43648.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough and fever. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is opacity in the left superior and posterior basal segments. There is associated volume loss of the left lower lobe.Heart size is within normal limits.Mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: Left lower lobe opacity in the superior and posterior basal segments with substantial volume loss. Although potentially due to an acute infectious pneumonia with a component of atelectasis from mucous plugging, a post obstructive process from obstructing neoplasm such as carcinoid may have a similar radiographic appearance. Depending on clinical presentation, short-term follow-up chest radiograph in 2 weeks after antibiotic therapy or immediate chest CT with contrast is recommended. The latter would be suggested if the patient has been experiencing recurrent symptoms or if the process fails to substantially improved after treatment. RECOMMENDATION(S): Either short-term follow-up with chest radiograph in 2 weeks after completion of antibiotic therapy or chest CT with contrast is recommended. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 5:00 PM, 5 minutes after discovery of the findings. " 9568d5aa-a9be832c-396e9da4-81136feb-121a38f5.jpg,validate/p16/p16748155/s59680533/9568d5aa-a9be832c-396e9da4-81136feb-121a38f5.jpg,validation," FINAL REPORT HISTORY: GI bleed, to assess for thoracic abnormality. FINDINGS: In comparison with the study of ___, there is little interval change. The suspected opacification at the left base has cleared. No pneumonia, vascular congestion, or pleural effusion. " 0a12620d-aede4a08-be96f6ab-5184e06c-755909f2.jpg,validate/p12/p12800722/s50410578/0a12620d-aede4a08-be96f6ab-5184e06c-755909f2.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the 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 unchanged. Interstitial pulmonary edema is mild-to-moderate and slightly progressed since the prior study. " b1fb1425-f1ad4e56-f22daa8f-d8308d54-b36572ad.jpg,validate/p14/p14540393/s55939380/b1fb1425-f1ad4e56-f22daa8f-d8308d54-b36572ad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man who presents with a CHF exacerbation // Interval change, please evaluate for pulmonary edema Interval change, please evaluate for pulmonary edema IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Severe cardiomegaly is chronic. Patient has had 2 cardiac valve replacements. Small left pleural effusion is smaller. Mild pulmonary edema has improved slightly since ___. No pneumothorax. " 460aaca0-12434b5b-5eb52a9d-d1e097d3-6ad70a84.jpg,validate/p18/p18479317/s51300485/460aaca0-12434b5b-5eb52a9d-d1e097d3-6ad70a84.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever following endoscopy, evaluate for infiltrate. TECHNIQUE: PA lateral chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: There are low lung volumes. Allowing for changes due to this, the cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. There may be minimal bibasilar atelectasis; otherwise, the lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: Low lung volumes. Minimal bibasilar atelectasis. No focal consolidation. " cbfe1c92-e77873e6-8428f1fd-4836e46a-d9dc477f.jpg,validate/p11/p11439189/s52478440/cbfe1c92-e77873e6-8428f1fd-4836e46a-d9dc477f.jpg,validation," WET READ: ___ ___ ___ 8:08 AM The ETT is in satisfactory position. NGT tip is in the stomach. Side hole is at the level of the GE junction. Low lung volumes. Bibasilar opacities are slightly improved. Stable mild cardiomegaly. WET READ VERSION #___ ___ ___ ___ 8:38 PM The ETT is in satisfactory position. NGT tip is in the stomach. Side hole is at the level of the GE junction. Low lung volumes. Bibasilar opacities are slightly improved. Stable mild cardiomegaly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left MCA stroke, COPD exacerbation // ETT placement COMPARISON: ___ IMPRESSION: All monitoring and support devices, including the endotracheal tube and the nasogastric tube are in normal position. No pleural effusions. No pulmonary edema. No pneumothorax. Moderate cardiomegaly is unchanged. Unchanged alignment of the sternal wires. " 06030156-163b173f-4576cdf5-c4d02706-7d76c092.jpg,validate/p10/p10345452/s53917996/06030156-163b173f-4576cdf5-c4d02706-7d76c092.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with persistent cough // Assess for PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Radiograph from ___ FINDINGS: The lung volumes continue to be low. Bibasilar opacities are mildly improved, however predominantly basal fibrosis persists. There is no evidence of pulmonary edema or pleural effusion. The cardiomediastinal silhouette is unchanged. IMPRESSION: No pneumonia. Persistent predominantly basal fibrosis, consistent with history of idiopathic lung disease. " c0cd028f-88052561-9b5352c2-4743ee4b-c0651367.jpg,validate/p17/p17506723/s55894959/c0cd028f-88052561-9b5352c2-4743ee4b-c0651367.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia // interval change interval change COMPARISON: Is chest radiographs ___ through ___. IMPRESSION: Rapid clearing of previous left lower lobe consolidation over just 24 hr indicates that this recent major change was largely resolution of atelectasis, not pneumonia. Improvement at the right base is due largely to decreasing moderate right pleural effusion. Heart size is normal. Left subclavian line, ET tube, and nasogastric feeding tube are in standard placements respectively. No pneumothorax. " 7fd1b39b-a3ef5252-ce293612-2d1e3ad4-f8679dc7.jpg,validate/p17/p17321335/s57210825/7fd1b39b-a3ef5252-ce293612-2d1e3ad4-f8679dc7.jpg,validation," FINAL REPORT INDICATION: Asthma exacerbation, persistent chest pain. 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. Streaky lucencies overlying the neck on the frontal view and abnormal lucency anterior to the trachea on the lateral view are concerning for pneumomediastinum. There is no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. IMPRESSION: Pneumomediastinum. No pneumothorax. No other acute process. Dr. ___ ___ this result to Dr. ___ ___ telephone at 2:22 AM on ___, at the time of discovery. " 2a6ba392-5a87646b-35efce3e-255db001-f521bcb2.jpg,validate/p15/p15619921/s55980618/2a6ba392-5a87646b-35efce3e-255db001-f521bcb2.jpg,validation," FINAL REPORT HISTORY: Increased work of breathing COMPARISON: FINDINGS: heart is upper limits normal in size. There is a left pleural effusion. There is pulmonary vascular redistribution. There is volume loss in the retrocardiac region. IMPRESSION: CHF. " 84935982-fad67bfc-5d9710eb-129f88db-8f8c8df3.jpg,validate/p14/p14147380/s52177069/84935982-fad67bfc-5d9710eb-129f88db-8f8c8df3.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after cystogastrostomy with stent placement and now new PICC line placement. PA and lateral upright chest radiograph were reviewed in comparison to ___. The right PICC line tip is at the level of mid SVC. Heart size and mediastinum are stable, unremarkable. Left lower lobe linear opacities and small right lower lobe opacities most likely represent atelectasis but attention to this area to exclude the possibility of developing infection is recommended. In the left suprahilar area, there is more nodular opacity noted than on the prior study. Although it might reflect summation of shadows, it should also be followed to exclude the possibility of developing infectious process. In the upper portion of the abdomen, there are drains noted, partially imaged. " 2cefff9c-440ac383-c821226c-b233dc16-9a8cf92f.jpg,validate/p17/p17287581/s58566238/2cefff9c-440ac383-c821226c-b233dc16-9a8cf92f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with elevated wbc on prednisone r/o infiltrate // leukocytosis r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Cardiomediastinal contours are stable with moderate cardiomegaly. 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 " 9407d860-da443504-724055af-1ddab864-2d859e8d.jpg,validate/p15/p15154432/s52798295/9407d860-da443504-724055af-1ddab864-2d859e8d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT // assess ETT TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: there is interval increase in the bilateral lower lobe infiltrates and effusion. There is pulmonary vascular redistribution. The heart is moderately enlarged. The 8 ET tube, right IJ line, and left IJ Cordis, and NG tube are unchanged.. IMPRESSION: Worsened fluid status " 8f487d28-5bd661e5-54927634-ab36fa69-b7fff9e1.jpg,validate/p10/p10466068/s56598095/8f487d28-5bd661e5-54927634-ab36fa69-b7fff9e1.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with new onset afib s/p cervical spine laminectomy for spinal cord meningioma // please eval for any acute cardiopulm process TECHNIQUE: Portable chest COMPARISON: None FINDINGS: The patient is significantly rotated to the left in this study. Within these limitations, there is mild pulmonary vascular congestion without pulmonary edema and moderate to severe cardiomegaly. Lungs are otherwise clear without focal consolidation. A rounded soft tissue density projecting over the heart were may be consistent with a hiatal hernia, or less likely an aortic aneurysm. In addition to thoracolumbar scoliosis, there are marked osteopenic and degenerative changes of the thoracolumbar spine. IMPRESSION: Mild pulmonary vascular congestion without pulmonary edema. No evidence of pneumonia. Note is made of a retrocardiac soft tissue abnormality possibly a hiatal hernia or less likely a thoracic aorta aneurysm. Recommend follow-up PA and lateral chest radiographs for further evaluation. RECOMMENDATION(S): Recommend PA and lateral chest radiographs for further evaluation of the retrocardiac soft tissue abnormality. " 21feef32-a3928d59-fdeee05d-2040aa15-e2613a7d.jpg,validate/p17/p17799305/s53571477/21feef32-a3928d59-fdeee05d-2040aa15-e2613a7d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Crackles in the right lower lung. Assess for pneumonia. FINDINGS: AP semi-upright portable chest radiograph was provided. There is left lower lobe opacity which is slightly improved from the prior exam though remains concerning for atelectasis or possible pneumonia. Within the right lung, there are scattered vague nodular opacities. The possibility of pneumonia must be considered. The mediastinal contour remains prominent. Overall, cardiac silhouette is difficult to assess. Bony structures are intact. " f45df688-a09c1a57-567f4589-4b3c5c29-4454ab30.jpg,validate/p12/p12778315/s55173837/f45df688-a09c1a57-567f4589-4b3c5c29-4454ab30.jpg,validation," FINAL REPORT HISTORY: Trauma, pedestrian struck, high thoracic spine pain. COMPARISON: Upright AP and lateral views of the chest. FINDINGS: Heart size is normal. Mediastinal and hilar contours are within normal limits, and the lungs are clear. The pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 82019f72-06867693-12f7d9ba-73f9f8c7-558b6907.jpg,validate/p16/p16260564/s52184752/82019f72-06867693-12f7d9ba-73f9f8c7-558b6907.jpg,validation," FINAL REPORT ___-year-old woman with persistent cough and difficulty with drawing blood from the central venous catheter. COMPARISON: ___. FINDINGS: The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. The right-sided tunneled central venous line does appear to have a kink in it which could explain the difficulty for withdrawing blood. " 01ce236e-b0fe2c7f-cbdd2604-d379fa74-30af84c1.jpg,validate/p19/p19859532/s52235965/01ce236e-b0fe2c7f-cbdd2604-d379fa74-30af84c1.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with PICC line placed during prior admission. Would like to re-confirm positioning. // Please eval for PICC placement TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___, ___ FINDINGS: The lungs are clear. A left subclavian PIC line tip is seen in the mid SVC. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pneumothorax or pleural effusion. IMPRESSION: 1. Left subclavian PIC line is seen in the mid SVC. No acute cardiopulmonary process. " 61fd13f2-423a8f15-7ff9e591-e42f8660-62c8e2ea.jpg,validate/p14/p14602966/s53192187/61fd13f2-423a8f15-7ff9e591-e42f8660-62c8e2ea.jpg,validation," FINAL REPORT HISTORY: Palpitations and occasional shortness of breath. COMPARISON: ___, and ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. The pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " d2f8977e-8d689cc6-a424cfdd-f6be3c7c-c5901691.jpg,validate/p16/p16739625/s51075194/d2f8977e-8d689cc6-a424cfdd-f6be3c7c-c5901691.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man status post pacemaker // Evaluate for lead placement TECHNIQUE: Chest PA and lateral COMPARISON: PA and lateral chest radiographs dated ___ FINDINGS: Since the chest radiographs obtained ___, there has been interval placement of a dual lead pacemaker with leads that appear to terminate in the right atrium and proximal anterior right ventricle. There is no pneumothorax. 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: Pacemaker leads follow their expected course. No acute post procedural complications. " bb8ac02f-bee331ce-0df4cd4b-abe3f234-21952475.jpg,validate/p17/p17752642/s50133914/bb8ac02f-bee331ce-0df4cd4b-abe3f234-21952475.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with CP // eval for PNA, cardiomegaly, ptx TECHNIQUE: Frontal view of the chest COMPARISON: Chest radiographs on ___ FINDINGS: The heart is enlarged, but similar in size to the prior examination of ___. The hilar contours are within normal limits. There is no focal consolidation or pneumothorax is identified. There may be a small left pleural effusion. IMPRESSION: Stable cardiomegaly. No focal consolidation or pneumothorax is identified. There may be a small left pleural effusion as the left costophrenic angle is not well seen. Consider followup chest radiograph with lateral view for further evaluation if clinically indicated. " 88af32ff-cbf8854e-b9aacfae-b16f0743-cc8fdf89.jpg,validate/p18/p18754310/s55604123/88af32ff-cbf8854e-b9aacfae-b16f0743-cc8fdf89.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with palpitations. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. There is no evidence for pulmonary edema. Heart and mediastinal contours are within normal limits. There is mild dextroconvex thoracic scoliosis. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 3653f20b-b67f057e-c3e2e2b8-2fdceca1-ef59fa0d.jpg,validate/p16/p16019229/s54564537/3653f20b-b67f057e-c3e2e2b8-2fdceca1-ef59fa0d.jpg,validation," FINAL REPORT HISTORY: Left pigtail pull, to assess for pneumothorax. FINDINGS: In comparison with study of earlier in this date, the left pigtail catheter has been removed and there is no evidence of pneumothorax. Diffuse bilateral pulmonary opacifications persist and there are somewhat lower lung volumes. " fd67f1d2-14d85771-5aed02a0-34309eff-f2eafffa.jpg,validate/p19/p19301174/s59869786/fd67f1d2-14d85771-5aed02a0-34309eff-f2eafffa.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph PA and lateral INDICATION: ___ year old man s/p RUL lobectomy ___ for stage 2a adenoca. persistent right lung effusion. // eval for interval change TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray ___ FINDINGS: Lung volumes are low. The right pleural effusion and adjacent atelectasis have significantly decreased since the prior radiograph in ___. There is no effusion in the left hemithorax. The lungs are otherwise free of consolidations or pneumothorax. No acute osseous abnormalities. Surgical clips are noted in the right apex and right mid lung zone. Cardiomediastinal silhouette is stable. IMPRESSION: Right pleural effusion has significantly decreased since ___. There are no new masses or pulmonary nodules. " b62ad53a-28bb4725-aedd7c2c-c944ff15-af478ba0.jpg,validate/p18/p18705722/s56933154/b62ad53a-28bb4725-aedd7c2c-c944ff15-af478ba0.jpg,validation," WET READ: ___ ___ ___ 4:22 AM 1. No evidence of acute cardiopulmonary process. 2. Stable severe cardiomegaly. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with ___ a fib, valve replacement, asthma, with SOB and wheeze, evaluate for pulmonary 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, including severe cardiomegaly and numerous sternotomy wires, is unchanged. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. Stable severe cardiomegaly. " 7284d639-42e0931e-d33fdf1f-10c9b8bc-1e0a0177.jpg,validate/p10/p10476390/s52189590/7284d639-42e0931e-d33fdf1f-10c9b8bc-1e0a0177.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough, history of pneumonia two weeks ago, question resolution. FINDINGS: PA and lateral views of the chest were obtained. The lungs appear clear bilaterally without focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette is normal. Bony structures intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 3651a662-d672fce0-6ddce504-6ca472b7-cf0ece68.jpg,validate/p12/p12283103/s51166422/3651a662-d672fce0-6ddce504-6ca472b7-cf0ece68.jpg,validation," FINAL REPORT AP CHEST, 11:34 P.M., ___ HISTORY: New shortness of breath, question effusion or pneumothorax. IMPRESSION: AP chest compared to only recent prior chest radiograph, ___: Asymmetric pulmonary abnormality is new, characterized as generalized increase in background density and interstitial abnormality in both lungs, with a right infrahilar and left perihilar prominence. It could be simple pulmonary edema or edema with aspiration pneumonia. Depending upon clinical circumstances, transfusion reaction or aspiration should be added to the list of possibilities. The heart is not enlarged, pleural effusion, if any, is small, and there is no mediastinal vascular engorgement, so that I doubt simple cardiac edema. Right subclavian infusion port ends in the low SVC. An upper enteric drainage tube ends in the upper portion of a non-distended stomach. Midline drains are noted, but not identifiable. Dr. ___ was paged at 9:48 a.m. as soon as the findings were recognized. " dc36f7c9-6fcda256-e9e57815-0fed3c66-52de1c9a.jpg,validate/p15/p15527518/s56678630/dc36f7c9-6fcda256-e9e57815-0fed3c66-52de1c9a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with persistent hypoxia // Please evaluate for interval change TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest radiograph dated ___. Chest CT dated ___. FINDINGS: The sternotomy wires appear intact and appropriately aligned. There is a right PICC line, which terminates at the cavoatrial junction. There are persistent multifocal opacities bilaterally, which were better characterized on the recent CT, but improved compared to the chest radiograph dated ___. The pulmonary vasculature is normal. The cardiomediastinal silhouette is stable. There are no pleural effusions. There is no pneumothorax. IMPRESSION: Persistent multifocal opacities bilaterally, improved since ___, but stable compared to the CT on ___. " ccdb8f09-6e1dee7b-9b6fb7e0-e93ef45e-97c44118.jpg,validate/p19/p19365165/s53266292/ccdb8f09-6e1dee7b-9b6fb7e0-e93ef45e-97c44118.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg x4 // eval for pneumo eval for pneumo IMPRESSION: Compared to postoperative chest radiograph ___. Patient has been extubated and other cardiopulmonary support devices removed. No pneumothorax or pleural effusion. Lung volumes remain quite low, but moderate left lower lobe atelectasis has improved. No pulmonary edema. Normal postoperative cardiomediastinal silhouette. " c7f43ebc-e5ed7da4-66e03ecb-a31a7217-d23d8e00.jpg,validate/p19/p19849930/s51184265/c7f43ebc-e5ed7da4-66e03ecb-a31a7217-d23d8e00.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old gentleman with history of coronary artery disease, status post CABG and redo CABG with bioprosthetic MVR in ___, paroxysmal atrial fibrillation, hypertension, hyperlipidemia, conduction system disease manifesting with RBBB status post dual-chamber pacemaker presenting with acute onset shortness of breath found to have cellulitis and aoschf. // interval change TECHNIQUE: Portable chest COMPARISON: ___ at 02:00. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 50816564-ec3d47bd-9354c952-87894788-b6c3526e.jpg,validate/p14/p14244969/s56961951/50816564-ec3d47bd-9354c952-87894788-b6c3526e.jpg,validation," FINAL REPORT INDICATION: History of glioblastoma with new cough. Please evaluate for pneumonia. COMPARISON: Multiple chest radiographs dating back to ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There is a left-sided port with the tip terminating in the mid SVC. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The heart size is normal. Note is made of mild bibasilar atelectasis. The visualized osseous structures are unremarkable. IMPRESSION: No focal consolidations concerning for pneumonia identified. " ba3b3d81-b54dab75-e1fc8d17-f3b949ea-602ad6ea.jpg,validate/p16/p16771607/s50601885/ba3b3d81-b54dab75-e1fc8d17-f3b949ea-602ad6ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman recently extubated after a week on the ventilator, with shortness of breath, likely aspiration // r/o interval change, pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous image, the patient has been extubated and the nasogastric tube was removed. The right internal jugular vein catheter remains in situ. Unchanged moderate bilateral pleural effusions, mild to moderate pulmonary edema and extensive areas of atelectasis at both the left and the right lung bases. Unchanged moderate cardiomegaly. " 1dd7f9d9-72685239-8af55665-154fc3bb-fe22bf54.jpg,validate/p15/p15670611/s51449464/1dd7f9d9-72685239-8af55665-154fc3bb-fe22bf54.jpg,validation," WET READ: ___ ___ ___ 1:40 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with rectal cancer on chemotherapy with relative leukocytosis and bandemia // ?infiltrate 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 grossly unchanged, allowing for differences in technique and inspiratory effort. There is no pneumothorax, pleural effusion, or consolidation. Left-sided pectoral power port projects over the mid SVC. Note is made of 2 old healed left rib fractures. IMPRESSION: No acute cardiopulmonary process. " 26a74691-350d5fad-282c6550-af335294-bfdb5b05.jpg,validate/p19/p19839844/s58402219/26a74691-350d5fad-282c6550-af335294-bfdb5b05.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p cardiac surgery- CTs d/c'd // evaluate for pneumothorax evaluate for pneumothorax IMPRESSION: Comparison to ___. Status post removal of all monitoring and support devices. Mild cardiomegaly. No pulmonary edema, no pleural effusions. No pneumonia. Minimal atelectasis at the right lung bases. " 691d99c0-a3fccc0c-f75d1e82-4c7f9e84-6e048c50.jpg,validate/p19/p19386901/s52279972/691d99c0-a3fccc0c-f75d1e82-4c7f9e84-6e048c50.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with hyponatremia and fever. Evaluate for evidence of acute cardiopulmonary process. 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. " 32508a8d-88f0d6ad-32f36f16-a06a499f-6e728c45.jpg,validate/p17/p17472823/s55824200/32508a8d-88f0d6ad-32f36f16-a06a499f-6e728c45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fevers, chills, HIV + with unknown CD4. Evaluate for infection. 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 intrathoracic process. " 154d2b6a-060ff07b-e07ba96e-9b0e625f-758a811d.jpg,validate/p11/p11230772/s52933132/154d2b6a-060ff07b-e07ba96e-9b0e625f-758a811d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with epigastric chest pain // ?cause of chest pain TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest 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. " 17d25b86-73af36a3-c64b65ed-668a092f-857c491b.jpg,validate/p16/p16448755/s51403053/17d25b86-73af36a3-c64b65ed-668a092f-857c491b.jpg,validation," FINAL REPORT INDICATION: Hypotension and fever. COMPARISONS: ___. FINDINGS: AP of the chest demonstrates low lung volumes, which accentuate bronchovascular markings. Pulmonary edema is new since prior. Heart is mildly enlarged. There is no large pleural effusion. No pneumothorax. Left lung base consolidation is also noted, more conspicuous since prior. IMPRESSION: 1. Pulmonary edema, new since ___. Mild cardiomegaly. 2. Left lung base consolidation, may represent atelectasis or infection in the appropriate clinical setting. Follow-up to resolution. " f267bd40-444f2b62-f400b55f-a9f90dc7-db036112.jpg,validate/p18/p18690742/s56844948/f267bd40-444f2b62-f400b55f-a9f90dc7-db036112.jpg,validation," 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. " 4b756fd5-3ffd8340-426cc818-eeaab46f-a3c33e59.jpg,validate/p14/p14247006/s52368334/4b756fd5-3ffd8340-426cc818-eeaab46f-a3c33e59.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST: REASON FOR EXAM: Assess pacer leads. Left transvenous pacemaker leads terminate in standard position in the right atrium, right ventricle and through the coronary sinus. There is no pneumothorax. There is small left pleural effusion. There are multifocal linear atelectases in the left lower lobe. Sternal wires are aligned. Patient is status post CABG. There are moderate-to-severe degenerative changes in the thoracic spine. " 78f28d03-e90d858a-3593e5af-37e1247c-d127edae.jpg,validate/p17/p17647154/s53072865/78f28d03-e90d858a-3593e5af-37e1247c-d127edae.jpg,validation," FINAL REPORT AP CHEST, 9:33 P.M. ON ___ HISTORY: ___-year-old woman with a right chest tube on waterseal. Evaluate pneumothorax. IMPRESSION: AP chest compared to ___ through ___ at 4:52 p.m.: Small right apical pneumothorax, unchanged in size over five hours, pleural tube still in place. Small right pleural effusion stable. Small left pleural effusion has increased since ___ but not in the course of today. Moderate left lower lobe atelectasis stable. Upper lungs clear. Borderline cardiomegaly stable. " 91ea24c1-ddf8f918-0c579885-c0bf36ed-3a2b306a.jpg,validate/p18/p18415616/s58605705/91ea24c1-ddf8f918-0c579885-c0bf36ed-3a2b306a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with fever // ? pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lung volumes are low leading to crowding of the bronchovascular structures. 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. " b51503ac-7904693d-19125ff2-ce41e4cf-0d0404f5.jpg,validate/p19/p19075794/s58879240/b51503ac-7904693d-19125ff2-ce41e4cf-0d0404f5.jpg,validation," FINAL REPORT HISTORY: MVC with intubation. FINDINGS: No previous images. Endotracheal tube tip lies approximately 3.3 cm above the carina. Nasogastric tube is difficult to evaluate beyond the lower esophagus. Image of the abdomen would be necessary for further evaluation of this tube. Low lung volumes probably are responsible for the prominence of the transverse diameter of the heart. No vascular congestion or acute focal pneumonia. " 1dfc22c0-281deadb-d5fd026e-061d6f7e-5843c63d.jpg,validate/p12/p12132246/s56038694/1dfc22c0-281deadb-d5fd026e-061d6f7e-5843c63d.jpg,validation," WET READ: ___ ___ ___ 7:41 PM Low lung volumes. Bibasilar atelectasis and likely small pleural effusions bilaterally. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post aortic root replacement, postoperative fevers, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, all monitoring and support devices have been removed. The alignment of the sternal wires is unremarkable. There continues to be moderate cardiomegaly. However, no pulmonary edema is present. Atelectases at both lung bases are seen in unchanged manner, left more than right. No pneumothorax. No pneumonia. No larger pleural effusions. " 4f76bf12-6451b1d1-7d2b5863-e4417799-7a783b09.jpg,validate/p19/p19552401/s50264712/4f76bf12-6451b1d1-7d2b5863-e4417799-7a783b09.jpg,validation," FINAL REPORT HISTORY: Shortness-of-breath and productive cough evaluate for pneumonia. COMPARISON: For chest radiograph performed earlier on the same day on ___. FINDINGS: PA and lateral chest radiographs were obtained. The patient is status post median sternotomy and CABG. There are prominent interstitial markings as well as bronchovascular crowding accentuated by low lung volumes. No focal opacity is seen. The cardiac silhouette is mildly enlarged. There is no pleural effusion or pneumothorax. IMPRESSION: No focal opacity. Prominent interstitial markings, mild pulmonary edema cannot be excluded. " be0f4800-8fd50bd2-015e414c-73b989fa-3dd1a185.jpg,validate/p18/p18335071/s55587051/be0f4800-8fd50bd2-015e414c-73b989fa-3dd1a185.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with R effusion now s/p R thoracentesis. // ptx COMPARISON: CT scan from ___. IMPRESSION: Left-sided Port-A-Cath is unchanged in position. Heart size is enlarged but stable. There has been interval decrease in the left-sided pleural effusion since the previous study. There are no pneumothoraces. Healed bilateral rib fractures are seen. " d46b9e5a-58942352-7ba03b6b-1bfda8fd-2f48fbba.jpg,validate/p17/p17724257/s55704126/d46b9e5a-58942352-7ba03b6b-1bfda8fd-2f48fbba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure, worsening productive cough, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, today's image shows an ongoing increase of the cardiac silhouette as well as of the pulmonary vascular calibers, associated with some thickening of the bronchial walls and indistinct hilar structures. Overall, these findings are suggestive of mild-to-moderate pulmonary edema. In addition, the atelectatic changes, notably at the left lung bases, have increased since the last comparison image. Finally, there is minimal blunting of the left costophrenic sinus, consistent with mild pleural effusion. The sternal wires are in unchanged alignment. At the time of dictation and observation, 9:28 a.m., on the ___, the referring physician ___. ___ was paged for notification and the findings were discussed over the telephone within the same minute. " a39a8ce9-f134e1c0-701de518-b01ba25c-4dd454f3.jpg,validate/p14/p14720722/s50053809/a39a8ce9-f134e1c0-701de518-b01ba25c-4dd454f3.jpg,validation," FINAL REPORT HISTORY: Palpitations, lightheadedness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: No acute cardiopulmonary abnormality. " 6db0d286-b92f3429-be9eddc4-d457d794-6207a4bf.jpg,validate/p16/p16182726/s59012722/6db0d286-b92f3429-be9eddc4-d457d794-6207a4bf.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Rapid atrial fibrillation. COMPARISON: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The heart is mild to moderately enlarged, perhaps somewhat larger than before. The mediastinal and hilar contours are unremarkable. There are new dense opacities involving both lower lobes, greater on the right than left, and there is probably also some degree of atelectasis or pneumonia seen on the lateral view anteriorly, probably referring to the right middle lobe. There is no pleural effusion or pneumothorax. Pulmonary vasculature appears essentially within normal limits. IMPRESSION: Findings consistent with multifocal pneumonia. Mild to moderate cardiomegaly. " 897dda68-c75ff4b1-d4292521-236344c1-e92a5e7a.jpg,validate/p15/p15263190/s51057077/897dda68-c75ff4b1-d4292521-236344c1-e92a5e7a.jpg,validation," 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. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is present. IMPRESSION: No acute cardiopulmonary abnormality. " 0a844956-23c42c42-15761e39-7061c96c-42ebd696.jpg,validate/p12/p12724643/s59873885/0a844956-23c42c42-15761e39-7061c96c-42ebd696.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. COMPARISON: Chest radiograph from ___ PA AND LATERAL CHEST RADIOGRAPHS: Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Flattening of the hemidiaphragms is unchanged and consistent with chronic obstructive pulmonary disease. Mild cardiomegaly is also stable. Mediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process " c0951fb0-d486943b-ef135df8-efbe718a-e2f8e127.jpg,validate/p15/p15388421/s59261779/c0951fb0-d486943b-ef135df8-efbe718a-e2f8e127.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MIE // Interval chsnge Interval chsnge IMPRESSION: Heart size and mediastinum are unchanged. Subcutaneous air on the right is unchanged. No definitive pneumothorax is seen. Mediastinal silhouette is stable. " 94932e0f-87e93a38-ae118f75-7d4286bc-1e17c3f2.jpg,validate/p15/p15002645/s56252561/94932e0f-87e93a38-ae118f75-7d4286bc-1e17c3f2.jpg,validation," FINAL REPORT INDICATION: ___M with CP // r/o acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " ca4db9c6-d7676ab4-8bc26c79-d7ad6790-137168f1.jpg,validate/p16/p16638943/s56336693/ca4db9c6-d7676ab4-8bc26c79-d7ad6790-137168f1.jpg,validation," FINAL REPORT INDICATION: Chest pain after cocaine use, patient was punched in the chest. Evaluate for trauma or acute cardiac or pulmonary process. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural abnormalities. The bony thorax is grossly intact. IMPRESSION: No acute cardiac or pulmonary process. " cc289265-e42a15f2-0fee563b-db1df449-fcf246d3.jpg,validate/p10/p10877695/s56629884/cc289265-e42a15f2-0fee563b-db1df449-fcf246d3.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with recent hospitalization at OSH p/w wheezing and cough // please evaluate for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. There is no evidence of pneumonia. The cardiomediastinal border is are normal and the hilar structures are normal. Cardiac size is normal. IMPRESSION: Normal chest x-ray without evidence of pneumonia NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 11:52 AM, 5 minutes after discovery of the findings. " 4bcf8dbe-85c8e300-720bd47a-9e3ccec5-7398a648.jpg,validate/p19/p19507787/s54226985/4bcf8dbe-85c8e300-720bd47a-9e3ccec5-7398a648.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with left jaw swelling, odynophagia, increased RR TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Heart size is top-normal in size. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion, focal consolidation or pneumothorax is present. No acute osseous abnormalities detected. IMPRESSION: Patchy bibasilar airspace opacities, likely atelectasis. Infection cannot be excluded in the correct clinical setting. " a3ecb739-fb5df55a-43e62ecd-1a71d5d9-4d340393.jpg,validate/p17/p17957742/s52181616/a3ecb739-fb5df55a-43e62ecd-1a71d5d9-4d340393.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG..now in ___ // eval for effusion, degree of pulm edema eval for effusion, degree of pulm edema COMPARISON: ___ IMPRESSION: ET tube tip is 8 cm above the carinal. NG tube passes below the diaphragm terminating in the stomach. Right internal jugular line tip is at the right atrium and should be pulled back a possible at least 3.6 cm. There is no pneumothorax. Pleural effusion is most likely present on the left. There is minimal interval improvement in pulmonary edema as well as in the left mid and lower lobe consolidations. " c1808050-5bb047dd-f789c110-fbc4c5a3-4056857b.jpg,validate/p16/p16727000/s51170286/c1808050-5bb047dd-f789c110-fbc4c5a3-4056857b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Productive cough. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a visually much more obvious parenchymal opacity in the left lower lobe. The opacity is likely to reflect pneumonia. No other pathologic findings, in particular no adenopathy or pleural effusions. Borderline size of the cardiac silhouette without pulmonary edema. The referring physician, ___. ___, was called at the ___ disease clinic and a message was left on the answering machine of his telephone and with the nurse at the reception. This was done at the time of dictation and observation, 2:29 p.m., on ___. " 548e00f2-bc38b87f-9fed291b-e36edabf-d5c4c5d8.jpg,validate/p15/p15860820/s56774722/548e00f2-bc38b87f-9fed291b-e36edabf-d5c4c5d8.jpg,validation," FINAL REPORT INDICATION: NG tube placement, status post transverse colectomy. COMPARISON: ___ and ___. FINDINGS: The enteric tube ends in the distal esophagus. No focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: Enteric tube ends in the distal esophagus. These findings were discussed with ___ ___ by Dr. ___ at 2:21 p.m. on ___ by telephone. " 44444333-a55f8304-ac91018e-eb2644d8-017f09e8.jpg,validate/p19/p19926820/s51616531/44444333-a55f8304-ac91018e-eb2644d8-017f09e8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with alcoholic hepatitis, ___, HFrEF, now with worsening cough. Evaluate for infection or volume overload. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___. FINDINGS: Mild cardiomegaly is unchanged. There is new mild pulmonary edema, evidenced by peribronchial cuffing and increased interstitial lung markings. No new focal consolidation, pleural effusion, or pneumothorax. Lung volumes are slightly lower. Enteric tube courses below the left hemidiaphragm and out of view. IMPRESSION: New mild pulmonary edema, evidenced by peribronchial cuffing and increased interstitial lung markings. No new focal consolidation. " 0bdaaf14-e12e7767-bbb1fbdc-b0c76cb6-024fa7b0.jpg,validate/p18/p18627179/s53019616/0bdaaf14-e12e7767-bbb1fbdc-b0c76cb6-024fa7b0.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with pneumonia versus aspiration pneumonitis. Portable AP radiograph of the chest was reviewed in comparison to ___. As compared to prior study, left perihilar consolidation has decreased and small likely consistent with aspiration as opposite to pneumonia. Left lower lobe consolidation is unchanged, associated with pleural effusion. The right lung is unchanged in appearance as well as the bilateral deep brain stimulators. " 41274a88-35f2b203-fd5fce88-6d4920b9-1679ef80.jpg,validate/p16/p16739392/s51976597/41274a88-35f2b203-fd5fce88-6d4920b9-1679ef80.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with multifocal pneumonia and colon cancer metastasis to the lungs. COMPARISON: None available. TECHNIQUE: Portable upright chest radiograph. FINDINGS: Study is technically limited by motion-related artifacts obscuring the lower lung fields. There are extensive bilateral upper zone opacities with air bronchograms suggestive of pneumonia, previously diagnosed at an outside hospital. Outside hospital imaging was not available for direct comparison. Left hemidiaphragm is not visualized and suggests left lower field atelectasis and/or pleural effusion. IMPRESSION: Technically limited study demonstrating bilateral upper zone pneumonia. Repeat imaging is recommended. " 833ac99b-696a88d3-17c94edc-aed50a8f-c6c1c33c.jpg,validate/p13/p13659261/s57355835/833ac99b-696a88d3-17c94edc-aed50a8f-c6c1c33c.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough and fever, rule out pneumonia. COMPARISON: Portable AP 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. " bf8d48ea-52276c53-ded13239-4cd1ba59-41539663.jpg,validate/p17/p17440770/s55273647/bf8d48ea-52276c53-ded13239-4cd1ba59-41539663.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with s/p, exquisite l lateral rib TTP and inspiratory pain // eval ? rib fracture, lung contusion COMPARISON: Chest radiographs ___ 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. Aortic knob calcifications are unchanged. Left humeral surgical hardware is again seen without obvious complication. Mild scoliosis is unchanged. IMPRESSION: No displaced rib fractures or acute intrathoracic process identified. If there is high clinical concern for displaced rib fracture requiring definitive diagnosis, rib series radiographs may be considered. " fb534d71-ffa68033-b19e129b-e09d1bbe-6188deb8.jpg,validate/p11/p11451979/s57824441/fb534d71-ffa68033-b19e129b-e09d1bbe-6188deb8.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 7:41 CLINICAL INDICATION: ___-year-old with CHF and pulmonary edema. Assess for interval change. Comparison is made to patient's prior study ___ at 8:24. Portable semi-erect chest film ___ at 7:41 is submitted. IMPRESSION: 1. Status post median sternotomy for CABG with stably enlarged heart and stable mediastinal contours. Right internal jugular introducer catheter with its tip in the distal SVC unchanged. Left PICC line is difficult to visualize due to overlying EKG wires but also appears to terminate in the distal SVC near the cavoatrial junction. Improving bilateral interstitial abnormality which likely reflects improving interstitial edema. Underlying interstitial lung disease also should be considered. No large pleural effusions. No pneumothorax. " d33ab8fd-e85a0f74-6e9ce052-c5b48262-004c5c1f.jpg,validate/p10/p10604406/s54966066/d33ab8fd-e85a0f74-6e9ce052-c5b48262-004c5c1f.jpg,validation," FINAL REPORT EXAMINATION: The CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with cough and right pleuritic chest pain // is there an infiltrate/effusion? COMPARISON: Chest radiograph ___. IMPRESSION: Lung zone volume but clear. Mild left pleural thickening is unchanged. Heart size normal. Thoracic aorta is quite tortuous but not clearly dilated. Pulmonary vasculature is normal. " e6f6f331-8a5314a6-3f7af25c-24bb0aa6-9a5c05fe.jpg,validate/p14/p14458546/s59428438/e6f6f331-8a5314a6-3f7af25c-24bb0aa6-9a5c05fe.jpg,validation," FINAL REPORT INDICATION: Metastatic brain cancer, fall. COMPARISON: Chest radiograph of ___ and CT torso on ___. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal. There is again seen abnormally enlarged contour of the right hilum consistent with lymphadenopathy on prior studies, unchanged. IMPRESSION: No acute cardiopulmonary process. Unchanged, enlarged right hilum consistent with lymphadenopathy better seen on prior studies. " b7c48559-6eb5f6fe-eea1195b-da75845a-680b1b58.jpg,validate/p10/p10476869/s57292220/b7c48559-6eb5f6fe-eea1195b-da75845a-680b1b58.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with dyspnea, cough and history of lymphoma. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Postsurgical changes are again noted in the suprahilar region on the left. Remaining lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " a4bc858e-0f46d994-08b5d1a6-a5ac8ee3-237a60b2.jpg,validate/p19/p19048845/s52989528/a4bc858e-0f46d994-08b5d1a6-a5ac8ee3-237a60b2.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p L CF endarterectomy w/ O2 requirement and increasing WBC. // Please eval for pneumonia COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: There is a small area density suggesting fluid within the minor fissure on the right. This is similar to a prior chest x-ray of ___. There is stable patchy density in both lung bases and in the left perihilar there is no CHF or pneumothorax. " 814dee47-c7f02401-aa5ff27d-4be8af6d-65231f26.jpg,validate/p12/p12882985/s56097915/814dee47-c7f02401-aa5ff27d-4be8af6d-65231f26.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, cough, pleuritic left-sided chest pain // 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. Spinal hardware is partially imaged. IMPRESSION: No acute cardiopulmonary process. " 64ada0ac-43ac24b9-729e1f93-f60b6ecc-3e367d6e.jpg,validate/p13/p13818030/s51196556/64ada0ac-43ac24b9-729e1f93-f60b6ecc-3e367d6e.jpg,validation," 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. " d096b6b1-76ab7de6-4aefa847-01cb4ea1-9cc9d4eb.jpg,validate/p12/p12385857/s51890599/d096b6b1-76ab7de6-4aefa847-01cb4ea1-9cc9d4eb.jpg,validation," WET READ: ___ ___ ___ 1:13 AM No new consolidation suspicious of pneumonia is identified. Patchy opacities in bilateral lower lobes and right middle lobe are similar to ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with gastroparesis flare - now with fever, leukocytosis // assess for pneumonia assess for pneumonia COMPARISON: PRIOR CHEST RADIOGRAPHS MOST RECENTLY ___. IMPRESSION: PATIENT HAS HAD RESECTION FROM THE LEFT LOWER LOBE, DEMARCATED BY VASCULAR CLIPS AND SCARRING. LINEAR ATELECTASIS OR SCARRING IN THE RIGHT LOWER LUNG IS UNCHANGED. LUNGS ARE OTHERWISE CLEAR. CARDIOMEDIASTINAL AND HILAR SILHOUETTES AND PLEURAL SURFACES ARE NORMAL. THERE ARE NO FINDINGS OF PNEUMONIA. " dcd03142-730b5754-b30263e0-844fbd77-08863af0.jpg,validate/p15/p15211528/s58527630/dcd03142-730b5754-b30263e0-844fbd77-08863af0.jpg,validation," 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. " d907629c-237104d2-1035c8c0-b695190c-e0cfe230.jpg,validate/p14/p14884535/s53944426/d907629c-237104d2-1035c8c0-b695190c-e0cfe230.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with decompensated. concern for pna on OSH imaging // ?pna ?pna IMPRESSION: Compared to chest radiographs since ___, most recently ___. Small left pleural effusion was seen on chest CT ___ ___ is nonhemorrhagic. Left lower lobe atelectasis is substantial, unchanged. Right lung clear. Heart size normal. No mediastinal widening. No pneumothorax. RECOMMENDATION(S): Chest CT with contrast agent if the patient can tolerate it. NOTIFICATION: The findings were discussed with ___ , M.D. by ___ ___, M.D. on the telephone on ___ at 3:42 PM, 1 minutes after discovery of the findings. " 3c0943ea-7c2c966c-53218c51-d4081358-758c6df4.jpg,validate/p19/p19231238/s51228133/3c0943ea-7c2c966c-53218c51-d4081358-758c6df4.jpg,validation," FINAL REPORT Study of ___ EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, SOB // Eval for pneumonia Eval for pneumonia IMPRESSION: In comparison with the there is still substantial enlargement of the cardiac silhouette, though the pulmonary vascularity has improved and there is only mild elevation of pulmonary venous pressure. Obliquity of the patient makes it somewhat difficult to compare the appearance of the heart and lungs, though no definite pneumonia is appreciated. " 72b90ce9-9d3b6ecb-e7229763-de8b433d-41c65e51.jpg,validate/p16/p16170655/s54212122/72b90ce9-9d3b6ecb-e7229763-de8b433d-41c65e51.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Fever, low oxygen saturation, question pneumonia. FINDINGS: Portable supine chest radiograph obtained. The heart is markedly enlarged. There is no definite sign of pneumonia or overt CHF. No large pleural effusion or pneumothorax is seen. The mediastinal contour is stable with atherosclerotic calcification along the aortic knob. Bony structures are intact. IMPRESSION: Cardiomegaly, unchanged, no definite sign of pneumonia or overt CHF. " 33f6f8a7-73cfaa9b-ef1929f4-b16033b8-d536a321.jpg,validate/p12/p12610375/s57271128/33f6f8a7-73cfaa9b-ef1929f4-b16033b8-d536a321.jpg,validation," 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. " 1efdce72-46a5e45f-c3f97b6c-5d19fe17-3e07aa03.jpg,validate/p10/p10297774/s53133434/1efdce72-46a5e45f-c3f97b6c-5d19fe17-3e07aa03.jpg,validation," WET READ: ___ ___ ___ 8:47 AM The intra-aortic balloon pump is in similar position to prior radiographs. The other support lines and devices are in unchanged position. The heart continues to be enlarged with pulmonary edema. WET READ VERSION #1 ___ ___ ___ 5:54 PM The intra-aortic balloon pump is in similar position to prior radiographs. The other support lines and devices are in unchanged position. The heart continues to be enlarged with pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiogenic shock, IABP in place // eval IABP positioning COMPARISON: ___, 07:24 IMPRESSION: As compared to the previous radiograph, there is no change in position of the intra-aortic balloon pump. The tip continues to project approximately 8 cm be low the upper most portion of the aortic arch. Unchanged monitoring and support devices. Unchanged moderate cardiomegaly and mild fluid overload. No pleural effusions. No pneumonia. " 8a34af8b-8529c82a-e7aa4a30-53cf5447-3b6b99c0.jpg,validate/p11/p11144826/s54972147/8a34af8b-8529c82a-e7aa4a30-53cf5447-3b6b99c0.jpg,validation," FINAL REPORT INDICATION: Cough and rhonchi for two weeks. 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. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia. Results were discussed with Dr. ___ at 10:20 AM on ___ via telephone by Dr. ___ at the time the findings were discovered. " 500b14ef-23bd2fbc-dff4d81c-4161e776-57ca2e01.jpg,validate/p11/p11276027/s56707846/500b14ef-23bd2fbc-dff4d81c-4161e776-57ca2e01.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. Question cardiomegaly. 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: 1. No cardiomegaly. 2. No acute cardiopulmonary process. " 5278ae6f-b6b357d8-7da0b765-1391bc40-2502a322.jpg,validate/p17/p17595498/s54405753/5278ae6f-b6b357d8-7da0b765-1391bc40-2502a322.jpg,validation," FINAL REPORT HISTORY: Increasing pain in the back and pain in the chest due to metastatic non-small cell lung cancer. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Reference chest CT from___ ___. FINDINGS: The heart size is normal. Mediastinal contour is unremarkable, although mediastinal lymphadenopathy was noted on the prior CT. Right hilar enlargement is compatible with known lymphadenopathy. 3.5 cm right upper lobe mass and 1.4 cm ill-defined nodule within the medial aspect of the superior segment of the left lower lobe are compatible with known sites of malignancy. Lungs are hyperinflated with flattening of the diaphragms and evidence of emphysematous changes. No focal consolidation, pleural effusion or pneumothorax is seen. There is diffuse demineralization of the osseous structures which limits detailed assessment. Known osseous metastatic lesions involving the thoracic spine, predominantly within the upper thoracic spine as well as within the ribs bilaterally are better seen on the recent CT. IMPRESSION: Right upper lobe 3.5 cm mass and 1.4 cm ill-defined nodule in the left lower lobe compatible with known malignancy. Unchanged right hilar adenopathy, and mediastinal lymphadenopathy is better seen on the prior CT. Diffuse osseous metastatic lesions are better seen on the prior CT and diffuse osteopenia limits assessment of the osseous structures. If there is continued concern for a fracture, then CT is suggested. " f1c0b58a-d5a9c646-c8463e7d-fdcf7f59-c52a476d.jpg,validate/p18/p18364681/s50516186/f1c0b58a-d5a9c646-c8463e7d-fdcf7f59-c52a476d.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 8:51 INDICATION: ___-year-old with pericardial effusion, afebrile, now with new fever, question pneumonia. Comparison is made to the patient's prior study of ___. Portable AP upright chest film ___ at 8:51 is submitted. IMPRESSION: 1. The heart remains enlarged, consistent with known pericardial effusion. There has been interval appearance of layering bilateral effusions with associated airspace opacity which most likely reflects combination of pulmonary edema and compressive atelectasis. No pneumothorax. Overall mediastinal contours are likely stable given differences in positioning between the studies. No acute bony abnormality. " e1820453-6a832def-b0f0d15e-9429cca1-15ff6379.jpg,validate/p11/p11105059/s58554023/e1820453-6a832def-b0f0d15e-9429cca1-15ff6379.jpg,validation," FINAL REPORT HISTORY: ___-year-old man ___ postoperative day after left total knee. Febrile and desaturating. Assess for pleural effusion consolidation or atelectasis. COMPARISON: None. FINDINGS: right lung is well expanded and clear. Mild atelectasis is present at the left base. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. Impression minimal . IMPRESSION: Mild left basilar atelectasis. Otherwise normal chest radiograph. No evidence of pneumonia. " 309167c6-15faab24-ae748a5d-7be6ae35-38276e75.jpg,validate/p16/p16413192/s50689898/309167c6-15faab24-ae748a5d-7be6ae35-38276e75.jpg,validation," 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. . " 72d3bad5-d066146f-709a9cf6-67b7f5ce-c2c2b7a3.jpg,validate/p16/p16635089/s59351973/72d3bad5-d066146f-709a9cf6-67b7f5ce-c2c2b7a3.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with unresponsive episode. Please assess for cardiopulmonary process. TECHNIQUE: Supine AP frontal chest radiograph was obtained. COMPARISON: Chest radiograph from ___. FINDINGS: There is a right central venous catheter which terminates in the right atrium. There has been interval removal of the left internal jugular central venous catheter. There continues to be mild pulmonary edema, and there are small bilateral pleural effusions. No focal consolidation or pneumothorax is seen. The cardiac silhouette is stable in size and mildly enlarged. IMPRESSION: Mild pulmonary edema and small bilateral effusions. " c514d966-4433513a-50cf30c4-210de405-8fd78b5d.jpg,validate/p17/p17429491/s50378072/c514d966-4433513a-50cf30c4-210de405-8fd78b5d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hypoxia // eval for ptx, worsening effusion TECHNIQUE: Portable AP view of the chest COMPARISON: ___ at 10:11 FINDINGS: The endotracheal tube and enteric tube remain in standard positions. There is persistent opacification of the left hemithorax with leftward shift of the mediastinal structures. There is minimal improved aeration within the left lung base, but continued marked atelectasis of the left lung with at least a small left pleural effusion. Fiducial marker indicating the site of an endobronchial lesion in the left mainstem bronchus is re- demonstrated. Right lung remains clear. No pneumothorax is identified. IMPRESSION: Slight interval improvement in aeration of the left lung base, but overall there is continued marked left lung atelectasis with at least a small left pleural effusion and persistent leftward shift of the mediastinal structures. " c13b0ec0-24cdc47c-de954ad8-d68fe25a-f93f1a4b.jpg,validate/p11/p11382726/s57791356/c13b0ec0-24cdc47c-de954ad8-d68fe25a-f93f1a4b.jpg,validation," FINAL REPORT INDICATION: History of increasing seizure activity. COMPARISON: None. FINDINGS: Portable frontal chest radiograph demonstrates no focal consolidation, pleural effusion, or pneumothorax. The heart size is top normal. The cardiac, hilar, and mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 2e4f432a-b6b50137-e95b7aa9-11a6e20f-33257ff7.jpg,validate/p18/p18699523/s52374025/2e4f432a-b6b50137-e95b7aa9-11a6e20f-33257ff7.jpg,validation," WET READ: ___ ___ ___ 10:04 PM Patchy right middle lobe opacity, raising concern for pneumonia. Recommend followup to resolution. Right-sided PICC again extends deep into the right atrium; if the desire position of the tip is at or just above the cavoatrial junction, the catheter could be pulled back by approximately 5.5-6 cm. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with PMH chronic pancreatitis presenting with subjective fever and productive cough and abdominal pain // pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided PICC again extends well into the right atrium. If the desired position of the tip is at or just above the cavoatrial junction, the catheter could be pulled back by approximately 5.5-6 cm. Patchy right middle lobe opacity is seen, new since the prior study, worrisome for pneumonia. Left lung is clear. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Patchy right middle lobe opacity, raising concern for pneumonia. Recommend followup to resolution. Right-sided PICC again extends deep into the right atrium; if the desire position of the tip is at or just above the cavoatrial junction, the catheter could be pulled back by approximately 5.5-6 cm. " 94a3e79c-a81ae4f2-6a6f8363-a5a04374-847a0911.jpg,validate/p16/p16455067/s51504069/94a3e79c-a81ae4f2-6a6f8363-a5a04374-847a0911.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with COPD and increased sputum output. Suspect left lower lobe pneumonia. IMPRESSION: PA and lateral chest compared to ___: Peribronchial opacification at both lung bases, best appreciated on the lateral view is new since ___, consistent with pneumonia. Followup advised for a posterior nodular component projecting over the lower thoracic spine. Lateral view also shows heavy calcification of the mitral annulus possibly extending into the mitral valve, warranting clinical evaluation for possible calcific aortic stenosis, even though heart size is normal and the pulmonary vasculature is not engorged. Hyperinflation and deficient vasculature in the upper lungs is an indication of emphysema. Findings were discussed by telephone with Dr. ___ at 4:25 p.m., 1 minute following recognition of the findings. " 749d7548-73506c3c-c2d571b0-609dd2f9-746e60a7.jpg,validate/p10/p10104308/s52433992/749d7548-73506c3c-c2d571b0-609dd2f9-746e60a7.jpg,validation," FINAL REPORT INDICATION: Patient with hyperglycemia. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes. Linear opacity involving the left lung base likely represents atelectasis. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. No pneumothorax is seen. Partially imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 26a540bc-6225b069-9beeeaeb-62ef6a4f-e8e962a1.jpg,validate/p11/p11849423/s59838903/26a540bc-6225b069-9beeeaeb-62ef6a4f-e8e962a1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with COPD, history of pulmonary embolism x2 presents with acute shortness of breath and chest pain this morning. Well's of 6 TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CT ___ FINDINGS: Lung volumes are slightly low. Heart size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Streaky opacities in both lung bases likely reflect areas of atelectasis. Linear scarring is noted within the right mid lung field compatible with prior wedge resections within the right upper and lower lobes. There is no focal consolidation, pleural effusion or pneumothorax. No acute osseous abnormalities demonstrated. IMPRESSION: Slightly low lung volumes with mild bibasilar atelectasis. " 908fdeac-a21b14b2-bc83a5cc-723d9d2e-abe63216.jpg,validate/p15/p15554865/s51056433/908fdeac-a21b14b2-bc83a5cc-723d9d2e-abe63216.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with COPD and asthma and lung cancer who presents with cough. Evaluate for infection. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___, ___ and CT from ___. FINDINGS: There is a right Port-A-Cath with its lead terminating at the cavoatrial junction. IMPRESSION: The cardiac silhouette is enlarged. There is a possible right pleural effusion. The lungs are clear of focal consolidation or pneumothorax. There is no pulmonary edema. RECOMMENDATION(S): Cardiomegaly and possible right pleural effusion. " 48b1b44b-64b861bb-a11666c5-cbf508ba-36b53960.jpg,validate/p13/p13030232/s52810743/48b1b44b-64b861bb-a11666c5-cbf508ba-36b53960.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p pacemaker placement // any evidence of acute bleed? ANY EVIDENCE OF ACUTE BLEED COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Left trans subclavian right atrial ventricular pacer leads in standard placements continuous from the left pectoral generator. New opacity in the soft tissues of the left chest wall could be due to hemorrhage. There is no mediastinal widening or pleural effusion. No pneumothorax. Lungs are clear and the heart is normal size. NOTIFICATION: Dr. ___ reported the findings to ___ by telephone ___ ___ at 11:14 AM, 5 minutes after discovery of the findings. " 2fd6448f-7b81b7db-fe912444-8e975bea-36e74b12.jpg,validate/p10/p10303503/s52338296/2fd6448f-7b81b7db-fe912444-8e975bea-36e74b12.jpg,validation," 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. " e01369f7-3be5c33f-1825d379-a94f9839-e92264d4.jpg,validate/p10/p10892316/s55793231/e01369f7-3be5c33f-1825d379-a94f9839-e92264d4.jpg,validation," FINAL REPORT INDICATION: Patient with shortness of breath and orthopnea. Assess for edema or effusion. COMPARISONS: Chest radiograph of ___. FINDINGS: Frontal and lateral views of the chest demonstrate confluent left lung base opacity obscuring left hemidiaphragm and left cardiac border. Small bilateral pleural effusions. There is no pulmonary edema. Hilar and mediastinal silhouettes are unchanged. Aorta remains tortuous with intra-aortic stent placement. Heart size difficult to assess due to adjacent opacities. There is no pneumothorax. Partially imaged upper abdomen is unremarkable. IMPRESSION: Left lung base opacity is new since ___ exam, and may represent atelectasis, effusion or infection in the appropriate clinical setting. " 7cdd0c6e-d0263417-262f1fce-bd3d2712-99409e00.jpg,validate/p19/p19991135/s51777681/7cdd0c6e-d0263417-262f1fce-bd3d2712-99409e00.jpg,validation," FINAL REPORT INDICATION: Pain, redness, and slight swelling at right chest surgical site for the past two days. Patient has undergone a prior right VATS, converted to a thoracotomy with right upper lobectomy for a pulmonary nodule which was thought to be malignant but pathology revealed only a granulomatous inflammatory process. Evaluate for acute process. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs of the chest were acquired. There is volume loss on the right with associated elevation of the right hemidiaphragm, consistent with the provided history of prior right upper lobectomy. Pleural densities along the right upper lateral chest wall are not significantly changed. Similarly, opacity at the right apex along the superior mediastinum is not significantly changed, possibly loculated fluid in the pleural space. There is no focal consolidation concerning for pneumonia. There is no left pleural effusion. No definite pneumothorax is seen. There is evidence of prior right thoracotomy, involving the right posterior sixth rib. Cervical fusion hardware is incompletely assessed. IMPRESSION: 1. No significant interval change. 2. Post-surgical changes on the right, as described above. " a7a748f6-dc129067-37236089-0cb868d3-dddc59bf.jpg,validate/p14/p14482644/s58269464/a7a748f6-dc129067-37236089-0cb868d3-dddc59bf.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with hypoxia possible pneumonia. Evaluate for acute process. TECHNIQUE: AP and lateral chest radiographs were provided. COMPARISON: Multiple prior studies most recently from ___. FINDINGS: Opacities projecting over the lower lobes on the lateral are concerning for infection. There is atelectasis at the right lung base with persistent elevation of the right hemidiaphragm. There is no pneumothorax. The cardiomediastinal silhouette is unchanged with unfolding of the thoracic aorta. Median sternotomy wires are intact. IMPRESSION: Opacities projecting over the lower lobes on lateral film are concerning for infection. " 2003ed42-d3448556-bc197114-45231666-ac359be3.jpg,validate/p10/p10062617/s52207698/2003ed42-d3448556-bc197114-45231666-ac359be3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with dCHF s/p SIRS, off abx // ? infiltrate COMPARISON: Chest radiographs since ___ most recently ___ IMPRESSION: Severe cardiomegaly is chronic, unchanged since ___, but improved since ___. Lungs are clear of pneumonia or pulmonary edema is the the the small right pleural effusion in is new or newly apparent. Transvenous right atrial and ventricular pacer leads are unchanged in standard placements. There is no pneumothorax. " fac51c9e-00c9e7c9-50c327fa-6b1085b5-3bfd46bd.jpg,validate/p18/p18458646/s58730105/fac51c9e-00c9e7c9-50c327fa-6b1085b5-3bfd46bd.jpg,validation," FINAL REPORT INDICATION: ___ year old man with possible effusion on AP film, needs PA/lateral for further evaluation // eval for effusion COMPARISON: Radiograph from ___ and chest CT from ___. IMPRESSION: Cardiomediastinal silhouette is within normal limits. There is a moderate right-sided pleural effusion which appears partially loculated. There are no pneumothoraces. There is a granuloma in the right upper lung which is better assessed on the CT scan from ___. No focal consolidation or pulmonary edema is seen. " 6629539f-36cf6fa0-fee7fa43-3f54a2f4-a28a8b49.jpg,validate/p16/p16514153/s54939793/6629539f-36cf6fa0-fee7fa43-3f54a2f4-a28a8b49.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___F with increasing dyspnea on exertion // eval for infiltrate and edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs: ___. CTA chest: ___ FINDINGS: The lungs are well-expanded and clear. There is no hilar or pleural abnormality. The cardiomediastinal silhouette is stable. Median sternotomy wires, aortic core valve, and prosthetic mitral valve are unchanged. No acute osseous abnormalities are detected. Minimal anterior height loss of multiple thoracic vertebra is unchanged. IMPRESSION: No acute intrathoracic process. " c952e009-79983faf-4d78d79c-5f83ce3b-37df813b.jpg,validate/p10/p10379879/s54295571/c952e009-79983faf-4d78d79c-5f83ce3b-37df813b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with history of an arrest like episode 3 weeks ago, history of deep venous thrombosis, chronic kidney disease, COPD, interstitial fibrosis // Please evaluate for acute process, please evaluate for DVT TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___, chest radiograph ___ FINDINGS: Lung volumes remain low with chronic interstitial opacities again noted along the periphery and lung bases with associated honeycombing and fibrosis. Patchy retrocardiac opacity likely reflects atelectasis, however it is hard to exclude slight worsening of interstitial lung disease compared to the previous radiograph. Cardiac and mediastinal contours are similar with the heart size appearing mildly enlarged. Pulmonary vasculature is not engorged. No pleural effusion or pneumothorax is clearly demonstrated. No acute osseous abnormalities seen. IMPRESSION: Chronic interstitial lung disease most likely reflective of usual interstitial pneumonia, better characterized on prior chest CT. Patchy retrocardiac opacity likely reflects atelectasis though it is difficult to exclude slight interval worsening of chronic interstitial lung abnormality. " 2d01483a-8149ea58-a0c8d088-0d5524a8-22eabb06.jpg,validate/p15/p15571899/s52776820/2d01483a-8149ea58-a0c8d088-0d5524a8-22eabb06.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CT removal // eval for ptx eval for ptx IMPRESSION: Compared to prior chest radiographs since ___ most recently ___, 12:34. No pneumothorax and minimal if any pleural effusion have developed in the left chest following removal of the pleural drainage catheter. Moderate left lower lobe atelectasis has worsened. Atelectasis at the right base is mild and unchanged. Postoperative enlargement of the cardiac silhouette is mild and unchanged. Right jugular line ends low in the SVC. " 56152f95-a92c30d5-116b8b27-1a9eff13-8969f4a4.jpg,validate/p19/p19149321/s52417732/56152f95-a92c30d5-116b8b27-1a9eff13-8969f4a4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p intubation ___ to necrotizing fascitis and respirtory stress // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the pulmonary vascular congestion has essentially cleared. The opacification at the left base, consistent with pleural fluid and atelectasis, has decreased, though some of this may be due to a more erect position of the patient. Monitoring and support devices are essentially unchanged. " 31008c18-41701fd9-6b9722ad-165a45e4-1a10cabf.jpg,validate/p10/p10086560/s53962945/31008c18-41701fd9-6b9722ad-165a45e4-1a10cabf.jpg,validation," 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. " a3f6f0b1-cb45d9fe-558112ed-a72354e4-47270b6f.jpg,validate/p17/p17750747/s54384783/a3f6f0b1-cb45d9fe-558112ed-a72354e4-47270b6f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___: COMPARISON: None. CLINICAL HISTORY: ___-year-old man with recent diagnosis of esophageal candidiasis, with neck pain and productive cough, assess for pneumonia or pneumomediastinum. FINDINGS: PA and lateral views of the chest were obtained. There is an elevated right hemidiaphragm. Lungs appear clear. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable with no signs of pneumomediastinum. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Elevated right hemidiaphragm. Otherwise, normal. " 67b31a27-272de88d-55fb132b-fbfb6d36-8244426b.jpg,validate/p17/p17451713/s54659172/67b31a27-272de88d-55fb132b-fbfb6d36-8244426b.jpg,validation," WET READ: ___ ___ 6:23 PM Hyperinflated, clear lungs. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with weakness // ? pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are hyperinflated but clear. There is no evidence of pneumonia. Heart size and mediastinal contours are stable. There is no evidence of pleural effusion or pneumothorax. Biapical scarring is stable. Clips project over the right lower chest wall/breast. Dextro convex scoliosis of the thoracic spine is unchanged. Bones are diffusely demineralized. There is also suggestion of height loss of mid upper thoracic vertebral bodies, not particularly well assessed IMPRESSION: Hyperinflated, clear lungs. " 71c72aae-7e9f8293-f3312680-8eb20dbc-53044cd4.jpg,validate/p12/p12297145/s57429357/71c72aae-7e9f8293-f3312680-8eb20dbc-53044cd4.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough, fever, left chest pain, HIV positive. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are increased interstitial markings bilaterally with a more confluent opacity projecting over the right lower lung. Findings are somewhat similar to prior, though it is unclear whether findings resolved in theinterval and reoccurred or have been present throughout. Findings are nonspecific and could be due to infection with mild pulmonary edema, but an atypical infection is also in the differential. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Increased interstitial markings bilaterally with more confluent area in the right lung base. Findings are similar to prior; however, it is unclear whether findings may represent chronic pulmonary edema, pneumonia with superimposed pulmonary edema or atypical infection. " 721c1d2b-1acc34fa-c5419d06-d8a994e6-0477178e.jpg,validate/p17/p17427285/s53745183/721c1d2b-1acc34fa-c5419d06-d8a994e6-0477178e.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with dyspnea // ?worsening effusions, pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right-sided pleural pigtail catheter in situ. Interval increase in size of the right-sided pleural effusion. Left pleural catheter in situ. Interval increase in size of the left-sided pleural effusion. No pneumothorax. Left-sided prepectoral Port-A-Cath in situ with its position unchanged. IMPRESSION: Interval increase in size of the bilateral pleural effusions. " 1d0e1a45-9f4b5ca0-2175146e-fc74963b-43bc4a8a.jpg,validate/p12/p12371390/s55678347/1d0e1a45-9f4b5ca0-2175146e-fc74963b-43bc4a8a.jpg,validation," WET READ: ___ ___ ___ 11:06 AM 1. Small right apical pneumothorax. 2. Moderate right pleural effusion. Right basilar opacity may reflect a combination of known tumor and atelectasis. Infection is not excluded. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with weakness TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Reference chest CTA ___, chest radiograph ___, PET-CT ___ FINDINGS: Small right apical pneumothorax is present. Cardiac and mediastinal contours are unchanged. Heart size is difficult to assess given the presence of a moderate size right pleural effusion. Right basilar opacity may reflect a combination of known tumor and atelectasis. No pulmonary vascular engorgement is demonstrated. Left lung is grossly clear. Emphysematous changes are again demonstrated within the upper lobes. No acute osseous abnormalities identified. Spiral tacks from prior hernia repair are seen within the left upper quadrant of the abdomen. IMPRESSION: 1. Small right apical pneumothorax. 2. Moderate right pleural effusion. Right basilar opacity may reflect a combination of known tumor and atelectasis. Infection is not excluded. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:44 PM. " 2577b081-c65a3a97-870ec2a8-96658cc1-4aa4b2a6.jpg,validate/p17/p17693753/s50849255/2577b081-c65a3a97-870ec2a8-96658cc1-4aa4b2a6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Recent pelvic abscess drainage, now sepsis. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Relatively extensive bilateral basal opacities, with the morphology suggesting moderate pulmonary edema. This is supported by bilateral perihilar haze, peribronchial cuffing and a questionable small right pleural effusion. Mild cardiomegaly. No pneumothorax. " 55ae0f28-34bc1495-0573eb95-5a2ba696-c75dd7e3.jpg,validate/p12/p12176298/s52090382/55ae0f28-34bc1495-0573eb95-5a2ba696-c75dd7e3.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: ___ radiograph. FINDINGS: Tracheostomy tube remains in standard position. Lung volumes are lower compared to the recent study, with resultant accentuation of cardiomediastinal contours and bronchovascular structures. With this limitation in mind, there has been no relevant short-interval change in the appearance of the chest since the recent study. " a6079069-2470aeae-a9b931ff-b7fe1387-2a1331bf.jpg,validate/p15/p15184004/s58811044/a6079069-2470aeae-a9b931ff-b7fe1387-2a1331bf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea // ? acute cardipulm process ? acute cardipulm process IMPRESSION: Comparison to ___. Other pre-existing interstitial markings, likely caused by mild to moderate interstitial lung edema, have decreased in severity but are still clearly visible. Subtle scars at the Re left and right lung bases. Are stable. Better seen than on the previous radiograph is a nodular structure projecting over the seventh right rib. , with a diameter of approximately 5 mm. The structure could be consistent with a known parenchymal consolidation and calcification in the right upper lobe, documented on the CT examination from ___. Moderate cardiomegaly persists. " 66a9e504-95e7a7d3-d14e1e2e-27373ab1-b7d53435.jpg,validate/p14/p14404312/s52281212/66a9e504-95e7a7d3-d14e1e2e-27373ab1-b7d53435.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p AAA repair // eval mediastinum eval mediastinum COMPARISON: ___ IMPRESSION: Reduced third is in unchanged position. Bibasal areas of atelectasis are present. Mediastinal position appears to be stable. Mediastinal please has substantially decreased in size currently with no concerns for widening. No pneumothorax or increase in pleural effusion demonstrated. " e1c47b59-760a2a14-45d745a6-373f3de8-d8d10b6b.jpg,validate/p13/p13855132/s55562802/e1c47b59-760a2a14-45d745a6-373f3de8-d8d10b6b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man babesiosis and grade III spenic rupture s/p trach is increased WBC. // ?pneumonia vs effusion compare to prior study ?pneumonia vs effusion compare to prior study IMPRESSION: Compared to chest radiographs ___ through ___. There is greater opacification in both lower hemi thoraces compared to ___. Some of this is undoubtedly due to increasing moderate pleural effusions, but there may be concern of concurrent consolidation, particularly in the left lower lobe. Mild pulmonary edema is also present. Heart is top-normal size. No pneumothorax. Tracheostomy tube is slightly off center and and should be examined clinically. Right PIC line ends close to the superior cavoatrial junction. " 73c8c62e-f11c9744-82accd71-2dbce335-5631ef62.jpg,validate/p16/p16545654/s59585501/73c8c62e-f11c9744-82accd71-2dbce335-5631ef62.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever on 104 on ___ and multiple potential sources of infection (including positive c diff) pCXR at the time with right sided opacities. // Please evaluate interval ___ ___ opacities for evidence of resolution of aspiration vs ongoing pneumonia vs other. IMPRESSION: As compared to ___ chest radiograph, recently described new right lung opacities have resolved in the mid lung and nearly resolved in the lower lung region. No new areas of consolidation are identified, and remainder of exam is unchanged except for improving atelectasis at the left base. " e093e5a6-473dac2c-40b17281-ba856173-f1bea6a2.jpg,validate/p12/p12292383/s53708092/e093e5a6-473dac2c-40b17281-ba856173-f1bea6a2.jpg,validation," FINAL REPORT HISTORY: Possible pneumonia. FINDINGS: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal or mildly enlarged, with a three-channel pacer device in place. Blunting of the costophrenic angles likely reflects pleural thickening. No evidence of acute focal pneumonia or vascular congestion. " e4a80672-c961b56f-30545bcc-9bf4435d-12362acc.jpg,validate/p11/p11362852/s51023511/e4a80672-c961b56f-30545bcc-9bf4435d-12362acc.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, question CHF. FINDINGS: PA and lateral views of the chest were provided demonstrating clear well-expanded lungs without 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. There are clips in the right upper quadrant noted. IMPRESSION: No acute intrathoracic process. " b8f6d5f0-04d56b92-45076707-337d1de6-f693c8e1.jpg,validate/p16/p16001269/s53199070/b8f6d5f0-04d56b92-45076707-337d1de6-f693c8e1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with SOB // r/o pulm abn r/o pulm abn IMPRESSION: In comparison with study of ___, there is again mild hyperexpansion of the lungs. Cardiac silhouette remains within normal limits and there is no acute pneumonia, vascular congestion, or pleural effusion. Prominent DISH involves the thoracic spine. " cd4f39cf-ae14b7f3-7c63979a-93c6e8cb-b6c103f0.jpg,validate/p16/p16346361/s52691485/cd4f39cf-ae14b7f3-7c63979a-93c6e8cb-b6c103f0.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with COPD with worsening dyspnea, weight gain on chronic prednisone for RA/?GCA // evaluation for PNA, edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes. The cardiac and mediastinal silhouettes are grossly stable. Right mid lung linear scarring with possible associated bronchiectasis and rightward shift of the upper mediastinum are re- demonstrated. Prominence of the central pulmonary vasculature may be due to mild pulmonary vascular congestion. There is persistent elevation of the right hemidiaphragm. No definite new focal consolidation is seen. IMPRESSION: Low lung volumes with possible mild pulmonary vascular congestion. Re- demonstrated right mid lung scarring, possible bronchiectasis, elevation of the right hemidiaphragm and rightward shift of the upper mediastinum. " f26cf72c-194cfaf2-9c6ef306-69450995-b6ee283d.jpg,validate/p15/p15747693/s52813295/f26cf72c-194cfaf2-9c6ef306-69450995-b6ee283d.jpg,validation," FINAL REPORT EXAMINATION: AP chest x-ray. INDICATION: A ___-year-old man with hypotension, vomiting, and dizziness, evaluate for infiltrate, pneumothorax, or mediastinal air. TECHNIQUE: Single AP upright frontal chest radiograph. COMPARISON: CT abdomen and pelvis with contrast ___. FINDINGS: The cardiomediastinal silhouettes are normal. There is a tortuous and calcified thoracic aorta. The bilateral hila are unremarkable. Patchy opacities at the lung bases likely reflect atelectasis. Additionally, an ill-defined opacity within the left lower lung appears new since ___, and may reflect superimposition of overlying structures. Otherwise, there is no focal lung consolidation. There is no pulmonary vascular congestion. There is biapical pleuroparenchymal scarring. There is no pneumothorax or effusion. IMPRESSION: Ill-defined opacity within the left lower lung, new since ___, possibly reflecting super imposition of overlying structures. Recommend non-urgent upright PA and lateral chest x-ray. " 7e349712-d62df1a6-c28185d7-b3e48400-d1ddac5f.jpg,validate/p15/p15439394/s50748252/7e349712-d62df1a6-c28185d7-b3e48400-d1ddac5f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with flu sob // ___ for interval ___ ___ for interval ___ IMPRESSION: Compared to prior chest radiographs since ___, most recently ___. Lung volumes are lower exaggerating the appearance of worsening moderately severe pulmonary edema. Cardiac decompensation or volume overload is reflected in interval widening of mediastinal veins and progression of moderate cardiomegaly. Pleural effusions are presumed, could be moderate on the right. No pneumothorax. " 1cd35517-01541257-3c990c2e-28dbb219-c4b8f1a9.jpg,validate/p11/p11463988/s58760020/1cd35517-01541257-3c990c2e-28dbb219-c4b8f1a9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with copd smoker recent treatment for bronchitis post four weeks with continued cough and worsening fatigue // pls eval for status of infectious process pls eval for status of infectious process COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Patient has history of left lower lobectomy. Postoperative appearance of the left hemithorax is somewhat unusual for that surgery, but is entirely unchanged at least since ___. There are no findings to suggest current pneumonia, new atelectasis, or cardiac decompensation. Heart size is top-normal. There is no pleural effusion. " b47ce911-168d7383-ab6a6a06-64f9b3ba-22995569.jpg,validate/p10/p10404367/s53918628/b47ce911-168d7383-ab6a6a06-64f9b3ba-22995569.jpg,validation," 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. " 47b9e598-a989d30f-97acde9f-413d00d4-744e2302.jpg,validate/p10/p10055361/s58672477/47b9e598-a989d30f-97acde9f-413d00d4-744e2302.jpg,validation," WET READ: ___ ___ ___ 12:47 AM PA catheter tip is likely in the right lower lobe pulmonary artery and can be pulled back by 2-3 cm for more central placement. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: CHF, new pulmonary artery catheter, assess Swan placement. CHEST, SINGLE AP PORTABLE VIEW. There is cardiomegaly. A pacemaker is present with the lead overlying the right ventricle. An apparent Swan-Ganz catheter is present, with tip overlying the distal right pulmonary artery. There is upper zone re-distribution, with mild vascular plethora, but no overt CHF. No focal infiltrate is detected. Possible trace fluid at the left costophrenic angle. S-G catheter tip overlies distal right pulmonary artery -- clinical correlation requested regarding possible retraction. " 47f67214-fd100a4e-25cad8ec-9cabbc9e-8ad27a95.jpg,validate/p10/p10900387/s55841214/47f67214-fd100a4e-25cad8ec-9cabbc9e-8ad27a95.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PEA arrest and concern for PNA // evaluate for interval change COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the monitoring and support devices are in constant position. The pre-existing opacities, notably at the lung base have substantially increased in extent and severity, there are also more focal and more dense than on the previous image. Pneumonia is the primary differential diagnosis. Moderate cardiomegaly and mild pulmonary edema, however, persist. A in atelectasis in the retrocardiac lung regions is slightly worsened. No pleural effusions. NOTIFICATION: At the time of dictation and observation, 11:11, on the ___, the referring physician ___. ___ was paged for NOTIFICATION. " 2d228406-07f4ad83-167e7943-732dc465-0126c4e4.jpg,validate/p18/p18160222/s50100618/2d228406-07f4ad83-167e7943-732dc465-0126c4e4.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Altered mental status and diffuse abdominal pain. TECHNIQUE: Chest, AP upright and lateral views. COMPARISON: ___. FINDINGS: The heart is mild to moderately enlarged. Very small bladder bilateral pleural effusions are suspected. There is a moderate interstitial abnormality with indistinct pulmonary vessels and thickening of the fissures which is most consistent with pulmonary edema. IMPRESSION: Findings consistent with moderate interstitial pulmonary edema. " 3eee2a24-bb0c1641-fe686dea-94ce11a7-e84a332e.jpg,validate/p16/p16873994/s50158298/3eee2a24-bb0c1641-fe686dea-94ce11a7-e84a332e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with crohns quantiferon gold inderminate rule out pulm tb // rule out tb TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. " 8d2f60fa-5ac3688a-0bfe883e-c4748611-f7c7e937.jpg,validate/p16/p16449190/s51128207/8d2f60fa-5ac3688a-0bfe883e-c4748611-f7c7e937.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyema s/p VATS now with single chest tube. // Status of Empyema s/p VATSPLEASE PERFORM AT ___ ___ thank you. Status of Empyema s/p VATSPLEASE PERFORM AT ___ ___ thank you. IMPRESSION: Comparison 2 ___, 00:09. The right chest tube is in stable position. The lateral and basal parenchymal and pleural opacities are stable. No change in appearance of the left lung and of the left heart border. " 65cc2d22-b5fde1dc-e370d619-53e20c76-67d1aa3f.jpg,validate/p16/p16773335/s56456741/65cc2d22-b5fde1dc-e370d619-53e20c76-67d1aa3f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pneumonia // eval pneumonia eval pneumonia COMPARISON: Chest radiographs since ___ through ___. IMPRESSION: Because mild pulmonary edema is improving, perhaps the multifocal consolidation which is also improving is asymmetric edema. Alternatively both edema and pneumonia are resolving independently. Moderate left pleural effusion however is larger. This moderate to severe cardiomegaly is chronic. Right PIC line ends in the mid SVC. No pneumothorax " 25a16e15-436d251f-1fc47019-752d41bb-b0aa734e.jpg,validate/p19/p19761472/s51984806/25a16e15-436d251f-1fc47019-752d41bb-b0aa734e.jpg,validation," 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. Mild degenerative changes are noted in the imaged thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " a27160d2-0951e4cd-2fe6af7a-3e165949-09e6da34.jpg,validate/p17/p17598516/s57199109/a27160d2-0951e4cd-2fe6af7a-3e165949-09e6da34.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Fever, status post cholecystectomy, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. Lungs are clear bilaterally. There is no sign of pneumonia or CHF. Cardiomediastinal silhouette is normal. Bony structures are intact. Clips in the right upper quadrant noted. There is no free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 726c7e68-28052351-4e51ec76-7a17678b-35b1fa36.jpg,validate/p18/p18935604/s57821135/726c7e68-28052351-4e51ec76-7a17678b-35b1fa36.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman s/p tracheoplasty // ? PTX TECHNIQUE: Portable chest radiograph COMPARISON: Prior chest radiograph from ___, ___, ___. FINDINGS: The patient is status post tracheoplasty. Lung volumes are low. Moderate bibasilar atelectasis and small bilateral pleural effusions, left greater than right, are new since ___, likely postsurgical. Widening of the mediastinum is expected in the postoperative period. The heart size is likely normal. There is a new pleural drain in the right lung. IMPRESSION: 1. Patient is status post tracheoplasty. No pneumothorax. 2. Moderate bibasilar atelectasis and small bilateral pleural effusions, left greater than right, are new since ___, probably postsurgical. " b0ce7fb3-a235c0d7-42ae345e-6763e8fd-87701ac9.jpg,validate/p10/p10933807/s52121545/b0ce7fb3-a235c0d7-42ae345e-6763e8fd-87701ac9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with repositioning of NGT, previously coiled in stomach. also has post-pyloric dobhoff // NGT position NGT position IMPRESSION: Compared to a chest radiographs ___ through ___. Esophageal drainage tube ends in the upper stomach. Feeding tube ends in the third portion of the duodenum. " 31514b8f-fbca8607-fb88cbc9-f384cb04-7aaa96e5.jpg,validate/p17/p17015391/s52622416/31514b8f-fbca8607-fb88cbc9-f384cb04-7aaa96e5.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with generalized weakness and increasing WBC. Rule out pneumonia. COMPARISONS: PA and lateral chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: A left pectoral neural stimulating device sends a lead to the left neck. The cardiac, mediastinal and hilar contours are normal. On the frontal view, both lungs are clear, and there is no pleural effusion, or pneumothorax. On the lateral view a triangular radiodensity overlying a upper thoracic vertebral body could be the superimposition of overlying bone structures, but because it could also be a lung nodule or small region of consolidation, we recommend oblique radiographs for further evaluation. Findings were discussed with Dr. ___ at 9:12 am on ___ via telephone. " 8a63ca1f-097fa8ba-90b832ce-26160435-caf1937d.jpg,validate/p15/p15782217/s56176431/8a63ca1f-097fa8ba-90b832ce-26160435-caf1937d.jpg,validation," 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. " f68a26b8-dbd1a3f3-afe2e445-e035a81e-5163286d.jpg,validate/p16/p16497039/s52422541/f68a26b8-dbd1a3f3-afe2e445-e035a81e-5163286d.jpg,validation," 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. " 48bc3709-43325f8a-9b5424e1-03471a40-0b94b4fb.jpg,validate/p11/p11057136/s58902575/48bc3709-43325f8a-9b5424e1-03471a40-0b94b4fb.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ year old man with PTX // eval PTX TECHNIQUE: Single upright radiograph of the chest is obtained. COMPARISON: ___ and ___. FINDINGS: The lower right pleural drainage catheter has been pulled back approximately 1 cm since the prior radiograph, side hole port might now be in the inter costal plane. The upper pigtail pleural drainage catheter is unchanged in position. The patient is slightly rotated to the right, accounting for apparent rightward mediastinal shift compared to the prior study. Persistent tiny right apical pneumothorax is unchanged, with no evidence of tension. Bilateral basal opacities are stable. Extensive subcutaneous emphysema in the chest wall and bilateral neck soft tissues is similar. Postsurgical changes are stable, as is heart size. IMPRESSION: Interval retraction of lower right pleural drainage catheter by approximately 1 cm, as described above. Unchanged tiny right apical pneumothorax with no evidence of tension. NOTIFICATION: The findings were discussed via telephone by Dr. ___ with Dr. ___ ___ resident) on ___ at 10:29 AM, 3 minutes after discovery of the findings. " d3bc4c2e-a638884d-a9145d33-c9dc058c-f82178ad.jpg,validate/p10/p10425278/s58170908/d3bc4c2e-a638884d-a9145d33-c9dc058c-f82178ad.jpg,validation," FINAL REPORT HISTORY: VATS lobectomy, right lower lobe. In comparison with study of ___, there is reexpansion of the lower portion of the right lung. There are some post-surgical changes on this side, but no evidence of acute abnormality. Apical pleural thickening is seen on the left, but otherwise, the lung is clear. " 973d8700-4120b7b6-d9b4de64-42d4af18-999c914d.jpg,validate/p11/p11888614/s51240157/973d8700-4120b7b6-d9b4de64-42d4af18-999c914d.jpg,validation," 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. " a7b35d97-6bb0fe0b-c5b9148c-de3fec35-b43a38ae.jpg,validate/p17/p17947312/s55364708/a7b35d97-6bb0fe0b-c5b9148c-de3fec35-b43a38ae.jpg,validation," FINAL REPORT INDICATION: ___M with bilateral ronchi. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral. COMPARISON: Chest radiograph ___. FINDINGS: Compared to the prior chest radiograph of ___ the previously identified bilateral lower lobe opacities. Effusions are no longer clearly identified. There is no new focal opacity. No pulmonary edema or pneumothorax. The cardiac and mediastinal contours are stable. IMPRESSION: Interval improvement but persistence of bibasilar opacities. " 87e38875-17aa2dbd-62a6b7cd-36180aad-7b591cd9.jpg,validate/p17/p17051420/s51981524/87e38875-17aa2dbd-62a6b7cd-36180aad-7b591cd9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea on exertion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CTA ___, chest CT ___ FINDINGS: Mild to moderate enlargement of the cardiac silhouette is unchanged. The mediastinal and hilar contours are similar. No pulmonary vascular congestion is visualized. Subtle increased interstitial opacities are demonstrated diffusely within the lungs, likely reflective of known chronic interstitial lung disease and chronic airways disease, better assessed on the previous chest CT. Atelectasis is also noted in both lung bases. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: Mild chronic interstitial abnormality better assessed on the previous chest CT from ___. No focal consolidation to suggest pneumonia. Bibasilar atelectasis. " 280f8abe-3688f9bc-4d342ba2-4ec9397a-50ca0c0a.jpg,validate/p13/p13074701/s51283094/280f8abe-3688f9bc-4d342ba2-4ec9397a-50ca0c0a.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with history of subdural with altered mental status. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: AP and lateral upright chest radiograph demonstrates clear lungs bilaterally with no focal consolidation concerning for pneumonia. There is no pleural effusion. Prominence of the left hilum thought to reflect a tortuous descending aorta. The right heart border is obscured on the frontal view, which does not correlate to an abnormality on lateral view. This is thought to reflect atelectasis. Diffuse mild interstitial markings is identified with mild bronchial wall thickening within the lower lungs. No acute osseous abnormality is identified. IMPRESSION: Mild interstitial abnormality with mild bronchial wall inflammation. This may reflect early edema. No focal consolidation convincing for pneumonia is identified. " e2cbe117-2ae3a308-04817b32-c24d1403-aa1efa58.jpg,validate/p17/p17422041/s50808184/e2cbe117-2ae3a308-04817b32-c24d1403-aa1efa58.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: History of influenza-like illness with cough, sore throat, congestion, question pneumonia. COMPARISON: ___. FINDINGS: Overall, there has been no significant interval change. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. Aortic knob calcification is again seen. Slight linear increase in opacity at the right lung base may be due to overlapping structures or chronic changes, similar to prior. " 8632cee9-1aaefdb1-556e88e3-dc99321d-c1a7a60d.jpg,validate/p10/p10706411/s58830770/8632cee9-1aaefdb1-556e88e3-dc99321d-c1a7a60d.jpg,validation," FINAL REPORT INDICATION: Overdose, status post intubation. COMPARISON: Chest radiograph ___. FINDINGS: There has been interval placement of a right internal jugular venous catheter with tip terminating at the cavoatrial junction. ET tube is present with tip 7 cm above the carina. Enteric tube is present with tip coiled in the stomach and side holes past the GE junction. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Consolidations in the right lung and left lower lung are nonspecific but may reflect aspiration. The left upper and mid lung are clear. IMPRESSION: 1. Lines and tubes in standard positions. 2. Diffuse right lung and left lower lung consolidations which are nonspecific but may reflect aspiration. " 10d961ec-24550f53-53e7dfda-bf89d469-81349b85.jpg,validate/p16/p16846280/s53637079/10d961ec-24550f53-53e7dfda-bf89d469-81349b85.jpg,validation," FINAL REPORT INDICATION: ___ year old man with ESRD for prerenal transplant evaluation. 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. " a79f1346-8ff73afc-0efdcfe3-12b0eb4b-c5415c7d.jpg,validate/p10/p10702059/s55347099/a79f1346-8ff73afc-0efdcfe3-12b0eb4b-c5415c7d.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea on exertion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is stable enlargement of the cardiomediastinal silhouette. Prominence of the right hilum is also stable dating back to at least ___. Minimal blunting of the costophrenic angles is stable, again may relate to scarring. No new focal consolidation is seen. There is no evidence of pneumothorax. IMPRESSION: No significant interval change. " 36d4d3a2-a72a3ad0-34d07a9d-a2e24e0d-f69eae09.jpg,validate/p14/p14640461/s56561821/36d4d3a2-a72a3ad0-34d07a9d-a2e24e0d-f69eae09.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post bronchoscopy. COMPARISON: Pre-bronchoscopy chest x-ray from ___. FINDINGS: As compared to the previous radiograph, the large perihilar opacity on the right has decreased. In return, however, there is a new post-interventional opacity at the medial bases of the right lung. There is no evidence of pneumothorax or other complications. Borderline size of the cardiac silhouette. " 4cefce8e-6e98e9d9-9ae4c15a-efcce611-5e88b9e6.jpg,validate/p19/p19646078/s51290959/4cefce8e-6e98e9d9-9ae4c15a-efcce611-5e88b9e6.jpg,validation," 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. " 05ef7553-6199360b-a8ffdd9a-da3292dc-e9e90d65.jpg,validate/p10/p10455192/s56269883/05ef7553-6199360b-a8ffdd9a-da3292dc-e9e90d65.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Tip of endotracheal tube is at the level of the carina, as communicated by phone to Dr. ___ on ___ at 3:15 p.m. at the time of discovery. Nasogastric tube terminates within the stomach. Lung volumes remain low. Persistent pulmonary vascular congestion as well as worsening bibasilar atelectasis and small bilateral pleural effusions. " 463d520b-c6e83e2b-7ff87dac-9007d5a7-3a7e77f7.jpg,validate/p16/p16500918/s53037353/463d520b-c6e83e2b-7ff87dac-9007d5a7-3a7e77f7.jpg,validation," FINAL REPORT INDICATION: ___F with weakness // eval for pna TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: Right chest wall dual lead pacing device is unchanged and prosthetic valve is again noted. Median sternotomy wires are intact. Cardiac enlargement is similar compared to prior given differences in technique. There is no consolidation, effusion, or edema. No acute osseous abnormalities. Surgical clips in the upper abdomen are seen on the lateral view. IMPRESSION: Cardiomegaly without acute cardiopulmonary process. " 8ae18e1f-8e94f781-eecad306-b8a3fd0c-41e3830a.jpg,validate/p11/p11806528/s55312343/8ae18e1f-8e94f781-eecad306-b8a3fd0c-41e3830a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with progressive dyspnea // acute pulm process COMPARISON: Prior exam dated ___. FINDINGS: PA and lateral views of the chest provided. There has been interval development of a large right pleural effusion with associated compressive atelectasis of the right middle and right lower lobes and the lower portion of the right upper lobe. The cause of this effusion is unclear. The left lung is clear. Right heart border cannot be defined in therefore heart size is difficult to assess. No pneumothorax is seen. Bony structures are intact. IMPRESSION: New large right pleural effusion with associated compressive atelectasis in the right middle and lower lobes. Thoracentesis may be considered. " d9aa4ddd-38984c21-06b72032-2335390f-f35f6388.jpg,validate/p15/p15570344/s50297298/d9aa4ddd-38984c21-06b72032-2335390f-f35f6388.jpg,validation," FINAL REPORT CHEST, 2 VIEWS: ___ HISTORY: ___-year-old female with recent hospitalization and confusion. COMPARISON: ___. FINDINGS: AP and lateral views of the chest again demonstrate elevation of the left hemidiaphragm. Relatively low lung volumes are seen with crowding of the bronchovascular markings, noting that mild pulmonary vascular congestion is possible. Possible left effusion seen posteriorly on the lateral view. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Possible mild pulmonary vascular congestion and left effusion. " 559e0312-b8388fae-d0cccb93-a9984974-be4c0a39.jpg,validate/p10/p10580538/s54410734/559e0312-b8388fae-d0cccb93-a9984974-be4c0a39.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with alcohol withdrawal and fever // evaluate for infection evaluate for infection IMPRESSION: There are no prior chest radiographs available for review. Mild bronchial cuffing or (see the anterior segmental bronchus, right upper lobe) more likely due to bronchial inflammation, than edema. Heterogeneous peribronchial opacification left lower lobe could be atelectasis or recent aspiration, should be followed. Remainder the lungs clear. Heart size normal. No appreciable pleural effusion. " 0de907a4-6bb7e508-2236f87c-0e572908-4e961c72.jpg,validate/p15/p15951517/s53431185/0de907a4-6bb7e508-2236f87c-0e572908-4e961c72.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: New ET tube, patient with SDH. ET tube is in standard position, the tip is 5.8 cm above the carina. Right IJ catheter tip is in the mid SVC. There is no pneumothorax. There are low lung volumes. There are minimal bibasilar atelectases, larger on the right side. Cardiac size is top normal. " ad154412-d2cd2613-fae42206-6c93d0c1-0870c427.jpg,validate/p10/p10426859/s53055806/ad154412-d2cd2613-fae42206-6c93d0c1-0870c427.jpg,validation," FINAL REPORT INDICATION: ___F with fever // ?pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear of consolidation, effusion, or vascular congestion. Cardiomediastinal silhouette is within normal limits. Tortuous thoracic aorta is noted with atherosclerotic calcifications at the arch. Mid to lower thoracic dextroscoliosis is again noted. Accentuated kyphosis is seen. IMPRESSION: No acute cardiopulmonary process. " 55958f70-8b9d327b-a13330e0-e7cd4f85-eff6578c.jpg,validate/p14/p14124506/s59378727/55958f70-8b9d327b-a13330e0-e7cd4f85-eff6578c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // eval location of ET tube, interval changes eval location of ET tube, interval changes IMPRESSION: In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 5.5 cm above the carina. Right subclavian catheter extends to the upper right atrium. Nasogastric tube extends well into the dilated stomach, be for coiling upon itself so that the tip lies just beneath the left hemidiaphragm. Diffuse bilateral pulmonary opacification process, though what appears slightly less prominent than on the previous study. " 7213183a-f4c808e8-d92a7bd9-0c865ae7-6c047423.jpg,validate/p10/p10877708/s53978959/7213183a-f4c808e8-d92a7bd9-0c865ae7-6c047423.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with no significant past medical history, migrating to ___, immigration requesting CXR for TB screen // TB screen COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lungs are grossly clear. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. IMPRESSION: Normal chest radiograph. " d1e212cd-f815c711-a14eb4f3-f4f39922-1c521880.jpg,validate/p12/p12881468/s58139258/d1e212cd-f815c711-a14eb4f3-f4f39922-1c521880.jpg,validation," FINAL REPORT HISTORY: Assess right pleural effusion status post thoracentesis. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. There is a persistent large right pleural effusion with slight improvement in aeration of the anterior segment of the right upper lobe. A right perihilar opacity corresponds to the patient's known mass that is better assessed on CT scan from ___. Multiple nodules are present in the left lung, consistent with known metastatic disease. There is no pleural effusion on the left. There is no pneumothorax. Mediastinum is midline. Heart size is difficult to assess due to intraparenchymal abnormalities. IMPRESSION: 1. Small improvement in aeration of the anterior segment of the right upper lobe following thoracentesis. 2. Large area of opacification remain in right lung secondary to persistent effusion and central obstruction. " b773ca60-909af556-717c269d-3cc56f9a-ed1809f5.jpg,validate/p12/p12352839/s55976022/b773ca60-909af556-717c269d-3cc56f9a-ed1809f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with weakness, new heart block TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Heart size remains moderately enlarged. The mediastinal and hilar contours are unchanged with mild atherosclerotic calcifications noted at the aortic knob. There is mild pulmonary vascular congestion without overt pulmonary edema. Streaky opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion or pneumothorax is clearly identified. Multilevel degenerative changes are again seen within the thoracic spine. IMPRESSION: Mild pulmonary vascular congestion and bibasilar atelectasis. " f75664c1-75c907cd-a11c5332-3376c93d-77968aa0.jpg,validate/p13/p13635173/s57683645/f75664c1-75c907cd-a11c5332-3376c93d-77968aa0.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cholelithiasis // pre-op eval Surg: ___ (CCY) COMPARISON: Compared to prior radiographs from ___. IMPRESSION: Cardiomediastinal silhouette is within normal limits. Lungs are slightly hyperexpanded. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " 3f3ffd00-e48eb8f8-cf152ab0-f13bfded-68f75822.jpg,validate/p10/p10261509/s56896434/3f3ffd00-e48eb8f8-cf152ab0-f13bfded-68f75822.jpg,validation," 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. " 06e192f9-86bb3477-c603b778-30d6e13a-7554d2f9.jpg,validate/p12/p12678475/s51186766/06e192f9-86bb3477-c603b778-30d6e13a-7554d2f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest dated ___, AP and lateral views of the chest dated ___ FINDINGS: Lung volumes are slightly low, which may contribute to vascular crowding in the lung bases. The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. There is no pleural effusion or pneumothorax. The lungs are grossly clear. IMPRESSION: No acute intrathoracic abnormality. " 245bf5c6-7a8705a1-c18f6265-11524888-0f4279ac.jpg,validate/p14/p14760908/s55256083/245bf5c6-7a8705a1-c18f6265-11524888-0f4279ac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with altered mental status TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Multiple clips are again noted within the anterior chest wall bilaterally compatible with prior mastectomies. Mild degenerative changes are seen within the thoracic spine with minimal loss of height of a mid thoracic vertebral body, unchanged. IMPRESSION: No acute cardiopulmonary abnormality. " fe45a6a2-c6e66cf4-18d77a79-eb97c848-b210db51.jpg,validate/p12/p12476587/s59836328/fe45a6a2-c6e66cf4-18d77a79-eb97c848-b210db51.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Status post right thoracentesis with right-sided back pain. REFERENCE EXAM: ___. FINDINGS: Again seen are diffuse increase in lung markings consistent with both alveolar and interstitial edema. There are bilateral pleural effusions, right greater than left. There is a possible tiny right apical pneumothorax. There continues to be dense retrocardiac opacity compatible with volume loss/infiltrate/effusion. Compared to the study from the prior day, the fluid status is slightly worse. " b2bcdf64-25f6dbb1-4d8a1f66-6d98cbc5-88ece5a4.jpg,validate/p18/p18398420/s59676553/b2bcdf64-25f6dbb1-4d8a1f66-6d98cbc5-88ece5a4.jpg,validation," FINAL REPORT INDICATION: Evaluate port placement prior to chemo. The port was placed in the outside hospital. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: A right-sided Port-A-Cath is present with the tip in the mid SVC. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: 1. Right PICC with the tip in the mid SVC. 2. No acute cardiopulmonary process. Results were discussed with Dr. ___ at 12:40 p.m. on ___ via telephone by Dr. ___ at the time the findings were discovered. " ad5e31c0-ee796071-cd3b1497-e69cfc1b-304b8720.jpg,validate/p18/p18553055/s55910779/ad5e31c0-ee796071-cd3b1497-e69cfc1b-304b8720.jpg,validation," FINAL REPORT INDICATION: ___M c ESRD on HD s/p emergent CABG x3 (LIMA>LAD, SVG>Diag, SVG>LPDA)/ MVR (29mm SJM Mechanical)/ open chest ___. now s/p bronchoscopy // to rule out pneumothorax TECHNIQUE: Chest PA and lateral FINDINGS: Indwelling support devices are stable in appropriate position. The right lung is clear. Near complete opacification of the left hemithorax with volume loss likely reflects substantial atelectasis. Aeration of left lung apex has not substantially changed. No visible pneumothorax. No definite deep sulcus sign. Large calcified mass in the right upper quadrant IMPRESSION: Near complete opacification of the left hemithorax with volume loss likely reflects substantial atelectasis has not substantially changed. " 6cbb4fac-3c0184e4-8753a69e-44593d37-39bff348.jpg,validate/p10/p10804747/s55363000/6cbb4fac-3c0184e4-8753a69e-44593d37-39bff348.jpg,validation," FINAL REPORT CLINICAL HISTORY: Pulmonary hypertension, evaluate for pneumonia and fluid overload. CHEST AP Since the prior chest x-ray, increased density extending from the right costophrenic angle is present indicating probable right pleural effusion. The small left effusion is unchanged. No evidence of failure is otherwise seen. IMPRESSION: New right effusion. " 35290c52-ed1004c2-d875ec82-4772660f-b12e9912.jpg,validate/p15/p15964158/s57318170/35290c52-ed1004c2-d875ec82-4772660f-b12e9912.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Recent rib fractures with hemothorax on ___, concern for worsening shortness of breath, question acute intrathoracic process. FINDINGS: PA and lateral views of the chest were provided. The lungs are clear and well inflated. There is air below the right hemidiaphragm which is of unclear etiology and may reside within interposed bowel loops adjacent to the liver though the possibility of free air is also a concern. Correlation with left lateral decubitus views or CT recommended. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. Old right rib deformities are again noted. IMPRESSION: Question or free air below the right hemidiaphragm. If clinical concern for free air is low, left lateral decubitus views may be helpful to confirm. Otherwise abdominopelvic CT recommended to further assess. " c2ff2cf8-74ff7bb2-b792a1b4-542d49e4-6bd3f286.jpg,validate/p10/p10705890/s57271259/c2ff2cf8-74ff7bb2-b792a1b4-542d49e4-6bd3f286.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___M with painful cough, fatigue // r/o pneumonia r/o pneumonia COMPARISON: ___ FINDINGS: The patient is status post median sternotomy as before. The lungs remain clear. There is atherosclerotic calcification. The heart and mediastinal structures are otherwise unremarkable for technique and unchanged. The bony thorax is grossly intact. There is no significant change. IMPRESSION: No active cardiopulmonary disease. " 84c283ad-12ae997d-6d06e458-d6ab8353-a803e922.jpg,validate/p12/p12032310/s57725595/84c283ad-12ae997d-6d06e458-d6ab8353-a803e922.jpg,validation," FINAL REPORT INDICATION: ___F with s/p fall down, cellulitis, uti, rhabdo // ?pulm edema TECHNIQUE: Single portable view of the chest. COMPARISON: ___ at 14:10. FINDINGS: Low lung volumes are again noted with secondary crowding of the bronchovascular markings. Superimposed vascular congestion is also suspected. Cardiac enlargement is similar compared to prior. There is no large pleural effusion. IMPRESSION: Low lung volumes with suspected superimposed pulmonary vascular congestion. No focal consolidation. " 278cc3b2-3b1e5d79-a9b63b24-d324d7fa-480b6406.jpg,validate/p11/p11291823/s59203202/278cc3b2-3b1e5d79-a9b63b24-d324d7fa-480b6406.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 3 EXAMS INDICATION: ___ year old man with recurrent aspiration causing hypoxemic respiratory failure now requiring NGT placement // Assess NGT placement. This will be performed in a two-step process requiring two films. Assess NGT placement. This will be performed in a two-step p IMPRESSION: In comparison with the earlier study of this date, the nasogastric tube has been removed and replaced with a Dobhoff tube that extends to the upper to mid portion of the stomach. There is increasing opacification at the right base with obscuration of the hemidiaphragm, consistent with collapse of the right lower lobe and possibly a portion of the middle lobe. Continued enlargement of the cardiac silhouette with pulmonary vascular congestion. Again the possibility of superimposed aspiration is difficult to exclude, especially in the absence of a lateral view. " 2cfc3f8e-8c276f49-9c1be44a-16d3c803-130f701b.jpg,validate/p11/p11862831/s51465722/2cfc3f8e-8c276f49-9c1be44a-16d3c803-130f701b.jpg,validation," FINAL REPORT HISTORY: Cough and rhonchi for 1 week, assess for pneumonia. 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. Pleural surfaces are unremarkable. IMPRESSION: Normal chest radiograph. Specifically, no evidence of pneumonia. " 67ace6d8-3c3b5a49-3f06a6d3-a54cb7bb-e0955382.jpg,validate/p10/p10733236/s53835425/67ace6d8-3c3b5a49-3f06a6d3-a54cb7bb-e0955382.jpg,validation," FINAL REPORT HISTORY: Cough and low-grade fever. TECHNIQUE: PA 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 pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 16adfbb6-cdabf9d0-1b7f24b0-601ed0d9-d7e59d90.jpg,validate/p14/p14504631/s57691231/16adfbb6-cdabf9d0-1b7f24b0-601ed0d9-d7e59d90.jpg,validation," 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. " cbad7351-9c2dbcb4-9af4b126-b9f80120-dbb40eb7.jpg,validate/p18/p18485280/s51190272/cbad7351-9c2dbcb4-9af4b126-b9f80120-dbb40eb7.jpg,validation," FINAL REPORT SINGLE AP PORTABLE VIEW OF THE CHEST REASON FOR EXAM: Altered mental status. The patient is status post ileostomy and colectomy. Comparison is made with prior study ___ preop evaluation. There are low lung volumes. Cardiomegaly and widened mediastinum is acentuated by low lung volumes, rotation of the patient and technique. There is mild vascular congestion. If any, there is a small left pleural effusion. There are mild bibasilar atelectasis. " f1427131-571aa420-8b7a6210-31ba4cb4-8f0cd24f.jpg,validate/p14/p14394983/s55552506/f1427131-571aa420-8b7a6210-31ba4cb4-8f0cd24f.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia or pneumothorax in a patient with chest pain. 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. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 1b05c556-b35ec217-5cfa1935-d69eddd9-2eb91bf1.jpg,validate/p18/p18834094/s52184767/1b05c556-b35ec217-5cfa1935-d69eddd9-2eb91bf1.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with RT MCA syndrome // NGT placement COMPARISON: Radiographs from ___ at 02:25 IMPRESSION: The Dobbhoff tube is unchanged in position. There is an apparent new nasogastric tube ; however, the distal tip is not well seen pass the mid esophagus. Please correlate clinically and repeat films recommended if there is high clinical concern. Lung fields are somewhat hyperexpanded. There has been improved aeration of the right upper lobe. No pneumothoraces are seen. " adab38ae-596dfe7f-588c8a0a-549cbe8b-6b3a83cf.jpg,validate/p17/p17328610/s53889998/adab38ae-596dfe7f-588c8a0a-549cbe8b-6b3a83cf.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs. Moderate cardiomegaly is stable, but there is no evidence of pulmonary edema. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 764c8f83-bcaf0546-c2efbd1a-cac8412f-a94ad5b3.jpg,validate/p16/p16578228/s51008579/764c8f83-bcaf0546-c2efbd1a-cac8412f-a94ad5b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Chills. COMPARISON: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. The aorta is moderately calcified and tortuous, as before. The heart is normal in size. There is no definite pleural effusion or pneumothorax. The lungs appear clear. Surgical clips project over the right upper quadrant of the abdomen. IMPRESSION: No evidence of acute cardiopulmonary disease. " 3ae122d7-6aacb946-2028935e-5a7159be-ee6df8c3.jpg,validate/p14/p14536465/s56642115/3ae122d7-6aacb946-2028935e-5a7159be-ee6df8c3.jpg,validation," FINAL REPORT HISTORY: Respiratory distress and delirium, to assess for pulmonary edema. FINDINGS: In comparison with the study of ___, the patient has taken a somewhat better inspiration. However, the cardiac silhouette remains moderately enlarged, and there is increased engorgement of ill-defined pulmonary vessels, consistent with worsening pulmonary edema. Opacification at the right base with poor definition of the hemidiaphragm is consistent with atelectasis and effusion. Mild basilar atelectasis is seen on the left. " 9de56d65-e063f769-b3b01c48-732773ba-b8aac165.jpg,validate/p16/p16820602/s51461299/9de56d65-e063f769-b3b01c48-732773ba-b8aac165.jpg,validation," FINAL REPORT HISTORY: Asthma and tobacco abuse with worsening tachypnea. FINDINGS: In comparison with the study of ___, patient has taken a better inspiration. Cardiac silhouette is within normal limits and there is no vascular congestion or pleural effusion. The linear opacifications at the bases most likely represent pulmonary vessels that are somewhat more prominent than on previous studies. In the appropriate clinical setting, developing consolidation could be considered. " 65c2dd00-e25443cf-8e11d8e1-9bed998e-4239686a.jpg,validate/p14/p14105959/s54078994/65c2dd00-e25443cf-8e11d8e1-9bed998e-4239686a.jpg,validation," 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. " bcd4ea98-b6998281-8691d973-a24e13f4-9af899b0.jpg,validate/p12/p12706699/s51602851/bcd4ea98-b6998281-8691d973-a24e13f4-9af899b0.jpg,validation," WET READ: ___ ___ ___ 2:10 AM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with cough // cough TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. 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. " 9a0fe2df-4545980e-8f020a9c-2f18d587-de2dd5cf.jpg,validate/p12/p12274603/s56082886/9a0fe2df-4545980e-8f020a9c-2f18d587-de2dd5cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M unrestrained MVC*** WARNING *** Multiple patients with same last name! // eval for acute traumatic injury TECHNIQUE: Single AP view 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. IMPRESSION: No acute cardiopulmonary abnormality. " 5c2b7a33-c4c5283c-175cfee0-2fd0eab2-ac63e2d5.jpg,validate/p16/p16617005/s56338854/5c2b7a33-c4c5283c-175cfee0-2fd0eab2-ac63e2d5.jpg,validation," FINAL REPORT INDICATION: ___ year old man with iph and sdh, intubated, line placement attempt // r/o pneumo TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the endotracheal tube projects over the mid thoracic trachea. Again noted are bilateral calcified pleural plaques, consistent with prior asbestos exposure. There is new mild pulmonary vascular congestion and ill-defined haziness over the left lower lung zone however no focal consolidation is identified. No pleural effusion or pneumothorax identified. The size of the cardiac silhouette is within normal limits. Calcification of the aortic arch is visualized. Remote appearing bilateral rib fractures. IMPRESSION: Extensive bilateral calcified pleural plaques. Mild pulmonary vascular congestion. No pneumothorax identified. " 54129f06-02102ca7-43059e4a-a9c67039-584459d4.jpg,validate/p13/p13131199/s58970873/54129f06-02102ca7-43059e4a-a9c67039-584459d4.jpg,validation," FINAL REPORT HISTORY: ___-year-old male in a motor vehicle accident. COMPARISON: None. TECHNIQUE: Single AP portable view of the chest. FINDINGS: The trauma board overlies the patient and somewhat obscures the film. With this in mind, the lungs are clear. The cardiac silhouette is normal in size. There is no pleural effusion and there is no pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " a6c2aaa8-0973071b-47304b8e-82e3420a-7dfc2e86.jpg,validate/p19/p19442084/s55269676/a6c2aaa8-0973071b-47304b8e-82e3420a-7dfc2e86.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough and purulent sputum. TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrates improved aeration of the right lower lobe. No focal opacity convincing for pneumonia is identified. Mild blunting of the right phrenic angle may reflect trace pleural effusion. Cardiac size appears overall stable. Again identified is an azygos lobe. IMPRESSION: These findings were communicated to the ordering physician ___. ___ by Dr. ___ ___ telephone at 15:01 on ___. " c8a5dbe4-2c9655ea-8320a4e2-6c3fc65a-c10e57a8.jpg,validate/p16/p16882666/s52250021/c8a5dbe4-2c9655ea-8320a4e2-6c3fc65a-c10e57a8.jpg,validation," FINAL REPORT INDICATION: ___F with midepigastric pain radiating to back. // ? widened mediastinum TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " d5032c96-f86f2bcb-6237c299-d4a73545-b7e7378a.jpg,validate/p12/p12856213/s55291405/d5032c96-f86f2bcb-6237c299-d4a73545-b7e7378a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with pancreatitis, increasing O2 requirement, evaluate for atelectasis vs ARDS TECHNIQUE: Portable chest COMPARISON: Chest radiograph ___. FINDINGS: Compared to prior, left basilar and retrocardiac atelectasis has mildly increased. Lung volumes remain low with mild vascular congestion. Right lung is grossly clear. No large pleural effusion. No pneumothorax. IMPRESSION: Low lung volumes with mild increased left basilar atelectasis. " 98a523bb-2f34a130-d0203e41-1eae3caf-90ab92e2.jpg,validate/p13/p13976720/s58638000/98a523bb-2f34a130-d0203e41-1eae3caf-90ab92e2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with AML and fever // evaluate for pneumonia IMPRESSION: In comparison to ___ chest radiograph, there has been little change in the appearance of the chest except for apparent development of a small right pleural effusion. If clinical suspicion for infection persists, PA and lateral radiographs may be helpful for more complete assessment of the lung bases. " b021820b-4f7f54fc-d744f5a7-83de21e9-c5e61e9a.jpg,validate/p17/p17673690/s53351801/b021820b-4f7f54fc-d744f5a7-83de21e9-c5e61e9a.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: sickle cell pain crisis with cough. FINDINGS: Comparison is made to prior study from ___. There has been placement of a right IJ central line with distal lead tip in the mid SVC. Lungs are clear and there is improved aeration since the prior study. There are no pneumothoraces. Heart size is normal. " a6c66d8a-2434ca26-58778797-d8f0aa1e-ac1d60aa.jpg,validate/p11/p11607177/s51865105/a6c66d8a-2434ca26-58778797-d8f0aa1e-ac1d60aa.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the placement after ICD placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. The left-sided pacemaker lead terminates in the expected location of the right ventricle. Cardiomegaly is severe. Mild vascular engorgement is present, slightly increased. No pneumothorax or pleural effusion demonstrated. " 1a15cbc6-e93bb130-9a8568fb-a30603dc-a809ac9e.jpg,validate/p12/p12132124/s58381243/1a15cbc6-e93bb130-9a8568fb-a30603dc-a809ac9e.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old woman postop day 1 for laparoscopic lysis of adhesions. FINDINGS: Comparison is made to previous study from ___. Heart size is upper limits of normal but stable. There is coarsening of the bronchovascular markings without signs for overt pulmonary edema or focal consolidation. There are densities at the perihilar region which may represent calcified lymph nodes, stable. No pneumothoraces are seen. " 3ca71653-e31b3bd4-d0172dcc-7fbb74a1-774d747b.jpg,validate/p16/p16602535/s57827231/3ca71653-e31b3bd4-d0172dcc-7fbb74a1-774d747b.jpg,validation," FINAL REPORT INDICATION: ___F with sob and weight gain, ___ of chf // CHF? TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Blunting of the posterior costophrenic angles suggests small effusions, new since prior. Increased interstitial markings are noted on the current exam, progressed since prior suggesting interstitial edema. Punctate calcific densities over the right lung apex are likely calcified granulomas. Mild cardiac enlargement is again noted. Relative elevation of the left hemidiaphragm is again seen. Severe compression deformity of likely T12 is unchanged. IMPRESSION: Cardiomegaly with mild pulmonary edema which has progressed since prior and new small bilateral pleural effusions. " 5630ebbd-7e38ba89-0b1fbc6f-a56f5dee-e60f09d3.jpg,validate/p10/p10012768/s55247703/5630ebbd-7e38ba89-0b1fbc6f-a56f5dee-e60f09d3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with MM, rale on exam,eval infiltrate edema // eval infiltrate edema eval infiltrate edema COMPARISON: Comparison to ___ at 19:07 FINDINGS: Portable upright chest radiograph ___ at 10:08 is submitted. IMPRESSION: Right subclavian central line unchanged in position. Lung volumes remain slightly diminished with streaky patchy opacities in the bases suggestive of atelectasis or scarring. No developing airspace consolidation is seen to suggest pneumonia. No pulmonary edema. Old right-sided rib fracture. Stable cardiac and mediastinal contours. " caec1bd2-623ffd33-0336db31-6d11c0a3-05900787.jpg,validate/p18/p18001762/s52387651/caec1bd2-623ffd33-0336db31-6d11c0a3-05900787.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with wheezing // eval for acute process COMPARISON: Prior exam from ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low and evaluation is somewhat limited due to underpenetrated technique likely in part due to large body habitus. The heart size appears enlarged though a component may be due to AP technique. There is no convincing evidence for pneumonia, large effusion or pneumothorax. Mild congestion difficult to exclude given technique though there is no overt edema. Bony structures are intact. IMPRESSION: Possible mild congestion. Limited exam. " e4a8bf8c-6dc5e570-e694f8e9-05b730d1-d8181ca9.jpg,validate/p17/p17190208/s54418757/e4a8bf8c-6dc5e570-e694f8e9-05b730d1-d8181ca9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with subdural hematoma, respiratory failure w/ bilateral PEs and probable VAP // ? interval change TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 37aa0653-742285a4-dbcaf3aa-0aade47a-53144047.jpg,validate/p16/p16573945/s52950244/37aa0653-742285a4-dbcaf3aa-0aade47a-53144047.jpg,validation," FINAL REPORT AP PORTABLE CHEST OF ___ COMPARISON: ___ radiograph. FINDINGS: The patient is status post recent median sternotomy and cardiovascular surgery. Low lung volumes accentuate the cardiomediastinal contours. Interval removal of various indwelling support and monitoring devices and placement of a right internal jugular central venous catheter which terminates deep within the right atrium. There is no visible pneumothorax. Worsening left lower lobe atelectasis is accompanied by a small left pleural effusion. " 55d8cc49-1283f754-4cb1fc09-078cc4d2-84c4c328.jpg,validate/p11/p11512173/s53539415/55d8cc49-1283f754-4cb1fc09-078cc4d2-84c4c328.jpg,validation," FINAL REPORT HISTORY: Left-sided chest pain. Evaluate for pneumothorax. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart size is normal. The mediastinal and hilar structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8bc13e0d-2ae6915c-b52d246c-273163e1-05d94f54.jpg,validate/p11/p11596230/s59608381/8bc13e0d-2ae6915c-b52d246c-273163e1-05d94f54.jpg,validation," 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. " 93dfc3a3-73c7f719-211b51ae-a612c0cd-124426cd.jpg,validate/p13/p13657580/s50803239/93dfc3a3-73c7f719-211b51ae-a612c0cd-124426cd.jpg,validation," FINAL ADDENDUM Tapering of the subglottic airway could be a normal anatomic variant of aging, but should be evaluated clinically for the possiblity of infectious tracheitis. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with basilar crackles on the left and wheezing. COMPARISON: Chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: Lungs are clear without confluent consolidation. There is no pulmonary edema or pleural effusions. Mediastinal and hilar contours are within normal limits. Mild cardiomegaly is new compared to prior examination. Flattening of the left hemidiaphragm is chronic. There is no pneumothorax. IMPRESSION: 1. Mild enlargement of the cardiac silhouette as compared to prior examination from ___. Possibly due to progressive cardiomegaly or pericardial effusion. 2. No pulmonary edema or pneumonia. " cd7f27a7-d78b82db-a59dbf75-e8dbca23-7738e8b6.jpg,validate/p16/p16733321/s59546312/cd7f27a7-d78b82db-a59dbf75-e8dbca23-7738e8b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with a few episodes of isolated left-sided chest pain. Recent URI. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The aorta is mildly tortuous, as seen previously. Mediastinal and hilar contours are otherwise unremarkable. Lungs are hyperinflated without focal consolidation. Bronchiectasis in the right upper lung field appears similar. No pleural effusion or pneumothorax is present. The pulmonary vasculature is not engorged. Mild degenerative changes are seen within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 6b0fb29a-70962935-1d584668-eb46de77-ba51ffab.jpg,validate/p11/p11904134/s57474675/6b0fb29a-70962935-1d584668-eb46de77-ba51ffab.jpg,validation," FINAL REPORT HISTORY: Asthma. FINDINGS: In comparison with study of ___, there is no change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. " fa4ce214-ecda3d3c-fd7d6834-0a097b27-42f33ccd.jpg,validate/p17/p17025899/s54956084/fa4ce214-ecda3d3c-fd7d6834-0a097b27-42f33ccd.jpg,validation," FINAL ADDENDUM Changes from the initial interpretation were discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. ______________________________________________________________________________ FINAL REPORT Hypoxia, chest pain and crackles, assess for infiltrate or edema. COMPARISONS: ___. Portable upright radiograph was obtained of the chest. Lungs are low in volume with extensive bilateral perihilar and lower lung opacities with likely trace bilateral pleural effusions compatible with pulmonary edema. However the heart is normal size and less than three weeks ago there were findings in the right lower lobe more likely pneumonia. Fullness in the right paratracheal stripe could be due to venous engorgement or adenopathy, now involving the aortopulmonic window. There is no pneumothorax. IMPRESSION: Moderate-to-severe pulmonary edema, alternatively severe pneumonia. " 5fcf4471-6190107a-1e07081c-1470a349-0d418cf1.jpg,validate/p13/p13050559/s55550785/5fcf4471-6190107a-1e07081c-1470a349-0d418cf1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with lymphoma s/p RUL lobectomy // Eval PTX/Effusion TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right PICC line tip is at the level of lower SVC. Heart size and mediastinum are overall stable. Right upper lobe opacity is related to recent lobectomy. No appreciable pneumothorax demonstrated although small amount is most likely present in the very apex. " f994a423-6ed44595-be6ddf82-5bda81cb-a31fa181.jpg,validate/p18/p18031120/s57036753/f994a423-6ed44595-be6ddf82-5bda81cb-a31fa181.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with decompensated CHF on bumex drip // interval change TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 7fabc941-8c81082a-2887f2f6-f4e26b25-3e5d981d.jpg,validate/p10/p10337761/s57325759/7fabc941-8c81082a-2887f2f6-f4e26b25-3e5d981d.jpg,validation," WET READ: ___ ___ ___ 9:19 PM Interval intubation with endotracheal tube tip projecting approximately 4.5 cm above the carina. Esophageal catheter with weighted tip projecting over the left upper quadrant likely within the stomach. Mild cardiomegaly, as noted previously. Small amount of density layering along the minor fissure, increased compared to prior. ______________________________________________________________________________ FINAL REPORT HISTORY: Tube placement. FINDINGS: In comparison with the study of ___, there has been placement of an endotracheal tube with the tip approximately 4.5 cm above the carina. Dobbhoff tube extends to the upper portion of the stomach. Continued mild enlargement of the cardiac silhouette with little change in the appearance of the lungs. " 3448589a-962fb0e3-e82d49fe-0a7776d8-8cee1b67.jpg,validate/p11/p11357946/s57965623/3448589a-962fb0e3-e82d49fe-0a7776d8-8cee1b67.jpg,validation," FINAL REPORT INDICATION: ___F with intermittent chest pain at rest, evaluate for acute process. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. Lung volumes are slightly low, however clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " 7821401b-59845f82-8b9f0df0-e51fe976-75b6d383.jpg,validate/p14/p14921998/s54350738/7821401b-59845f82-8b9f0df0-e51fe976-75b6d383.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Multiple sclerosis and aspiration risk. COMPARISONS: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: A PICC line terminates in the left brachiocephalic vein. The lung volumes are low. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. Posterior basilar opacity in the left lower lobe could be seen with atelectasis or possibly aspiration. A left mid lung opacity has resolved. IMPRESSION: Patchy posterior left basilar opacity, probably due to atelectasis, although a small focus of aspiration is possible. " f2059a66-4c5c576e-d36fbcfd-ebf3db33-0a29893a.jpg,validate/p12/p12643523/s58403792/f2059a66-4c5c576e-d36fbcfd-ebf3db33-0a29893a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest tightness with anxiety 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. " 820ba101-dc03a44a-04698d94-253f737a-c2b6d580.jpg,validate/p13/p13558097/s59606681/820ba101-dc03a44a-04698d94-253f737a-c2b6d580.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Fever and neutropenia. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: Port-A-Cath terminates at the uppermost right atrium. The patient is status post coronary artery bypass graft surgery. 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. " 9beb0fb6-f4c95438-bdedb4c2-3f7951c1-a1a62e4a.jpg,validate/p11/p11146315/s58504694/9beb0fb6-f4c95438-bdedb4c2-3f7951c1-a1a62e4a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with DLBCL presents from clinic with low grade fever and malaise // Eval etiology of fever. ?PNA Eval etiology of fever. ?PNA COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Catheter ports project over and partially obscure the right midlung, but there does appear be a new somewhat circumscribed opacity, at the level of the anterior right sixth rib laterally, concerning for focal infection. No other pulmonary abnormality is visible. Heart is normal size. Pulmonary vasculature is unremarkable. Small right pleural effusion has decreased since ___. Right central venous infusion port catheter ends in the left low SVC. NOTIFICATION: Dr. ___ reported the findings to ___, ___ by telephone on ___ at 9:58 AM, 1 minutes after discovery of the findings. " dc8770dc-9b8ec29d-be36e84c-ef8c2dcd-bf567bd3.jpg,validate/p13/p13177223/s56478460/dc8770dc-9b8ec29d-be36e84c-ef8c2dcd-bf567bd3.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with syncope and cough. COMPARISON: Chest radiograph from ___ and CTA chest from ___. FINDINGS: The lungs are mildly hyperinflated, with biapical hyperlucency, increase in anteroposterior diameter, and widening of the retrosternal clear space. Cardiomediastinal and hilar contours are normal. No focal consolidation is present. There are no pleural effusions, pneumothorax, or pneumomediastinum. IMPRESSION: No acute cardiopulmonary process. " d6f47561-fb6c6024-5f6f3af2-34c08c2f-297da193.jpg,validate/p16/p16539558/s57817733/d6f47561-fb6c6024-5f6f3af2-34c08c2f-297da193.jpg,validation," FINAL REPORT HISTORY: Status post lysis of adhesions, evaluate NG tube placement. COMPARISON: CT abdomen pelvis ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: NG tube is present. The side port ends at or just below the gastroesophageal junction. The tube could safely be advanced 5-7 cm for positioning of the side port within the stomach. The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart size is normal. The mediastinal and hilar structures are unremarkable. A small amount of free air is seen beneath the right hemidiaphragm, consistent with recent surgery. " 93e809ec-dc6c099e-315e838d-7b7e8340-f943d2f7.jpg,validate/p12/p12911421/s55759586/93e809ec-dc6c099e-315e838d-7b7e8340-f943d2f7.jpg,validation," FINAL REPORT INDICATION: Dyspnea, ECG changes. Evaluate for acute process. COMPARISON: Chest radiograph ___ through ___. TECHNIQUE: Portable supine AP radiograph of the chest. FINDINGS: Right internal jugular central venous catheter has been removed. Median sternotomy wires appear intact. Lung volumes are relatively normal. There are worsening opacities in the left lung and more mild at the right base. The heart is not enlarged. The mediastinal and hilar contours are normal. The pleural effusions have decreased/resolved. There is no pneumothorax. IMPRESSION: Worsening opacity predominantly in the left lung may reflect asymmetric pulmonary edema; however, pneumonia is possible. " 49d12566-1566372b-397f5a05-2bed59ae-39e88c79.jpg,validate/p18/p18871003/s57171594/49d12566-1566372b-397f5a05-2bed59ae-39e88c79.jpg,validation," 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. " 553bc88a-61fdbb46-cb8c4923-efdb81a5-221ec025.jpg,validate/p12/p12774561/s51374854/553bc88a-61fdbb46-cb8c4923-efdb81a5-221ec025.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with see above. // Patient with recurrent chest infections, please assess for underlying issues. Patient with recurrent chest infections, please assess for u IMPRESSION: No previous images. The lungs are substantially hyperinflated, though there is no evidence of acute pneumonia, vascular congestion, or pleural effusions. Biapical opacification suggests old tuberculous disease. " 7593fa68-4b969aa8-107ae860-3c919d48-e25c6591.jpg,validate/p12/p12547577/s59138754/7593fa68-4b969aa8-107ae860-3c919d48-e25c6591.jpg,validation," FINAL REPORT HISTORY: Multiple sclerosis, presenting with GI bleed. Question pneumonia or effusions. Also with hypoxia. COMPARISON: ___. TECHNIQUE: AP and lateral views of the chest. FINDINGS: Lungs are clear. Cardiac silhouette is normal in size. There is no pleural effusion, pneumothorax, pulmonary edema or pneumonia. Scoliosis is present and the bones are diffusely osteopenic. IMPRESSION: No acute cardiopulmonary process. " bf008cc8-d72898d5-0e46d973-60325652-38ad5dec.jpg,validate/p18/p18646710/s52567268/bf008cc8-d72898d5-0e46d973-60325652-38ad5dec.jpg,validation," FINAL REPORT EXAMINATION: CXR INDICATION: ___F with fever, cough // r/o pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, 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. " 58d61700-3673ad8c-0a42df29-2cdb7970-2260424e.jpg,validate/p14/p14808939/s53067152/58d61700-3673ad8c-0a42df29-2cdb7970-2260424e.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest pain. Evaluate for evidence of acute cardiopulmonary process. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: There are low lung volumes. The right lung is clear. There is a retrocardiac opacity obscuring the left hemidiaphragm, likely pneunonia vs atelectasis. There may be a tiny component of pleural effusion. The heart size is top normal. The cardiomediastinal and hilar contours are unremarkable. Sclerotic intramedullary lesion in the right humeral neck is unchanged and likely represents an enchondroma. IMPRESSION: Left lung base opacity consistent with pneumonia vs atelectasis. There may be an associated tiny pleural effusion. " bc27b69c-6b1705c3-5f107f13-e92326ab-25308fd3.jpg,validate/p15/p15981676/s51237389/bc27b69c-6b1705c3-5f107f13-e92326ab-25308fd3.jpg,validation," FINAL REPORT EXAM: AP portable view of the chest. CLINICAL INFORMATION: Slight cough while recovering from sepsis. COMPARISON: None. FINDINGS: Single AP portable view of the chest was obtained. Left-sided dual-lumen catheter is seen terminating in the proximal to mid SVC. There is blunting of the costophrenic angles. This may be due to trace pleural effusions. Left base retrocardiac opacity may be due to atelectasis, also pleural effusion, however underlying consolidation is not excluded. There is moderate pulmonary vascular congestion. The cardiac and mediastinal silhouettes are unremarkable. " c7820c92-cccd528f-9196bb0f-026629b1-a6451653.jpg,validate/p17/p17642642/s58030378/c7820c92-cccd528f-9196bb0f-026629b1-a6451653.jpg,validation," FINAL REPORT INDICATION: History: ___M with new PICC line // Eval PICC placement COMPARISON: ___. TECHNIQUE: Single frontal view of the chest. FINDINGS: A right PICC courses into the SVC but its tip is not well-visualized. Heart size and cardiomediastinal contours are normal. Mild reticular pattern is stable without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Tip of a right PICC is not well visualized. PA and lateral radiographs are recommended. " e4f122a7-74815c53-fc0242b0-d7d8b586-f929c416.jpg,validate/p19/p19677506/s56904248/e4f122a7-74815c53-fc0242b0-d7d8b586-f929c416.jpg,validation," FINAL REPORT INDICATION: History of heroin use. Now febrile. COMPARISONS: None. FINDINGS: There is a hazy opacity in the right mid to lower lung ___ which is not definitely seen on the lateral radiograph. This is concerning for a possible pneumonia or aspiration. There is no evidence of pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is normal. IMPRESSION: Hazy opacification in the right mid to lower lung ___, ___ be due to infection or aspiration. " 3e5411bd-d6667aa5-ff136804-fb6b330e-c4f107da.jpg,validate/p12/p12177591/s51167801/3e5411bd-d6667aa5-ff136804-fb6b330e-c4f107da.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of fall, altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. As seen on the prior study, there is marked right apical scarring with upward retraction of the right pulmonary hilum and there is now tenting of the right hemidiaphragm. A more prominent rounded opacity in the right hilar region could relate to vascular structures although it is more prominent than on prior studies, an underlying lesion is not excluded and could be further evaluated on CT. Mild left apical scarring is seen. There is also some retraction of the left hilum upward. No large pleural effusion or pneumothorax is seen. No evidence of an acute fracture is seen although if there is high concern, dedicated imaging of the region of interest would be recommended. IMPRESSION: 1. Slight increase of prominence of the right hilar region which may be due to different position, patient is rotated to the right; although underlying lesion not excluded. Suggest repeat PA and lateral views with patient in better positioning. Alternatively area could be further evaluated on CT. 2. Marked right apical scarring again seen with retraction of the right hilum. 3. No acute fracture seen. However, if high clinical concern, suggest dedicated imaging of the region. " a34b1c2a-64c4e723-548abdd0-a3c96bad-2c1cfd2c.jpg,validate/p17/p17006872/s52412201/a34b1c2a-64c4e723-548abdd0-a3c96bad-2c1cfd2c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Followup of right pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a decrease in extent of the known right pneumothorax. The diameter of the pneumothorax apically is now about 1.7 cm. There is improved diaphragmatic depression. Unchanged appearance of the cardiac silhouette. No pleural effusions. " 37b56e80-8c99380f-49b78b8d-ce6c11cc-09ddd77e.jpg,validate/p16/p16245480/s59724720/37b56e80-8c99380f-49b78b8d-ce6c11cc-09ddd77e.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with history of sarcoidosis, evaluate for abnormal cough. 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. " 1c83e732-749364b7-d577658c-1ce18cb5-ee051ad8.jpg,validate/p16/p16805727/s59262028/1c83e732-749364b7-d577658c-1ce18cb5-ee051ad8.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Prolonged smoking history with congestive heart failure and left ventricular ejection fraction decreased. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. New interstitial opacity is noted in both lower lungs bilaterally that might be consistent with minimal interstitial vascular engorgement. No overt pulmonary edema is seen. Alternatively infectious process would be another possibility. Given the short-term prior followup, interval development of interstitial lung disease is less likely, although it is still possible. " efa280b4-ab9921dd-e10b0695-dea0c2f9-925ee947.jpg,validate/p14/p14482820/s59283708/efa280b4-ab9921dd-e10b0695-dea0c2f9-925ee947.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ yo female with history of hypertension and diabetes who experienced chest pain and had PEA arrest s/p CPR x3. // interval change interval change IMPRESSION: In comparison with the study of ___ the monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette without definite vascular congestion. Basilar atelectatic changes are seen bilaterally, especially on the left. " 743ef004-03171745-6f2fa761-1a803e04-8c38b67c.jpg,validate/p15/p15355458/s52638501/743ef004-03171745-6f2fa761-1a803e04-8c38b67c.jpg,validation," WET READ: ___ ___ 6:57 PM RIJ, LSC and ETT are satisfactorily positioned. DHT is in the mid esophagus (but by the time of wet read has been removed and OGT on subsequent film is satisfactorily positioned). Bilateral effusions, atelectasis are unchanged with slight interval improvement in mild to moderate pulmonary edema WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:43 P.M., ___ HISTORY: ___-year-old woman with a new Dobbhoff tube in place. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Feeding tube with a wire stylet in place ends in the upper esophagus. ET tube, left subclavian and right internal jugular catheters in standard placements. Lung volumes are quite low, exaggerating the severity of mild pulmonary edema and bibasilar atelectasis. Bilateral pleural effusions are small to moderate. Heart size normal. Very large calcified mitral annulus could be responsible for mitral regurgitation. Subsequent chest radiograph showed repositioning of standard upper enteric drainage catheter and removal of the errant feeding tube. " caced535-09e096e7-8e71b44b-2342e508-46b2be6f.jpg,validate/p11/p11853755/s59620379/caced535-09e096e7-8e71b44b-2342e508-46b2be6f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F multiple falls. +head strike. pain lower ribs bil. // injury TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ AT 15:39 FINDINGS: The patient's chin overlies the medial lung apices on 1 of the frontal images is mild blunting the lateral costophrenic angle suggesting small pleural effusions. Prominence of the pulmonary arteries is consistent with pulmonary hypertension. There is also mild to moderate pulmonary edema. Chain suture material is again noted over the medial right upper lung. The cardiac silhouette remains mildly enlarged. The aorta is calcified and tortuous. No pneumothorax is seen. IMPRESSION: Small bilateral pleural effusions and pulmonary edema. Evidence of pulmonary hypertension. No obvious displaced rib fracture, however, this study is not sensitive for the detection of rib fracture. If high clinical concern for rib fracture, dedicated rib series or CT is more sensitive. " 1fea986d-3a6a6c72-b7f703ae-0f8a6c99-49524a55.jpg,validate/p18/p18919567/s57837637/1fea986d-3a6a6c72-b7f703ae-0f8a6c99-49524a55.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with pain in the left anterior chest on palpation, who presents for evaluation. COMPARISON: Chest radiographs from ___; ___; ___ and CT abdomen and pelvis from ___. TECHNIQUE: PA and lateral radiograph of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear. There is chronic eventration of the right hemidiaphragm. IMPRESSION: No acute abnormalities are identified to explain patient's left anterior chest pain. " 50455047-d611cb52-2cd5da9b-8af50a3f-71a68396.jpg,validate/p18/p18084430/s57451984/50455047-d611cb52-2cd5da9b-8af50a3f-71a68396.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: Recent unexplained weight loss. Heavy cigarette smoker. IMPRESSION: PA and lateral chest compared to ___: Severe hyperinflation due to emphysema is unchanged. Right apical pleural parenchymal scarring is slightly more pronounced than the left, as before, and unchanged in the interim. Cardiomediastinal and hilar silhouettes are unremarkable. There are no focal pulmonary abnormalities, and no findings to suggest active infection or malignancy. " 3742a3a6-562f4ad6-d66027a0-a6da02cd-c2e7caaf.jpg,validate/p18/p18240093/s53217611/3742a3a6-562f4ad6-d66027a0-a6da02cd-c2e7caaf.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Persistent asthma flare and ongoing shortness of breath. AP and lateral views of the chest were reviewed in comparison to ___. As compared to the prior study, there is slight interval improvement in vascular congestion. Images continue to be very substantially affected by motion artifact. Within those limitations, there is interval change in right pleural effusion. Left lower lung is obscured by a substantial skinfold projecting over the chest. No pneumothorax is seen. Right internal jugular line catheter is at the level of mid SVC. " 1999da3b-c89ba3ff-2a6edc7f-a3b34e00-5cf24b5a.jpg,validate/p15/p15766903/s53742225/1999da3b-c89ba3ff-2a6edc7f-a3b34e00-5cf24b5a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD exacerbation // eval for consolidation, pulm edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Massive overinflation. Normal size of the cardiac silhouette. No overt pulmonary edema. No pneumonia. No pleural effusions. " 2c4ffd51-21389a96-f9fbaf8a-d86315ac-ebe7f514.jpg,validate/p13/p13880030/s52517436/2c4ffd51-21389a96-f9fbaf8a-d86315ac-ebe7f514.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fatigue and SOB. // r/o pneumonia COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. The lungs are hyperinflated, but grossly clear. There is no pleural effusion, or pneumothorax. The hilar and cardiomediastinal contours are normal. Contour differences in the breasts, suggest left breast resection unchanged from ___. IMPRESSION: The lungs are moderately hyperinflated, unchanged from ___. No pneumonia. " 5598a3d8-70c56530-a48e612e-a77c7510-35dcd59f.jpg,validate/p10/p10699336/s55529643/5598a3d8-70c56530-a48e612e-a77c7510-35dcd59f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with mucous plugging s/p bronch // eval for interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 06:10 IMPRESSION: Substantial improvement in the left lung collapse is demonstrated with re- opening of the left upper lung but still persistent atelectasis of the left lower lobe. Rest of the findings are unchanged. " f27a5cb4-0aec1151-bfc2e54f-5346b23d-744f07c1.jpg,validate/p14/p14835908/s53293470/f27a5cb4-0aec1151-bfc2e54f-5346b23d-744f07c1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with flank pain // ? infectious process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Low lung volumes with bibasilar atelectasis. Small opacification at the left base, which is concerning for pneumonia, appreciated on both frontal and lateral radiographs. Moderate enlargement of the cardiac silhouette is new since ___, with cardiomegaly and/or pericardial effusion. No pulmonary edema. No pleural effusion. No pneumothorax. Configuration of the mediastinum at the thoracic inlet with undulation of the trachea could be due to tortuous vessels alone or possible contribution of enlarged right thyroid lobe. IMPRESSION: Likely left lower lobe pneumonia. Suggest repeat chest radiograph electively to document clearing. The region may need to be clarified with chest CT. Note: Abdomen CT performed 3 hr after this examination confirmed enlargement of probable pneumonia, left lower lobe, alternatively very large pulmonary infarct. There is no pericardial effusion. " 1225ee5c-ef7cb207-43729db2-9e63492e-76f878e9.jpg,validate/p19/p19982872/s56245934/1225ee5c-ef7cb207-43729db2-9e63492e-76f878e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___/F s/p right TKA with temp ___.8 // atelectasis vs pna ? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Minimal atelectasis at the left lung bases. No pneumonia, no pulmonary edema, no pleural effusions. Borderline size of the cardiac silhouette with elongation of the descending aorta. " d9ea109d-a06a93a3-c939367c-c8ae71ad-535152a4.jpg,validate/p16/p16163176/s51108315/d9ea109d-a06a93a3-c939367c-c8ae71ad-535152a4.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and COPD. 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 disease. " 69cb7c76-4398f2e9-b0316c32-992166e3-d6267b17.jpg,validate/p10/p10530907/s53919204/69cb7c76-4398f2e9-b0316c32-992166e3-d6267b17.jpg,validation," WET READ: ___ ___ ___ 8:12 AM Compared with the outside hospital chest radiograph from ___, no significant changes. Mild patchy opacity in the right lung base may reflect atelectasis. In the correct clinical setting, aspiration or developing infection is not excluded. No evidence of pneumothorax or pleural effusions. WET READ VERSION #1 ___ ___ ___ 5:28 PM Compared with the outside hospital chest radiograph from ___, no significant changes. Mild patchy opacity in the right lung base may reflect atelectasis. In the correct clinical setting, aspiration or developing infection is not excluded. No evidence of pneumothorax or pleural effusions. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with acute hepatitis, with shortness of breath and cough. // evaluate for any evidence of PNA, effusion or edema evaluate for any evidence of PNA, effusion or edema COMPARISON: Comparison to outside chest study dated ___ at 13:56 FINDINGS: Portable upright chest radiograph ___ at 17:12 is submitted. IMPRESSION: Cardiac and mediastinal contours are stable. Faint patchy opacity at the right lung base could reflect atelectasis, pneumonia, or aspiration. Clinical correlation is advised. No pleural effusions or pneumothorax. No pulmonary edema. " 3cacfdc5-91953d7b-1755e7fa-82ecf353-803e6b40.jpg,validate/p13/p13644218/s51958857/3cacfdc5-91953d7b-1755e7fa-82ecf353-803e6b40.jpg,validation," 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. " 51a71857-88130a7a-a5c62ed8-a25f94c0-96d4d58e.jpg,validate/p19/p19069718/s50063748/51a71857-88130a7a-a5c62ed8-a25f94c0-96d4d58e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dizziness and dementia // Eval for PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. Costochondral calcification is seen bilaterally, most notably on the right. . The cardiac silhouette remains enlarged. The aorta is tortuous. Surgical clips were again noted in the epigastric region, at the level of the gastroesophageal junction. IMPRESSION: No acute cardiopulmonary process. " 694dbafd-4e502f7d-8747017c-0102ff60-3a354ad3.jpg,validate/p19/p19780620/s57203590/694dbafd-4e502f7d-8747017c-0102ff60-3a354ad3.jpg,validation," FINAL REPORT INDICATION: ___ year old man with cirrhosis and COPD with cough and SOB // Aspiration vs. volume overload COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: Nasogastric tube is beyond the GE junction and the tip is beyond the edge of the film. The PICC line on the right is noted in the tip is in the SVC. There is no pneumothorax effusion consolidation or CHF. " 127bc255-6941d446-6e616697-7a9c1a39-dd8b8ce2.jpg,validate/p11/p11304959/s54197787/127bc255-6941d446-6e616697-7a9c1a39-dd8b8ce2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF exac // interval changes in pulmonary edema interval changes in pulmonary edema IMPRESSION: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with prominent pulmonary edema. Retrocardiac opacification with silhouetting of the hemidiaphragm suggests substantial volume loss in the left lower lobe with probable small pleural effusions bilaterally. " 05c137e3-0dc470d5-035f26fe-f1d720d9-c6183183.jpg,validate/p14/p14086847/s56231284/05c137e3-0dc470d5-035f26fe-f1d720d9-c6183183.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Esophageal cancer, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a new plate-like atelectasis at the right lung base. Postoperative appearance of the mediastinum and the remaining right lung is unchanged. On the left, a pre-existing pleural effusion with subsequent partial atelectasis of the left lower lobe has slightly increased in extent and severity. To exclude developing pneumonia, short-term radiographic followup should be performed. No other relevant changes. The right chest tube remains in situ. " 54a71acb-431f2120-fbff46db-22a38c3b-22ee21a6.jpg,validate/p18/p18512995/s51680219/54a71acb-431f2120-fbff46db-22a38c3b-22ee21a6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with ___ esoinophillic pna increasing sob // r/o PNA TECHNIQUE: Chest Frontal and Lateral COMPARISON: None. FINDINGS: NO FOCAL CONSOLIDATION IS SEEN. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Surgical clips overlie the left breast. IMPRESSION: No focal consolidation. " c1c1bf7b-7a70d9c2-2d02a9b9-85bd0f38-8b74bdc7.jpg,validate/p16/p16787268/s59030291/c1c1bf7b-7a70d9c2-2d02a9b9-85bd0f38-8b74bdc7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hx of hemorragic stroke presenting with worsening dysphagia, cough // ? cardiopulmonary process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lateral view is suboptimal due to the patient's overlying arm and low lung volumes. The lungs are clear without focal consolidation. There is mild elevation of the right hemidiaphragm. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Chronic appearing deformity projecting projecting over the anterior left first rib. IMPRESSION: No acute cardiopulmonary process. " 927b8643-a12e1163-00bce6dd-25fa3b17-2ea5d871.jpg,validate/p13/p13897119/s53628146/927b8643-a12e1163-00bce6dd-25fa3b17-2ea5d871.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple lung nodules, POD___ s/p VATS RUL wedge // Evaluate for interval change Evaluate for interval change IMPRESSION: Compared to chest radiographs since ___, most recently ___. Right pleural drainage catheter has been slightly repositioned, but there is no pneumothorax, or more than a very small right pleural effusion. Mild cardiomegaly has increased. Lungs are clear of any focal abnormality. " 48b692dd-5603da5c-a7f69974-2717a1b6-c1f56422.jpg,validate/p10/p10645933/s58494150/48b692dd-5603da5c-a7f69974-2717a1b6-c1f56422.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with fever with abdominal pain. FINDINGS: Frontal and lateral views of the chest are compared to previous exam 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. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " d516d463-38fd1a31-4b307d9b-4c891c47-91defc5a.jpg,validate/p14/p14541551/s55403543/d516d463-38fd1a31-4b307d9b-4c891c47-91defc5a.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with MVC stroke, NG tube location? COMPARISON: ___. FINDINGS: Portable AP chest radiograph is obtained with the patient in the supine position. Tip of NG tube ends at the level of the diaphragm in the lower esophagus. The cardiomediastinal contour is stable. The lungs remain clear. No significant pleural effusions and no pneumothorax. IMPRESSION: Tip of NG stops just short of the stomach and needs to be advanced. " dde9fcbd-c326acc6-351c6ddf-f6330267-6a5549bd.jpg,validate/p13/p13628037/s51123097/dde9fcbd-c326acc6-351c6ddf-f6330267-6a5549bd.jpg,validation," FINAL REPORT AP CHEST 9:23 P.M. ___ HISTORY: ___-year-old man with fever and neutropenia. Suspect AML. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Lungs are low in volume but clear, as far as one can tell on bedside chest radiograph. Heart size is normal. There is no appreciable pleural effusion or evidence of central lymph node enlargement. Recommend at least conventional radiographs of the chest given the clinical history. " 599fc86b-6d1edf5b-76c5a66f-2085222f-dd231938.jpg,validate/p19/p19103939/s50789912/599fc86b-6d1edf5b-76c5a66f-2085222f-dd231938.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Substernal chest pain, assess for cardiomegaly or pneumothorax. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, pneumothorax. The heart and mediastinal contours are normal. The imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute findings in the chest. " d1ed62d4-1322bd71-c4a77445-61404bc9-a8d6dcc3.jpg,validate/p14/p14320851/s57008487/d1ed62d4-1322bd71-c4a77445-61404bc9-a8d6dcc3.jpg,validation," FINAL REPORT Dizziness and unsteadiness, multiple cavernomas on MRI, rule out acute lung process. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Moderate scoliosis causes asymmetry of the rib cage. No acute lung parenchymal process, in particular no evidence of pneumonia or pulmonary edema. On the lateral radiograph only, a small area of atelectasis is seen at the left lung base. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. Mild tortuosity of the thoracic aorta. " 22c99eec-7433c36d-5b30ef3c-e259e82c-08ace1d9.jpg,validate/p10/p10976602/s51665787/22c99eec-7433c36d-5b30ef3c-e259e82c-08ace1d9.jpg,validation," FINAL REPORT HISTORY: Diastolic CHF. Evaluation for pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Multiple chest radiographs the most recent of ___. FINDINGS: The heart is enlarged. There is gas in either stomach or bowel portion of the left hemidiaphragm, which is similar in appearance to the prior study. There is a small effusion on the left side. There is no evidence of pneumonia or pulmonary edema. There is no pneumothorax. Mediastinal contours are grossly normal. IMPRESSION: No evidence of pneumonia or pulmonary edema. These findings were communicated to Dr. ___ by telephone at 4:30 PM on ___ by Dr. ___. " c217962e-686175d4-2fec0cf7-989cd9e6-92316d6f.jpg,validate/p12/p12257614/s57948785/c217962e-686175d4-2fec0cf7-989cd9e6-92316d6f.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with COPD and left-sided chest pain. Assess for pleural effusion. COMPARISON: None available in the ___ system PA AND LATERAL CHEST RADIOGRAPHS: Hyperinflated lungs with relative apical ___ is consistent with emphysema. No pleural effusion is identified. There is no confluent consolidation or pneumothorax. However, there is an 8-mm opacity in the left mid lung on the frontal radiograph, which is suspicious for a pulmonary nodule. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: Hyperinflated emphysematous lungs with a possible left mid lung 8-mm nodule. Recommend dedicated chest CT for further assessment. Dr. ___ communicated the above findings and recommendations to Dr. ___ at 16:35 on ___ by telephone " 1c2dacf9-20e79234-46d277d3-014b2ad5-8ec02667.jpg,validate/p11/p11865423/s51961924/1c2dacf9-20e79234-46d277d3-014b2ad5-8ec02667.jpg,validation," FINAL REPORT INDICATION: Chest pain. Evaluate for pneumonia or fluid overload. COMPARISONS: 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. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. No pulmonary edema is detected. IMPRESSION: Cardiac silhouette top normal but no evidence of pulmonary edema or pneumonia. " b7125570-97465b1a-fa956164-6747eef8-d0d13b70.jpg,validate/p18/p18448597/s57009730/b7125570-97465b1a-fa956164-6747eef8-d0d13b70.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure, requiring intubation // eval for consolidation, tube placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the tip of the endotracheal tube is now closer to the carina than before. The tip projects 1.8 cm above the carina. Low lung volumes. Mild pulmonary edema. No larger pleural effusions. No pneumothorax. Mild retrocardiac atelectasis. " a93a99c8-285fe90f-27d9c897-deae8041-310bf014.jpg,validate/p15/p15620990/s59008963/a93a99c8-285fe90f-27d9c897-deae8041-310bf014.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Single portable AP upright radiograph of chest was compared with prior chest radiographs from ___ with the most recent from ___. FINDINGS: Following the right chest tube removal, a faint lucency at the right lung apex is most likely a tiny apical pneumothorax. Since ___, bibasal lung atelectasis and mild pleural effusions have improved. Mildly enlarged heart size, mediastinal and hilar contours are stable. Patient is status post median sternotomy, and sternal sutures are intact. Left PICC line ends at mid SVC. " 09fb8eb1-6a8a5c25-498be97d-c9202fbd-9aea1d39.jpg,validate/p16/p16649269/s55727407/09fb8eb1-6a8a5c25-498be97d-c9202fbd-9aea1d39.jpg,validation," 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. " 33bf3120-3342656d-d6b8fe56-8ba4f1ec-ab611ce3.jpg,validate/p12/p12434487/s53528442/33bf3120-3342656d-d6b8fe56-8ba4f1ec-ab611ce3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fever, cough, shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is mildly enlarged. Mediastinal and hilar contours are unremarkable. There is minimal pulmonary vascular engorgement without frank pulmonary edema. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: No radiographic evidence for pneumonia. " 7390c5d2-6b939447-01a2a0cc-56bd595b-dfd1f534.jpg,validate/p14/p14726463/s53278895/7390c5d2-6b939447-01a2a0cc-56bd595b-dfd1f534.jpg,validation," FINAL REPORT INDICATION: ___-year-old female status post intubation. COMPARISON: ___. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in a supine position. FINDINGS: The endotracheal tube tip courses into the proximal right mainstem bronchus. The left lung is aerated. An esophageal catheter terminates in the left upper quadrant, likely within the stomach. No focal consolidation, pleural effusion, or pneumothorax is seen. Surgical clips project over the right neck. IMPRESSION: Endotracheal tube tip in the proximal right main stem bronchus. These findings were reported to ___ by ___ by telephone at 2:12 p.m. on ___ at the time of discovery of these findings. " f0acf9a5-48e26304-6e05e57c-442f71bf-42666865.jpg,validate/p13/p13122325/s51788848/f0acf9a5-48e26304-6e05e57c-442f71bf-42666865.jpg,validation," FINAL REPORT INDICATION: ___M with fever // eval for pna TECHNIQUE: PA and lateral views of 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. " 73a517de-091e0a7a-c57a10c1-afb08c62-87034ea8.jpg,validate/p11/p11533501/s57912353/73a517de-091e0a7a-c57a10c1-afb08c62-87034ea8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Hypotension. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The patient is status post sternotomy and probably coronary artery bypass graft surgery. 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. " f1b0ed4d-f56e6d77-89291aee-7b2ff857-e9f459b5.jpg,validate/p18/p18570637/s56970395/f1b0ed4d-f56e6d77-89291aee-7b2ff857-e9f459b5.jpg,validation," WET READ: ___ ___ ___ 10:32 PM Hyperinflation with chronic underlying lung disease. Possible trace residual pleural effusions. Rounded opacity projecting over the right upper lung, potentially focal region of infection. Given patient's degree of underlying parenchymal disease, however, followup is suggested to document resolution of this finding to exclude underlying mass lesion ______________________________________________________________________________ FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with asymptomatic hyperkalemia. Question pneumonia. COMPARISON: Chest x-ray and CT from ___. FINDINGS: AP and lateral views of the chest. The lungs are hyperinflated with coarse increased interstitial markings compatible with chronic underlying lung disease. There is new focal consolidation in the right upper lung, not seen on previous exam on the frontal view. There is trace blunting of the posterior costophrenic angles which may be small residual pleural effusions, improved from prior. The cardiomediastinal silhouette is unchanged. No acute osseous abnormality is detected. IMPRESSION: Hyperinflation with chronic underlying lung disease. Possible trace residual pleural effusions. Rounded opacity projecting over the right upper lung, potentially focal region of infection. Given patient's degree of underlying parenchymal disease, however, followup is suggested to document resolution of this finding to exclude underlying mass lesion. " a71e533c-7f00920a-d1444941-10cef569-35002819.jpg,validate/p19/p19424434/s50064116/a71e533c-7f00920a-d1444941-10cef569-35002819.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with weight loss // pls eval for pulmonary pathology 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 evidence of metastatic disease. No acute cardiopulmonary process. " b22042c4-fb3cd4ec-108371d6-3db77ee0-51e475ad.jpg,validate/p18/p18896198/s58702968/b22042c4-fb3cd4ec-108371d6-3db77ee0-51e475ad.jpg,validation," 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. " c813d4a4-d0bb43eb-a4b3d8c7-6a37430c-e27625ce.jpg,validate/p14/p14823694/s55486662/c813d4a4-d0bb43eb-a4b3d8c7-6a37430c-e27625ce.jpg,validation," 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. " 66ab28d8-4b553b9a-cf11580e-169032e6-b8bf71ce.jpg,validate/p12/p12674071/s59382564/66ab28d8-4b553b9a-cf11580e-169032e6-b8bf71ce.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior CT exam from ___. CLINICAL HISTORY: Cough and fever, assess pneumonia. FINDINGS: PA and lateral views of the chest were provided. The patient is known to have extensive pulmonary fibrosis, which in comparison with a prior chest radiograph from ___ appears similar in overall extent and severity. No definite evidence for a superimposed pneumonia. No effusion or pneumothorax is seen. Overall, cardiomediastinal silhouette appears grossly stable. The bony structures are intact. IMPRESSION: Extensive pulmonary fibrosis, similar to examinations. " 2c00b286-a5948ac8-e03116ae-06ed158b-a8f07903.jpg,validate/p10/p10900387/s51624280/2c00b286-a5948ac8-e03116ae-06ed158b-a8f07903.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M pmh HIV, Hep C, autoimmune hemolytic anemia, abd wall hematoma, ESRD on HD p/w AMS. Had a full run of HD today after which she developed decreased level of alertness. // please evaluate for picc placement COMPARISON: ___. IMPRESSION: Right PICC terminates in the proximal right atrium just below the expected level of the junction of the superior vena cava and right atrium. Stable cardiomegaly accompanied by pulmonary vascular congestion and worsening of moderate pulmonary edema. Small left pleural effusion is again demonstrated. " 3375ba4c-35fc4d0b-4de0795e-c421a3e0-5895475f.jpg,validate/p13/p13273041/s51442393/3375ba4c-35fc4d0b-4de0795e-c421a3e0-5895475f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: Shortness of breath and anemia on dialysis. Evaluate for edema. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Moderate cardiomegaly with pulmonary vascular congestion and moderate interstitial pulmonary edema. Cardiomediastinal silhouette is otherwise unchanged with mild unfolding of the thoracic aorta. No dense consolidation suspicious for pneumonia. Small bilateral pleural effusions. No pneumothorax. IMPRESSION: Pulmonary vascular congestion, moderate interstitial pulmonary edema and small bilateral effusions, improved compared to ___. " 41d26ef7-833a6b21-21b9c7f6-0b3dd2be-33ab9ae7.jpg,validate/p19/p19653727/s55468921/41d26ef7-833a6b21-21b9c7f6-0b3dd2be-33ab9ae7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with wheezing // eval infiltrate 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. " c982a2ef-6552da7f-3919cb67-f974ee80-7b064e01.jpg,validate/p15/p15386262/s52949502/c982a2ef-6552da7f-3919cb67-f974ee80-7b064e01.jpg,validation," 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. " 6368ced3-604d6f8f-c76863ce-2e49c19c-e7302c0b.jpg,validate/p14/p14464018/s58994248/6368ced3-604d6f8f-c76863ce-2e49c19c-e7302c0b.jpg,validation," FINAL REPORT HISTORY: ___-year-old man status post biventricular ICD placement via left subclavian access. Confirm lead placement. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: The left biventricular ICD is in appropriate position with leads ending at the right atrium, right ventricle and left ventricle appropriately. Moderate cardiomegaly continues without pulmonary edema. Lungs are clear without pneumothorax, consolidation or pleural effusion. IMPRESSION: Left ICD with appropriate lead placement at right atrium, right ventricle and left ventricle. No complications including pneumothorax. " 8e23f08a-9a1ab29d-d5d38dfe-c0c62ac5-c2febbb7.jpg,validate/p17/p17441758/s54102594/8e23f08a-9a1ab29d-d5d38dfe-c0c62ac5-c2febbb7.jpg,validation," FINAL REPORT INDICATION: ___M with parasthesia and weakness in R face and R arm, now resolved // ? abnormality, signs of TIA/stroke? PNA TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: Lung volume is low. There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. Aortic contour is tortuous. IMPRESSION: No radiographic evidence of pneumonia. " 38d8e31e-d7f872dc-9b36b0dc-d52c4a44-d82a4c15.jpg,validate/p19/p19874582/s55048924/38d8e31e-d7f872dc-9b36b0dc-d52c4a44-d82a4c15.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___M with chest pain // ptx? ptx? COMPARISON: None FINDINGS: The lungs are clear. The heart and mediastinal structures are unremarkable. The bony thorax is grossly intact. IMPRESSION: No active disease. " 677b22bf-431fa847-675567f6-d4dbd3be-c588ed8b.jpg,validate/p17/p17734241/s52120882/677b22bf-431fa847-675567f6-d4dbd3be-c588ed8b.jpg,validation," 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. " 4103f6a7-a86123b3-e61844ff-b3b68331-a49a8dfc.jpg,validate/p14/p14219343/s52817882/4103f6a7-a86123b3-e61844ff-b3b68331-a49a8dfc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF and +flu swab admitted for CHF exacerbation. Interval change. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Compared with the prior radiograph, the severity pulmonary edema has improved. Moderate to severe cardiomegaly is stable. A persistent right lower lobe opacity concerning for pneumonia, given the improved edema. No pneumothorax. No change in the continuous left pacemaker leads terminating in the right atrium and right ventricle. IMPRESSION: 1. Persistent right lower lobe opacity is concerning for pneumonia. 2. Improved pulmonary edema. " fb100f52-8f256883-630f1f05-8c21c404-2c7552c8.jpg,validate/p10/p10021487/s52264519/fb100f52-8f256883-630f1f05-8c21c404-2c7552c8.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: MVC. Cardiac size is top normal. Right subclavian catheter tip is at the cavoatrial junction. There is no pneumothorax. Bibasilar opacities, larger on the right side, are a combination of atelectasis and a moderate-to-large right pleural effusion and a small left pleural effusion. NG tube is out of view, below the diaphragm. " 97d0bd5b-14fc069d-404c6080-13e31685-c70cb69a.jpg,validate/p16/p16449190/s58258637/97d0bd5b-14fc069d-404c6080-13e31685-c70cb69a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyemea s/p vats now with fever // New fever spike in patient with empyema sp VATS New fever spike in patient with empyema sp VATS IMPRESSION: Comparison to ___. No relevant change in appearance of the postoperative right-sided chest. The position of the hemidiaphragm, the position of the chest tube, and the areas of postoperative changes at the lateral and basal aspect of the right hemi thorax are stable. Stable appearance of the left lung. Mild cardiomegaly persists. " 88b3db1a-ead865d1-620f0615-3058a4be-7c821d97.jpg,validate/p19/p19799143/s50357992/88b3db1a-ead865d1-620f0615-3058a4be-7c821d97.jpg,validation," FINAL REPORT HISTORY: PICC placement. FINDINGS: In comparison with the study of ___, there has been placement for right subclavian PICC line that extends to the upper portion of the SVC. There is continued enlargement of the cardiac silhouette without pulmonary vascular congestion, raising the possibility of cardiomyopathy or pericardial effusion. Opacifications projected above the upper chest on the right again most likely represents the hair of the patient. The lungs are essentially clear without pulmonary vascular congestion. " fd86a5d4-f1c356c9-cd85e48d-f7aeacea-d19c5ab0.jpg,validate/p16/p16624717/s51803557/fd86a5d4-f1c356c9-cd85e48d-f7aeacea-d19c5ab0.jpg,validation," WET READ: ___ ___ ___ 2:05 PM Right PICC tip in the low SVC. No pneumothorax. Persistent mild vascular congestion with small left pleural effusion. ___ d/w ___, IV nurse, ___ at 1:45 PM WET READ VERSION #1 ___ ___ ___ 1:48 PM Right PICC tip in the low SVC. No pneumothorax. Persistent mild vascular congestion with small left pleural effusion. ___ d/w ___, IV nurse, ___ at 1:45 PM ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with picc // r picc up to ij. power flushed, repeat x-ray. ___ iv ___ TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 7 hours earlier IMPRESSION: Right PICC tip is in thelower SVC. No other interval changes. . " 83cdb647-ca8ce2f7-63d5341a-2cc6e12c-3bba01e3.jpg,validate/p10/p10665449/s56484615/83cdb647-ca8ce2f7-63d5341a-2cc6e12c-3bba01e3.jpg,validation," FINAL REPORT HISTORY: Post-surgery, to check for lines. FINDINGS: No previous images. Obliquity of the patient and respiratory motion somewhat obscures the image. The endotracheal tube appears to be about 3.5 cm above the carina. There is enlargement of the cardiac silhouette with engorged and ill-defined pulmonary vessels consistent with some elevated pulmonary venous pressure. Probable atelectatic changes at both bases. " eb610979-98cdf629-e1fb806f-4b5d5f53-871552d2.jpg,validate/p18/p18605680/s50155132/eb610979-98cdf629-e1fb806f-4b5d5f53-871552d2.jpg,validation," FINAL REPORT INDICATION: ___-year-old male who presents for evaluation of pleural effusions recently seen on MR from ___. COMPARISONS: MRA torso from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Again seen is an rounded mass in the right lower lobe measuring 5.3 cm x 6 cm, better seen on the MR from ___. No other focal consolidations are identified. There is no pneumothorax. There is a small right-sided pleural effusion. The aorta is tortuous. The hilar and mediastinal contours are otherwise unremarkable. The heart size is normal. The patient is status post median sternotomy with evidence of aortic and mitral valve repair. IMPRESSION: 1. Stable small right pleural effusion. 2. 6-cm round right lower lobe opacity, better evaluated on the MR from ___. The differential is wide, including malignancy, rounded atelectasis, or organizing pneumonia. A dedicated Chest CT is highly recommended to further evaluate and characterize this abnormality. " e818889d-331211e0-3243592a-1d9e7bd9-7ac60501.jpg,validate/p16/p16918051/s54180142/e818889d-331211e0-3243592a-1d9e7bd9-7ac60501.jpg,validation," FINAL REPORT HISTORY: Syncope. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. The pulmonary vascularity is normal. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Multilevel degenerative changes are present within the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " dabf964e-2b6835f7-0adebf05-c7021e64-efd5b895.jpg,validate/p10/p10808116/s56082741/dabf964e-2b6835f7-0adebf05-c7021e64-efd5b895.jpg,validation," FINAL REPORT INDICATION: History: ___F with cough, night sweats // Eval for acute process 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. " 03d2087a-bf4bfeb6-566a8ae4-af8a9996-691452a6.jpg,validate/p11/p11177136/s53470945/03d2087a-bf4bfeb6-566a8ae4-af8a9996-691452a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with probable influenza now reports productive cough. // Pls. assess for pneumonia. PRODUCTIVE COUGH,INFLUENZA SYMPTOMS,VOMITING,FEVER ETC SEVERAL DAYS R/O PNEUMONIA IMPRESSION: In comparison with the study of ___, there again is hyperexpansion of the lungs raising the possibility of chronic pulmonary disease. However, no evidence of acute pneumonia, vascular congestion, or pleural effusion. Surgical clips are again seen in the region of the thyroid. " 0e6ecfff-73e7c9c0-0f80a841-e66720b3-861e7481.jpg,validate/p14/p14707155/s57782490/0e6ecfff-73e7c9c0-0f80a841-e66720b3-861e7481.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p dual chamber ICD. // Assess leads placement and r/o PTx. Assess leads placement and r/o PTx. IMPRESSION: Comparison to ___. The patient has received the new left pectoral pacemaker. The position of the leads is unremarkable, in the left atrium and the left ventricle, respectively. Stable elevation of the left hemidiaphragm with platelike areas of atelectasis. No pneumothorax or other complication. No pulmonary edema. " da0b20ca-f07b9865-50ac3db0-eb89d060-6b1dfd99.jpg,validate/p18/p18847797/s56971200/da0b20ca-f07b9865-50ac3db0-eb89d060-6b1dfd99.jpg,validation," 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. " aab36be4-db5baef9-0f4e8e12-39974a20-7a472aea.jpg,validate/p19/p19563021/s53808797/aab36be4-db5baef9-0f4e8e12-39974a20-7a472aea.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with ankle deformity status post fall. Pre-op. COMPARISON: None. FINDINGS: AP and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " d2b54262-423381bf-0437b755-6e63b8a6-7ee38c0f.jpg,validate/p11/p11167924/s51308743/d2b54262-423381bf-0437b755-6e63b8a6-7ee38c0f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COP on steroids, CHF, aspiration and other issues desatting // r/o new aspiration, pulm edema, effusion r/o new aspiration, pulm edema, effusion COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Substantial clearing of combination of mild pulmonary edema and bibasilar consolidation since ___. Moderate cardiomegaly improved minimally. Small left pleural effusion persists. No pneumothorax or right pleural effusion. Feeding tube ends in the region of the pylorus. Left PIC line ends at the origin of the SVC. " 321f2a9f-8eb9eb9b-9ff4fa65-0ef6ccb3-34a96118.jpg,validate/p13/p13501962/s59134560/321f2a9f-8eb9eb9b-9ff4fa65-0ef6ccb3-34a96118.jpg,validation," 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. " 715d0cdc-ddee4d9b-b5a28b77-350e1063-bc606f0d.jpg,validate/p19/p19991135/s54602632/715d0cdc-ddee4d9b-b5a28b77-350e1063-bc606f0d.jpg,validation," FINAL REPORT HISTORY: Lobectomy, to assess for change. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place without definite pneumothorax. The left lung remains essentially clear except for some atelectatic changes at the base. Extensive subcutaneous emphysema again persists along the right lateral chest wall. Opacification along the mediastinal border on the right again could reflect collection of pleural fluid. The development of hematoma cannot be excluded in the appropriate clinical setting. " 72dffcab-64918beb-ed01bf66-a49a3ffc-4c4309cd.jpg,validate/p19/p19906533/s59602223/72dffcab-64918beb-ed01bf66-a49a3ffc-4c4309cd.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: fever. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. Surgical clips project in the right upper quadrant. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " af7eaeaa-1ccfacfc-9578bf5d-533d1a0d-0c6601bd.jpg,validate/p10/p10206502/s50532934/af7eaeaa-1ccfacfc-9578bf5d-533d1a0d-0c6601bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF, crackles on exam and new O2 req after 2L IVF // evaluate for pulm edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the extent of a right pleural effusion has minimally increased. The lung volumes continue to be low and reticular opacities are seen at both lung bases. Mild fluid overload is present. Unchanged appearance of the cardiac silhouette. " eb28d201-b695a694-b5f8f92a-8c654e22-35d20fc2.jpg,validate/p11/p11842879/s51937040/eb28d201-b695a694-b5f8f92a-8c654e22-35d20fc2.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Weakness, immune compromise. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The lateral view is suboptimal due to the patient's overlying arm. Given this, no definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen. IMPRESSION: Suboptimal lateral view due to the patient's overlying arm. Given this, no definite focal consolidation seen. " 83ef2677-b734e9c1-836b6c6e-4b24c5da-c39e9f68.jpg,validate/p14/p14247006/s56128376/83ef2677-b734e9c1-836b6c6e-4b24c5da-c39e9f68.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Fever and rales at the right base. PA and lateral upright chest radiographs were reviewed in comparison to ___. Pacemaker leads terminate in the similar location in the right atrium, right ventricle and the left epicardial vein. Heart size and mediastinum are stable in the patient who is after median sternotomy and CABG. Lungs are essentially clear. There is interval development of new opacity projecting just above the minor fissure that potentially might reflect a focus of developing infection. No pleural effusion or pneumothorax is seen. IMPRESSION: Suspected right upper lobe developing infectious process, otherwise stable appearance of the radiograph. " 174d1d1a-1a0d9cba-1a7a4ffc-a0c910d0-f20fd572.jpg,validate/p19/p19519327/s54653389/174d1d1a-1a0d9cba-1a7a4ffc-a0c910d0-f20fd572.jpg,validation," FINAL REPORT AP CHEST, 12:06 A.M. ON ___ HISTORY: ___-year-old woman with uterine carcinoma and a psoas abscess. Fever, tachycardia and hypotension. Evaluate possible pneumonia. IMPRESSION: AP chest compared to ___: Cardiomediastinal silhouette has a normal appearance for supine positioning. Lungs clear. No pneumonia or pleural abnormality. " 82366968-f1e305b3-85dc3d12-07963195-ee6a4422.jpg,validate/p12/p12747817/s51185447/82366968-f1e305b3-85dc3d12-07963195-ee6a4422.jpg,validation," FINAL REPORT INDICATION: Hyperglycemia and elevated white count. COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: Left-sided dual-chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. The heart size is mildly enlarged with a left ventricular predominance. The mediastinal and hilar contours are unremarkable. There are streaky opacities in the lung bases, with mild blunting of the right costophrenic angle suggestive of a small pleural effusion. No pneumothorax is identified. There is no pulmonary vascular congestion. Clips are noted within the right upper quadrant of the abdomen. There are no acute osseous abnormalities. IMPRESSION: Bibasilar streaky opacities likely reflecting areas of atelectasis. Small right pleural effusion. " 17f97830-03efb3a3-3e1e6e66-4dba01a6-6a18c308.jpg,validate/p11/p11287191/s53663425/17f97830-03efb3a3-3e1e6e66-4dba01a6-6a18c308.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cough/asthma flare/R ___ ___ // RLL pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The overall appearance of the lungs are unchanged in appearance with subpleural nodular and reticular opacities an upper lobe predominance. The right hilar opacity extending to the periphery of the right lung has increased when compared to the prior examination. No acute focal consolidation. The cardiomediastinal silhouette is unchanged. The lung volumes are stable in appearance. IMPRESSION: Interval increase in the right hilar opacity, superimposed on chronic peripheral, upper lobe predominant opacities. The differential could include eosinophilic pneumonia if there is a history of asthma. " 0796086c-8c3c30e6-69b7804c-57bdb4dd-587bacc9.jpg,validate/p18/p18370366/s54261822/0796086c-8c3c30e6-69b7804c-57bdb4dd-587bacc9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man with elevated CK + Transaminitis // pulmonary process, lymphadenopathy TECHNIQUE: Single, AP, portable view of the chest. 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. " b220e29b-6d75c535-56fce0d9-d20ffdea-5d89f0fa.jpg,validate/p11/p11106897/s56548524/b220e29b-6d75c535-56fce0d9-d20ffdea-5d89f0fa.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Open chest, evaluation for lines. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the endotracheal tube has been pulled back. The other monitoring and support devices are in constant position. The pre-existing lung parenchymal opacities have decreased in extent and severity. However, they are still clearly visible. Signs of mild fluid overload are present in almost unchanged manner. Unchanged appearance of the cardiac silhouette. " ef2e38b8-e9932268-b9869f5e-e16ab32e-7632c2b1.jpg,validate/p19/p19209496/s59215573/ef2e38b8-e9932268-b9869f5e-e16ab32e-7632c2b1.jpg,validation," FINAL REPORT INDICATION: COPD and fever with HIV. 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. The lungs are hyperexpanded, with increased lucency in the upper zones, compatible with COPD. Mild dextroscoliosis is centered about the thoracic spine. Bibasilar opacities appear more prominent. IMPRESSION: No acute intrathoracic process. However, slightly increased bibasilar density warrants further evaluation with CT if fevers persist or worsen. " 8f354a72-c0553096-cdf77747-13f0b922-2fdcc03a.jpg,validate/p18/p18797250/s51149169/8f354a72-c0553096-cdf77747-13f0b922-2fdcc03a.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with COPD, DM w/fever, evaluate for source. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: A CLUSTER OF PERIBRONCHIAL OPACITIES WITH POSSIBLE MILD BRONCHIECTASIS IN THE RIGHT UPPER LOBE COULD BE AN ACUTE INFECTION, OR CHRONIC BRONCHIECTASIS. TWO SMALL OVOID OPACITIES IN THE LEFT UPPER LUNG, AN 11 MM LESION PROJECTING OVER THE FIRST ANTERIOR INTERSPACE AND A SUB CM LESION PROJECTING OVER THE SECOND ANTERIOR INTERSPACE COULD BE DUE TO ACUTE INFECTION AS WELL. LOWER LUNGS ARE CLEAR. THERE IS NO PLEURAL ABNORMALITY OR EVIDENCE OF CENTRAL LYMPH NODE ENLARGEMENT. HEART SIZE IS NORMAL. LATERAL VIEW SHOWS HEAVY CALCIFICATION IN THE PROXIMAL ARTERIES OF THE AORTIC ARCH. S shaped scoliosis of the thoracic spine is noted with moderate underlying degenerative changes. IMPRESSION: 1. SMALL PNEUMONIA OR CHRONIC BRONCHIECTASIS, RIGHT UPPER LOBE. 2. TWO LEFT UPPER LOBE LUNG NODULES COULD BE INFECTIOUS BUT NEED TO BE FOLLOWED. RECOMMENDATION(S): Follow-up chest radiographs in 3 weeks following treatment are recommended to ensure resolution and to evaluate for persistence of left upper lobe nodules. NOTIFICATION: The findings were discussed with ___, R.N. by ___ ___, M.D. on the telephone on ___ at 1:42 PM, 2 minutes after discovery of the findings. " 1d2fa964-871ea633-5e37c598-195c219a-165681dd.jpg,validate/p13/p13999026/s55980781/1d2fa964-871ea633-5e37c598-195c219a-165681dd.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG // eval for effusion infiltrate COMPARISON: Radiographs from ___ IMPRESSION: The right IJ Cordis has been removed. Dobbhoff tube is again seen. There is unchanged cardiomegaly. There is a left retrocardiac opacity which is slightly larger. There remains small bilateral effusions. There are no pneumothoraces. " 916c8cda-4a5b71e7-48853bfe-64498756-5f944dfe.jpg,validate/p19/p19358609/s58804781/916c8cda-4a5b71e7-48853bfe-64498756-5f944dfe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chf, multifocal pneumonia, intubated // evaluate for changes in pulmonary edema TECHNIQUE: Portable chest COMPARISON: ___. IMPRESSION: There has been some interval partial clearing of the right-sided infiltrate. However given the extensive distortion of the thoracic anatomy it is difficult to assess for resolution of the acute on chronic changes. The ET tube is unchanged " 99e83507-fd1f6838-50623835-ef6257a9-33a6be19.jpg,validate/p13/p13899130/s53161646/99e83507-fd1f6838-50623835-ef6257a9-33a6be19.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with productive cough with wheezing for 4 wks // pneumonia COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous radiograph, normal lung volumes. Borderline size of the cardiac silhouette without pulmonary edema. No pneumonia, no pleural effusions. " fe531efc-81e79a7a-bebe0869-53407138-9ae3d6cb.jpg,validate/p19/p19543748/s56593534/fe531efc-81e79a7a-bebe0869-53407138-9ae3d6cb.jpg,validation," 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. " 95593209-dbf5bd1d-4d956531-cdc56ed6-ef3f9101.jpg,validate/p16/p16869513/s55628548/95593209-dbf5bd1d-4d956531-cdc56ed6-ef3f9101.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ and ___. 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. " 83456932-a145da76-a83e7751-3ab67c1c-29f20286.jpg,validate/p10/p10705688/s56207261/83456932-a145da76-a83e7751-3ab67c1c-29f20286.jpg,validation," WET READ: ___ ___ ___ 11:05 AM No acute cardiopulmonary process ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with chest pain and DOE // effusion? PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph on ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 27d9921e-56ec41cf-e85dfc61-7e2d1a2e-d237116e.jpg,validate/p16/p16296993/s55931575/27d9921e-56ec41cf-e85dfc61-7e2d1a2e-d237116e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with COPD, acute onset dyspnea today // ?infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are relatively low lung volumes and mild vascular congestion. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mild to moderately enlarged. Compression of a vertebral body at the thoracolumbar junction is again noted. IMPRESSION: Low lung volumes and mild vascular congestion. Mild to moderate enlargement of the cardiac silhouette. " 351a6182-3b356131-814f3252-a60aabae-6fc7aa3f.jpg,validate/p17/p17051420/s50928792/351a6182-3b356131-814f3252-a60aabae-6fc7aa3f.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with diaphoresis. Evaluation for acute process. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate interval resolution of right lung base opacity since the prior study. There remains a small amount of atelectasis in the left lung base. Otherwise, the lungs are clear with no sign of pleural effusion, pulmonary edema, pneumothorax or focal consolidation concerning for pneumonia. The heart size is mildly enlarged, as before. The mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. Interval resolution of right lung base opacity since the prior study. " 2167259e-427ad08b-ab70830c-26556470-8568f252.jpg,validate/p11/p11295107/s57477605/2167259e-427ad08b-ab70830c-26556470-8568f252.jpg,validation," FINAL REPORT HISTORY: Fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The mediastinal contours are unremarkable. Streaky ill-defined opacities within the lung bases, more so on the left than on the right could reflect infection, aspiration, or atelectasis. No large pleural effusion or pneumothorax is present. There no overt pulmonary edema is seen. Mild cephalization of the left pulmonary vascular markings is noted. No acute osseous abnormalities present. IMPRESSION: Bibasilar ill-defined opacities which could reflect infection, atelectasis or aspiration. " 37e7e109-1e1e6bce-20a938dc-cfa538e9-c2c08520.jpg,validate/p18/p18593673/s59649984/37e7e109-1e1e6bce-20a938dc-cfa538e9-c2c08520.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with near syncope and shortness of breath. 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. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " 8ed61046-b2e1b1e0-94dc85b6-0d21f32e-2fa9e69a.jpg,validate/p12/p12183945/s53968763/8ed61046-b2e1b1e0-94dc85b6-0d21f32e-2fa9e69a.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cellulitis. 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. " 06b30503-b3b81e1c-b2c61f86-4f9d0a65-11afbe34.jpg,validate/p13/p13325402/s58490140/06b30503-b3b81e1c-b2c61f86-4f9d0a65-11afbe34.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ARDS // interval change? interval change? IMPRESSION: ET tube tip is 5.5 cm above the carinal. NG tube tip is in the stomach. Left internal jugular line tip is at the level of lower SVC. Right internal jugular line tip is at the level of mid SVC. There is interval improvement in pulmonary edema and bibasal consolidations but there is new left lower lobe atelectasis with substantial left mediastinal shift. Assessment of the patient after bronchoscopy of physical therapy is to be considered. " 925fee9c-276fc631-c393b6c5-4f03c455-775db932.jpg,validate/p17/p17302022/s52157745/925fee9c-276fc631-c393b6c5-4f03c455-775db932.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AF on amiodarone. // Evaluation of pulmonary toxicity. Evaluation of pulmonary toxicity. COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lungs are well expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Transvenous pacer leads and in the right atrium and right ventricle as before. Mild compression of mid and lower thoracic vertebral bodies is new since ___, as seen on the lateral view. " b4cc754f-8d940bcf-9a138b6c-9c06ff4c-a1bd66b5.jpg,validate/p12/p12921089/s57546786/b4cc754f-8d940bcf-9a138b6c-9c06ff4c-a1bd66b5.jpg,validation," FINAL REPORT HISTORY: Chest pain, question pneumothorax. COMPARISON: None available. FINDINGS: Frontal lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " d47b6063-9e73cd54-9154e14f-8edc0293-ff6f417d.jpg,validate/p15/p15887852/s54177807/d47b6063-9e73cd54-9154e14f-8edc0293-ff6f417d.jpg,validation," WET READ: ___ ___ ___ 4:16 AM No evidence pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with fall with subdural hematoma which is acute on chronic as well as worsening slurred speech // Pneumonia? TECHNIQUE: Upright frontal view of the chest. COMPARISON: None available. FINDINGS: Lung volumes are low and there is crowding of the bronchovascular structures. There is no pleural effusion, pneumothorax, or acute consolidation. Cardiac silhouette is top-normal in size but likely secondary to technical factors. Asymmetric elevation of the right hemidiaphragm is noted. There is no acute osseous abnormality. There is no free air underneath the bilateral hemidiaphragms. Right ventriculoperitoneal shunt catheter projects over the right hemithorax. Cardiac rhythm recorder is projecting over left lung base. IMPRESSION: No evidence pneumonia. " b536cf02-77a8e4b5-388a1d74-fb78bfdd-900d147b.jpg,validate/p12/p12559662/s50607742/b536cf02-77a8e4b5-388a1d74-fb78bfdd-900d147b.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with COPD and mental status change and cough and shortness of breath. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. Lungs are hyperinflated but clear of focal consolidation or effusion. There is no pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Hyperinflation without acute cardiopulmonary process. " a5b415f2-b092fbdd-488fd0f8-0d4c383a-eed231bc.jpg,validate/p15/p15541869/s55364313/a5b415f2-b092fbdd-488fd0f8-0d4c383a-eed231bc.jpg,validation," WET READ: ___ ___ ___ 7:09 PM Bilateral low lung volumes with accentuation of cardiac silhouette. Again noted is a large hiatal hernia with adjacent basilar atelectasis. Left costophrenic angle not well visualized, atelectasis vs pleural effusion cant be excluded. Minimal opacification at the right medial lung base may represent atelectasis, however infectious proces can't be excluded in the correct clinical setting. ______________________________________________________________________________ FINAL REPORT AP CHEST 6:40 P.M. ___ HISTORY: Decreased breath sounds and crackles at the right base, evaluate the lungs. IMPRESSION: AP chest compared to ___: Generalized interstitial pulmonary abnormality could be mild edema. Careful followup is advised because of the nodular quality of this abnormality which makes it imperative to exclude disseminated metastases or granulomatous infection. Low lung volumes exaggerate hilar size, another region that should be evaluated with conventional radiographs when feasible. Moderate cardiomegaly and large hiatus hernia are bigger today than they were in ___. Pleural effusions are small if any. Dr. ___ was paged. " dc4ce626-c748dc69-faa44a67-d0d35966-b8c35968.jpg,validate/p16/p16844011/s51312879/dc4ce626-c748dc69-faa44a67-d0d35966-b8c35968.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Altered mental status. TECHNIQUE: Chest, AP upright and lateral. COMPARISON: ___. 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. A chronic deformity of the distal right clavicle appears unchanged and may be due to an non-united fracture in the past. IMPRESSION: No evidence of acute disease. " 6029240f-b9ed074c-29d1a4f6-4a1f54d0-8d8f3447.jpg,validate/p14/p14300020/s57090708/6029240f-b9ed074c-29d1a4f6-4a1f54d0-8d8f3447.jpg,validation," FINAL REPORT INDICATION: ___ year old man with cough // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: In comparison to the prior study there is no substantial change. Heart is normal in size and cardiomediastinal contours stable. There is no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No evidence of pneumonia. NOTIFICATION: Findings were discussed by Dr. ___ with Dr. ___ ___ , on ___ at 3:00p, via telephone, as requested. " 3c7c8605-6ceec966-3fe2574a-ae315c90-e00ed273.jpg,validate/p18/p18357153/s56963763/3c7c8605-6ceec966-3fe2574a-ae315c90-e00ed273.jpg,validation," FINAL REPORT HISTORY: Epigastric and chest pain x1 hr. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: The lung volumes are noted to be low. Minimal, linear bibasilar atelectasis is present. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " e1e22d43-9edace44-8d7b1189-7b56bbeb-34ab8d54.jpg,validate/p10/p10874140/s50710808/e1e22d43-9edace44-8d7b1189-7b56bbeb-34ab8d54.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with cough and mild hypoxemia, r/o infiltrate // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: The cardiomediastinal silhouette is normal. The hila and pleura are unremarkable. The lungs are hyperexpanded with flattening of the left hemidiaphragm and increased AP diameter suggestive of chronic lung disease. On PA imaging there appears to be a subtle opacification of the right lower lung that corresponds with increased opacification overlying the the cardiac silhouette on lateral imaging which may indicate a developing right middle lobe pneumonia. There is a 5 mm right upper lobe nodule stable since ___ study. No pleural effusions or pneumothorax are seen. IMPRESSION: 1. Subtle opacification of the right middle lobe which may indicate a developing pneumonia. 2. Hyperexpanded lungs with increased AP diameter consistent with chronic lung disease. 3. Stable 5 mm right upper lobe nodule. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 15:53 into the Department of Radiology critical communications system for direct communication to the referring provider. " 5b38f79c-f50b2a57-9baf255d-cee34a42-9acd1eb5.jpg,validate/p14/p14497007/s56420176/5b38f79c-f50b2a57-9baf255d-cee34a42-9acd1eb5.jpg,validation," 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. " ac28c491-9feaa23f-f2da007b-594b53ed-5bf219bf.jpg,validate/p19/p19696532/s59698971/ac28c491-9feaa23f-f2da007b-594b53ed-5bf219bf.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with chest pain // r/o infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: Lung volumes are low, however the lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A rounded calcific density projecting over the heart on the lateral view is unchanged from prior and may represent a coronary stent. IMPRESSION: No acute cardiopulmonary process. " 091684f5-39969bc7-3852aa18-28effa2d-222c6c0a.jpg,validate/p19/p19501510/s54411196/091684f5-39969bc7-3852aa18-28effa2d-222c6c0a.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with symptoms of pneumonia. COMPARISON: Prior chest CT dated ___. FINDINGS: AP upright and lateral views of the chest were provided. Patient is known to have underlying emphysema accounting for hyperinflation and upper lobe lucency. There are ill-defined peribronchovascular opacities in the lower lungs concerning for pneumonia, perhaps slightly progressed from the prior CT chest. No large effusion or pneumothorax is seen. The heart and mediastinal contour appears stable. Clips are noted in the left upper abdomen. Bones appear intact. IMPRESSION: Emphysema with irregular peribronchovascular opacity in the lower lungs, slightly increased from prior CT exam from 2 days ago, likely reflect worsening pneumonia. " cd96c041-d393cf59-ff0b0a95-c5ed904b-f1db9c65.jpg,validate/p19/p19930326/s59842105/cd96c041-d393cf59-ff0b0a95-c5ed904b-f1db9c65.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Left kidney mass. // Please evaluate for changes and other abnormalities. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes remain low. Borderline size of the cardiac silhouette without pulmonary edema. No pneumonia, no pleural effusions. Normal appearance of the hilar and mediastinal structures. " 5d4a6d54-0dcfed74-155ae9bd-720ae78a-eba09dd7.jpg,validate/p15/p15022313/s50366440/5d4a6d54-0dcfed74-155ae9bd-720ae78a-eba09dd7.jpg,validation," WET READ: ___ ___ ___ 4:34 AM No acute cardiopulmonary pathology. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with tachy, syncope // eval for pna TECHNIQUE: Single portable upright radiograph the chest was obtained. COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. Hilar pleural surfaces are normal. IMPRESSION: No acute cardiopulmonary radiologic abnormality. " 1ec8fa8a-ba033f42-40561f5d-aed8267e-8c382e0d.jpg,validate/p19/p19524190/s52576625/1ec8fa8a-ba033f42-40561f5d-aed8267e-8c382e0d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ESRD , SOB // Evaluate lung status Evaluate lung status IMPRESSION: In comparison with study of ___, there again is hyperexpansion of the lungs with flattening hemidiaphragms consistent with chronic pulmonary disease. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " 3d926d03-30371493-078d26a6-215c8fb9-b383e6c3.jpg,validate/p13/p13417577/s54405002/3d926d03-30371493-078d26a6-215c8fb9-b383e6c3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with LUL lesion s/p RFA assess PTX // Assess Pneumothorax in patient s/p RFA LUL lesion. Please perform CXR at 5 pm (4 hours check). Please if possible upright position COMPARISON: ___, 15:07. IMPRESSION: As compared to the previous radiograph, the extent of the known left apical pneumothorax, measuring approximately 8-10 mm in diameter, is not substantially changed. There is currently no evidence of tension. Unchanged appearance of the heart and of the right lung. " bad6cd5d-5eb4aabf-280aeba2-34b69229-b5f7ea27.jpg,validate/p19/p19449400/s57561951/bad6cd5d-5eb4aabf-280aeba2-34b69229-b5f7ea27.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) Chest PA and lateral INDICATION: ___ year old woman with RT mca stroke // Please assess for NGT placement TECHNIQUE: Single frontal view of the chest COMPARISON: Portable chest x-ray ___ FINDINGS: The enteric tube is not clearly identified below the level of the carina though there is the suggestion that it does is far as the gastroesophageal junction. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: Recommend conventional radiographs to document position of the esophageal drainage tube. RECOMMENDATION(S): PA and lateral views for better visualization of the esophageal drainage tube. . " 3c097888-643a9a45-b5084449-3aa16966-51ccd590.jpg,validate/p11/p11124675/s52819409/3c097888-643a9a45-b5084449-3aa16966-51ccd590.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval change. COMPARISON: ___, 11:17. FINDINGS: As compared to the previous radiograph, the patient has been extubated and the endotracheal tube has been replaced by a tracheostomy tube. The position of the tracheostomy tube is unremarkable, its tip projects approximately 3.8 cm above the carina. The course of the nasogastric tube and the right PICC line are unchanged. Slightly more severe than on the previous exam are the very widespread bilateral parenchymal opacities, that has a reticulonodular appearance on the image. Unchanged moderate cardiomegaly with retrocardiac atelectasis and a likely very small left effusion. " bdf1cbcc-976d63ab-2cf24c0c-1e724a40-0c835652.jpg,validate/p15/p15354831/s53622487/bdf1cbcc-976d63ab-2cf24c0c-1e724a40-0c835652.jpg,validation," FINAL REPORT INDICATION: ___F with SOB and new renal failure // ?PNA vs CHF TECHNIQUE: AP upright and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: AP upright and lateral chest radiograph demonstrate low lung volumes. There is central vascular engorgement and cardiomegaly, the latter probably exaggerated by low lung volumes. No focal opacity is identified. No over pulmonary edema is seen. There is no large pleural effusion. No pneumothorax. No air under the right hemidiaphragm. IMPRESSION: Enlarged cardiac silhouette and central vascular engorgement likely accentuated by low lung volumes. Superimposed pulmonary vascular congestion is possible. " d14825ec-12bd26bb-edf51695-c642099e-bf79a136.jpg,validate/p14/p14371035/s53140586/d14825ec-12bd26bb-edf51695-c642099e-bf79a136.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with altered mental status. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. There is mild bibasilar atelectasis. Lungs are otherwise clear. Cardiomediastinal silhouette is stable in configuration. Previously identified right IJ central lines are no longer seen. Right-sided PICC identified with tip seen to at least the lower SVC; however, exact tip cannot be delineated due to overlying osseous structures. Severe degenerative changes at the shoulders bilateral in addition to multiple bilateral rib fractures and probable right thoracotomy changes. IMPRESSION: Bibasilar opacities suggestive of atelectasis, although a component of infection cannot be excluded. " 0630ee85-041ecf53-f28ae6d1-8efd2b2c-d2d2891d.jpg,validate/p15/p15161981/s56397774/0630ee85-041ecf53-f28ae6d1-8efd2b2c-d2d2891d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: HX SARCOID IN BONES IMPRESSION: In comparison with the study of ___, there is little overall change. Hyperexpansion of the lungs suggests some underlying chronic pulmonary disease. However, no acute pneumonia, vascular congestion, or pleural effusion. Specifically, no hilar or mediastinal adenopathy or prominence of interstitial markings to radiographically suggest sarcoidosis in the chest. " 71c04a39-e3be3568-7cd701ca-186bc913-245ae02d.jpg,validate/p10/p10785570/s58371852/71c04a39-e3be3568-7cd701ca-186bc913-245ae02d.jpg,validation," FINAL REPORT INDICATION: Epigastric pain. Evaluate for free air. 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. There is no free air seen under either hemidiaphragm. Suture anchors are noted in the left humeral head. IMPRESSION: 1. No acute cardiac or pulmonary process. 2. No free air under the diaphragm. " 77cba5fe-76a70c68-c7d83c54-e62af40d-57da1521.jpg,validate/p13/p13515776/s54759121/77cba5fe-76a70c68-c7d83c54-e62af40d-57da1521.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Asthmatic bronchitis, rule out pneumonia. COMPARISON: ___. FINDINGS: Unchanged mild overinflation. No pleural effusions. No focal parenchymal opacity suggesting pneumonia. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. " a0f73c44-484429c3-c13f0b59-3006a616-bddd6c1c.jpg,validate/p15/p15022658/s53824621/a0f73c44-484429c3-c13f0b59-3006a616-bddd6c1c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PNA in ___, has HIV // eval for PNA resolution eval for PNA resolution IMPRESSION: Comparison to ___. Lung volumes have increased, the previous parenchymal opacity at the right lung basis is no longer visualized. However, a nodular change in the left upper lobe is again visualized. The changes also documented on the CT examination from ___. The lesion should be followed until complete resolution. " b0fc69fc-bf0b3605-c7c522d3-1b8b4154-3c5965ba.jpg,validate/p13/p13598803/s51670609/b0fc69fc-bf0b3605-c7c522d3-1b8b4154-3c5965ba.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with known emphysema, aspergillomas and recurrent pneumonias with recent lingular pneumonia, re-assessment. PA and lateral upright chest radiographs were reviewed in comparison to ___. As compared to the prior study, there is substantial interval decrease in the density in the lingular consolidation consistent with its gradual resolution. Substantial distortion of the parenchyma in particular in the upper lungs is re-demostrated with no substantial interval change or new areas of consolidation demonstrated. There is also decrease in density in the right lower lung that might be consistent with decrease in the right middle lobe consolidation. Bilateral breast prostheses projecting on both PA and lateral views. There is no pleural effusion or pneumothorax. " c4bf1297-273a2c08-c9208a6b-3106d12f-4c194b7d.jpg,validate/p11/p11552741/s52505850/c4bf1297-273a2c08-c9208a6b-3106d12f-4c194b7d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic lung cancer, in respiratory distress. // interval change interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Patient has been extubated. Mild to moderate pulmonary edema has worsened since ___ and and there may be new small right pleural effusion. Chronic changes in the left lung are stable. Large heart and vascular mediastinum are long-standing as well. Right jugular line ends in the low SVC. " 49b14488-60b3fe58-bd08dd78-be942902-bc96135b.jpg,validate/p17/p17051420/s58138890/49b14488-60b3fe58-bd08dd78-be942902-bc96135b.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with dyspnea, evaluate for evidence of effusion. TECHNIQUE: AP chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: The cardiomediastinal silhouettes are stable, consistent with mild cardiomegaly. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no pulmonary vascular congestion or pulmonary edema. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. Stable mild cardiomegaly. " c4f15627-67e5659b-9c96e5e7-33584b55-5bf6dfeb.jpg,validate/p11/p11401718/s53442741/c4f15627-67e5659b-9c96e5e7-33584b55-5bf6dfeb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with weakness and syncope, history of achalasia. COMPARISON: ___ and ___ CT exam. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes low. Bronchovascular crowding in the lower lungs with mild atelectasis noted without convincing evidence for pneumonia or aspiration. No large effusion or pneumothorax. On the lateral projection, there is an ovoid radiodensity posterior to the heart which may reside within the distal esophagus in this patient with known achalasia. No signs of edema or congestion. Cardiomediastinal silhouette appears grossly unchanged. Imaged bony structures appear intact. IMPRESSION: As above. " f1d06d34-0f00e641-44fd1d26-55a5d764-1e7f3319.jpg,validate/p18/p18664755/s50204905/f1d06d34-0f00e641-44fd1d26-55a5d764-1e7f3319.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with syncope, luekocytosis resolving // r/o pna COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pulmonary edema. No pneumonia, no pleural effusions. " bc9bf62c-6e449d1c-3be2c4b3-99b96a2e-4f526f1b.jpg,validate/p11/p11352753/s51735029/bc9bf62c-6e449d1c-3be2c4b3-99b96a2e-4f526f1b.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough. COMPARISON: ___. FINDINGS: There is minimal left base atelectasis. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 17823010-afc1dd4e-cf50fbc0-a3c33001-c121d290.jpg,validate/p15/p15621186/s52547218/17823010-afc1dd4e-cf50fbc0-a3c33001-c121d290.jpg,validation," FINAL REPORT HISTORY: Fevers, change in mental status. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are reduced compared to the previous exam. Heart size remains borderline enlarged. The aorta remains tortuous. There is crowding of the bronchovascular structures but no overt pulmonary edema. Patchy opacities are noted within the lung bases, more pronounced on the left, which may reflect areas of atelectasis though infection or aspiration cannot be completely excluded. No pleural effusion or pneumothorax is seen. Bullet shaped radiopaque foreign body is noted within the left axilla. IMPRESSION: Low lung volumes with patchy bibasilar opacities likely reflective of atelectasis. Infection or aspiration cannot be excluded in the correct clinical setting. " 847fa77a-181b3bf3-cd114f9e-2f64b191-b1f2338b.jpg,validate/p10/p10287440/s58790738/847fa77a-181b3bf3-cd114f9e-2f64b191-b1f2338b.jpg,validation," FINAL REPORT HISTORY: Cough for 1 week. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph. ___ chest CT. FINDINGS: The heart size is normal. A moderate to large hiatal hernia is re- demonstrated. The mediastinal and hilar contours otherwise are unchanged. Pulmonary vascularity is normal. Subtle branching opacities in the mid lung fields bilaterally may correlate to the clusters of peribronchial tiny opacities seen on recent CT. No pleural effusion, focal consolidation or pneumothorax is visualized. No acute osseous abnormalities are identified. IMPRESSION: 1. Subtle branching opacities within the mid lung fields may correlate with the areas suspicious for chronic atypical mycobacterial infection or aspiration, as described on the prior Chest CT. No new focal consolidation is otherwise noted. 2. Moderate to large hiatal hernia. " fadd7c19-8f14186c-bb1785d1-7c3502bc-b7840489.jpg,validate/p12/p12041766/s52172830/fadd7c19-8f14186c-bb1785d1-7c3502bc-b7840489.jpg,validation," FINAL REPORT AP CHEST, 4:09 A.M., ___ HISTORY: ___-year-old woman with history of strokes and atrial fibrillation, on warfarin, with CHF. Confusion. IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Cardiac silhouette is very large due to cardiomegaly, with or without pericardial effusion. In the absence of mediastinal vascular engorgement any pericardial effusion is not hemodynamically significant. Thoracic aorta is calcified in the ascending portion, but not dilated. Pulmonary vasculature is unremarkable and lungs are clear. There is no appreciable pleural abnormality. " 1dbbe669-c7ba664f-890e90ac-3fe62da7-310f0445.jpg,validate/p12/p12475471/s56503954/1dbbe669-c7ba664f-890e90ac-3fe62da7-310f0445.jpg,validation," FINAL REPORT INDICATION: History: ___M with extensive cardiac PMH who presents with DOE. // ? PNA ? CHF exacerbation ? pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Frontal and lateral radiographs of the chest demonstrate clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. Median sternotomy wires and mediastinal clips are noted. IMPRESSION: No acute cardiopulmonary process. " 6f99108b-fabf1bae-af4b6eb6-4f3f8052-fb375558.jpg,validate/p15/p15605278/s59877678/6f99108b-fabf1bae-af4b6eb6-4f3f8052-fb375558.jpg,validation," 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. " 04ba318d-8e90499d-d73d3778-fa6dcd0a-0c4444f9.jpg,validate/p16/p16159749/s55455638/04ba318d-8e90499d-d73d3778-fa6dcd0a-0c4444f9.jpg,validation," FINAL REPORT HISTORY: Scant bibasilar rales which do not appear after coughing. Evaluate for fluid. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral chest radiographs are grossly unchanged from prior radiograph, demonstrating a normal cardiomediastinal silhouette and hyperinflated lungs without focal consolidation or pulmonary edema. There is no pleural effusion or pneumothorax. IMPRESSION: Unchanged hyperinflated lungs without focal consolidation, pulmonary edema, or pleural effusion. " d539d15d-e6cb8f31-217f269a-25cdbcd1-8c7d5a8a.jpg,validate/p19/p19231238/s54158425/d539d15d-e6cb8f31-217f269a-25cdbcd1-8c7d5a8a.jpg,validation," FINAL REPORT INDICATION: ___F with confusion // CXR: Eval for pnaCT head: eval for ICH TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: When compared to prior, there has been no significant interval change. There is persistent pulmonary edema. More confluent infrahilar opacity on the right could represent superimposed infection. There is no large effusion. Degree of cardiomegaly is unchanged. No acute osseous abnormalities. IMPRESSION: Pulmonary edema with more confluent opacity in the right infrahilar region which could represent edema versus superimposed infection. " 23fdc685-8851eb9b-b5ee438b-0f486c37-4677e1ed.jpg,validate/p13/p13473495/s57447816/23fdc685-8851eb9b-b5ee438b-0f486c37-4677e1ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Hemodialysis diabetes and congestive heart failure. Question acute cardiopulmonary disease. TECHNIQUE: Chest, portable AP upright. COMPARISON: ___. FINDINGS: A dialysis catheter terminates in the right atrium. There is a vascular stent projecting over the left chest apex which probably corresponds to a left subclavian venous stent. The heart is again moderately enlarged. The lung volumes are low. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute disease. " 98893daa-f4632ce8-7ed2a02b-414f6f9d-8ba34213.jpg,validate/p18/p18550032/s51679419/98893daa-f4632ce8-7ed2a02b-414f6f9d-8ba34213.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ett // ett ett IMPRESSION: Comparison to ___. The tip of the endotracheal tube projects approximately 8 cm above the carinal, the tube needs to be advanced by approximately 2-3 cm. The other monitoring and support devices are in stable correct position. Moderate cardiomegaly persists. Mild to moderate bilateral pleural effusions. Unchanged basal areas of atelectasis. " 4888afef-913eae93-98870007-bc007794-99bd83c2.jpg,validate/p17/p17396346/s51275663/4888afef-913eae93-98870007-bc007794-99bd83c2.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with pain. COMPARISON: ___ and ___. FINDINGS: PA and lateral views of the chest. The exam is somewhat limited secondary to patient body habitus. Linear opacities at the right lung base suggestive of atelectasis, similar to prior. Lungs are otherwise clear and there is no effusion. Cardiac silhouette is enlarged but stable. Left axillary surgical clips are noted. IMPRESSION: No definite acute cardiopulmonary process. " d006f6a1-8d9c10f6-1f106b3d-73fba077-5016940b.jpg,validate/p17/p17446941/s50866717/d006f6a1-8d9c10f6-1f106b3d-73fba077-5016940b.jpg,validation," FINAL REPORT INDICATION: Ten-day history of cough and increased dyspnea on exertion, recently completed antibiotic treatment without improvement. COMPARISON: ___ chest CT and chest radiograph. PA AND LATERAL VIEWS OF THE CHEST: The heart size remains mild-to-moderately enlarged. Extensive calcified hilar and mediastinal lymph nodes are again demonstrated with upward retraction of the hila bilaterally, and biapical fibrosis. Blunting of the costophrenic angles bilaterally is compatible with small bilateral pleural effusions. No new areas of focal consolidation are present. There are calcified bilateral breast implants present, and partially imaged is a right humeral head prosthesis. There is diffuse demineralization of the osseous structures with mild compression deformity of a low thoracic vertebral body, unchanged. IMPRESSION: Little interval change from prior with findings compatible with sarcoidosis. Persistent small bilateral pleural effusions. No new areas of focal consolidation identified. " 0549d4d4-5a1d291c-c1c99914-8d3fc60d-400ead3f.jpg,validate/p17/p17326247/s53145222/0549d4d4-5a1d291c-c1c99914-8d3fc60d-400ead3f.jpg,validation," WET READ: ___ ___ ___ 7:56 PM Normal chest. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: ___ M w/SOB TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The lungs are well-expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation. Bony structures are intact. IMPRESSION: Normal chest. " 5063dbb2-a92cde98-163b5f23-1a24195e-2c6a2722.jpg,validate/p14/p14816035/s55974134/5063dbb2-a92cde98-163b5f23-1a24195e-2c6a2722.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Chest tube placement ___ // Evidence of migration, PTX Evidence of migration, PTX IMPRESSION: In comparison with the study of ___, the right pigtail catheter it is extremely difficult to identified. No pneumothorax on this side and small residual pleural effusion and compressive atelectasis. On the left, the pigtail catheter appears to have been removed. No pneumothorax is identified and only mild atelectatic change and possible small effusion on this side. " b627f81e-5511f048-5447d69b-c76a9a23-bc8da409.jpg,validate/p18/p18051152/s52090022/b627f81e-5511f048-5447d69b-c76a9a23-bc8da409.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with altered mental status and leukocytosis. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There has been interval removal of a right PICC. Lung volumes are low. Moderate to severe bibasilar atelectasis and moderate bilateral pleural effusions have not cleared. No pneumothorax is seen. IMPRESSION: Bilateral pleural effusions with bibasilar atelectasis, similar compared to prior exam. " f123b9b1-6a745e82-2c99a730-768cd8b6-91d8ad97.jpg,validate/p18/p18026902/s57297476/f123b9b1-6a745e82-2c99a730-768cd8b6-91d8ad97.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p type A dissection repair // interval change TECHNIQUE: Portable chest film COMPARISON: Radiographs dating back to ___ FINDINGS: Left chest tube remains in place. ET tube terminates 5 cm above the carina. Median sternotomy clips and drains are unchanged in position. NG tube has migrated proximally since the prior examination, terminating near the cardia of the stomach with the port in the mid esophagus. Right layering mild to moderate pleural effusion with blurring of the right hemidiaphragm. There are prominent vascularity with horizontal linear opacities corresponding to mild interstitial edema, and interval finding. There is also a consolidation in the right lower lung which could be atelectasis or aspiration. The heart is moderately enlarged. IMPRESSION: Interval mild right-sided interstitial edema and layering right-sided mild to moderate pleural effusion. NG tube migrating proximal since the prior examination with the side port at the mid-esophagus; the NG tube can be advanced 15 cm. Right lower lung consolidation which could represent aspiration or atelectasis. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 12:13 PM, 1 minutes after discovery of the findings. " 87199d02-7a415dc5-c9c4f11f-120ecd1d-a5713162.jpg,validate/p18/p18688402/s51108219/87199d02-7a415dc5-c9c4f11f-120ecd1d-a5713162.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Pneumonia. Hypercarbic respiratory failure and pulmonary edema. Comparison is made with prior study ___. ET tube is in standard position. Left PICC tip is in the mid SVC. Enteric tubes tip are in the stomach. The NG tube side port is at the EG junction and should be advanced for a more standard position. Cardiomegaly is stable. Large bilateral effusions with adjacent atelectasis and vascular congestion are unchanged. " dfe5b525-f2472642-516239a4-c36b6723-fd61451b.jpg,validate/p14/p14014950/s52131300/dfe5b525-f2472642-516239a4-c36b6723-fd61451b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p mv repair // evaluate right ptx evaluate right ptx IMPRESSION: The Swan-Ganz has been removed. Pacemaker defibrillator hr are in several locations. Large left pleural effusion, moderate right pleural effusion, vascular congestion and bibasal areas of atelectasis are unchanged. Right pneumothorax appears to be minimally improved. " 8f94536e-00df114e-74fab5c0-496efc72-313f4d81.jpg,validate/p17/p17954167/s56199792/8f94536e-00df114e-74fab5c0-496efc72-313f4d81.jpg,validation," FINAL REPORT PATIENT HISTORY: ___-year-old man with history of stroke, recent seizure requiring intubation at OSH. INDICATION: Evaluation for interval changes. TECHNIQUE: Portable AP single-view chest x-ray in semi-supine position. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: All the monitoring devices are unchanged and in standard position. Lung volume is still low, but with increased opacification for worsening of the pulmonary edema. Persistent bibasilar atelectasis, especially on the left base, and pleural effusion. Heart size is still mildly enlarged. There is no pneumothorax. IMPRESSION: Increased pulmonary edema with persistent bibasilar atelectasis and pleural effusion. " f4c548ae-58c1afde-b6263898-147c0f15-d75fbb87.jpg,validate/p16/p16921333/s50325481/f4c548ae-58c1afde-b6263898-147c0f15-d75fbb87.jpg,validation," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with multiple myeloma, status post failed central line placement, evaluate for possible pneumothorax. FINDINGS: AP single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. Comparison of the frontal views do not disclose any new pulmonary or pleural abnormality. Specifically there is no evidence of any pneumothorax in the apical area. " bc8db468-b178d3ba-03bdb07d-16e95e5f-775875b8.jpg,validate/p13/p13849733/s51947909/bc8db468-b178d3ba-03bdb07d-16e95e5f-775875b8.jpg,validation," FINAL REPORT HISTORY: Chronic effusions, left sided rales, resolving pneumonia clinically. CHEST, TWO VIEWS. Compared with ___, at 17:02 p.m., the radiographic appearance is stable. Again seen is background COPD, with extensive parenchymal scarring, cardiomegaly, and moderately large right effusion with underlying collapse and/or consolidation. Increased opacity in the right ___/infrahilar region and pleural thickening and scarring with retraction in the left upper zone as well as blunting of the left costophrenic angle and scarring at the left base. Left vascular stent noted. Prior old right-sided rib fractures again noted. IMPRESSION: 1) COPD with extensive pleural/parenchymal scarring, right effusion with underlying collapse and/or consolidation, and right ___/infrahilar opacity are unchanged compared with ___. 2) The right-sided changes should be followed to conclusion to exclude underlying mass. The left apical scarring should also be followed over time to exclude an underlying neoplasm. " 15b70d93-0112300c-f6ecf8c7-dac8608d-47bdfb9b.jpg,validate/p14/p14618137/s59743664/15b70d93-0112300c-f6ecf8c7-dac8608d-47bdfb9b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with tachypnea and recent knee replacement. STUDY: Portable AP upright chest radiograph. COMPARISON: ___. FINDINGS: The heart size is within normal limits. The mediastinal contours are normal. The lung volumes are low, which show no consolidation. There is no large pleural effusion or pneumothorax. Clips in the neck from prior thyroid surgery are unchanged. IMPRESSION: Low lung volumes with no evidence of pulmonary or pleural abnormality. " 14d199e0-2ffbe5c0-17c10c34-cab9a9b8-aa217aca.jpg,validate/p15/p15596774/s53435029/14d199e0-2ffbe5c0-17c10c34-cab9a9b8-aa217aca.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with fever of unknown origin. 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 radiographic evidence of acute cardiopulmonary process. " 9eaf4d81-dccacd17-560a5d3c-231aacfb-6fc9cbac.jpg,validate/p18/p18049473/s52311476/9eaf4d81-dccacd17-560a5d3c-231aacfb-6fc9cbac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with abd pain, tachypnea TECHNIQUE: Portable AP radiograph COMPARISON: Chest PA lateral dated ___. FINDINGS: AP portable upright view of the chest provided. Diffuse bilateral ground glass pulmonary opacities are noted. There is relative increased opacity additionally in the left mid to lower lung. The possibility of pulmonary edema with a superimposed left mid to lower lung pneumonia is raised. No large effusion is seen. No pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are diffusely sclerotic consistent with renal osteodystrophy. IMPRESSION: 1. Diffuse pulmonary edema. 2. Possible pneumonia in the left lower lung. " 56125d16-6a2b4dc3-0b79a99c-6ef18fab-c3cdd9e8.jpg,validate/p11/p11435281/s51102580/56125d16-6a2b4dc3-0b79a99c-6ef18fab-c3cdd9e8.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: None. TECHNIQUE: Chest, AP upright 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 bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " f97918cd-cf5f9240-6b224ff1-52bd6422-e2b604b6.jpg,validate/p19/p19853875/s52992450/f97918cd-cf5f9240-6b224ff1-52bd6422-e2b604b6.jpg,validation," FINAL REPORT INDICATION: DKA. Evaluate for pneumonia. COMPARISON: Chest radiograph on ___. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " 878bf637-8706c7e0-b16ca520-fb11b6fb-357aea14.jpg,validate/p17/p17755234/s53612350/878bf637-8706c7e0-b16ca520-fb11b6fb-357aea14.jpg,validation," FINAL REPORT HISTORY: Pleural effusion, scheduled for thoracentesis. FINDINGS: In comparison with the study of ___, the patient is now upright so that the apparent improvement in the degree of pleural effusion is not convincing. There is a large right effusion and small left effusion with basilar atelectasis bilaterally. Left hemodialysis catheter remains in place. " 0857715c-d3140d0e-baa01f47-8e9bc472-de1b8854.jpg,validate/p12/p12844527/s52734198/0857715c-d3140d0e-baa01f47-8e9bc472-de1b8854.jpg,validation," FINAL REPORT HISTORY: Neutropenia, fever. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours are unchanged, with the heart size within normal limits. The aorta is mildly tortuous. The pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Bone island is again demonstrated within the ___ posterior right rib. Partially imaged is thoracic spinal fusion hardware with corpectomy in the upper to mid thoracic spine. S-shaped scoliosis of the thoracic spine is re- demonstrated. IMPRESSION: No acute cardiopulmonary process. " 739be77e-1298edc0-104ab3c1-a0657c90-827eebff.jpg,validate/p16/p16326143/s57686816/739be77e-1298edc0-104ab3c1-a0657c90-827eebff.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with HLD, obesity with chest discomfort and SOB, now resolved // r/o pna, pulm edema COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Eventration of the right hemidiaphragm again seen P 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. " f9ff2b3d-acc84159-abc4a26f-1d532324-450d6547.jpg,validate/p19/p19243413/s59770345/f9ff2b3d-acc84159-abc4a26f-1d532324-450d6547.jpg,validation," FINAL REPORT HISTORY: Allographic stem-cell transplant with fever. Rule out pneumonia COMPARISON: ___ FINDINGS: Frontal radiographs of the chest demonstrate normal heart size. A left sided PICC terminates in the upper SVC. The cardiomediastinal silhouette and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax. No displaced rib fracture identified. IMPRESSION: No pneumonia " fb3d5f11-667a8e02-d39c9002-dc2e9bd8-a8fd06b0.jpg,validate/p13/p13912710/s51925065/fb3d5f11-667a8e02-d39c9002-dc2e9bd8-a8fd06b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M fulminant liver failure TECHNIQUE: Portable supine AP view of the chest COMPARISON: None. FINDINGS: Endotracheal tube tip terminates 6 cm from the carina. Enteric tube tip is within the stomach. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is heavily evident on this supine exam. No displaced fractures are visualized. IMPRESSION: Standard positioning of the endotracheal and enteric tubes. No acute cardiopulmonary abnormality. " e30be331-edaedffe-b25a8989-4fca3a73-108629ce.jpg,validate/p17/p17679569/s51301230/e30be331-edaedffe-b25a8989-4fca3a73-108629ce.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with s/p tracheoplasty, right chest tube to water seal, pls eval interval change at ___ ___ ___/ ___ year old woman with s/p tracheoplasty, right chest tube to water seal, pls eval interval change at ___ ___ TECHNIQUE: Single AP radiograph of the chest COMPARISON: ___ FINDINGS: Right-sided chest tube tip projects over the upper mediastinum. Persistent small right pleural effusion and tiny pneumothorax at the right costophrenic angle. There is atelectasis of the right middle lobe. Persistent bilateral diffuse vascular prominence noted. Epidural catheter is unchanged in position. Improving right perihilar opacities compared to the most recent prior radiograph. Stable mild cardiomegaly. Bony thorax remains unchanged. IMPRESSION: Right-sided chest tube to water seal with a tiny right pneumothorax at the costophrenic angle and trace pleural effusion. Interval significant improvement in right perihilar opacities with new right middle lobe atelectasis and unchanged left lower lobe linear atelectasis. " 63fe14e7-4a775b1d-6d5b2d03-4672e39c-6524d4f7.jpg,validate/p12/p12124636/s52807129/63fe14e7-4a775b1d-6d5b2d03-4672e39c-6524d4f7.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain, elevated troponin // Acute cardiopulmonary process TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: The lungs are clear. No focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 35b50664-7c4dba0a-a17be9c9-af0a630d-964843f0.jpg,validate/p14/p14975219/s55054102/35b50664-7c4dba0a-a17be9c9-af0a630d-964843f0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx astham, allergies, remote history of ""lung scarring"", presenting with dyspnea on exertion for several months. ECHO normal. Looking for other causes for DOE. // Evidence of lung scarring? Evidence of mass? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Lungs are well inflated and grossly clear. No pleural effusion or pneumothorax. Hilar contours are normal. There is prominence of the main pulmonary artery. IMPRESSION: 1. No acute cardiopulmonary process. Mildly prominent nonspecific diffuse interstitial lung markings. 2. There is mild prominence of the main pulmonary artery. " 007ea029-47485200-c8cd0f7e-76299176-31daf57d.jpg,validate/p17/p17935897/s57526652/007ea029-47485200-c8cd0f7e-76299176-31daf57d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypercarbic respiratory failure // Any interval change? TECHNIQUE: Chest single COMPARISON: ___ 09:01 FINDINGS: Sternotomy, valve prosthesis. Right perihilar, basilar opacity has improved. Stable left perihilar opacity, left basilar consolidation. Mildly improved right pleural effusion. Stable left pleural effusion. Increased heart size, pulmonary vascularity, stable. IMPRESSION: Interval mild improvement. " d7c07cad-e7762f86-1de12e74-4ed1aa44-037ae127.jpg,validate/p15/p15952888/s57945451/d7c07cad-e7762f86-1de12e74-4ed1aa44-037ae127.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with brain mass. // Preop Surg: ___ (Brain biopsy/resection) TECHNIQUE: Single AP radiograph of the chest. COMPARISON: CT dated ___. Chest radiograph dated ___. FINDINGS: Low lung volumes. Bibasilar opacities likely represent atelectasis. No focal consolidations. The pulmonary vasculature is normal. The right mediastinum appears enlarged, which may be rotational. Moderate-sized hiatal hernia is unchanged. No pneumothorax. IMPRESSION: 1. Low lung volumes and bibasilar atelectasis, but no focal consolidations. 2. Right mediastinal enlargement, which may be rotational, but repeat radiographs with improved positioning should be obtained. 3. Moderate-sized hiatal hernia. RECOMMENDATIONS: Repeat radiographs with improved positioning is recommended to rule out right mediastinal enlargement. NOTIFICATIONS: The impression and recommendation above was entered by Dr. ___ on ___ at 11:12 into the Department of Radiology critical communications system for direct communication to the referring provider. " 9cb71a28-bf690bb1-26cc97e5-848c76ff-ee5ba6cb.jpg,validate/p11/p11647491/s50820505/9cb71a28-bf690bb1-26cc97e5-848c76ff-ee5ba6cb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT advancement // NGT placement COMPARISON: Chest x-ray from ___ at 12:13 FINDINGS: An NG tube is present. The tip extends beneath the diaphragm and overlies the expected site of the gastric fundus. The sideport lies near the expected location of the GE junction. Inspiratory volumes are low. Cardiomediastinal silhouette is unchanged. Slight asymmetry in a density of the hemithoraces, more lucent on the right, is unchanged. The chin overlies the upper chest in the midline. Extreme left costophrenic angle excluded from film. No focal consolidation or gross effusion is identified. " df56e5b4-90969d8e-9cef7907-57285633-fa220c0c.jpg,validate/p15/p15579947/s58210535/df56e5b4-90969d8e-9cef7907-57285633-fa220c0c.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain with pleurtic component // ? infectious process 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 abnormalities. IMPRESSION: No acute cardiopulmonary process. " d6202fa7-ccdcbf69-214c9912-f13ecc32-a5e0fdae.jpg,validate/p10/p10374990/s57752431/d6202fa7-ccdcbf69-214c9912-f13ecc32-a5e0fdae.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R chylothorax s/p chest tube placement. // Please evaluate for interval change in chylothorax, chest tube placement IMPRESSION: Right pigtail pleural catheter remains in place with persistent small to moderate right pleural effusion. Right apical pneumothorax is difficult to exclude due to partial obscuration of this region by the flexed position of the neck. With the exception of limited visualization of this region, there is otherwise no relevant change from the recent radiograph of 1 day earlier. " fe254888-768943f4-3af683a9-52bdc125-b2f60548.jpg,validate/p15/p15808961/s55599527/fe254888-768943f4-3af683a9-52bdc125-b2f60548.jpg,validation," WET READ: ___ ___ ___ 7:59 PM Normal cardiac silhouette. Right upper lung opacity potentially due to scarring however given lack of priors to document stability, chest CT is suggested for further evaluation on a nonurgent basis to evaluate for underlying mass lesion. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chest pain // Please eval for cardiomegaly TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is right apical opacity, some of which has a spiculated margin. Given superior retraction of the hilum on the right this could be due to scarring although underlying lesion would also be possible. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities. IMPRESSION: Right upper lung opacity potentially due to scarring however given lack of priors to document stability, chest CT is suggested for further evaluation on a nonurgent basis to evaluate for underlying mass. " 2b9e91f8-ddc731e8-cc788dca-9fcbcbf6-18586fa1.jpg,validate/p12/p12138413/s57723726/2b9e91f8-ddc731e8-cc788dca-9fcbcbf6-18586fa1.jpg,validation," WET READ: ___ ___ ___ 2:21 AM 1. Mild pulmonary edema with mild cardiomegaly. 2. Rounded 1.8 cm dense retrocardiac opacity may represent a partially calcified lymph node or pulmonary nodule. Differential includes focal pneumonia in the appropriate clinical setting. Comparison with prior films would be helpful and if not available consider repeat frontal and lateral chest radiograph 6 weeks after resolution of symptoms. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with sob. Assess for fluid overload TECHNIQUE: Single portable semi-erect frontal chest radiograph. COMPARISON: None. FINDINGS: Minimal peribronchial cuffing with mild perihilar opacities and mild cardiomegaly is most consistent with mild pulmonary edema. A rounded 1.8 cm dense retrocardiac opacity is noted. No pleural effusion or pneumothorax. Mediastinal contour is unremarkable. Aortic arch calcifications are present. IMPRESSION: 1. Mild pulmonary edema with mild cardiomegaly. 2. Rounded 1.8 cm dense retrocardiac opacity may represent a partially calcified lymph node or pulmonary nodule. Differential includes focal pneumonia in the appropriate clinical setting. Comparison with prior films would be helpful and if not available consider repeat frontal and lateral chest radiograph 6 weeks after resolution of symptoms. " a6f3eb9b-3d2fe601-c57455ee-5c373473-c27821fd.jpg,validate/p12/p12414328/s50417877/a6f3eb9b-3d2fe601-c57455ee-5c373473-c27821fd.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Status post arrest. COMPARISON: None. FINDINGS: Single AP portable view of the chest was obtained. The patient is status post median sternotomy. There is mild-to-moderate pulmonary edema. The cardiac silhouette is mildly enlarged. No large pleural effusions are seen, but small pleural effusions to be difficult to exclude. Right base opacity most likely represents a prominent vascular structure, although underlying consolidation due to aspiration or infection not excluded. Mediastinum is within normal limits. IMPRESSION: Pulmonary edema and mild cardiomegaly. Difficult to exclude small pleural effusions. Patchy right base opacity may relate to prominent vascular structures, although underlying consolidation from aspiration or infection may be present. " f3e8100a-025fae07-305e54f6-3a994c7f-d5b9a8e8.jpg,validate/p16/p16945691/s50294000/f3e8100a-025fae07-305e54f6-3a994c7f-d5b9a8e8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP // eval for cardiomegaly TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is severe cardiomegaly. The aorta is tortuous. The lungs are clear without focal consolidation. There is no elevated pulmonary vascular congestion, pulmonary edema, or pleural effusion. A left chest wall pacemaker is present, with leads terminating in the right atrium and right ventricle. Surgical clips are noted overlying the upper abdomen. IMPRESSION: Severe cardiomegaly. " 4853190c-c8ac0c09-0627d090-4dc4a530-72ddb855.jpg,validate/p17/p17118648/s56539312/4853190c-c8ac0c09-0627d090-4dc4a530-72ddb855.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) CLINICAL HISTORY History: ___F with cough // pna pna COMPARISON: ___ FINDINGS: The lungs are clear. The heart and mediastinal structures are unremarkable in appearance. The bony thorax is grossly intact. There is no significant interval change. IMPRESSION: No active disease. " b466e0b4-a9b90f92-b156081c-9d20b8ce-f1b45f91.jpg,validate/p18/p18517718/s52043785/b466e0b4-a9b90f92-b156081c-9d20b8ce-f1b45f91.jpg,validation," FINAL REPORT SINGLE PORTABLE VIEW OF THE CHEST REASON FOR EXAM: Respiratory distress, tachypnea. Comparison is made with prior study ___. Mild pulmonary edema is new. Left lower lobe retrocardiac opacities have increased, consistent with increasing atelectasis. Cardiomediastinum is unchanged. There is no pneumothorax. If any, there is a small right pleural effusion. NG tube tip is in the stomach. " 3fee0682-231a4968-00593ef2-652c36ae-98495700.jpg,validate/p16/p16662264/s50752207/3fee0682-231a4968-00593ef2-652c36ae-98495700.jpg,validation," FINAL REPORT HISTORY: Self extubation, reintubated, question aspiration, check tube position. COMPARISON: Chest x-ray dated ___. On the current film, the ET tube extends to the origin of the right main stem bronchus and should be retracted approximately 2-3 cm. An NG tube is present, sideport in the region of the GE junction or immediately distal to it and tip overlying the stomach. Again seen are diffuse bilateral somewhat patchy alveolar infiltrates throughout the entire right lung and through most of the left lung, with relative sparing of the left upper zone. Possible slight interval improvement in the appearance of the infiltrates, as the previously seen right middle lobe bronchograms are less apparent. No gross effusion. IMPRESSION: 1. ET tube at origin of right main stem bronchus. Findings called to the ordering clinician, Dr ___, at the time of discovery at 5:36 p.m. on the day of the exam and discussed with her shortly thereafter (___, phone). 2) NG tube tip overlying stomach, but sideport is at or immediately distal to the GE junction. " 63c25b19-7c711773-99778121-1cd28e35-14db37d3.jpg,validate/p18/p18001587/s52325089/63c25b19-7c711773-99778121-1cd28e35-14db37d3.jpg,validation," WET READ: ___ ___ ___ 8:42 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with rheumatoid arthritis, on prednisone with altered mental status and leukocytosis, question infection. Comparison to ___. Single portable AP chest film dated ___ at ___ is submitted. IMPRESSION: 1. Heart is upper normal of limits in size given portable technique. No evidence of pulmonary edema, pleural effusion, pneumothorax or focal airspace consolidation to suggest pneumonia. Slightly prominent azygous vein which likely represents a fluid replete state. No acute bony abnormality. " 5ec01dd5-78c8c95c-92a3cfda-82eaffd7-77419ded.jpg,validate/p14/p14244279/s55805334/5ec01dd5-78c8c95c-92a3cfda-82eaffd7-77419ded.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain and shortness of breath // ?acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The cardiomediastinal silhouette is stable since the prior examination, with at least moderate cardiomegaly. There is central pulmonary vascular congestion, likely slightly more prominent than on prior examination. The thoracic aorta is tortuous. There is no focal consolidation. There is no definite pleural effusion or pneumothorax. Anterior cervical fusion hardware is again demonstrated. IMPRESSION: Central pulmonary vascular prominence without overt edema. Stable cardiomegaly. " c1610076-7344ca52-76ac1da0-6b6e055a-0888a924.jpg,validate/p11/p11888614/s56780883/c1610076-7344ca52-76ac1da0-6b6e055a-0888a924.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Mild pulmonary vascular redistribution persists. Interstitial prominence is likely chronic. Heart and mediastinal contours are within normal limits. IMPRESSION: Pulmonary vascular congestion, a little more congested than his best recent chest radiograph on ___. " da89fc36-e5f83079-01d094fe-7a2a0783-372db55f.jpg,validate/p10/p10420279/s57008767/da89fc36-e5f83079-01d094fe-7a2a0783-372db55f.jpg,validation," FINAL REPORT HISTORY: Alcohol abuse with palpitations. 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. " 1bc4afa6-791708f6-f5d10134-198546c2-096269b5.jpg,validate/p11/p11014692/s54706436/1bc4afa6-791708f6-f5d10134-198546c2-096269b5.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with babesiosis, marked hemolysis and hyponatremia, chest radiograph prior to transfusion TECHNIQUE: PA and lateral chest radiographs were obtained with 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 within normal limits. IMPRESSION: No acute cardiopulmonary radiographic abnormality. " 9d49710c-bb1b9b76-fd628b93-63d23d15-6ea91595.jpg,validate/p18/p18251740/s53615665/9d49710c-bb1b9b76-fd628b93-63d23d15-6ea91595.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness and orthostasis. COMPARISONS: ___. TECHNIQUE: Chest, PA upright and lateral views. FINDINGS: The heart is normal in size. There is mild unfolding of the upper thoracic aorta. The mediastinal and hilar contours appear unchanged. There are streaky band-like opacities in the medial right lower and in the right upper lung, most compatible with mild atelectasis, while a more generalized interstitial abnormality has resolved. There is no pleural effusion or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. Resolution of interstitial abnormality. Band-like opacities compatible with minor atelectasis in the right lung. " ce1e8b75-171f4363-bf3acf9d-a4e998ee-3fa4f39d.jpg,validate/p18/p18202111/s53357978/ce1e8b75-171f4363-bf3acf9d-a4e998ee-3fa4f39d.jpg,validation," WET READ: ___ ___ 1:26 PM 1. No new focal consolidation worrisome for pneumonia. 2. Incomplete evaluation of the known pulmonary nodules. There may be a new 8 mm nodule in the right upper lung from the chest CT of ___. Repeat evaluation with cross-sectional imaging would depend on the clinical circumstance. 3. Right upper extremity PICC courses into the mid SVC. ______________________________________________________________________________ FINAL REPORT INDICATION: Anemia, chronic kidney disease and right-sided pleuritic chest pain with hypertension. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CT ___. FINDINGS: A right upper extremity PICC courses into the mid SVC. Small left pleural effusion is slightly larger. There is no right pleural effusion. No pneumothorax or focal airspace consolidation worrisome for pneumonia. The known pulmonary nodules, thought to be rheumatoid in nature, are partially visualized. The largest is seen in the left lobe lung and measures 3.2 x 2.1 cm, unchanged accounting for differences in technique. The known necrotic left lower lobe nodule is partially visualized through the left hemidiaphragm. There is an 8 mm nodular opacity seen in the right upper lung and a smaller, vague opacity in the left mid lung, which were not visualized on the chest CT from ___. The mediastinal and hilar structures are unremarkable. Heart size is normal. No pulmonary edema. IMPRESSION: 1. No new focal consolidation worrisome for pneumonia. 2. Small pleural effusion, slightly larger from ___. 3. Incomplete evaluation of the known pulmonary nodules. There may be a new 8 mm nodule in the right upper lung and a smaller nodule in the left midlung from the chest CT of ___. Reassessment with non-emergent chest CT is suggested for further assessment. 4. Right upper extremity PICC courses into the mid SVC. " 66fdbbcb-200f3e7b-0401becf-55ba0350-850b2fb8.jpg,validate/p10/p10164613/s57212847/66fdbbcb-200f3e7b-0401becf-55ba0350-850b2fb8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with 02 sat ___ on 4l via nc // R/O PE, CHF, Pneumonia R/O PE, CHF, Pneumonia IMPRESSION: As compared to ___, the nasogastric tube was removed. The lung volumes have substantially decreased, with atelectatic areas at both lung bases. In addition, there is increased radiodensity at the right lung base, potentially reflecting pneumonia. No pleural effusions. Mild cardiomegaly without pulmonary edema. " 5cc6dc4f-22c00e07-da7a9d7e-946f4761-72c26d12.jpg,validate/p10/p10410774/s58610336/5cc6dc4f-22c00e07-da7a9d7e-946f4761-72c26d12.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with slurred/slow speech, status post parietal lobe tumor resection TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Flattening of diaphragms and widening of the AP diameter of the thorax is compatible with underlying COPD. Lung volumes are slightly decreased compared to the previous radiograph. Small bilateral pleural effusions have increased since the prior study, and there worsening patchy bibasilar airspace opacities which could reflect atelectasis but infection is not excluded. Heart size also appears mildly enlarged with mild pulmonary vascular congestion, both of which have increased since the prior radiograph. Chain sutures are noted in the left mid lung. There is no pneumothorax. No acute osseous abnormalities detected. IMPRESSION: Patchy bibasilar airspace opacities may reflect atelectasis but infection or aspiration cannot be excluded. Increased small bilateral pleural effusions. Mild cardiomegaly and mild pulmonary vascular congestion, increased from prior. " 18f2b76a-d77d748d-2b848856-341093c8-2c7f67b2.jpg,validate/p16/p16179092/s56673013/18f2b76a-d77d748d-2b848856-341093c8-2c7f67b2.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Chest pain. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " d9e0ad21-6d587335-c939c6c5-f2155b05-440b9cba.jpg,validate/p14/p14280581/s51470944/d9e0ad21-6d587335-c939c6c5-f2155b05-440b9cba.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Found down. TECHNIQUE: Chest, portable AP upright. COMPARISON: None. FINDINGS: The heart is normal in size. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Opacity in the left lower lung suggests pneumonia; noting blurring of the left cardiac border, it probably localizes to the lingula. IMPRESSION: Opacity suggesting pneumonia in the left lower lung, probably in the lingula. Follow-up radiographs are recommended to show resolution in ___ weeks. " cc4596f1-d984df70-bf62787d-228ca21b-6c9eb4ff.jpg,validate/p13/p13752571/s55235500/cc4596f1-d984df70-bf62787d-228ca21b-6c9eb4ff.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with persistent upper respiratory symptoms with left-sided rhonchi. COMPARISON: PA and lateral chest radiographs, ___ and multiple chest radiographs dating back to ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are mildly hyperinflated bilaterally with no areas of focal consolidation, pleural effusion, mass lesions, or evidence of pneumothorax. There is stable linear calcification seen in the right mediastinum which is unchanged since ___. The aorta is mildly tortuous and dilated. The heart is of normal size. The pleural surfaces are unremarkable with stable flattening of the hemidiaphragms. There are stable moderate multilevel degenerative changes with large anterior osteophytes. IMPRESSION: No evidence of malignancy or infection. " b38cc0f4-0985aade-9b2075bf-3cf9064c-7f422cc1.jpg,validate/p12/p12176298/s56019048/b38cc0f4-0985aade-9b2075bf-3cf9064c-7f422cc1.jpg,validation," FINAL REPORT INDICATION: Evaluation for mucous plugging and shortness of breath in a patient status post righ upper lobe wedge resection and superior vena cava reconstruction. COMPARISON: Multiple chest radiographs, the most recent of ___, 15 hours prior. FINDINGS: Portable AP view of the chest was reviewed and compared to the prior study. A right pleural catheter courses along the lateral right chest and is unchanged in position. Upper enteric tube passes into stomach and off of the radiograph. Midline sternotomy wires are intact and aligned. Right hilar clips and additional clips in the right hemithorax are unchanged. Diffuse opacities throughout the left lung have continued to increase since ___ and are highly concerning for infection. Right lower lung atelectasis and a right apical pneumothorax are unchanged. A triangular opacity in the right upper lung adjacent to he superior mediastinum is unchanged and could represent fluid related to the surgery. The heart size is normal and aortic calcifications are unchanged. There is no pleural effusion. Subcutaneous air along the right lateral chest wall has decreased. Right-sided rib defects and deformiting as well as resection of the medial aspect of the right clavicle are unchanged. IMPRESSION: 1. Continued increase in heterogeneous opacities in the left lung is concerning for infection. 2. Unchanged right upper lung wedge-shaped opacity that could represet a fluid collection. 3. Unchanged small right apical pneumothorax. " 4f1a5cb0-4dcfac39-98e7c944-ecb7a1c0-d028409d.jpg,validate/p13/p13757356/s53409104/4f1a5cb0-4dcfac39-98e7c944-ecb7a1c0-d028409d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with porcine aortic valve endocarditis, now with new fevers // Assess for pneumonia IMPRESSION: As compared to ___ radiograph,appearance of the chest is stable in this patient with evidence of previous median sternotomy and aortic valve replacement. Cardiomediastinal contours are normal, and lungs are clear. " 889e6c39-f18ba4d5-b74a0aac-9207b351-b09a0133.jpg,validate/p11/p11263330/s50623798/889e6c39-f18ba4d5-b74a0aac-9207b351-b09a0133.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man currently intubated after drainage of retropharyngeal abscess // Please assess for interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 7 cm above the carinal. NG tube tip is in the stomach. Pacemaker defibrillator lead is in appropriate location. Cardiomegaly is unchanged. Vascular congestion/ mild interstitial edema are unchanged. " 407e4a2d-e88aee0a-857a16b0-a3ba2d9b-c178b50e.jpg,validate/p14/p14480817/s51520211/407e4a2d-e88aee0a-857a16b0-a3ba2d9b-c178b50e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with altered mental status// Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Consolidative opacities are noted in both lung bases, more so on the right. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: Bibasilar consolidative airspace opacities concerning for multifocal pneumonia. " 8ce8cf5a-d0a96774-958bd81d-ef02cbee-f5495713.jpg,validate/p11/p11708598/s59744901/8ce8cf5a-d0a96774-958bd81d-ef02cbee-f5495713.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with left rib pain. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lung volumes are low. Cardiomediastinal silhouette and hilar contours appear unremarkable. The lungs appear clear. No obvious pleural effusion or pneumothorax. No apparent rib fractures. IMPRESSION: No evidence of acute cardiopulmonary process. " b2abd14c-d120fd9f-57f69ca0-20a3119b-2d5271d1.jpg,validate/p17/p17415919/s53735830/b2abd14c-d120fd9f-57f69ca0-20a3119b-2d5271d1.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Dyspnea and dizziness with low blood pressure. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: The patient is status post coronary artery bypass graft surgery. 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. " 902eff2e-fa561f7b-5fa0f94e-e783fda8-9929d74a.jpg,validate/p10/p10295064/s59266404/902eff2e-fa561f7b-5fa0f94e-e783fda8-9929d74a.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with myalgias. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 006c7ff8-5a6afee0-79373cfb-ea4e4b32-47772737.jpg,validate/p16/p16000871/s56018087/006c7ff8-5a6afee0-79373cfb-ea4e4b32-47772737.jpg,validation," 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 ___. " 03a153b1-fdb4dac5-efcbde61-414e936b-3e51ac8d.jpg,validate/p11/p11825167/s59749433/03a153b1-fdb4dac5-efcbde61-414e936b-3e51ac8d.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: Chest radiograph ___. FINDINGS: Frontal and lateral views of the chest demonstrate fully expanded and clear lungs. The cardiomediastinal and hilar contours are normal. There is no pneumothorax or pleural effusion. Pleural surfaces are unremarkable. IMPRESSION: Normal chest radiograph. " d88a26e7-ac207959-980fb356-eb8fb248-6091357b.jpg,validate/p14/p14093425/s56961923/d88a26e7-ac207959-980fb356-eb8fb248-6091357b.jpg,validation," 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. " da69209b-99f12c6d-c2990439-bcc39a40-2083e0c5.jpg,validate/p19/p19927870/s54166251/da69209b-99f12c6d-c2990439-bcc39a40-2083e0c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with cough // ?pna TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: There is persistent hyperinflation of the lungs which may be due to chronic obstructive pulmonary disease. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Hyperinflated lungs suggesting COPD. No focal consolidation. " 257fcdee-57d482c7-6591c519-19907590-dbd2ab4e.jpg,validate/p16/p16519859/s51718746/257fcdee-57d482c7-6591c519-19907590-dbd2ab4e.jpg,validation," FINAL REPORT INDICATION: Headache, fever and neck stiffness, here to evaluate for acute cardiopulmonary process. COMPARISON: Report from prior chest radiograph dated ___. Prior images are not available for comparison due to inability of the PACS system to fetch archived images. 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 and there is no overt pulmonary edema. 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 a gastric lap band in place with connective tubing and a partially imaged port in the anterior abdomen. IMPRESSION: No acute cardiopulmonary process. " 64087e17-b2c4c1e2-7b02c4e0-05cc4bea-960a28c7.jpg,validate/p18/p18495839/s50826678/64087e17-b2c4c1e2-7b02c4e0-05cc4bea-960a28c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman // ETT placement TECHNIQUE: Portable AP film was obtained COMPARISON: None FINDINGS: No ET tube is identified on this study correlation with the procedural history is suggested. A left projection the heart size is probably normal. There is atelectasis or developing consolidation in the right lower lobe. There is a mild thoracic scoliosis. The lung parenchyma is otherwise grossly clear IMPRESSION: ET tube not seen " 3b3b89f1-dd7ddb9d-5440fd11-9f098a3a-eb851d64.jpg,validate/p15/p15116656/s57537117/3b3b89f1-dd7ddb9d-5440fd11-9f098a3a-eb851d64.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with dementia presents with agitation TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Assessment is limited by rotation. Cardiac silhouette size remains moderately enlarged, but unchanged. Mediastinal and hilar contours are relatively similar. Previously noted mild interstitial pulmonary edema has essentially resolved. There is continued opacification in the right lung base likely reflective of a combination of a small right pleural effusion and right basilar atelectasis. Infection is not completely excluded in the correct clinical setting. No additional focal consolidation is seen. There is no pneumothorax. Moderate multilevel degenerative changes are noted in the thoracic spine. IMPRESSION: Right basilar opacification, not substantially changed in the interval, likely a combination of small right pleural effusion and right basilar atelectasis. Infection is difficult to exclude in the correct clinical setting. " 39f86cf4-a3e52924-095ef2ac-96462597-8a4fd005.jpg,validate/p15/p15002645/s55247252/39f86cf4-a3e52924-095ef2ac-96462597-8a4fd005.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with history of atypical lchest pain, with chronic cough. 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. " 872b570f-7d5a0cbc-1103c0cf-2bef769f-7fb33ba8.jpg,validate/p16/p16305120/s51731471/872b570f-7d5a0cbc-1103c0cf-2bef769f-7fb33ba8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with shortness of breath // eval for CHF TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Heart appears top-normal in size. Mediastinal contour is normal. Streaky perihilar opacity, left greater than right may reflect central airways inflammation. No lobar consolidation is seen. No large effusion or pneumothorax. No congestion or edema. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: As above. " 832bba7b-db7dccb7-405e5b6d-4bf739c3-6e0b3435.jpg,validate/p16/p16968520/s54259580/832bba7b-db7dccb7-405e5b6d-4bf739c3-6e0b3435.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left PTX // intrapulmonary process TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 2 hours earlier IMPRESSION: NG tube tip isin the stomach, the side port is at the level of the EG junction should be advanced for more standard position. ET tube is in standard position. Tiny left pneumothorax is unchanged. Cardiomediastinal contours are normal. Left lower lobe consolidation is unchanged. Other small multifocal opacities in the right lung and in the periphery of the left mid lung have improved. " 51a231b8-6bc7743e-9fc6e772-b5d22993-20590a7e.jpg,validate/p19/p19620193/s59114418/51a231b8-6bc7743e-9fc6e772-b5d22993-20590a7e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of cough, fever, wheezing. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is diffuse bilateral alveolar opacities involving all lobes. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Diffuse bilateral alveolar opacities. Differential diagnosis includes diffuse pneumonia, which may be atypical, pulmonary hemorrhage, even pulmonary edema. Recommend clinical correlation and followup to resolution. " 3ceb04fb-228e3733-760569e1-af6e3db7-4c4a814d.jpg,validate/p11/p11775105/s57394656/3ceb04fb-228e3733-760569e1-af6e3db7-4c4a814d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with AMS, fever, cough // ich, pna COMPARISON: Prior study from ___. FINDINGS: AP portable upright view of the chest. Airspace consolidation is noted in the lower lungs left greater than right concerning for pneumonia. Patient is intubated with the tip of the endotracheal tube residing 6.6 cm above the carina. An NG tube courses into the left upper quadrant though the distal side port is in the lower esophagus. Cardiomediastinal silhouette is unremarkable. IMPRESSION: Lower lung opacities concerning for pneumonia. ET tube somewhat high-riding. Consider advancement by 3 cm for more optimal positioning. " 20875480-007bd6f1-1a21e435-5bc321a5-f687cde6.jpg,validate/p17/p17865089/s52859157/20875480-007bd6f1-1a21e435-5bc321a5-f687cde6.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same day. FINDINGS: Tip of endotracheal tube terminates 3.5 cm above the carina. Left subclavian catheter terminates in superior vena cava, and a nasogastric tube courses below the diaphragm. Heart size is normal. Moderate-to-large right and moderate left pleural effusions have increased in size with associated worsening basilar atelectasis. " 8a87a975-e7294b9c-0351f207-33a3bc3c-d8bec2fa.jpg,validate/p15/p15490195/s56853972/8a87a975-e7294b9c-0351f207-33a3bc3c-d8bec2fa.jpg,validation," 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. " a5588d26-5d150348-feeef988-c0e2cc3d-3a920033.jpg,validate/p13/p13689440/s56080076/a5588d26-5d150348-feeef988-c0e2cc3d-3a920033.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with RLL mass and pulmonary fibrosis status post right thoracotomy and right lower lobe wedge resection on ___. TECHNIQUE: Single frontal view of the chest COMPARISON: Chest CT from ___, ___. PET-CT from ___. Chest radiograph from ___ FINDINGS: In apical thoracostomy tube is noted. Postsurgical ___ project over the right chest. Left pectoral transvenous pacer leads terminate in the right atrium and right ventricle. Postsurgical are noted in the mediastinum and abdomen. Patient has had aortic valve replacement. Median sternotomy wires are intact. Lung volumes are low. The cardiomediastinal silhouette is unremarkable. A focal opacity projects over the right hilar region likely representing postsurgical hematoma from recent wedge resection of the known right lower lobe pulmonary nodule. There is no a miniscule right apical pneumothorax as well as mild subcutaneous emphysema extending from the right side of the neck to the right lateral chest. There is no pleural effusion. IMPRESSION: 1. Focal opacity projecting over the right hilar region likely represents postsurgical hematoma from recent right lower lobe wedge resection. Recommend follow-up chest radiograph assess resolution. 2. Miniscule right apical pneumothorax, likely postsurgical. 3. Mild subcutaneous emphysema extending from the the right side of the neck to the right lateral chest, likely postsurgical. RECOMMENDATION(S): Follow-up chest radiograph. NOTIFICATION: The findings were discussed with ___, N.P. by ___, M.D. on the telephone on ___ at 3:05 PM, 5 minutes after discovery of the findings. " 3c8c5b8a-df5b7eb1-db8d7e4d-603aa917-96746f01.jpg,validate/p12/p12043836/s52584796/3c8c5b8a-df5b7eb1-db8d7e4d-603aa917-96746f01.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with sob, mechanical valves not on Coumadin. COMPARISON: Prior study from ___. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires are again noted with prosthetic cardiac valves again seen. Previously noted right IJ central venous catheter is been removed there has been placement of a left chest wall Port-A-Cath with tip in the mid SVC region. The heart is moderately enlarged. There is persistent consolidation at the right mid to lower lung with moderate right pleural effusion which appears partially loculated. Prominence of the mediastinum appears grossly unchanged. The left lung remains clear. Bony structures are noted to be sclerotic with a rugger ___ appearance, suggestive of renal osteodystrophy. IMPRESSION: Persistent moderate cardiomegaly with loculated moderate right pleural effusion and consolidation in the right mid and lower lung. Overall, no significant change from prior exam. Port-A-Cath positioned appropriately and previous right IJ central venous catheter removed in the interval. " 916d5b66-73151669-ab0c568f-7856c92d-39cb7b81.jpg,validate/p15/p15478350/s58452051/916d5b66-73151669-ab0c568f-7856c92d-39cb7b81.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Fever, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate low lung volumes with no convincing signs of pneumonia or CHF. No effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Low lung volumes with no convincing signs of pneumonia. " 095ffbfd-fea5fe99-5da7768f-afffc5a4-885315d1.jpg,validate/p16/p16020842/s54630437/095ffbfd-fea5fe99-5da7768f-afffc5a4-885315d1.jpg,validation," FINAL REPORT INDICATION: ___ year old man with AAA repair // check NGT placement COMPARISON: Chest x-ray from ___ at 07:48 FINDINGS: An ET tube is present, tip approximately a 6.2 cm above the carina. An NG tube is present, tip extending beneath the diaphragm, off film. A left subclavian central line tip overlies the proximal/mid SVC. No pneumothorax is detected . Lung findings are grossly unchanged. IMPRESSION: NG tube tip extends beneath the diaphragm on off the film. " 89bbd01a-1b813ef1-ed6f3202-e64724d7-74c6c176.jpg,validate/p19/p19753118/s57556192/89bbd01a-1b813ef1-ed6f3202-e64724d7-74c6c176.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with left chest pain //? pneumothorax COMPARISON: Prior CT of the chest from ___ as well as chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires, prosthetic cardiac valve and mediastinal clips are again noted. A retrocardiac opacity is compatible with known hiatal hernia. Faint linear density in the left lower lung is likely atelectasis. No focal consolidation, large effusion or pneumothorax is seen. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: Hiatal hernia, otherwise unremarkable. " e3a4d7d6-0856f7c1-3968b016-08db47d9-21f02272.jpg,validate/p11/p11266603/s54403851/e3a4d7d6-0856f7c1-3968b016-08db47d9-21f02272.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man s/p right thoracentesis with subsequent hypoxemia. // eval for change in right lung field - ? re-expansion pulm edema TECHNIQUE: Portable chest radiograph COMPARISON: Chest x-ray ___ FINDINGS: The entire right hemithorax is opacified, largely due to pleural effusion, but there is also a component of underlying pulmonary edema and atelectasis. This is a dramatic change compared to the prior radiograph performed yesterday evening, which suggests re-expansion pulmonary edema. The left lung is essentially clear. There is no pneumothorax. Left heart border is unremarkable. No acute osseous abnormalities. The VP shunt is unchanged in position. IMPRESSION: Significant worsening opacification of the entire right hemithorax, suggesting re-expansion pulmonary edema in the setting of recent thoracentesis. " bf17673f-ae8b3f98-f6f0ed84-19f788e7-cefd5fe0.jpg,validate/p19/p19557539/s54460047/bf17673f-ae8b3f98-f6f0ed84-19f788e7-cefd5fe0.jpg,validation," FINAL REPORT PORTABLE AP CHEST FROM ___ AT ___ CLINICAL INDICATION: ___-year-old status post PEA arrest and intubated, evaluation for infection and aspiration. Comparison is made to the patient's prior study ___ at 2:00 a.m. Single portable upright chest film, ___ at 8:30 a.m., is submitted. IMPRESSION: 1. Right internal jugular central line, endotracheal tube, nasogastric tube are unchanged in position. 2. Interval improvement in aeration in the right mid lung with only a fine linear residual opacity likely reflecting scarring or residual subsegmental atelectasis. No evidence of pulmonary edema or pneumothorax. Retrocardiac opacity possibly represents a partial lower lobe atelectasis, although aspiration or pneumonia cannot be entirely excluded. Left costophrenic angle is not well visualized but this could be related to positioning rather than representing a layering pleural effusion. Followup imaging would be advised, however. A 5-mm radiopaque opacity at the right apex may be related to a rib or possibly represent a calcified granuloma given its density. Cardiac and mediastinal contours appear stable. " b0cf331f-ab312a06-33e2b84f-aab2b91d-f7bdae13.jpg,validate/p15/p15835816/s53550183/b0cf331f-ab312a06-33e2b84f-aab2b91d-f7bdae13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with r/o sepsis // ?PNA TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The aorta is calcified and tortuous. The cardiac silhouette is top-normal. IMPRESSION: No acute cardiopulmonary process. " 88d9c60b-7415920c-db7870d1-4b5b0f29-92ec9fd2.jpg,validate/p11/p11306899/s58197100/88d9c60b-7415920c-db7870d1-4b5b0f29-92ec9fd2.jpg,validation," WET READ: ___ ___ 12:28 PM As compared to prior chest radiograph from ___, left lung remains collapsed. Increased opacity at the right lung base likely reflects atelectasis, however worsening infectious process cannot be entirely excluded. There is increased bibasilar atelectasis. Right sided small pleural effusions has increased in size, left sided pleural effusion is not significantly changed. Upper lungs remain clear. D/w ___ by ___ telephone on ___ at 12:30 PM, 3 minutes after discovery. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with pneumonia and effusions. IMPRESSION: PA and lateral chest compared to ___: Moderate bilateral pleural effusions and severe bibasilar atelectasis have all worsened since ___. The upper lungs are clear aside from pulmonary vascular redistribution. Heart is moderately enlarged. There is no pulmonary edema. " 43bc61db-ea5e1cc4-a888fa68-9f82456d-7e17435c.jpg,validate/p18/p18103848/s57201485/43bc61db-ea5e1cc4-a888fa68-9f82456d-7e17435c.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG, tiss AVR, ___ ligation, PVI // predischarge eval TECHNIQUE: Frontal and lateral chest radiographs COMPARISON: ___ FINDINGS: Status post median sternotomy and cardiac valve replacement. The tip of the right PICC line in terminates in the mid SVC. There is persisting pulmonary edema with small bilateral pleural effusions. The size and appearance of the cardiac silhouette is unchanged. IMPRESSION: Persisting pulmonary edema and bilateral pleural effusions. No significant interval change. " bf199a22-30c945b2-fa5ebbe6-27fe7b02-3e4d1e68.jpg,validate/p15/p15040921/s51584682/bf199a22-30c945b2-fa5ebbe6-27fe7b02-3e4d1e68.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. 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. There is a mild anterior wedge compression fracture, likely chronic, involving an upper thoracic vertebral body with mild degenerative changes. IMPRESSION: No evidence of acute disease. " 0e6b7b64-15ec9db2-77217330-852a19f2-61b4087d.jpg,validate/p12/p12008386/s56298021/0e6b7b64-15ec9db2-77217330-852a19f2-61b4087d.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___F with syncope now w lightheadness // Ich, c- spine fracture TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: Lungs are well inflated and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation. IMPRESSION: No acute cardiopulmonary process. " b794c926-d152da02-f8aa2a77-8bcae557-09851ee6.jpg,validate/p14/p14792353/s54727411/b794c926-d152da02-f8aa2a77-8bcae557-09851ee6.jpg,validation," FINAL REPORT INDICATION: ___M with left sided chest pain, history cad // r/p pna, ptx, cardiomegaly, pulm edema TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Chronic changes noted at the right lung apex with scarring and volume loss noting rightward deviation of the trachea and superior retraction of the right hilum. Adjacent linear calcifications are noted as well as post thoracotomy changes with right fifth rib resection. The lungs are otherwise clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. Chronic changes centered in the right lung apex, potentially scarring with suspected underlying resection. " b9f600d8-1d6f0c07-bfa369d4-bbafa361-61d12308.jpg,validate/p11/p11123733/s52279091/b9f600d8-1d6f0c07-bfa369d4-bbafa361-61d12308.jpg,validation," WET READ: ___ ___ ___ 6:41 PM No change in large bilateral pleural effusions and cardiomegaly ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, evaluation for volume overload. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change. Small bilateral pleural effusions, subsequent areas of atelectasis at both lung bases. Mild cardiomegaly without overt pulmonary edema. No evidence of pneumonia or other parenchymal changes in the interval. " 743af070-148b9a75-bb4a8083-25207039-88f16ce0.jpg,validate/p15/p15373049/s52075894/743af070-148b9a75-bb4a8083-25207039-88f16ce0.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with right upper quadrant and right flank pain, evaluate for infiltrate or free air. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bones are intact. Imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " aefeadcb-b07eb8bc-dffe9116-dce47031-478be558.jpg,validate/p11/p11856988/s59819793/aefeadcb-b07eb8bc-dffe9116-dce47031-478be558.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough and shortness of breath. Evaluate for infiltrate. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate clear, well-expanded lungs. There is moderate hyperexpansion and lucency consistent with emphysema. There is no pleural effusion or pneumothorax. Minimal linear atelectasis or scar is noted in the left mid lung. The cardiac silhouette is top normal in size, the mediastinal contours are normal, with calcification of the aortic knob present. Pleural thickening or effusion is present on the left. IMPRESSION: Emphysema. Atelectasis is a non-specific finding; the examination neither suggests nor excludes the diagnosis of acute pulmonary embolus. " 0f7375a4-1dda9fd6-dd2ee65c-e64b568d-ab72165f.jpg,validate/p14/p14871009/s57282440/0f7375a4-1dda9fd6-dd2ee65c-e64b568d-ab72165f.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Cardiogenic shock, respiratory failure. Comparison is made with prior study, ___. There are persistent low lung volumes. Moderate cardiomegaly is accentuated by the low lung volumes. Moderate right and probably small left effusion are unchanged and associated with atelectasis, left greater than right. Mild-to-moderate pulmonary edema has improved. Left IJ catheter tip is in unchanged position in the proximal SVC. " 7af00748-1f309f91-bb2453c3-6450dd99-ac137848.jpg,validate/p16/p16296993/s50415951/7af00748-1f309f91-bb2453c3-6450dd99-ac137848.jpg,validation," FINAL REPORT HISTORY: Hypoxemia in the setting of holding diuretics. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: As compared to the prior examination, there are decreased lung volumes and the interval development of a moderate left pleural effusion. There is no definite focal consolidation, right-sided pleural effusion, pneumothorax, or appreciable pulmonary edema. The heart borders are not well visualized. The mediastinal and hilar contours are stable. IMPRESSION: Interval development of a left moderate pleural effusion. No overt pulmonary edema or focal consolidation. Findings were conveyed by Dr. ___ to Dr. ___ ___ telephone at 14:22 on ___, 5 minutes after discovery. " 4551956c-cc719cf6-63fd0438-5285309b-ae50cad4.jpg,validate/p17/p17754292/s52443528/4551956c-cc719cf6-63fd0438-5285309b-ae50cad4.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with cough and fever for 4 days, 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 acute cardiopulmonary process. " 6d810f8d-490c989a-e12d552c-9ad94b60-86a79b6d.jpg,validate/p15/p15023845/s53257805/6d810f8d-490c989a-e12d552c-9ad94b60-86a79b6d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent pacemaker // evaluate for lead placement evaluate for lead placement IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the dual-channel pacer with leads in the right atrium and apex of the right ventricle. No evidence of post -procedure pneumothorax or appreciable pulmonary vascular congestion or acute pneumonia. " 0a588fda-09883428-1997fbdf-c3698cb1-95701b24.jpg,validate/p17/p17063562/s55948124/0a588fda-09883428-1997fbdf-c3698cb1-95701b24.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with diffuse rash for 3 days in the setting of upper respiratory infection. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: A small focal opacity is seen best on lateral view but may be silhouetting the medial right hemidiaphragm on frontal view. No pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are within normal limits. Findings and further imaging options and recommendations were discussed with ___ by ___ by telephone at 9:45 a.m. on ___ at the time of initial review of the study. " d5204051-9f239dac-7ec2de39-ee983914-4ece87a3.jpg,validate/p13/p13332086/s55433351/d5204051-9f239dac-7ec2de39-ee983914-4ece87a3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with altered mental status TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac, mediastinal and hilar contours are unremarkable. The aorta is mildly tortuous. The pulmonary vasculature is normal. Patchy opacity within the left lung base likely reflects an area of atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Patchy opacity in the left lung base, likely atelectasis. " e581cb80-6bb93334-c90436f5-cfbc036e-b8ce2586.jpg,validate/p16/p16864674/s54003909/e581cb80-6bb93334-c90436f5-cfbc036e-b8ce2586.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with known HCC, s/p RFA, now with worsening ascites, RUQ pain, suspicion for R effusion on exam // ? R pleural effusion COMPARISON: ___. IMPRESSION: As compared to the previous image, there is a newly 0 current right pleural effusion, better seen on the lateral than on the frontal image. Subsequent areas of atelectasis are present at the right and also at the left lung bases. No pulmonary edema. No pneumothorax. Borderline size of the cardiac silhouette. " bb9a8897-6ab6e1ff-e8cfa053-4e40e6f7-f5cb89d5.jpg,validate/p19/p19834718/s54765436/bb9a8897-6ab6e1ff-e8cfa053-4e40e6f7-f5cb89d5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Central line placement. PA and lateral upright chest radiographs were reviewed in comparison to ___. Right subclavian line was inserted with its tip being at the level of mid SVC. There is no pneumothorax or apical hematoma demonstrated. Right upper lobe nodular opacities unchanged. Heart size and mediastinum are stable and unremarkable. There is no pleural effusion or pneumothorax. " 1042f1a2-cff66746-f2f6fbc2-eec33968-a3ad455c.jpg,validate/p10/p10596591/s55464130/1042f1a2-cff66746-f2f6fbc2-eec33968-a3ad455c.jpg,validation," 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. " 6df607f5-d1abe24d-135f3d39-db4cb6bb-383419d2.jpg,validate/p13/p13832093/s57861255/6df607f5-d1abe24d-135f3d39-db4cb6bb-383419d2.jpg,validation," FINAL REPORT INDICATION: ___M with melanoma, now with fatigue, weight loss // r/o infection/mass TECHNIQUE: PA and lateral views of the chest. COMPARISON: Correlation made to chest CT from ___. FINDINGS: The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Coronary artery stent is noted. Cervical fixation hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " b3ae610a-c8a82825-cc449600-fdc91e82-be588c8c.jpg,validate/p18/p18754895/s58068737/b3ae610a-c8a82825-cc449600-fdc91e82-be588c8c.jpg,validation," WET READ: ___ ___ ___ 11:17 PM No acute process. Unchanged exam with stable elevation of the right hemidiaphragm. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Minimal elevation of the right hemidiaphragm. No pneumonia, no pleural effusion, no pulmonary edema. Normal size of the cardiac silhouette. " aedf2559-b443798e-fae3332d-42861141-6b903e0e.jpg,validate/p15/p15985339/s59125311/aedf2559-b443798e-fae3332d-42861141-6b903e0e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p r stab wound and pleural effusion // s/p ___; r/o PTX s/p ___; r/o PTX IMPRESSION: Comparison to ___. The small right pleural effusion is stable. No right pneumothorax. Normal appearance of the heart and of the left lung. " c7209e6b-f4b53c9f-1bb44a9c-f4273774-cccdf682.jpg,validate/p11/p11593310/s53935374/c7209e6b-f4b53c9f-1bb44a9c-f4273774-cccdf682.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with LEFT SIDED CP. Evaluate for PTX . TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is a small left apical pneumothorax. The lungs are clear without focal consolidation. No pleural effusion is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Small left apical pneumothorax. NOTIFICATION: Findings were communicated to the ED QA nurses by ___, M.D. on the telephone on ___ at 8:13 AM, 2 minutes after discovery of the findings. " 19a2a757-4f583858-f4b78453-f0a6d553-47d1487a.jpg,validate/p14/p14657989/s52707597/19a2a757-4f583858-f4b78453-f0a6d553-47d1487a.jpg,validation," FINAL REPORT INDICATION: History of cirrhosis and chronic pancreatitis with epigastric pain. COMPARISON: Radiograph available from ___. 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. No bony abnormalities are detected. IMPRESSION: No acute intrathoracic process. " 7e736619-59dbf194-bdbc3587-78d1a746-85f92c38.jpg,validate/p17/p17464246/s57160253/7e736619-59dbf194-bdbc3587-78d1a746-85f92c38.jpg,validation," FINAL REPORT HISTORY: Patient with history of melanoma, eval disease status. COMPARISON: ___. FINDINGS: Lungs are fully expanded and clear. Cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No radiographic evidence for intrathoracic metastases. " b2992a35-63a6fe40-54c6c299-1fa760c1-06bc6bb6.jpg,validate/p15/p15620544/s57981006/b2992a35-63a6fe40-54c6c299-1fa760c1-06bc6bb6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg with increasing right effusion, deep sulcus on left // eval for ptx, increasing effusion TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 2 hr earlier IMPRESSION: There is no evident pneumothorax. Moderate pulmonary edema is grossly unchanged. No other interval change from prior study. " e5f0c4e8-fa041c4c-0d6a2355-891055ad-da9195b7.jpg,validate/p16/p16316457/s53857092/e5f0c4e8-fa041c4c-0d6a2355-891055ad-da9195b7.jpg,validation," FINAL REPORT HISTORY: Cough, altered mental status. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: Chest radiograph ___. Chest CTA ___. FINDINGS: The heart is mildly enlarged. The mediastinal and hilar contours are unchanged, with mild calcification noted at the aortic arch. The pulmonary vascularity is mildly prominent suggesting congestion, but is slightly improved compared to the prior exam. Blunting of the costophrenic angle on the frontal view likely reflects chronic pleural thickening. There is streaky opacity in the retrocardiac region likely reflective of atelectasis. No focal consolidation is identified, and there is no pneumothorax. Biapical pleural thickening is and unchanged. Deformity of the left chest wall is re- demonstrated. Multiple clips are noted within the posterior mediastinum. IMPRESSION: Minimal left basilar atelectasis. Mild pulmonary vascular congestion, improved compared to the prior exam. " 0ee19dbe-aca0afe5-be021c0e-4dd181f0-4d9cd6d6.jpg,validate/p17/p17875843/s55395192/0ee19dbe-aca0afe5-be021c0e-4dd181f0-4d9cd6d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion, s/p pigtail placement // pigtail placement, interval change pigtail placement, interval change IMPRESSION: In comparison with study of ___, there is a right pigtail catheter in place and no evidence of pneumothorax. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure in a patient with intact midline sternal wires. There is some increase in the small right pleural effusion. Dense calcification is seen in the diaphragmatic pleura, suggesting asbestos-related disease. " 5ae2733a-0a3f027e-7e9db253-2f06c8e7-cbd7143f.jpg,validate/p18/p18539425/s51758106/5ae2733a-0a3f027e-7e9db253-2f06c8e7-cbd7143f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Stem transplant, on high-dose steroids, new cough and green sputum. IMPRESSION: PA and lateral chest compared to ___ through ___: Region of prior consolidation and volume loss in the posterior basal segment of the left lower lobe has been present to some extent since ___ and has not cleared. A second region of mild consolidation in the right middle lobe, seen best on the lateral view, has worsened since ___. Very mild peribronchial infiltration in the axillary region of the left upper lung at the level of the second anterior interspace is also new. Findings point toward multifocal infection, perhaps with more than one pathogen. Depending upon clinical circumstances, it might be helpful to establish a radiographic baseline using chest CT imagings. No pleural effusion or evidence of central lymph node enlargement. Heart size normal. Dr. ___ paged. " 36f1ea75-87d5910b-0ae9014a-94413104-d735e009.jpg,validate/p14/p14133956/s51093638/36f1ea75-87d5910b-0ae9014a-94413104-d735e009.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. There is a new fine reticular abnormality. Differential considerations are mild vascular congestion, atypical pneumonia or airway inflammation. There are no pleural effusion or pneumothorax. Bony structures are unremarkable. " bf86442e-f4ed20b2-a70ab87b-2d38e4ef-d30a5afc.jpg,validate/p16/p16382419/s59686569/bf86442e-f4ed20b2-a70ab87b-2d38e4ef-d30a5afc.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with chest tightness and shortness of breath. Evaluate for acute cardiopulmonary process. COMPARISONS: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is borderline cardiomegaly. The cardiomediastinal contours are normal. There is possible mild cephalization which may suggest increased pulmonary venous pressures. The lungs are otherwise clear without focal consolidation. No pleural effusion or pneumothorax. The osseous structures are unremarkable. No radiopaque foreign body. IMPRESSION: Mild cephalization suggests increased pulmonary venous pressures. No focal consolidation. " 86ea9a5e-7f310285-195188f7-1ad76f2b-ddfa77a0.jpg,validate/p13/p13364829/s59342951/86ea9a5e-7f310285-195188f7-1ad76f2b-ddfa77a0.jpg,validation," FINAL REPORT HISTORY: Respiratory failure and GI bleed. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. The perihilar opacification seen previously is no longer apparent. There is some retrocardiac opacification consistent with volume loss within the left lower lobe. The right lung is essentially clear. " d8817d66-91ba98f7-640761a6-8a1b182a-256a65b5.jpg,validate/p19/p19212070/s52312055/d8817d66-91ba98f7-640761a6-8a1b182a-256a65b5.jpg,validation," WET READ: ___ ___ 8:24 AM No pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old woman with fatigue. Assess for pneumonia. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___ and 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 including no evidence of pneumonia. " f9840a87-17d9ee1a-4c6813f8-7c3297ba-c262477b.jpg,validate/p13/p13325402/s51298911/f9840a87-17d9ee1a-4c6813f8-7c3297ba-c262477b.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Status post kidney transplant, with slight confusion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette remains enlarged. There is a stable slight prominence of the aortic arch, stable since at least ___. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Degenerative changes are seen at the right shoulder and acromioclavicular joints. The right humeral head is high riding which can be seen in rotator cuff disease. IMPRESSION: Cardiomegaly. No acute cardiopulmonary process. " 6fa4a320-fab9af6f-5b3c6408-90f6bb71-8d435eb7.jpg,validate/p19/p19326866/s54976385/6fa4a320-fab9af6f-5b3c6408-90f6bb71-8d435eb7.jpg,validation," WET READ: ___ ___ ___ 4:03 PM Dobhoff tube with distal tip terminating in the stomach beyond the level of the gastroesophageal junction. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with SAH and facial fractures s/p fall with new dobhoff placement. // Check new Dobhoff placement TECHNIQUE: Portable upright AP chest radiograph. COMPARISON: Chest radiograph from ___. FINDINGS: Dobhoff tube with distal tip terminating in the stomach beyond the level of the gastroesophageal junction. Right PICC, unchanged. Decreased prominence of left pleural effusion and stable left basilar atelectasis. IMPRESSION: Dobhoff tube with distal tip terminating in the stomach beyond the level of the gastroesophageal junction. NOTIFICATION: The findings were discussed with ___, neurosurgery, by ___, M.D. on the telephone on ___ at 2:54 PM, at the time of discovery of the findings. " beadc7a2-5de7ccb8-022f234d-5722ccd8-8a23e9ca.jpg,validate/p10/p10351336/s59529633/beadc7a2-5de7ccb8-022f234d-5722ccd8-8a23e9ca.jpg,validation," FINAL REPORT INDICATION: 3 wks cough weakness recent drug rash, recent hx SJS, ddx incl eosinophilc syndrome vs viral syndrome, rule out 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. Visualized upper abdomen is unremarkable. Osseous structures are grossly intact. IMPRESSION: No evidence of acute cardiopulmonary process. " 1964f992-e889c387-3ddf7caa-547bf5d4-62df0259.jpg,validate/p17/p17137598/s59648266/1964f992-e889c387-3ddf7caa-547bf5d4-62df0259.jpg,validation," 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. " c3cdabac-6fa5ecd8-dc3a817e-a43bbe91-0923b326.jpg,validate/p13/p13977407/s57356128/c3cdabac-6fa5ecd8-dc3a817e-a43bbe91-0923b326.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with a history of ileus who presents for NG tube placement evaluation. COMPARISON: Chest radiographs from ___, ___, ___. TECHNIQUE: Single AP portable exam of the chest. FINDINGS: The left PIC line terminates in the proximal superior vena cava. The enteric tube appears to terminate in the distal esophagus and needs to be advanced. The cardiac silhouette remains enlarged with stable pulmonary vascular congestion and minimal bilateral pulmonary edema. Rightward deviation of the trachea is secondary to the known enlargement of the left lobe of the thyroid gland. No new focal consolidations, significant pleural effusions, or pneumothorax is identified. IMPRESSION: Enteric tube with its sidehole in the distal esophagus. This needs to be advanced. These findings were discussed with Dr. ___ at 5:10 p.m. by Dr. ___ by telephone on the day of the exam. " 03e59e83-0c283b1a-b6cf2207-16788c2d-6945d790.jpg,validate/p10/p10616358/s51663708/03e59e83-0c283b1a-b6cf2207-16788c2d-6945d790.jpg,validation," FINAL REPORT HISTORY: Chest pain, upper respiratory infection. 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 aorta is slightly tortuous and there appears to be some calcification at the aortic knob. The cardiac silhouette is top-normal. There is no pulmonary edema. IMPRESSION: No acute cardiopulmonary process, specifically no focal consolidation to suggest pneumonia. " 8fa9f9de-0f178cf7-d2ed34f9-faacb6e1-b5f287c5.jpg,validate/p15/p15851682/s51505355/8fa9f9de-0f178cf7-d2ed34f9-faacb6e1-b5f287c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT // ETT TECHNIQUE: Portable AP radiograph of the chest COMPARISON: ___ and dating back to ___. FINDINGS: A right pectoral pacemaker sends leads to the right atrium and right ventricle. Two right-sided chest tubes, a right midline catheter, the left IJ central venous line, ET tube and nasogastric tube are unchanged in position. Sternotomy wires are intact and aligned. There is no pneumothorax. Slightly increased opacification at the left base is most likely due to atelectasis. The heart and mediastinum are within normal limits despite the projection. IMPRESSION: New minimal left basilar subsegmental atelectasis. Otherwise no significant interval change. " b5af1508-1b39c88d-eb8e8bea-4b486dae-b30e2a14.jpg,validate/p11/p11423154/s53302503/b5af1508-1b39c88d-eb8e8bea-4b486dae-b30e2a14.jpg,validation," 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. " 2308bc64-e4560f7e-17e715af-9dd11286-f4280350.jpg,validate/p12/p12042461/s59843437/2308bc64-e4560f7e-17e715af-9dd11286-f4280350.jpg,validation," WET READ: ___ ___ ___ 7:31 PM Persistent right lower lung opacity and right pleural effusion. Effusion perhaps slightly decreased since radiograph dated ___. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with right lower lobe necrotizing pneumonia and parapneumonic effusion, followup. PA and lateral upright chest radiographs were reviewed in comparison to ___ and chest CT from ___. As compared to ___ there is interval improvement of pulmonary edema. Right lower lobe consolidation with internal cavitation surrounded by pleural effusion appears to be grossly unchanged in the short interim. There is no evidence of progression of left consolidation. Small amount of left pleural effusion is noted. " 3b3ff917-4dd1a83d-c33a35f3-5cba1a75-427db8d7.jpg,validate/p14/p14237047/s55317506/3b3ff917-4dd1a83d-c33a35f3-5cba1a75-427db8d7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multifocal aspiration PNA // interval change interval change IMPRESSION: Compared to chest radiographs ___. Severe multifocal pneumonia has not improved, and may have worsened in the right midlung. Lucencies in the right lower chest suggest that the pneumonia may be necrotizing. Heart size normal. Pleural effusions small on the right, not apparent on the left. No pneumothorax. ET tube in standard placement. Right jugular line ends in the low SVC. " 37d442ea-8f437cae-94dbde30-7deee6c3-f464983c.jpg,validate/p19/p19130309/s54309326/37d442ea-8f437cae-94dbde30-7deee6c3-f464983c.jpg,validation," 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. " 22bf04c0-c75581bf-80dbf548-57a434b8-ca0774b6.jpg,validate/p11/p11201441/s56610840/22bf04c0-c75581bf-80dbf548-57a434b8-ca0774b6.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: ___ chest x-ray. FINDINGS: Following removal of right-sided chest tube, a large basilar right pneumothorax has developed. There is a suggestion of possible tension with slight shift of the cardiac silhouette towards the left and the change in position of the right hemidiaphragm. Adjacent lung parenchyma is atelectatic, with relative sparing of the right apex. Within the left lung, slight worsening of perihilar opacities is demonstrated and may reflect a component of pulmonary edema. Persistent moderate left effusion and adjacent left retrocardiac atelectasis or consolidation. Free intraperitoneal air is identified below the right hemidiaphragm, and has also been reported on abdominal imaging ___ CT torso. " 0bbd90f2-cd9eb0cf-49cad2a1-9f131877-2257f10d.jpg,validate/p16/p16945691/s57390551/0bbd90f2-cd9eb0cf-49cad2a1-9f131877-2257f10d.jpg,validation," FINAL REPORT INDICATION: History: ___F with abdominal pain, worse with bowel movements, repeat presentation for same; SOB earlier today // CXR: eval for consolidationCT A/P: eval for diverticulitis TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: A left axillary dual lead pacemaker is present with tip terminating in the right atrium and right ventricle as expected. Moderate cardiomegaly is stable. There is no pneumothorax or pleural effusion. The lungs are well expanded and clear without focal consolidation concerning for pneumonia. Surgical clips are present in the upper abdomen. IMPRESSION: No acute cardiopulmonary process.Stable moderate cardiomegaly. " 75219170-3b4d4698-b8ad76bf-75d342cd-adf47ee8.jpg,validate/p16/p16061352/s56638196/75219170-3b4d4698-b8ad76bf-75d342cd-adf47ee8.jpg,validation," FINAL REPORT EXAMINATION: Portable chest INDICATION: ___ year old woman with hepatitis, SOB/hypoxia s/p thoracentesis for pleural effusion // S/p thoracentesis TECHNIQUE: Single frontal view COMPARISON: Study performed 5 hours earlier FINDINGS: As compared to chest x-ray from the same date, interval drainage of left-sided pleural effusion. Mild pulmonary edema with moderate cardiomegaly. Mild retrocardiac atelectasis has improved. Multiple surgical clips in the left chest wall. No pneumothorax. IMPRESSION: Successful drainage of left pleural effusion. No pneumothorax. Mild to moderate pulmonary edema. " c3bc7428-af93b234-cdf06259-bdafb5e0-9e4a8566.jpg,validate/p15/p15687550/s57713673/c3bc7428-af93b234-cdf06259-bdafb5e0-9e4a8566.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with recent flu, cough, fevers, // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The cardiac silhouette is normal in size. The mediastinal 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. " 6e128fd5-f196a9de-49a7a7b1-0db3dc86-691f3687.jpg,validate/p16/p16547007/s54008102/6e128fd5-f196a9de-49a7a7b1-0db3dc86-691f3687.jpg,validation," FINAL REPORT INDICATION: ___F with possible aspiration // eval for interval change TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Right basilar opacity may be due to atelectasis noting low lung volumes, not significantly changed from prior. Blunting of left costophrenic angle suggests small effusion as on prior. The cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No significant interval change. Small left effusion. Right basilar opacity potentially atelectasis noting that aspiration cannot be excluded. " bda65f4e-d9bcaa57-c6044fa2-69dddf66-87ceb13b.jpg,validate/p14/p14597448/s56640687/bda65f4e-d9bcaa57-c6044fa2-69dddf66-87ceb13b.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with MDS and fevers. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Chest radiographs available from ___ and ___. FINDINGS: The heart size is normal. The hilar and mediastinal contours are within normal limits. Coarse interstitial opacities throughout both lungs are unchanged since ___. Vague nodular opacities within the left upper and right lower lung are unchanged, and no new nodules are detected. There is no pneumothorax, focal consolidation, or pleural effusion. Mild biapical thickening is unchanged. " 67d4fd2b-a37629b5-84fc646b-dd1817bb-87b9536d.jpg,validate/p13/p13349392/s53454578/67d4fd2b-a37629b5-84fc646b-dd1817bb-87b9536d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with asthma/COPD, cough and fever TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The aorta remains tortuous and calcified at the aortic arch. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Lungs are hyperinflated. Minimal streaky opacities in the lung bases likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: Minimal streaky opacities in the lung bases, likely atelectasis. " 163ac722-e8b92831-c1bfafba-8e5972cf-69c427b6.jpg,validate/p13/p13723259/s58885564/163ac722-e8b92831-c1bfafba-8e5972cf-69c427b6.jpg,validation," 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. " 89f29df3-58dfab29-83db755b-dcd26bbf-508ab230.jpg,validate/p19/p19478643/s57656247/89f29df3-58dfab29-83db755b-dcd26bbf-508ab230.jpg,validation," 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. The lungs appear clear. Surgical clips project over the left upper quadrant of the abdomen as well as in the midline of the epigastrium. IMPRESSION: No evidence of acute cardiopulmonary disease. " 79e3b714-fea8c2e6-9afe6f7b-32c638a8-5cdedd06.jpg,validate/p12/p12762827/s52579933/79e3b714-fea8c2e6-9afe6f7b-32c638a8-5cdedd06.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Adrenal insufficiency, weight loss, rule out granulomatous disease or other process. COMPARISON: No comparison available at the time of dictation. FINDINGS: Lung volumes are normal. No pleural effusions. Normal size of the cardiac silhouette. No pneumonia, no masses, no lung nodules. The hilar and mediastinal contours are normal. Normal size of the cardiac silhouette. " 6d3465b4-27e53bd9-f6ad68a4-0747d2e6-3fea9b1b.jpg,validate/p16/p16019229/s52582561/6d3465b4-27e53bd9-f6ad68a4-0747d2e6-3fea9b1b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Fluid overload, status post sepsis, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes remain low, monitoring and support devices are in constant position. The bilateral pleural fluid collections are unchanged. The retrocardiac lung areas have slightly increased in transparency, likely reflecting improved ventilation. No new parenchymal opacities. " 1ab76fe3-68d75087-674ecd1c-03c37f8f-14fc695f.jpg,validate/p14/p14221521/s59883527/1ab76fe3-68d75087-674ecd1c-03c37f8f-14fc695f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with new onset afib // r/o acute process COMPARISON: No prior chest imaging IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. " a6ad5b5f-8cff90a8-c4a4a357-11e54fd3-2c0b62b3.jpg,validate/p10/p10193065/s52866095/a6ad5b5f-8cff90a8-c4a4a357-11e54fd3-2c0b62b3.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with congestive heart failure and dyspnea on exertion. Please evaluate for pulmonary edema. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The heart continues to be enlarged with mild to moderate CHF. Possible minimal blunting of both costophrenic angles could reflect small bilateral effusions. There is bibasilar atelectasis. No focal consolidation or pneumothorax is detected. Right-sided rib fractures are better seen on the dedicated chest CT. IMPRESSION: Cardiomegaly with mild CHF. Possible very small bilateral effusions. " 8582ec54-2af9842c-dac1960f-63010484-e7e39d0e.jpg,validate/p19/p19263343/s56360865/8582ec54-2af9842c-dac1960f-63010484-e7e39d0e.jpg,validation," FINAL REPORT HISTORY: Pneumonia. FINDINGS: In comparison with study of ___, there has been development of increased opacification in the right mid and upper zone consistent with upper lobe pneumonia. There is also opacification at the left base consistent with probable pneumonia and possible pleural effusion in this region as well. This information was telephoned to Dr. ___ at 2:20 p.m. on ___. " 05b65c00-bee69a56-bbff2d08-6b340866-4b297b7b.jpg,validate/p12/p12036096/s52719822/05b65c00-bee69a56-bbff2d08-6b340866-4b297b7b.jpg,validation," FINAL REPORT INDICATION: History of breast and endometrial cancer. Please evaluate for acute intrathoracic process. COMPARISON: Chest radiograph from ___. 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. IMPRESSION: No acute intrathoracic process identified. " f831ea27-000327af-da68d5c2-1abad8b8-aa928173.jpg,validate/p16/p16046758/s50218593/f831ea27-000327af-da68d5c2-1abad8b8-aa928173.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with pleural effusion. COMPARISON: ___ and ___. FINDINGS AND IMRPESSION: Frontal and lateral views of the chest were obtained. The right pleural effusion is worse, with decreased right lung aeration. The left layering pleural effusion is unchanged. Mild pulmonary edema is new from ___, similar to ___. The heart cannot be evaluated. " 83c6e93b-ad656e5d-5fa4ff44-8fe0ab5a-4e553e5a.jpg,validate/p15/p15368003/s54355604/83c6e93b-ad656e5d-5fa4ff44-8fe0ab5a-4e553e5a.jpg,validation," FINAL REPORT HISTORY: Overdose, now intubated. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: None. FINDINGS: Endotracheal tube tip terminates approximately 5.8 cm from the carina. The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. There is minimal atelectasis within the lung bases. No focal consolidation, pleural effusion or pneumothorax is seen. A clip projects over the left upper quadrant of the abdomen. IMPRESSION: Endotracheal tube is in standard position. Minimal bibasilar atelectasis. " ea030e7a-2e3b1346-bc518786-7a8fd698-f673b44c.jpg,validate/p10/p10000032/s56699142/ea030e7a-2e3b1346-bc518786-7a8fd698-f673b44c.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with cirrhosis. TECHNIQUE: Frontal 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. Multiple surgical clips project over the left breast, and old left rib fractures are noted. IMPRESSION: No acute cardiopulmonary process. " 20b1b75a-cb66a445-f1d0da82-144e0c02-0d8b4fa5.jpg,validate/p10/p10020944/s59618738/20b1b75a-cb66a445-f1d0da82-144e0c02-0d8b4fa5.jpg,validation," FINAL REPORT PORTABLE SUPINE CHEST, ___ Compared to previous study of ___. FINDINGS: Interval improved aeration of the right lung, with residual partial atelectasis of right middle and right lower lobes. Small right pleural effusion is also present. Left lung is grossly clear except for minimal patchy atelectasis at the base, partially improved from the prior study. " 54974042-f4808a64-a17fb0c5-7ec50cde-48d0df90.jpg,validate/p11/p11167079/s52284709/54974042-f4808a64-a17fb0c5-7ec50cde-48d0df90.jpg,validation," 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. " f52e19e0-9569d75a-7c2e1cca-588fe579-e22a208b.jpg,validate/p14/p14036332/s52691805/f52e19e0-9569d75a-7c2e1cca-588fe579-e22a208b.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with multiple myeloma COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPHS: There are opacities in the left upper lung and bilateral lung bases, concerning for multifocal pneumonia. Blunting of the left costophrenic angle suggests a small left effusion. There is no pneumothorax. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: 1. Multifocal pneumonia 2. Probable small left pleural effusion Dr. ___ communicated the above findings with ___ at 17:18 on ___ by telephone " ebc70af7-3f77c265-5a05164f-e7471ac2-c8b13a90.jpg,validate/p14/p14508231/s59712635/ebc70af7-3f77c265-5a05164f-e7471ac2-c8b13a90.jpg,validation," FINAL REPORT INDICATION: History: ___F with shortness of breath // acute process? COMPARISON: ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Heart size and cardiomediastinal contours are normal. Minimal bibasilar opacities are decreased since the prior exam, likely atelectasis. Lungs are otherwise clear without focal consolidation, pleural effusion, or pneumothorax. Cervical spine fusion hardware is in stable position. IMPRESSION: No acute cardiopulmonary process. " b1f115cf-3e89ad87-200f8fec-03dd982b-473ef4fb.jpg,validate/p17/p17988248/s54744679/b1f115cf-3e89ad87-200f8fec-03dd982b-473ef4fb.jpg,validation," WET READ: ___ ___ ___ 8:13 PM Status post placement of a stent in the left mainstem bronchus. No pneumothorax, although overlying leads, especially overlying the right hemithorax, limit evaluation. Small to moderate right pleural effusion with adjacent atelectasis again noted. Fiducial seed noted in the right lower lobe. The findings and recommendation were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:10 PM. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with adenocarcinoma post airway stent. Evaluate for pneumothorax // Check for pneumothorax Check for pneumothorax IMPRESSION: Comparison to ___. Minimal increase in extent of a pre-existing right pleural effusion with subsequent right basilar atelectasis. The position of a right hilar fiducial marker is constant. Status post placement of a stent in the left main bronchus. The bronchus appears patent. No pathologic changes in the left lung parenchyma. " cabfa648-ac52a602-2344bc10-d63de751-05396504.jpg,validate/p10/p10131388/s59122401/cabfa648-ac52a602-2344bc10-d63de751-05396504.jpg,validation," FINAL REPORT INDICATION: ___-year-old female post assault, evaluate for right rib fractures. COMPARISON: ___. CHEST, PA AND LATERAL: The lungs are clear. Cardiomediastinal and hilar contours are normal. There are no pleural effusions or pneumothorax. No displaced rib fractures are identified. IMPRESSION: No radiographic evidence of rib fractures. " 71a6c8fd-664af625-4aca7eff-ee3e3103-707af7d5.jpg,validate/p19/p19978087/s51213983/71a6c8fd-664af625-4aca7eff-ee3e3103-707af7d5.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough, chills, nausea, vomiting, and diarrhea. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs are clear. There are no pleural effusions or pneumothorax. The bony structures appear within normal limits. IMPRESSION: No evidence of acute cardiopulmonary disease. " e24a3129-8d7d8fa2-c1e96252-09dc08ac-4448f347.jpg,validate/p14/p14068639/s53752986/e24a3129-8d7d8fa2-c1e96252-09dc08ac-4448f347.jpg,validation," FINAL REPORT INDICATION: History: ___F with dyspnea on exertion TECHNIQUE: Chest upright AP and Lateral COMPARISON: ___ FINDINGS: AICD is in appropriate position. As compared to the prior exam, there are increasing perihilar opacities and vascular indistinctness compatible with moderate pulmonary edema. The heart size is moderately enlarged. No pleural effusion. No pneumothorax. Assessment of the lung apices is obscured by the patient's chin and neck soft tissues projecting over this region. Multiple clips are noted in the upper abdomen. IMPRESSION: Cardiomegaly and moderate pulmonary edema compatible with congestive heart failure. " 48507dc5-56158ffb-f945b462-9c1a6ce8-568f9f53.jpg,validate/p17/p17289623/s57690135/48507dc5-56158ffb-f945b462-9c1a6ce8-568f9f53.jpg,validation," WET READ: ___ ___ 4:21 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with n/v/orthostasis // any cpd TECHNIQUE: AP upright and lateral chest radiographs COMPARISON: ___ FINDINGS: The lungs are well inflated and clear. There is no focal consolidation or pleural effusion. No pneumothorax. Heart size and mediastinal contours are normal. The descending thoracic aorta is mildly tortuous. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 38babb06-7635ae42-80cc33b2-e8de051f-c3c06515.jpg,validate/p17/p17147966/s56718555/38babb06-7635ae42-80cc33b2-e8de051f-c3c06515.jpg,validation," FINAL REPORT HISTORY: Back pain when breathing, known existing DVT, rule out cardiopulmonary process. TECHNIQUE: PA and lateral views of the chest were obtained. COMPARISON: None available. FINDINGS: The lungs are clear without focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 43896e3f-eebf2910-705d02fb-0bbb24e3-f5b644cb.jpg,validate/p10/p10421957/s58477781/43896e3f-eebf2910-705d02fb-0bbb24e3-f5b644cb.jpg,validation," FINAL REPORT HISTORY: ___-year-old female status post intubation. COMPARISON: Chest CT from essentially the same time. FINDINGS: Single portable view of the chest. Endotracheal tube is seen with tip approximately 3.5 cm from the carina. Patchy regions of consolidation seen in the mid upper lungs, right worse than left. There is no large pneumothorax. The cardiomediastinal silhouette is within normal limits. Known bilateral rib fractures are better characterized on CT. " bd4b25c8-86f21a9a-4b4c567a-8e88da8a-6c70d2c3.jpg,validate/p11/p11967908/s57319593/bd4b25c8-86f21a9a-4b4c567a-8e88da8a-6c70d2c3.jpg,validation," FINAL REPORT INDICATION: History: ___F with cough, SOB // eval for PNA COMPARISON: Multiple prior exams, most recently of ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Right axillary clips are unchanged. Right basilar pleural catheter has been removed. Lungs are hyperexpanded, similar to prior, consistent with COPD. Mild diffusely increased interstitial markings are chronic. No focal consolidation or pneumothorax is seen. There is a small right-sided pleural effusion best seen on the lateral view. Heart size and cardiomediastinal contours are normal. IMPRESSION: No focal consolidation. " 78c3b0ec-05b9bbdd-a89d9f5c-ebe0cfa8-55bf97bf.jpg,validate/p15/p15713699/s51699868/78c3b0ec-05b9bbdd-a89d9f5c-ebe0cfa8-55bf97bf.jpg,validation," WET READ: ___ ___ ___ 11:19 PM Minimal atelectasis the lung bases. No focal consolidation, pleural effusion or pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with reported BOOP/COP p/w worsening cough and DOE. // ? new infiltrates ? new infiltrates IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. Minimal bibasal atelectasis are noted. For pre size details please review chest CT obtained the same day later. " 8596116f-aaeb7198-bb2766b3-c7e141ca-8e76630c.jpg,validate/p15/p15554865/s58882128/8596116f-aaeb7198-bb2766b3-c7e141ca-8e76630c.jpg,validation," FINAL REPORT INDICATION: History: ___F with NCC Lung CA, recently finished rx for PNA, now with recurrent cough and mild dyspnea // Eval for PNA or acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ FINDINGS: PA and lateral chest radiograph demonstrates a right chest port, its tip which projects over the anticipated location of the cavoatrial junction. Linear density within the right midlung zone likely reflects subsegmental atelectasis though fluid within the minor fissure is a possibility. Cardiomediastinal and hilar contours are stable relative to prior examination, the heart which is enlarged. No opacity convincing for pneumonia is present. There is no large pleural effusion. No evidence of pneumothorax or pulmonary edema. IMPRESSION: No opacity convincing for pneumonia. Interval placement of a right chest port. Probable subsegmental atelectasis within the right mid lung zone may alternatively reflect fluid within the minor fissure. " bc412d5d-68f35aee-c19bab00-37ec0526-092ef2b6.jpg,validate/p10/p10027957/s54120913/bc412d5d-68f35aee-c19bab00-37ec0526-092ef2b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Crohn's disease and left sided chest wall pain, fever and full chest feeling // R/o pneumonia TECHNIQUE: Chest PA and Lateral COMPARISON: None 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. " 72e7fb00-ef222ed8-42d3a2c3-78518c80-a6fd4f02.jpg,validate/p15/p15696669/s50873437/72e7fb00-ef222ed8-42d3a2c3-78518c80-a6fd4f02.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with traumatic injury, question chest injury. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Tiny nodular foci projecting over the right mid lung over the right sixth and seventh posterior ribs likely represent calcified granulomas. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " a3313def-ec82fa03-95257a94-03967168-3bca3cea.jpg,validate/p16/p16924201/s52871387/a3313def-ec82fa03-95257a94-03967168-3bca3cea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with two weeks of prod cough and reported hypoxia // r/o acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are low. Bibasilar linear opacities likely represent atelectasis or scarring. There is no effusion or pneumothorax. Unfolded aorta is similar to prior. Cardiomediastinal silhouette is stable. Ossific densities inferior to the humeral heads bilaterally may represent intraarticular bodies. Incidentally noted is colonic interposition between the right hemidiaphragm and the liver. IMPRESSION: No acute intrathoracic process. " 098b6956-53f763f0-209d028f-3b5c765d-748745d9.jpg,validate/p17/p17451713/s58537847/098b6956-53f763f0-209d028f-3b5c765d-748745d9.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with presyncope. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are hyperinflated, but clear of focal consolidation. Biapical scarring is again noted. Cardiomediastinal silhouette is stable in configuration. Mid thoracic dextroscoliosis is again noted. No displaced rib fractures are seen. IMPRESSION: Hyperinflation without acute cardiopulmonary process. " 7696d416-428b316c-975a867d-31b0afb8-b48f1b72.jpg,validate/p10/p10804034/s55520865/7696d416-428b316c-975a867d-31b0afb8-b48f1b72.jpg,validation," WET READ: ___ ___ ___ 8:14 AM Bilateral hilar enlargement is not significantly changed. Lung volumes remain decreased with no new focal consolidation concerning for pneumonia. Findings discussed with Dr. ___ by NSR the telephone on ___ at 17:23, 5 min after discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough, chest/back pain // ? pneumonia ? pneumonia IMPRESSION: In comparison with the study of ___, there is little change. Mild prominence of the hila is again appreciated. The cardiac silhouette is at the upper limits of normal in size and there is no evidence of vascular congestion or acute pneumonia. " 2b9199ab-30fd56cd-71defa46-1bc6192a-0dda6035.jpg,validate/p17/p17018837/s59825451/2b9199ab-30fd56cd-71defa46-1bc6192a-0dda6035.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with right PICC line // eval for PICC line placement COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the position of the right PICC line is unchanged. The line projects over the mid to lower SVC. The cavitary lesion in the left upper lung has minimally decreased in extent. However, there is a newly appeared mild to moderate right pleural effusion with subsequent right basilar atelectasis. Blunting of the left costophrenic sinus suggests the presence of a minimal left pleural effusion. Borderline size of the cardiac silhouette. No pneumothorax. " c3458159-2cfe4307-5e2113a4-5dc0da35-de95247c.jpg,validate/p15/p15022111/s50210836/c3458159-2cfe4307-5e2113a4-5dc0da35-de95247c.jpg,validation," FINAL REPORT HISTORY: Substernal chest pain. FINDINGS: In comparison with study of ___, there is little change and no evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. Metallic opacification projected just under the dome of the hemidiaphragm on the right could represent a coil from previous interventional procedure. " a8880cbe-737f1db5-54d3eb8f-c00706fa-b6bddb04.jpg,validate/p17/p17137598/s57759317/a8880cbe-737f1db5-54d3eb8f-c00706fa-b6bddb04.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p CABG // eval for ptx-post pull TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The patient has been extubated. The enteric tube has been removed. The chest tubes and mediastinal drain have been removed. The right IJ central venous catheter is in unchanged position. The lung volume is small. No pulmonary edema. Linear atelectasis is seen in the right mid lung. Left lower lobe atelectasis stable. Bilateral pleural effusion has worsened. The right pulmonary nodule is better seen in prior study but stable since ___. The right hemidiaphragm is chronically elevated since ___. The cardiomediastinal silhouette is unchanged. IMPRESSION: 1. Interval removal of multiple devices including ETT, enteric tube, and chest tubes. 2. Worsening bilateral pleural effusion. No pulmonary edema or pneumothorax. " 6672acdb-bca0a0ed-dbcbb5fc-4e5b160a-62fb41d4.jpg,validate/p14/p14189406/s56723874/6672acdb-bca0a0ed-dbcbb5fc-4e5b160a-62fb41d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with shock, STEMI, and pneumonia // interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild to moderate pulmonary edema is stable. There are lower lung volumes. Cardiac size is top normal. Right lower lobe atelectasis has markedly increased. Small right effusion has increased ET tube is in standard position. There is no pneumothorax. Left perihilar consolidation is unchanged from prior study " 86f0764c-4148a780-f1b607af-a7b33573-61c8421f.jpg,validate/p17/p17547554/s51035137/86f0764c-4148a780-f1b607af-a7b33573-61c8421f.jpg,validation," FINAL REPORT HISTORY: Thoracentesis, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the left chest tube remains in place and there is no evidence of pneumothorax. Patchy bilateral areas of opacification persist, as does right pleural effusion with compressive atelectasis at the base. The left base is essentially unchanged. " bcdbd451-5d73cff8-dea368ef-25050c5d-78d0cf59.jpg,validate/p16/p16259867/s58569771/bcdbd451-5d73cff8-dea368ef-25050c5d-78d0cf59.jpg,validation," FINAL REPORT STUDY: PA and lateral chest performed on ___. CLINICAL HISTORY: ___-year-old male with cirrhosis and ascites and worsening clinical status with hepatorenal syndrome. FINDINGS: Comparison is made to previous study from ___. There is a feeding tube whose distal tip is not included on the edge of the film. The heart size is within normal limits. Lungs are clear. There are no radiographic signs for aspiration. There is no consolidation, pleural effusions or pulmonary edema. No pneumothoraces are identified. " c7f1eed7-29c734aa-08e45dae-30c64bab-420df046.jpg,validate/p11/p11861017/s55326819/c7f1eed7-29c734aa-08e45dae-30c64bab-420df046.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man recent aspiration of tube feeds. CXR portable to be performed ___ for evaluation of pulmonary process in setting of aspirated tube feeds. // CXR portable to be performed ___ for evaluation of pulmonary process in setting of aspirated tube feeds. TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiographs dating back to ___, most recently ___. FINDINGS: In comparison with chest radiographs from ___, small right pleural effusion persists. Retrocardiac opacity has improved, with better visualization of the left hemidiaphragm. Right perihilar and basilar opacities persist, likely reflecting combination of atelectasis, aspiration or infection. No appreciable effusion on the left. No central vascular congestion or overt pulmonary edema. Top-normal heart size is stable. Tracheostomy tube in standard placement, unchanged. IMPRESSION: 1. Improved left retrocardiac opacity. 2. Persistent right perihilar and basilar opacities and small right pleural effusion. " 015c9f4d-10b93db6-7fd24a4a-8edd051e-a6863279.jpg,validate/p14/p14383525/s56535936/015c9f4d-10b93db6-7fd24a4a-8edd051e-a6863279.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with a fever. IMPRESSION: PA and lateral chest compared to ___. There may be a new very small left pleural effusion. Lungs are clear. Cardiomediastinal and hilar silhouettes are normal. " d6398972-7e4ffdbc-77d29a89-23978dea-b57cc2a6.jpg,validate/p11/p11522912/s50891062/d6398972-7e4ffdbc-77d29a89-23978dea-b57cc2a6.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with tracheostomy with MRSA. Evaluate for pneumonia. FINDINGS: Comparison is made to previous study from ___. There is a tracheostomy tube which is appropriately sited. There is a left-sided central venous line with the distal lead tip in the mid SVC, unchanged. There is a feeding tube whose distal tip is below the GE junction off the field of view of study. The heart size is enlarged but unchanged. There is some atelectasis at the right lung base. There is a left retrocardiac opacity which is unchanged from prior. There are no signs for overt pulmonary edema or pneumothoraces. " b4d1d218-8c1c9318-12920c13-f91a8863-f384cc9f.jpg,validate/p14/p14400773/s59007933/b4d1d218-8c1c9318-12920c13-f91a8863-f384cc9f.jpg,validation," 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. " 7f9d790f-5edf1ee8-1e2ba362-c2c0ace4-c2c6f840.jpg,validate/p12/p12553538/s56260929/7f9d790f-5edf1ee8-1e2ba362-c2c0ace4-c2c6f840.jpg,validation," 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. " ca979e5c-38eae1da-4eb3fc43-9377fd2f-f793bff0.jpg,validate/p18/p18738310/s59578620/ca979e5c-38eae1da-4eb3fc43-9377fd2f-f793bff0.jpg,validation," FINAL REPORT INDICATION: Concern for right pneumothorax. COMPARISON: Chest radiograph and chest CT, ___. FINDINGS: Cardiomediastinal and hilar contours are stable with mild cardiomegaly. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. Left retrocardiac opacity has improved on the current study. Rightward deviation of the trachea is due to an enlarged left thyroid lobe, as seen on recent chest CT. IMPRESSION: No pneumothorax. " 86cf38d4-963f2655-70039b77-b5206e7f-379941c9.jpg,validate/p15/p15345462/s55790218/86cf38d4-963f2655-70039b77-b5206e7f-379941c9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with chest pain, s/p fall TECHNIQUE: Chest: PA and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: PA and lateral views the chest provided. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. No signs of congestion or edema. The cardiac and mediastinal silhouettes are unremarkable. No displaced rib fracture seen. Bony structures appear intact. IMPRESSION: No acute cardiopulmonary process. " a2ef10da-6c9f03bc-0fe8a905-a8068531-939c0e99.jpg,validate/p12/p12493668/s55928378/a2ef10da-6c9f03bc-0fe8a905-a8068531-939c0e99.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with empyema and pneumonia. Please perform at 5am on ___. // Evaluate effusion, CT placement, pneumothorax COMPARISON: Radiographs from ___ and 18:42 IMPRESSION: The right basilar pigtail catheter is unchanged in position. There is again seen near complete white out of the right lung with a small amount of aerated lung within the mid zone. These findings are stable. There is decrease in the interstitial prominence in the left lung since the prior study. There are no pneumothoraces. " 9a5bff66-9980322a-4af44eb0-65998b00-27e3a2e7.jpg,validate/p13/p13558097/s56183397/9a5bff66-9980322a-4af44eb0-65998b00-27e3a2e7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with metastatic pancreatic cancer presents with fever TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph and ___ CT chest FINDINGS: Patient is status post mean sternotomy and CABG. Left-sided Port-A-Cath tip terminates in the proximal right atrium. Heart size is normal. The mediastinal and hilar contours are unchanged with mild calcified atherosclerotic disease noted throughout the aorta. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " ff2c6746-85664b95-70d5cb50-b1ad063f-8bd55595.jpg,validate/p10/p10650522/s50438413/ff2c6746-85664b95-70d5cb50-b1ad063f-8bd55595.jpg,validation," FINAL REPORT CHEST RADIOGRAPH Comparison is made with a prior study from ___. CLINICAL HISTORY: Diaphoresis, epigastric pain, assess cardiomegaly. FINDINGS: PA and lateral views of the chest provided demonstrate midline sternotomy wires and mediastinal clips. The heart is top normal in size. Lungs are clear. No signs of pneumonia or CHF. No pleural effusion or pneumothorax. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 99dbd90a-b66a0c18-466175fd-f5fe089e-8c92b47e.jpg,validate/p18/p18573829/s59567651/99dbd90a-b66a0c18-466175fd-f5fe089e-8c92b47e.jpg,validation," 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. " b0d09b5b-377b4c6a-4d6c81f0-b44b83e4-4a3a8194.jpg,validate/p17/p17135687/s57557178/b0d09b5b-377b4c6a-4d6c81f0-b44b83e4-4a3a8194.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CT x1 // ? pneumothorax COMPARISON: Radiographs from ___. IMPRESSION: There has been placement of a tracheostomy. The rest of the lines and tubes are unchanged in position. Shrapnel is seen projecting over the right and left upper lung fields. Cardiomediastinal silhouette is within normal limits. There is a new left retrocardiac opacity. There is mild pulmonary edema. There are no pneumothoraces. " 84623a8e-5a4ee921-4d6d68f2-88d4817f-8906b854.jpg,validate/p14/p14296716/s56600861/84623a8e-5a4ee921-4d6d68f2-88d4817f-8906b854.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: 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 normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary abnormality. " 700bea8c-6ef76e9b-b2ffd1e7-d8ca38af-94aa2aa3.jpg,validate/p15/p15676084/s58373111/700bea8c-6ef76e9b-b2ffd1e7-d8ca38af-94aa2aa3.jpg,validation," FINAL REPORT HISTORY: Fever, history of esophageal cancer. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. Mediastinal contours are unchanged with right mediastinal bulge compatible with known neoesophagus. Previously noted air-fluid level within the neoesophagus is not seen on the current exam. Patchy opacities in the lung bases likely reflect atelectasis. No focal consolidation is demonstrated. A small right pleural effusion persists, unchanged. No pneumothorax or pulmonary vascular congestion is identified. IMPRESSION: Persistent small right pleural effusion. No new focal consolidation to suggest pneumonia. " a81cd8c0-9538d1f6-e905590c-8ffa4470-ee600a5d.jpg,validate/p11/p11620358/s55277447/a81cd8c0-9538d1f6-e905590c-8ffa4470-ee600a5d.jpg,validation," FINAL REPORT EXAMINATION: Chest two views INDICATION: ___M with dyspnea // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: PA and lateral views the chest. When compared to prior, there has been no significant interval change. The lungs are clear without focal consolidation effusion, or pulmonary edema. The cardiomediastinal silhouette is stable. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " eecb2a1d-a906a947-2f3b8879-eef1a572-b6efee9a.jpg,validate/p18/p18488823/s59858156/eecb2a1d-a906a947-2f3b8879-eef1a572-b6efee9a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RLL PNA // eval resolution eval resolution COMPARISON: A chest radiographs ___ and ___. IMPRESSION: The subtle increase in radiodensity over the lower spine seen on the lateral view on ___ is not clearly changed from ___ and looks pretty much the same today. I can't say that I see a focus of pneumonia; if any is present it is quite small. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 468df880-10005e8e-d4fa6433-d08fa89c-7b141448.jpg,validate/p17/p17622916/s57419136/468df880-10005e8e-d4fa6433-d08fa89c-7b141448.jpg,validation," FINAL REPORT HISTORY: Postoperative increase in oxygen requirement. FINDINGS: In comparison with the study of ___, there again are bilateral pleural effusions with evidence of pulmonary vascular congestion and compressive atelectasis at the bases. In the appropriate clinical setting, superimposed pneumonia would have to be considered. The right IJ catheter extends at least to the cavoatrial junction and quite probably into the upper portion of the right atrium. " c007cfde-ad68ad8a-0e03da06-58e9666a-d56dc812.jpg,validate/p18/p18550032/s53186488/c007cfde-ad68ad8a-0e03da06-58e9666a-d56dc812.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old man with R pleural effusion, likely hepatic hydrothorax // Assess for OG placement Assess for OG placement IMPRESSION: ET tube tip is 6.3 cm above the carinal. NG tube tip is in the stomach. Severe cardiomegaly is unchanged. Bilateral pleural effusions are large in potentially increased since the prior study. " aedfcdd8-6438b27a-5d6b20d6-08c03afc-b40c0830.jpg,validate/p18/p18322589/s51231499/aedfcdd8-6438b27a-5d6b20d6-08c03afc-b40c0830.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chronic heart failure exacerbation, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a severe increase in extent of the bilateral parenchymal opacities. These are strongly suggestive for severely increasing pulmonary edema. In addition, a small right pleural effusion has newly occurred. There is unchanged evidence of cardiomegaly. No pneumonia, retrocardiac atelectasis is present. At the time of dictation, ___, 8:27 a.m., referring physician, ___. ___, was paged for notification. " 257dd21a-c4a96464-f475f0a5-74f06c20-78b576c0.jpg,validate/p11/p11759231/s50141464/257dd21a-c4a96464-f475f0a5-74f06c20-78b576c0.jpg,validation," FINAL REPORT HISTORY: Positive PPD. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. Multiple tiny calcified granulomas are noted. The heart size is normal. Mediastinal contours are normal. No bony abnormalities detected. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 66235db4-892741fc-00c8a284-b9845a93-4ef8260b.jpg,validate/p13/p13177514/s59900555/66235db4-892741fc-00c8a284-b9845a93-4ef8260b.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough, tachypnea and mucosal drainage. COMPARISON: No relevant comparisons available. TWO VIEWS OF THE CHEST: The lungs are low in volume but clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " d102a34f-b11c6e5c-f05a114a-7801c2b5-e57f3e42.jpg,validate/p10/p10589692/s59660640/d102a34f-b11c6e5c-f05a114a-7801c2b5-e57f3e42.jpg,validation," FINAL REPORT HISTORY: Hypoxia. COMPARISON: Chest radiograph ___, ___. FINDINGS: Frontal views of the chest were reviewed. The cardiomediastinal and hilar contours remains stable with severe cardiomegaly and marked pulmonary artery enlargement. There is no pneumothorax. A small right pleural effusion and right infrahilar consolidation are new. IMPRESSION: New small right pleural effusion and right basal pneumonia or atelectasis. Chronic severe cardiomegaly and pulmonary hypertension. Dr ___ ___/w Dr ___ at 8:30AM. " 7f9634bd-04f73544-6c2ab020-8051bf34-a6f6e234.jpg,validate/p14/p14120635/s57938036/7f9634bd-04f73544-6c2ab020-8051bf34-a6f6e234.jpg,validation," FINAL REPORT INDICATION: ___M with chest pain, afib rvr // chest pain TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Lower lung volumes seen on the current exam. There is however new mild pulmonary edema and new small bilateral pleural effusions. Cardiac silhouette is enlarged since prior. Metallic density again seen in the left hilum. No acute osseous abnormalities. IMPRESSION: New mild pulmonary edema and small bilateral effusions since ___. " 1814f3f6-738464ea-8c11c59b-067e82c0-37434bf7.jpg,validate/p15/p15349186/s58643403/1814f3f6-738464ea-8c11c59b-067e82c0-37434bf7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest/midback pain pls eval pna, effusion, // History: ___M with chest/midback pain pls eval pna, effusion, TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 70d95cf9-ae46e0d1-6f324bf8-46649945-32fdc62e.jpg,validate/p12/p12019988/s50465990/70d95cf9-ae46e0d1-6f324bf8-46649945-32fdc62e.jpg,validation," WET READ: ___ ___ ___ 4:12 PM Probable left pleural thickening. No definite acute cardiopulmonary process. Rounded opacity in the right hilar region is probably a vessel on-end. Consider repeat chest radiograph to confirm. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with left sided chest pain // eval for pneumothorax or pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: PA and lateral chest radiograph demonstrates clear lungs bilaterally. Rounded opacity in the right hilar region is probably a vessel on end. Blunting of the left costophrenic angle may reflect pleural thickening. There is no large pleural effusion. There is no pneumothorax. There is no air under the right hemidiaphragm. No evidence of pulmonary edema. Heart size is within normal limits. IMPRESSION: Probable left pleural thickening. No definite acute cardiopulmonary process. Rounded opacity in the right hilar region is probably a vessel on-end. Consider repeat chest radiograph to confirm. " a9cbaf56-264a9f47-32bf0875-a1667b2c-0aa29f0a.jpg,validate/p15/p15883255/s54424326/a9cbaf56-264a9f47-32bf0875-a1667b2c-0aa29f0a.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with recently dx PEs, new fevers // evaluate for PNA, atelectasis COMPARISON: Compared to radiographs from ___ IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are bilateral pleural effusions, right greater than left which are stable in size. Bibasilar atelectasis is seen. There are no pneumothoraces. No pulmonary edema or focal consolidation is seen. " 43a94262-7fdfe8b4-c5e4f73d-08797320-625f39e1.jpg,validate/p11/p11211680/s55572543/43a94262-7fdfe8b4-c5e4f73d-08797320-625f39e1.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with chest pain, dyspnea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs remain 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. " 5e5ca259-92313cec-69023f62-f91742ff-8e4baa14.jpg,validate/p13/p13343381/s53480950/5e5ca259-92313cec-69023f62-f91742ff-8e4baa14.jpg,validation," WET READ: ___ ___ 5:35 PM No acute cardiopulmonary process, specifically no focal consolidation. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Depression, questionable pneumonia. FINDINGS: There is no radiograph available for comparison. Normal size of the cardiac silhouette. No pneumonia. No pulmonary edema. No pleural effusions or other acute or chronic lung parenchymal changes. Normal hilar and mediastinal contours. " a998f8ae-25669e3b-80457a5a-24edf861-78ec1849.jpg,validate/p15/p15595779/s54126693/a998f8ae-25669e3b-80457a5a-24edf861-78ec1849.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M s/p fall down ___ steps // eval for mediastinal injury, heart border, previous CXR at OSH provided poor visualization COMPARISON: Outside hospital radiograph of the chest from earlier today. FINDINGS: PA and lateral views of the chest provided. Lungs are clear without focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. No pulmonary edema. Bony structures intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings. " 8ac1bca4-65d98432-cdd55075-e0038d28-89d4d719.jpg,validate/p11/p11211680/s55801459/8ac1bca4-65d98432-cdd55075-e0038d28-89d4d719.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough. Question pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are well aerated without pneumothorax, vascular congestion, or pleural effusion. IMPRESSION: No acute cardiopulmonary process such as pneumonia. " 762ee7fc-c2a280de-703ce691-05f2da1a-3ff44b6e.jpg,validate/p11/p11971081/s57075811/762ee7fc-c2a280de-703ce691-05f2da1a-3ff44b6e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with hypoxia, transferred from outside hospital for pneumonia. COMPARISON: Chest radiograph of ___. CT torso ___. FINDINGS: Frontal and lateral views of the chest were obtained. Bulky mediastinal and hilar lymphadenopathy is similar to ___. The heart size is normal. New heterogeneous opacity in the superior segment of the right lower lobe is most consistent with pneumonia, though metastatic progression cannot be excluded. Right lower and left mid lung pulmonary nodules appear stable since ___. No substantial pleural effusion. No pneumothorax. Catheter of the left chest wall port terminates in the right atrium. IMPRESSION: 1. New right lower lobe opacity is consistent with pneumonia, though metastatic progression cannot be excluded. 2. Unchanged appearance of bulky lymphadenopathy and lung nodules since ___. " 7dc1c6c0-50eaadd1-b868c6f7-dc998e5d-decd233c.jpg,validate/p17/p17222468/s57902044/7dc1c6c0-50eaadd1-b868c6f7-dc998e5d-decd233c.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiograph of ___. FINDINGS: The patient is status post recent right upper lobe resection. Small-to-moderate right apicolateral pneumothorax is again demonstrated and has minimally decreased in size. Extensive subcutaneous emphysema in right chest wall is also slightly better. Right chest tube is unchanged in position, and postoperative alterations of the right mediastinal and hilar regions appear unchanged allowing for positional differences between the studies. Minimal atelectasis is present at the lung bases, left greater than right, and there are also apparent small pleural effusions. IMPRESSION: Slight decrease in right pneumothorax and subcutaneous emphysema with right chest tube in place. " 453e0a0d-79cea4e2-f31b67a5-960cbf76-937170e0.jpg,validate/p10/p10925136/s52423683/453e0a0d-79cea4e2-f31b67a5-960cbf76-937170e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistant cough // cough COMPARISON: No comparison IMPRESSION: Low lung volumes. Minimal elongation of the descending aorta. No pulmonary edema. No pneumonia, no pleural effusions. " 512613ad-cf627e49-7ba37430-969bc3f1-0964ffe9.jpg,validate/p13/p13385785/s59414262/512613ad-cf627e49-7ba37430-969bc3f1-0964ffe9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, left basilar crackles, evaluation for pneumonia. COMPARISON: ___. FINDINGS: The lung volumes are normal. Normal size of the cardiac silhouette. Normal appearance of the hilar and mediastinal structures. On the frontal image, no abnormality in the lung parenchyma is noted. On the lateral image, however, there is a so called spine sign, with an increase in density of the lung parenchyma at the level of the lower lobes. In the appropriate clinical setting, this can potentially indicate the presence of an infectious process at the level of the lower lobes. There are no pleural effusions. Mild tortuosity of the thoracic aorta. No pneumothorax. The observation was made at 11:25 a.m., ___, and at the same time point, Dr. ___ was paged for notification. " 4bd73fa2-06827cfd-5755a8d1-7f3bd5b1-1b637ddb.jpg,validate/p18/p18551287/s55401267/4bd73fa2-06827cfd-5755a8d1-7f3bd5b1-1b637ddb.jpg,validation," FINAL REPORT INDICATION: ___ M w/ HBV/HDV/?EtOH-related cirrhosis, now reactivated on transplant list, admit to ICU for altered mental status, ? inability to protect airway, now with increased work of breathing // assess interval change TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: The tip of the left PICC line projects over the lower SVC. The gastric tube projects below the level of the diaphragms but beyond the field of view of this radiograph. Persisting small layering right pleural effusion. No focal consolidation or pneumothorax identified. The size of the cardiac silhouette is within normal limits. IMPRESSION: No significant interval change since prior exam. Persisting small right layering pleural effusion. " 258c5521-ec5820c6-2ab122a2-bc34d0f1-2aed9cab.jpg,validate/p16/p16865608/s58030663/258c5521-ec5820c6-2ab122a2-bc34d0f1-2aed9cab.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Dyspnea, weight gain and hypoxia. COMPARISON: None. TECHNIQUE: Chest, semi-upright AP portable. FINDINGS: The heart is mild to moderately enlarged. The superior vena cava is probably distended noting widening of the vascular pedicle. Perihilar congestion is moderate and more generally there is widespread opacification suggesting mild to moderate pulmonary edema. There is no definite pleural effusion or pneumothorax. IMPRESSION: Findings suggest pulmonary edema. " 9d6140cc-19c99f86-4d834805-7fc2aaaa-5473ea56.jpg,validate/p13/p13873516/s51320741/9d6140cc-19c99f86-4d834805-7fc2aaaa-5473ea56.jpg,validation," FINAL ADDENDUM ADDENDUM: Comparison studies from ___ are now available. There has been complete resolution of the right sided pneumonia since that study. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Recently diagnosed right upper lobe pneumonia. Assessment after treatment. Prior studies are not available for comparison. PA and lateral upright chest radiographs demonstrate normal heart size, normal mediastinal contours. Lungs are clear and there is no pleural effusion or pneumothorax. Current study demonstrates no evidence of pneumonia. " fa103036-99eb9488-e376744d-867dd615-f5117aa1.jpg,validate/p16/p16907362/s53764722/fa103036-99eb9488-e376744d-867dd615-f5117aa1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o plasmacytoma on revlimid with fevers, green prod cough, course breath sounds // Any sign of 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. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 44ad7b42-45200b2e-4b5535ae-d4139724-50b1377b.jpg,validate/p18/p18931257/s59488789/44ad7b42-45200b2e-4b5535ae-d4139724-50b1377b.jpg,validation," FINAL REPORT INDICATION: ___M with several days cough, wheezing // eval ? infx 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. " df77758f-defab45e-ca954866-e8285f5c-3980ea98.jpg,validate/p15/p15782217/s57557354/df77758f-defab45e-ca954866-e8285f5c-3980ea98.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain. 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 enlarged. The aorta remains tortuous. There may be minimal pulmonary vascular congestion. There is moderate compression deformity of the superior endplate of a lower thoracic vertebral body likely also present on the prior study. " 6b514480-8acfbfa9-2bc0ea3f-6badec10-e1b86486.jpg,validate/p14/p14726463/s55050768/6b514480-8acfbfa9-2bc0ea3f-6badec10-e1b86486.jpg,validation," FINAL REPORT AP CHEST, 2:18 A.M., ___ HISTORY: ___-year-old with a series of strokes and advanced dementia. Seizures in the setting of UTI. Possible pneumonia. IMPRESSION: AP chest compared to ___: Patient is rightward shifted which projects the large heart over the right lower lung, but nevertheless, there is clearly progressive opacification of the right lung and decrease in volume of the right hemithorax suggesting a large component of atelectasis, conceivably obscuring pneumonia, but not necessarily. Left lung is grossly clear. As before, the endotracheal tube is too high, 2 cm above the upper margin of the clavicles and no less than 6 cm above the carina. It should be advanced at least 3 cm for more secured seating and improved aeration. Moderate cardiomegaly is stable. At least a small right pleural effusion, new or increased since ___, is presumed. Nasogastric tube is looped in the stomach. Right PIC line ends at the junction of brachiocephalic veins. A new lead runs parallel to the left clavicle ending in the midline, but I do not recognize it. Clinical correlation is needed. There is no left pleural effusion or pneumothorax. Dr. ___ was paged. " d59a339b-4716324c-5c089a61-d9171e3f-9daf6634.jpg,validate/p16/p16279993/s59990572/d59a339b-4716324c-5c089a61-d9171e3f-9daf6634.jpg,validation," FINAL REPORT EXAM: CHEST FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: ___-year-old female with history of 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. There is thickening of the right paratracheal stripe which may be due to prominent vasculature, although underlying lymphadenopathy is not excluded, and further evaluation with non-urgent chest CT (assuming no concern for acute aortic syndrome) advised. IMPRESSION: Prominent right mediastinal soft tissue while could relate to vasculature, underlying lymphadenopathy or other soft tissue not excluded. Recommend further evaluation with CT. " b487a4ff-5cea73e5-dde0ffba-cd2f4a75-7d1cd4fb.jpg,validate/p18/p18695475/s59064312/b487a4ff-5cea73e5-dde0ffba-cd2f4a75-7d1cd4fb.jpg,validation," FINAL REPORT PORTABLE CHEST X-___ ___ ___ COMPARISON: ___ radiograph. FINDINGS: Feeding tube has been advanced, now terminating in the upper stomach. Cardiomediastinal contours are unchanged. Lung volumes are increased, and lungs are grossly clear. " 15960230-6ef0b173-c679a3b1-ae2476f3-f7bd3254.jpg,validate/p15/p15245907/s58885933/15960230-6ef0b173-c679a3b1-ae2476f3-f7bd3254.jpg,validation," FINAL REPORT HISTORY: Chronic aspiration, to assess for pneumonia. FINDINGS: Technically limited study. In comparison with the study of ___, there is no evidence of acute focal pneumonia or vascular congestion. Continued substantial elevation of the left hemidiaphragmatic contour. " 6961df8e-b8fb2155-36f4f6e3-fcc0dbf0-6609df0e.jpg,validate/p16/p16336316/s54192774/6961df8e-b8fb2155-36f4f6e3-fcc0dbf0-6609df0e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hyperglycemia, infectious workup // Eval for infiltrates 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. " b8f29c0b-58216422-d697c1b6-696ec92d-c5d3d499.jpg,validate/p18/p18285504/s58674867/b8f29c0b-58216422-d697c1b6-696ec92d-c5d3d499.jpg,validation," FINAL REPORT INDICATION: Right upper quadrant pain with a pleuritic component, evaluate for pneumonia or effusion. COMPARISONS: None. PA AND LATERAL VIEWS OF THE CHEST: The cardiomediastinal, pleural and pulmonary structures are unremarkable. There is no pneumothorax or pleural effusion. There is no airspace consolidation to suggest pneumonia. The heart size is normal. Clip seen overlying the expected area of the gallbladder, likely from prior cholecystectomy. IMPRESSION: No acute cardiopulmonary process. " 72a91083-0608df46-5cb4c584-18ef162f-38ffdb9f.jpg,validate/p18/p18116982/s54400262/72a91083-0608df46-5cb4c584-18ef162f-38ffdb9f.jpg,validation," WET READ: ___ ___ ___ 10:23 AM Subtle increased opacity corresponding to the right lower lobe may represent an early developing pneumonia in the appropriate clinical context. Recommend clinical correlation. ______________________________________________________________________________ FINAL REPORT INDICATION: Fever, here to evaluate for pneumonia. COMPARISON: Multiple prior chest radiographs, most recently dated ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Subtly increased hazy opacification at the bilateral lung fields, predominantly in the bases is likely related to technique. Within this limitation, there is subtly increased opacity in the right lung base on the frontal view, which may correspond to increased density over the spine on the lateral view. There is no pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. The trachea is midline. No acute osseous abnormality is detected. There is no free air beneath the right hemidiaphragm. IMPRESSION: Subtle increased opacity corresponding to the right lower lobe may represent an early developing pneumonia in the appropriate clinical context. " bcbc602d-8d5bb3ab-b02da725-5d062af1-238e0cf2.jpg,validate/p18/p18663874/s55159058/bcbc602d-8d5bb3ab-b02da725-5d062af1-238e0cf2.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with s/p bronch, TBB for ___, with cough, initially central chest discomfort, now dull right parasternal upper chest ache, worse with cough. Coughed up a few clots of blood today. // Please assess for infiltrate, effusion, free air. TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dated from ___ through ___. FINDINGS: The cardiac silhouette is mildly enlarged. Lobulation to mediastinal reflections projecting over the aortopulmonic window and left hilus reflect central adenopathy seen on recent chest CT. Lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No complications following transbronchial biopsy. " 2a498476-4a50246e-bfe2339c-27527f18-55927388.jpg,validate/p16/p16021017/s50923921/2a498476-4a50246e-bfe2339c-27527f18-55927388.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: GP bacteremia with fever, assess for pneumonia. Comparison is made with prior study ___. New faint peripheral left upper lobe opacity is conserning for pneumonia. Otherwise the lungs are grossly clear. There is no pneumothorax or pleural effusion. Cardiomediastinal contours are normal. Mild biapical pleural thickening is again noted. " 78f04d16-c4e49fc6-7de7f16e-2c3bdb2c-6a3f7e0b.jpg,validate/p14/p14213029/s59347879/78f04d16-c4e49fc6-7de7f16e-2c3bdb2c-6a3f7e0b.jpg,validation," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Chest radiographs from approximately 4 hours prior on the same day, as well as ___. FINDINGS: Portable frontal chest radiographs demonstrate sternal wires, as well as pacer leads projecting over the right heart border. Opacity in the upper right lung with rightward shift of the upper mediastinum consistent with volume loss. Flattened hemidiaphragms are consistent with hyperinflation. No focal consolidation or large pleural effusion or pneumothorax is identified. IMPRESSION: Opacity in the right upper lung with rightward shift of the upper mediastinum consistent with volume loss. The differential includes upper lobe collapse, fibrosis, and tuberculosis. NOTIFICATION: These findings were discussed via telephone with Dr. ___ ___ by Dr. ___ at ___ on ___, after review with the attending. The patient does not have a known history of malignancy/radiation or risk factors for tuberculosis. " b73af8e2-be1b235b-f3f15d80-0e651b74-d8d44a3e.jpg,validate/p19/p19661672/s55199385/b73af8e2-be1b235b-f3f15d80-0e651b74-d8d44a3e.jpg,validation," 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. " 76a2cb1b-72ee0665-867bd845-2929dc68-001ec9de.jpg,validate/p12/p12431768/s54384708/76a2cb1b-72ee0665-867bd845-2929dc68-001ec9de.jpg,validation," FINAL REPORT INDICATION: Dyspnea and new tachypnea. Evaluate for aspiration. COMPARISON: Chest radiograph ___ through ___. TECHNIQUE: Semi-upright AP radiograph of the chest. FINDINGS: Lung volumes are very low and the film is somewhat underpenetrated. Faint bibasilar opacities are similar to yesterday's study and may reflect mild atelectasis; however, pneumonia or aspiration cannot be completely excluded. The heart is mildly enlarged. The mediastinal and hilar contours are unremarkable. There is calcification of the aortic arch. There is no large pleural effusion or pneumothorax. IMPRESSION: Faint bibasilar opacities in the setting of low lung volumes may reflect atelectasis, although pneumonia or aspiration in the right clinical setting cannot be completely excluded. " 0675d753-b1fa6b02-65cdbc15-4c5673a5-641f70b5.jpg,validate/p17/p17429491/s52449914/0675d753-b1fa6b02-65cdbc15-4c5673a5-641f70b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p fiducial placement on left // assess fiducial placement assess fiducial placement IMPRESSION: In comparison with the procedure study, there is no change in the appearance of the fiducial seed in the left infrahilar region. No evidence of post -procedure pneumothorax. Blunting of the costophrenic angles is seen. " 046bf7a8-e31a3bfc-25eccd80-20e2659b-d22e251e.jpg,validate/p15/p15470171/s50162674/046bf7a8-e31a3bfc-25eccd80-20e2659b-d22e251e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right pre-existing pleural effusion has minimally increased in extent. A pre-existing left pleural effusion, with associated atelectasis, is stable. The lung parenchyma still appears overinflated but no evidence of pneumonia is seen. Unchanged normal size of the cardiac silhouette. Unchanged appearance of the mediastinum. " 7e6968e1-f32b65c0-1f0009d6-f522e133-3aac6b36.jpg,validate/p18/p18628529/s54578374/7e6968e1-f32b65c0-1f0009d6-f522e133-3aac6b36.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest pain, sickle cell. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest obtained. Left-sided Port-A-Cath is seen terminating in the low SVC. The proximal aspect of the Port-A-Cath takes a sharp right angle. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. There may be very minimal pulmonary vascular congestion. IMPRESSION: No focal consolidation. Possible minimal pulmonary vascular congestion. No cardiomegaly. " e61cd4fe-3f41fd69-0a918ddd-88cb88fd-55124588.jpg,validate/p18/p18619829/s50427708/e61cd4fe-3f41fd69-0a918ddd-88cb88fd-55124588.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with mental status change yesterday // please assess for pna or infection TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: There is a new left-sided effusion and new retrocardiac opacity. While some of the retrocardiac opacity could be due to effusion a could also be due to volume loss/infiltrate. IMPRESSION: New left effusion. Is unclear if there is a left lower lobe infiltrate as well. " dde4fe11-4daf3997-e3b23c7d-fcbc81f3-86a5d76e.jpg,validate/p16/p16948316/s53597842/dde4fe11-4daf3997-e3b23c7d-fcbc81f3-86a5d76e.jpg,validation," 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. " e6877a42-ffb625d0-05637b1b-1de5658e-889ffd56.jpg,validate/p11/p11457450/s57057049/e6877a42-ffb625d0-05637b1b-1de5658e-889ffd56.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man trabsferring for OSH with concern for PNA vs. CHF // Assess for evidence of CHF vs. PNA Assess for evidence of CHF vs. PNA IMPRESSION: Heart size and mediastinum are unremarkable. Pulmonary arteries enlargement, perihilar interstitial markings, perihilar and lower lobe opacities and bilateral pleural effusions in combination with ___ B-lines are concerning for pulmonary edema. He underlying infectious process is a possibility. There is no pneumothorax. Reassessment of the patient after diuresis is recommended for establishing the role of pulmonary edema versus infection. " b3dd7255-88a6e27f-607c968c-84834b8a-eb5f25d4.jpg,validate/p16/p16571136/s56961189/b3dd7255-88a6e27f-607c968c-84834b8a-eb5f25d4.jpg,validation," FINAL REPORT INDICATION: History of metastatic renal cell carcinoma with stridor and dyspnea. Evaluate for stent migration. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: The stent overlies the right cardiac border likely within the bronchus intermedius, and does not appear significantly changed in position since the prior exam. Again, there is a right hilar mass, which appears similar. Multiple pleural nodules are also stable. There is no new focal airspace consolidation or pulmonary edema. There is no pleural effusion or pneumothorax. The cardiac size is normal. IMPRESSION: 1. No significant change in the position of the right-sided bronchial stent. 2. No significant change in appearance of the right hilar and multiple other pleural metastases. No evidence of an acute pneumonia is identified. " 1df538e3-b5ffe956-b85cd633-0adbf130-26ff58a5.jpg,validate/p12/p12490049/s52800446/1df538e3-b5ffe956-b85cd633-0adbf130-26ff58a5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // rule out pneumonia TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size and mediastinum assessment demonstrate mild cardiomegaly. Lungs are clear. There is no pleural effusion or pneumothorax demonstrated. " 1c4eaca3-6b3c2113-dd77e710-c548e71a-8ba4767f.jpg,validate/p16/p16783674/s57364496/1c4eaca3-6b3c2113-dd77e710-c548e71a-8ba4767f.jpg,validation," 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. " 91081732-32e10235-9711c9e1-cd025e76-bc4ee2e0.jpg,validate/p15/p15289580/s51508938/91081732-32e10235-9711c9e1-cd025e76-bc4ee2e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever, cough // PNA/infection TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no pneumothorax. The heart and mediastinum are within normal limits. Regional bones are osteopenic. IMPRESSION: Clear lungs with no evidence of pneumonia. " 11a527e8-950f20fb-80cee695-66915917-efefbd12.jpg,validate/p17/p17469778/s55593606/11a527e8-950f20fb-80cee695-66915917-efefbd12.jpg,validation," FINAL REPORT HISTORY: Repositioned ET tube . COMPARISON: reference exam: ___. FINDINGS: ET tube is 6 cm above the carina bilateral central lines are unchanged. NG tube tip is in the stomach. The heart is mildly enlarged, slightly larger than on there prior. There is hazy opacity projecting over both lower lobes left greater than right representing volume loss and infiltrate. On the left there is probably also an effusion. There is mild pulmonary vascular redistribution IMPRESSION: ET tube 6 cm above the carina. " 765f7b87-51f2e7c0-a0e1dce9-79ab71b7-0e4e5bdd.jpg,validate/p18/p18395216/s53621752/765f7b87-51f2e7c0-a0e1dce9-79ab71b7-0e4e5bdd.jpg,validation," FINAL REPORT HISTORY: Dyspnea. COMPARISON: ___. FINDINGS: Single portable view of the chest demonstrates decreasing pulmonary edema. No pneumothorax is present. Bilateral layering pleural effusions are likely present. Cardiac size is slightly enlarged. Vascular congestion is of course present. Retrocardiac consolidation is likely due to atelectasis however pneumonia in the correct clinical setting can be considered. IMPRESSION: Slightly improved pulmonary edema compared to the study from 2 days prior. " 5d118ddf-cf8011f9-494e7295-1ed7cf31-6121a38b.jpg,validate/p18/p18624005/s50049318/5d118ddf-cf8011f9-494e7295-1ed7cf31-6121a38b.jpg,validation," 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. " 81758957-b2f265b9-a2edd09d-2e9b0e3c-0723e25d.jpg,validate/p19/p19905579/s56894478/81758957-b2f265b9-a2edd09d-2e9b0e3c-0723e25d.jpg,validation," FINAL REPORT INDICATION: History of shortness of breath. Please evaluate for pneumonia versus pulmonary edema. COMPARISONS: None. TECHNIQUE: AP 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. " adb06c4e-e18a9148-fa469d6b-736e0585-346427de.jpg,validate/p17/p17547554/s54758745/adb06c4e-e18a9148-fa469d6b-736e0585-346427de.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with altered mental status, stigmata of fall TECHNIQUE: Portable upright AP view of the chest COMPARISON: Chest radiograph ___. Chest CT from ___ and PET-CT from ___ FINDINGS: The cardiac silhouette size is normal and unchanged. The mediastinal and hilar contours are similar. Atherosclerotic calcifications are noted at the aortic knob. The pulmonary vasculature is not engorged. Biapical opacities are again noted, with streaky left basilar opacity likely reflective of atelectasis. There may be a trace left pleural effusion as there is blunting of the left costophrenic angle. No pneumothorax or pulmonary edema is demonstrated. No acute osseous abnormality is detected. IMPRESSION: 1. Unchanged biapical pulmonary opacities, which have been previously characterized on chest CT from ___ and PET-CT from ___. If clinically indicated, further assessment with a dedicated chest CT can be obtained for direct comparison. 2. Left basilar atelectasis and probable trace left pleural effusion. " afb9ade8-7bb24c4e-a4948b0c-965b65a5-6f6628eb.jpg,validate/p17/p17904720/s52785955/afb9ade8-7bb24c4e-a4948b0c-965b65a5-6f6628eb.jpg,validation," WET READ: ___ ___ ___ 2:54 AM 1. Interval increase in small right and moderate left pleural effusion. 2. Left basilar opacity may represent combination of pleural effusion and atelectasis however superimposed infection cannot be excluded. Clinical correlation recommended. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with basilar crackles and cough; assess for pneumonia (+cough) TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___, ___, ___. FINDINGS: The lungs are mildly hypoinflated with crowding of vasculature. No pneumothorax. Interval increase in size of a small right and moderate left pleural effusion with fluid in the left major fissure. Left basilar opacity noted. Aortic arch calcifications are present. Right hilar prominence is stable. Visualized cardiomediastinal silhouette is unremarkable. Right PICC tip in the low SVC. IMPRESSION: 1. Interval increase in small right and moderate left pleural effusion. 2. Left basilar opacity may represent combination of pleural effusion and atelectasis however superimposed infection cannot be excluded. Clinical correlation recommended. " ca288679-ca9ffe6a-0d7595c9-7750d945-cca5c28e.jpg,validate/p11/p11522912/s59741053/ca288679-ca9ffe6a-0d7595c9-7750d945-cca5c28e.jpg,validation," FINAL REPORT HISTORY: ___ years old man with respiratory failure, episode of hypoxia since x-ray in the morning. Assess interval changes. COMPARISON: Exam is compared to chest x-ray of ___ at 3:19 a.m. FINDINGS: All the monitoring and support devices are unchanged in standard position. Interval increase of right base atelectasis with improvement of left base ventilation for reduced atelectasis. Stable bibasilar small pleural effusion. Heart size still mildly enlarged. There is no pneumothorax. IMPRESSION: Alternance bibasilar atelectasis " 9c4375a0-b4a11c16-d41691ab-fc02097e-43fa52ce.jpg,validate/p13/p13962573/s59342440/9c4375a0-b4a11c16-d41691ab-fc02097e-43fa52ce.jpg,validation," FINAL REPORT INDICATION: PICC line 4cm out // Position of PICC line in right arm TECHNIQUE: Portable AP Upright view of the chest COMPARISON: ___ FINDINGS: The right PICC terminates in the mid SVC, previously at the cavoatrial junction. The cardiomediastinal silhouette including moderate to severe cardiomegaly is unchanged. Persistent mild pulmonary edema and small bilateral effusions. No pneumothorax. IMPRESSION: 1. The right PICC has been pulled back now terminating in the mid SVC, previously at the cavoatrial junction. 2. Persistent moderate to severe cardiomegaly, mild pulmonary edema and small bilateral effusions. " 5b0f4dfe-0950a6c1-27c9e6b4-86fe113d-c5e0f210.jpg,validate/p19/p19555515/s53475663/5b0f4dfe-0950a6c1-27c9e6b4-86fe113d-c5e0f210.jpg,validation," FINAL REPORT HISTORY: Persistent cough and chest pain. FINDINGS: In comparison with the study of ___, there is no definite change in the appearance of the heart and lungs. Mild enlargement of the heart with tortuosity of the aorta without vascular congestion. On the lateral view, there is a vague suggestion of some increased opacification overlying the anterior portion of several lower thoracic vertebrae. This most likely represents vascular structures, though in the appropriate clinical setting, the possibility of superimposed pneumonia cannot be unequivocally excluded. " 318bc605-0ee5a40b-c604c2a0-b83fa0de-61474b74.jpg,validate/p13/p13875890/s58601378/318bc605-0ee5a40b-c604c2a0-b83fa0de-61474b74.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with vent dependence // interval scan interval scan IMPRESSION: Compared to chest radiographs ___ through ___. Bilateral perihilar consolidation, more pronounced in the right lung than the left has improved slightly on the right common not on the left. No appreciable pleural abnormality. Heart size normal. ET tube, left PIC line, and transesophageal drainage tube are in standard placements respectively. " 43c2cead-8dce2aea-f81013c5-fc2fa446-d47bb9d1.jpg,validate/p19/p19731864/s52033279/43c2cead-8dce2aea-f81013c5-fc2fa446-d47bb9d1.jpg,validation," FINAL REPORT TECHNIQUE: PA and lateral radiograph of chest were reviewed in comparison to prior study from ___. FINDINGS: Enlarged heart size is stable since ___. Mediastinal and hilar contours are unremarkable. Aorta is tortuous in course, unchanged in appearance. There are no lung opacities concerning for pulmonary edema/pneumonia. There is no pleural effusion. IMPRESSION: Moderately enlarged heart size, stable since ___. No findings concerning for pulmonary edema or pneumonia. " 1ff6d881-762d705d-4537673c-50d8e8ca-90cdd959.jpg,validate/p13/p13876660/s52036384/1ff6d881-762d705d-4537673c-50d8e8ca-90cdd959.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman ___F PMH asthma, Bipolar disorder left suboccipital craniotomy and choroid plexus papilloma resection. NG tube just placed. Need to check position. // Check NGT position. Check NGT position. IMPRESSION: In comparison with the study of ___, there has been placement of a nasogastric tube that extends to the mid to lower portion of the stomach with the side port at about the level of the esophagogastric junction. The tube should be pushed forward several cm to be in better position. There are lower lung volumes that mildly accentuate the transverse diameter of the heart. Some tortuosity of the descending aorta is seen. Increased opacification at the left base is consistent with atelectasis and probable small effusion. Minimal atelectatic changes are seen on the right. " 03a046dc-db045ed8-892a40a9-79079ff2-2deed93c.jpg,validate/p18/p18913382/s59220060/03a046dc-db045ed8-892a40a9-79079ff2-2deed93c.jpg,validation," FINAL REPORT CHEST ON ___. HISTORY: Pneumonia with new oxygen requirement. FINDINGS: Compared to the study from the prior day, there is no significant change in the dense right lower lobe infiltrate. No new infiltrate is seen. " ec087149-28b6ec48-11799289-f67a3c35-bf584929.jpg,validate/p17/p17875858/s50696087/ec087149-28b6ec48-11799289-f67a3c35-bf584929.jpg,validation," FINAL REPORT INDICATION: Cough and mid epigastric pain. TECHNIQUE: Two views of the chest. COMPARISON: None available. FINDINGS: No focal opacity to suggest pneumonia is seen. No pleural effusion or pneumothorax is present. There may be mild vascular congestion; however, no overt pulmonary edema. The heart size is top normal. " 8b022030-a44f6023-40010130-e9f936f3-6f2dc281.jpg,validate/p19/p19991135/s56217968/8b022030-a44f6023-40010130-e9f936f3-6f2dc281.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post right upper lobectomy. Comparison is made with prior study performed a day earlier. Interstitial opacities in the right lung have minimally increased, likely due to edema. In the right upper hemithorax several air-fluid levels are more conspicuous than in prior studies .. Right perihilar opacity is grossly unchanged, allowing the difference in position of the patient. The left lung is clear. The right chest tube remains in unchanged position. Right chest wall subcutaneous emphysema has improved. " 7f3bfa34-77a25257-faceb73a-e24cca91-cc2edd51.jpg,validate/p14/p14277220/s55719848/7f3bfa34-77a25257-faceb73a-e24cca91-cc2edd51.jpg,validation," 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. " 61493095-abd06fbd-92736385-eda00456-afbe264e.jpg,validate/p13/p13085886/s56635058/61493095-abd06fbd-92736385-eda00456-afbe264e.jpg,validation," 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. " b89a13dd-0fa627f9-54f5691c-ca4f08e6-d34e7c60.jpg,validate/p10/p10583673/s51435289/b89a13dd-0fa627f9-54f5691c-ca4f08e6-d34e7c60.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with AMS // ? 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. THE AORTA IS SOMEWHAT TORTUOUS. IMPRESSION: No acute cardiopulmonary process. " 23b116b9-1a85bd4d-0d1edcab-470753c9-f34e82bf.jpg,validate/p13/p13729204/s54752160/23b116b9-1a85bd4d-0d1edcab-470753c9-f34e82bf.jpg,validation," FINAL REPORT INDICATION: History of tachycardia, leukocytosis, please evaluate for pneumonia. COMPARISONS: Multiple chest radiographs dating back to ___, most recently from ___. 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 evidence of pneumonia. " 975b31fa-e3c19390-729f4baa-679c25b9-79d41f93.jpg,validate/p12/p12568708/s50422335/975b31fa-e3c19390-729f4baa-679c25b9-79d41f93.jpg,validation," WET READ: ___ ___ ___ 6:19 PM Scattered areas of hazy opacity in the right upper and left upper and lower lobes concerning for multi focal pneumonia though somewhat atypical in appearance. Recommend follow-up to resolution after treatment to exclude underline malignancy. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F vomiting and new AMS, with cirrhosis of the liver. Evaluate for infectious process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___. FINDINGS: There are scattered areas of nodular opacity in the right upper and left mid lung. Findings are most likely representative of pneumonia though follow-up to resolution is advised. No large effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: Nodular opacity in the right upper and left mid lung concerning for pneumonia. Followup to resolution is advised to exclude underlying malignant process. RECOMMENDATION(S): Follow up to resolution after treatment " 0ec7e18b-ec1f4c50-3c8dde8d-3dcfa05d-36c11bd4.jpg,validate/p15/p15467950/s56580922/0ec7e18b-ec1f4c50-3c8dde8d-3dcfa05d-36c11bd4.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with HIV, recent pneumonia, cough, rhonchi and wheezes bilaterally on exam, rule out 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 grossly clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are within normal limits. There is no pleural effusion or pneumothorax. Note is made of focal levoscoliosis centered at T3-4 level with possible vertebral body deformities, unchanged since at least ___. This could represent posttraumatic change or, very possibly, may reflect developmental deformities of the vertebral bodies. IMPRESSION: No evidence of acute pulmonary process. " b301f53a-45930253-68b89087-3b715d63-9c890b85.jpg,validate/p14/p14213226/s54627804/b301f53a-45930253-68b89087-3b715d63-9c890b85.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Hip and pelvic pain. COMPARISONS: 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. The lungs appear clear. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " f02e7214-7a870565-705f3192-0d583608-99f8feaa.jpg,validate/p14/p14814097/s56342494/f02e7214-7a870565-705f3192-0d583608-99f8feaa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough and RUQ abd pain, vomtiing COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Low lung volumes limits assessment. The lungs appear clear. Cardiomediastinal silhouette appears stable. Bony structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " af737c76-e5f3adf2-2b87e95f-1f68d611-9e7328f6.jpg,validate/p10/p10219031/s57147178/af737c76-e5f3adf2-2b87e95f-1f68d611-9e7328f6.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Fall, with chest wall pain. 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, as are the hilar contours. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 08369b6c-15df7a19-a5ef0293-619ca57e-3344bd60.jpg,validate/p13/p13588142/s58950981/08369b6c-15df7a19-a5ef0293-619ca57e-3344bd60.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: History: ___F with severe cough for days // ? infiltrate ? infiltrate TECHNIQUE: PA and lateral views of the chest. COMPARISON: Prior chest radiograph from ___. FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded. There is minimal subsegmental atelectasis at the bases. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " dd25ed17-923391e2-c200a2dc-10e09e72-e270be63.jpg,validate/p15/p15784637/s57417038/dd25ed17-923391e2-c200a2dc-10e09e72-e270be63.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p esophagectomy // R/O PTX post CT removal COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the right chest tube has been removed. There is no evidence for pneumothorax. Expected appearance of the new esophagus with a small air-fluid level. Moderate cardiomegaly. Mild bilateral basal atelectasis. No pneumonia. " 4d42ebec-ef0d448f-bbc717fb-6a32f424-726acd33.jpg,validate/p17/p17078350/s51206224/4d42ebec-ef0d448f-bbc717fb-6a32f424-726acd33.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___-year-old man with cirrhosis and weakness // eval for pleural effusion TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: ___. FINDINGS: The inspiratory lung volumes are appropriate. A small right pleural effusion and mild associated atelectasis of the right lung base is improved compared to the prior study. No focal consolidation or pneumothorax is detected. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. IMPRESSION: Improved small right pleural effusion and associated atelectasis from ___. " 485d207a-4135a2cb-68687be0-8c72f995-a8e72b58.jpg,validate/p10/p10193065/s55346818/485d207a-4135a2cb-68687be0-8c72f995-a8e72b58.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with PMH of heart issue (pt is confused and no records), now with CP and SOB, edema on exam // any e/o pulmonary edema? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The cardiac silhouette is moderately a markedly enlarged. The aorta is unfolded. No pleural effusion is seen. No definite focal consolidation is seen. In the left mid to lower lung retrocardiac region there is an apparent rounded opacity, measuring approximately 1.9 x 1.5 cm ; the differential diagnosis being pulmonary nodule versus artifact. Recommend follow-up chest CT for further assessment. Prominence of the central pulmonary vasculature suggests pulmonary vascular engorgement without overt pulmonary edema. IMPRESSION: Central pulmonary vascular engorgement without overt pulmonary edema. 1.9 x 1.5 cm rounded opacity in the left mid to lower hemi thorax, projecting over the cardiac shadow, differential diagnosis includes pulmonary nodule versus artifact. Recommend followup non emergent chest CT for further assessment. RECOMMENDATION(S): Non emegent chest CT for further evaluation of left mid to lower hemi thorax nodular opacity. " c60f099d-f4f92f94-ec6afd24-49528611-03ebfbe6.jpg,validate/p16/p16773288/s50993264/c60f099d-f4f92f94-ec6afd24-49528611-03ebfbe6.jpg,validation," WET READ: ___ ___ 7:04 PM S/p chest tube removal this AM. No pneumothorax identified. Possible slightly increase in size of left pleural effusion, although exam limited by patient positioning and rotation. Otherwise no significant change. Stable post-operative appearance of the mediastinal contours and right central venous catheter. -___ ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with open thoracoabdominal aneurysm repair, chest tube removal, rule out pneumothorax. COMPARISON: ___. FINDINGS: There is no pneumothorax after chest tube removal. Right jugular line ends in lower SVC. Widening of the mediastinum and cardiac contour is unchanged. There is stable left moderate pleural effusion with atelectasis. CONCLUSION: 1. There is no pneumothorax after chest tube removal. 2. Unchanged left moderate pleural effusion with atelectasis. 3. Stable mediastinal and cardiac contour enlargement. " 2f3fbb17-f97e4496-7259213b-408132bc-8868ab77.jpg,validate/p18/p18532425/s59806310/2f3fbb17-f97e4496-7259213b-408132bc-8868ab77.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure // please assess for interval change please assess for interval change COMPARISON: ___ IMPRESSION: The patient was extubated. A right internal jugular line tip is at the level of mid SVC. NG tube tip is in the stomach. Cardiomegaly is unchanged. Bibasal areas of atelectasis have improved in the interim. No appreciable pneumothorax is seen. " 1387afba-1f2e3fc1-9395fb48-8316b46a-8fb70acc.jpg,validate/p18/p18926074/s51447993/1387afba-1f2e3fc1-9395fb48-8316b46a-8fb70acc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with bladder ca // please evaluate for any abnormalites COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Mild overinflation. No pneumonia, no pulmonary edema. No pleural effusions. Moderate scoliosis. Normal size of the cardiac silhouette. " 59dc14c6-8279514f-ff2ce31d-ecbb0b70-ae2b8168.jpg,validate/p18/p18913382/s57432583/59dc14c6-8279514f-ff2ce31d-ecbb0b70-ae2b8168.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with weakness and subjective fevers. COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPHS: There is new consolidation within the right lower lobe seen on both the frontal and lateral views, findings concerning for new pneumonia given the clinical history. No significant associated pleural effusion is identified. The left lung is clear. Cardiomediastinal and hilar contours are within normal limits. There is no pneumothorax. IMPRESSION: New right lower lobe pneumonia " 2f192381-4bfab9b0-437455ce-de407645-ae6c9a93.jpg,validate/p14/p14601638/s52812762/2f192381-4bfab9b0-437455ce-de407645-ae6c9a93.jpg,validation," FINAL REPORT INDICATION: History of severe COPD and increased dyspnea. COMPARISON: PA and lateral chest radiograph ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Lungs are hyperinflated bilaterally with paucity of pulmonary markings in the upper fields consistent with diagnosis of COPD. There is no pneumothorax or pleural effusion. There is no evidence of CHF. The cardiomediastinal silhouette is within normal limits. Pleural surfaces are unremarkable. An area of subtly increased opacity in the right lower lung field which, in view of the symptoms, may be suggestive of pneumonia. Incidentally seen is a calcified left axillary joint body. IMPRESSION: Right lower lobe opacity for which, in view of symptoms, pneumonia cannot be excluded. These findings were discussed with Dr. ___ ___ phone at 12:25 p.m. by ___. " 1a921a31-52780275-df98b34d-99bea4dc-a89e6d39.jpg,validate/p19/p19225261/s59092407/1a921a31-52780275-df98b34d-99bea4dc-a89e6d39.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo female with Sarcoma left proximal forearm (olecranon area), status post tumor bed reexcision, ___. // interval evaluation for r/o metastatic disease COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous examination. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pulmonary nodules or masses. No pleural effusions. No pneumonia. " 153b3028-dcfd9919-682fceb9-d5dfb2cf-f9913277.jpg,validate/p14/p14371035/s50128489/153b3028-dcfd9919-682fceb9-d5dfb2cf-f9913277.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with urosepsis and hypoxemia and confusion off sup O2. // ? atelectasis, consolidation TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: There are low lung volumes. Cardiomegaly cannot be assessed. Widening mediastinum is unchanged. Right PICC tip is in the in cavoatrial junction. Bibasilar atelectasis larger on the right have minimally increased. If any there are small bilateral effusions IMPRESSION: Increasing right lower lobe atelectasis. " 04a6ec80-af0568af-2eb4967b-f906fd53-6a4e6a0d.jpg,validate/p15/p15367414/s52535914/04a6ec80-af0568af-2eb4967b-f906fd53-6a4e6a0d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p CABG w/increased chest tube output r/o effusion s/p CABG w/increased chest tube output r/o effusion IMPRESSION: In comparison with the study of ___, the Swan-Ganz catheter is been removed and a right IJ sheath is in place. Specifically, no evidence of a pneumothorax with the left chest tube in place. The left hemidiaphragm is more sharply seen on the current study, suggesting either improved pleural effusion or a more upright position of the patient. The atelectatic changes at the right base are more prominent on the current study. " 365df755-22b8017b-24c0f7d6-9d6bbd87-333f1a4c.jpg,validate/p13/p13948622/s52890474/365df755-22b8017b-24c0f7d6-9d6bbd87-333f1a4c.jpg,validation," FINAL REPORT INDICATION: ___ year old man with mild interstitial abnormalities. // F/U COMPARISON: ___. IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. No definite interstitial abnormalities are seen. If there is persistent concern, a high-resolution CT would be more sensitive. There are no pneumothoraces. " 9a4a7d44-9f7dd316-96d762d9-45405d57-9147f6c6.jpg,validate/p15/p15216729/s54588570/9a4a7d44-9f7dd316-96d762d9-45405d57-9147f6c6.jpg,validation," FINAL REPORT HISTORY: ARDS worsening. COMPARISON: ___. FINDINGS: This is a slightly rotated film the heart size is mildly enlarged, larger than prior. The bilateral alveolar infiltrates are now more fluffy and hazy in appearance and more confluent. Dual lead pacemaker is present. ET tube is 5 cm above the carina. Right subclavian line tip is in the SVC. IMPRESSION: Worsened appearance to the lungs. This could be CHF or infection on top of ARDS or could be progression of ARDS. " af3d5e6e-e45e1165-c1bfa33b-43c931e8-8ab17c69.jpg,validate/p14/p14785071/s50067176/af3d5e6e-e45e1165-c1bfa33b-43c931e8-8ab17c69.jpg,validation," FINAL REPORT AP CHEST, 4:39 A.M., ___ HISTORY: A ___-year-old man with pleural effusions after pneumonia. IMPRESSION: AP chest compared to ___: Lung volumes are lower, and pulmonary and mediastinal vasculature are more engorged, with slight increase in interstitial edema, all pointing toward cardiac decompensation. There may have been an increase in the small left pleural effusion, best evaluated on the lateral projection. There is no pneumothorax. Heart size is top normal, larger today than yesterday. No pneumothorax. " 8c490bd1-988c71f0-0df9d63c-652b07fa-b76de52e.jpg,validate/p11/p11821055/s58781108/8c490bd1-988c71f0-0df9d63c-652b07fa-b76de52e.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with subarachnoid hemorrhage, intubated. TECHNIQUE: Single portable supine radiograph. COMPARISON: Radiograph performed on the same date, ___, a proximal 3 hours prior. FINDINGS: Single supine AP radiograph demonstrates an endotracheal tube which appears to terminate 2.8 cm above the level of the carina. An enteric tube descends the thorax in an uncomplicated course, its tip projecting over the right upper quadrant in appropriate position. Relative to prior study, enteric tube has been advanced. Subtle left perihilar and lower lobe opacity could reflect aspiration. There is no pleural effusion identified. There is no pneumothorax. IMPRESSION: Supportive devices in appropriate position. No pneumothorax. Possible aspiration in the left lower lung. " 06c339b8-10d6142c-1ead5a41-0460a04f-d0339531.jpg,validate/p16/p16820602/s51959787/06c339b8-10d6142c-1ead5a41-0460a04f-d0339531.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with asthma exacerbation. COMPARISON: None available. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: New acute cardiopulmonary process. " d1a9c8a5-c7670031-f3116914-dc08e277-58ac2fb2.jpg,validate/p11/p11079199/s53250911/d1a9c8a5-c7670031-f3116914-dc08e277-58ac2fb2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent fevers, previously dx LLL PNA, evaluate changes, complications // ___ year old woman with persistent fevers, previously dx LLL PNA, evaluate changes, complications ___ year old woman with persistent fevers, previously dx LLL PNA, evaluate changes, complications COMPARISON: Chest radiographs ___ and most recently ___. IMPRESSION: Small region of consolidation at the base the left lung is larger today than on ___ indicating pneumonia has not improved, and there may also be a new tiny left pleural effusion. Right lung and right pleural space are normal. Moderate to severe cardiomegaly is unchanged since ___, worsened since ___. Pulmonary vasculature is normal and there is no edema. " d0cfdfb5-a71287e5-fdaf4e89-324a4582-e0a9aba6.jpg,validate/p18/p18673042/s53561396/d0cfdfb5-a71287e5-fdaf4e89-324a4582-e0a9aba6.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with ICD placement, left subclavian access re-positioned. COMPARISON: ___ at 5:45 p.m. FINDINGS: Left-sided pacemaker with atrioventricular leads is in adequate position. There is no pneumothorax or pleural effusion. Moderate cardiomegaly is unchanged. Abdominal aorta is possibly dilated up to 3.5 cm and could be further assessed with dedicated study. CONCLUSION: 1. New atrioventricular pacemaker is in adequate position without complication. 2. Possible abdominal aorta dilatation could be further assessed by a dedicated study. " 63b0a573-7806f36f-f3660d3f-e9279376-f3e847c0.jpg,validate/p10/p10798458/s50661009/63b0a573-7806f36f-f3660d3f-e9279376-f3e847c0.jpg,validation," WET READ: ___ ___ 11:19 PM 1. No acute cardiopulmonary process. 2. Partially imaged gaseous distention of small bowel. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with hx of volvulus, w/severe abdominal tenderness, nausea/vomiting, evaluate for consolidation. TECHNIQUE: Chest PA and lateral COMPARISON: None. 8 FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. A distended gas-filled loop of small bowel is partially visualized in the left upper abdomen. IMPRESSION: 1. No acute cardiopulmonary process. 2. Partially imaged gaseous distention of small bowel. " 9bfcef40-4a3787dc-f3ca7ef2-453380bf-0426619f.jpg,validate/p17/p17556194/s58497090/9bfcef40-4a3787dc-f3ca7ef2-453380bf-0426619f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with trach collar and picc p/w leukocytosis and stage 4 decub // eval PICC placement TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___, ___, ___, ___ FINDINGS: Portable semi-upright radiograph of the chest demonstrates a stable midline tracheostomy tube. Again seen is partially calcified right lower lobe pleural and parenchymal opacity, similar to the prior examinations, and more fully characterized on concurrent abdominal CT lung images of the same date. No definite new focal consolidation is identified. Blunting of the right costophrenic angle is chronic and unchanged. There is no pneumothorax. A right-sided central catheter terminates in the mid SVC. The cardiomediastinal contours are stable. IMPRESSION: No definite acute intrathoracic abnormality. Please see separately dictated CT abdomen of ___ for more complete assessment of partially calcified right lower lobe pleural and parenchymal abnormality. " 554f7145-a074c1d2-85e9b05d-3534f8d4-864ae25c.jpg,validate/p10/p10441044/s55845225/554f7145-a074c1d2-85e9b05d-3534f8d4-864ae25c.jpg,validation," FINAL ADDENDUM Findings were discussed with Dr. ___ at 11:53 a.m. ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Chest tube on waterseal, assess for pneumothorax. Comparison is made with prior study performed six hours earlier. There is a new large left pneumothorax. Cardiomediastinal contour is shifted towards the right side consistent with the tension pneumothorax. There are no other interval changes. Clinical team aware of the findings at the time of interpretation. " ef23f49c-ac56afb2-4674a69e-1ede4674-ca2e31b5.jpg,validate/p19/p19151721/s58335716/ef23f49c-ac56afb2-4674a69e-1ede4674-ca2e31b5.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with vascular disease and concern for pneumonia. COMPARISON: Chest radiograph from ___. PA AND LATERAL CHEST RADIOGRAPHS: Lungs are clear without confluent consolidation. There is no overt interstitial edema. There is new blunting of the bilateral costophrenic angle suggestive of new small pleural effusions. Mediastinal and hilar contours are within normal limits. Mild cardiomegaly is unchanged. Median sternotomy wires appear intact and clips from prior CABG are noted. There is no pneumothorax. IMPRESSION: New small bilateral pleural effusions. " 57c63004-3800e40a-19ba16e8-f93d07db-110b5799.jpg,validate/p16/p16576109/s54518565/57c63004-3800e40a-19ba16e8-f93d07db-110b5799.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with left arm numbness and leukocytosis. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. The heart size and cardiomediastinal contours are normal. Aside from a solitary band of linear scarring or atelectasis in the left midlung, the lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " e62d9777-a61d35ab-9c96d430-4569fa04-85cee7ba.jpg,validate/p16/p16141003/s50485706/e62d9777-a61d35ab-9c96d430-4569fa04-85cee7ba.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath on exertion. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Projecting over the posterolateral right eighth and anterolateral right sixth rib, there is a subtle ovoid opacity of unclear clinical significance, which is stable since the prior study. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 605aa3e2-5b8cb114-3e00a616-4538d584-09e55871.jpg,validate/p19/p19348515/s55082271/605aa3e2-5b8cb114-3e00a616-4538d584-09e55871.jpg,validation," WET READ: ___ ___ 9:38 PM Very small right apical pneumothorax appears stable. Little change in comparison to prior radiograph and CT from the same day. ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old male with right pleural effusion status post thoracentesis. Questionable right-sided pneumothorax. FINDINGS: Comparison is made to previous study from ___. There is a very tiny right apical pneumothorax, which is unchanged. There are again seen bilateral pleural effusions with areas of consolidation in the right base. This likely represents partially loculated fluid. Heart size is upper limits of normal but stable. Overall, there has been no significant change. " 73b0e801-00d19176-986fa377-b6128d77-99e0eaf9.jpg,validate/p14/p14973190/s52667350/73b0e801-00d19176-986fa377-b6128d77-99e0eaf9.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: There has been interval removal of the enteric catheter. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits. There has been interval resolution of previously seen subcutaneous emphysema. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " cb856b90-796f5218-70b5ca49-3a13fb42-717ef3f0.jpg,validate/p12/p12291726/s58395027/cb856b90-796f5218-70b5ca49-3a13fb42-717ef3f0.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough, congestion and chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Areas of reticular scarring projecting over the right upper lobe and left upper-to-mid lung are similar in distribution as compared to the prior study in this patient with reported history of sarcoidosis. No definite new areas of focal consolidation are seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are stable. IMPRESSION: No acute cardiopulmonary process. Again seen areas of chronic lung changes bilaterally, as above and mild prominence of the hila compatible with patient's known history of sarcoidosis. No definite new focal consolidation. " 0e2da32b-a205771d-a18b0692-bb34fe34-7e682dd1.jpg,validate/p14/p14325424/s58101022/0e2da32b-a205771d-a18b0692-bb34fe34-7e682dd1.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: Left pigtail pleural catheter remains in place in the periphery of the left mid hemithorax. There has been improvement in the extent of subcutaneous emphysema in the left chest wall. A small apicolateral pneumothorax is present on the left. Support and monitoring devices are unchanged in position except for removal of a left PICC. Cardiomediastinal contours are stable. With the exception of improving aeration in the left lower lobe, overall appearance of lungs and pleura is similar to the recent radiograph of one day earlier. " b0f1973e-856122ce-278d0aa1-065f6168-7095be31.jpg,validate/p14/p14709655/s51699250/b0f1973e-856122ce-278d0aa1-065f6168-7095be31.jpg,validation," FINAL REPORT HISTORY: For possible liver transplant. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. There may be minimal atelectatic changes at the bases, but no acute pneumonia or vascular congestion. " 35f3c832-29b69e9c-38e5372d-f2a82b05-eee6e175.jpg,validate/p10/p10699336/s54298247/35f3c832-29b69e9c-38e5372d-f2a82b05-eee6e175.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MVC, cardiac arrest x 2 with ROSC s/p cric with TBI, multiple cervical and thoracic vertebral fractures, mediastinal hematoma, SDH, seizures, respiratory failure // ?interval change ?interval change IMPRESSION: As compared to ___, the lung volumes have decreased. Mild cardiomegaly persists. The changes in appearance of the vasculature suggest mild pulmonary edema. Increasing bilateral areas of basilar atelectasis. No pleural effusions. " 11fa7ede-9dfb2962-63450747-dc7cc3d5-579a8349.jpg,validate/p13/p13948093/s52871001/11fa7ede-9dfb2962-63450747-dc7cc3d5-579a8349.jpg,validation," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomediastinal contours are normal. Previously present left lower lobe consolidation has resolved, but there is some residual bronchial wall thickening in this region, best visualized on the lateral view. Linearly oriented opacities in the lingula appear to correspond to post-radiation scarring based on correlative CT of ___. Lungs are otherwise clear. Asymmetrical biapical thickening appears similar. There is no pleural effusion. Scoliosis is noted. IMPRESSION: Resolution of left lower lobe pneumonia with residual left lower lobe bronchial wall thickening. " f50081f7-53e62563-5a9469a3-77d38804-c06f0c2f.jpg,validate/p19/p19780620/s55513536/f50081f7-53e62563-5a9469a3-77d38804-c06f0c2f.jpg,validation," WET READ: ___ ___ ___ 6:28 PM Side port of the nasogastric tube now appears to terminate within the fundus of the stomach. The nasogastric tube is coiling in the fundus with the tip likely terminating prior to the pylorus. Stable post pyloric Dobhoff tube. The findings were discussed with Dr. ___, M.D. by ___ ___, M.D. on the telephone on ___ at 6:26 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old man with NGT placement with tachycardia and shortness of breath. // Please evaluate location of NGT and acute pulmonary process. Please evaluate location of NGT and acute pulmonary process. IMPRESSION: Side port of the nasogastric tube now appears to terminate within the fundus of the stomach. The nasogastric tube is coiling in the fundus with the tip likely terminating prior to the pylorus. Stable post pyloric Dobhoff tube. Left pleural effusion is unchanged. NOTIFICATION: The findings were discussed with Dr. ___, M.D. by ___, M.D. on the telephone on ___ at 6:26 PM, 5 minutes after discovery of the findings. " 6e5ebe83-95004697-0d0d3e1e-86a8cd60-1f62569e.jpg,validate/p19/p19103751/s58966657/6e5ebe83-95004697-0d0d3e1e-86a8cd60-1f62569e.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with Multiple myeloma. New onset of SOB // New onset SOB 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. RECOMMENDATION(S): The findings were discussed by Dr. ___ ___ ___ on the telephone on ___ at 4:29 PM, 120 minutes after discovery of the findings. " 9c3e9183-b677c395-2e793065-20024bd4-7319cd06.jpg,validate/p14/p14906254/s53290722/9c3e9183-b677c395-2e793065-20024bd4-7319cd06.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain COMPARISON: None FINDINGS: PA and lateral views of the chest provided. The heart is top-normal in size. The mediastinal contour is normal. No focal consolidation, large effusion or pneumothorax. No convincing signs of congestion or edema. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. Top-normal heart size. " d94243fd-9967cfee-78689435-b69c56f6-e99650c9.jpg,validate/p10/p10970873/s51765379/d94243fd-9967cfee-78689435-b69c56f6-e99650c9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p CABG x7 // eval effusions COMPARISON: ___ IMPRESSION: As compared to the previous image, the alignment of the sternal wires is unchanged. The right internal jugular vein catheter has been removed. Atelectasis at the right lung bases is slightly more extensive than on the previous image but a pre-existing platelike left atelectasis has completely resolved. Better seen on the lateral than on the frontal image are small bilateral pleural effusions, restricted to the area of the costophrenic sinuses. No pulmonary edema. No pneumonia. " fd1ee407-d30f48fb-089e873e-05a65ec7-931a408e.jpg,validate/p17/p17222468/s56038529/fd1ee407-d30f48fb-089e873e-05a65ec7-931a408e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of COPD, now shortness of breath and non-productive cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Bilateral calcified granulomas are again seen. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac, mediastinal, and hilar contours are stable. No pleural effusion or pneumothorax seen. IMPRESSION: No significant interval change. " 06344c80-907a2c00-e2336486-6a00654c-dc702c00.jpg,validate/p15/p15566987/s50725729/06344c80-907a2c00-e2336486-6a00654c-dc702c00.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old male with history of advanced Parkinsons disease, AS s/p TAVR ___, CKD who presents from___ Rehab after his Dobhoff Tube was dislodged. Had repeat Dobhoff replaced today, desaturated earlier that improved with suction. // ?aspiration TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ obtained at 13:52 IMPRESSION: Dobbhoff tube tip is in the stomach. Cardiomediastinal silhouette is unchanged. Replaced transcatheter aortic valve is noted. Bibasal atelectasis is present. The increase in bibasal opacities is concerning for aspiration. " d7df0213-6f55a3b9-4f2fea41-687f0c98-57e2a90c.jpg,validate/p18/p18303550/s59557447/d7df0213-6f55a3b9-4f2fea41-687f0c98-57e2a90c.jpg,validation," WET READ: ___ ___ ___ 3:01 PM Complete opacification of the left hemi thorax due to massive left pleural effusion. Small right pleural effusion. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with dyspnea, renal cell CA w/ h/o effusions and post-obstructive PNAs. Evaluate for effusion versus pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray from ___ FINDINGS: There is complete opacification of the left hemi thorax secondary to massive pleural effusion with rightward shift of the mediastinum. There is also a small effusion on the right. The right lung is grossly clear. Cardiac silhouette cannot be assessed on this study. No pneumothorax is present. Surgical clips project over the left mediastinum. IMPRESSION: Complete opacification of the left hemi thorax due to massive left pleural effusion. Small right pleural effusion. " f5e122f9-ce76da02-681c06c9-4cdaf062-0d3eb1c7.jpg,validate/p14/p14605976/s57797492/f5e122f9-ce76da02-681c06c9-4cdaf062-0d3eb1c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hemoptysis, hx of ___ year tobacco use/COPD // r/o abnormality EPISODE OF HEMOPSTYSIS PAST HX ___YR TOBACCO USE,COPD R/O ABNORMALITY COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Vascularity in the left upper lung is chronically diminished. There is no focal pulmonary abnormality. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. RECOMMENDATION(S): Chest CT would be helpful in detecting subtle endobronchial lesions. " bba92b83-1a1e0435-5e8bef9a-49d20b62-6690f003.jpg,validate/p19/p19758701/s57106054/bba92b83-1a1e0435-5e8bef9a-49d20b62-6690f003.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT // ?placement ?placement COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Feeding tube passes into the stomach and out of view. Lungs are well expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces " 11bd5388-7b1c6296-db2f08dc-3dab180c-d3a69db4.jpg,validate/p17/p17792869/s58779912/11bd5388-7b1c6296-db2f08dc-3dab180c-d3a69db4.jpg,validation," FINAL REPORT AP CHEST, 3:58 A.M. ON ___ HISTORY: ___-year-old man here for hypothermia. Evaluate for possible pneumonia. IMPRESSION: AP chest compared to ___: Lungs are even lower today than before. Marked elevation of the right lung base, probably the hemidiaphragm is more pronounced, all serving to increased caliber of pulmonary and mediastinal vessels, which could be normal. The heart is normal size. There is no pleural effusion, pneumothorax or any focal consolidation. " 88005adb-42094dd2-744a7d7e-ac32fa0b-64281d21.jpg,validate/p15/p15889331/s56976219/88005adb-42094dd2-744a7d7e-ac32fa0b-64281d21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with desat's, increasing sputum // Assess for infiltrate COMPARISON: ___, 02:05 IMPRESSION: As compared to the previous radiograph, the atelectasis in the mid right lung has resolved. The free intra-abdominal air is less well seen than on the previous exam. Moderate atelectasis at the left lung bases, at overall smaller lung volumes. The tracheostomy tube is in unchanged position. Unchanged moderate cardiomegaly. " aaaad605-caac52ba-093d27e4-7b180dbc-79f3bcab.jpg,validate/p18/p18927189/s51391323/aaaad605-caac52ba-093d27e4-7b180dbc-79f3bcab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with metastatic colon cancer with lung masses, new altered mental status // eval for pneumonia, new cardiopulm process eval for pneumonia, new cardiopulm process IMPRESSION: Compared to chest radiographs ___. No pneumothorax pleural effusion pulmonary edema or evidence of pneumonia. Heart size normal. Left subclavian infusion port catheter ends in the low SVC. Large lung masses unchanged. Slight interval change in the sub small pleural mass in the right upper hemithorax " 3a3a6ab3-52dae35b-59ab6489-6b18039e-c63136af.jpg,validate/p13/p13670843/s52048574/3a3a6ab3-52dae35b-59ab6489-6b18039e-c63136af.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hypertensive urgency/emergency and possible CNS involvement with dizziness, L sided weakness // ? intracranial process? intrathoracic process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Subtle retrocardiac basilar opacity, better seen on the lateral view, most likely is due to overlapping structures and mild atelectasis, however, underlying aspiration or less likely infection are not excluded, but felt less likely. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. The aortic knob is calcified. No overt pulmonary edema is seen. IMPRESSION: Subtle retrocardiac basilar opacity, better seen on the lateral view, most likely is due to overlapping structures and mild atelectasis, however, underlying aspiration or less likely infection are not excluded, but felt less likely. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. The aortic knob is calcified. No overt pulmonary edema is seen. " a3e70504-0cb3f9bd-03bc5e7c-36df12fd-d5aa8e20.jpg,validate/p12/p12280996/s50444107/a3e70504-0cb3f9bd-03bc5e7c-36df12fd-d5aa8e20.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with pancreatitis // eval effusions TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There is mild left basilar atelectasis and without definite focal consolidation. Pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. . IMPRESSION: Left basilar atelectasis without focal consolidation. No pleural effusions seen. " d3e1d850-006bf59b-cd3ccfb0-f762716e-d8814b88.jpg,validate/p11/p11820695/s52750881/d3e1d850-006bf59b-cd3ccfb0-f762716e-d8814b88.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: DKA, cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. A right-sided Port-A-Cath is again seen terminating at the cavoatrial junction. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No focal consolidation. No acute cardiopulmonary process. " 6d04d9e4-abb4406c-97957122-a37148b4-f504af5a.jpg,validate/p12/p12244889/s52312276/6d04d9e4-abb4406c-97957122-a37148b4-f504af5a.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with ESRD, being evaluated for kidney transplantation listing // Lung status TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: Since ___, mild cardiomegaly and pulmonary vascular distension in the upper lungs have both increased, consistent with mild cardiac decompensation. Granuloma in the right lateral lower lobe is unchanged, as expected. There is no evidence of active infection. No pleural effusions. No pneumothorax. The cardiomediastinal silhouette and hilar structures are normal. IMPRESSION: Since ___,new mild cardiac failure as indicated by worsening mild cardiomegaly and new pulmonary edema. Stable small right lung granuloma. " ee4a7178-3c253753-e39ab614-164aa972-32bc6876.jpg,validate/p19/p19951239/s52939041/ee4a7178-3c253753-e39ab614-164aa972-32bc6876.jpg,validation," WET READ: ___ ___ ___ 6:49 PM Right upper lobe pneumonia. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with fever and cough // r/o acute infectious process TECHNIQUE: Chest PA and lateral COMPARISON: None available FINDINGS: PA and lateral chest radiograph demonstrates an airspace opacity within the right upper lobe marginated by the minor fissure. The left lung field is clear. There is no pleural effusion or pneumothorax. Heart size is normal. There is no evidence of pulmonary edema. IMPRESSION: Right upper lobe pneumonia. " 251bf982-b6ff097c-e3c89859-b834c433-e868aae6.jpg,validate/p13/p13809932/s59192516/251bf982-b6ff097c-e3c89859-b834c433-e868aae6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CKD // please evaluate for any acute process please evaluate for any acute process IMPRESSION: In comparison with the study of ___, there again is blunting of the left costophrenic angle. No evidence of acute pneumonia or vascular congestion. " 1a4f0f80-06846dd0-60f0ecf5-afcc2ec5-2236f04b.jpg,validate/p12/p12549793/s50965085/1a4f0f80-06846dd0-60f0ecf5-afcc2ec5-2236f04b.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain and shortness of breath, evaluate for acute process. COMPARISON: None available. FINDINGS: There is no focal consolidation. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " f0b051f2-808dda9c-2d0d4d3e-b05ac89f-5f6722e9.jpg,validate/p19/p19188435/s59093351/f0b051f2-808dda9c-2d0d4d3e-b05ac89f-5f6722e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p ex-lap/LAR, drainage abscess, with increased difficulty breathing // r/o pleural effusion TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Increased opacity throughout the left hemi thorax reflects layering pleural effusion. There is no evident pneumothorax. There are persistent low lung volumes. Cardiomediastinal contours are unchanged. Pulmonary edema has markedly improved. Pneumoperitoneum has improved. Right central catheter is in unchanged position in the right atrium " 78c5a22c-872866ed-0132b3a6-287bc9f8-7f0b8647.jpg,validate/p10/p10504635/s59142245/78c5a22c-872866ed-0132b3a6-287bc9f8-7f0b8647.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx aml now with cough // Assess for pulm consolidation Assess for pulm consolidation TECHNIQUE: PA and lateral COMPARISON: ___ FINDINGS: The distal end of the peritracheal stripe appears full and the lungs vasculature appears slightly prominent. Otherwise, there are no other abnormalities including pneumothorax, pleural effusions, or pulmonary edema. The heart is of normal size. IMPRESSION: Prominent vascularity, otherwise no cause can be found for the patient's cough. There is no consolidation. " d9b0a2ac-7daeb929-63567b09-ab11ed33-b83ce8f5.jpg,validate/p14/p14047315/s51988294/d9b0a2ac-7daeb929-63567b09-ab11ed33-b83ce8f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH with ventricular extension, e/o L ACA and AComm aneurysms on CTA, s/p intubation and EVD placement and right pigtail for pleural effusion // please eval for interval change please eval for interval change COMPARISON: ___ IMPRESSION: ET tube tip is 4.5 cm above the carinal. NG tube tip is in the stomach. Cardiomediastinal silhouette is stable. Right pigtail catheter is in place, unchanged. There is interval increase in left pleural effusion. Widespread parenchymal opacities of the on the left are re- demonstrated, concerning for either combination of atelectasis and pleural effusion or potentially interval development of infectious process. There is no pneumothorax. " e57b6fd1-ee35bbf4-2aea85ca-6a6883a7-040ed051.jpg,validate/p11/p11541295/s53348345/e57b6fd1-ee35bbf4-2aea85ca-6a6883a7-040ed051.jpg,validation," FINAL REPORT INDICATION: ___ F PMH autonomic dysfunction/POTS, migraines, cellulitis c/b c diff with 2 recurrences, MVP presenting with chest pain. // please assess for pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 0fe34379-ca4527b6-023d771c-70f1019d-927ebc7a.jpg,validate/p12/p12436584/s59520596/0fe34379-ca4527b6-023d771c-70f1019d-927ebc7a.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and shortness of breath. COMPARISON: None. 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. " 205f32fd-08a04f4a-5e8cf25f-6e7a201a-7a64820b.jpg,validate/p19/p19975044/s55437525/205f32fd-08a04f4a-5e8cf25f-6e7a201a-7a64820b.jpg,validation," FINAL REPORT HISTORY: Patient with new sternal drainage, evaluate for effusion or wire break. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Compared to prior study, median sternotomy wires are unchanged in position and orientation. However, there is a questionable focal break in the seventh wire, best appreciated on the lateral view. There is improvement in the small left pleural effusion and associated retrocardiac compressive atelectasis. The right pleural effusion has improved, although there is now linear atelectasis in the right juxtahilar region. No focal consolidation, pneumothorax, or pulmonary edema is seen. Postoperative cardiomediastinal silhouette and hilar contours are stable. IMPRESSION: 1. Possible tiny/focal disruption in the seventh sternotomy wire best visualized on lateral view, in retrospect unchanged since ___. If there is clinical suspicion for dehiscence or peristernal infection, CT would be recommended. 2. Interval improvement in bilateral pleural effusions and left retrocardiac atelectasis, but new right juxtahilar linear atelectasis. " 0f46a09e-a24fbcf2-ac9a6c92-1ce768c5-efb59b58.jpg,validate/p18/p18062541/s53722594/0f46a09e-a24fbcf2-ac9a6c92-1ce768c5-efb59b58.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea // Eval for cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is mildly enlarged but unchanged. The aorta is mildly unfolded and demonstrates atherosclerotic calcifications. Mediastinal and hilar contours are otherwise unchanged. There is no pulmonary edema. Streaky opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion or pneumothorax is identified. There are mild degenerative changes noted in the imaged thoracolumbar spine. Multiple clips are again demonstrated in the right upper quadrant of the abdomen. . IMPRESSION: Patchy opacities in the lung bases most likely reflective of atelectasis. " 413268d7-7b44805f-2e40b8a4-eecabf03-b4aef878.jpg,validate/p14/p14244279/s52166465/413268d7-7b44805f-2e40b8a4-eecabf03-b4aef878.jpg,validation," FINAL REPORT INDICATION: ___M with chest pressure, dyspnea // Evaluate for penumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is stable. Tortuosity of the descending thoracic aorta is again noted. Anterior cervical fixation hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " 1cec1edd-6c63fdf6-9699768d-cee6dab5-3720860d.jpg,validate/p17/p17865089/s52123478/1cec1edd-6c63fdf6-9699768d-cee6dab5-3720860d.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___. FINDINGS: Indwelling support and monitoring devices remain in standard position. Persistent moderate-to-large right pleural effusion, and apparent slight decrease in size of a now small left pleural effusion with adjacent left basilar atelectasis. Possible ascites and anasarca. " 330a5763-a38c162a-557d1f3b-89dd4451-63c7e492.jpg,validate/p10/p10689216/s58042568/330a5763-a38c162a-557d1f3b-89dd4451-63c7e492.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with near syncope, cough, sputum // ? acute cardiopulm 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, with the cardiac silhouette top-normal in size.. IMPRESSION: No acute cardiopulmonary process. " 6b744300-f4596796-814f3d99-56af2ebd-46a853dd.jpg,validate/p10/p10143711/s53622177/6b744300-f4596796-814f3d99-56af2ebd-46a853dd.jpg,validation," 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. " b134d683-46626523-c72e7db7-6e5052d3-28bf5d32.jpg,validate/p10/p10216097/s58231661/b134d683-46626523-c72e7db7-6e5052d3-28bf5d32.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF exacerbation, hemothorax, pneumo, s/p RHC/LHC, still dyspnic. // please eval evolution of effusion, edema, pneumo please eval evolution of effusion, edema, pneumo IMPRESSION: In comparison with the study of ___, there is little change. Again there is substantial enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure in prominence of the mediastinum. Probable loculated pleural fluid is again seen in the right mid zone. " 5428fd80-1b236923-6f5b4334-e8046f20-8077e342.jpg,validate/p10/p10787013/s53635057/5428fd80-1b236923-6f5b4334-e8046f20-8077e342.jpg,validation," 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. " c25630a4-8f908ccd-b213490f-15f2adab-e977e054.jpg,validate/p16/p16535066/s53539006/c25630a4-8f908ccd-b213490f-15f2adab-e977e054.jpg,validation," 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. " 921f8643-e52750b2-f081caf5-c900c6a5-dea06116.jpg,validate/p18/p18476657/s50294268/921f8643-e52750b2-f081caf5-c900c6a5-dea06116.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Syncope. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A stimulator device has been placed and projects over the left mid chest. 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. Severe mid-to-lower thoracic compression fracture appears unchanged. IMPRESSION: No evidence of acute cardiopulmonary disease. " 52a4a374-e12cc345-28f9fcb2-52e155a1-6d955d8b.jpg,validate/p13/p13368143/s55745612/52a4a374-e12cc345-28f9fcb2-52e155a1-6d955d8b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, cough // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ at 17:24 and cyst ___ FINDINGS: The cardiac silhouette remains moderately enlarged. No focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: No definite focal consolidation to suggest pneumonia. " 78fff626-1b5a1687-d7c415f3-67d3d228-07191929.jpg,validate/p17/p17782175/s50662159/78fff626-1b5a1687-d7c415f3-67d3d228-07191929.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath for the last week. Evaluate for evidence of pneumonia versus bronchitis. 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: No acute intrathoracic process. " d05d2ad3-15cfa841-8ef024ea-7fb61cf3-30f43b19.jpg,validate/p12/p12670557/s59741835/d05d2ad3-15cfa841-8ef024ea-7fb61cf3-30f43b19.jpg,validation," FINAL REPORT PORTABLE AP RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old female with left internal jugular central line placed. TECHNIQUE: Single portable AP radiograph of the chest was obtained. COMPARISON: ___. FINDINGS: There has been interval placement of a right-sided internal jugular central venous catheter with tip projecting over the right atrium. No evidence of pneumothorax is seen. Redemonstration of vague opacity within the right upper lung is again noted and is more apparent on this exam. The technique is somewhat different; this film is somewhat more blurry. Vague opacity is also seen at the right lung base, probably atelectasis. Probable small bilateral pleural effusions are noted. Heart size is unchanged. There is no evidence of pneumoperitoneum and osseous structures are unchanged. IMPRESSION: 1. Interval placement of right-sided central venous catheter with tip projecting over the right atrium without evidence of pneumothorax. 2. More conspicuous opacity in the right upper lobe, a possible developing infectious process but potentially the apparent increase is due to differences in technique. " d9317c5c-09a961b4-d79cb0ea-4f6ec586-09f00b71.jpg,validate/p12/p12791607/s58127970/d9317c5c-09a961b4-d79cb0ea-4f6ec586-09f00b71.jpg,validation," 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 // interval change interval change IMPRESSION: In comparison with the study of ___, there is little overall change. Increased opacification at the left base with elevation of the hemidiaphragmatic contour is consistent with atelectatic changes presumably related to the interventional procedure. No evidence of acute pneumonia or vascular congestion. " c17d9c19-09ff7012-70214d4f-8357e390-2ba1e38f.jpg,validate/p14/p14354835/s55118493/c17d9c19-09ff7012-70214d4f-8357e390-2ba1e38f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent b/l chest tube placement with small left apical PTX // interval evaluation of PTX interval evaluation of PTX COMPARISON: ___ IMPRESSION: No change in the overall appearance of supporting devices. Is present. There is interval decrease in left basal pneumothorax with slight increase in the left pleural effusion. Apical pneumothorax is small and unchanged. " c21392c0-53398243-8f4e3092-53f65e7e-21f762af.jpg,validate/p14/p14503537/s52713551/c21392c0-53398243-8f4e3092-53f65e7e-21f762af.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough and hypereosinophilia who presents for evaluation for a granulomatous lesion. COMPARISONS: Radiographs from ___; ___; ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The heart size is normal. The hilar and mediastinal contours are normal. There is a small amount of right-sided atelectasis. Otherwise, the lungs are clear. No focal consolidation, pneumothorax or pleural effusions are seen. Incidental note is made of unilateral degenerative changes in the mid-thoracic spine across two or three vertebral bodies, with osteophytes extending off the left vertebral border. The visualized portion of the VP shunt does not demonstrate any kinking. IMPRESSION: No acute intrathoracic abnormalities identified. Specifically, no evidence of any granulomatous lesions. " 8c077bde-90216a85-c1fd7db5-60347ea2-689d5abb.jpg,validate/p15/p15446860/s59670719/8c077bde-90216a85-c1fd7db5-60347ea2-689d5abb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dyspnea // r/o infiltrates 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 focal consolidation to suggest pneumonia. " 8b9966e4-206cf611-a76cf43b-fc49734f-aba57ed4.jpg,validate/p11/p11845452/s54846639/8b9966e4-206cf611-a76cf43b-fc49734f-aba57ed4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with prior study from ___. CLINICAL HISTORY: Short of breath and chest pain. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well expanded lungs without focal consolidation, effusion, or pneumothorax. There is slight flattening of the diaphragms which is suggestive of underlying COPD. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " a1db13c3-a014bb09-b97eca5c-35eb6500-427e491e.jpg,validate/p14/p14130631/s51226283/a1db13c3-a014bb09-b97eca5c-35eb6500-427e491e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia, intubated // interval change? COMPARISON: Chest radiograph ___ FINDINGS: Single AP view of the chest provided. ET tube is 4.2 cm above the carina. NG tube courses below the level of the hemidiaphragm and out of view. Bilateral alveolar opacities are significantly worsened from ___. No pneumothorax. Probable small left pleural effusion and associated atelectasis is unchanged. Hilar contours are normal. Moderate cardiomegaly is unchanged. IMPRESSION: Significant worsening of bilateral alveolar opacities is concerning for worsening pneumonia. " c7ef56f6-3017015e-5aab5c4a-e567b2ef-0d174800.jpg,validate/p16/p16780540/s55612623/c7ef56f6-3017015e-5aab5c4a-e567b2ef-0d174800.jpg,validation," 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. " bdeeeb80-e5a75dd1-37902aa9-b22ac00e-5428bff6.jpg,validate/p10/p10461044/s57003121/bdeeeb80-e5a75dd1-37902aa9-b22ac00e-5428bff6.jpg,validation," FINAL REPORT INDICATION: ___M with SOB and cough // infiltrate. Patient has history of lung cancer, per the electronic medical record. TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: New compared to prior bilateral hazy perihilar opacities. Better seen on the lateral view is a focal rounded opacity projecting posteriorly, overlying the lower lobes, likely localizing to the right on the frontal view. Additional nodular opacity projects over the anterior right third rib laterally, new since prior. It is uncertain if this is due to rib changes or underlying parenchymal abnormality. There is no large pleural effusion. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires are intact. No acute osseous abnormalities IMPRESSION: Bilateral perihilar opacities new since prior potentially due to edema, infection and/or malignancy in light of patient's history. More focal opacity projecting over the lower lobes on the lateral view, likely on the right based on the frontal which could correlate with known malignancy. Additional opacity projecting over the anterior right third rib could be due to rib changes or underlying parenchymal abnormality. Correlation with cross-sectional imaging, presumably performed elsewhere is suggested for further characterization of these findings. Otherwise, additional cross-sectional imaging will be necessary. " 7fb85cbc-5726dbb5-c4265d07-50581455-02950dec.jpg,validate/p14/p14532649/s56464868/7fb85cbc-5726dbb5-c4265d07-50581455-02950dec.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Coffee-ground emesis, hypoxia, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of massive diffuse bilateral parenchymal opacities, likely representing a combination of pulmonary edema and pneumonia, as described in previous reports. Borderline size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. No new parenchymal opacities. No larger pleural effusions. Unchanged position of the left PICC line. " 8f84385d-6d8c4fe2-7d1ea5b1-c898dcea-aa4fa256.jpg,validate/p10/p10568523/s58303938/8f84385d-6d8c4fe2-7d1ea5b1-c898dcea-aa4fa256.jpg,validation," 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. " 6b376503-2bf974c5-8e823af6-c3749183-ce4646c1.jpg,validate/p11/p11290019/s53698287/6b376503-2bf974c5-8e823af6-c3749183-ce4646c1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Pneumonia 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 with resolution of recently described heterogeneous right lower lobe opacities. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Healed left rib fractures are again demonstrated as well as slight elevation of the left hemidiaphragm IMPRESSION: No current evidence of pneumonia. " 727cc826-247c4def-e2088488-2842f46c-11a7a23d.jpg,validate/p19/p19188435/s53126252/727cc826-247c4def-e2088488-2842f46c-11a7a23d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with ETT, pulmonary edema // PNA, edema TECHNIQUE: Portable FINDINGS: As compared to ___, endotracheal tube terminates 3.5 cm from the carina. The nasogastric tubes is curled in the known large hiatus hernia containing the majority of the stomach as well as loops of transverse colon. Right IJ catheter is in the right atrium. Moderate pulmonary edema has increase since the prior. Small bilateral effusions are stable. No pneumothorax. IMPRESSION: Moderate pulmonary edema has slightly increased. " ea86b0ba-0b0f551a-fc7cb9a6-7ed28607-71cbbe04.jpg,validate/p15/p15797232/s54711057/ea86b0ba-0b0f551a-fc7cb9a6-7ed28607-71cbbe04.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Altered mental status and possible syncope. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 3b224053-a68d64f3-7afcf922-2cf10765-45c5d89d.jpg,validate/p11/p11738518/s51924872/3b224053-a68d64f3-7afcf922-2cf10765-45c5d89d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with acute COPD exacerbation and h/o heart failure, w/ new dyspnea // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Stable moderate enlargement of the cardiac silhouette with normal hilar and mediastinal contours. Lungs remain hyperexpanded but clear. No pleural effusion, pulmonary edema or pneumothorax. Mild anterior wedge compression deformities of multiple mid thoracic vertebral bodies is unchanged. A partially visualized aortic stent in the upper abdomen is unchanged. IMPRESSION: No acute process NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:45 PM, 10 minutes after discovery of the findings. " 4ebc0fd5-90940eab-b7387fbb-1b0ab295-e0285500.jpg,validate/p10/p10398981/s53362517/4ebc0fd5-90940eab-b7387fbb-1b0ab295-e0285500.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxemic respiratory failure, intubated, acute renal and liver failure, now with acute hypoxia and hypotension. // Eval for interval change (pneumothorax, pulm edema, vs other process). Eval for interval change (pneumothorax, pulm edema, vs other process). IMPRESSION: ET tip is 4.7 cm above the carinal. NG tube tip is in the stomach. Right internal jugular line tip is at the level of mid SVC. Left internal jugular line tip is at the level of cavoatrial junction/proximal right atrium. There is progression of left lung atelectasis. Widespread parenchymal opacities are unchanged. " e2e42688-4631a3ef-bd6ad843-c4955c6d-331b0c2b.jpg,validate/p16/p16734287/s56408527/e2e42688-4631a3ef-bd6ad843-c4955c6d-331b0c2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea and abdominal pain COMPARISON: Chest radiographs ___ and CT chest ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Cardiomegaly is mild. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. Calcification of the mitral annulus is not significantly changed. Degenerative changes in the spine are not significantly changed. IMPRESSION: No acute intrathoracic process. " 400794d6-b020206b-eb271b68-5acae9df-b8ca1484.jpg,validate/p10/p10267699/s51395650/400794d6-b020206b-eb271b68-5acae9df-b8ca1484.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough for three weeks. Evaluate for evidence of infiltrate. 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: No evidence of acute cardiopulmonary process. " 9b0efde3-ee759b64-da70b5a9-701034a8-65039735.jpg,validate/p19/p19398915/s56273602/9b0efde3-ee759b64-da70b5a9-701034a8-65039735.jpg,validation," FINAL REPORT HISTORY: Left PICC placement and shortness of breath. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: Left PICC tip terminates in the upper SVC. Large right pleural effusion appears slightly increased in size compared to the previous exam with associated right basilar atelectasis. The cardiac, mediastinal and hilar contours appear grossly unchanged. Patchy opacity within the left mid lung field appears new and is concerning for an area of developing infection. There is no left-sided pleural effusion or pneumothorax. No acute osseous abnormalities are demonstrated. IMPRESSION: 1. Left PICC tip in the upper SVC. 2. Large right pleural effusion, slightly increased in size compared to the prior exam with associated right basilar atelectasis. 3. New ill-defined opacities within the left mid lung field concerning for infection. " d2ba7ae7-aa7ce10c-e8d176f8-fb0ea6a0-8fff92cf.jpg,validate/p13/p13638768/s56901277/d2ba7ae7-aa7ce10c-e8d176f8-fb0ea6a0-8fff92cf.jpg,validation," FINAL REPORT HISTORY: History of prostate cancer and fevers, now with intermittent cough following recent travel to ___. Followup for left upper lobe nodule seen on prior exam. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to chest radiograph dated ___. FINDINGS: Redemonstrated are multiple bilateral nodules of varying sizes, with a dominent retrocardiac nodule seen within the posterior left lower lobe. Other nodules may be in the lungs and/or ribs as they overlie multiple ribs. No lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. No bony abnormality is detected. IMPRESSION: 1. Multiple bilateral nodular opacities. Recommend dedicated chest CT for localization and further characterization. 2. No evidence of lobar consolidation. " a8e9eef1-30566b08-b53b6565-65e2044c-1e5526b9.jpg,validate/p11/p11761176/s56770363/a8e9eef1-30566b08-b53b6565-65e2044c-1e5526b9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: New left hemiparesis. Question infection. COMPARISONS: ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. Subpleural thickening at each lung apex appears unchanged. Otherwise the lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease. " 1ae5f43c-73855685-b28df0c2-f69c04ea-c1c4d10b.jpg,validate/p17/p17473651/s56171845/1ae5f43c-73855685-b28df0c2-f69c04ea-c1c4d10b.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with altered mental status. Question pneumonia. COMPARISON: Chest x-ray from ___. Chest CT from ___. FINDINGS: AP and lateral views of the chest. The lungs are clear of focal consolidation or effusion. Opacity in the left posterior costophrenic angle is compatible with previously identified Bochdalek's hernia. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 7487924e-03fbb530-b7b17507-2b1e94f1-b314b8a8.jpg,validate/p16/p16787268/s52099770/7487924e-03fbb530-b7b17507-2b1e94f1-b314b8a8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left basal ganglia bleed, increased ICP, intubated // assess airway TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: There is no interval change in the position of the left subclavian line tip terminating in the azygos system. Left retrocardiac consolidation is unchanged. Mediastinal silhouette is unchanged. No interval development of pulmonary edema demonstrated. The S essentially no substantial change to the prior study demonstrated except for at least partial improvement of previously seen right lower lung atelectasis " 0d53b054-153787bd-f44a5046-dad19b24-0e46905c.jpg,validate/p10/p10759461/s58566250/0d53b054-153787bd-f44a5046-dad19b24-0e46905c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Sepsis, questionable pneumonia. COMPARISON: ___, 5:38 a.m. FINDINGS: As compared to the previous radiograph, there is unchanged cardiomegaly and unchanged appearance of the right internal jugular vein catheter. This catheter projects with its tip over the right atrium, the device could be pulled back by 3 to 4 cm. There is no pneumothorax. Unchanged patient rotation. There are minimal non-characteristic parenchymal scars at the right lung bases and an area of small atelectasis at the left lung bases. These areas are unchanged as compared to the prior image. There is no evidence of additional parenchymal processes and notably no evidence of pneumonia. No larger pleural effusions are present. " b7941ea0-429f1ce8-baff2c60-c281f0a3-db454ec9.jpg,validate/p12/p12773304/s57993146/b7941ea0-429f1ce8-baff2c60-c281f0a3-db454ec9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with aspiration, leukocytosis // ?PNA ?PNA IMPRESSION: Compared to chest radiographs ___ through ___. Previous interstitial pulmonary abnormality is resolved. No good evidence for pneumonia. Cardiomediastinal and hilar silhouettes and pleural surfaces normal. " e61b84d2-520482b9-7cf7fab1-e15e5f00-445f2b26.jpg,validate/p11/p11266603/s51945292/e61b84d2-520482b9-7cf7fab1-e15e5f00-445f2b26.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with non-expanding R lung, now s/p clamp trial and d/c of R pleural pigtail // change in R ptx? pls perform film as upright as possible COMPARISON: ___, 16:02 IMPRESSION: As compared to the previous radiograph, the previously placed right pigtail catheter has been removed. There is a minimal decrease in extent of the known right pneumothorax. Right basilar atelectasis, however, persists. The pre-existing depression of the right hemidiaphragm is less severe than on the previous image. Unchanged appearance of the cardiac silhouette. Normal left hemithorax. " 7a386a68-d4509dda-3e11848b-00ecceb2-8c873467.jpg,validate/p11/p11551927/s52176549/7a386a68-d4509dda-3e11848b-00ecceb2-8c873467.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with alcoholic cirrhosis, psuedocyst, received 9L paracentesis today. Now with worsening abdominal pain and tenderness. Looking for signs of free air under the diaphragm. // Evidence of free air under the diaphragm COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have slightly decreased. There is no evidence of free intraperitoneal air. No pleural effusions. No pneumonia, no pulmonary edema. Normal size of the cardiac silhouette. " 6c7b314e-eccdb582-32b1ff8c-0148581a-57b7c528.jpg,validate/p14/p14101623/s59871201/6c7b314e-eccdb582-32b1ff8c-0148581a-57b7c528.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with liver adenocarcinoma, CAD, now with leukocytosis, low grade fever, and SOB // eval for PNA COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Normal lung volumes. Moderate cardiomegaly with tortuosity of the thoracic aorta. No pulmonary edema. No pneumonia. Known healed left-sided rib fractures. Better appreciated than on the previous radiographs are severe degenerative shoulder changes bilaterally. " 91675f55-35821a15-2dc39e58-b8ceea9b-34e2a571.jpg,validate/p14/p14309697/s54674227/91675f55-35821a15-2dc39e58-b8ceea9b-34e2a571.jpg,validation," FINAL REPORT HISTORY: Pre-syncope. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No evidence of pneumonia, vascular congestion, or pleural effusion. " 35fb9420-c53e3c0c-a583ee62-9b3a5638-ad0bbdff.jpg,validate/p18/p18111516/s51330761/35fb9420-c53e3c0c-a583ee62-9b3a5638-ad0bbdff.jpg,validation," FINAL REPORT HISTORY: Question aspiration pneumonia. CHEST, SINGLE AP PORTABLE VIEW. COMPARISON: ___ at 3:38 a.m. There are low inspiratory volumes. There is cardiomegaly with mild unfolding of the aorta. No CHF, focal infiltrate or effusion. Incidental note is made of degenerative changes at the right glenohumeral joint and a clip in the right upper quadrant of the abdomen. IMPRESSION: Cardiomegaly. No focal opacity to suggest aspiration. " 90b92a06-b737ae11-ab1dc72d-1925e819-dd94fb1b.jpg,validate/p19/p19324253/s52867231/90b92a06-b737ae11-ab1dc72d-1925e819-dd94fb1b.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Weakness and hypotension. 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. IMPRESSION: No evidence of acute disease. " 37de695f-250872b3-01f034bc-3903a9b2-a30b0895.jpg,validate/p13/p13391297/s54079485/37de695f-250872b3-01f034bc-3903a9b2-a30b0895.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Shortness of breath with coarse breath sounds, question pneumonia. FINDINGS: PA and lateral views of the chest provided. Lung volumes are low with basilar opacities, most likely atelectatic. No effusion or pneumothorax. Heart size is difficult to assess. Mediastinal contour is normal. Bony structures are intact. No free air below the right hemidiaphragm. Clips in the upper abdomen are again noted. IMPRESSION: Low lung volumes with basilar atelectasis. No convincing signs of pneumonia. " 7453ece6-40e5768b-9f50b062-5c245a04-e5793c3c.jpg,validate/p13/p13569368/s56722037/7453ece6-40e5768b-9f50b062-5c245a04-e5793c3c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with tracheal stenosis, COPD presents with mild tachypnea, rhonchi on exam. // infection TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Tracheostomy tube is re- demonstrated.There are relatively low lung volumes. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. There is mild prominence of the central pulmonary vasculature which may be due to pulmonary vascular engorgement. No definite new focal consolidation is seen. Chronic deformity of right-sided ribs is re- demonstrated. IMPRESSION: Relatively low lung volumes. Mild central pulmonary vascular engorgement. No definite new focal consolidation. " a72b323a-cf9c5c27-a61cb36d-3b952e03-c86b24fc.jpg,validate/p12/p12764457/s51345693/a72b323a-cf9c5c27-a61cb36d-3b952e03-c86b24fc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, fever, sputum production. ? pneumonia // ? pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the cardiac silhouette. " 4192eb9b-20007aef-fbcde7bc-3d351d50-b1f9aff3.jpg,validate/p16/p16100213/s57476940/4192eb9b-20007aef-fbcde7bc-3d351d50-b1f9aff3.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough assess for pneumonia. TECHNIQUE: PA and lateral views of the chest were provided. COMPARISON: Prior exam ___. PROCEDURE: FINDINGS: PA and lateral views of the chest were provided. Clips are again noted in the left axilla. Low lung volumes without definite signs of pneumonia or CHF. Cardiomediastinal silhouette is stable with atherosclerotic calcifications along the aortic knob. Bony structures appear intact. IMPRESSION: No acute findings. NOTIFICATION: " 5a4d6506-c565e5af-813d3ba5-72fd6f77-ac40ae71.jpg,validate/p17/p17947312/s50145480/5a4d6506-c565e5af-813d3ba5-72fd6f77-ac40ae71.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever/chills/cough of ___ hours duration; no focality on lung examination // please assess for pneumonia please assess for pneumonia IMPRESSION: Compared to chest radiographs since ___, most recently ___. New consolidation, most pronounced in the right upper lobe but also in the right lower lung is most likely pneumonia. Mild cardiomegaly is more pronounced. There is no appreciable pleural effusion. NOTIFICATION: The findings were discussed with ___, MD , M.D. by ___, M.D. on the telephone on ___ at 4:33 PM, 22 minutes after the initial page that was placed immediately upon discovery of the findings. " 20b75c0a-c3eef182-f873e7dd-9615fc66-061eef23.jpg,validate/p10/p10043514/s52308461/20b75c0a-c3eef182-f873e7dd-9615fc66-061eef23.jpg,validation," 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. " 8c443bed-f3c728bf-4a056a16-ee850e0b-d9dc535e.jpg,validate/p11/p11607177/s51065201/8c443bed-f3c728bf-4a056a16-ee850e0b-d9dc535e.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with CHF. // Comparison to previous. COMPARISON: Multiple chest radiographs from ___ to ___ FINDINGS: There are no significant changes compared to the prior radiographs. Bronchovascular markings are accentuated by low lung volumes. No evidence of pneumonia, pulmonary edema or pneumothorax. Stable cardiomegaly which is unchanged since ___. Transvenous pacemaker is unchanged in position with leads terminating in the right atrium and coronary sinus. Pulmonary artery catheter terminates in the main pulmonary artery. No acute osseous abnormalities. IMPRESSION: No significant interval changes. No pulmonary edema. " c84678ca-5c75e1c5-0a4c9334-2334f0e5-2f660565.jpg,validate/p19/p19415089/s51120416/c84678ca-5c75e1c5-0a4c9334-2334f0e5-2f660565.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT) INDICATION: ___ year old man with recent PNA, but persistent cough and sob. // Is there evidence of resolution of pna? COMPARISON: ___ FINDINGS: The lungs are hyper inflated. The nodular density in the left upper lobe has cleared. Increased markings are present particularly in the left base, a new finding. . The left basilar disease appears more prominent than previously. There is no pleural effusion. The mediastinum is normal. The heart size is normal. The osseous structures are normal for age. IMPRESSION: The nodular density in the left upper lobe has cleared, but there is now new left infrahilar left lower lobe parenchymal disease likely pneumonia or atelectasis. Followup recommended. " e4329473-b32ca92e-cd63ee76-2e9dce9b-9b749363.jpg,validate/p15/p15366293/s57799436/e4329473-b32ca92e-cd63ee76-2e9dce9b-9b749363.jpg,validation," FINAL REPORT EXAMINATION: Portable upright chest x-ray INDICATION: ___ year old woman s/p tracheal stent placement // eval fo consolidation TECHNIQUE: Portable upright chest x-ray COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: The cardiac silhouette is normal. The hilar and mediastinal contours are unremarkable. Patient is status post tracheal stent placement with the trachea remaining patent. No focal consolidations, pleural effusions, pulmonary edema, or pneumothorax are seen. IMPRESSION: No evidence of pneumonia. " c1d5f89b-8c6de5fa-a9008a71-0befe3c3-b8688781.jpg,validate/p11/p11877234/s59227454/c1d5f89b-8c6de5fa-a9008a71-0befe3c3-b8688781.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, nausea. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The cardiac silhouette remains moderately to severely enlarged. No pleural effusion or definite focal consolidation is seen. There is minimal interstitial edema. Right-sided PICC is again seen, distal aspect not well seen, likely due to overlying left-sided AICD lead. Single-lead left AICD is seen with lead grossly similar in position. No evidence of pneumothorax is seen. The aortic knob is again calcified. IMPRESSION: Moderate-to-severe enlargement of the cardiac silhouette with minimal interstitial edema. " ef11ff0d-792e5af2-09cef72b-4240ef55-866c8f20.jpg,validate/p11/p11847817/s53919897/ef11ff0d-792e5af2-09cef72b-4240ef55-866c8f20.jpg,validation," FINAL REPORT EXAMINATION: Radiograph. INDICATION: ___M with CP, assess etiology. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the osseous structures are unremarkable. No displaced rib fracture. IMPRESSION: No acute cardiopulmonary process. " 0b9c70aa-f69e7e82-275efe63-d89e5356-d84f4a27.jpg,validate/p15/p15722937/s55367236/0b9c70aa-f69e7e82-275efe63-d89e5356-d84f4a27.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated with likely ARDS // ? acute process ? acute process IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. Monitoring and support devices remain in place. The overall pattern is consistent with improving pulmonary edema and residual volume loss in the left lower lobe. However, in the appropriate clinical setting, superimposed pneumonia would be difficult to exclude. " 8d8c094f-6c201c7f-8b3ca16d-ac50ca92-d6071bdb.jpg,validate/p12/p12945897/s53916096/8d8c094f-6c201c7f-8b3ca16d-ac50ca92-d6071bdb.jpg,validation," 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 lungs appear clear. Bony structures are unremarkable. There has been no significant change. IMPRESSION: No evidence of acute cardiopulmonary disease. " c051f61a-52a671c2-2afbac66-5ba1337e-d045574c.jpg,validate/p11/p11895636/s55054713/c051f61a-52a671c2-2afbac66-5ba1337e-d045574c.jpg,validation," 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. " 3ea3c127-f9f8ebf3-34fb6291-b251d768-7d2f2bb5.jpg,validate/p17/p17405009/s59372295/3ea3c127-f9f8ebf3-34fb6291-b251d768-7d2f2bb5.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with likely diabetic ketoacidosis and hyperglycemia, evaluate for pneumonia. COMPARISON: ___. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are within normal limits. Both lungs are clear with no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 4d5f07e9-74ae05ac-0d51d09e-37c28993-6c8bcec7.jpg,validate/p13/p13134519/s58894513/4d5f07e9-74ae05ac-0d51d09e-37c28993-6c8bcec7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with acute confusion, headache, chest pain. HTN emergency // Eval for acute neurologic abnormality, CV abnormality COMPARISON: Chest radiographs ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Moderate cardiomegaly is similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Moderate cardiomegaly is similar to prior. " c7de4d84-f64e85bd-050c24aa-aeceefd6-59a37e4d.jpg,validate/p19/p19156000/s52216843/c7de4d84-f64e85bd-050c24aa-aeceefd6-59a37e4d.jpg,validation," FINAL REPORT HISTORY: Pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 10d84633-c224eec2-1be17831-5e6d0382-d7a0fa8a.jpg,validate/p15/p15415409/s52583457/10d84633-c224eec2-1be17831-5e6d0382-d7a0fa8a.jpg,validation," WET READ: ___ ___ 11:48 PM R PICC with tip in right atrium. could be pulled back 2-3 cm to terminate in cavoatrial junction. NGT well positioned. ETT 2 cm above carina. central pulmonary vasculature engorgement with hazy pulmonary vascualture indicaing pulmonary edema. However, additional multifocal opacifications also evident particularly in the left mid and lower lungs, concerning for infection, assymetric pulmonary edema is less likely consideration. possible small bialteral pleural effusions. suggest reimaigng after diuresis. ___ ______________________________________________________________________________ FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: Patient with PICC line placement. FINDINGS: No previous studies for comparison. There is a right-sided PICC line with distal lead tip is in the right atrium. This could be pulled back 3-4 cm for remarkable placement. The side port of nasogastric tube is below the gastroesophageal junction. The tip of the endotracheal tube is 3 cm above the carina. There is increase in pulmonary interstitial markings suggestive of pulmonary vascular edema. There are more confluent opacities within the left mid and lower lung fields, which may represent asymmetric pulmonary edema or developing consolidation. " 7f72be95-e1621f3f-90960d8d-a6dca68e-9470abf7.jpg,validate/p12/p12358216/s53526637/7f72be95-e1621f3f-90960d8d-a6dca68e-9470abf7.jpg,validation," FINAL REPORT AP CHEST, 3:12 A.M. ___ HISTORY: Evaluate pneumonia, pneumomediastinum and ET tube placement. IMPRESSION: AP chest compared to ___ through ___ at 6:57 p.m.: ET tube in standard placement. Nasogastric tube loops in the stomach. Right PIC line still ends more than 5 cm below the level of the carina. In order to locate it in the low SVC, it should be withdrawn 2 cm. Large right pleural effusion has increased substantially, and there is still heterogeneous opacification in the left lung, which could be either infection or edema. No pneumothorax or appreciable pneumomediastinum. " 95bc1aa9-38b184e6-d77a2f71-9873f09e-df0f7b27.jpg,validate/p16/p16739625/s56581159/95bc1aa9-38b184e6-d77a2f71-9873f09e-df0f7b27.jpg,validation," 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. Lungs are hyperinflated but clear. Pulmonary vasculature is normal. No pleural effusion, focal consolidation, or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 07650cc0-6be95003-35abb198-ee956198-60b92f22.jpg,validate/p15/p15923118/s52110003/07650cc0-6be95003-35abb198-ee956198-60b92f22.jpg,validation," FINAL REPORT INDICATION: Cough for four days, fatigue and leukocytosis. COMPARISONS: ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Postoperative mediastinum and mild cardiomegaly is unchanged from prior exam. Hilar contours are normal. A heterogenous density in the posterior right lower lobe is worrisome for pneumonia. The left lung is clear. There is no pleural effusion or pneumothorax. IMPRESSION: Heterogenous right posterior lower lobe opacity worrisome for pneumonia. Results were discussed over the telephone with Dr. ___ by Dr. ___ at 11:32 a.m. on ___ at time of initial review. " ed26b3ba-950f444a-a1ad0153-03173dc1-e9527c33.jpg,validate/p17/p17517983/s57604519/ed26b3ba-950f444a-a1ad0153-03173dc1-e9527c33.jpg,validation," FINAL REPORT HISTORY: Neck and shoulder pain. COMPARISON: Chest radiograph ___, ___. FINDINGS: AP and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear without focal consolidation. Pulmonary vasculature is within normal limits. No displaced fractures are noted. IMPRESSION: No acute cardiopulmonary process. " c83aa5b2-036daac0-fa05ad7f-2d68ac33-10e9297c.jpg,validate/p17/p17576736/s51406362/c83aa5b2-036daac0-fa05ad7f-2d68ac33-10e9297c.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with R pleural effusion s/p drainage, septic w/ intermittent fevers // ?PTX, pleural effusion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___ and ___ FINDINGS: The right lung is clear without pleural effusion. The moderate left pleural effusion has slightly improved. Left basilar opacity remains, likely atelectasis. A tiny left apical pneumothorax remains unchanged. Stable cardiomegaly. IMPRESSION: 1. Slight decrease in size of moderate left pleural effusion with persistent adjacent left basilar atelectasis and or consolidation. 2. Stable tiny left apical pneumothorax. " 54cbaa1e-8fb9cf58-0ec6eb8b-75151bf2-fc45b45d.jpg,validate/p13/p13989300/s51173922/54cbaa1e-8fb9cf58-0ec6eb8b-75151bf2-fc45b45d.jpg,validation," FINAL REPORT HISTORY: Chest pain x. TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___. FINDINGS: No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top-normal. The mediastinal silhouette is unremarkable. Hilar contours are stable. No displaced fracture is seen. Thoracolumbar scoliosis is partially imaged. IMPRESSION: No acute cardiopulmonary process. " 4a02ad34-33ae9d97-c1b1a47a-9eea03e4-49735526.jpg,validate/p19/p19980241/s58237304/4a02ad34-33ae9d97-c1b1a47a-9eea03e4-49735526.jpg,validation," WET READ: ___ ___ ___ 11:00 PM Small left pleural effusion and minor a left lower lung atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LATERAL) INDICATION: ___-year-old man with pyelonephritis status-post per acute nephrostomy and ceftriaxone x11d, now with worsening flank pain; evaluate for acute cardiopulmonary process. TECHNIQUE: PA and lateral radiograph views of the chest were obtained. COMPARISON: PA and lateral chest radiograph dated ___. FINDINGS: Stable bilateral lower lung volumes. The small left pleural effusion is new. There is minor atelectasis of the left lung base. No pneumothorax, focal consolidation, or pulmonary edema. Stable appearance of the mediastinum and hila. The heart size is normal. IMPRESSION: Small left pleural effusion and minor left lower lung atelectasis. " 0c00053c-f2ee2f02-a42662da-ac1a4b6f-53d0ac13.jpg,validate/p19/p19701893/s51127596/0c00053c-f2ee2f02-a42662da-ac1a4b6f-53d0ac13.jpg,validation," 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. " 63e55f07-abfc6bfc-feb015cc-55c27774-8018569d.jpg,validate/p15/p15432819/s56336924/63e55f07-abfc6bfc-feb015cc-55c27774-8018569d.jpg,validation," FINAL REPORT HISTORY: Shortness of breath, hypoxia, rales. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph and CT torso ___. FINDINGS: Moderate enlargement of cardiac silhouette is unchanged. The mediastinal contours are stable. Atherosclerotic calcifications of the thoracic aorta are again noted. There is no pulmonary vascular congestion. Enlargement of the hila bilaterally reflects dilated pulmonary arteries, suggestive of pulmonary arterial hypertension. Small right pleural effusion persists. Bibasilar atelectasis is noted and elevation of the right hemidiaphragm is again seen. There is no pneumothorax. Multilevel degenerative changes in the thoracic spine are again present. Cholecystectomy clip in the right upper quadrant the abdomen is again noted. IMPRESSION: Unchanged small right pleural effusion and bibasilar atelectasis. Bilateral hilar enlargement suggestive of underlying pulmonary arterial hypertension. " 72700175-a8c8a912-eb578afd-4cbda153-f68e6a4a.jpg,validate/p19/p19758044/s55857418/72700175-a8c8a912-eb578afd-4cbda153-f68e6a4a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with picc repo // L picc repo sal ___ L picc repo sal ___ IMPRESSION: In comparison with the earlier study of this date, there is an placement of a left subclavian PICC line that extends to the lower SVC. Otherwise, little change. 2 chest tubes remain in place on the right and there is no evidence of pneumothorax. " 428a80aa-52a16128-fea55f87-40127811-8c58da85.jpg,validate/p19/p19291771/s53959732/428a80aa-52a16128-fea55f87-40127811-8c58da85.jpg,validation," WET READ: ___ ___ ___ 8:14 AM Stable cardiomegaly and low lung volumes. Right bases opacity is similar to prior but may represent developing infection. Mild pulmonary edema with interval decrease in left pleural effusion. NG tube terminates below the diaphragm. WET READ VERSION #1 ___ ___ ___ 8:43 PM Stable cardiomegaly and low lung volumes. Right bases opacity is similar to prior but may represent developing infection. Mild pulmonary edema with interval decrease in left pleural effusion. NG tube terminates below the diaphragm. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p open appy for perf now increasing white count, delirium, fever spikes // please assess for lung pathology COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is noted. Low lung volumes. Moderate cardiomegaly. The monitoring and support devices are constant. Mild pulmonary edema is unchanged. No pleural effusions. No pneumothorax. " e51a6037-e3fc2f65-fdc220b5-33412d43-37e343d5.jpg,validate/p19/p19569832/s55235448/e51a6037-e3fc2f65-fdc220b5-33412d43-37e343d5.jpg,validation," FINAL REPORT HISTORY: Fever, to assess for pneumonia. FINDINGS: In comparison with the study of ___, the patient has taken a somewhat better inspiration. Nasogastric tube tip remains in the distal stomach. Lungs are essentially clear with the prior granulomatous and rib fracture is again noted. " 2e691303-2c3be76e-14d7933b-60051d93-1ae09eed.jpg,validate/p12/p12160337/s53756330/2e691303-2c3be76e-14d7933b-60051d93-1ae09eed.jpg,validation," 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. " 3f898687-471c5730-b53a1c8e-8a073d97-59fdefd6.jpg,validate/p10/p10320090/s57625472/3f898687-471c5730-b53a1c8e-8a073d97-59fdefd6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dilated CM, CHF presenting with chest pain/pressure and sob. // Assess for potential cause of chest pain Assess for potential cause of chest pain IMPRESSION: In comparison to study of ___, there is again substantial enlargement of the cardiac silhouette consistent with cardiomyopathy. Pacer device remains in place and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 39842cb4-5b88922a-b5371395-b15671b8-de9925ac.jpg,validate/p12/p12401831/s58805214/39842cb4-5b88922a-b5371395-b15671b8-de9925ac.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female with altered mental status, found down with vomitus. Question aspiration pneumonia. TECHNIQUE: Frontal and lateral views of the chest are compared to previous exam from ___. FINDINGS: There are streaky bibasilar opacities which are confirmed on the lateral view. Superiorly the lungs are clear. Cardiomediastinal silhouette is normal. Lower thoracic dextroscoliosis again noted. Radiopaque substances projects in the left upper quadrant, potentially within the stomach. IMPRESSION: Streaky bibasilar opacities which could represent aspiration versus bibasilar atelectasis=. No large confluent consolidation. " e7de6972-2c0259a7-ae1fcf7c-fe9a4141-03151f1e.jpg,validate/p11/p11062577/s52674642/e7de6972-2c0259a7-ae1fcf7c-fe9a4141-03151f1e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: Ms. ___ is a ___ yo woman with a PMH of HepC cirrhosis who was found down at home, intubated at ___ and placed on pressors, and transferred to ___ for further management. Has bands on CBC. On pressors // on vent COMPARISON: Chest radiographs ___. IMPRESSION: ET tube and nasogastric tube in standard placements. Lungs clear, possibly hyperinflated. Normal cardiomediastinal and hilar silhouettes. No pneumothorax. " c2fcb03c-1e46495a-5a973845-a16f7f3a-ae8bcab5.jpg,validate/p19/p19045827/s52902703/c2fcb03c-1e46495a-5a973845-a16f7f3a-ae8bcab5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ low O2 sats s/p craniotomy for SDH // ? cardiopulmonary process COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation or increased ventilatory pressure is. The areas of atelectasis, pre-existing at the right and left lung base, have completely resolved. No larger pleural effusions. No pneumonia. No pulmonary edema. Borderline size of the cardiac silhouette. The nasogastric tube and the endotracheal tube are in unchanged position. " c42a648a-29500a95-17ff44b4-cc904ddc-9f39bef3.jpg,validate/p13/p13877204/s58796585/c42a648a-29500a95-17ff44b4-cc904ddc-9f39bef3.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Worsening shortness of breath and hypoxia, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the widespread bilateral parenchymal opacities, likely reflecting a combination of pulmonary edema and infection, are constant in appearance. They have neither increased nor decreased since the previous exam. Currently, there are no larger pleural effusions and the size of the cardiac silhouette is mildly enlarged. No pneumothorax. No new parenchymal changes. " 20d31334-aad85144-b98293a2-e4e6bd62-191b31a7.jpg,validate/p11/p11943612/s58379727/20d31334-aad85144-b98293a2-e4e6bd62-191b31a7.jpg,validation," 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. " c84c0054-b77e3662-9af7a9ae-e4cf122e-85d60f15.jpg,validate/p16/p16051431/s52211767/c84c0054-b77e3662-9af7a9ae-e4cf122e-85d60f15.jpg,validation," 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. " 1c93277a-bf0774fc-b4604932-ecc73db3-24b20231.jpg,validate/p13/p13689440/s53701738/1c93277a-bf0774fc-b4604932-ecc73db3-24b20231.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with recurrent SOB, CHF and endocarditis. // r/o pulmonary edema TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating from ___ to ___. FINDINGS: Small to moderate bilateral pleural effusions have increased in size compared with the immediate prior study of ___. Mild pulmonary edema is slightly improved. The right chest wall dual-chamber pacemaker leads project in unchanged position. The right-sided PICC line ends in the lower SVC. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Increased bilateral pleural effusions, now small to moderate. 2. Slightly improved mild pulmonary edema. " 8b2eac26-43dc96d4-51cdb403-8a298c16-d39eabf1.jpg,validate/p11/p11556982/s57014551/8b2eac26-43dc96d4-51cdb403-8a298c16-d39eabf1.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever after recent resection. History of Crohn's disease. COMPARISON: ___. TECHNIQUE: Chest, AP upright and lateral. FINDINGS: A PICC line terminates in the superior vena cava. The cardiac, mediastinal and hilar contours appear unchanged. The lungs appear clear. The are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " d8d2d678-b2c70c8d-93b0e5c5-da3b9de9-927dfa13.jpg,validate/p14/p14218694/s51937146/d8d2d678-b2c70c8d-93b0e5c5-da3b9de9-927dfa13.jpg,validation," FINAL REPORT CLINICAL HISTORY: Cirrhosis, hepatitis, Dobbhoff tube placed, confirm position. CHEST AP: The tip of the Dobbhoff tube is only just within the stomach and probably partially at the gastroesophageal junction and should be advanced. Some blunting of the right costophrenic angle is present, otherwise the lung fields are clear. IMPRESSION: Dobbhoff tube only just in stomach and should be advanced. " 57975b81-4f853816-3847aceb-14b90d44-5b89e19d.jpg,validate/p14/p14508231/s53414365/57975b81-4f853816-3847aceb-14b90d44-5b89e19d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with abdominal pain, fever // rule out rll pna TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax seen. Spinal hardware is demonstrated at the level of C7-T1. " 68c74308-cc0aca9c-275e6735-f598bbb6-68b08735.jpg,validate/p10/p10553685/s58978992/68c74308-cc0aca9c-275e6735-f598bbb6-68b08735.jpg,validation," 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. " de1b1db4-618f776d-bc96525e-f4df267c-4314def8.jpg,validate/p10/p10849254/s56460193/de1b1db4-618f776d-bc96525e-f4df267c-4314def8.jpg,validation," FINAL REPORT INDICATION: Patient status post fall. COMPARISONS: ___, CT chest of ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes, which accentuate bronchovascular markings. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart is mildly enlarged. Pacemaker or AICD device leads terminate in right atrium and right ventricle. Compression deformity of the mid thoracic vertebral body is new since ___ exam. IMPRESSION: 1. No evidence of acute cardiopulmonary process. 2. A compression deformity of mid thoracic vertebral body is new since ___ exam. Dr. ___ was paged at the time of discovery. " 048d665a-5e7f8a05-68001ea4-e8312a8c-45f235f8.jpg,validate/p14/p14581354/s57622894/048d665a-5e7f8a05-68001ea4-e8312a8c-45f235f8.jpg,validation," WET READ: ___ ___ ___ 10:08 PM 1. No evidence of a pneumothorax. 2. Stable to slight interval improvement of the mild pulmonary edema. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Pacemaker. Evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous image, the patient has received a left pectoral pacemaker. One lead projects over the right ventricle, one over the right atrium. The leads are intact. No lead fracture. No pneumothorax. Borderline size of the cardiac silhouette. No pulmonary edema. No pleural effusions. " 1019134c-711f6739-2d771fd0-e78b6a87-6fc5bf25.jpg,validate/p14/p14810396/s53314399/1019134c-711f6739-2d771fd0-e78b6a87-6fc5bf25.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Arterial thrombosis on bypass graft. Question acute disease. COMPARISONS: ___. TECHNIQUE: Chest, AP 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. " 602f9425-e72a85fc-8f728699-b31352f2-857db26a.jpg,validate/p17/p17297649/s52328076/602f9425-e72a85fc-8f728699-b31352f2-857db26a.jpg,validation," WET READ: ___ ___ 7:47 PM 1. Stable interstitial edema, unchanged from the prior exam. 2. Mild bibasalar atelectasis. 3. Cardiomediastinal and hilar contours unchanged. 4. No evidence of pneumonia. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with fevers // r/o pneumonia TECHNIQUE: PA and lateral images of the chest. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded. There is no pulmonary opacity or mass. Trace bilateral pleural effusions are seen. The left ventricle and left atrium are enlarged and a pacer with intact leads is noted, findings which are consistent with chronic heart failure. There is no pulmonary edema or other evidence of acute heart failure. Trace bilateral pleural effusions are seen. The right pulmonary artery is enlarged, suggestive of pulmonary hypertension. Calcifications are seen in the aortic arch. The aorta is noted to be tortuous. IMPRESSION: 1. No evidence of pneumonia or pulmonary edema. No acute cardiopulmonary process. 2. Enlarged left ventricle and left atrium, consistent with chronic heart failure. 3. Enlarged right pulmonary artery, suggestive of pulmonary hypertension. " bfd0d74c-78de159a-cd377484-80acaab5-feece5a7.jpg,validate/p17/p17671017/s51563909/bfd0d74c-78de159a-cd377484-80acaab5-feece5a7.jpg,validation," FINAL REPORT HISTORY: ___-year-old male, status post bronchoscopy with biopsies, rule out pneumothorax. COMPARISON: PET-CT, ___. FINDINGS: Portable upright frontal chest radiograph demonstrates interval increase in size of a dense consolidative opacity in the right upper lobe with surrounding airspace opacity. There is no pneumothorax. Cardiac silhouette remains normal in size, the mediastinal contours remain normal. Median sternotomy wires are fractured at nearly all visible levels. IMPRESSION: Interval increase in right upper lobe mass-like opacity likely secondary to post-biopsy hemorrhage or lavage surrounding pre-existing mass, without evidence of pneumothorax. " 19739c20-d6817381-0904952e-094850ef-2a04da73.jpg,validate/p18/p18809552/s53821345/19739c20-d6817381-0904952e-094850ef-2a04da73.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with DOE // CHF? COMPARISON: ___ and CT chest from ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. Slightly coarsened interstitial markings may reflect known interstitial lung disease. The heart is top-normal in size. No convincing signs of pulmonary vascular congestion or overt edema. No large effusion or pneumothorax. Bony structures are intact. IMPRESSION: As above. " aba5dca5-1c92654c-94d86590-5a842616-2b98e20e.jpg,validate/p14/p14624216/s57356858/aba5dca5-1c92654c-94d86590-5a842616-2b98e20e.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with chest pain. 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. " 433c8580-be030596-ba84907c-e17769f2-a8c49924.jpg,validate/p16/p16103717/s57650631/433c8580-be030596-ba84907c-e17769f2-a8c49924.jpg,validation," FINAL REPORT HISTORY: ___-year-old male cyclist, hit. With right-sided rib fractures, right pneumothorax, and fever, evaluate for pneumonia. COMPARISON: ___. FINDINGS: Repeat AP and lateral chest radiographs demonstrate a right subclavian central venous catheter tip remains in place in the mid SVC. There is a remnant right apical pneumothorax, unchanged. There is opacity near the right heart border and right lower lung. Subcutaneous gas on the right thoracic wall is unchanged. The pulmonary vasculature is normal. There is a small right pleural effusion. Rib fractures are not well seen. IMPRESSION: 1. Small residual right apical pneumothorax. 2. Sequelae of known lacerations in the right lung, unchanged. " 73720d4b-dc1395c0-460542e9-a9b30de9-39faf09f.jpg,validate/p10/p10219031/s59505332/73720d4b-dc1395c0-460542e9-a9b30de9-39faf09f.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. There is no pleural effusion or pneumothorax is seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " c044e70e-51a6ecf7-7263a260-c29e60e6-e675630c.jpg,validate/p13/p13631957/s58358782/c044e70e-51a6ecf7-7263a260-c29e60e6-e675630c.jpg,validation," FINAL REPORT INDICATION: ___M w/chest pain TECHNIQUE: PA and lateral views the chest COMPARISON: ___. FINDINGS: 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. " fd824519-3a210880-c379c86c-5f19d550-5ce05333.jpg,validate/p19/p19696298/s53977705/fd824519-3a210880-c379c86c-5f19d550-5ce05333.jpg,validation," WET READ: ___ ___ ___ 6:13 PM final image demonstrates NG positioned in the stomach. plate-like atelectasis in the left lung, persistent/minimally improved atelectasis in the RML. ___ ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: NG tube placement. Several radiographs of the chest obtained consecutively were brought to our review demonstrating the process of insertion of the NG tube. The last radiograph demonstrates the NG tube tip being in the stomach. Heart size and mediastinal contours are stable. Bibasal opacities are overall unchanged. No development of pleural effusion or pneumothorax is demonstrated. " 0b462b7e-c0f01fc4-1e75a0bd-0c8458b1-1335c635.jpg,validate/p17/p17788370/s51084021/0b462b7e-c0f01fc4-1e75a0bd-0c8458b1-1335c635.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right empyema s/p right vats decortication // assess interval change assess interval change IMPRESSION: Since study of ___, the pseudotumor in the inner aspect of the minor fissure has cleared. Otherwise, little change in the postoperative appearance of the right hemithorax with no evidence of pneumothorax. Left lung remains essentially clear. The left subclavian PICC line is unchanged. " 6a5ceb39-66979d09-257692f7-dbbd934d-da8f6953.jpg,validate/p17/p17968028/s54055853/6a5ceb39-66979d09-257692f7-dbbd934d-da8f6953.jpg,validation," FINAL REPORT INDICATION: ___F with h/o CHF // eval for structural process, pulmonary edema TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: There is perihilar haziness and indistinctness of the pulmonary vessels compatible with moderate pulmonary edema, slightly worse when compared to older exam. Degree of cardiac enlargement is similar. Trace pleural effusions are also suspected. No acute osseous abnormalities. IMPRESSION: Moderate pulmonary edema. " d5280ede-05ab8b3a-4104b25f-00ac28a5-c80b004f.jpg,validate/p14/p14670928/s59024522/d5280ede-05ab8b3a-4104b25f-00ac28a5-c80b004f.jpg,validation," WET READ: ___ ___ ___ 9:50 PM port-a-cath has access needle in place, not an unexpected finding. lungs clear, cardiomediastinal contours unremarkable. no pleural effusons or pneumothorax. ___ ______________________________________________________________________________ FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess for metal in the port. There is no radiopaque/metal density material in the port. The port tip is at the mid SVC. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. " e07c50fe-8d7edde6-31aaf3f4-f54d839a-1c245778.jpg,validate/p10/p10509294/s57921290/e07c50fe-8d7edde6-31aaf3f4-f54d839a-1c245778.jpg,validation," WET READ: ___ ___ ___ 10:24 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chronic bronchitis, ostomy, here w/ cough/chills // pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest x-ray and ___ chest CT. FINDINGS: The lungs are well inflated and clear. Elevation of the right hemidiaphragm is unchanged as is prominent extrapleural fat adjacent to the left upper lung laterally. Heart size and mediastinal contours are normal. There is no pleural effusion or pneumothorax. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 32a94052-d342d2d8-0a5cb660-9fb6d773-c23348d9.jpg,validate/p14/p14108116/s56438010/32a94052-d342d2d8-0a5cb660-9fb6d773-c23348d9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Fever, cough, tachypnea, assess pneumonia. FINDINGS: PA and lateral views of the chest provided. The heart remains moderately enlarged. Lung volumes are low. There is no focal consolidation, effusion or pneumothorax. No signs of pulmonary edema. The aorta is mildly calcified and slightly unfolded. Old right rib cage deformities are again noted. IMPRESSION: No pneumonia. " 90e0ca7a-c80aa03b-c9a54b19-49cbfe28-8281b61e.jpg,validate/p17/p17503573/s50143204/90e0ca7a-c80aa03b-c9a54b19-49cbfe28-8281b61e.jpg,validation," FINAL REPORT INDICATION: History: ___F with chest pain // 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. " 931a1cbb-01bb2e6b-9096b1a2-7f3f1b14-23f3e570.jpg,validate/p11/p11408283/s50274325/931a1cbb-01bb2e6b-9096b1a2-7f3f1b14-23f3e570.jpg,validation," 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. " ccd12d64-919be30d-f2f00b75-3ffab3e9-489c348c.jpg,validate/p12/p12691429/s53111772/ccd12d64-919be30d-f2f00b75-3ffab3e9-489c348c.jpg,validation," FINAL REPORT INDICATION: Weight loss. COMPARISON: ___. FINDINGS: Two views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are unremarkable. High-riding left humeral head suggest rotator cuff pathology. IMPRESSION: No acute intrathoracic process. " f6d68322-28d091af-e0211a88-4b5d6daa-e452549d.jpg,validate/p10/p10356999/s53947845/f6d68322-28d091af-e0211a88-4b5d6daa-e452549d.jpg,validation," FINAL REPORT HISTORY: Left-sided back and chest discomfort. 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. " 929733c8-5894ff66-3059985f-159f2797-4b0ed730.jpg,validate/p16/p16069646/s51240793/929733c8-5894ff66-3059985f-159f2797-4b0ed730.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with history of atrial fibrillation, now with tachycardia, fevers, chronic cough // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CT ___ FINDINGS: Mild cardiomegaly is re- demonstrated. The aorta is tortuous with atherosclerotic calcifications noted at the aortic knob. Ascending aortic aneurysm is better assessed on the previous chest CT. Hilar contours are normal. Pulmonary vasculature is normal. Elevation of the right hemidiaphragm is unchanged. Trace bilateral pleural effusions are demonstrated, new in the interval with subsegmental atelectasis seen in the right lung base. 14 mm right upper lobe pulmonary nodule is unchanged. No focal consolidation or pneumothorax is seen. Multiple clips and coils are noted projecting over the lower mediastinum and gastroesophageal junction. IMPRESSION: 1. Small bilateral pleural effusions. No pneumonia. 2. Unchanged right upper lobe pulmonary nodule. 3. Known ascending aortic aneurysm is better assessed on previous chest CT. " 7b17e55f-47f7118a-67e5343c-2a280115-5339df93.jpg,validate/p19/p19277082/s54038844/7b17e55f-47f7118a-67e5343c-2a280115-5339df93.jpg,validation," 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. " 997d4f8b-c1e79134-a559661a-85478925-6e1dc007.jpg,validate/p19/p19960115/s56892500/997d4f8b-c1e79134-a559661a-85478925-6e1dc007.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with influenza, PNA, recurrent pleural effusions; please eval for interval change // eval PNA, interval change eval PNA, interval change IMPRESSION: Comparison to ___. No relevant change is noted. The lung volumes are low. Left pleural effusion of moderate extent, with subsequent left retrocardiac atelectasis. Signs of mild pulmonary edema persists. Stable monitoring and support devices, stable mild cardiomegaly. " 994780b4-e7940b86-690530f3-92780eb3-c1718c62.jpg,validate/p10/p10884787/s50868269/994780b4-e7940b86-690530f3-92780eb3-c1718c62.jpg,validation," FINAL REPORT HISTORY: TB meningitis. COMPARISON: ___. FINDINGS: A small area of subsegmental atelectasis at the left CP angle. Otherwise the lungs are clear. The cardiac and mediastinal silhouettes are normal. There is no focal infiltrate. An IVC filter is present. IMPRESSION: no infiltrate " 332449e2-e70f56b6-21d21ce9-c78f982b-a473d950.jpg,validate/p19/p19780620/s54115365/332449e2-e70f56b6-21d21ce9-c78f982b-a473d950.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with PMHx COPD, GERD, HTN, chronic SDH, prostate cancer s/p prostatectomy with new diagnosis of likely ETOH Cirrhosis with active ETOH use who presents with several days of nausea/abdominal pain found to have alcoholic hepatitis and severe gastric outlet obstruction now s/p EGD with dilation. Now on antibiotics from ___ due to leukocytosis/tachycardia. Currently stable. Status post dobhoff advancement by GU on ___. // please assess for interval change, aspiration please assess for interval change, aspiration IMPRESSION: Compared to chest radiographs ___. Small left pleural effusion stable. Heart size normal. Lungs grossly clear. No pneumothorax. Normal hilar and mediastinal contours. Indwelling right PIC line ends in the low SVC and a transesophageal drainage tube passes into the stomach and out of view. " 7591788d-5cf88f9b-1fb362d8-8ba8c189-9c189d2d.jpg,validate/p14/p14932781/s52910153/7591788d-5cf88f9b-1fb362d8-8ba8c189-9c189d2d.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. The cardiac silhouette size is top normal, unchanged. The mediastinal and hilar contours are stable. Lung volumes are slightly decreased compared to the prior exam, causing mild crowding of the bronchovascular structures. No pulmonary edema is present. Minimal streaky opacities are seen within both lung bases, likely atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. Old right-sided rib fracture is again noted. There are mild degenerative changes in the thoracic spine. IMPRESSION: Mild bibasilar atelectasis. " a329e451-5e6745e1-78e2271d-0097ae97-72eb0e2d.jpg,validate/p13/p13272752/s54405833/a329e451-5e6745e1-78e2271d-0097ae97-72eb0e2d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with history of MI presenting with SOB found to have significant left sided pleural effusion s/p thoracentesis and chest tube placement now with hypotension. // Please evaluate for worsening pneumothorax/acute process. Please evaluate for worsening pneumothorax/acute process. COMPARISON: Prior chest radiographs ___ through ___ at 17:20. IMPRESSION: Atelectasis at the base the left lung has increased. Small pneumothorax, some at the base, some at the apex and very small left pleural effusion are still present despite the small bore basal pleural drainage catheter. Heart size normal. Right lung clear. " 2183f963-df6ee804-51f6317d-380e14fe-67744d50.jpg,validate/p17/p17275231/s51428451/2183f963-df6ee804-51f6317d-380e14fe-67744d50.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Fevers to 101 and cough, assess pneumonia. FINDINGS: PA and lateral views of the chest were obtained. A CBD stent in the right upper quadrant is again noted as well as a catheter in the anterior upper abdomen with adjacent surgical clips. There is no definite sign of pneumonia, pleural effusion or pneumothorax. A subtle nodular opacity adjacent to the left heart border in the left lower lung is seen on the frontal view, possibly may represent a new pulmonary nodule as it was not clearly seen on the prior exam. Cardiomediastinal silhouette appears stable. The hyperinflated widened AP diameter reflects known underlying emphysema. Bony structures appear intact. No free air below the right hemidiaphragm. IMPRESSION: Emphysema, possible nodule in the left lower lung. Recommend non-emergent CT to assess further. No signs of pneumonia or CHF. " 1e8c03b0-7d62ea47-87e82dc0-3c61dd7d-892322b5.jpg,validate/p13/p13680126/s57967302/1e8c03b0-7d62ea47-87e82dc0-3c61dd7d-892322b5.jpg,validation," FINAL REPORT INDICATION: ___M with metastatic stage 4 lung Ca, on chemo, with increasing chest pain and cough // ?PNA TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Right chest wall Port-A-Cath is again noted. Postoperative changes are noted with surgical clips at the left hilum. Left lung is grossly clear. There are new regions of consolidation in the right lung, one linear region projecting over the right upper lobe, potentially in part atelectasis. More patchy region of consolidation projecting more inferiorly over the right lung, likely within the middle lobe based on the lateral view. There is no effusion. Chronic changes of the left lateral ribs are again noted. Surgical clips seen in the upper abdomen. IMPRESSION: New regions of the consolidation in the right lung which could represent infection in the proper clinical setting. Followup suggested after treatment. " 622eb7f1-a1038908-32265d8c-b13fc1d2-de6222a6.jpg,validate/p10/p10449408/s55509904/622eb7f1-a1038908-32265d8c-b13fc1d2-de6222a6.jpg,validation," 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. " 3dd861c1-be155263-13a3c6c6-4f89eba2-c52dc117.jpg,validate/p19/p19278034/s58429705/3dd861c1-be155263-13a3c6c6-4f89eba2-c52dc117.jpg,validation," FINAL REPORT HISTORY: Healthy male with two months of cough. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lungs are clear. Cardiac silhouette is normal in size. No pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest x-ray. " d9f2d5e8-70be3e90-8473f1c8-8eefdab6-84074743.jpg,validate/p10/p10229323/s54957682/d9f2d5e8-70be3e90-8473f1c8-8eefdab6-84074743.jpg,validation," FINAL REPORT INDICATION: MVC and spinal fusion with prolonged intubation, no reintubated. COMPARISON: ___ at 5:28 a.m. FINDINGS: ET tube ends 3.7 cm from the carina. Right IJ central venous line ends at the superior cavoatrial junction. Spinal hardware is seen. The enteric ends in the stomach. Right lower lung opacity is slightly increased. Diffuse pulmonary edema is decreased. IMPRESSION: Slight increase in right lower lung opacity may represent atelectasis or pneumonia and decrease in mild pulmonary edema. " b754f00a-95365b36-1ec3f44c-15474a57-6cac004f.jpg,validate/p11/p11648387/s59161829/b754f00a-95365b36-1ec3f44c-15474a57-6cac004f.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post transbronchial biopsy, assess for pneumothorax. Comparison is made with prior studies, CT, ___ and chest x-ray, ___. There is no evident pneumothorax. Cardiomediastinal contours are unchanged. Multiple bilateral lung nodules are better seen in prior CT. New right lower lobe irregular opacities are likely secondary to post-procedure hemorrhage. There are left lower linear atelectases. " 2ccc15d1-0dcd5d45-4379e5ca-e456db64-09493e11.jpg,validate/p16/p16861367/s52117796/2ccc15d1-0dcd5d45-4379e5ca-e456db64-09493e11.jpg,validation," FINAL REPORT AP CHEST, 5:12 A.M., ___ HISTORY: ___-year-old male with a large subarachnoid hemorrhage, respiratory insufficiency. IMPRESSION: AP chest compared to ___: Some of the heterogeneous opacification at the lung bases, which worsened between ___ and ___, has reticular quality of fibrosis or bronchiectasis. In the absence of radiographic findings to suggest variations in cardiac function, I would attribute the day-to-day changes to aspiration. Hyperlucency in the upper lungs suggests emphysema. Heart is normal size, and pleural effusion minimal if any. ET tube and left subclavian line in standard placements respectively. No pneumothorax. " f6706deb-b50d7381-54371906-846feef9-6521513d.jpg,validate/p12/p12969820/s50275532/f6706deb-b50d7381-54371906-846feef9-6521513d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with sob // acute process 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. " 20d0cbcb-d005c3a2-ebf46b9c-ef9b0390-0e89f864.jpg,validate/p12/p12479159/s59754193/20d0cbcb-d005c3a2-ebf46b9c-ef9b0390-0e89f864.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with AML, concern for line movement // is line in correct spot? is line in correct spot? COMPARISON: Prior chest radiographs ___. IMPRESSION: Left PIC line has been withdrawn to the origin of the right brachiocephalic vein, approximately 11 cm proximal to the estimated level of the superior cavoatrial junction. Upper lungs clear. Mild bronchiolitic nodules, both lower lungs, unchanged since at least ___. Previous cardiomegaly has resolved. There is no pulmonary edema. Pleural effusion minimal on the left if any. No pneumothorax. " d3237c7b-4af2df91-61680a5b-6559788d-21e58352.jpg,validate/p12/p12120688/s55343719/d3237c7b-4af2df91-61680a5b-6559788d-21e58352.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Cough. 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. " 9d81a371-df0c548d-1c4f15d8-36fd7385-11855ee0.jpg,validate/p14/p14997223/s51386152/9d81a371-df0c548d-1c4f15d8-36fd7385-11855ee0.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with liver transplant and pleural effusion, thoracocentesis for 1.4 liters. Assess for recurrence. COMPARISON: ___. FINDINGS: Right pleural effusion has mildly reaccumulated. Right lower lobe atelectasis has increased. Mediastinal contour and mild cardiac enlargement is stable. There is no pneumothorax. CONCLUSION: Reaccumulation of right pleural effusion is small. Right lower lobe atelectasis has also increased. " f0ec23ac-84c9f249-f6d3b813-7af1aba8-cd28ee5b.jpg,validate/p16/p16072940/s52668444/f0ec23ac-84c9f249-f6d3b813-7af1aba8-cd28ee5b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with right-sided chest wall pain anteriorly, reproducible to palpation // ?PTX, pneumonia, rib pathology, mediastinal enlargement COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Lungs are well inflated and grossly clear. No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal. Mild to moderate degenerative changes of the thoracic spine. IMPRESSION: Mild to moderate degenerative changes of the thoracic spine, otherwise normal chest radiograph. " f47a83de-e51c978c-94c06b9a-b256599f-9bfe387f.jpg,validate/p12/p12938496/s54392997/f47a83de-e51c978c-94c06b9a-b256599f-9bfe387f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with prior CTA imaging showing aspiration pneumonia. Has this resolved. IMPRESSION: PA and lateral chest compared to ___: Lungs are fully expanded and clear. Moderate cardiomegaly has improved slightly. Pulmonary vasculature and mediastinal veins are not distended, there is no edema or pleural effusion. Right transjugular dialysis catheter ends in the upper right atrium. " 02bf0ba3-a6bbb0eb-8753e1e6-702578d2-027ac96c.jpg,validate/p19/p19837737/s50709585/02bf0ba3-a6bbb0eb-8753e1e6-702578d2-027ac96c.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with temporary pacer. Evaluate position. FINDINGS: AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. Marked increase of pulmonary vascular congestive pattern with prominent perivascular haze and beginning central edema. A right internal jugular approach was used for the pacing wire, seen to reach the diaphragmatic level via the cardiac area of the right atrium. The wire tip, however, points downwards being directed into the inferior vena cava or possibly entering in an aberrant posterior interventricular coronary vein. Precise termination point must be decided by EKG of electrical capture. The typical structure of a CoreValve can be identified in the area of the left ventricular outflow and root of aorta. There is no pneumothorax. " f0215fa5-7fdbc2c9-6657e5d8-61d79e86-4a9a8b9b.jpg,validate/p17/p17804391/s57642259/f0215fa5-7fdbc2c9-6657e5d8-61d79e86-4a9a8b9b.jpg,validation," 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. " fe8eeb89-769bd999-df652f16-42965c7f-4c73a88f.jpg,validate/p11/p11585485/s54491673/fe8eeb89-769bd999-df652f16-42965c7f-4c73a88f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lymphoma, now with fevers, malaise // ___ year old man with lymphoma, now with fevers, malaise TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior radiographs most recent on ___. CT on ___. FINDINGS: A left-sided Port-A-Cath is in stable position. There is a moderate right pleural effusion, slightly decreased in size from the most recent prior CT in ___. Additionally, there is adjacent pulmonary opacity involving the right lower lobe and right middle lobe, which could represent areas of collapse or infection. There is streaky opacity at the base of the left lung, most consistent with atelectasis. No left pleural effusion or pneumothorax is seen. IMPRESSION: Moderate right pleural effusion and adjacent pulmonary opacity are minimally decreased in size from CT in ___. Pulmonary opacity likely reflects right lower lobe collapse however underlying infection should be considered in the appropriate setting. Left basal atelectasis. NOTIFICATION: . " 3b461447-5738ebd7-6fb26001-a5a9dd43-c7c1b500.jpg,validate/p14/p14787420/s50903194/3b461447-5738ebd7-6fb26001-a5a9dd43-c7c1b500.jpg,validation," 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. " d85433d2-9fde7a25-31f59886-aa7eef8d-8c0f13db.jpg,validate/p11/p11577638/s54946457/d85433d2-9fde7a25-31f59886-aa7eef8d-8c0f13db.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, subjective fevers // Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The aortic knob is calcified and the aorta is mildly tortuous, as seen previously. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacities are noted in both lung bases, which may reflect atelectasis, but infection is not excluded. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Patchy opacities in lung bases could reflect atelectasis but infection cannot be excluded in the correct clinical setting. " 95379858-d41beac2-adfe8310-37dc0747-7c85aa22.jpg,validate/p10/p10760672/s57270460/95379858-d41beac2-adfe8310-37dc0747-7c85aa22.jpg,validation," FINAL REPORT INDICATION: Intraparenchymal hemorrhage. COMPARISON: Chest radiograph ___. TECHNIQUE: Frontal chest radiograph. FINDINGS: An endotracheal tube terminates approximately 3.5 cm above the carina. A nasogastric tube and left subclavian central venous catheter are unchanged in position. There is no pneumothorax, focal consolidation, or pleural effusion. The cardiac and mediastinal contours remain within normal limits. IMPRESSION: No acute intrathoracic process. " 179bba67-6b02d0cc-7e303d17-a34cfe22-4ddb9918.jpg,validate/p19/p19605370/s53750613/179bba67-6b02d0cc-7e303d17-a34cfe22-4ddb9918.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fever and cough. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear without consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " 5cd7d077-6d36f118-83255585-fc670cc0-5cb72c8e.jpg,validate/p17/p17406428/s55287886/5cd7d077-6d36f118-83255585-fc670cc0-5cb72c8e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with tachycardia, SOB, hypoxic ; evaluate for etiology. TECHNIQUE: AP upright and lateral radiograph views of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: Multiple support devices have been removed in the interim. The Dobhoff tube tip projects chest the low the GE junction in the proximal stomach, advanced from the prior exam. There is mild elevation of the right hemidiaphragm with right lower lobe atelectasis. No focal consolidation, effusion, edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. Extensive multilevel degenerative changes with anterior osteophytes in the visualized thoracic spine are noted. IMPRESSION: 1. Dobhoff tube tip has been advanced in the interim, just past the gastroesophageal junction. Recommend further advancement by approximately 8-10 cm to ensure that the tip remains within the stomach lumen. 2. Right lower lobe atelectasis. " 0aed45f0-5abd9a2e-2400be7a-0f8c5c32-6b9a6236.jpg,validate/p18/p18683964/s55975900/0aed45f0-5abd9a2e-2400be7a-0f8c5c32-6b9a6236.jpg,validation," 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. " 3ae191c8-378034a9-8dff4ec3-0ff2141f-7455c3e3.jpg,validate/p15/p15297941/s50348683/3ae191c8-378034a9-8dff4ec3-0ff2141f-7455c3e3.jpg,validation," 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 " 23b2534e-0125166e-4b0286a5-79b37c0d-ea24aa7e.jpg,validate/p11/p11951640/s51163578/23b2534e-0125166e-4b0286a5-79b37c0d-ea24aa7e.jpg,validation," FINAL REPORT HISTORY: Right upper quadrant pleuritic pain, assess for right lower lobe infiltrate. 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 acute cardiopulmonary process. " 78a152da-dff08625-2ec5f1ef-8ed77fab-7f022a06.jpg,validate/p10/p10815821/s54983818/78a152da-dff08625-2ec5f1ef-8ed77fab-7f022a06.jpg,validation," FINAL REPORT HISTORY: Chest pain. Evaluate for acute process. COMPARISON: None available. 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. " a3673557-fc963473-de3c3581-90ff4038-ef2df932.jpg,validate/p17/p17603668/s59357975/a3673557-fc963473-de3c3581-90ff4038-ef2df932.jpg,validation," WET READ: ___ ___ 10:05 PM Hazy left basilar opacity, potentially atelectasis noting that developing infection would be possible. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with cough // fever TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: Right chest wall dual lumen central venous catheter is again seen. There is hazy left basilar opacity which is more conspicuous compared to the prior exam. Elsewhere, the lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Stent is identified in the upper abdomen on the lateral view. IMPRESSION: Hazy left basilar opacity, potentially atelectasis noting that developing infection would be possible. " dbcc363d-e5ef68d9-951a08ed-00676364-880ca7ab.jpg,validate/p17/p17393801/s51934890/dbcc363d-e5ef68d9-951a08ed-00676364-880ca7ab.jpg,validation," FINAL REPORT HISTORY: Hypotension and chest pain. COMPARISON: Chest CT from the same day. FINDINGS: Bilateral pleural effusions, small on the right, moderate on the left with adjacent atelectasis are better delineated on dedicated CT. The heart appears enlarged consistent with known pericardial effusion. Mild increased interstitial opacities are noted within the left upper lobe. No acute fractures are identified. IMPRESSION: Cardiomegaly with known pericardial effusion. Bilateral pleural effusions, moderate on the left and small on the right, with adjacent atelectasis. " ebd9070a-92da3da0-79a68fda-cd96029c-e20784ac.jpg,validate/p19/p19306986/s54027068/ebd9070a-92da3da0-79a68fda-cd96029c-e20784ac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with ETT, s/p og tube placement COMPARISON: Prior exam performed ___ min earlier. FINDINGS: AP portable semi upright view of the chest. Endotracheal tube is unchanged in position with its tip positioned 3.6 cm above the carinal. An orogastric tube extends into the left upper abdomen. Bilateral pleural effusions with bibasilar atelectasis noted, new from prior. IMPRESSION: Appropriately positioned ET and OG tubes. Small effusions and basilar atelectasis new from prior. " e7ce5c2f-28ab5154-01e4847b-00f15d28-48b396d1.jpg,validate/p13/p13777829/s58254850/e7ce5c2f-28ab5154-01e4847b-00f15d28-48b396d1.jpg,validation," FINAL REPORT INDICATION: History: ___F with concern for effusion // evidence of effusion TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph from ___. FINDINGS: The heart size is normal. There has been slight interval improvement in the moderate right pleural effusion, with adjacent atelectasis. The mediastinal contours are normal. The left lung is clear. There is no pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: Slight interval improvement in the moderate right pleural effusion compared to the prior exam. Left lung is clear. " f1956989-d83b5f72-5adbc6e2-780f5ab7-532165cd.jpg,validate/p15/p15233042/s52389934/f1956989-d83b5f72-5adbc6e2-780f5ab7-532165cd.jpg,validation," FINAL REPORT INDICATION: ___F with confusion // eval for PNA, pulm edema TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: When compared to prior, there has been no significant interval change. Pulmonary vascular congestion persists. There is no superimposed consolidation. The cardiomediastinal silhouette is stable, pulmonary arterial enlargement is again noted. Median sternotomy wires, several of which are fractured are unchanged. Atherosclerotic calcifications noted at the aortic arch. Hardware in the proximal right humerus is partially visualized. IMPRESSION: No significant interval change. Pulmonary vascular congestion without focal consolidation. " b6bdc9c6-9ba83d85-007c01d0-2fcad3ae-49cc43d8.jpg,validate/p17/p17366913/s56639167/b6bdc9c6-9ba83d85-007c01d0-2fcad3ae-49cc43d8.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Confusion. PA and lateral upright chest radiographs were reviewed in comparison to ___. The VP shunt is projecting over the medial right hemithorax. Heart size and mediastinum are unremarkable. Minimal linear scarring in the right lower lung is redemonstrated, unchanged. Rest of the lungs are clear. There is no appreciable pleural effusion or pneumothorax. The patient is after internal fixation and pinning of the left humerus. " 39895bd8-435c4579-d48ba383-7d9376f2-e3670114.jpg,validate/p17/p17078867/s52620240/39895bd8-435c4579-d48ba383-7d9376f2-e3670114.jpg,validation," 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. " 74436696-0639a5c0-74aec43b-72b5a650-4e1c542b.jpg,validate/p16/p16564743/s58572412/74436696-0639a5c0-74aec43b-72b5a650-4e1c542b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p knee surgery with postoperative fevers // ? pneumonia , atelectasis ? pneumonia , atelectasis IMPRESSION: As compared to ___, no relevant change is noted. Borderline size of the cardiac silhouette. No pulmonary edema. No pneumonia. Mild elongation of the descending aorta. No pleural effusions. " 083a401d-0ee15b4b-bdab0017-a1b65829-74504ede.jpg,validate/p13/p13247581/s55003756/083a401d-0ee15b4b-bdab0017-a1b65829-74504ede.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with symptoms suspicious for pneumonia. COMPARISON: Portable upright chest x-ray ___. TECHNIQUE: Portable upright chest radiograph. FINDINGS: Again seen is bilateral lower lobe atelectasis and a tiny right pleural effusion. Lateral right middle lobe opacity is again seen. Cardiomediastinal silhouette is unchanged. Right IJ catheter is in unchanged position terminating in the mid SVC. Pleural surfaces are unremarkable. The patient is status post median sternotomy with wires seen midline. IMPRESSION: Bibasilar atelectasis with subtle lateral right middle lobe opacity. In the appropriate clinical setting, pneumonia should be considered. " 4742a52a-800aa303-1d863b64-fb215577-9e919543.jpg,validate/p16/p16013042/s56036609/4742a52a-800aa303-1d863b64-fb215577-9e919543.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M s/p central line. Assess right IJ line placement. COMPARISON: Chest radiograph ___ 14:19 FINDINGS: Supine frontal chest radiograph demonstrates endotracheal tube in appropriate position at the level of the clavicles 4.5 cm above the level of the carina. The enteric feeding tube tip is now within the mid esophagus, retracted from previous examination. A right IJ tip is seen at the proximal most portion of the right atrium. Surgical clips are again seen over the epigastric region. Opacity in the left mid lung, may be in the lingula or posterior left lower lobe is stable from previous examination. Heart, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. Right IJ tip within the proximal most portion of right atrium. 2. Enteric feeding tube within mid esophagus, retracted from previous examination. 3. Stable opacity in left mid lung. NOTIFICATION: Few attempts were made to contact ___ MD. " 3db12414-6180bce3-4950d097-fec42d0b-dc879505.jpg,validate/p11/p11051985/s59164678/3db12414-6180bce3-4950d097-fec42d0b-dc879505.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB, metastatic prostate cancer // eval acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Again noted are diffusely sclerotic appearing osseous structures, particularly in the vertebral bodies, consistent with known metastatic prostate cancer; please note that this appearance limits the evaluation for subtle parenchymal abnormalities. No acute fractures identified. IMPRESSION: 1. Diffuse sclerosis of the imaged bones compatible with diffuse metastatic disease from prostate cancer. 2. Within the limitations of this study, no definite parenchymal consolidation is identified. No pleural effusions or pneumothorax. " d71c05b9-d4c358d6-d0e41f05-b43771c9-58b0ab47.jpg,validate/p11/p11585485/s54115787/d71c05b9-d4c358d6-d0e41f05-b43771c9-58b0ab47.jpg,validation," FINAL REPORT INDICATION: ___ year old man with chest tube // chest tube COMPARISON: Radiograph ___ IMPRESSION: Left-sided Port-A-Cath and a right-sided chest tube are unchanged in position. There is unchanged cardiomegaly. There is again seen bilateral pleural effusions, left greater than right, unchanged. Small amount of loculated fluid within the right mid lung field is unchanged. There are no pneumothoraces. " 098430ac-262dc54f-9f70f2d1-9f633442-d8feccb8.jpg,validate/p12/p12468629/s54411232/098430ac-262dc54f-9f70f2d1-9f633442-d8feccb8.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Weakness and elevated white blood cell count. COMPARISON: ___. FINDINGS: Patient is status post median sternotomy and CABG. Fractured superior most wire is again seen. Cardiac and mediastinal silhouettes are stable with the cardiac silhouette mildly enlarged. Small right-sided pleural effusion is again seen, which is likely chronic. Overlying right base opacity may be due to overlying atelectasis, but is concerning for pneumonia given the clinical scenario. Left lung is clear. There is no left pleural effusion. No evidence of pneumothorax is seen. IMPRESSION: Again seen small right pleural effusion, which may be chronic. Overlying right base opacity pneumonia vs atelectasis; given clinical scenario, pneumonia is of concern. Stable cardiomediastinal silhouette. " 95cd2b39-95121fbb-22bd60ab-d99b8ff7-31655030.jpg,validate/p14/p14740322/s59201267/95cd2b39-95121fbb-22bd60ab-d99b8ff7-31655030.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with status epilepticus // Interval change; intubated Interval change; intubated IMPRESSION: Comparison the ___. No relevant change is noted. Monitoring and support devices are stable. Minimal atelectasis at the right lung basis. No pneumonia, no pulmonary edema, no pleural effusions. " af5618d6-e0021048-c45ad57e-7dbafc25-4d4209c2.jpg,validate/p11/p11459626/s58049103/af5618d6-e0021048-c45ad57e-7dbafc25-4d4209c2.jpg,validation," FINAL REPORT INDICATION: History of cholangitis, now with fever and abdominal pain, here to evaluate for pneumonia. COMPARISON: Chest radiograph, last performed on ___. TECHNIQUE: AP upright radiographs and lateral radiograph of the chest. FINDINGS: Diffuse mild interstitial opacities are slightly increased from the most recent prior study of ___. Increased opacification of the right lung base is noted. The lung volumes remain low. No pneumothorax is detected. Blunting of the bilateral costophrenic angles is compatible with small bilateral pleural effusions. The mediastinal and hilar contours are unchanged. The aortic knob remains densely calcified. A prosthetic aortic valve is again noted and unchanged in position. The patient is status post median sternotomy with wires appearing intact. Dense mitral annular calcifications are again noted. IMPRESSION: Chronic interstitial abnormality could represent edema or fibrosis. Possible superimposed consolidation in the right lung base. Small bilateral pleural effusions. " 1c5763e0-d13efdf9-373927d6-1e1f67ff-db63aad1.jpg,validate/p14/p14513439/s58965863/1c5763e0-d13efdf9-373927d6-1e1f67ff-db63aad1.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with dizziness, evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. Linear opacity at the left lung bases consistent with atelectasis. There is no focal lung consolidation. IMPRESSION: No evidence of pneumonia. " 94137f75-9b4332b1-da256f30-18266f20-ac250635.jpg,validate/p11/p11129702/s50871084/94137f75-9b4332b1-da256f30-18266f20-ac250635.jpg,validation," FINAL REPORT HISTORY: Fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. Aorta is mildly tortuous. The pulmonary vasculature is normal and the hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is seen. The pulmonary vasculature is normal. Clips are demonstrated within the right upper quadrant of the abdomen. IMPRESSION: No acute cardiopulmonary abnormality. " 8790de86-b765405d-c51f88cf-67903955-e7e0fa2a.jpg,validate/p15/p15439394/s56918100/8790de86-b765405d-c51f88cf-67903955-e7e0fa2a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with rales on exam // Rales on exam - CT shows NSIP. CXR pulmonary edema, she is hypoxic, please assess extent of pulmonary edema. Rales on exam - CT shows NSIP. CXR pulmonary edema, she is hypoxic, please assess extent of pulmonary edema. COMPARISON: Comparison to ___ 04:41 FINDINGS: PA and lateral views of the chest ___ at 11:07 is submitted. IMPRESSION: There is a persistent bilateral interstitial and airspace process throughout the lungs but with relative sparing of the apices. When compared to the most recent comparison of ___, there is overall improved aeration suggesting that the superimposed edema is resolving. However, when compared to ___, there is still likely mild pulmonary edema superimposed on the known interstitial lung disease. Overall cardiac and mediastinal contours are stable. No pneumothorax or large effusions. There is a left humeral prosthesis Rounded calcific opacities overlying the right scapula likely represent loose bodies. " 24da6a0d-1117385d-89a27012-ca68f298-317d7ba0.jpg,validate/p17/p17055354/s59776382/24da6a0d-1117385d-89a27012-ca68f298-317d7ba0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lymphoma s/p thoracentesis for pleural effusion. // ?PTX ?PTX IMPRESSION: Comparison to ___, 10:51. Status post left thoracocentesis. The pre-existing small left pleural effusion has almost completely resolved. No evidence of pneumothorax. Slightly improved ventilation of the left lung base. No other relevant changes. " fd228853-2df84977-18361e36-f22ccc25-7d9a4046.jpg,validate/p14/p14171423/s50659042/fd228853-2df84977-18361e36-f22ccc25-7d9a4046.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bilat pleural effusions, recent history of pulmonary embolism, status post chest tube placement. TECHNIQUE: Portable chest x-ray. COMPARISON: CT chest dated ___. FINDINGS: Right chest port and pacer lead are unchanged. There has been interval placement of right sided pigtail catheter at the right mid lung. Bilateral pleural effusions have decreased since CT dated ___. Cardiomediastinal silhouette is unchanged. IMPRESSION: Small residual right pleural effusion, status post drainage catheter placement. " a36f33c8-ccd9e145-614e1fd3-6086475c-226d5000.jpg,validate/p15/p15173403/s56594851/a36f33c8-ccd9e145-614e1fd3-6086475c-226d5000.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of fall on ___. Evaluate rib fractures. 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 ___. PA and lateral chest views were obtained with patient in upright position. The heart size is stable showing a relative prominence of the left ventricular contour, but no signs of left atrial enlargement or pulmonary congestion. Appearance of thoracic aorta with general widening and moderate elongation unchanged. The previously described multiple right-sided rib fractures with considerable displacement remain unchanged in position; however, the surrounding soft tissue prominences have regressed markedly. There remains a mild blunting of the right lateral pleural sinus, likely representing scar formations now. The thickening of the lower right lateral pleural space along the chest wall has regressed considerably. There is no evidence of new pulmonary abnormalities. The left hemithorax remains unchanged without evidence of new abnormalities. Unchanged position of previously described multiple right-sided displaced rib fractures but regression of soft tissue thickenings indicating healing. No new pulmonary or cardiovascular abnormalities are identified. " 41bc29d2-350f5bb7-e899ee37-10fa7b84-cab55924.jpg,validate/p10/p10175233/s50344856/41bc29d2-350f5bb7-e899ee37-10fa7b84-cab55924.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with chronic cough, persists despite multimodality therapy. Had unremarkable CXR in ___ // Any lesion on CXR that might explain cough? TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiograph from ___, ___, ___. FINDINGS: The lungs are mildly hyperinflated. There is no pulmonary edema, pneumonia, pneumothorax, or pleural effusion. The cardiomediastinal silhouette, hila, and pleural surfaces are unchanged. Mild leftward tracheal deviation may suggest thyromegaly. IMPRESSION: 1. No acute cardiopulmonary process. No new lesions are identified. " 6812a988-da0c9233-b2301f38-b1953fd2-4bf47d1f.jpg,validate/p14/p14280192/s59095800/6812a988-da0c9233-b2301f38-b1953fd2-4bf47d1f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p OGT placement s/p OGT placement IMPRESSION: In comparison with the study ___ ___, a view of the abdomen shows that the nasogastric tube extends to the antrum. Little overall change in the appearance of the heart and lungs. " a1428c5e-4e69dac3-b2cf7c6a-91b11def-b57a35da.jpg,validate/p15/p15179179/s50872961/a1428c5e-4e69dac3-b2cf7c6a-91b11def-b57a35da.jpg,validation," 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. " 85bc21bb-b0d94e91-b7b9184b-c391eb62-066aa65b.jpg,validate/p13/p13751863/s53530461/85bc21bb-b0d94e91-b7b9184b-c391eb62-066aa65b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest pain, evaluation for intrapulmonary process. COMPARISON: ___. FINDINGS: An ovalary structure now seen on the frontal radiograph reflects an intrafissural portion of right pleural effusion, as documented on the lateral image. The structure is not a mass. The pleural effusion on the right has minimally increased. Left and right atelectasis are seen in unchanged manner. No evidence of acute lung changes. Normal size of the cardiac silhouette. No pneumothorax. No evidence of pneumonia. " 08d38061-08dc5c49-97c5124a-58f0a02b-1f6b7e22.jpg,validate/p11/p11115360/s52090201/08d38061-08dc5c49-97c5124a-58f0a02b-1f6b7e22.jpg,validation," FINAL REPORT INDICATION: ___ year old man with old smoking history and more shortness of breath. // ? lesions TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and chest radiograph from ___ FINDINGS: Paucity of the vessels, particularly in the upper lobes, are suggestive of emphysema. The lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. Median sternotomy wires are unchanged since ___. IMPRESSION: Stable emphysema. No evidence of pneumonia. No acute cardiopulmonary process. " 4f5f70f1-9e997a98-fcde4be4-41c238b7-297b85b0.jpg,validate/p14/p14864908/s56091785/4f5f70f1-9e997a98-fcde4be4-41c238b7-297b85b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx asthma, DM, pericardial effusion, now with cold sxs x 3 d, cough, sob, ; diffuse wheezes , rhonchi, few carackles left base // r/o pNA r/o pNA IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal in size or slightly enlarged. No vascular congestion, pleural effusion, or acute focal pneumonia. " a74ed116-346acbff-2d713d0e-1fb158e5-2c7db689.jpg,validate/p17/p17396841/s54232796/a74ed116-346acbff-2d713d0e-1fb158e5-2c7db689.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with worsening shortness of breath found to have NSTEMI // Please evaluate for pulmonary edema Please evaluate for pulmonary edema IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with pulmonary vascular congestion. The hemidiaphragms are more sharply seen, which could represent decreased pleural effusion or merely a more erect position of the patient. Asymmetric opacification at the left base, possibly with air bronchograms, could raise the possibility of superimposed pneumonia in the appropriate clinical setting. " 7c21c774-371a4306-6abe8fd9-46aa020b-0e7791ea.jpg,validate/p10/p10074556/s52494638/7c21c774-371a4306-6abe8fd9-46aa020b-0e7791ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___M with hx pancreatitis w/pancreatic divisum, now admitted w/necrotizing pancreatitis, subsequently found to have SBO on CT scan, s/p exlap, LOA, drainage pancreatic abscess, now with tachycardia ___0, febrile // pneumonia, pulmonary process COMPARISON: Chest radiograph ___ through ___. IMPRESSION: A left PIC line ends close to the superior cavoatrial junction. Lung volumes are low but no focal pulmonary abnormality is seen. There is no pulmonary edema or pleural effusion. Heart size is normal. Widening of the mediastinum is largely due to venous engorgement. " 481b6c95-e118e414-ba10bbe7-9bd6eb9e-7560d36d.jpg,validate/p15/p15951127/s53268068/481b6c95-e118e414-ba10bbe7-9bd6eb9e-7560d36d.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: Radiograph of earlier the same day. FINDINGS: Endotracheal tube is in standard position, but cuff appears slightly overdistended as discussed during ICU rounds with Dr. ___ at 8:55 am on ___ at the time of discovery. Cardiac silhouette is upper limits of normal in size. Interval rapid worsening of bilateral predominantly perihilar airspace opacities, which may be due to a combination of pulmonary edema and aspiration. Moderate bilateral pleural effusions have increased in size. " ff7ea320-706d1234-4d80e99a-462e66ab-f423ac2b.jpg,validate/p15/p15568805/s50861566/ff7ea320-706d1234-4d80e99a-462e66ab-f423ac2b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with status, intubuated in ed, altered ms // confirm tube placement TECHNIQUE: AP upright COMPARISON: None FINDINGS: Single AP portable chest radiograph demonstrates an endotracheal tube which terminates approximately 1.3 cm above the level of the carina for which repositioning is advised. An enteric tube descends the thorax in an uncomplicated course, its terminal tip not imaged. A right ureteral stent is looped within the expected location of the renal pelvis projecting over the right upper quadrant. Cardiomediastinal and hilar contours are stable. Hilar congestion with mild pulmonary edema noted. There is no large pleural effusion. There is no pneumothorax. IMPRESSION: Endotracheal tube low in position for which repositioning is advised. Mild edema. Note that study was performed on ___ and reviewed on ___ due to error in transcription. " 7ef65999-99b4580f-364a4f9b-c344489a-89baf666.jpg,validate/p10/p10487009/s56900095/7ef65999-99b4580f-364a4f9b-c344489a-89baf666.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with removal of chest tubes // eval for PTX eval for PTX IMPRESSION: Comparison to ___, 08:52. The chest tubes have been removed. There is no left pneumothorax. On the right, a 1-2 mm apical pneumothorax is visualized. No evidence of tension. Normal size of the heart. No pulmonary edema. No pleural effusions. " 72cb44a4-805a1d17-e0fb2714-79a601fd-489c9a45.jpg,validate/p13/p13877204/s51513996/72cb44a4-805a1d17-e0fb2714-79a601fd-489c9a45.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of AML, worsening dyspnea, rule out acute process. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, pre-existing minimal basal opacities bilaterally have completely resolved. Currently, there is no evidence of pneumonia or other acute lung change. No pulmonary edema. No pleural effusion, no pneumothorax. Borderline size of the cardiac silhouette. Moderate tortuosity of the thoracic aorta. Unchanged left pectoral pacemaker. " 0b242c23-3dda0d51-03ee0df6-8a83bc7e-244476a2.jpg,validate/p13/p13272752/s55862914/0b242c23-3dda0d51-03ee0df6-8a83bc7e-244476a2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval COMPARISON: ___. IMPRESSION: As compared to the previous image, the extent of the existing fluid or pneumothorax on the left has increased despite drainage of the pathology. Unchanged appearance of the heart and of the right lung. " 339d1ff7-9834670e-63e64fd4-cb6b7fb3-0ccdf023.jpg,validate/p16/p16861367/s50445147/339d1ff7-9834670e-63e64fd4-cb6b7fb3-0ccdf023.jpg,validation," FINAL REPORT HISTORY: 0 large subarachnoid hemorrhage now in vasospasm. COMPARISON: ___. FINDINGS: Compared to prior study there is no significant interval change. IMPRESSION: No change. " 15868612-626b66e8-c82f6132-b51e847b-4eb15b63.jpg,validate/p15/p15352109/s51991192/15868612-626b66e8-c82f6132-b51e847b-4eb15b63.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Left lower lobe pneumonia, followup. COMPARISON: ___. AP chest radiograph. Heart size is normal. Mediastinum is normal. The lung opacification is clear with almost entire resolution of right lower lobe pneumonia. There is no pleural effusion or pneumothorax. Hyperinflation is suspected on the lateral view. Repeated radiograph in four weeks for documentation of complete resolution is recommended. " 7e7936c2-dc8d1936-3b47c32d-f87e45b2-2925e1b6.jpg,validate/p15/p15038855/s58857299/7e7936c2-dc8d1936-3b47c32d-f87e45b2-2925e1b6.jpg,validation," WET READ: ___ ___ ___ 1:17 AM Low lung volumes with bibasilar atelectasis. New right lower lobe opacity likely represents atelectasis however superimposed infection cannot be excluded. The findings were discussed with Dr.___, M.D. by ___, M.D. on the telephone on ___ at 1:15 AM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p C-section c/b preeclampsia and endometritis, now with fever, tachycardia. RLL crackles noted on exam. // please eval for PNA, pulmonary edema please eval for PNA, pulmonary edema IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lung volumes are chronically low. Pulmonary vascular engorgement and slight cardiomegaly are consistent with late pregnancy. Opacification of both lower lungs medially could be due to atelectasis alone. There is probably no pulmonary edema or appreciable pleural effusion. " 193055f1-e64091f1-31808630-7da7139b-36a4d50d.jpg,validate/p10/p10952022/s51815553/193055f1-e64091f1-31808630-7da7139b-36a4d50d.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of fall, head injury. COMPARISON: ___ FINDINGS: Frontal and lateral views of the chest were obtained. No large pleural effusion, or pneumothorax is seen. The cardiac silhouette is not enlarged. The mediastinal and hilar contours are unremarkable and stable since the prior chest radiograph of ___. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " fb60d0b3-2ae1d195-83ea6086-d4c20d2b-ae83d6b2.jpg,validate/p18/p18847764/s51665249/fb60d0b3-2ae1d195-83ea6086-d4c20d2b-ae83d6b2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: CHEST, RIB PAIN IMPRESSION: Compared to chest radiographs since ___ most recently ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . No rib lesion or displaced fracture seen. Focal findings in the chest wall would need to be marked to direct attention to specific ribs. " d671106b-e3a0e92e-64bbb05c-f3ad99ae-1eda53f7.jpg,validate/p16/p16514111/s57510714/d671106b-e3a0e92e-64bbb05c-f3ad99ae-1eda53f7.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with SOB on exertion, lower extremity edema // Eval fluid overload TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is a small right pleural effusion and trace left pleural effusion. Mild to moderate interstitial edema. Right lower lobe opacity is seen, which may relate to fluid overload, however, pneumonia may be present in the appropriate clinical setting. Peribronchial thickening is also seen. The mediastinal contours unremarkable. The cardiac silhouette is mild to moderately enlarged. IMPRESSION: Small right and trace left pleural effusions. Enlarged cardiac silhouette. Mild to moderate interstitial edema. Right base opacity may relate to fluid overload, however, consolidation due to pneumonia may be present in the appropriate clinical setting. " fe8f025a-41325e4c-e090af91-42307d14-f94a0816.jpg,validate/p11/p11210828/s57540557/fe8f025a-41325e4c-e090af91-42307d14-f94a0816.jpg,validation," FINAL ADDENDUM ADDENDUM Additional information has been obtained from ___ Clinical Lookup since the approval of the original report. Reason for exam should also state nausea. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old female with ""acute process"". 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. Osseous structures are without an acute abnormality. Imaged upper abdomen is unremarkable. IMPRESSION: No acute intrathoracic abnormality. " 78ca5bf7-9af12524-0cd2bd0f-466c301c-5278ce0c.jpg,validate/p16/p16662264/s58623741/78ca5bf7-9af12524-0cd2bd0f-466c301c-5278ce0c.jpg,validation," WET READ: ___ ___ 7:17 PM RML opacity has become more confluent with a new right effusion. a small left sided ill-defined opacity slightly obscures the cardiac apex and is concerning for an addtional focus of infection likely within the lingula. a small left effusion may also be present. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Renal transplant with multifocal pneumonia with new left-sided pleuritic chest pain. REFERENCE EXAM: Chest x-ray from ___ and CT from ___. FINDINGS: Again seen is the right middle lobe infiltrate. There is also left lingular infiltrate that is slightly increased in conspicuity compared to prior. There are small bilateral pleural effusions that have increased compared to prior. The patchy upper lobe infiltrate seen on CT is not as well visualized on the chest x-ray. IMPRESSION: Bilateral pneumonia with increased effusion. " 091c12bb-042d75e1-aec6f7f3-3cc38e95-6c29616d.jpg,validate/p16/p16590876/s52817041/091c12bb-042d75e1-aec6f7f3-3cc38e95-6c29616d.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with presyncope. COMPARISON: Multiple prior exams, most recently of ___. FINDINGS: Frontal and lateral views of the chest. Bilateral calcified granulomas are unchanged. No focal consolidation, pleural effusion, or pneumothorax. Mild cardiac enlargement is similar to prior. Aortic calcifications are unchanged. The mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. Stable mild cardiomegaly. " d2c5e504-c3c391b8-602b0072-515c1ea4-d651eb51.jpg,validate/p17/p17175688/s53329655/d2c5e504-c3c391b8-602b0072-515c1ea4-d651eb51.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chr shortness of breath // eval for pna vs pulmonary edema TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___, ___, ___ FINDINGS: In comparison to the most recent examination, the cardiomediastinal silhouette and pulmonary vasculature are stable. Again seen is mild cardiomegaly. The hila are congested. Minimal peripheral vascular indistinctness is noted, slightly greater than on most recent examination. Possible basilar septal lines are noted. Fissural fluid is seen. No definite consolidation is identified. There is no pleural effusion or pneumothorax. IMPRESSION: Mild pulmonary edema. Cardiomegaly " 21d55c60-f71e9242-7d3e79d3-6a758bac-54e2e217.jpg,validate/p16/p16898765/s50006260/21d55c60-f71e9242-7d3e79d3-6a758bac-54e2e217.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with syncope // Please eval for pna COMPARISON: None. FINDINGS: Compared with ___, I doubt significant interval change. No focal infiltrate to suggest pneumonia is identified. Again seen is COPD, mild cardiomegaly, prominent pulmonary arteries, vascular plethora, bibasilar atelectasis and/or scarring, and an eventrated right hemidiaphragm. The previously seen posterior left effusion is smaller, and there is residual blunting of both costophrenic angles. Osteopenia, compression fractures, hand sites of vertebroplasty are again noted. IMPRESSION: No focal infiltrate identified to suggest pneumonia. Extensive chronic changes appear stable. " 38c92e03-3c514919-383fc0e5-e396e4b5-96a21a01.jpg,validate/p13/p13802517/s56201355/38c92e03-3c514919-383fc0e5-e396e4b5-96a21a01.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with autonomic failure reporting chest pain // reporting chest pain TECHNIQUE: Single frontal view of the chest COMPARISON: Chest radiograph ___, ___. FINDINGS: Cardiomediastinal silhouette is unremarkable. There is no pulmonary edema or focal consolidation. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary abnormality. " f48ea612-610fb64a-18fb3068-87dfb6ce-d23b79b7.jpg,validate/p18/p18938959/s58163140/f48ea612-610fb64a-18fb3068-87dfb6ce-d23b79b7.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with lung cancer, question pneumonia. COMPARISONS: PA and lateral chest radiographs from ___. ___ CT ___. TECHNIQUE: PA and lateral radiographs are provided. FINDINGS: There is no pleural effusion or pneumothorax. Increased retrocardiac opacity is noted. A left bronchial stent is in place. Rounded opacity in right upper lobe is unchanged. Other previously noted solid and ground glass nodules in the lungs are better visualized on the prior CT. Cardiomediastinal silhouette is otherwise unchanged, with similar widening compatible with lymphadenopathy. Known left hilar mass is better visualized on prior CT. Bony structures are unremarkable. IMPRESSION: 1. Increasing retrocardiac opacity, possibly related to atelectasis or infection. 2. Unchanged left hilar mass, nodular opacity in the right lower lobe, and mediastinal and right hilar lymphadenopathy, all of which are better seen on the prior CT. " e9b61670-f84e5067-a6e72ace-6f7b6b01-e284813e.jpg,validate/p16/p16196296/s52593276/e9b61670-f84e5067-a6e72ace-6f7b6b01-e284813e.jpg,validation," FINAL REPORT INDICATION: Chest pain, productive cough. COMPARISON: Chest radiographs ___ and ___. PA AND LATERAL VIEWS OF THE CHEST: The cardiac silhouette size is mildly enlarged but unchanged. The mediastinal and hilar contours are normal. There is subtle hazy opacification within the left lung base, which may reflect an area of atelectasis or developing infection. No definite pleural effusion or pneumothorax is seen. Pulmonary vascularity is normal. There are no acute osseous findings. IMPRESSION: Subtle opacity within the left lung base, which could reflect an area of atelectasis though infection cannot be excluded. " 12d1f4a4-8c6a2b87-03ff5851-74f7e68d-486e284f.jpg,validate/p18/p18326030/s56662966/12d1f4a4-8c6a2b87-03ff5851-74f7e68d-486e284f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion and chest tube // interval changes interval changes IMPRESSION: A right pneumothorax is small but minimally increased compared to previous examination. Right basal consolidation is there is EGA of drain pleural effusion. Left basal opacity is minimal but increased since the prior study. There is no left pneumothorax. Heart size and mediastinum are stable. RECOMMENDATION(S): The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 9:11 AM, 3 minutes after discovery of the findings. " 97e25810-c49c7809-10637ef4-114fe508-d288b861.jpg,validate/p10/p10461044/s57355219/97e25810-c49c7809-10637ef4-114fe508-d288b861.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post CABG. Comparison is made with prior study ___. Cardiomegaly and widened mediastinum are unchanged. There are persistent lower lung volumes. Small left pleural effusion is probably unchanged. Small right pleural effusion is new or newly apparent. There is mild increase in mild vascular congestion. Bibasilar atelectases have worsened in the left side. Right IJ catheter sheath tip is in upper SVC. It is kinked at the skin entrance. Sternal wires are aligned. " fb26ec2b-cfdb2ac5-af486774-1d9926d4-34554df3.jpg,validate/p12/p12754187/s50028735/fb26ec2b-cfdb2ac5-af486774-1d9926d4-34554df3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cough, increasing )2 requirement // interval change interval change IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits of normal in size. Mild indistinctness of pulmonary vessels is consistent with some elevation of pulmonary venous pressure. Opacification at the left base with silhouetting of the hemidiaphragm most likely reflect pleural effusion and volume loss in the lower lobes. However, in the appropriate clinical setting, superimposed pneumonia would have to be seriously considered. " 243ad9ca-32cb7abb-bd4dcb6e-1d02e75f-f5e773ac.jpg,validate/p19/p19023232/s50567162/243ad9ca-32cb7abb-bd4dcb6e-1d02e75f-f5e773ac.jpg,validation," FINAL REPORT INDICATION: ___F with syncopal episode // evaluate for pneumonia, fluid overload COMPARISON: Multiple prior exams, most recently chest CT of ___ and chest radiograph of ___. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: Large bore right-sided catheter terminates in the right atrium. Heart size and mediastinal contours are normal. Aortic knob calcification is unchanged. Lungs are clear without pleural effusion, focal consolidation, or pneumothorax. IMPRESSION: No focal consolidation or pleural effusion. Right tunneled catheter terminates in the right atrium. " 7bcc9e32-59209c86-cd09da6d-4ae14295-257ad4c1.jpg,validate/p10/p10219031/s57147178/7bcc9e32-59209c86-cd09da6d-4ae14295-257ad4c1.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Fall, with chest wall pain. 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, as are the hilar contours. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 8935368d-65e84b73-5fd99015-9b372980-9e9fde4c.jpg,validate/p14/p14957416/s52421451/8935368d-65e84b73-5fd99015-9b372980-9e9fde4c.jpg,validation," WET READ: ___ ___ ___ 9:05 AM Normal chest radiograph. Specifically no free intraperitoneal air. WET READ VERSION #1 ___ ___ ___ 5:35 AM No acute cardiopulmonary process. Specifically no free intraperitoneal air. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old man with epigastric pain, nausea, and vomiting. Assess for free air under the diaphragm TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: Lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart is top-normal in size. Mediastinal contour and hila are unremarkable. Limited assessment of the upper abdomen is unremarkable. No free intraperitoneal air. IMPRESSION: Normal chest radiograph. Specifically no free intraperitoneal air. " b9c89b5e-f64d3bb9-6f001fa5-b14c7aab-9e845a85.jpg,validate/p16/p16861367/s52820175/b9c89b5e-f64d3bb9-6f001fa5-b14c7aab-9e845a85.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with subarachnoid hemorrhage, for assessment of the ET tube. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 8 cm above the carina. The NG tube tip is in the stomach. The left subclavian line tip is at the level of mid SVC. Heart size and mediastinum are unremarkable. Substantial emphysema and bibasilar interstitial opacities/fibrosis appear to be unchanged as compared to ___. No interval increase in pleural effusion and no interval development of pneumothorax is seen. " 09ed44a6-c93474ad-3d576f2d-c9d79175-efa0b077.jpg,validate/p17/p17430165/s52113806/09ed44a6-c93474ad-3d576f2d-c9d79175-efa0b077.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent episodes of exertional CP and DOE. h/o AFib, Cholesterol // r/o underlying pathology r/o underlying pathology IMPRESSION: In comparison with the study of ___, there is little change. Mild hyperexpansion of the lungs suggests underlying chronic pulmonary disease. However, no acute pneumonia, vascular congestion, or pleural effusion. Dual channel pacer device remains in place with leads in the right atrium and apex of the right ventricle. Of incidental note is again an old healed fracture of the right clavicle. " acac98d9-9d8a8b6b-709afd59-cdb9ded2-636fbe39.jpg,validate/p19/p19062997/s56152700/acac98d9-9d8a8b6b-709afd59-cdb9ded2-636fbe39.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, 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. " 39ad7d8d-aa1af1dc-d4ac4255-5e882d97-da0a8ab8.jpg,validate/p16/p16002684/s53427748/39ad7d8d-aa1af1dc-d4ac4255-5e882d97-da0a8ab8.jpg,validation," 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. " b500809a-bcfad02d-040bfbe9-bdca702c-f021119d.jpg,validate/p12/p12948123/s52391528/b500809a-bcfad02d-040bfbe9-bdca702c-f021119d.jpg,validation," 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. " de130f42-98da840f-975a0d74-9a1e3b73-03f8f177.jpg,validate/p16/p16002684/s58671188/de130f42-98da840f-975a0d74-9a1e3b73-03f8f177.jpg,validation," WET READ: ___ ___ ___ 1:35 AM 1. Left basilar opacity may reflect a combination of pleural effusion and atelectasis, although infection is not excluded. 2. Heterogeneous right basilar opacity may represent atelectasis, aspiration, or pneumonia in the appropriate clinical setting. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with sepsis // stat TECHNIQUE: Portable semi-upright chest radiograph. COMPARISON: None. FINDINGS: There are low lung volumes, with resultant bronchovascular crowding. Note is made of a large hiatal hernia. Left basilar opacity likely reflects a combination of pleural effusion and consolidation. There is a heterogeneous opacity at the right base. No pneumothorax. Elliptical opacity with a sharp medial margin projects over the right midlung at the level of the seventh posterior interspace, probably pleural loculation or focal pleural thickening. IMPRESSION: 1. Left basilar opacity may reflect a combination of pleural effusion and consolidation, although infection is not excluded. 2. Heterogeneous right basilar opacity may represent atelectasis, aspiration, or pneumonia in the appropriate clinical setting. 3. Focal right pleural thickening, possibly involving major fissure. RECOMMENDATION(S): Obtain prior chest or right rib radiographs as a first step in evaluating right pleural abnormality, in order to exclude a mass. NOTIFICATION: ED QA nurses notified of revision by email. " 7e05df42-77c60edb-0c6a3d31-cbe1f1e2-0a05913c.jpg,validate/p14/p14642407/s51730690/7e05df42-77c60edb-0c6a3d31-cbe1f1e2-0a05913c.jpg,validation," 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. " bd7c1df6-b39324f5-f4d31fb1-43ebaccf-f65d7a70.jpg,validate/p16/p16289299/s51278428/bd7c1df6-b39324f5-f4d31fb1-43ebaccf-f65d7a70.jpg,validation," WET READ: ___ ___ ___ 12:11 PM Mildly hypoinflated lungs, otherwise normal chest radiograph. No evidence of pulmonary edema. WET READ VERSION #1 ___ ___ ___ 11:52 AM Mildly hyperinflated lungs, otherwise normal chest radiograph. No evidence of pulmonary edema. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with dyspnea, hx of chf. Assess for worsening pulmonary edema. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrate mildly hypoinflated lungs with vascular crowding and patchy atelectasis. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. No focal opacity. IMPRESSION: Mildly hypoinflated lungs, otherwise normal chest radiograph. No evidence of pulmonary edema. " 8ec382ca-3948c808-4ad464aa-1913aa44-f07efcbf.jpg,validate/p15/p15232493/s53525200/8ec382ca-3948c808-4ad464aa-1913aa44-f07efcbf.jpg,validation," FINAL REPORT HISTORY: Crackles and decreased oxygen saturation. FINDINGS: In comparison with the study of ___, there is continued pulmonary edema with enlargement of the cardiac silhouette. The tip of the PICC line has been pulled back to the lower portion of the SVC. " 9e087d29-a4308702-126699ce-13ebb167-cdc5ce47.jpg,validate/p17/p17649973/s57954884/9e087d29-a4308702-126699ce-13ebb167-cdc5ce47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with SLE presents with fever, abdominal pain, any infectious intrathoracic source? 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. " 476c216a-bb4e6726-4a8e1a83-f174c374-ea423ede.jpg,validate/p17/p17051420/s57554948/476c216a-bb4e6726-4a8e1a83-f174c374-ea423ede.jpg,validation," FINAL REPORT EXAMINATION: AP and lateral images of the chest. INDICATION: History: ___M with chest pain // eval for cardiopulmonary process TECHNIQUE: AP and lateral images of the chest. COMPARISON: Comparison is made chest radiographs from ___ and ___. FINDINGS: The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart is top normal in size. IMPRESSION: No acute cardiopulmonary process. " e0aa1512-959a8409-0edd437a-75cba38d-0c04529d.jpg,validate/p19/p19601036/s54513711/e0aa1512-959a8409-0edd437a-75cba38d-0c04529d.jpg,validation," WET READ: ___ ___ ___ 9:02 AM Dobhoff tube is appropriately coiled within the stomach. WET READ VERSION #1 ___ ___ ___ 1:07 AM Dobhoff tube is appropriately coiled within the stomach. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman s/p CABG // eval dobhoff FINDINGS: Since the previous radiograph of several hours earlier, a Dobbhoff tube has been replaced and coils within the stomach, with distal tip directed cephalad. Moderate bilateral pneumothoraces are in retrospect unchanged from the prior radiograph, with bilateral chest tubes in place. Cardiomediastinal contours are stable. Interval improvement in extent of bibasilar atelectasis. Persistent small bilateral pleural effusions. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___ on the telephone on ___ at 9:02 AM, 30 minutes after discovery of the findings. " 466dcdc9-a30f6929-e901c28c-f87b82bf-31b3ed1d.jpg,validate/p10/p10401318/s59030330/466dcdc9-a30f6929-e901c28c-f87b82bf-31b3ed1d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with f/u PNA // compare with ___ TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The previously noted right lower lobe pneumonia has resolved. No new areas of airspace consolidation. No pulmonary edema. No cardiomegaly. Surgical clips in the upper abdomen. Bilateral, fairly symmetrical apical pleural thickening. IMPRESSION: The previously noted right lower lobe pneumonia has resolved " a6eeb29e-804fb989-983690e3-ab869095-7ecc43a3.jpg,validate/p11/p11245558/s54920705/a6eeb29e-804fb989-983690e3-ab869095-7ecc43a3.jpg,validation," WET READ: ___ ___ ___ 9:22 PM Low lung volumes without radiographic evidence for acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: Evaluation for transplantation. FINDINGS: No previous images. The heart is normal in size and the lungs are clear without vascular congestion or pleural effusion. " 7eb494f2-6a699679-55750de4-8361e10d-9a576360.jpg,validate/p19/p19870522/s56973532/7eb494f2-6a699679-55750de4-8361e10d-9a576360.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with left shoulder pain, question pneumothorax. COMPARISON: Multiple priors most recently from ___. FINDINGS: No evidence of pneumothorax. Mediastinal and hilar contours are normal. Volumes are persistently low, however, lungs appear stable with focal linear opacities at the bases that likely represent atelectasis. No pleural effusion is seen. No free air under the diaphragms. IMPRESSION: No evidence of pneumothorax. Persistently low lung volumes with bibasilar atelectasis. " e2161093-ea122b73-7a72fac0-d13af370-cc00f797.jpg,validate/p17/p17984444/s54511211/e2161093-ea122b73-7a72fac0-d13af370-cc00f797.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Confusion, question pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. The lung volumes are low with streaky lower lung atelectasis noted, best on lateral view. There is no effusion or pneumothorax. No convincing signs of pneumonia. The cardiomediastinal silhouette is within normal limits. The bony structures are stable with redemonstration of a compression deformity at the thoracolumbar junction as compared with a prior radiograph from ___. IMPRESSION: Streaky lower lung atelectasis without convincing signs of pneumonia. " 7bf8d4d3-8bb99a4d-7f6953cc-8f138ac4-0efcfb54.jpg,validate/p11/p11971081/s57168104/7bf8d4d3-8bb99a4d-7f6953cc-8f138ac4-0efcfb54.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with recurrent pleural effusions, status post PleurX catheter placement, here to evaluate for interval changes. COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The appearance of the chest is overall unchanged. A left Port-A-Cath terminates in the right atrium. A right PleurX catheter extends to the right lung apex without pneumothorax. There is a persistent small-to-moderate right pleural effusion with fluid extending into the minor fissure and underlying atelectasis, unchanged. A trace left pleural effusion is also noted. The left lung is clear. Bilateral extensive mediastinal and hilar adenopathy is stable. The cardiomediastinal silhouette is incompletely evaluated but does not appear grossly changed. IMPRESSION: Stable appearance of the chest with small to moderate right pleural effusion and trace left pleural effusion compared to ___. " 82724278-0af9928a-b19d88a7-5680a2bc-968940e1.jpg,validate/p12/p12920352/s54379701/82724278-0af9928a-b19d88a7-5680a2bc-968940e1.jpg,validation," FINAL REPORT CHEST TWO VIEWS ___ HISTORY: ___-year-old female with broken leg. Pre-op. FINDINGS: AP 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. " c77a8ffb-f22dbe21-0951ec7a-c88ed498-b64aacef.jpg,validate/p11/p11919168/s50890646/c77a8ffb-f22dbe21-0951ec7a-c88ed498-b64aacef.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral chest radiograph 3 views. COMPARISON: None available. FINDINGS: The heart size is normal. The cardiomediastinal silhouette and hilar contour is unremarkable. The lungs are clear without focal consolidation, effusion or pneumothorax. No acute bony change is identified. IMPRESSION: No acute intrathoracic process. " 0e8bf5f3-4044a572-f60c90d8-22b6e942-c15caa9c.jpg,validate/p13/p13859753/s51186861/0e8bf5f3-4044a572-f60c90d8-22b6e942-c15caa9c.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Woman with increasing dyspnea, cause of dyspnea. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: The lungs are clear. There is no pneumothorax or pleural effusion. Mild cardiomegaly is stable 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. CONCLUSION: There is no significant change since ___. There are no acute cardiopulmonary findings. " c7b0aadd-bd5f99c5-b14d8a80-f1eb032a-27fbb060.jpg,validate/p17/p17620982/s55920538/c7b0aadd-bd5f99c5-b14d8a80-f1eb032a-27fbb060.jpg,validation," FINAL REPORT INDICATION: ___-year-old female patient with pulmonary edema and pleural effusion status post thoracentesis. 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 from ___, there has been interval decrease of large right pleural effusion. Consolidation in the left lung has improved, likely reflective of a combination of atelectasis and edema. There is mild pulmonary edema. Cardiomegaly is stable. There is no pneumothorax. IMPRESSION: 1. Interval decrease of large right pleural effusion. 2. Improved left lung consolidation, likely due to a combination of atelectasis and edema. " 4ac6c776-cf9be340-7da1c72b-18159656-b72987a1.jpg,validate/p12/p12252602/s50803832/4ac6c776-cf9be340-7da1c72b-18159656-b72987a1.jpg,validation," FINAL REPORT INDICATION: ___ year old man with left sided numbness, ?stroke // R/O pulmonary process, aspiration etc EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: None available. FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Pectus excavatum is again noted. Borderline cardiomegaly may be exaggerated by the pectus excavatum. Mediastinal and hilar silhouettes are normal size. IMPRESSION: Borderline cardiomegaly. Mild to moderate pectus excavatum. Otherwise normal chest. " 92732428-d06bca02-518dd779-fee1c730-840a4696.jpg,validate/p19/p19252503/s57162562/92732428-d06bca02-518dd779-fee1c730-840a4696.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever. // Please evaluate for cause of fever TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ and ___ IMPRESSION: Heart size is top-normal. , unchanged. Tortuous aorta E is unchanged. Lungs are essentially clear. No appreciable pleural effusion or pneumothorax demonstrated. Opacity projecting over the heart on the lateral view is unchanged and most likely reflects extensive fat pad. " 75fdf46a-e644180a-3b853a5b-9166e3f0-8bcb7528.jpg,validate/p15/p15488435/s58716197/75fdf46a-e644180a-3b853a5b-9166e3f0-8bcb7528.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph from ___. CLINICAL HISTORY: ___-year-old female with shortness of breath upon exertion with wheezing, question pulmonary edema or pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. There are small bilateral pleural effusions. A dextroscoliosis of the T-spine is noted. The heart is stable in size. There is a nodular opacity in the right perihilar region which may represent superimposed bony structures though a true pulmonary nodule is difficult to exclude. No pneumothorax is seen. No overt pulmonary edema. Bony structures appear intact. Right AC joint arthropathy is noted. IMPRESSION: Small bilateral pleural effusions. Possible right pulmonary nodule for which non-emergent chest CT is recommended to further assess. " 6678f86b-19b64992-6123cf6a-09f59366-0c730033.jpg,validate/p12/p12978146/s59932625/6678f86b-19b64992-6123cf6a-09f59366-0c730033.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with left humerus fracture. // pre-op TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are hyperinflated. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. Dislocated left shoulder with proximal left humeral fracture, better assessed on left shoulder and humerus radiographs. IMPRESSION: No acute cardiopulmonary process. Left shoulder fracture-dislocation. " a13158d2-ef4d617d-14b48d70-f55fa207-ff812c37.jpg,validate/p12/p12993146/s57270572/a13158d2-ef4d617d-14b48d70-f55fa207-ff812c37.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with delirium // eval ? infiltrate, edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The patient arterial no focal consolidation is seen. No pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 24a0be34-7200a436-fd4ac2fe-c0fda764-3c54f875.jpg,validate/p15/p15147932/s53342396/24a0be34-7200a436-fd4ac2fe-c0fda764-3c54f875.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Persistent dyspnea. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable. Bibasilar opacities are redemonstrated, grossly unchanged since ___. There is no appreciable pleural effusion, but small amount of pleural fluid cannot be excluded. No pneumothorax is seen. No evidence of pulmonary edema is present. " 252179c8-5a1ac200-ef821138-099543cd-c9eb6a2a.jpg,validate/p18/p18031120/s57733597/252179c8-5a1ac200-ef821138-099543cd-c9eb6a2a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cardiogenic shock, PA line // line placement, interval changes line placement, interval changes IMPRESSION: In comparison with the study of ___, there is little change. Again there is substantial enlargement of the cardiac silhouette with little change in the appearance of the Swan-Ganz catheter and pacer lead. No evidence of pulmonary edema or acute focal pneumonia. " 05504a45-a3631ef0-a08eb865-df93ffc6-7396def0.jpg,validate/p17/p17463554/s58056433/05504a45-a3631ef0-a08eb865-df93ffc6-7396def0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SAH, intubated // intubated, serial monitoring intubated, serial monitoring IMPRESSION: Comparison to ___. No relevant change. Monitoring and support devices are stable. No pleural effusions. No pneumonia, no pulmonary edema. Minimal retrocardiac atelectasis. " 989ba2b3-8b0ccea7-e964cae8-43960287-10ffcd0f.jpg,validate/p18/p18545924/s53666167/989ba2b3-8b0ccea7-e964cae8-43960287-10ffcd0f.jpg,validation," 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. " 33e26629-1a629b9a-a36b1791-27d490c7-0cb386f1.jpg,validate/p17/p17437387/s50921522/33e26629-1a629b9a-a36b1791-27d490c7-0cb386f1.jpg,validation," FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old male with right sternoclavicular mass. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: None. FINDINGS: No focal consolidations are seen. There is no pneumothorax or pleural effusions. The heart is normal in size. No significant degenerative change is seen within the osseous structures. There is suggestion of a 4.6 x 2.4 cm soft tissue opacity overlying the mid-to-distal clavicle on the right side and the second and third right ribs - which may correlate with patient's palpable abnormality. No remodeling of the underlying osseous structures is seen. " f3ea765f-94e8db3e-180c279c-03faf770-26d11e3e.jpg,validate/p19/p19398915/s50718354/f3ea765f-94e8db3e-180c279c-03faf770-26d11e3e.jpg,validation," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: History of confusion, presenting with increasing shortness of breath. COMPARISON: ___. FINDINGS: There has been interval, likely increase in large right-sided pleural effusion, given differences in technique. Underlying consolidation is not excluded. There are patchy opacities projecting over the left mid-to-lower lung which could be due to multifocal infection versus less likely edema. The mediastinal and cardiac silhouettes are not well assessed due to the large right-sided opacity from pleural effusion, however, the right aspect of the mediastinum and heart appear unremarkable. No large left pleural effusion is seen. There is no evidence of pneumothorax. IMPRESSION: 1. Interval increase in large right pleural effusion, underlying consolidation cannot be excluded. 2. Patchy opacities in the left mid-to-lower lung raise concern for multifocal infection, aspiration, edema felt less likely. " c4007e14-e41d1162-14ebb779-3842d2b6-cf78e3e8.jpg,validate/p17/p17557505/s59380318/c4007e14-e41d1162-14ebb779-3842d2b6-cf78e3e8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with as above // s/p CABG w/L apical PTX after CT removal-evaluate ?resolution s/p CABG w/L apical PTX after CT removal-evaluate ?resolution IMPRESSION: Compared to prior chest radiographs, ___ through ___. Previous tiny left apical pneumothorax is no longer visible at the apex, but there is a suggestion that it has migrated medially along the upper mediastinum. Mild pulmonary edema and heterogeneous opacification in both lung bases have increased since early on ___. The basal abnormality could be dependent edema and atelectasis, but raises concern for pneumonia. Careful followup advised. The expected postoperative appearance to the cardiomediastinal silhouette is unchanged. " 71dac788-5a1bdb38-8c5712c1-90b53370-9af8a34d.jpg,validate/p10/p10398856/s53330812/71dac788-5a1bdb38-8c5712c1-90b53370-9af8a34d.jpg,validation," 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. " c6906845-92908d8c-8142f886-b995870c-e96692ab.jpg,validate/p18/p18935604/s50948745/c6906845-92908d8c-8142f886-b995870c-e96692ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R thoracotomy, tracheobronchoplasty. // check interval change check interval change IMPRESSION: Compared to chest radiographs ___ through ___. Small right pleural effusion has increased. No pneumothorax. No mediastinal abnormality. Lateral view shows expected posterior wall thickening and luminal indentation of the postoperative trachea. Heart size top-normal, increased since the previous study, accompanied by slight increase in pulmonary vascular caliber but no edema, points to that possible early cardiac decompensation. Left lung clear. " f4712105-836f8d47-2f460149-f2fd2cc3-d4773c2a.jpg,validate/p18/p18919240/s54390492/f4712105-836f8d47-2f460149-f2fd2cc3-d4773c2a.jpg,validation," 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. " 7c343b11-ae5876f1-83590037-e781f9bc-19089004.jpg,validate/p11/p11189718/s59662260/7c343b11-ae5876f1-83590037-e781f9bc-19089004.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with chest/back pain and ?decreased Breath sounds in the right base. History of asthma. Recently returned from trip to ___. // R/O PNA, effusion TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___ CTA chest with and without contrast from ___ FINDINGS: The lungs are clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion, pulmonary edema, pneumothorax, or pneumonia. IMPRESSION: Normal radiographic examination of the chest. " da3e19fd-b3b4c8ce-9e70bc5e-6ba81266-3b663c0c.jpg,validate/p14/p14766138/s51044185/da3e19fd-b3b4c8ce-9e70bc5e-6ba81266-3b663c0c.jpg,validation," FINAL REPORT INDICATION: Lap cholecystectomy on ___ complicated with a bile leak and CBD stent placed. New hypoxemia. Possible atelectasis, pleural effusion, or pneumonia. TECHNIQUE: AP upright and lateral chest radiographs. COMPARISON: Multiple priors, most recently on ___. FINDINGS: A drain overlying the right upper quadrant is noted. There are bilateral pleural effusions, not seen on ___. Atelectasis of the right middle lobe is noted. There is no vascular congestion or pneumothorax. An underlying pneumonia cannot be completely excluded. " 60c60c6e-1471b41d-d8ae011a-299592ea-7c39d5e7.jpg,validate/p10/p10886362/s50301215/60c60c6e-1471b41d-d8ae011a-299592ea-7c39d5e7.jpg,validation," FINAL REPORT HISTORY: Status post AVR. FINDINGS: The endotracheal tube is too high, at the thoracic inlet. This finding was called to the CCU nurse, ___ at 5:00 p.m. at the time of dictating this report by Dr. ___. Otherwise, the appearance of the lungs is unchanged. Pacemaker and left IJ line are unchanged. " 1dbf37ae-2c7e1d9f-c516a85a-90b0e44e-f20b0caa.jpg,validate/p19/p19917992/s51023489/1dbf37ae-2c7e1d9f-c516a85a-90b0e44e-f20b0caa.jpg,validation," FINAL REPORT HISTORY: NG placement. FINDINGS: Nasogastric tube extends well into the stomach, crossing the lower margin of the image in the lower body of organ. The cardiac silhouette is mildly enlarged, but there is no definite vascular congestion, pleural effusion, or acute focal pneumonia. " 04e5c297-c4b14655-baf8fbb6-91387ca0-d7dcee2b.jpg,validate/p16/p16479007/s57798516/04e5c297-c4b14655-baf8fbb6-91387ca0-d7dcee2b.jpg,validation," FINAL REPORT INDICATION: ___M with cough ,weakness. // pneumonia? TECHNIQUE: PA and lateral views 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. " d948c265-8855e0e4-d90cccb9-7dac5e3a-fa08c2d2.jpg,validate/p16/p16907073/s54462184/d948c265-8855e0e4-d90cccb9-7dac5e3a-fa08c2d2.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with acute onset R sided chest and back pain // any PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is somewhat rotated to the right. Patient is status post median sternotomy.Right lower lobe opacity with blunting of the posterior costophrenic angle is worrisome for pneumonia and pleural effusion. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Right lower lobe opacity worrisome for pneumonia and small pleural effusion. Subtle left base opacity may be due to atelectasis. " 082236f2-601635b6-24dc7754-27e3eea9-e1892c40.jpg,validate/p15/p15116019/s52261565/082236f2-601635b6-24dc7754-27e3eea9-e1892c40.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with shortness of breath, recent pulmonary stent placement. Evaluate for evidence of pneumothorax. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The lungs are well expanded. Distal trachea stent is partially visualized. Some streaky opacities along both bases likely represent subsegmental atelectasis. Otherwise, no focal parenchymal opacities are identified. There is no pleural effusion or pneumothorax. Mild cardiomegaly is redemonstrated and not significantly changed from prior. No bony abnormalities are identified. IMPRESSION: No evidence of acute cardiopulmonary process. Mild cardiomegaly. " 5fa77e75-98df5d4f-944a1859-5776bb7a-ca235e3c.jpg,validate/p18/p18432300/s55789486/5fa77e75-98df5d4f-944a1859-5776bb7a-ca235e3c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and CABG. Mild enlargement of the cardiac silhouette is slightly increased in size compared to the previous study. Mediastinal and hilar contours are normal. Atherosclerotic calcifications are noted within the thoracic aorta diffusely. Pulmonary vasculature is not engorged. Streaky opacities are demonstrated in both lung bases, most likely reflective of atelectasis. Small bilateral pleural effusions are new compared to the previous exam. No pneumothorax is present. There are no acute osseous abnormalities identified. IMPRESSION: Small bilateral pleural effusions with bibasilar atelectasis. No pulmonary edema. " 510a86f2-e3785b91-d2d29288-bbbe5acd-ff15b511.jpg,validate/p16/p16246807/s56957904/510a86f2-e3785b91-d2d29288-bbbe5acd-ff15b511.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: None. FINDINGS: PA and lateral views of the chest were viewed. The cardiomediastinal and 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 pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 93a9b259-574a9768-6a91002f-a15b2712-b96426ea.jpg,validate/p12/p12325171/s58188333/93a9b259-574a9768-6a91002f-a15b2712-b96426ea.jpg,validation," FINAL REPORT INDICATION: Weight loss, smoking history, hypertension, and hyperlipidemia. Rule out lung lesion or atherosclerotic cardiovascular disease. COMPARISON: Multiple prior radiographs of the chest, most recently ___. TECHNIQUE: Upright PA and lateral radiographs of the chest. FINDINGS: Mild hyperinflation of the lungs is unchanged. There is no focal consolidation. The cardiomediastinal silhouettes, hilar contours, and pleural surfaces are normal. Atherosclerotic calcification of the aortic arch is not significantly changed. There is no pleural effusion or pneumothorax. IMPRESSION: Mild hyperexpansion of the lungs and calcification of the arch of the aorta is unchanged from the comparison radiograph. " b549178f-dba7c50d-c091ac63-d02c9b18-45355b64.jpg,validate/p14/p14588844/s52595748/b549178f-dba7c50d-c091ac63-d02c9b18-45355b64.jpg,validation," FINAL REPORT INDICATION: ___F with pleuritic CP x3days // Eval for possible PNA, Left upper lobe TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 03f4d773-09d392fe-f66a8f8a-eaa14094-15bb920f.jpg,validate/p16/p16660343/s51138011/03f4d773-09d392fe-f66a8f8a-eaa14094-15bb920f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dobbhoff placement. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, the Dobbhoff catheter is malpositioned in the right main bronchus. Immediate repositioning is required (a later radiograph from the same patient, taken at 2:11, documents this repositioning). No evidence of complications such as pneumothorax. " 8e287533-fea55088-72c9a9e3-4345bf4d-c54bea93.jpg,validate/p12/p12379221/s56000373/8e287533-fea55088-72c9a9e3-4345bf4d-c54bea93.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with ams // please evaluate for abnormality TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen.There is no pleural effusion or pneumothorax. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 2117fa95-6d7ebf53-c4c7dd2c-889695fb-984e8064.jpg,validate/p17/p17774633/s55900514/2117fa95-6d7ebf53-c4c7dd2c-889695fb-984e8064.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, dullness at bases. COMPARISON: ___. FINDINGS: There are small-to-moderate bilateral pleural effusions with overlying atelectasis. There are multiple areas of opacity in the lungs involving the bilateral upper lobes, right greater than left; right middle lobe and lingula, as well as the lower lobes. While findings may be due to severe multifocal infection, other etiologies such as metastatic disease should be considered and needs to be excluded. The aortic knob is calcified. The cardiac silhouette size is grossly stable as compared to the prior study. There is no pneumothorax. IMPRESSION: Small-to-moderate bilateral pleural effusions. Extensive multifocal opacities bilaterally, as above, concerning for severe multifocal infection, however, recommend followup to resolution as underlying metastatic disease/malignancy should be excluded. " 88307003-b3e55266-5c52f43e-227fdd2b-7c979c40.jpg,validate/p11/p11423592/s54915820/88307003-b3e55266-5c52f43e-227fdd2b-7c979c40.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Left-sided rib pain status post MVA. 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. Mild degenerative changes are seen along the spine including intervertebral disc space narrowing at at least one level in the mid thoracic spine. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 01211b1d-8e60e8b7-6e77079a-efa3601f-f2e29b7b.jpg,validate/p11/p11084812/s56205931/01211b1d-8e60e8b7-6e77079a-efa3601f-f2e29b7b.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with shortness of breath. COMPARISON: Chest radiograph from ___ and CTA chest from ___. CHEST, PA AND LATERAL: Examination is suboptimal due to underexposure. Again seen is diffuse mild interstitial pulmonary abnormality. No focal consolidation. Mild enlargement of the cardiac shadow is stable. There are no pleural effusions or pneumothorax. IMPRESSION: 1. Chronic interstitial pulmonary disease, better evaluated on prior CT. 2. Mild cardiomegaly. 3. No acute cardiopulmonary process. " 1aed15cc-044e32c2-ff0c0023-ef447e1d-a5f6a8ee.jpg,validate/p13/p13035989/s57519281/1aed15cc-044e32c2-ff0c0023-ef447e1d-a5f6a8ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with (+) PPD, asympt, no hx TB/contact. also (+) vacc scar L shoulder // screen screen IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease or old tuberculous disease. " c768701c-459fc594-999a66de-8ed5a37d-55fa541d.jpg,validate/p15/p15573773/s56388322/c768701c-459fc594-999a66de-8ed5a37d-55fa541d.jpg,validation," FINAL REPORT CHEST TWO VIEWS: ___: HISTORY: ___-year-old female with shortness of breath, cough, right PICC line. FINDINGS: Frontal and lateral views of the chest were compared to previous exam from ___. Right-sided central line is seen with tip at the RA SVC junction. Again noted are bibasilar regions of consolidation with more dense opacity in the lateral view seen posteriorly, potentially in the right lower lobe. Superiorly, the lungs are clear. Cardiac silhouette is enlarged but stable in configuration. Bilateral proximal humeral hardware is again seen. Multiple bilateral rib fractures are also noted as well as a mid thoracic dextroscoliosis. IMPRESSION: Bibasilar opacities with more dense consolidation posteriorly, likely in the right lower lobe. Findings may represent atelectasis, however, effusion or component of consolidation due to infection is also possible. Please clinically correlate. " 963e24eb-678c66cc-6c742027-4a1d9fb5-27e293d7.jpg,validate/p16/p16644826/s57163244/963e24eb-678c66cc-6c742027-4a1d9fb5-27e293d7.jpg,validation," WET READ: ___ ___ 9:19 PM Subtle rounded enlargement of the inferior right paratracheal soft tissue density, suggest further evaluation on nonemergent chest CT in this patient with history of breast cancer. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest pain TECHNIQUE: Frontal lateral views of the chest. COMPARISON: ___. FINDINGS: Right breast shadow is absent in this patient with history of prior mastectomy. Surgical clips are seen in the right axillary region. There is mild blunting of the right costophrenic angle suggesting a small right pleural effusion. Mild bibasilar atelectasis is seen. No definite focal consolidation. There is no evidence of pneumothorax. The cardiac silhouette is stable. There is possible slight prominence enlargement of the right of the lower right peritracheal soft tissue as compared to prior study. No overt pulmonary edema is seen. IMPRESSION: 1. Small right pleural effusion. Bibasilar atelectasis. 2. Subtle rounded enlargement of the inferior right paratracheal soft tissue density, suggest further evaluation on nonemergent chest CT in this patient with history of breast cancer. " 4dc84355-933fdde8-c60aedf6-fe9cf7d7-78074b63.jpg,validate/p17/p17717614/s51108097/4dc84355-933fdde8-c60aedf6-fe9cf7d7-78074b63.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p cabg // eval for infiltrate COMPARISON: Radiographs from ___ IMPRESSION: Support lines and tubes are unchanged in position. Cardiac silhouette is enlarged but stable. There has been improved aeration of the right upper lobe since prior. There remains low lung volumes and a left retrocardiac opacity. There are no pneumothoraces. " 90c3a345-9b89f701-5151dc14-389979bc-a6758c47.jpg,validate/p13/p13272752/s51408716/90c3a345-9b89f701-5151dc14-389979bc-a6758c47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with malignant left pleural effusion s/p chest tube // evaluate for improvement in hydro/pneumothoraces evaluate for improvement in hydro/pneumothoraces IMPRESSION: In comparison with the study of ___, the subpulmonic pneumothorax continues to decrease with the chest tube in place. Remainder of the study is within normal limits. " 81f9752b-e42fe6d4-2cf8158e-e64de497-c12b0fb3.jpg,validate/p15/p15103745/s50484359/81f9752b-e42fe6d4-2cf8158e-e64de497-c12b0fb3.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Altered mental status with stroke. Assessment of lung fields. AP chest radiograph. The right jugular line tip is at the level of mid SVC. The ET tube tip is approximately 7 cm above the carina. The NG tube tip is in the stomach. Heart size and mediastinum are grossly unchanged. Large bilateral pleural effusions are present as well as bibasilar atelectasis. There is no pneumothorax. " 7f4d7beb-4c6d5aa6-430fc61f-9470e985-3059c886.jpg,validate/p14/p14981236/s54657073/7f4d7beb-4c6d5aa6-430fc61f-9470e985-3059c886.jpg,validation," FINAL REPORT STUDY: AP chest, ___. CLINICAL HISTORY: ___-year-old man respiratory distress and pulmonary edema. FINDINGS: Comparison is made to previous studies from ___. Endotracheal tube has been removed. The right IJ Cordis and enteric tube are unchanged. There is persistent pulmonary edema. There is worsening in the right lung and improvement in the left. There is right-sided pleural effusion. No pneumothoraces are seen. " 55e6e427-be424b57-62f54312-db1fcf98-add7d424.jpg,validate/p13/p13107111/s51913649/55e6e427-be424b57-62f54312-db1fcf98-add7d424.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Hypertension, suspected pneumonia. AP radiograph of the chest was reviewed in comparison to ___. Substantial prominence of the main pulmonary artery suspected, concerning for pulmonary hypertension. Attentively, a lung mass, mimicking pulmonary artery dilatation cannot be excluded and correlation with chest CT is required. Lungs are essentially clear except for bibasal atelectasis appears to be grossly unchanged and there is no interval development of substantial pleural fluid or pneumothorax that would be new as compared to prior study. " 07695f34-69c3fe9d-bc04c852-bb26bf1a-af5b429a.jpg,validate/p17/p17734689/s58831797/07695f34-69c3fe9d-bc04c852-bb26bf1a-af5b429a.jpg,validation," WET READ: ___ ___ ___ 10:40 AM No acute cardiopulmonary process. WET READ VERSION #1 ___ ___ ___ 9:40 AM Abnormality in the right lung base likely correlates to combination prior granulomatous infection atelectasis, as better assessed on CT Chest from ___. However, superimposed pneumonia cannot exclude in the right clinical setting. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with s/p L mesh for flank hernia. Back pain and chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___ FINDINGS: PA and lateral views the chest provided. Pectus excavatum deformity of the sternum and spinal hardware noted. Lung volumes are low. Allowing for this the lungs are clear. Cardiomediastinal silhouette is stable. No acute osseous abnormality. IMPRESSION: No acute cardiopulmonary process. " 1dff9cee-a6eddc4e-3b86b3ff-756ace69-b3e00bcd.jpg,validate/p17/p17509107/s51654003/1dff9cee-a6eddc4e-3b86b3ff-756ace69-b3e00bcd.jpg,validation," FINAL REPORT AP CHEST, 11:49 A.M., ___ HISTORY: ___-year-old man after liver transplant. Assess Dobbhoff tube placement. IMPRESSION: AP chest compared to ___. Three images are provided. #1 shows a feeding tube with the wire stylet in place looping in the lower esophagus, #2 with the loop in the upper esophagus, and #3 with the tube in the upper stomach, less distended with air and fluid than in the earlier two images. Lungs are low in volume but essentially clear. This exaggerates mild cardiomegaly. There is no pulmonary edema or pleural effusion. Findings were discussed by telephone with the patient's nurse at 3:10PM. " 3e9a3cb4-85d759ad-5e84e781-e1e4c80b-26b2ef53.jpg,validate/p12/p12315463/s55559859/3e9a3cb4-85d759ad-5e84e781-e1e4c80b-26b2ef53.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Febrile neutropenia. AP radiograph of the chest was reviewed in comparison to ___. The Port-A-Cath catheter tip is at the level of cavoatrial junction (right). The new inserted left subclavian line terminates at the low SVC. Heart size is enlarged. Hiatal hernia is present, relatively large partially imaged. Basal opacity is noted, new and might be concerning for developing infectious process. No appreciable pleural effusion or pneumothorax is seen. " 246072b9-d030ccf9-55eaa759-2276fbfe-ccfc620a.jpg,validate/p14/p14657773/s50595579/246072b9-d030ccf9-55eaa759-2276fbfe-ccfc620a.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with intermittent right shoulder and scapular pain worsened by pressure. Right upper quadrant pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of focal consolidation or effusion. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 6960543d-e69b4f03-a58397c3-201d8f54-e3b7b5f7.jpg,validate/p18/p18202111/s53047706/6960543d-e69b4f03-a58397c3-201d8f54-e3b7b5f7.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with rheumatoid arthritis and rheumatoid nodules in lung, evaluate for interval change. 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 remains normal. No changes in mediastinal structures or appearance of thoracic aorta. The pulmonary vasculature is not congested. The previously identified rather well described nodular-appearing densities in the left lower lobe area remain. The same holds for an abnormal prominence in the lower portion of the left hilum. These lesions have not increased in size significantly. Detailed comparison, however, suggests that there is probably some development of new similar nodular densities highly above and to the left of the previously described lower lobe densities. Lateral view suggests that these new nodules are located in the left lower lobe posterior segment whereas the previously existing nodules are located mostly to the anterior portion of the lower lobe area. Comparison also reveals that no pleural effusion has developed on either side and no pneumothorax is present in the apical area. The right hemithorax remains entirely normal. IMPRESSION: Persistent nodular densities previously identified as representing rheumatoid nodules. Chest examination followup shows persistence of this lesion in rather unchanged appearance. Newly similar nodules have developed in left lower lobe posterior segment. They appear to be of same nature. Further clinical workup with chest CT required will depend on patient's clinical presentation. " 32131c11-fb7f403e-8eada748-70adffac-8198c8d3.jpg,validate/p13/p13578996/s54166188/32131c11-fb7f403e-8eada748-70adffac-8198c8d3.jpg,validation," 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. " 6d26cfaf-14381374-6808b551-d1e43f62-e5a04986.jpg,validate/p14/p14493762/s54640216/6d26cfaf-14381374-6808b551-d1e43f62-e5a04986.jpg,validation," WET READ: ___ ___ ___ 10:14 PM A series of 2 chest radiographs were performed sequentially the first at 19:39, which depicts the weighted tip of the Dobbhoff tube in the mid esophagus. The subsequent radiograph taken at 19:43 demonstrates that the tube has been advanced and is now looped within the stomach. Otherwise, bilateral parenchymal opacities are not significantly changed from the prior radiograph taken on ___ at 12:39. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with EtOH cirrhosis // Dobhoff placement TECHNIQUE: Sequential portable AP radiographs of the chest from ___. COMPARISON: ___. FINDINGS: A left-sided Dobbhoff catheter terminates in the right atrium. A newly placed feeding tube initially ends in the mid-esophagus, but is advanced into the stomach on the subsequent radiograph. Bilateral airspace and interstitial opacities are unchanged. There is no pneumothorax. The heart and mediastinum are within normal limits despite the projection. IMPRESSION: Newly placed feeding tube coils in stomach. Unchanged bilateral airspace and interstitial opacities which may be due to either edema or infection. " 4db220a2-9740db2e-1a339507-b0ac0b4a-debb0116.jpg,validate/p10/p10018205/s58629645/4db220a2-9740db2e-1a339507-b0ac0b4a-debb0116.jpg,validation," 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 and mediastinal silhouettes are unremarkable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 09546be8-b1bc0403-ddf64abd-f0f31189-e9cbae10.jpg,validate/p11/p11234441/s51690817/09546be8-b1bc0403-ddf64abd-f0f31189-e9cbae10.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: Cancer, on chemotherapy with fever, assess for pneumonia. FINDINGS: PA and lateral views of the chest were provided. A Port-A-Cath is again seen projecting over the right lower chest with catheter extending into the mid SVC. Previously noted kink within the catheter is improved. The lungs are clear without focal consolidation, effusion, or pneumothorax. No signs of CHF. Cardiomediastinal silhouette is stable. Bony structures appear intact. IMPRESSION: No signs of pneumonia. " 8612f7bc-333e20f1-47b2622e-d5b6bf1b-8a1444dd.jpg,validate/p19/p19704930/s51512657/8612f7bc-333e20f1-47b2622e-d5b6bf1b-8a1444dd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with persistent cough, and rhonchi over the left posterior chest, not clearing with coughing. looking for etiology. // ? pneumonia PERSISTENT COUGH W/RHONCHI LT POSTERIOR CHEST 10 DAYS,NOT CLEARING WITH COUGHING R/O PNEUMONIA,ABNORMALITY COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Lungs are clear. There is no pleural effusion or pneumothorax. No focal pneumonia noted. " a35c5107-e43a7930-5430fece-549f5464-448549c4.jpg,validate/p14/p14748360/s59892593/a35c5107-e43a7930-5430fece-549f5464-448549c4.jpg,validation," FINAL REPORT INDICATION: Fall. COMPARISON: ___. UPRIGHT AP AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. There is no focal consolidation, pleural effusion or pneumothorax. Cholecystectomy clips are noted in the right upper quadrant of the abdomen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 5df3fcc3-ae0f8227-08095142-075d2038-76e6108a.jpg,validate/p15/p15366293/s51501427/5df3fcc3-ae0f8227-08095142-075d2038-76e6108a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with known bronchial stent with SOB. Pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Lungs are well-expanded and clear. No focal consolidation, effusion, pneumothorax, or edema. Cardiomediastinal contours are unchanged. Hilar contours are also unchanged. No acute osseous abnormality. IMPRESSION: No pneumonia. " 698dbc0e-d26524bb-a24563c1-904ba0ac-7be5e6be.jpg,validate/p16/p16046758/s59921061/698dbc0e-d26524bb-a24563c1-904ba0ac-7be5e6be.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with metastatic non-small cell lung cancer, bilateral pleural effusions, bilateral Pleurx catheters, assess for interval changes. COMPARISON: ___. TECHNIQUE: AP upright and lateral chest radiographs. FINDINGS: Comparison with prior study is difficult due to changes in obliquity. Bilateral Pleurx catheters are unchanged. Post-surgical and post-radiation changes are again noted in the right apex, but the apical cavity seen previously is no longer visualized. Mild pulmonary edema seen previously is improved. No pneumothorax. IMPRESSION: Resolution of pulmonary edema seen previously on the left. " abadc361-ebb336a9-2d9b5b71-cf82ca48-d9adcc39.jpg,validate/p12/p12385857/s55876031/abadc361-ebb336a9-2d9b5b71-cf82ca48-d9adcc39.jpg,validation," FINAL REPORT HISTORY: Patient with vomiting, evaluate for pneumonia. COMPARISON: Chest radiograph and chest CT from ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Again noted is a rounded opacity in in the superior left lower lobe, better evaluated on CT scan from ___. There is mild linear atelectasis/scarring bilaterally. There is no evidence of pneumonia. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Redemonstration of rounded opacity in in the superior left lower lobe, better evaluated on prior CT from ___. 2. No evidence of pneumonia. " cc222e11-1fa3c063-50c23af9-a1bc30cb-44e0eb76.jpg,validate/p12/p12900408/s59218751/cc222e11-1fa3c063-50c23af9-a1bc30cb-44e0eb76.jpg,validation," 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. " 21fad3f5-13c37696-0926110a-b6ff61ee-b819ffd2.jpg,validate/p16/p16200793/s55848010/21fad3f5-13c37696-0926110a-b6ff61ee-b819ffd2.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiographs INDICATION: ___ year old man with shortness of breath post cardiac surgery // eval for effusions, infiltrates, atelectasis TECHNIQUE: Portable chest COMPARISON: PA and lateral chest radiographs dated ___ FINDINGS: In comparison to the chest radiographs obtained 1 day prior, there is lateral displacement of the left hemidiaphragm apex, consistent with a subpulmonic effusion. Small right pleural effusion is unchanged. Increased right basilar opacities may be a combination of atelectasis and/or developing pneumonia. Heart size and cardiomediastinal silhouettes are unchanged. Median sternotomy wires are midline and intact. Old posterior left rib fractures are unchanged. IMPRESSION: Increased right basilar opacity is concerning for a combination of atelectasis and/or developing pneumonia. Small, bilateral pleural effusions. " b786c90a-38d5e553-51e9cf1c-262226a2-df321476.jpg,validate/p14/p14809300/s53167771/b786c90a-38d5e553-51e9cf1c-262226a2-df321476.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with history of COPD, lung cancer status post CyberKnife, and hip replacement 6 weeks ago, presenting with dyspnea, leukocytosis, and fever. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. FINDINGS: There is a small right pleural effusion and a right lower lobe opacity. There is also concurrent mild interstitial pulmonary edema. A fiducial marker is seen in the right upper lobe. There is no pneumothorax. Cardiac silhouette is unchanged. IMPRESSION: Small right pleural effusion and mild interstitial pulmonary edema most consistent with decompensated congestive heart failure. However, given the strong clinical evidence for an infectious process, right lower lobe pneumonia must be suspected. " 001078f2-9b0f7698-cfb147e3-18d47ad7-eb278050.jpg,validate/p16/p16616852/s57129861/001078f2-9b0f7698-cfb147e3-18d47ad7-eb278050.jpg,validation," FINAL REPORT INDICATION: ___F with dka // 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. " 12083641-5d225c7d-f02bf538-8482957e-c29dbc08.jpg,validate/p15/p15641930/s51639826/12083641-5d225c7d-f02bf538-8482957e-c29dbc08.jpg,validation," FINAL REPORT HISTORY: Congestive heart failure. Evaluation for interval change. TECHNIQUE: Frontal view of the chest. COMPARISON: Multiple chest radiographs the most recent on ___. FINDINGS: The heart size is enlarged. There is an interval worsening of the previously noted perihilar opacities. There is also worsening of the right upper lobe opacity consistent with mitral regurgitation. There is some subpulmonic fluid at the base of the right lung. There is no evidence of pneumothorax. IMPRESSION: Evidence of worsening pulmonary edema and mitral regurgitation. " 9e6dad78-b6562594-147e715a-726b7662-acfe4ebb.jpg,validate/p19/p19601036/s51293107/9e6dad78-b6562594-147e715a-726b7662-acfe4ebb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___F s/p CABG and mitral valve repair ___ c/b chylothorax s/p L VATS ___ c/b L lung collapse and hypoxia s/p bronch x2 // L chest tube fell out eval for interval PTX or worsening effusion COMPARISON: Chest radiographs ___ and ___ most recently 10:24. IMPRESSION: Moderate left pleural effusion has decreased since ___:24 following removal of the left pleural drain. There is no pneumothorax. Consolidation at the base of the left lung is severe. In most locations there is no longer any pulmonary edema, but greater opacification at the right base has been attributable to edema in the past, accompanied by small right effusion. Right pleural drain unchanged in position. Small right pneumothorax is larger than it was earlier in the day comparable to the size on ___. Right PIC line ends in the mid SVC. " 49d1ede0-1598496f-8dfb646d-792888d6-ad33a9fb.jpg,validate/p13/p13568894/s51610415/49d1ede0-1598496f-8dfb646d-792888d6-ad33a9fb.jpg,validation," FINAL REPORT EXAMINATION: Is radiograph. INDICATION: ___M with chest pain, cough. Assess for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well inflated and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No acute cardiopulmonary process. " f3348b4c-1f2dbce7-87494ef2-7f9f31ae-c76c5e2a.jpg,validate/p13/p13641334/s50792520/f3348b4c-1f2dbce7-87494ef2-7f9f31ae-c76c5e2a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pressure in epigastrium. // Cardiopulmonary process? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ 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. " 903ef674-dfece124-cb359ce8-16f02d81-f403f4d6.jpg,validate/p16/p16098564/s55654592/903ef674-dfece124-cb359ce8-16f02d81-f403f4d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with 4 weeks of left scapular pain radiating to left arm with central chest discomfort and dynamic EKG changes TECHNIQUE: Chest PA and lateral COMPARISON: CT torso ___, chest radiograph ___ FINDINGS: Lung volumes are lower compared to the previous study. This accentuates the size of the cardiac silhouette which appears moderately enlarged. Superior mediastinal widening is likely attributable to lower lung volumes. The aortic knob remains distinct. Hilar contours are normal. Pulmonary vasculature is normal. Minimal atelectasis is seen in the retrocardiac region. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes noted within the thoracic spine. IMPRESSION: Lower lung volumes account for accentuation of the cardiac silhouette now appearing moderately enlarged. Minimal retrocardiac atelectasis without focal consolidation. " 66b910f4-b029e521-3273d94b-06f1e589-ed91ba0a.jpg,validate/p13/p13648633/s51833821/66b910f4-b029e521-3273d94b-06f1e589-ed91ba0a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for PICC placement. COMPARISON: Portable chest x-ray from ___. FINDINGS: As compared to the previous radiograph, the course of the right-sided PICC line is unremarkable, the tip of the line projects over the lower SVC. There is no evidence of complications, notably no pneumothorax. Unchanged course of the nasogastric tube. Low lung volumes, but no evidence of acute lung disease. " 8478a21f-87dcf13a-89fce56c-159b0792-7dbd1825.jpg,validate/p13/p13412848/s59030880/8478a21f-87dcf13a-89fce56c-159b0792-7dbd1825.jpg,validation," FINAL REPORT INDICATION: ___F with SOB // Eval for pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: When compared to prior, there has been no significant interval change. Severe enlargement of the cardiac silhouette and tortuosity of the descending thoracic aorta is again noted. Vague right basilar opacity is unchanged from prior exam and may be due to atelectasis in setting of low lung volumes. There is no overt edema. No acute osseous abnormalities. IMPRESSION: Low lung volume with right basilar opacity, likely atelectasis. No definite acute cardiopulmonary process. " 1ee1e1ae-e71966da-bc8cdd0e-43a5d2b9-d2ba7500.jpg,validate/p15/p15159712/s53919845/1ee1e1ae-e71966da-bc8cdd0e-43a5d2b9-d2ba7500.jpg,validation," FINAL REPORT HISTORY: Elevated white blood cell count, evaluate for pneumonia or acute process. COMPARISON: Chest radiographs ___ in ___. CT torso ___. FINDINGS: Frontal and lateral views of the chest were performed. The lung volumes are low, which has resulted in vascular crowding. Obscuration of the left heart border is thought to be secondary to the high diaphragm. There is no pleural effusion or pneumothorax. Deviation of the trachea towards the right, likely from a large tortuous aorta, is unchanged. The cardiac silhouette remains moderately enlarged. IMPRESSION: No acute cardiopulmonary process. " 373080f5-e865036f-fb93b8a1-a74f815c-2a4e05ff.jpg,validate/p17/p17564669/s50831524/373080f5-e865036f-fb93b8a1-a74f815c-2a4e05ff.jpg,validation," 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. " 82788d7c-00689b51-39615b1b-25cd0089-cc08d9fd.jpg,validate/p13/p13696823/s56211313/82788d7c-00689b51-39615b1b-25cd0089-cc08d9fd.jpg,validation," FINAL REPORT INDICATION: ___ year old man with aids, scabies, fever, cough. Evaluate for pneumonia. TECHNIQUE: AP frontal chest radiographs were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: The heart is mildly enlarged. There is no focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. IMPRESSION: Mild cardiomegaly. " 326ae802-68678e27-a46d8051-caff9ae8-9dc9beee.jpg,validate/p16/p16625317/s50418759/326ae802-68678e27-a46d8051-caff9ae8-9dc9beee.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with diarrhea // eval for infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Increased interstitial markings are again seen bilaterally, grossly similar as compared to the prior study, consistent with mild to moderate pulmonary vascular congestion. No pleural effusion is seen currently. The cardiac silhouette remains mild to moderately enlarged. Mediastinal contours are stable. No focal consolidation is seen. IMPRESSION: Mild to moderate pulmonary vascular congestion again seen, similar to prior. No definite pleural effusion seen on the current study. Persistent cardiomegaly. " df043a02-ef422adb-5f616740-a5c8d360-841398b9.jpg,validate/p14/p14237047/s55423279/df043a02-ef422adb-5f616740-a5c8d360-841398b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest tube // chest tube positioning, r/o PTX chest tube positioning, r/o PTX IMPRESSION: Compared to chest radiographs ___. Very small right apical pneumothorax unchanged. Small volume of residual right pleural effusion, which drained appreciably with repositioning of the right pleural drainage catheter on ___ is unchanged as is the position of the catheter in the lateral costal pleural space. Moderate right lower lobe atelectasis persists. Left lung is clear. Heart size is normal. " 2943acaf-04285b66-becb4acf-c4bc1883-495bb97c.jpg,validate/p13/p13031211/s57936270/2943acaf-04285b66-becb4acf-c4bc1883-495bb97c.jpg,validation," FINAL REPORT INDICATION: Tachycardia. COMPARISON: None. AP UPRIGHT VIEW OF THE CHEST: The heart 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. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 1830ee2a-e26e6489-c9fbe4b8-f0eca396-199e385c.jpg,validate/p16/p16660031/s56066861/1830ee2a-e26e6489-c9fbe4b8-f0eca396-199e385c.jpg,validation," FINAL REPORT HISTORY: Confusion and vertigo. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is normal. The mediastinal and hilar contours are relatively unchanged with mild unfolding of thoracic aorta. The pulmonary vascularity is not engorged. Bibasilar airspace opacities have a somewhat linear configuration are likely related to atelectasis. Infection, however, cannot be excluded particularly at the right lung base. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Bibasilar airspace opacities, likely reflective of atelectasis though infection particularly at the right lung base is not completely excluded. " 3fc8d478-4cb12ba3-0fea8208-da10d27d-f0fc6ce1.jpg,validate/p11/p11296439/s57073327/3fc8d478-4cb12ba3-0fea8208-da10d27d-f0fc6ce1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with pacer. ?bradycardia // eval for lead placement COMPARISON: ___ and ___. FINDINGS: PA and lateral views of the chest provided. Dual lead left chest wall pacer is unchanged with intact appearing leads extending the region the right atrium and right ventricle. Lung volumes are low limiting assessment. Allowing for this, the lungs are clear. No large effusion or pneumothorax. Cardiomediastinal silhouette appears stable and normal. Lap band projects over the upper abdomen. No free air below the right hemidiaphragm. Bony structures are intact. IMPRESSION: As above. " 2ff73e08-240fb146-de9b6248-00c1a15c-58931230.jpg,validate/p14/p14415891/s58612124/2ff73e08-240fb146-de9b6248-00c1a15c-58931230.jpg,validation," FINAL REPORT INDICATION: History of recurrent left effusion. Reevaluate. COMPARISONS: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained with a total of three exposures. FINDINGS: The lungs are clear without consolidation or edema. There is little change in the blunting of the left costophrenic angle likely due to a small pleural effusion, pleural scarring, or a combination of the two. There is no right pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No significant change in the blunting of the left costophrenic angle, possibly due to a small pleural effusion, pleural scarring, or combination of the two. " 1b492907-73384316-49538221-07d3e5a6-a00534fa.jpg,validate/p12/p12016108/s57835079/1b492907-73384316-49538221-07d3e5a6-a00534fa.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Fever and recent pneumonia. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: Central venous catheters have been removed. The heart is normal in size. The aortic arch is partly calcified. The mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no definite pleural effusions or pneumothorax. The bones are probably demineralized to some degree. Slight degenerative changes appear similar along the thoracic spine. IMPRESSION: No evidence of acute disease. " 43ae24fb-a1978705-586ac545-d280588b-07416748.jpg,validate/p15/p15549843/s57232534/43ae24fb-a1978705-586ac545-d280588b-07416748.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dementia s/p fall with L hip fx on plain film. Will get surgery per Ortho // Preop Surg: ___ (hip fx) TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Moderate cardiomegaly is stable. The aorta is tortuous. Bibasilar atelectasis have improved. Bilateral healed rib fractures are again noted. There is no pneumothorax, pleural effusion, pneumonia or pulmonary edema IMPRESSION: No acute cardiopulmonary abnormality " 621c61c1-9b9e056f-f7999628-e11dd987-9162b46a.jpg,validate/p19/p19557250/s54386491/621c61c1-9b9e056f-f7999628-e11dd987-9162b46a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated // line placement, opacity line placement, opacity IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Again there are extremely low lung volumes with enlargement of the cardiac silhouette and retrocardiac opacification consistent with substantial volume loss in the left lower lobe and small effusion. No appreciable 0 evidence of vascular congestion. " ae2e777f-2e31a303-cc9919ef-8323423f-b51ed0fb.jpg,validate/p17/p17528875/s57187234/ae2e777f-2e31a303-cc9919ef-8323423f-b51ed0fb.jpg,validation," FINAL REPORT HISTORY: Right upper lobe pneumonia. TECHNIQUE: PA and lateral chest radiograph 2 views. COMPARISON: ___. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. The previously seen wedge-shaped density inferior to the right hilus has nearly completely resolved with subtle density remaining on lateral view. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: Near complete resolution of right upper lobe pneumonia with remaining density likely representing residual scarring. " 6182960f-665f17d6-b386f10f-5b504218-7bb2ef7c.jpg,validate/p17/p17542952/s58043004/6182960f-665f17d6-b386f10f-5b504218-7bb2ef7c.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with abdominal pain, bilateral pleural effusion on CT. Evaluate for effusion. CHEST, TWO VIEWS: Comparison is made to a prior study of ___. The heart is normal in size. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. The lungs are clear. There is obscuration of the costophrenic angle laterally and posteriorly on both sides. This is more prominent on the left than on the right. IMPRESSION: Small bilateral pleural effusions, left greater than right. " b526d67d-a071ca1b-f74ddad1-d783168e-8e58bd00.jpg,validate/p17/p17967970/s54277703/b526d67d-a071ca1b-f74ddad1-d783168e-8e58bd00.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with SOB, s/p right lung VATS <1 month ago. // PNA? Effusion? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Large right pleural effusion with overlying atelectasis is re- demonstrated, grossly stable. Chain sutures are seen overlying bilateral upper lungs and there is persistent right apical opacity. No pneumothorax is seen. The right aspect of the cardiac silhouette is not well assessed due to the large right pleural effusion although there appears to be mediastinal shift to the left, stable. The left lung is clear. Aortic knob calcification is seen. There is diffuse osteopenia. IMPRESSION: Persistent large right pleural effusion with overlying atelectasis. " a2924f49-66c56a20-0c805c7f-69479d71-6cb32048.jpg,validate/p18/p18489959/s50714273/a2924f49-66c56a20-0c805c7f-69479d71-6cb32048.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory failure, evaluation for interval changes. COMPARISON: ___, 4:12 p.m. FINDINGS: As compared to the previous radiograph, there is no relevant change. Constant appearance of the endotracheal tube and the nasogastric tube. The nasogastric tube can now be followed along its entire course, but the tip is not included on the image. Unchanged moderate cardiomegaly with blunting of the left costophrenic sinus, likely caused by mild pleural effusion. Mild pulmonary edema. No new parenchymal opacities. " 8582bfec-c884d687-5db316a9-9c03abbe-a29a688e.jpg,validate/p13/p13166275/s59600302/8582bfec-c884d687-5db316a9-9c03abbe-a29a688e.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Upright AP view of the chest. COMPARISON: ___. FINDINGS: Lung volumes are reduced. The heart size is mildly enlarged. Mediastinal contours are unremarkable. There is bronchovascular crowding, and probable mild pulmonary vascular congestion. Streaky patchy opacities in the lung bases could reflect atelectasis. There may be minimal blunting of the right costophrenic angle, suggestive of a trace effusion. No pneumothorax is identified. IMPRESSION: Low lung volumes with probable mild pulmonary vascular congestion. Patchy bibasilar airspace opacities could reflect atelectasis. Likely small right pleural effusion. " 592defad-2e702335-9d6d541c-e2385852-2ab659ad.jpg,validate/p16/p16934455/s51634837/592defad-2e702335-9d6d541c-e2385852-2ab659ad.jpg,validation," FINAL REPORT INDICATION: ___M with SOB, DOE, evaluate for pulmonary edema. COMPARISON: Comparison is made to chest radiograph from ___. TECHNIQUE PA and lateral view of the chest. FINDINGS: There are bilateral pleural effusions left greater than right. Mild vascular congestion is present. The heart is top-normal in size. The mediastinal contour is normal. There is no focal consolidation seen IMPRESSION: Small left greater than right pleural effusions and mild vascular congestion. " cc1675fb-89c355e2-1bedf1aa-311fc06e-027faef7.jpg,validate/p13/p13384632/s53984793/cc1675fb-89c355e2-1bedf1aa-311fc06e-027faef7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with known COPD and pulmonary htn, now with respiratory distress after surgery // Please assess for pulmonary edema, pneumothorax Please assess for pulmonary edema, pneumothorax IMPRESSION: As compared to ___, no relevant change is seen. Mild to moderate bilateral pleural effusions, mild cardiomegaly. Status post CABG and normal alignment of the sternal wires. Mild pulmonary edema. No pneumothorax. Retrocardiac atelectasis. No pneumonia. " fae4ad6f-8cfaddc5-261293b3-6caf013f-996b110a.jpg,validate/p16/p16183583/s51148950/fae4ad6f-8cfaddc5-261293b3-6caf013f-996b110a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ILD s/p VATS with known small apical pneumothorax // Please evaluate for change in right apical pneumothorax COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the small left apical pneumothorax after VATS surgery has resolved. Unchanged air collection in the left chest wall. Unchanged position of the left PICC line. Normal size of the cardiac silhouette persists. Minimal retrocardiac atelectasis is constant. " 41d403b5-f5431cd2-34b4a0b3-8d44c431-8752f712.jpg,validate/p10/p10917306/s52308244/41d403b5-f5431cd2-34b4a0b3-8d44c431-8752f712.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with dyspnea, fever TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and CABG. Heart size is top normal. Mediastinal and hilar contours are unchanged. The pulmonary vasculature is normal. Left lower lobe consolidative opacity is demonstrated with a small left pleural effusion. Right lung is clear. No pneumothorax is noted. There are no acute osseous abnormalities. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: Left lower lobe pneumonia with small left pleural effusion. Followup radiographs after treatment are recommended to ensure resolution of this finding. " d22b4394-cc4e798f-009a533b-b7e904aa-d7f82c86.jpg,validate/p14/p14345906/s50940490/d22b4394-cc4e798f-009a533b-b7e904aa-d7f82c86.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with heart failure, receiving intrathecal methotrexate for CNS lymphoma with worsening O2 requirement // assess for pulmonary edema vs. pneumonia COMPARISON: ___ TdT FINDINGS: Heart is upper limits of normal in size, accompanied by pulmonary vascular congestion and mild interstitial edema. Right middle lobe nodule is unchanged and has been more fully characterized by CT of ___. " 65640840-ade71d27-54622c41-1a7f5555-2508f7eb.jpg,validate/p19/p19931619/s58181433/65640840-ade71d27-54622c41-1a7f5555-2508f7eb.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old female with depression and generalized weakness, question pneumonia or CHF. FINDINGS: Frontal and lateral views of the chest. No prior. The lungs are clear. The cardiac silhouette is enlarged. Surgical clips are seen in the right upper quadrant suggesting prior cholecystectomy. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: Cardiomegaly but no acute cardiopulmonary process. " e97e828c-23cc68b6-cfb6280f-4f37f696-37f8f688.jpg,validate/p11/p11585485/s54065846/e97e828c-23cc68b6-cfb6280f-4f37f696-37f8f688.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with B-cell lymphoma, diastolic heart failure, with persistent cough. // Please assess for interval change of pleural effusion. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. There is a minimal increase in extent of the known right pleural effusion, with an increase in right subsequent atelectasis. Minimal increase in retrocardiac atelectasis. Unchanged appearance of the cardiac silhouette. No new parenchymal opacities. " a15ba4d7-49e2f6cb-a3e6c1b8-f7bdb370-2a356705.jpg,validate/p19/p19174686/s52203704/a15ba4d7-49e2f6cb-a3e6c1b8-f7bdb370-2a356705.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with weakness, history of congestive heart failure TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged. The aorta is tortuous. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Linear opacities within the left upper lung field may reflect atelectasis or scarring. No focal consolidation, pleural effusion or pneumothorax is present. Lungs are hyperinflated. Mild degenerative changes are seen within the thoracic spine. Multiple rounded radiopaque densities projecting over the right shoulder are likely external to the patient. Marked narrowing of the right acromiohumeral interval suggests rotator cuff disease. IMPRESSION: No acute cardiopulmonary abnormality. " 540f340e-5dd5ac96-15b2e3ed-da8636fa-58a48801.jpg,validate/p16/p16429115/s51858356/540f340e-5dd5ac96-15b2e3ed-da8636fa-58a48801.jpg,validation," FINAL REPORT CHEST, TWO VIEWS. HISTORY: ___ year-old male with syncope. Evaluate for cardiomegaly or acute abnormality. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " f2ef36cb-452c2403-b1d19c54-30d7afac-e12bc727.jpg,validate/p10/p10998936/s54167675/f2ef36cb-452c2403-b1d19c54-30d7afac-e12bc727.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___F with fever, neutropenia. // ___F with fever, neutropenia. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Lungs remain hyperinflated. Patchy medial left base opacity, increased since the prior study, could be due to atelectasis, aspiration, or pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Persistently hyperinflated lungs may be due to COPD. Patchy medial left base opacity, increased since the prior study, and could be due to atelectasis, aspiration, or pneumonia. " 12184a65-acf07162-0031b4b3-67eacda7-1b0ac4d3.jpg,validate/p13/p13229615/s52764685/12184a65-acf07162-0031b4b3-67eacda7-1b0ac4d3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD exacerbation and ? pneumonia. Increased work breathing. Eval for interval change. // interval change interval change IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the heart and lungs. The opacification at the right base is again seen. " c296a44c-9fb23a52-9d2e8d59-c35afe4f-28367be7.jpg,validate/p17/p17454111/s58129073/c296a44c-9fb23a52-9d2e8d59-c35afe4f-28367be7.jpg,validation," FINAL REPORT INDICATION: ___M with fall, possible LOC. // ?ich, c spine fracture, pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___ and ___ chest x-rays. FINDINGS: The lungs are clear of focal consolidation worrisome for pneumonia. There is no effusion or pneumothorax. The cardiomediastinal silhouette is stable in configuration. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 4e754404-d9296ad0-34c36e8c-3efc87fa-d89fe6f8.jpg,validate/p17/p17592232/s54691632/4e754404-d9296ad0-34c36e8c-3efc87fa-d89fe6f8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with L pigtail // pneumothorax? pneumothorax? IMPRESSION: Compared to chest radiographs ___ through ___. Small to moderate left pneumothorax has developed, primarily in the left lower chest. Pigtail drainage catheter still in place. Moderate consolidation of both lung bases is been present for several days. On the right it is largely atelectasis. The left could be pneumonia. Emphysema is severe. Heart size is normal. Tracheostomy tube slightly off midline. Indwelling left PIC line ends in the mid to low SVC, unchanged. No right pneumothorax or pleural effusion. " 0e736f38-f1d8e5dd-820aaf09-c4742588-86bef7c8.jpg,validate/p18/p18700598/s50484690/0e736f38-f1d8e5dd-820aaf09-c4742588-86bef7c8.jpg,validation," FINAL REPORT INDICATION: ___M with h/o HIV and cough // ?PNA TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " a8b24df3-703ef389-71284884-c2b97de1-e0bebe89.jpg,validate/p12/p12392459/s51657059/a8b24df3-703ef389-71284884-c2b97de1-e0bebe89.jpg,validation," WET READ: ___ ___ ___ 6:34 AM 1. Reticular nodular opacities can be seen with atypical infection, less prominent than on ___. 2. No pleural effusion. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough and hemoptysis // PNA? effusion? acute pathology? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. FINDINGS: Lung volumes are low. Lung volumes are low, with associated crowding of bronchovascular structures at the lung bases. Mediastinal contours, hila, and cardiac silhouette are stable from ___. No pneumothorax or pleural effusion. Pleural thickening within an elevated right minor fissure is stable from ___. The aortic arch is calcified and the aorta is tortuous. IMPRESSION: No pneumonia or pleural effusion. If hemoptysis persists, consider chest CT to evaluate for radiographically occult cause for this finding. " 5597fa7f-0ff7d442-75a5865e-cbd6f800-700f4657.jpg,validate/p16/p16066951/s52268121/5597fa7f-0ff7d442-75a5865e-cbd6f800-700f4657.jpg,validation," FINAL REPORT HISTORY: Autoimmune hepatitis on prednisone and azathioprine presented with chills and green sputum production. Evaluate for infectious process. COMPARISON: None available. FINDINGS: AP and lateral radiographs of the chest. There is mild apical pleural thickening which is not significant. Tracheobronchial calcifications are noted. No acute focal consolidation is seen. No pleural effusion or pneumothorax is identified. The cardiac silhouette is normal appearing. No rib fractures identified. IMPRESSION: No acute cardiopulmonary process. " 52aad43f-2d7ca883-0d26a384-653af093-91502add.jpg,validate/p10/p10874140/s50710808/52aad43f-2d7ca883-0d26a384-653af093-91502add.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and lateral INDICATION: ___ year old woman with cough and mild hypoxemia, r/o infiltrate // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: The cardiomediastinal silhouette is normal. The hila and pleura are unremarkable. The lungs are hyperexpanded with flattening of the left hemidiaphragm and increased AP diameter suggestive of chronic lung disease. On PA imaging there appears to be a subtle opacification of the right lower lung that corresponds with increased opacification overlying the the cardiac silhouette on lateral imaging which may indicate a developing right middle lobe pneumonia. There is a 5 mm right upper lobe nodule stable since ___ study. No pleural effusions or pneumothorax are seen. IMPRESSION: 1. Subtle opacification of the right middle lobe which may indicate a developing pneumonia. 2. Hyperexpanded lungs with increased AP diameter consistent with chronic lung disease. 3. Stable 5 mm right upper lobe nodule. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 15:53 into the Department of Radiology critical communications system for direct communication to the referring provider. " 3cc64db0-06592984-90bb3b59-f3c766e6-dd80ef5b.jpg,validate/p18/p18705722/s58124153/3cc64db0-06592984-90bb3b59-f3c766e6-dd80ef5b.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG/MVR/TV repair // eval for pleural effusions TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: Monitoring and support devices are in unchanged position. The lung volume is small. Pulmonary edema has improved. No new consolidation. Small bilateral pleural effusion is unchanged. Bilateral mid lung atelectasis is stable. No pneumothorax. Severe cardiomegaly is unchanged IMPRESSION: 1. Improved pulmonary edema with persistent small bilateral pleural effusion. 2. Otherwise stable chest radiograph. " 405f9637-9cc2167a-09b8ce06-433255f4-9ba9933e.jpg,validate/p14/p14771250/s56176221/405f9637-9cc2167a-09b8ce06-433255f4-9ba9933e.jpg,validation," WET READ: ___ ___ ___ 4:19 PM Left lower lobe opacity is concerning for pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with cough, chills // pna? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Left lower lobe opacity is concerning for pneumonia. The right lung is clear. There is no pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: Left lower lobe opacity is concerning for left lower lobe pneumonia. " fd78ce08-378cd508-ba18ef55-012bf415-de477a20.jpg,validate/p14/p14471216/s53693382/fd78ce08-378cd508-ba18ef55-012bf415-de477a20.jpg,validation," 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. " de488652-897d97db-b2899bd6-19f67662-31931e4c.jpg,validate/p13/p13204581/s53388431/de488652-897d97db-b2899bd6-19f67662-31931e4c.jpg,validation," WET READ: ___ ___ ___ 8:21 PM The findings were discussed with Dr. ___ by ___, M.D. on the telephone on ___ at 8:19 PM, ___ min after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with increasing oxygen requirement 24 hours following MIE converted to open // effusion? pulm edema? TECHNIQUE: Portable chest x-ray COMPARISON: Comparison on ___ 05:55 FINDINGS: Increased bilateral perihilar, basilar opacities compared with prior exam, suggests pulmonary edema. Pneumonitis less likely. Increased left pleural effusion. Stable left lower lobe, right medial basal consolidation. Tiny right apical pneumothorax. Lucency right lung base, may represent small right basilar component. Findings not definitely seen on prior exam. Decreased subcutaneous right chest wall emphysema. Postoperative changes. Enteric tube tip near diaphragmatic border. Tubes, drains in place. IMPRESSION: Small right pneumothorax. New bilateral predominantly perihilar opacities, likely edema. Increased left pleural effusion. Remainder as above " 166c34bd-b8d2c82a-a4afbde7-74aba89e-a13e50ce.jpg,validate/p14/p14772351/s54479123/166c34bd-b8d2c82a-a4afbde7-74aba89e-a13e50ce.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness after recent spinal surgery. Question pneumonia. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. Possibly there are trace pleural effusions bilaterally. The lungs appear clear. Mild rightward convex curvature is noted along the thoracic spine. The bones are probably demineralized. An anterior flowing syndesmophyte is present throughout the visualized thoracic spine suggesting idiopathic skeletal hyperostosis. IMPRESSION: Possible trace pleural effusions; no evidence of pneumonia. " 2b6ad1b4-aae60920-ad28718c-1dd82bb3-44dbff64.jpg,validate/p16/p16644826/s58533386/2b6ad1b4-aae60920-ad28718c-1dd82bb3-44dbff64.jpg,validation," FINAL REPORT HISTORY: Lymphadenopathy after biopsy, to assess for pneumothorax. FINDINGS: In comparison with study of ___, following biopsy, there is no definite pneumothorax. There is some possible additional prominence of the mediastinum on the right, which could reflect some post-procedure bleeding. Dense streak of atelectasis is seen at the right base with a smaller streak at the left base. Otherwise, little overall change. " 60b3ce13-21a6db9d-07def8cb-1858b653-e0de4c79.jpg,validate/p17/p17135687/s59220925/60b3ce13-21a6db9d-07def8cb-1858b653-e0de4c79.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bilateral chest tubes // ?ptx, hemothorax, tube placement ?ptx, hemothorax, tube placement IMPRESSION: In comparison with the study of ___, the tip of the endotracheal tube lies approximately 5.5 cm above the carina. There are bilateral chest tubes with no evidence of pneumothorax. Hazy opacification on the right is consistent with either hemorrhage within overlying soft tissues or fluid in the pleural space. The subcutaneous emphysema along the right lateral chest wall is decreasing a in this patient with multiple opaque bullet fragments projected over the chest and axillary regions. " d8523ad2-498f5bb4-894c11d6-6419efb1-af885422.jpg,validate/p10/p10540652/s57651859/d8523ad2-498f5bb4-894c11d6-6419efb1-af885422.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain and palpitations. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Again seen are post-operative changes of left mastectomy. The lungs are clear of focal consolidation, effusion or pneumothorax. There is no pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits, noting pectus deformity, accentuating its size on the frontal film. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 92ab2800-489ba2ec-9cc183a0-8e1dd828-a5ed8e58.jpg,validate/p16/p16822208/s55811842/92ab2800-489ba2ec-9cc183a0-8e1dd828-a5ed8e58.jpg,validation," 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. " 928f369b-25a9688f-2bb16788-b2b801ba-89eb398f.jpg,validate/p11/p11682585/s55863067/928f369b-25a9688f-2bb16788-b2b801ba-89eb398f.jpg,validation," FINAL REPORT CHEST FILM, ___ HISTORY: CHF, check NG tube. FINDINGS: NG tube tip is in the proximal stomach with proximal port just above the gastroesophageal junction. This should be advanced. Right IJ line tip is in the SVC. Sternal wires and mediastinal clips are again seen. Compared to the study from ___, the vascular plethora is less pronounced. There continues to be moderate cardiomegaly and small bilateral effusions, left greater than right. " 2ce2e566-c81b0ad1-7e9344c3-d2ae9030-0ddd05d6.jpg,validate/p16/p16458160/s51383891/2ce2e566-c81b0ad1-7e9344c3-d2ae9030-0ddd05d6.jpg,validation," 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 ___. " 900949fd-794acc52-c45266ff-18c15992-8af15e31.jpg,validate/p15/p15854896/s58755487/900949fd-794acc52-c45266ff-18c15992-8af15e31.jpg,validation," 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. " df68248c-246fd865-72d51b84-c8b7418a-30534803.jpg,validate/p15/p15952632/s50198184/df68248c-246fd865-72d51b84-c8b7418a-30534803.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with chest pain // ?pna TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: As compared to the prior examination, there has been no relevant interval change. Again, surgical clips are noted overlying the thoracic inlet at the level of the thyroid. There is no evidence of lobar consolidation, large pleural effusion, or pneumothorax. Slight obscuration of the left costophrenic angle is likely secondary to overlying soft tissue. Descending thoracic aortic calcifications are noted. The cardiomediastinal silhouette is unchanged. IMPRESSION: No evidence of acute cardiopulmonary process. " 6d2c9130-1af097be-0ea3d05c-0bef62c7-879af179.jpg,validate/p16/p16798076/s56127705/6d2c9130-1af097be-0ea3d05c-0bef62c7-879af179.jpg,validation," FINAL REPORT AP CHEST, 11:16 A.M., ___. HISTORY: ___-year-old woman with COPD. Femur fracture. Left lower lobe collapse. IMPRESSION: AP chest compared to ___: Left lower lobe is still collapsed. Possibility of a retained foreign body in the left lower lobe bronchus should be entertained. Lungs are otherwise clear. No pleural effusion. Heart size normal. " 0d119c52-4ae70100-91d13916-142e4a61-a317102b.jpg,validate/p16/p16893353/s58752116/0d119c52-4ae70100-91d13916-142e4a61-a317102b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with copd exacerbation and PNA with tachypnea and diffuse wheezing on exam // eval for worsening PNA IMPRESSION: As compared to ___ chest radiograph, cardiomediastinal contours are stable. Improving right lower lobe opacity is likely due to resolving atelectasis and less likely improving pneumonia given the rapid change over 2 days. No new areas of consolidation are identified to suggest a new site of infection. " b98212cc-436e9991-ff10c03f-cba9bad0-271a01ec.jpg,validate/p17/p17910941/s55681320/b98212cc-436e9991-ff10c03f-cba9bad0-271a01ec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, dyspnea // Evaluate for pneumonia Evaluate for pneumonia IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. The cardiac silhouette is at the upper limits of normal or mildly enlarged. No vascular congestion, pleural effusion, or acute focal pneumonia. " d2295b0e-257c6a7f-655954a1-62a03628-cfc913f6.jpg,validate/p15/p15211280/s53641898/d2295b0e-257c6a7f-655954a1-62a03628-cfc913f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old male smoker with COPD, OSA, and chronic cough who presents with increase of chronic cough with intermittant production of white/yellow sputum. // Pneumonia? FINDINGS: As compared to prior study of ___, cardiomediastinal contours are stable. Lung volumes are lower, and the left hemidiaphragm contour appears less distinct on the lateral view compared to the previous exam. Saber sheath trachea configuration is consistent with provided history of COPD. IMPRESSION: Limited study due to low lung volumes. Repeat lateral radiograph with improved technique may be helpful to exclude the possibility of an early pneumonia at the left lung base. " 3a6952d3-7609370b-539e782f-8fcb6ac8-566dd4bc.jpg,validate/p14/p14912272/s54377525/3a6952d3-7609370b-539e782f-8fcb6ac8-566dd4bc.jpg,validation," WET READ: ___ ___ ___ 11:40 PM Decreased right pleural effusion status post catheter placement. Persistent small left pleural effusion. Multi-focal opacities, as seen previously, likely corresponding to masses seen on CT. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest pain after right thoracocentesis, evaluation for pneumothorax. COMPARISON: ___, 5:45 a.m. FINDINGS: Compared to the previous radiograph, the right pleural effusion has decreased after catheter placement. A small left pleural effusion persists. The multiple opacities bilaterally, better documented on a recent CT examination from ___, are constant. On the radiograph, there is no compelling evidence for pneumothorax. The appearance of the cardiac silhouette is constant. " 50671769-7c685d22-40b7fd5e-151990cd-7cfdb7e6.jpg,validate/p15/p15971063/s57219298/50671769-7c685d22-40b7fd5e-151990cd-7cfdb7e6.jpg,validation," FINAL REPORT PORTABLE CHEST FILM, ___ AT 4:50 A.M. CLINICAL INDICATION: ___-year-old with subarachnoid hemorrhage and stroke, followup chest film. Comparison is made to the patient's prior study of ___ at 4:21. Portable semi-erect chest film ___ at 4:50 a.m. is submitted. IMPRESSION: 1. Tracheostomy tube remains in satisfactory position. The left subclavian PICC line has its tip in the proximal SVC. Overall cardiac and mediastinal contours are stable. There continues to be a layering left effusion with retrocardiac consolidation likely representing partial lower lobe atelectasis. Remaining lungs are clear. No pulmonary edema. No pneumothorax. A linear line in the periphery of the right upper lung is felt to represent artifact. " f8c01359-cf9476f3-f098b0a4-3a871265-3bd3d8bb.jpg,validate/p15/p15498178/s56078345/f8c01359-cf9476f3-f098b0a4-3a871265-3bd3d8bb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with emphysema with brownish prod cough // eval pna COMPARISON: Prior CT chest from ___. FINDINGS: PA and lateral views of the chest provided. A peripheral nodular opacity in the left upper lobe is again seen measuring approximately 2.6 x 2.6 cm, better assessed on recent CT. Underlying fibrotic lung disease is noted. A similar pattern of lower lung opacities is seen compared with recent prior exam likely reflecting emphysema/ fibrosis. No large effusion or pneumothorax. Cardiomediastinal silhouette stable. Bony structures intact. IMPRESSION: 2.6 cm mass in the left upper lobe is concerning for a neoplasm. Extensive underlying emphysema/fibrosis. " b515844b-b318c970-8e9131f4-d170ec54-f5900853.jpg,validate/p13/p13486482/s55452479/b515844b-b318c970-8e9131f4-d170ec54-f5900853.jpg,validation," FINAL REPORT PA AND LATERAL FILM ___ AT 9:27. CLINICAL INDICATION: Chest tube, assess for interval change. Comparison is made to the patient's prior study ___. Images of the chest dated ___ at 9:27 are submitted. IMPRESSION: A left-sided chest tube remains in place. Lung volumes remain low with patchy opacity at the left base likely reflecting atelectasis. Pneumonia or aspiration cannot be excluded. There is no pneumothorax. No evidence of pulmonary edema. Possible small left effusion. Acute left-sided rib fractures are difficult to appreciate on the current study. Evidence of old right-sided rib fractures. " 3f95ba63-2b4367c4-94dda5c3-7ceb6e06-ca795b9a.jpg,validate/p15/p15353701/s54143924/3f95ba63-2b4367c4-94dda5c3-7ceb6e06-ca795b9a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female with history of severe mitral regurgitation (s/p Mitraclip ___ and ___), diastolic heart failure, afib, hypertension, asthma, prior breast cancer, and recent admission for acute decompensated heart failure complicated by hypoxic respiratory failure and cardiogenic shock presenting from SNF with progressive dyspnea found to have diastolic heart failure exacerbation with possible concurrent pneumonia. // interval change? TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: The patient is status post mitral valve clipping. The size of the bilateral pleural effusions are unchanged, moderate on the right, small on the left. There is persistent mild pulmonary edema. There are no new focal consolidations. The cardio mediastinal silhouette is stable. There is no pneumothorax. A tortuous and densely calcified thoracic aorta is again demonstrated. IMPRESSION: 1. Persistent mild pulmonary edema and cardiomegaly. 2. Stable bilateral pleural effusions, right greater than left. " b1e3c1fd-3f9df783-933c3fbb-f00de88f-e11615c6.jpg,validate/p15/p15002645/s50070149/b1e3c1fd-3f9df783-933c3fbb-f00de88f-e11615c6.jpg,validation," FINAL REPORT HISTORY: Chest pain x. TECHNIQUE: Frontal and lateral views of the chest. 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. The hilar contours are also stable. No displaced fracture is seen. IMPRESSION: No acute cardiopulmonary process. " 48fcb2be-7e69b0cc-85f054c7-41893c4e-82a4ea9a.jpg,validate/p17/p17585916/s51774836/48fcb2be-7e69b0cc-85f054c7-41893c4e-82a4ea9a.jpg,validation," 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. " d65dc5e0-95832400-988c7e85-656a1649-d4f3d015.jpg,validate/p17/p17972600/s59250146/d65dc5e0-95832400-988c7e85-656a1649-d4f3d015.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of end-stage renal disease, hypertension, presenting with acute shortness of breath, question pneumonia, volume overload. 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. " 3f8ee5c1-9b0ba406-09c3cbfd-ee8e0bc6-3fb7f483.jpg,validate/p19/p19341743/s52965631/3f8ee5c1-9b0ba406-09c3cbfd-ee8e0bc6-3fb7f483.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with bulimia s/p vomiting with acute shortness of breath // eval for aspiration COMPARISON: CHEST RADIOGRAPHS SINCE ___ MOST RECENTLY ___ AND ___. IMPRESSION: SINCE ___ MILD PULMONARY EDEMA AND PULMONARY VASCULAR CONGESTION HAVE RESOLVED AND HEART SIZE HAS DECREASED CONSISTENT WITH RESOLVED CARDIAC DECOMPENSATION. LUNGS ARE CLEAR AND THERE IS NO PLEURAL ABNORMALITY. THERE ARE NO FINDINGS TO SUGGEST ASPIRATION OR PNEUMONIA. " 58f018af-feddf77f-35b6a8fd-ce2d521c-cdc48f7e.jpg,validate/p15/p15009233/s54027174/58f018af-feddf77f-35b6a8fd-ce2d521c-cdc48f7e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: ___-year-old female with congestive heart failure, MVR with worsening shortness of breath. FINDINGS: PA and lateral views of the chest were provided. PA and lateral views of the chest provided demonstrate cardiomegaly unchanged, with significant improvement in pulmonary edema seen on prior, with only minimal residual interstitial edema present on today's exam. No large effusion or pneumothorax. Scoliosis is stable. Bony structures appear intact. IMPRESSION: Minimal residual pulmonary interstitial edema. Stable cardiomegaly. " 6590b07a-8ccbf98f-77fd33aa-1c58e78d-7ca8bd8a.jpg,validate/p19/p19026820/s54855046/6590b07a-8ccbf98f-77fd33aa-1c58e78d-7ca8bd8a.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumothorax after left chest tube removal. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: A frontal chest radiograph demonstrates interval removal of a left chest tube, now with a tiny apical pneumothorax which is new. The remainder of the exam is unchanged, including small bilateral pleural effusions and bibasilar atelectasis. There is no new focal consolidation. Left rib fractures are again noted. The visualized upper abdomen is unremarkable. IMPRESSION: Interval removal of a left chest tube, now with a tiny apical pneumothorax which is new. NOTIFICATION: These findings were communicated via telephone by ___ ___, MD, ___, NP, at ___ on ___, during initial review. " 3f27ead3-01ab2020-be145fa0-70cd51b2-e06e54a3.jpg,validate/p15/p15239201/s54523843/3f27ead3-01ab2020-be145fa0-70cd51b2-e06e54a3.jpg,validation," WET READ: ___ ___ ___ 11:28 PM No significant interval change in left pleural effusion with associated atelectasis. Mild pulmonary vascular congestion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis presents with worsening hyperbilirubinemia now with worsening SOB // eval interval change in left pleural effusion eval interval change in left pleural effusion COMPARISON: Chest radiographs ___. IMPRESSION: Opacification at the base of the left lung has increased slightly since ___, accompanied by at least a small or moderate left pleural effusion, which is unchanged. Appearance of the left lower lobe could be explained by atelectasis, but pneumonia is of greater concern. Pulmonary vascular engorgement is chronic. Heart is not enlarged and mediastinal veins are not engorged. . " fa0625fe-f125e163-a99a8319-15519efc-fc2ad509.jpg,validate/p13/p13696823/s57299216/fa0625fe-f125e163-a99a8319-15519efc-fc2ad509.jpg,validation," WET READ: ___ ___ 12:57 AM New radiopacity in the anterior mediastinum, posterior to the xiphoid process of the sternum and projecting over the anterior cardiac margin is of unclear clinical significance and may be the result of difference in radiographic projection compared with ___. However given history of HIV further assessment with chest CT is recommended to exclude neoplastic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with cough and history of HIV and probable tuberculosis. Evaluate for acute pulmonary process. TECHNIQUE: PA and lateral chest radiographs COMPARISON: ___. FINDINGS: The lungs are well expanded and clear. Cardiac size is normal. There is no pleural effusion or pneumothorax. There is opacification overlying the lower portion of the cardiac silhouette anteriorly. This could merely be a manifestation of a different obliquity from the study of ___ and merely represent normal fat. If there is any clinical suspicion relative to this area, a repeat lateral view with the obliquity of the ___ study could be obtained. IMPRESSION: Essentially within normal limits except for possible anterior opacification at the base on the lateral view. If this is an area of clinical concern, a repeat lateral with the obliquity of the ___ study could be obtained. If there is a substantial difference, a CT could be be warranted. " 46318065-890f539c-0ecc7789-4e963be1-a2678b3f.jpg,validate/p12/p12385857/s55876031/46318065-890f539c-0ecc7789-4e963be1-a2678b3f.jpg,validation," FINAL REPORT HISTORY: Patient with vomiting, evaluate for pneumonia. COMPARISON: Chest radiograph and chest CT from ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Again noted is a rounded opacity in in the superior left lower lobe, better evaluated on CT scan from ___. There is mild linear atelectasis/scarring bilaterally. There is no evidence of pneumonia. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Redemonstration of rounded opacity in in the superior left lower lobe, better evaluated on prior CT from ___. 2. No evidence of pneumonia. " 2f0a6e91-92581931-596e786b-f053f32d-74b7e67c.jpg,validate/p14/p14800808/s54062027/2f0a6e91-92581931-596e786b-f053f32d-74b7e67c.jpg,validation," FINAL REPORT INDICATION: ___M with chest trauma // acute process? TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. Nipple shadows project over the lungs bilaterally. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. Hiatal hernia is again noted. No acute osseous abnormalities, multiple old anterior right rib fractures are noted. IMPRESSION: No acute cardiopulmonary process. " f2c071f5-e7f26af4-8b03464a-a42213e6-485d4e16.jpg,validate/p10/p10779064/s55322914/f2c071f5-e7f26af4-8b03464a-a42213e6-485d4e16.jpg,validation," FINAL REPORT HISTORY: Jugular venous distention, palpitations, history of mitral and tricuspid regurgitation and myocardial infarction. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size is normal. The aortic knob is calcified. Mediastinal contours unremarkable. Mild pulmonary vascular congestion is present with trace right pleural effusion persisting. There is no pneumothorax. Scarring within the lung apices is re- demonstrated. Multiple clips are again noted within the upper midline abdomen. IMPRESSION: Mild pulmonary vascular congestion and small right pleural effusion. " 22afb1de-6c174b5f-257c7f88-30b237e1-d9d0762d.jpg,validate/p13/p13880645/s53343434/22afb1de-6c174b5f-257c7f88-30b237e1-d9d0762d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute SOB // pulm edema COMPARISON: ___ IMPRESSION: Heart is upper limits of normal in size. Pulmonary vascular congestion is present without overt pulmonary edema. There is no definite pleural effusion or pneumothorax. " 5aef31e9-e2236aae-08018f2f-bf159877-a0b1343b.jpg,validate/p12/p12993146/s57270572/5aef31e9-e2236aae-08018f2f-bf159877-a0b1343b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with delirium // eval ? infiltrate, edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The patient arterial no focal consolidation is seen. No pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " de4379b2-2b478d8c-fde0d393-99be57a5-79f1c40f.jpg,validate/p11/p11956852/s56500105/de4379b2-2b478d8c-fde0d393-99be57a5-79f1c40f.jpg,validation," FINAL REPORT HISTORY: Redo AVR evaluate for effusions. TECHNIQUE: Single AP view. COMPARISON: Chest x-ray from ___. FINDINGS: There are low inspiratory volumes. The patient is status post sternotomy, with multiple surgical clips. Mild prominence of the cardiomediastinal silhouette is stable. There is minimal patchy opacity at the left base, which is similar to the earlier film and may represent atelectasis and/or and postoperative changes. Minimal blunting of the left costophrenic angle noted. No gross effusion. There is upper zone redistribution with mild vascular blurring, also similar to the prior film, allowing for technique. Right hemidiaphragm is again noted to be elevated. IMPRESSION: Mild vascular plethora and minimal patchy opacity at left base unchanged. No gross effusion. " f608cced-6b58fb15-27c96aec-bee65e84-0155c300.jpg,validate/p18/p18828251/s59257021/f608cced-6b58fb15-27c96aec-bee65e84-0155c300.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough and shortness of breath. STUDY: PA and lateral chest radiograph. COMPARISON: ___. ___ FINDINGS/IMPRESSION: The heart size is enlarged similar to prior study. Its rounded shape raises a question of cardiomyopathy and less likely pericardial effusion. Sternotomy wi " 756b11bb-6b6103a8-b919f9b6-175b3306-242a28f2.jpg,validate/p16/p16576075/s55982805/756b11bb-6b6103a8-b919f9b6-175b3306-242a28f2.jpg,validation," FINAL REPORT INDICATION: New left subclavian line. COMPARISONS: Chest radiograph from ___, 35 minutes prior. FINDINGS: Single AP view of the chest demonstrates a new left subclavian line terminating in the mid SVC. ET tube and NG tube are in appropriate position. There is a hazy opacity in the lower lung, which may represent atelectasis or infection. Stable right pleural effusion. IMPRESSION: 1. New left subclavian central line terminates in the mid SVC. 2. Hazy opacity in right lower lung may be atelectasis or infection. " 6702e8d8-bce3e905-b40b704b-328e2509-519d4817.jpg,validate/p19/p19966115/s59164593/6702e8d8-bce3e905-b40b704b-328e2509-519d4817.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with rhinorrhea, congestion, cough and concern for pneumonia vs. heart failure exacerbation // Evaluate for pneumonia vs. heart failure Evaluate for pneumonia vs. heart failure IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains at the upper limits and normal in size. There is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " bc23c43b-57108922-fff7a747-27ded7ed-cb129a73.jpg,validate/p13/p13007657/s59058075/bc23c43b-57108922-fff7a747-27ded7ed-cb129a73.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: ___. CHEST, PA AND LATERAL: The lungs are clear. Heart size is top normal. The aorta is tortuous and calcified. No pleural effusions or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 40c7d9ed-25cbbb9e-5509b315-7484ad13-872571bc.jpg,validate/p14/p14530916/s53623043/40c7d9ed-25cbbb9e-5509b315-7484ad13-872571bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST PA AND LATERAL INDICATION: ___ year old man with cough. R/o pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. 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 pneumonia or other acute cardiopulmonary process. " 7bd12d93-c5f6dbed-ae2ab9ba-a83b3c12-887bd599.jpg,validate/p14/p14474735/s52063105/7bd12d93-c5f6dbed-ae2ab9ba-a83b3c12-887bd599.jpg,validation," FINAL REPORT AP CHEST, 4:37 P.M., ___ HISTORY: ___-year-old woman with tracheal stenosis after debridement. IMPRESSION: AP chest compared to ___. Wide mediastinal caliber is comparable to ___, probably not any indication of acute complication. Previous right perihilar consolidation has cleared, but a new region of consolidation at the base of the right lung could be pneumonia. Mild cardiomegaly is chronic. No pneumothorax. Small right pleural effusion may be present. " 5752a4ac-442c053e-4d4c6225-affe13e5-fa9fd5de.jpg,validate/p18/p18043576/s55135208/5752a4ac-442c053e-4d4c6225-affe13e5-fa9fd5de.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NGT, s/p self removal of NGT and subsequent replacement of NGT. // eval for interval NGT placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Since the prior study there was no substantial change demonstrated including the supporting tubes and lines as well as parenchymal opacities and potentially present bilateral pleural effusions. " a4813a76-d88a6e3d-b3272c0a-9a136eb4-6254b0a7.jpg,validate/p13/p13777829/s57670193/a4813a76-d88a6e3d-b3272c0a-9a136eb4-6254b0a7.jpg,validation," 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 interval change. Again there is mild enlargement of the cardiac silhouette with tortuosity of the descending aorta. Hyperexpansion of the lungs is consistent with chronic pulmonary disease, though there is no evidence of acute focal pneumonia. Nodular opacifications are again seen in the right lower lung. " 50107eed-e62dfa82-e845e4a4-521fff8c-d4303b97.jpg,validate/p18/p18221698/s54184062/50107eed-e62dfa82-e845e4a4-521fff8c-d4303b97.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with CHF and DOE // Evaluation of volume status TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The cardiac silhouette is enlarged. The mediastinal silhouette is normal. The hila are normal. There is increased density throughout the right lung due to the overlying soft tissue density. Otherwise the lungs are grossly clear. No consolidation. No pleural abnormalities. There is hypertrophic changes of the spine. IMPRESSION: Cardiomegaly with no evidence of fluid over lobe. " 434d90dc-0d2e28c8-a3742d84-9ea5415f-cedc5d53.jpg,validate/p13/p13179422/s56246181/434d90dc-0d2e28c8-a3742d84-9ea5415f-cedc5d53.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Patient is status post left upper wedge resection and mediastinal lymph node dissection on ___. Comparison is made with prior study, ___. Cardiomediastinal contours are normal. Right effusion has resolved. If any, there is a tiny left effusion. There is no pneumothorax. Surgical chains project in the left apex medially. Otherwise, the lungs are clear. " 315aaf06-658a585a-2c1a72e7-23edd467-db896754.jpg,validate/p17/p17553763/s56849473/315aaf06-658a585a-2c1a72e7-23edd467-db896754.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with altered mental status TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiac silhouette size is milldy enlarged. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion, pneumothorax, or focal consolidation is present. No acute osseous abnormalities detected. Multilevel degenerative changes are noted within the mid to lower thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 04eaf225-402f8db2-ab263a75-99cedcab-9f4a0e87.jpg,validate/p17/p17396346/s59476541/04eaf225-402f8db2-ab263a75-99cedcab-9f4a0e87.jpg,validation," FINAL REPORT EXAMINATION: Portable chest INDICATION: ___ year old woman with COPD, asthma, pHTN now with dyspnea // dyspnea TECHNIQUE: Portable AP upright view of the chest COMPARISON: PE portable chest from earlier in the day FINDINGS: There is severe cardiomegaly, bilateral effusions, and pulmonary vascular congestion. Pulmonary vascular congestion appears mildly improved when compared to the prior examination. Otherwise, there has been no significant interval change. IMPRESSION: Mild interval improvement in pulmonary vascular congestion. Examination and dictation reviewed with Dr. ___. " 8b37ec11-465fc687-a3e4d0e5-76a3dfd1-1c74356e.jpg,validate/p18/p18605511/s52231671/8b37ec11-465fc687-a3e4d0e5-76a3dfd1-1c74356e.jpg,validation," 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. " a2e2f2b0-80c3a92d-fa5b605f-cc50556c-3f032f37.jpg,validate/p13/p13974671/s58168353/a2e2f2b0-80c3a92d-fa5b605f-cc50556c-3f032f37.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with recent fall // please evaluate for hemothorax, fracture 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. Multilevel hypertrophic spurring of the visualized thoracic spine is compatible with mild degenerative change. IMPRESSION: No acute intrathoracic process. " 1e10bc51-1f8b0cfa-3ebb5949-86459348-df3d1c22.jpg,validate/p13/p13567851/s53443703/1e10bc51-1f8b0cfa-3ebb5949-86459348-df3d1c22.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough, assessment for pneumonia or chronic heart failure. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The lung volumes are normal. Borderline size of the cardiac silhouette without pulmonary edema. The pacemaker leads are in unchanged and correct position. No pleural effusions. No pulmonary edema. No pneumonia. " 902abcb6-a055deb3-71cf123b-5a1c9d68-584c2bc4.jpg,validate/p10/p10970092/s59135513/902abcb6-a055deb3-71cf123b-5a1c9d68-584c2bc4.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough, question pneumonia. COMPARISON: CT of the chest from ___ and chest radiograph ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and show an improved linear opacity in the right middle lobe. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. IMPRESSION: No acute intrathoracic process. Please note that the solid nodules noted on the previous CT examination are too small to be characterized by chest radiography. A followup chest CT is recommended as noted in the previous report. " a958faf2-0942f44e-ab58e86e-bccd159e-a53f0b11.jpg,validate/p16/p16471296/s50487727/a958faf2-0942f44e-ab58e86e-bccd159e-a53f0b11.jpg,validation," FINAL REPORT History: Chest pain Comparison: ___ Findings: PA and lateral views of chest demonstrate a left-sided Port-A-Cath terminating in the mid SVC. There may be minimal intersitial edema, but no focal opacities concerning for infection. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. " b7888b94-651656fc-f0dd7a5d-9ae476c0-17fceb2e.jpg,validate/p19/p19213399/s53765929/b7888b94-651656fc-f0dd7a5d-9ae476c0-17fceb2e.jpg,validation," FINAL REPORT AP AND LATERAL CHEST X-RAY OF ___ No prior studies for comparison. FINDINGS: Heart size is normal. Aorta is mildly tortuous. Prominence of the central pulmonary arteries is present bilaterally. Lungs are slightly overexpanded but grossly clear except for focal linear atelectasis versus scar at the left lung base. There are no pleural effusions or acute skeletal findings. IMPRESSION: Focal linear opacity in left lower lobe is a very nonspecific finding, but linear atelectasis can be observed in the setting of pulmonary embolism, the clinically suspected diagnosis provided in the history for this exam. With this in mind, further evaluation with CT pulmonary angiogram should be considered to more definitively evaluate for the possibility of pulmonary embolism given the clinical suspicion for this entity. " 72005672-8d1a163a-e63e111b-62bd9c71-60b1978e.jpg,validate/p12/p12021305/s50011736/72005672-8d1a163a-e63e111b-62bd9c71-60b1978e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS RUL // check interval change check interval change IMPRESSION: In comparison with the study of ___, there is little change in the appearance of the postsurgical change follow bowing right upper lobectomy. No evidence of pneumothorax. Blunting of the right costophrenic angle is again seen. No acute pneumonia or vascular congestion. " 7c44efa3-24903da8-236cf569-e43c7f56-fe767594.jpg,validate/p17/p17640083/s59019569/7c44efa3-24903da8-236cf569-e43c7f56-fe767594.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hemoptysis in sputum. CXR to evaluate. // CXR to evaluate for hemoptysis in sputum. CXR to evaluate for hemoptysis in sputum. IMPRESSION: Compared to ___. Cardiac silhouette has increased in size substantially common due to progressive cardiomegaly or developing pericardial effusion. Lungs are clear and there is no pleural abnormality. NOTIFICATION: The findings were discussed on the telephone by Dr. ___ with ___, ___ who responded 1 minute(s) after the initial page placed at 5:32 PM, ___ within one minute after initial discovery of the findings. " 108dc57d-fd1f91c0-eb813fb1-db19a821-78b6a5bf.jpg,validate/p16/p16844011/s51312879/108dc57d-fd1f91c0-eb813fb1-db19a821-78b6a5bf.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Altered mental status. TECHNIQUE: Chest, AP upright and lateral. COMPARISON: ___. 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. A chronic deformity of the distal right clavicle appears unchanged and may be due to an non-united fracture in the past. IMPRESSION: No evidence of acute disease. " f7a23990-5e6af428-268ba52f-20de694f-52b696e0.jpg,validate/p14/p14766138/s59551408/f7a23990-5e6af428-268ba52f-20de694f-52b696e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with parapneumonic effusion // s/p chest tube left IMPRESSION: Since the prior radiograph of ___, a left pigtail pleural catheter has been placed with slight decrease in size of left pleural effusion. With persistent adjacent left retrocardiac atelectasis and or consolidation. Questionable tiny left apical pneumothorax. " 1ecba9e5-4ac6ab07-76e5cf6c-3e2af1fd-1644acbf.jpg,validate/p16/p16437766/s58304682/1ecba9e5-4ac6ab07-76e5cf6c-3e2af1fd-1644acbf.jpg,validation," FINAL REPORT HISTORY: Chest and mid back pain. FINDINGS: No previous images. Cardiac silhouette is within normal limits, and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 29e45af6-1105d108-a4c6295f-32b255e2-a881762f.jpg,validate/p17/p17685971/s53863021/29e45af6-1105d108-a4c6295f-32b255e2-a881762f.jpg,validation," FINAL REPORT HISTORY: Patient with asthma, assess for evidence of right or left heart failure. COMPARISON: ___ FINDINGS: Frontal and lateral chest radiographs were obtained. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. There is stable leftward tracheal deviation, unchanged from prior study. The heart size is normal. The mediastinal and hilar contours are within normal limits. IMPRESSION: 1. No radiographic evidence for acute cardiopulmonary process. 2. Stable leftward tracheal deviation, likely reflective of right thyroid lobe enlargement. " 8663bfe1-18084f85-99b7229a-2790283a-46ffbed2.jpg,validate/p12/p12729806/s57424855/8663bfe1-18084f85-99b7229a-2790283a-46ffbed2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with known chf, a history of colon CA (stage II, PT3N0M0, history of PE, and distant tobacco use with asymptomatic insp wheezing bilaterally, left>R lung field // r/o mass r/o mass IMPRESSION: In comparison with study of ___, there is little overall change. Low lung volumes accentuate the transverse diameter of the heart in this patient with some cardiomegaly and intact pacer leads. Indistinctness of pulmonary vessels is consistent with the diagnosis of elevated pulmonary venous pressure. No evidence of acute focal pneumonia or pleural effusion. " 71a2abea-73100fa7-59b03915-d3b1f427-c3864088.jpg,validate/p12/p12763554/s57003506/71a2abea-73100fa7-59b03915-d3b1f427-c3864088.jpg,validation," FINAL REPORT HISTORY: Chest pain. Evaluate for pneumonia, edema. TECHNIQUE: 2 frontal chest radiographs were obtained. COMPARISON: None available. FINDINGS: The heart is moderately enlarged without signs of heart failure including pulmonary edema or pleural effusions. There is no focal opacity or pneumothorax. The mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 7e61564b-01923d4b-e6d58024-ce4a4e4b-7de9eda8.jpg,validate/p10/p10426775/s58627729/7e61564b-01923d4b-e6d58024-ce4a4e4b-7de9eda8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is mildly enlarged. The mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary abnormality. " 2e11d19f-7fd45c8b-fd747233-8ee0a18d-191447d3.jpg,validate/p14/p14794396/s51199892/2e11d19f-7fd45c8b-fd747233-8ee0a18d-191447d3.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with chest wall tenderness // Eval for cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest radiograph from ___ and chest CT from ___. FINDINGS: Since the prior study, the previously described right upper lobe nodularity has improved, with residual left upper lobe opacities, possibly repesenting postinflammatory scarring. There is no large pleural effusion, focal pneumonia, or pneumothorax. Left apical clips are unchanged in position. The cardiomediastinal silhouette is stable. Postsurgical changes in the upper abdomen are related to prior left nephrectomy. IMPRESSION: 1. No acute cardiopulmonary process. 2. Improved biapical opacities as compared to prior radiograph in early ___. Small pulmonary nodules are better assessed on prior chest CT from ___. " d7e2929a-44d5304e-064f06d4-6bc302ab-144489ce.jpg,validate/p18/p18215397/s59978191/d7e2929a-44d5304e-064f06d4-6bc302ab-144489ce.jpg,validation," FINAL REPORT HISTORY: Elevated white blood cell count, assess for pneumonia. COMPARISON: None. FINDINGS: 2 views were obtained of the chest. Vague opacity in the right lower lung could reflect developing infection without definite correlate on the lateral view. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours. Medial displacement of the gastric bubble suggests enlarged spleen. IMPRESSION: Vague right lower lung opacity without correlate on lateral view could reflect developing infectious process. Splenomegaly. " 852cf807-843ae612-6c226904-7d3e4985-65c8bff6.jpg,validate/p10/p10900906/s56504262/852cf807-843ae612-6c226904-7d3e4985-65c8bff6.jpg,validation," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: Left arm PICC now occluded. Question PICC position. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. Battery pack is again seen overlying the right hemithorax. Left-sided PICC is seen, distal aspect is not well appreciated, however, may be within the low SVC. The cardiac silhouette remains mildly enlarged. Mediastinal contours are stable. There are low lung volumes. No new focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: Distal aspect of the left PICC is not well seen but may terminate in the distal SVC. " d7fc6c53-92414646-ff34839f-7f4f4c49-25b0814a.jpg,validate/p15/p15023390/s58158162/d7fc6c53-92414646-ff34839f-7f4f4c49-25b0814a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, fever. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ FINDINGS: Heterogeneous opacification at the left lung base may represent a developing infection. Otherwise, the lungs are clear. Left upper extremity PICC line terminates in the lower SVC. Cardiomediastinal silhouette is normal. Again seen is a mild rightward curvature of thoracic spine. No pleural effusion or pneumothorax. IMPRESSION: Subtle heterogeneous opacification of the left lung base may represent a developing infection, possibly atypical pneumonia. " 5a3fa739-807e5667-fd54fbfb-1df52e6a-5acd167c.jpg,validate/p12/p12594793/s54328670/5a3fa739-807e5667-fd54fbfb-1df52e6a-5acd167c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CAD s/p PCI // Please evaluate for any evidence of pulmonary edema Please evaluate for any evidence of pulmonary edema IMPRESSION: There no prior chest radiographs available for review. Heart is normal size. Lungs are clear. No pleural abnormality. The stomach is severely distended with air. " 24116668-762fa810-f326c820-abe66a0e-96edc83e.jpg,validate/p18/p18397764/s53334825/24116668-762fa810-f326c820-abe66a0e-96edc83e.jpg,validation," FINAL REPORT HISTORY: Syncope. 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. A punctate sclerotic focus projecting over the intersection of the left fifth posterior and third anterior rib is unchanged from prior study and likely represents a calcified bone island or granuloma. Lungs are otherwise clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute intrathoracic process. " 0ae571fc-a9cf1c9c-79a9f5e1-98bb16f0-1495df85.jpg,validate/p11/p11455001/s53957792/0ae571fc-a9cf1c9c-79a9f5e1-98bb16f0-1495df85.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with respiratory insufficiency. COMPARISON: ___. FINDINGS: The endotracheal tube is in adequate position at 3.2 cm above the carina. There is right-sided subclavian line projecting in the lower SVC. The NG tube is also in adequate position. The mediastinal and cardiac contour are within normal limits and unchanged. Stability of the mild-to-moderate pleural effusion with bibasilar atelectasis. CONCLUSION: 1. The tubes are in adequate position. 2. Stability of the moderate bibasilar atelectasis and pleural effusion. " 65d92abe-363a5b28-d69bd069-adf893ac-a5ab63ad.jpg,validate/p11/p11091044/s55801364/65d92abe-363a5b28-d69bd069-adf893ac-a5ab63ad.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with s/p chest tube placement. // repeat after chest tube placement. TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ at 15:45 FINDINGS: Left chest tube in place. There is a small left apical pneumothorax. Left base opacity is likely due to combination of small pleural effusion and atelectasis. The right lung is clear. No right pleural effusion or focal consolidation is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Small left apical pneumothorax with left chest tube in place. Left base opacity likely due to combination of small pleural effusion and atelectasis. " 5686d3bf-ab6d948e-bede562b-af161f52-835f8a6a.jpg,validate/p12/p12139354/s59015436/5686d3bf-ab6d948e-bede562b-af161f52-835f8a6a.jpg,validation," FINAL REPORT HISTORY: Fever and tachycardia. COMPARISON: ___. FINDINGS: Single frontal view of the chest. The catheter of a right chest wall port terminates in the lower SVC. Heart size and cardiomediastinal contours are normal. Lung volumes are low. Numerous ill-defined nodular opacities are consistent with known pulmonary metastases. The azygous vein is very prominent. No lobar consolidation, pleural effusion, or pneumothorax. IMPRESSION: Numerous pulmonary nodules consistent with known metastases. " 3d2dcd58-76ba3a81-1669dc6e-986d71aa-206dd135.jpg,validate/p19/p19937193/s55464659/3d2dcd58-76ba3a81-1669dc6e-986d71aa-206dd135.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with seizure and new cough, now has increased O2 requirement // ?infiltrate ?infiltrate IMPRESSION: There no prior chest radiographs since ___ most recently ___. In the setting of chronic moderate cardiomegaly and persistent pulmonary vascular congestion, new opacification at the lung bases should be treated as possible edema. Alternatively this could represent aspiration, particularly in the right lower lobe. Small left pleural effusion is new. No pneumothorax. " 232e6337-d49c3c6a-09fed104-5daa05b1-840cb26b.jpg,validate/p18/p18378270/s51672651/232e6337-d49c3c6a-09fed104-5daa05b1-840cb26b.jpg,validation," FINAL REPORT HISTORY: Loss of consciousness, seizure. TECHNIQUE: Chest: Frontal and lateral views. COMPARISON: ___. FINDINGS: Dual lead left-sided pacemaker is again seen with the distal end of the study positions of the right atrium and right ventricle. Only seen on the lateral view, there is patchy streaky opacity projecting over the lower posterior lungs, similar to that seen on ___, which may represent atelectasis or scarring, not seen on the frontal view. Findings could also be related in part to adjacent osteophytes. No definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No overt pulmonary edema is seen. IMPRESSION: Streaky opacity projecting over the lower lung fields on the lateral view, not seen on the frontal view, similar appearance to chest radiographs from ___, may relate to atelectasis/scarring and possibly adjacent osteophytes. " 32f14351-28c99dab-583fa51c-7bf2e1a5-14729a9e.jpg,validate/p12/p12138413/s59968719/32f14351-28c99dab-583fa51c-7bf2e1a5-14729a9e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with history of Atrial fibrillation, on warfarin, and HTN who presented with fatigue and leg swelling, found to have complete heart block with variable junctional escape, along with elevated troponin and BNP concerning for NSTEMI with concomitant heart failure // ? interval change ? interval change IMPRESSION: In comparison with the study of ___, there is little change. Again there is enlargement of the cardiac silhouette with mild vascular congestion. The right IJ temporary pacer is been removed and replaced with a right subclavian pacer that extends to the right atrium. Otherwise little change. " bb19293c-4e9f8d2c-c876d191-9e868f3d-1ddf3867.jpg,validate/p11/p11350326/s56591371/bb19293c-4e9f8d2c-c876d191-9e868f3d-1ddf3867.jpg,validation," FINAL REPORT HISTORY: Chest pain, shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary process. " 452705f5-dcf25e10-22343f9e-d58c7749-ef9e8644.jpg,validate/p11/p11955591/s53156267/452705f5-dcf25e10-22343f9e-d58c7749-ef9e8644.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Productive cough, evaluation for abnormalities. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. There are no pleural effusions. There is mild enlargement of the left hilus and a double contour, potentially explained by an atelectatic lung region. In addition, a linear structure is seen projecting over the aortopulmonary window. Overall, there is sufficient evidence to recommend CT, in order to clarify the findings in the region of the left hilus. The size of the cardiac silhouette is normal. No pleural effusions. Otherwise normal lung parenchyma. No pneumothorax. A note was added to the radiology dashboard for communication of important results. " 271ca422-4e99e70e-a884530b-3fc3737d-ce1155f3.jpg,validate/p19/p19087494/s54363221/271ca422-4e99e70e-a884530b-3fc3737d-ce1155f3.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: No prior radiographs for comparison. FINDINGS: Tip of endotracheal tube terminates approximately 4 cm above the carina. Cardiomediastinal contours are within normal limits allowing for rotation. The aorta is tortuous, and the heart demonstrates left ventricular configuration. Lungs are clear except for linear left basilar atelectasis or scar. Moderate gastric distention is present. " 65180cef-6e31c205-824b1b2f-45310384-4cdabebc.jpg,validate/p15/p15993209/s50534528/65180cef-6e31c205-824b1b2f-45310384-4cdabebc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lung abscess and associated effusion // monitoring response to therapy--___ for change from prior TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are stable, cardiac size cannot be evaluated, the aorta is tortuous. Patient is status post CABG. Left pleural effusion and adjacent consolidation has improved. . The right lung is grossly clear. There is no pneumothorax. Sternal wires are aligned. IMPRESSION: Improved left lung consolidation and small left effusion " 1f2a40c9-2d7931e8-3247ffb8-daa01682-8c6c1010.jpg,validate/p13/p13857873/s57690056/1f2a40c9-2d7931e8-3247ffb8-daa01682-8c6c1010.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with recent pacemaker placement here with chest pain. Evaluate for effusion. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. CT chest dated ___. FINDINGS: The lungs are well-expanded. Oblique linear band in the right upper lobe with surgical clip is compatible with post treatment changes and prior resection of a mass. Streaky opacity in the left costophrenic angle likely reflects scarring or atelectasis. The heart is mildly enlarged. Mediastinal contours are unchanged. Left pectoral pacemaker device is unchanged. No pulmonary edema, effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process of. No pulmonary edema. " dd045735-e121f8df-de64560b-017b6181-809beea0.jpg,validate/p18/p18599567/s50269495/dd045735-e121f8df-de64560b-017b6181-809beea0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with polytrauma including rib fractures and R hemothorax now s/p chest tube removal at approx 7:15 PM // interval change s/p chest tube removal - please do at approximately ___ or 10:30PM COMPARISON: ___, 05:41 IMPRESSION: As compared to the previous radiograph, the right chest tube has been removed. The known right rib fractures are constant in appearance. No pneumothorax is visualized. Minimal air collection at the site of the previous tube insertion at the level of the right chest wall. Minimal left and right basilar atelectasis. Unchanged appearance of the cardiac silhouette. " 5cf2981e-a2b5e6f8-16c05c27-a7ad6252-76e7a792.jpg,validate/p15/p15763204/s58958596/5cf2981e-a2b5e6f8-16c05c27-a7ad6252-76e7a792.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain. Evaluate for cardiopulmonary process. COMPARISON: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. Lung volumes are low. Bibasilar and retrocardiac opacities are consistent with atelectasis. The heart size and cardiomediastinal contours are stable. No pleural effusion or pneumothorax. IMPRESSION: Low lung volumes with bibasilar and retrocardiac opacities most consistent with atelectasis. " fd64bcfe-06a2c74c-a49a0ae7-962be3fd-fe044e27.jpg,validate/p13/p13279382/s51972024/fd64bcfe-06a2c74c-a49a0ae7-962be3fd-fe044e27.jpg,validation," FINAL REPORT HISTORY: A ___-year-old man with aspiration. Assess NG tube placement. IMPRESSION: Three successive frontal views of the chest show repositioning of nasogastric tube, first in the upper midline, either in the airway or esophagus, second looped at the gastroesophageal junction, and third still looped at the gastroesophageal junction. Findings were discussed with the medical student normal, by telephone, at 4:00 p.m. Lungs are essentially clear. Heart is top normal size. There is no pleural abnormality. Colon remained significantly distended, a new finding on ___. There is partially formed stool impregnated with contrast agent in the right colon. I recommended abdominal radiographs to assess the full extent of any colonic dilatation or possible obstruction. " 63b11a5f-2fa67145-76d4356a-8491910b-67477d43.jpg,validate/p15/p15079493/s52789259/63b11a5f-2fa67145-76d4356a-8491910b-67477d43.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ongoing leukocytosis, productive cough despite Abx // please assess for interval change, ? infiltrate IMPRESSION: In comparison to ___ chest radiograph, pulmonary vascular congestion is accompanied by worsening asymmetrical perihilar opacities, affecting the right lung to a greater degree than the left. Although potentially due to asymmetrical edema, superimposed pneumonia should be considered within the current clinical context. " 7193a72c-21dfbee5-58095568-20779faa-c4e0d866.jpg,validate/p13/p13652475/s52762127/7193a72c-21dfbee5-58095568-20779faa-c4e0d866.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with new AML, fever to 101, neutropenic right lower lung field rhonchi. COMPARISON: ___ to ___. FINDINGS: New small area of consolidation in right lower lobe mainly seen on the lateral view at the costo-diaphragmatic angle is highly concerning for pneumonia. The left lung is unremarkable. Mediastinal and cardiac contours are normal. Right subclavian line ends in lower SVC. There is no pleural effusion or pneumothorax. CONCLUSION: New consolidation seen on the lateral view at the costo-diaphragmatic angle probably on the right side is worrisome for pneumonia. This was discussed with Dr. ___. " 121c456c-0b1e79f5-5da1cff4-89f4615e-b81ce8e8.jpg,validate/p11/p11104709/s51366664/121c456c-0b1e79f5-5da1cff4-89f4615e-b81ce8e8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CT torso from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Profound weakness, question pneumonia. FINDINGS: AP upright and lateral views of the chest provided. In this patient with known metastatic disease of the chest, there is essentially no change in the large masses that occupying the left lower lobe and left upper lobe compared with a prior study from earlier this month. The right lung remains clear. A small left effusion is difficult to exclude. No right effusion seen. Cardiomediastinal silhouette is stable. Bony structures intact. IMPRESSION: Left lung lesions, better assessed on prior CT, compatible with metastasis without definite interval change. " 682ed74a-57b1fedb-20f93e0c-3a837675-724efec3.jpg,validate/p14/p14755254/s55942594/682ed74a-57b1fedb-20f93e0c-3a837675-724efec3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with b/l pulm edema // ? chf TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Pacer defibrillator leads are unchanged, terminating in the right atrium and right ventricle. There is a left retrocardiac opacity, which most likely represents atelectasis. No other focal consolidation, pleural effusion or pneumothorax. No evidence of pulmonary edema. Heart size is mildly enlarged. IMPRESSION: No acute cardiopulmonary process. " 3e1bc703-36407364-45d3fc50-273cb4b6-22546e2f.jpg,validate/p12/p12844314/s56233535/3e1bc703-36407364-45d3fc50-273cb4b6-22546e2f.jpg,validation," FINAL REPORT HISTORY: Chest pain. Rule out acute process. 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. " 5a736880-17379ff4-128b1e4b-5789a5ab-9db1a4a1.jpg,validate/p14/p14210409/s58577046/5a736880-17379ff4-128b1e4b-5789a5ab-9db1a4a1.jpg,validation," FINAL REPORT INDICATION: ___-year-old with question pneumonia. TECHNIQUE: Frontal and lateral CXR. FINDINGS: A small left pleural effusion and fluid in the major fissure is seen. The cardiomediastinal silhouette and hila are normal. There is no pneumothorax. No pneumonia. IMPRESSION: Small left pleural effusion. " 5c905cea-1408075c-92cde335-c745de81-676ffc92.jpg,validate/p13/p13680126/s59020622/5c905cea-1408075c-92cde335-c745de81-676ffc92.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p LUL segmentectomy // R/O loc eff R/O loc eff COMPARISON: Chest radiographs since ___, most recently ___ at 8:50 a.m. IMPRESSION: Small collection of air has developed at the apex of the postoperative left lung. Apical pleural drain in place. Previous fluid collection or hematoma in the left upper chest has decreased in size, and now there is a small volume of pleural fluid along the lateral and diaphragmatic pleural surfaces, probably draining from above. Emphysema is most severe in the apex the right lung. Heart is normal size. Left hilar shows the expected displacement following upper lobe resection. " 6df689b8-c3d8a16a-065c2176-95c18f53-4f9e225e.jpg,validate/p14/p14344189/s56614013/6df689b8-c3d8a16a-065c2176-95c18f53-4f9e225e.jpg,validation," FINAL REPORT HISTORY: Interstitial lung disease and possible PCP. FINDINGS: In comparison with the study of ___, there is no interval change. Monitoring and support devices remain in place. Diffuse pulmonary opacifications are again seen, suggesting such diagnoses as interstitial lung disease, infection, pulmonary edema, and hemorrhage, all of which are superimposed on chronic diffuse interstitial lung disease. IMPRESSION: Little change. " d02f1fc5-3ab1b98d-484654b2-5116e23e-ae592608.jpg,validate/p15/p15788155/s54582636/d02f1fc5-3ab1b98d-484654b2-5116e23e-ae592608.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. The heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Normal chest radiographs. " 54820810-1ff223c5-79827824-1f8f9c48-d8255c94.jpg,validate/p16/p16844011/s55907494/54820810-1ff223c5-79827824-1f8f9c48-d8255c94.jpg,validation," FINAL REPORT HISTORY: Seizure and fall, to assess for rib fracture. FINDINGS: In comparison with the study of ___, there is again hyperexpansion of the lungs consistent with chronic pulmonary disease. No definite rib fracture, though oblique views could be obtained for further evaluation. No evidence of pneumothorax. " 68d3f255-76356e39-8a71eb6f-fd2f3f08-1a1cd100.jpg,validate/p11/p11582633/s52325126/68d3f255-76356e39-8a71eb6f-fd2f3f08-1a1cd100.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with edema and SOB // r/o acute CP process 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 " b1f02c41-c6261e12-b6275795-b8bd9287-52dd0d9f.jpg,validate/p17/p17713592/s57331010/b1f02c41-c6261e12-b6275795-b8bd9287-52dd0d9f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: PICC that TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs ___ FINDINGS: A left PICC line terminates in the distal SVC. There are no other significant changes compared with prior The lungs are clear without focal consolidation. Pleural and parenchymal scarring at the periphery of the left lung base is unchanged since ___ The cardiac and mediastinal silhouettes are unremarkable. Median sternotomy wires are intact. IMPRESSION: Left PICC line terminates in the distal SVC. NOTIFICATION: The findings were discussed by Dr. ___ with ___ of ___ team on the telephoneon ___ at 11:15 AM, 1 minutes after discovery of the findings. " 626693d2-5bdf6b66-b544287c-e7c1f243-17fdd70e.jpg,validate/p18/p18899080/s54157168/626693d2-5bdf6b66-b544287c-e7c1f243-17fdd70e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new L pleff s/p chest tube placement // r/o PTX COMPARISON: Prior exam performed earlier today. FINDINGS: AP portable semi upright view of the chest. In the interval there has been placement of a left pigtail chest tube with slight decrease in left pleural effusion. No pneumothorax. IMPRESSION: Left pigtail chest tube in place with slightly decreased left pleural effusion. " 1d203503-13bd1903-33e65d4e-cfafe758-56e8d304.jpg,validate/p19/p19478022/s55531817/1d203503-13bd1903-33e65d4e-cfafe758-56e8d304.jpg,validation," 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. " c6e9eb10-276b8271-26a02b42-2b216e31-d4f3c1c4.jpg,validate/p10/p10132217/s50573119/c6e9eb10-276b8271-26a02b42-2b216e31-d4f3c1c4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH TECHNIQUE: Semi-erect portable chest view was read in comparison with prior chest radiograph from ___. FINDINGS: Over last 24 hours, mild to moderate pulmonary edema is unchanged. Mildly enlarged heart, prominent bilateral hila and presumed small bilateral pleural effusions are similar. Right internal jugular line terminates at lower SVC. Mediastinal contour is stable. IMPRESSION: Over last 24 hours, mild to moderate pulmonary edema is unchanged. " f6a7709c-35d6a069-ec9a63df-9a5d350e-7c933151.jpg,validate/p18/p18017572/s52030715/f6a7709c-35d6a069-ec9a63df-9a5d350e-7c933151.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with right-sided pneumothorax, assess for resolution. COMPARISONS: ___. Two views of the chest were obtained. The lungs are well expanded and clear. There is no pleural effusion or residual pneumothorax. Mild right-sided apical pleural thickening is likely a sequela of the traumatic event. The heart is normal in size with normal cardiomediastinal contours. IMPRESSION: No residual pneumothorax. " cac91d6b-0c312250-6e8cf984-2b6bd930-56f2c99f.jpg,validate/p17/p17542660/s51294388/cac91d6b-0c312250-6e8cf984-2b6bd930-56f2c99f.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with worsening liver function. COMPARISON: None. PA & LATERAL VIEWS CHEST: Lung volumes are low which may accentuate lung markings, however they are still somewhat more prominent than expected. Cardiomediastinal silhouette and hilar contours appear grossly unremarkable. There is a trace right pleural effusion. No pneumothorax. IMPRESSION: Low lung volumes with prominent interstitial markings; there may be a component of chronic interstitial disease underlying interstitial edema. No focal consolidation. " 91310c64-f689bd9a-53a0bb24-83baba02-d33e0c78.jpg,validate/p11/p11932181/s53058995/91310c64-f689bd9a-53a0bb24-83baba02-d33e0c78.jpg,validation," FINAL REPORT INDICATION: Lower back pain, pre-operative radiograph. COMPARISON: None. FINDINGS: PA and lateral radiographs were acquired of the chest. The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Bilateral degenerative changes of the acromioclavicular joints are noted. IMPRESSION: No acute cardiac or pulmonary process. " acfee755-a69886af-7461b55e-37d77347-5a1d5492.jpg,validate/p14/p14464018/s58994248/acfee755-a69886af-7461b55e-37d77347-5a1d5492.jpg,validation," FINAL REPORT HISTORY: ___-year-old man status post biventricular ICD placement via left subclavian access. Confirm lead placement. TECHNIQUE: PA and lateral chest radiographs were obtained of the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: The left biventricular ICD is in appropriate position with leads ending at the right atrium, right ventricle and left ventricle appropriately. Moderate cardiomegaly continues without pulmonary edema. Lungs are clear without pneumothorax, consolidation or pleural effusion. IMPRESSION: Left ICD with appropriate lead placement at right atrium, right ventricle and left ventricle. No complications including pneumothorax. " 0af935e5-e6d31d6c-72e2cefa-e01587f9-d779b01c.jpg,validate/p11/p11865423/s55518951/0af935e5-e6d31d6c-72e2cefa-e01587f9-d779b01c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with neuro sx, also with chest tightness // eval for consolidation 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. " 3d2ab042-018dfd66-4c5dd969-26a29326-b64ac69e.jpg,validate/p16/p16154666/s50489437/3d2ab042-018dfd66-4c5dd969-26a29326-b64ac69e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: New dyspnea on exertion. Evidence of chronic heart failure and interstitial lung disease. COMPARISON: No direct chest radiographic comparison available, the examination is compared to a CTA examination from ___. FINDINGS: The lung volumes are low. Moderate cardiomegaly and tortuosity of the thoracic aorta but without evidence of overt pulmonary edema. At the right lung bases, appreciated on both the lateral and the frontal view, there is a subtle increase of interstitial structures, notably in the peribronchial areas. Moreover, there is a subtle zone of parenchymal opacity in the right upper lobe, supporting the suspicion of the presence of a diffuse interstitial process. CT should be performed to confirm or rule out this suspicion. Severe aortic calcifications. Severe valvular ring calcifications. No pneumothorax. No pleural effusions. The information was added to the radiology dashboard. Moreover, the referring physician was paged at the time of observation and dictation. " a9127003-36e1698d-809508ef-46e83618-0f3d2e73.jpg,validate/p14/p14206167/s57078236/a9127003-36e1698d-809508ef-46e83618-0f3d2e73.jpg,validation," 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. " 56236bac-7020ebe6-5785629a-684648d0-2d14e9c5.jpg,validate/p14/p14283639/s56275103/56236bac-7020ebe6-5785629a-684648d0-2d14e9c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man that needs V/Q scan // ordered for CXR for V/Q scan ordered for CXR for V/Q scan COMPARISON: ___ IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion or pneumothorax. " 7930aea9-d0108eda-0487f13b-5d2680c4-bd93f369.jpg,validate/p10/p10013569/s56197670/7930aea9-d0108eda-0487f13b-5d2680c4-bd93f369.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Acute heart failure, evaluation for Swan-___ catheter placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the Swan___ catheter, introduced over the right internal jugular vein, is unchanged in position. The tip is located too much distally and should be pulled back by approximately 4 cm. The course of the catheter is unremarkable. Unchanged appearance of the heart and the lung parenchyma, without substantial interval changes. No pneumothorax. " de33b132-c00cb43a-e513b112-cc791889-1228f71f.jpg,validate/p17/p17892707/s50456732/de33b132-c00cb43a-e513b112-cc791889-1228f71f.jpg,validation," FINAL REPORT STUDY: PA and lateral chest ___. CLINICAL HISTORY: ___-year-old man with non-Hodgkin's lymphoma and malignant pleural effusions. FINDINGS: Comparison is made to previous study from ___. Median sternotomy wires are seen. There are pleural effusions, right worse than left. There are no signs for overt pulmonary edema. No pneumothoraces are present. The effusions have increased since ___ study. " 1a5e6b7f-0b3c1a8c-1fd137b7-6e041535-0ef09c0a.jpg,validate/p16/p16167724/s50338090/1a5e6b7f-0b3c1a8c-1fd137b7-6e041535-0ef09c0a.jpg,validation," WET READ: ___ ___ 6:29 PM Interval increase in bilateral pleural effusions. Bilateral lower lung consolidations persist; increased opacification of the lower lungs bilaterally may be due mostly to pleural fluid or a combination of fluid and worsening consolidations. Discussed with ___ ___ by phone at 18:24 on ___ at time of initial review. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with large SCC of mouth, known aspiration constantly, being kept NPO, but developed acute worsening of hypoxia today after working with PT. // ? interval change in pneumonia COMPARISON: Chest radiographs ___. IMPRESSION: Small to moderate bilateral pleural effusion has developed, partially obscuring regions of consolidation seen earlier in both lower lobes. It is possible that both areas improved, but confirmation with conventional chest radiographs is essential following remission of pleural effusion. Upper lungs are clear. Heart size is normal. Left PIC line ends low in the SVC " e263120f-796f9bc3-db0a1894-37c78764-4ed70f55.jpg,validate/p10/p10254837/s58200553/e263120f-796f9bc3-db0a1894-37c78764-4ed70f55.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA and lateral) INDICATION: ___-year-old woman with a week of cough and hemoptysis; evaluate for consolidation. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: PA and lateral views the chest provided demonstrate persistent moderate cardiomegaly. Scattered pulmonary opacities are noted most confluent in the right lower lung which could reflect multifocal pneumonia versus asymmetric pulmonary edema. No large pleural effusions are seen. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Cardiomegaly, pulmonary edema and probable multifocal pneumonia. " df388a84-e4de14cf-493263de-d9ec924e-cbb656fc.jpg,validate/p17/p17620982/s57855988/df388a84-e4de14cf-493263de-d9ec924e-cbb656fc.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY OF ___ COMPARISON: ___ radiograph. FINDINGS: Cardiomegaly is accompanied by pulmonary vascular engorgement and worsening widespread interstitial edema. Right pleural effusion has increased in size and is now large. Small left pleural effusion has also increased. Basilar lung opacities most likely represent atelectasis. IMPRESSION: Worsening edema accompanied by increasing pleural effusions, right greater than left. " cbb42f00-cbef1d92-624924fe-273a3a33-abe083e6.jpg,validate/p16/p16006682/s54056623/cbb42f00-cbef1d92-624924fe-273a3a33-abe083e6.jpg,validation," 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. " 2e64a575-0e8326f1-dcb866c2-ddf64a77-0602518b.jpg,validate/p16/p16458188/s50410990/2e64a575-0e8326f1-dcb866c2-ddf64a77-0602518b.jpg,validation," FINAL REPORT HISTORY: Several months of cough. FINDINGS: No previous images. The heart is normal in size and the lungs are clear without vascular congestion or pleural effusion. There is mild hyperexpansion of the lungs, raising the possibility of some underlying chronic pulmonary disease. " a2db422a-b0df7495-3db9e793-e90ff7c4-6305f256.jpg,validate/p14/p14280192/s59392226/a2db422a-b0df7495-3db9e793-e90ff7c4-6305f256.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p CABG/MVR, evaluate for pulm edema/ effusion with worsening hypoxia. TECHNIQUE: Single AP view of the chest. COMPARISON: Chest x-ray from ___ FINDINGS: The Swan-Ganz catheter has been removed in the interim. Remaining lines and support devices are in unchanged positions. Pulmonary edema, now moderate, is improved since the prior study. The left lower lobe is collapsed. Bilateral effusions have decreased in size. The cardiac silhouette is mildly enlarged. There is no pneumothorax. IMPRESSION: 1. Interval improvement in pulmonary edema, now moderate. 2. Left lower lobe collapse. Decreased bilateral pleural effusions. " bbcdb51c-48f4378b-11e7eb1f-27382fd1-9561bd79.jpg,validate/p13/p13655179/s59812281/bbcdb51c-48f4378b-11e7eb1f-27382fd1-9561bd79.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma presents with 3 weeks of progressive cough and night sweats // eval PNA eval 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 effusion. " 5b2bca3d-6771f277-015f15d5-a65d4925-2510505b.jpg,validate/p17/p17171812/s52587865/5b2bca3d-6771f277-015f15d5-a65d4925-2510505b.jpg,validation," WET READ: ___ ___ ___ 8:16 AM 1. Right PICC tip in low SVC. 2. Bilateral lower lobe atelectasis. WET READ VERSION #1 ___ ___ ___ 12:52 AM 1. Right PICC tip in low SVC. 2. Bilateral lower lobe atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PICC from outside hosp // eval PICC placement COMPARISON: ___. IMPRESSION: New right-sided PICC line. The tip projects over the lower SVC. No evidence of complications, notably no pneumothorax. Otherwise no relevant change. " 1ffc8024-986d8cce-50305b12-9cf22853-ab877d01.jpg,validate/p12/p12410201/s56035296/1ffc8024-986d8cce-50305b12-9cf22853-ab877d01.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with egoph l>r ahd dry rales r base // abnl ex doe, fatigue TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Sternotomy wires and surgical clips are stable. 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. No significant interval change from ___. " 56d26a89-e162cf54-f26fd531-742f572c-cfe3f8c2.jpg,validate/p18/p18218394/s56835017/56d26a89-e162cf54-f26fd531-742f572c-cfe3f8c2.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Question pneumonia. Patient with history of asthma. Comparison is made with prior study ___. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " c883532f-0d4a48dc-4e276012-459e890d-f599c0ac.jpg,validate/p10/p10702059/s54419387/c883532f-0d4a48dc-4e276012-459e890d-f599c0ac.jpg,validation," FINAL REPORT HISTORY: Decreased breath sounds right lobe. FINDINGS: In comparison with the study of ___, there is again mild enlargement of the cardiac silhouette with tortuosity of the aorta but no vascular congestion or pleural effusion. Specifically, no acute focal pneumonia. " 862e0545-d4092779-12087436-19ce177f-b3cd6613.jpg,validate/p16/p16286577/s53845585/862e0545-d4092779-12087436-19ce177f-b3cd6613.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever/cough // 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. " 10dfb34c-d1168792-2f2ba907-298ab4fa-d5348f7c.jpg,validate/p12/p12927133/s59704932/10dfb34c-d1168792-2f2ba907-298ab4fa-d5348f7c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Cough for two weeks with green sputum, question pneumonia. FINDINGS: PA and lateral views of the chest are provided. There is mild elevation of the left hemidiaphragm. The lungs are clear. No signs of pneumonia or CHF. No effusion or pneumothorax is seen. Cardiomediastinal silhouette appears normal. Bony structures are intact. There is no free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. Left hemidiaphragm mildly elevated. " cf43ee29-c9ddf9ff-eb9c200d-9e55c144-8ce241b8.jpg,validate/p18/p18933476/s50193896/cf43ee29-c9ddf9ff-eb9c200d-9e55c144-8ce241b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with bilateral chest tube // post-pull COMPARISON: ___, 08:41 IMPRESSION: As compared to the previous radiograph, the right chest tube has been removed. The extent of the right pneumothorax is unchanged. Minimal improvement of the right basilar atelectasis. Unchanged appearance of the left hemithorax. " 79ba95c0-8ee534d2-7039f21b-ef5be81e-38882c46.jpg,validate/p15/p15801557/s54600813/79ba95c0-8ee534d2-7039f21b-ef5be81e-38882c46.jpg,validation," FINAL REPORT HISTORY: Altered mental status, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little overall change. There is again hyperexpansion of the lungs with some enlargement of the cardiac silhouette and tortuosity of the aorta. No evidence of acute focal pneumonia. The nodular opacification seen previously in the left upper zone is not appreciated on this study, possibly due to a different obliquity of the patient. " c6126868-dde5a3b3-4ed54015-61a9227d-8ff61605.jpg,validate/p11/p11792958/s50847883/c6126868-dde5a3b3-4ed54015-61a9227d-8ff61605.jpg,validation," FINAL REPORT HISTORY: CHF exacerbation. FINDINGS: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with a pacer device in place and some increasing pulmonary vascular congestion. Opacification at the left base is consistent with some combination of volume loss in the lower lobe, pleural effusion, and possible supervening pneumonia. " c8658102-b1187952-7e7d7671-73bf7938-925fc90e.jpg,validate/p15/p15363567/s56481689/c8658102-b1187952-7e7d7671-73bf7938-925fc90e.jpg,validation," FINAL REPORT HISTORY: Hypoxia and improving hypercarbia but with a rising white count and increased sputum production and at high risk for aspiration. TECHNIQUE: AP and lateral chest radiograph, 2 views. COMPARISON: ___. FINDINGS: Cardiomediastinal silhouette and hilar contours are normal. Previously appreciated left lower lung consolidation is improved but with persistent small left pleural effusion. There is no pneumothorax. Right lung is clear. A PEG tube projects over the left upper quadrant. IMPRESSION: Interval improvement in the left lower lung consolidation which likely represented atelectasis. Persistent small left pleural effusion. " 2d6fe2d9-d160362b-47f6e5d7-8ae71a85-28452c57.jpg,validate/p16/p16531216/s55177456/2d6fe2d9-d160362b-47f6e5d7-8ae71a85-28452c57.jpg,validation," FINAL REPORT INDICATION: Recent chemotherapy, breast cancer, chills and leukocytosis. COMPARISON: CT chest ___ FINDINGS: AP and lateral views of the chest. Slightly low lung volumes. No focal consolidation, pleural effusion or pneumothorax. Streaky right basilar opacity likely reflects atelectasis. The mediastinal and hilar contours are unchanged with tortuosity of the thoracic aorta again seen. Clips are noted in the the left axillary region and the patient is status post left mastectomy. IMPRESSION: No acute cardiopulmonary process. " 9af200b9-7964494c-ae906e74-bad5d2a9-294b7836.jpg,validate/p10/p10326429/s50390069/9af200b9-7964494c-ae906e74-bad5d2a9-294b7836.jpg,validation," FINAL REPORT AP CHEST, 10:11 A.M., ___ HISTORY: ___-year-old woman with hypoxia after vomiting, question aspiration. IMPRESSION: AP chest compared to ___, 8:59 a.m. Asymmetry in opacification of the lungs persists. Left is relatively clear. The right shows edema, and there is a small right pleural effusion, layering posteriorly. It is possible that these are changes due to aspiration, but asymmetric distribution of edema is another possibility, sometimes due to patient positioning. Heart is mildly enlarged, but shifted leftward, without obvious cause. No pneumothorax. Relative elevation of the left hemidiaphragm is presumably due to eventration, but could reflect left upper quadrant pathology such as splenomegaly. Right PIC line ends in the mid SVC. Upper mediastinal widening has been present since at least ___, presumably due to fat deposition. " 0ceba999-63721c97-cf1fe9fa-ca5a05e0-10e932c2.jpg,validate/p19/p19695104/s54046700/0ceba999-63721c97-cf1fe9fa-ca5a05e0-10e932c2.jpg,validation," FINAL REPORT INDICATION: Decreased breath sounds on exam, dyspnea, evaluation for pulmonary edema. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Status post CABG. Multiple clips and sternal wires in situ. No pleural effusions. No pulmonary edema. No pneumonia. No pneumothorax. " 13d27dc8-16c7db92-d4514e6d-61fd09ac-a0acb7dd.jpg,validate/p15/p15514299/s57878159/13d27dc8-16c7db92-d4514e6d-61fd09ac-a0acb7dd.jpg,validation," FINAL REPORT INDICATION: Laceration over the right ribs. Evaluate for pneumothorax. COMPARISONS: None. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The soft tissues are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 49abed97-b42ec072-9e805746-06651488-dee501a2.jpg,validate/p14/p14490191/s54751807/49abed97-b42ec072-9e805746-06651488-dee501a2.jpg,validation," FINAL REPORT INDICATION: Atrial fibrillation. COMPARISONS: None available. FINDINGS: PA and lateral views of the chest demonstrate low lung volumes. No pleural effusion, focal consolidation, or pneumothorax is present. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Right lung base opacity likely represents atelectasis. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " d623ee2b-9cb7bdb0-edc62230-c7cf9f27-675d8340.jpg,validate/p14/p14426231/s57521544/d623ee2b-9cb7bdb0-edc62230-c7cf9f27-675d8340.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness and pre-syncopal // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Linear opacities at the lung bases bilaterally reflect a combination of scarring and atelectasis as seen on a prior cross-sectional study of the chest. There is no new focal consolidation, pleural effusion, or pneumothorax. Heart size and mediastinal contours are stable. Osseous structures appear intact. IMPRESSION: Mild bibasilar scarring/ atelectasis, but no evidence of pneumonia. " 40131150-87c257ce-848d4057-88fc1f8a-3995bcef.jpg,validate/p13/p13903940/s52999135/40131150-87c257ce-848d4057-88fc1f8a-3995bcef.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p proximal extension EVAR, reintubated for hypercarbic resp failure // interval cxr, pulmonary edema TECHNIQUE: Portable AP chest radiograph COMPARISON: Chest radiographs since ___, most recently ___. FINDINGS: Endotracheal and nasogastric tubes are stable and in appropriate position. There has been significant improvement in engorgement of the pulmonary vascular pedicle, pulmonary edema, and layering right pleural effusion. Lung volumes are low with bibasilar atelectasis. Opacity at the left lung base is persistent. No pneumothorax. Surgical clips overlying the left upper chest are unchanged. IMPRESSION: 1. Significantly improved pulmonary edema and right pleural effusion since ___. 2. Persistent left basilar opacity likely represents combination of atelectasis and residual pulmonary edema, however in the right clinical setting, pneumonia cannot be excluded. " d3a1f137-410ee091-891879fd-918434d2-fd002726.jpg,validate/p11/p11514486/s51878922/d3a1f137-410ee091-891879fd-918434d2-fd002726.jpg,validation," 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. " 34170b1b-3c4950d7-478510f2-25b385a0-6df5af58.jpg,validate/p10/p10387377/s54157983/34170b1b-3c4950d7-478510f2-25b385a0-6df5af58.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: CAD COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Small left pleural effusion with subsequent atelectasis. Minimal fluid overload. Borderline size of the cardiac silhouette. No interval appearance of pneumonia. " d24b9202-a98cacf8-9d3a7a96-413145a2-96918c43.jpg,validate/p18/p18934359/s57301835/d24b9202-a98cacf8-9d3a7a96-413145a2-96918c43.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with epigastric pain radiating to her flank. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Relatively low lung volumes are seen, but the lungs are clear. The cardiomediastinal silhouette is within normal limits. Mild mid thoracic dextroscoliosis is noted. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 453fdc2d-723a5d68-e63f885a-112eccff-33a7635e.jpg,validate/p17/p17284612/s58959724/453fdc2d-723a5d68-e63f885a-112eccff-33a7635e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough // ?pna CHRONIC COUGH,ON CONSTANT O2 R/O PNEUMONIA,ABNORMALITY IMPRESSION: In comparison with the study of ___, there is little overall change. Mild to moderate enlargement of the cardiac silhouette without appreciable vascular congestion. No change in the lung linear scarring, with no evidence of acute pneumonia. " d89e3d5f-fc13a1dd-83549832-c759f3f8-c93c4d96.jpg,validate/p12/p12070984/s51039939/d89e3d5f-fc13a1dd-83549832-c759f3f8-c93c4d96.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion. COMPARISON: Comparison is made to the chest radiograph report from ___ as archived images were not available at the time of interpretation. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Heart size is mildly enlarged with mild tortuosity of the thoracic aorta. Hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " a4c5f833-7d077578-d8ac6f89-1e458546-8ba52e2a.jpg,validate/p18/p18259094/s58435277/a4c5f833-7d077578-d8ac6f89-1e458546-8ba52e2a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman PVD on call for leg amputation // r/o intrathoracic process / preop Surg: ___ (AKA) COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Severe cardiomegaly is long-standing small right pleural effusion and mild right basal atelectasis may be present. . Left lung is grossly clear. No pneumothorax. " 30c11a87-448150bb-b0f77eda-bc724fd5-11061018.jpg,validate/p16/p16316457/s58218240/30c11a87-448150bb-b0f77eda-bc724fd5-11061018.jpg,validation," FINAL REPORT CLINICAL HISTORY: Admitted with pneumonia, now worsening hypoxia. CHEST AP There has been no significant change since the initial film of ___. The size of the bilateral effusions is unchanged. The position of the right PICC line is also unaltered. No increased opacification in either lung field is identified. IMPRESSION: No change. " 852b0393-cd268a37-b5cf5942-f7f1ce5c-923b22a9.jpg,validate/p11/p11332825/s55167920/852b0393-cd268a37-b5cf5942-f7f1ce5c-923b22a9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with cardiac arrest COMPARISON: None FINDINGS: AP portable supine view of the chest. Endotracheal tube is seen with its tip located 2.3 cm above the carinal. The orogastric tube extends into the upper abdomen though the tip is excluded from view. Mild edema is noted with hilar congestion and mild interstitial pulmonary edema. Lower lung opacities could reflect aspiration. No supine evidence for large effusion or pneumothorax. Cardiomediastinal silhouette appears grossly unremarkable. No bony injuries. IMPRESSION: ET and OG tubes positioned appropriately. Mild edema with lower lung opacities concerning for aspiration or pneumonia. " 90a7805e-611d926e-e4d8fbfa-33003d99-21894215.jpg,validate/p18/p18971123/s52900276/90a7805e-611d926e-e4d8fbfa-33003d99-21894215.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with eating disorder protocol s/p dubhoff tube which patient manipulated tonight. // Please confirm position. TECHNIQUE: Portable AP upright radiograph view of the chest COMPARISON: Chest radiograph dated ___. FINDINGS: The right subclavian approach PICC line tip projects over the expected region of the distal SVC, unchanged. The Dobhoff tube has been retracted compared to the prior exam and its tip now projects over the expected region of the stomach - is likely just past the GE junction and should be advanced at least 5 cm. The lungs are otherwise well expanded and clear. No focal consolidation, edema, pleural effusion, or large pneumothorax. The right lung apex is cut off from the image. No acute osseous abnormality. IMPRESSION: Dobhoff tube terminates in the proximal stomach. Advancement is suggested for standard positioning. " 6e559418-c63e5d7b-897be06a-9b6d4bcc-cb8cd508.jpg,validate/p16/p16813112/s57901246/6e559418-c63e5d7b-897be06a-9b6d4bcc-cb8cd508.jpg,validation," FINAL REPORT INDICATION: Recent CABG, poor oral intake and vomiting. COMPARISON: ___. CHEST, PA AND LATERAL: Changes of CABG with median sternotomy wires and mediastinal clips. Pulmonary aeration has improved, without focal consolidation. Stable small pleural effusions. Heart size is top normal. Aorta is mildly tortuous and calcified. Mild acromioclavicular arthropathy. IMPRESSION: No acute process. Persistent small pleural effusions. " 11d66df4-3300a603-45be7305-6b7cb6d1-871cdd58.jpg,validate/p16/p16955701/s59050142/11d66df4-3300a603-45be7305-6b7cb6d1-871cdd58.jpg,validation," 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. " 2419a301-14fa3dae-e589e088-9ba3dc20-7025a285.jpg,validate/p15/p15803381/s59612926/2419a301-14fa3dae-e589e088-9ba3dc20-7025a285.jpg,validation," FINAL REPORT HISTORY: Dyspnea, hypoxia, and weakness. COMPARISON: Multiple chest radiographs, most recently from ___. Frontal and lateral radiographs from ___. FINDINGS: There is a moderate left pleural effusion, similar to multiple recent studies. Left basilar opacification is similar to the prior exam, likely atelectasis, but infection cannot be excluded. There is mild pulmonary vascular congestion and cardiomegaly. There is no pneumothorax. IMPRESSION: Mild pulmonary vascular congestion, cardiomegaly, and a moderate left pleural effusion. Persistent left basilar opacification may reflect compressive atelectasis but infection is not excluded. " 6e475a4f-8f74b60f-b209fd45-c8f8d404-2deed8c6.jpg,validate/p19/p19931382/s53607123/6e475a4f-8f74b60f-b209fd45-c8f8d404-2deed8c6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Chest pain, question acute intrathoracic process. FINDINGS: AP upright and lateral views of the chest were obtained. CT chest ___ ___ also used for comparison purposes. There is no focal consolidation, effusion, or pneumothorax. Lung volumes are slightly low. Cardiomediastinal silhouette is normal. Atherosclerotic calcifications along the aortic knob noted. Bony structures appear intact. IMPRESSION: No acute intrathoracic process. " f79c9acc-f240ddc3-7a0ab362-a1c230b6-8f7bf8de.jpg,validate/p13/p13184526/s59151379/f79c9acc-f240ddc3-7a0ab362-a1c230b6-8f7bf8de.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with cough course lung sounds // ? PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Minimal basilar atelectasis is seen. There is no focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 64baf58e-ffa0fd0e-d96ee484-54b2a8cb-5ea3eeb0.jpg,validate/p15/p15746885/s55714985/64baf58e-ffa0fd0e-d96ee484-54b2a8cb-5ea3eeb0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ yo M w/ decompensated HCV cirrhosis, HfPEF, Afib, c/o increased exertional dyspnea. // ?pulmonary edema v. infiltrate COMPARISON: Chest radiographs since ___, most recently ___, read in conjunction with chest CT scan ___. IMPRESSION: Small bilateral pleural effusions increased since ___. Pulmonary hila are chronically enlarged. Mediastinal caliber has decreased since ___ when the chest CT showed mediastinal adenopathy in the prevascular station. Very mild interstitial pulmonary abnormality could be early edema. If symptoms persist after cardioversion, I would recommend chest CT scanning to look for interstitial lung disease. " c6700a8b-ee7ebf7a-b3549686-4972d00f-7dbe6243.jpg,validate/p15/p15883255/s54424326/c6700a8b-ee7ebf7a-b3549686-4972d00f-7dbe6243.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with recently dx PEs, new fevers // evaluate for PNA, atelectasis COMPARISON: Compared to radiographs from ___ IMPRESSION: Cardiomediastinal silhouette is within normal limits. There are bilateral pleural effusions, right greater than left which are stable in size. Bibasilar atelectasis is seen. There are no pneumothoraces. No pulmonary edema or focal consolidation is seen. " 939c227f-48dd3df6-02f575cf-99f0df39-df2c8c82.jpg,validate/p11/p11556950/s50767196/939c227f-48dd3df6-02f575cf-99f0df39-df2c8c82.jpg,validation," 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. " ac21da14-c3d22cf0-ac792ff1-1824ec21-d78bb119.jpg,validate/p11/p11294748/s58378277/ac21da14-c3d22cf0-ac792ff1-1824ec21-d78bb119.jpg,validation," FINAL REPORT HISTORY: Neck pain, left arm weakness after involvement in motor vehicle collision. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities are demonstrated. IMPRESSION: No acute cardiopulmonary process. " 70acbf70-c48bfb3e-d5bb11ac-9e4c665d-d0096ccd.jpg,validate/p10/p10297774/s58585839/70acbf70-c48bfb3e-d5bb11ac-9e4c665d-d0096ccd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF, IABP in place. IABP position? Interval change? TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from ___, and ___. FINDINGS: The tip of the intra-aortic balloon pump projects approximately 1 cm below the aortic knob apex. The right IJ Swan-Ganz projects over the descending right pulmonary artery and should be withdrawn 1-2 cm. Stable mild cardiomegaly without evidence of pulmonary edema. No new focal consolidation concerning for pneumonia or pneumothorax. Unchanged intact median sternotomy wires, mediastinal clips, and a left pacemaker. IMPRESSION: 1. The tip of the IABP projects approximately 1 cm below the aortic knob apex. 2. The right ___ projects over the descending right pulmonary artery and should be withdrawn 1-2 cm into the main pulmonary artery, if desired. " 0f20ee22-e94f2f64-34dacfb1-8619278b-a033c9e6.jpg,validate/p12/p12270337/s50320436/0f20ee22-e94f2f64-34dacfb1-8619278b-a033c9e6.jpg,validation," FINAL REPORT HISTORY: Bilateral lower extremity swelling with worsening dyspnea. COMPARISON: Chest radiograph ___. FINDINGS: An AP view of the chest was reviewed. There is mild cardiomegaly. The mediastinal and hilar contours are unremarkable. There is a small right pleural effusion. The pulmonary vasculature is indistinct. There is no focal consolidation concerning for pneumonia. IMPRESSION: Mild cardiomegaly with indistinct vascular markings and new small right pleural effusion, consistent with mild pulmonary vascular congestion. " 6cad9bdf-e3f54d00-19ba9319-cc1978d8-16701827.jpg,validate/p19/p19528638/s57548127/6cad9bdf-e3f54d00-19ba9319-cc1978d8-16701827.jpg,validation," FINAL REPORT EXAMINATION: Upright portable AP chest radiograph INDICATION: ___M with hematuria x2 weeks, dizziness // R/O Pneumonia TECHNIQUE: Upright portable AP chest radiograph COMPARISON: ___ FINDINGS: Compared to ___, lung volumes remain slightly low. There is consolidation at the lung bases, right greater than left, representing atelectasis, aspiration or pneumonia. No pleural effusion. No pneumothorax. Heart size is normal and unchanged. IMPRESSION: Bibasilar opacities, right greater than left, which may represent atelectasis, aspiration or pneumonia. " caaf4b6e-2a49490b-f5da8d2e-7d8f35ff-44b70d1f.jpg,validate/p16/p16909817/s56704608/caaf4b6e-2a49490b-f5da8d2e-7d8f35ff-44b70d1f.jpg,validation," WET READ: ___ ___ 12:20 PM Subtle opacity in the left lower lobe suspicious for pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough and fever // eval for pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ chest x-ray and ___ abdominal CT. FINDINGS: The lungs are hyperinflated. There is mild scarring at the left lung base abutting the diaphragm, similar to prior CT. There is however superimposed hazy left basilar opacity in the retrocardiac region which localizes posteriorly on the lateral view. Left apical pleural based scarring with associated volume loss is again noted. Prior left-sided Port-A-Cath is no longer visualized. Nipple shadows are noted over the lung bases. The lungs are otherwise clear. No acute osseous abnormalities. IMPRESSION: Subtle opacity in the left lower lobe suspicious for pneumonia. " e66e31fb-56368277-ce2d550f-ac33d146-422fc4cf.jpg,validate/p10/p10151713/s51822615/e66e31fb-56368277-ce2d550f-ac33d146-422fc4cf.jpg,validation," FINAL REPORT HISTORY: Chest pain and productive cough. COMPARISON: Multiple prior studies with the most recent chest radiograph ___. FINDINGS: There is a faint opacity which is likely representative of the atelectasis in the right lower lobe. Otherwise, the remainder of the lungs are clear. Cardiac and mediastinal contours are normal. No acute fractures are identified. IMPRESSION: No acute cardiopulmonary process. " 97b0c437-63bbd6e5-608234e6-555aae9e-58e52ae0.jpg,validate/p18/p18879982/s50146006/97b0c437-63bbd6e5-608234e6-555aae9e-58e52ae0.jpg,validation," FINAL REPORT INDICATION: Pleural effusion. COMPARISON: Chest radiograph ___, ___. FINDINGS: The mediastinal and hilar contours are stable with calcification of the aortic knob. There is no right pleural effusion. Again demonstrated is a stable left loculated pleural effusion. The heart size cannot be assessed due to the presence of this effusion. There has been interval placement of a left chest tube with tip terminating at the left lung base. There is no pneumothorax. There is no focal consolidation concerning for pneumonia. IMPRESSION: Stable left loculated pleural effusion with interval placement of a left chest tube. " 38d5b760-3ac69e49-fa75a43b-15bef2a9-b1b7f7cb.jpg,validate/p10/p10650522/s55234575/38d5b760-3ac69e49-fa75a43b-15bef2a9-b1b7f7cb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CHF having desaturations to high 80s // ? worsening pulm edema vs pneumonia? COMPARISON: ___, 06:13 IMPRESSION: As compared to the previous radiograph, centralized pulmonary edema has increased in severity. Unchanged moderate cardiomegaly. Status post CABG. No larger pleural effusions. No pneumonia. " 4109f723-2db9e882-c70ed953-ee902b1f-bbeabc83.jpg,validate/p12/p12493668/s58567779/4109f723-2db9e882-c70ed953-ee902b1f-bbeabc83.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS decortication for empyema // interval change interval change IMPRESSION: In comparison with the study ___ ___, there is little overall change in the postoperative appearance of the right hemithorax with no evidence of pneumothorax on this side. Right PICC line again extends to the cavoatrial junction. The left lung is clear and there is no evidence of vascular congestion. " ae039f1d-4b1e23ed-a6c4bc82-60979f5a-059d3dc3.jpg,validate/p11/p11745865/s52874036/ae039f1d-4b1e23ed-a6c4bc82-60979f5a-059d3dc3.jpg,validation," 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. " 5297561a-e3327fae-cbc56f3d-f4e20cf4-67c26ce4.jpg,validate/p18/p18881805/s58440114/5297561a-e3327fae-cbc56f3d-f4e20cf4-67c26ce4.jpg,validation," FINAL REPORT INDICATION: Palpitations and presyncope. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral views of the chest were obtained. FINDINGS: In comparison to the prior exam, the lung volumes are slightly lower, accentuating the bronchovascular structures. There is no focal air space opacity, pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " f7a33c03-7e3bd175-021f1da1-493db936-9870931d.jpg,validate/p17/p17378979/s54114771/f7a33c03-7e3bd175-021f1da1-493db936-9870931d.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, cough and fevers. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are clear and lung volumes are normal. No pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. Mediastinal and hilar contours are unremarkable. IMPRESSION: Normal chest radiograph. " a5efd2d8-69be05d1-59286346-8b1862a5-a57c315c.jpg,validate/p14/p14779783/s55027222/a5efd2d8-69be05d1-59286346-8b1862a5-a57c315c.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain // evaluate for cardiomegaly, pulmonary edema, ACS TECHNIQUE: PA and lateral views 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. " 8fe26e54-a08ba295-8322fb5a-2b5360e5-6329bf2c.jpg,validate/p10/p10232836/s58320793/8fe26e54-a08ba295-8322fb5a-2b5360e5-6329bf2c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever, cough // Eval for PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs 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 evidence of pneumonia. " df1dfc77-73fbc905-d0ad4f2b-c37251cb-1e9056b7.jpg,validate/p19/p19054301/s57211600/df1dfc77-73fbc905-d0ad4f2b-c37251cb-1e9056b7.jpg,validation," FINAL REPORT INDICATION: ___-year-old male POD# 5 status post CABG. Patient now with hematocrit drop and possible mediastinal widening on recent chest radiograph. Assess for interval change. COMPARISON: Chest radiographs dating back to ___, most recent postoperative radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: There is unchanged retrocardiac opacification. Bilateral pleural effusions, moderate on the left and small on the right are unchanged. No pneumothorax or pneumomediastinum is evident. Mediastinal contours appear within normal limits given recent cardiac surgery. There is no radiographic evidence of developing mediastinal hematoma. Median sternotomy wires appear intact. There is no interstitial edema. IMPRESSION: 1. Unchanged retrocardiac opacity and bilateral pleural effusions, left greater than right. No significant interval change compared to recent prior examination. 2. No new mediastinal widening to suggest hematoma " aec28a74-ab2d0ecb-aaa180d3-9c30d708-30722367.jpg,validate/p12/p12390274/s58695752/aec28a74-ab2d0ecb-aaa180d3-9c30d708-30722367.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with history of asthma, interstitial lung disease and known pneumonia on levofloxacin presents with worsening oxygen saturation // evaluate interval change for known pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Overall interstitial opacity is increased in the interval which raises concern for development of interstitial edema. Difficult to exclude a superimposed pneumonia though findings appear diffuse. No large effusion is seen. The overall cardiomediastinal silhouette is stable. No pneumothorax. Bony structures are intact. IMPRESSION: Worsening interstitial opacities likely reflect development of interstitial pulmonary edema. Difficult to exclude a subtle superimposed pneumonia. " a9f2d9af-c4b6bae6-6e0b9083-2db8461b-481f87f2.jpg,validate/p13/p13031024/s59557856/a9f2d9af-c4b6bae6-6e0b9083-2db8461b-481f87f2.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with fever // eval for pna TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute intrathoracic process. " a74cdbf0-63560f9d-2e442fad-41281596-9f909c9d.jpg,validate/p14/p14353305/s52663876/a74cdbf0-63560f9d-2e442fad-41281596-9f909c9d.jpg,validation," 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. " fdebdb8c-4103cfbf-8f197567-77a17070-ecf139fb.jpg,validate/p14/p14365867/s57213878/fdebdb8c-4103cfbf-8f197567-77a17070-ecf139fb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung mass and c/f malignancy, s/p bronch w/tbbx on left // ptx COMPARISON: Fluoroscopy from ___. IMPRESSION: Status post fluoroscopy on the left. Extensive left post interventional parenchymal opacities, likely a combination of bleeding and pulmonary edema. No pneumothorax is visualized. Unchanged appearance of the right lung. " 088f4fdb-3816277f-6f38d3d0-c9279611-7f1f205a.jpg,validate/p13/p13665754/s50574495/088f4fdb-3816277f-6f38d3d0-c9279611-7f1f205a.jpg,validation," WET READ: ___ ___ ___ 2:59 PM 2.2 cm ovoid opacity at the right base may reflect a nipple shadow. Consider shallow oblique radiographs with nipple markers for confirmation. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with ACS TnT 0.___ chest pain // eval ? acute chest process r/o additional abnormalities TECHNIQUE: Portable supine AP chest COMPARISON: Chest radiograph ___ FINDINGS: There is mild bibasilar atelectasis. 2.2 cm ovoid opacity at the right base may reflect nipple shadow. The heart is top normal. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. Two adjacent linear opacities projecting over the right axillary soft tissues may reflect skin folds IMPRESSION: 1. 2.2 cm ovoid opacity at the right base may reflect a nipple shadow. Consider shallow oblique radiographs with nipple markers for confirmation. 2. Linear opacities projecting over the right axillary soft tissues could be skin folds or less likely an unusual appearance for fracture of the humerus. Please correlate clinically. NOTIFICATION: The findings were telephoned to ___ ___ by ___ at 14:59, ___, ___ min after discovery. Updated final impression was submitted to the ED ___ nurses for communication to the patient's primary care physician by ___ at 17:48, ___. " 0153563c-30f478ca-01109930-1b316e12-d69196ab.jpg,validate/p17/p17515788/s50163101/0153563c-30f478ca-01109930-1b316e12-d69196ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain, palpitations TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Coronary artery stents are re- demonstrated. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is seen. There are mild degenerative changes noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 7a93b80c-9656e2d5-909042eb-0af84476-5efcc93a.jpg,validate/p13/p13477622/s57116188/7a93b80c-9656e2d5-909042eb-0af84476-5efcc93a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) IN O.R. INDICATION: ___ year old man s/p MIE, NGT dc'd // eval for interval change eval for interval change IMPRESSION: In comparison with the study of ___, the nasogastric tube has been removed. Little change in the appearance of the heart and lungs with bibasilar atelectatic changes and blunting of the costophrenic angles. " 9c583292-47a56ec4-51d4f9d4-e3908f49-14f98d2f.jpg,validate/p16/p16223641/s51144421/9c583292-47a56ec4-51d4f9d4-e3908f49-14f98d2f.jpg,validation," FINAL REPORT STUDY: PA and lateral chest as well as the right side down decubitus chest radiograph performed on ___. CLINICAL HISTORY: ___-year-old woman, shortness of breath and right-sided pleural effusion in the setting of liver abscess. FINDINGS: Comparison is made to the prior radiographs from ___. There are bilateral pleural effusions which are small to moderate in size, right greater than left. On the right side down decubitus radiograph, there is some mild loculation of the fluid at the right base; however, the majority of the effusion appears to layer. The heart size is upper limits of normal. There are no signs for overt pulmonary edema or focal consolidation. There are degenerative changes of the lower lumbar spine with mild wedging of several mid thoracic vertebral bodies. " 294c291b-5f0e592d-7f6e307c-3407f07b-6ac65ac2.jpg,validate/p18/p18551287/s59216986/294c291b-5f0e592d-7f6e307c-3407f07b-6ac65ac2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, myalgia, nonproductive cough. Evaluate for infection. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Compared with the prior study, lung volumes are lower, causing bronchovascular crowding. The heart size is exaggerated from the AP projection. No new focal consolidation, effusion, or pneumothorax. Incidental note is made of embolization coils and a TIPS stent. IMPRESSION: No focal consolidation concerning for pneumonia. " b9901f98-66ba1cbb-45a4f95a-52b520c3-ab3b2cdd.jpg,validate/p18/p18022983/s52601618/b9901f98-66ba1cbb-45a4f95a-52b520c3-ab3b2cdd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p anterior/lateral T11-L3 interbody fusion, chest tube placed intra-operatively, CXR to assess // assess lungs and chest tube s/p surgery in PACU assess lungs and chest tube s/p surgery in PACU IMPRESSION: No previous images. Low lung volumes with atelectatic changes at the bases, especially on the right, following recent surgery. Right chest tube is in place and there is no evidence of pneumothorax. No vascular congestion or acute focal pneumonia. " 8d186722-75ec6c71-d6e3e2a1-dde09a49-242b6d18.jpg,validate/p13/p13528930/s55508899/8d186722-75ec6c71-d6e3e2a1-dde09a49-242b6d18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atrial fibrillation on amiodarone COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation. There is no pulmonary edema or pleural effusion. Mild cardiomegaly is stable. Mediastinal, hilar, and cardiac contours are normal. IMPRESSION: Mild cardiomegaly, otherwise normal chest radiograph. " 2408f4d6-94618411-c1909ac9-ada980e7-8fd2c598.jpg,validate/p16/p16292028/s51764127/2408f4d6-94618411-c1909ac9-ada980e7-8fd2c598.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: Chest pain this morning. FINDINGS: Frontal and lateral views of the chest. No prior. On the frontal exam, the lungs are clear. However, on the lateral, there is increased opacity projecting over the spine. Elsewhere, the lungs are clear and the costophrenic angles are sharp. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Subtle increased opacity in the lateral view projecting over the spine, potentially atelectasis given lack of findings on the frontal view, however repeat exam with better inspiratory effort can be performed to further evaluate. " e382a6d0-a0ffa235-fe10286e-fbdebf17-31fcf61a.jpg,validate/p16/p16931692/s55168634/e382a6d0-a0ffa235-fe10286e-fbdebf17-31fcf61a.jpg,validation," WET READ: ___ ___ ___ 3:29 AM PICC terminates at the confluence of the bracheocephalic and SVC, retracted since the prior study d/w ___ iv team at 3:30 am ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: PICC line placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The patient still carries a PICC line. The tip of the line terminates at the confluence of the brachiocephalic vein and the superior vena cava, it has been retracted since the prior study. There is no evidence of complications, no pneumothorax. The size of the cardiac silhouette continues to be mildly enlarged. No pulmonary edema. No pneumonia. No larger pleural effusions. " 1a14fbfa-2c33e416-db452ecb-f4bbbb81-8904d774.jpg,validate/p18/p18033645/s51502473/1a14fbfa-2c33e416-db452ecb-f4bbbb81-8904d774.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 3 EXAMS INDICATION: ___ year old man s/p NG tube placement // confirm correct placement of NG TECHNIQUE: 3 Portable chest COMPARISON: ___. FINDINGS: This series of 3 films demonstrate interval placement of a second NG tube. Both of the NG tubes are in the stomach. The ET tube, subclavian line, and bilateral mid and lower lobe volume loss are unchanged. IMPRESSION: No change. " 32e173ce-a06285b8-a69627a1-e8ba3af4-b4f9f6f4.jpg,validate/p15/p15985103/s52937369/32e173ce-a06285b8-a69627a1-e8ba3af4-b4f9f6f4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Followup chest x-ray after pneumothorax. COMPARISON: ___. FINDINGS: As compared to the radiograph from 3:38 p.m., there is no longer evidence of a visible right pneumothorax. The masses in the right lung are unchanged. " 45ed6925-68caae60-b9f2c50c-fd1f08bc-df88254f.jpg,validate/p14/p14493762/s56251179/45ed6925-68caae60-b9f2c50c-fd1f08bc-df88254f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with duodenal perf, respiratory failure, and right chest pigtail // eval interval change eval interval change IMPRESSION: In comparison with the study of ___, of the monitor and support devices are essentially unchanged. Diffuse bilateral pulmonary opacifications processed. Although this most likely represents pulmonary edema, the possibility of pneumonia or even ARDS can certainly not be excluded. The left hemidiaphragm is now well seen, consistent with improving pleural effusion and volume loss in the left lower lobe. " fc054b98-a5fb00cf-4b78fca8-b5d1d3bd-0197d33e.jpg,validate/p11/p11218867/s55747846/fc054b98-a5fb00cf-4b78fca8-b5d1d3bd-0197d33e.jpg,validation," FINAL REPORT HISTORY: Chest tube and possible pneumothorax. FINDINGS: In comparison with the study of ___, the left chest tube remains in place, though the tip is several cm lower. No evidence of pneumothorax. Minimal atelectatic changes at the left base. Port-A-Cath remains in place. " 7cb3c3e7-d1d799e7-d53a4d53-402c1088-df6ee51d.jpg,validate/p12/p12610389/s56070381/7cb3c3e7-d1d799e7-d53a4d53-402c1088-df6ee51d.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with asthma and hypoxia. Question pneumonia. COMPARISON: ___. FINDINGS: AP view of the chest. The lungs are clear of focal consolidation or large effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 90eecc54-e343be61-ec1e776e-f9ae68c2-bd2a46c8.jpg,validate/p15/p15849649/s51941425/90eecc54-e343be61-ec1e776e-f9ae68c2-bd2a46c8.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with metastatic colon cancer and lower extremity edema. COMPARISON: None. FINDINGS: PA and lateral views of the chest. Left chest wall port is seen with the catheter tip in the mid SVC. There is elevation of the right hemidiaphragm. The lungs are clear without consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. No evidence of pulmonary edema. " dc73a694-37b474d2-cc60be7d-f7c6d350-d7bb56a9.jpg,validate/p17/p17476472/s53136247/dc73a694-37b474d2-cc60be7d-f7c6d350-d7bb56a9.jpg,validation," FINAL REPORT INDICATION: ___F with fever, cough, muscle aches. evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear without focal consolidation. Pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 4576dac1-ec9a7689-0feea42f-597b0b67-dabdf996.jpg,validate/p19/p19947046/s59066579/4576dac1-ec9a7689-0feea42f-597b0b67-dabdf996.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is subtle right upper lobe patchy opacity in one to two locations which could represent pneumonia. The left lung is clear. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Subtle patchy opacities projecting over the right upper lung may raises concern for infection. Recommend followup to resolution. " 63da54b5-d4ffff71-1443655e-21096fa1-78281c31.jpg,validate/p15/p15805011/s51529532/63da54b5-d4ffff71-1443655e-21096fa1-78281c31.jpg,validation," FINAL REPORT INDICATION: Cough. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: 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. " 340dd499-0171eee3-de6bfd61-ea21e6c3-7c7f5c9e.jpg,validate/p17/p17914820/s53111089/340dd499-0171eee3-de6bfd61-ea21e6c3-7c7f5c9e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with pericardial drain placement following right ventricular puncture during AICD placement. Now with worsening hypotension and hypoxemia. Evaluation for pneumonia. COMPARISON: Comparison is made to radiograph of the chest from ___. FINDINGS: Upright portable radiograph of the chest demonstrates unchanged position of dual-lead AICD, with leads terminating in the right atrium and right ventricle. The cardiac size is unchanged since the prior study, and there is a new pericardial drain in place. Increased retrocardiac opacification is likely due to atelectasis, and increased bilateral interstitial markings reflect mild underlying edema. Bilateral reticular opacities are unchanged due to interstitial pulmonary fibrosis, along with stable left apical scarring. There is no pneumothorax. The proximal esophagus is distended with air, possible due to dysmotility. IMPRESSION: 1. Mild acute interstitial edema. 2. Increased left retrocardiac opacity, likley atelectasis. 3. Distended proximal esophagus, possibly due to dysmotility. Consider barium study if esophageal symptoms are present. " 5824badd-9331e4b6-6cd5e2e6-cf334bfa-2e9eb1e3.jpg,validate/p13/p13689440/s53393645/5824badd-9331e4b6-6cd5e2e6-cf334bfa-2e9eb1e3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with as above // s/p pacer lead change r/o PTX, check lead placement TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right PICC line tip is at the level of mid SVC. Cardiomediastinal silhouette is unchanged. Bilateral pleural effusions are present, substantial. Mild vascular enlargement is noted. There is no pneumothorax. " 010ccb7a-61519315-74608616-6b25380a-e9fd2b9e.jpg,validate/p14/p14368383/s59431821/010ccb7a-61519315-74608616-6b25380a-e9fd2b9e.jpg,validation," FINAL REPORT INDICATION: ___F with cardiac arrest // ETT placement TECHNIQUE: Single supine portable view of the chest COMPARISON: None FINDINGS: An ETT has been placed which extends into the region of the carina and should be retracted for better positioning. Cardiac size is enlarged even given the AP view. Hazy area of opacity in the right upper hemi thorax and left lower lobe is compatible with pulmonary edema. No pleural effusion or pneumothorax. IMPRESSION: ET tube in the region of the carina and should be retracted for better positioning. Right upper lobe opacity and left lower lobe is compatible with pulmonary edema, less likely pneumonia given the patient's presentation. NOTIFICATION: Subsequent exam was already performed which shows the ETT in appropriate position. " d26734cb-36cfb21f-4b74fd08-31bb9b9c-a9def1a2.jpg,validate/p13/p13874311/s54603185/d26734cb-36cfb21f-4b74fd08-31bb9b9c-a9def1a2.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Leukocytosis. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no pleural effusions or pneumothorax. Mild degenerative changes are similar along the thoracic spine. IMPRESSION: No evidence of acute disease. " 43ff6b3b-28dc5109-bfca7c4c-19323cd8-970e62b3.jpg,validate/p15/p15403852/s55172668/43ff6b3b-28dc5109-bfca7c4c-19323cd8-970e62b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p AVR/MVR // eval effusions/pneumonia eval effusions/pneumonia COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Moderate pulmonary edema has improved since ___, best appreciated in the right lung. On the left however there is new left perihilar consolidation concerning for pneumonia, although asymmetric edema is a possibility. There is also at least a moderate left pleural effusion. Moderate enlargement of cardiac silhouette is long-standing. No pneumothorax. Tracheostomy tube midline. Indwelling left PIC line ends in the upper right atrium. " a4009f5f-ee586002-b68c3478-3009d110-698ab9f0.jpg,validate/p15/p15586579/s53264165/a4009f5f-ee586002-b68c3478-3009d110-698ab9f0.jpg,validation," WET READ: ___ ___ 11:29 AM 1. Probable mid right lung pneumonia. 2. Symmetrically obscured inferolateral heart borders are likely related to a large pericardial fat pad. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M with dyspnea. Crackles on auscultation. TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable AP chest radiograph FINDINGS: The lungs are well expanded. There are subtle open opacities in the mid right lung not definitively identified on lateral radiograph. Hazy opacities symmetrically obscure the inferolateral heart borders bilaterally. No pleural effusion or pneumothorax. Heart size is top normal. IMPRESSION: 1. Probable mid right lung pneumonia. 2. Symmetrically obscured inferolateral heart borders are likely related to a large pericardial fat pad. " 5ff58c0f-61eb79e9-2a801dec-6958d825-bf6495cf.jpg,validate/p13/p13035993/s54206396/5ff58c0f-61eb79e9-2a801dec-6958d825-bf6495cf.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with history of diastolic heart failure. Questionable pulmonary edema, assess for interval change. 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 at the upper limit of normal variation, but no typical configuration abnormality can be identified. Thoracic aorta is mildly widened and elongated but no local contour abnormalities or advanced wall calcifications are seen. The pulmonary vasculature is characterized by relatively prominent central vessel and some irregularity in the peripheral vascular distribution, all compatible with some evidence of COPD. Acute parenchymal infiltrates, however, cannot be identified. The lateral and posterior pleural sinuses are free from any significant fluid accumulation. No evidence exists in the apical area on the frontal view. Skeletal structures of the thorax grossly within normal limits. Comparison is extended to seven preceding PA and lateral chest examinations beginning ___ to now. At no point was there any significant interval change in the appearance of the findings. On all studies, the heart size was observed to be at the upper limit of normal variation. According to history, the patient had undergone right coronary artery single vessel angioplasty intervention at another institution. An additional finding made on the chest x-ray is that the patient is very adipose with large soft tissue structures surrounding the thorax. IMPRESSION: Stable chest findings. No signs of acute pulmonary infection or acute CHF with pulmonary congestion. " 562a5755-da2ee0e9-b3d02461-32dfb6ce-733c00da.jpg,validate/p16/p16030116/s59948146/562a5755-da2ee0e9-b3d02461-32dfb6ce-733c00da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with sob, cough // r/o infiltrate COMPARISON: ___ and ___ FINDINGS: PA and lateral views of the chest provided. Mild linear density in the lower lungs left greater than right likely reflect atelectasis, difficult to exclude an early pneumonia. No large effusion or pneumothorax. No evidence of edema or pneumonia. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: Lower lung atelectasis with possible early pneumonia at the left lung base. " c6e86a41-af0dc99d-365a23d9-086d34ff-2de8c859.jpg,validate/p17/p17517983/s58867575/c6e86a41-af0dc99d-365a23d9-086d34ff-2de8c859.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with recurrent chest pain. History of chronic kidney disease, on dialysis. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. When compared with most recent exam, there has been interval improvement of bilateral opacities with some persistent indistinct pulmonary vascular markings. There are small bilateral pleural effusions, new since prior. Mildly enlarged cardiac silhouette is unchanged. No acute osseous abnormality is identified. IMPRESSION: Interval improvement in the bilateral parenchymal opacities, most suggestive of improved pulmonary edema. New small bilateral pleural effusions. " 0cc6d4a7-c4ca8a72-a856b1cc-b65ee8e1-1e6f860e.jpg,validate/p18/p18300044/s57763561/0cc6d4a7-c4ca8a72-a856b1cc-b65ee8e1-1e6f860e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD and new tachypnea. // etiology of tachypnea? etiology of tachypnea? IMPRESSION: In comparison with the study of ___, there are continued bilateral pulmonary opacifications. More coalescent areas in the right mid to upper zone as well as much of the left hemithorax raises the possibility of superimposed pneumonia in a patient with elevated pulmonary venous pressure. Blunting of the costophrenic angles persists. " 5111662d-13945b6a-b656e094-52c92b3a-3b79d4ac.jpg,validate/p11/p11094463/s58718716/5111662d-13945b6a-b656e094-52c92b3a-3b79d4ac.jpg,validation," 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. " a7796b4f-e2ab9d1e-cfe98ed3-605114f1-04b36cd2.jpg,validate/p14/p14290495/s56938469/a7796b4f-e2ab9d1e-cfe98ed3-605114f1-04b36cd2.jpg,validation," FINAL REPORT INDICATION: Chest tightness in the setting of anxiety, here to evaluate for pneumonia. COMPARISON: Chest radiographs dated ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: 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. The trachea is midline. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 868f9103-10b6fe32-9131b912-015b412b-05a2b277.jpg,validate/p10/p10354193/s53284921/868f9103-10b6fe32-9131b912-015b412b-05a2b277.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with R chest wall pain // eval PTX, effusion COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Best seen on the lateral projection is airspace consolidation in the right lower lobe in which is concerning for pneumonia. There may be associated tiny pleural effusion. There is mild elevation of the right hemidiaphragm. Left lung is clear. No signs of edema or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Right lower lobe pneumonia with associated small pleural effusion. " 50398157-eb03ae75-799d03ae-cfd399d0-db9b3f00.jpg,validate/p18/p18035751/s50613969/50398157-eb03ae75-799d03ae-cfd399d0-db9b3f00.jpg,validation," FINAL REPORT HISTORY: Chest pain radiating to the back. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. The lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 9997aa97-88716fe8-94296014-8ab9c350-80357049.jpg,validate/p15/p15621186/s58567511/9997aa97-88716fe8-94296014-8ab9c350-80357049.jpg,validation," FINAL REPORT AP CHEST, 7:54 A.M. ON ___ HISTORY: ___-year-old male fell, with confusion. Evaluate possible pneumonia. IMPRESSION: AP chest compared to only prior chest radiograph ___: Lungs are low in volume. Heterogeneous opacification at the base of the left lung could be early pneumonia. There is no pulmonary edema. Ascending thoracic aorta is heavily calcified, but the contour of the mediastinum has not changed since ___ and there is no pulmonary edema. Heart size is normal. " dcfbc656-d661cdaa-0276bdca-8e43978e-bf4ba906.jpg,validate/p17/p17018536/s59019561/dcfbc656-d661cdaa-0276bdca-8e43978e-bf4ba906.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of cough, syncope. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. It is difficult to exclude small bilateral pleural effusions, particularly on the left. Minimal left mid lung atelectasis is seen. There is mild central pulmonary vascular engorgement. The cardiac silhouette is mildly enlarged. Mediastinal contours are grossly stable given differences in inspiration. IMPRESSION: 1. Mild central pulmonary vascular engorgement. Small bilateral pleural effusions versus pleural thickening; finding has been seen on frontal radiograph from at least ___ and may represent pleural thickening. 2. Mild enlargement of the cardiac silhouette. " ba9d9e42-ea42a74c-03f2a0bf-2f3df169-ffcb23aa.jpg,validate/p13/p13622559/s53472748/ba9d9e42-ea42a74c-03f2a0bf-2f3df169-ffcb23aa.jpg,validation," WET READ: ___ ___ ___ 9:53 PM No acute intrathoracic process. Right PICC in mid SVC is appropriate. A ___ ___ ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: HIV, presenting with recurrent fevers, question pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia. An area of minimally increased lung density at the lung bases, better seen on the lateral than on the frontal radiograph, is unchanged. There are no newly appeared parenchymal opacities. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. Right-sided PICC line is unchanged. " 8910eca4-d8176a73-6e1f1381-cf81a893-ec423a36.jpg,validate/p13/p13071917/s50148430/8910eca4-d8176a73-6e1f1381-cf81a893-ec423a36.jpg,validation," FINAL REPORT INDICATION: History: ___F with cp // r/o infiltrate COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: There is hyperinflation. There is a large hiatal hernia. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. " 3f58ce1a-63ebbc69-8b11c559-0070b777-4daad377.jpg,validate/p16/p16077947/s58631468/3f58ce1a-63ebbc69-8b11c559-0070b777-4daad377.jpg,validation," FINAL REPORT INDICATION: ___ year old man with weakness and aflutter with RVR, evaluate for pneumonia or CHF.. COMPARISON: None Available. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: Mild to moderate cardiomegaly is unchanged. There is no focal consolidation. There is no overt pulmonary edema. There is no pneumothorax or pleural effusion. IMPRESSION: Unchanged moderate mild to moderate cardiomegaly. No overt pulmonary edema or radiographic evidence of pneumonia. " d6f0c76b-6775603a-35a3a6eb-ed6a711f-9cb25f7c.jpg,validate/p14/p14596797/s55762436/d6f0c76b-6775603a-35a3a6eb-ed6a711f-9cb25f7c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with FN // r/o infx COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous image. No pneumonia, no pulmonary edema, no pleural effusions. Unchanged right pectoral Port-A-Cath. The size and shape of the cardiac silhouette is constant. " 3d6d68aa-9d35b913-a15fece4-63393d34-ee249118.jpg,validate/p15/p15517844/s58143364/3d6d68aa-9d35b913-a15fece4-63393d34-ee249118.jpg,validation," FINAL REPORT INDICATION: ___F w/cough for 3 weeks TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is significant elevation of the left hemidiaphragm. There is no prior to evaluate for acuity of this finding. The lungs however are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No definite acute cardiopulmonary process, no focal consolidation. Elevation of the left hemidiaphragm, the chronicity of which is uncertain. " f767bab0-4898ec21-e2397dfc-7c07e20a-fb895e2f.jpg,validate/p17/p17393801/s58076889/f767bab0-4898ec21-e2397dfc-7c07e20a-fb895e2f.jpg,validation," FINAL REPORT HISTORY: ___M with known pleural effusion, assess progression COMPARISON: Prior exam from ___ and CT of the chest dated ___. FINDINGS: PA and lateral views of the chest were provided. Since the prior exam, left pleural effusion has decreased with improved aeration in the left lower lung. There is minimal right pleural effusion which persists and appears unchanged. No signs of edema or pneumothorax. The heart size appears stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Small residual bilateral pleural effusions and lower lobe atelectasis, improved on the left. " 04248201-8ba460dd-381173a6-1c0ca438-88a5133c.jpg,validate/p17/p17036580/s51327920/04248201-8ba460dd-381173a6-1c0ca438-88a5133c.jpg,validation," FINAL REPORT HISTORY: Increasing white count. FINDINGS: In comparison with the study of ___, there are again areas of increased opacification at the bases with poor definition of the hemidiaphragms, more prominent on the left. This is consistent with layering pleural effusion and underlying atelectasis. In the appropriate clinical setting, the possibility of supervening pneumonia would have to be considered. Tracheostomy tube remains in place and there is no evidence of vascular congestion. " 142ac7d5-2a4418fb-309fcd35-ab028059-5aa94f47.jpg,validate/p10/p10892549/s57134204/142ac7d5-2a4418fb-309fcd35-ab028059-5aa94f47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with empyema, chest tube in place. // Comparison to previous, obtain rior to 7 am ___ please. Comparison to previous, obtain rior to 7 am ___ please. TECHNIQUE: Frontal chest radiograph COMPARISON: Radiograph dated ___ and CT dated ___ FINDINGS: There is increased opacity overlying the mid left lung which could represent increase in loculated fluid collection in the region of the previously described empyema (CT dated ___). Left-sided pleurX catheter remains unchanged position. Allowing for changes in position, the cardiomediastinal silhouette is unremarkable. There is blunting of the left costophrenic angle and associated opacity likely representing atelectasis, but an infectious process cannot be ruled out. IMPRESSION: There is increased opacity overlying the mid left lung, which could represent an increase in loculated fluid collection in the region of the previously described empyema. " a0fd1226-9477f44c-d43892e1-940297af-5356c049.jpg,validate/p18/p18780736/s58819701/a0fd1226-9477f44c-d43892e1-940297af-5356c049.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with CLL // Increased cough. Assess for pneumonia/abnormality Increased cough. Assess for pneumonia/abnormality COMPARISON: Prior chest radiographs ___. IMPRESSION: Moderate left pleural effusion has increased substantially since ___, obscuring the left heart border, responsible for left lower lobe atelectasis. . I cannot say whether the diameter of the cardiomediastinal silhouette has increased. This may be an important consideration regarding possible pericardial effusion. Small right pleural effusion is minimally larger. Left upper lobe is clear. Atelectasis at the right lung base is mild. An indwelling right subclavian infusion catheter ends just above the origin of the SVC, unchanged. " a4f90f66-4fcb4bce-0314b185-10357a9f-d9973cb0.jpg,validate/p17/p17883072/s53782263/a4f90f66-4fcb4bce-0314b185-10357a9f-d9973cb0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with AML, new tachypnea and tachycardia // ? evaluate volume overload, evaluate for effusion TECHNIQUE: CHEST TWO VIEWS. COMPARISON: 614 at ___ IMPRESSION: The right-sided PICC line is unchanged. At the aeration is improved compared to the study from earlier the same day. There small areas of volume loss at both bases but no focal infiltrate. The heart is mildly enlarged. There is mild pulmonary vascular redistribution. There possible tiny pleural effusions. Overall, this is an improved appearance compared to the study from earlier the same day " 39f5048d-50e87b9b-4068c9da-a92507ba-06ea6346.jpg,validate/p16/p16161095/s52790583/39f5048d-50e87b9b-4068c9da-a92507ba-06ea6346.jpg,validation," FINAL REPORT INDICATION: Dyspnea, evaluate for cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: This study is read in conjunction with concurrent CTA Chest FINDINGS: There are bibasilar opacities, right greater than left. An opacity at the periphery of the right lung base corresponds to pulmonary infarct seen on CT. The heart is mildly enlarged. There is no pleural effusion or pneumothorax. Visualized upper abdomen is unremarkable. Degenerative changes are seen in the thoracic spine. IMPRESSION: Bibasilar opacities which may represent atelectasis/aspiration given known PE. Right lower lobe infarct better characterized on concurrent CT chest. " ddc25440-accf6af2-ee544305-061d20d4-8b46ef2d.jpg,validate/p18/p18236397/s57360678/ddc25440-accf6af2-ee544305-061d20d4-8b46ef2d.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ No prior studies for comparison. FINDINGS: Cardiomediastinal contours are normal. Lungs are clear except for a calcified granuloma in the right mid lung. Focal pleural or extrapleural opacity adjacent to the intersection of the left eighth posterior and left seventh anterior ribs is noted. Costophrenic sulci appear clear. Degenerative changes are present in the spine. IMPRESSION: Focal pleural opacity in lower left hemithorax could reflect a localized pleural plaque, other cause of pleural thickening, or a focal extrapleural lipoma. In the absence of prior radiographs for comparison, followup radiograph in three months may be helpful to assess for stability and to exclude an active process in this region. Findings entered into radiology communications dashboard on ___. " 975f31d4-10070e66-62ae9185-b476fe8d-504635fe.jpg,validate/p15/p15610977/s54971786/975f31d4-10070e66-62ae9185-b476fe8d-504635fe.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph, portable AP. INDICATION: ___M with ETT ETT position TECHNIQUE: Portable AP radiograph of the chest is obtained. COMPARISON: Chest radiograph: ___ at 16:56. FINDINGS: The endotracheal tube has been repositioned, now appropriately terminating in the upper thoracic trachea, below the thoracic inlet, approximately 6.5 cm above the carina. There has been progressive opacification of the left upper lobe since the prior study suggesting atelectasis/ mucous plugging. Otherwise, the appearance of the chest is unchanged. IMPRESSION: 1. Endotracheal tube has been repositioned, now in appropriate position. 2. Worsening left upper lobe opacification and persistent left lower lobe atelectasis. " 9bb246a3-a006cce3-1d747f56-6851720a-af0b9a83.jpg,validate/p17/p17336850/s55390376/9bb246a3-a006cce3-1d747f56-6851720a-af0b9a83.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest radiograph. INDICATION: ___-year-old man with severe multiple sclerosis, now with concern for aspiration pneumonia. TECHNIQUE: Portable AP chest radiograph. COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Interval placement of a nasogastric tube, which terminates in the stomach. Stable, borderline cardiomegaly. Mediastinal and hilar contours are normal. Slight interval improvement in low lung volumes bilaterally. Persistent retrocardiac opacity suggests atelectasis. Stable opacity in the right cardiophrenic sulcus could represent atelectasis or pneumonia. Interval resolution of small left pleural effusion. No pneumothorax. IMPRESSION: Slight interval improvement in lung volumes bilaterally. Stable bibasilar opacities likely reflect atelectasis, but superimposed infection cannot be excluded. " 7d6b3a6f-2d79fc19-23ce48c4-b8c5f29e-e7393678.jpg,validate/p10/p10481168/s57035937/7d6b3a6f-2d79fc19-23ce48c4-b8c5f29e-e7393678.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with gi bleed // ETT location ETT location IMPRESSION: Compared to chest radiographs since ___, most recently one ___. New right jugular line ends close to the superior cavoatrial junction. No attendant mediastinal widening, pleural effusion or pneumothorax. Moderate left pleural effusion and left basal atelectasis are unchanged. Extensive blastic and lytic osseous metastases are long-standing. Right central venous infusion port catheter ends close to the inferior cavoatrial junction. " 8ba2d553-1c29db95-f7275b4e-7d721efa-2cc5caa2.jpg,validate/p12/p12734486/s58534664/8ba2d553-1c29db95-f7275b4e-7d721efa-2cc5caa2.jpg,validation," 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. " f6c02391-543a16a6-2d5d18a5-8a89f32f-0cb4544a.jpg,validate/p10/p10364180/s51539305/f6c02391-543a16a6-2d5d18a5-8a89f32f-0cb4544a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is minimally improved pulmonary edema. However, the edema is still moderate in severity. A right basal atelectasis is unchanged. Unchanged size of the cardiac silhouette, with slightly enlarged pulmonary arteries, left more than right, suggesting pulmonary hypertension. " 24f48dcc-083ff43c-c4ad3b3d-4a660a13-6d00d8c1.jpg,validate/p11/p11068569/s53322729/24f48dcc-083ff43c-c4ad3b3d-4a660a13-6d00d8c1.jpg,validation," WET READ: ___ ___ 10:30 AM There are focal consolidations in the right middle lobe and left lower lobe, compatible with pneumonia. Heart is mildly enlarged. There is pulmonary vascular congestion, but no overt pulmonary edema. WET READ VERSION #1 ___ ___ ___ 7:23 PM There are focal consolidations in the right middle lobe and left lower lobe, compatible with pneumonia. Heart is mildly enlarged. There is pulmonary vascular congestion, but no overt pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with PNA, hypoxia, nephrolithiasis on IVF // ?pulm edema, LLL PNA COMPARISON: Radiographs from ___ IMPRESSION: There are new areas of consolidation within the right middle lobe and left lower lobe suggestive of pneumonia. Heart size is prominent but stable. There is mild prominence of the pulmonary vascular markings. There are no pneumothoraces. " 2cd21b50-064f1f6b-23de6f1b-67acf5cd-754b3d18.jpg,validate/p12/p12945037/s56137456/2cd21b50-064f1f6b-23de6f1b-67acf5cd-754b3d18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with hypoxia after resuscitation // presence of infiltrate, pulmonary edema TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Low lung volumes and bibasilar atelectasis. Bibasilar opacities could relate to atelectasis although underlying aspiration may be present or even infection. No large pleural effusion is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. " b54aec40-11676d34-1a2938e1-96e7253d-f0d5ed4c.jpg,validate/p10/p10532853/s50101250/b54aec40-11676d34-1a2938e1-96e7253d-f0d5ed4c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cirrhosis and HF // Assess known pleural effusion and pulmonary edema for improvement Assess known pleural effusion and pulmonary edema for improvement COMPARISON: Chest radiographs ___. IMPRESSION: Increase in volume of the moderate multiloculated right hydro pneumothorax, largely anterior and lateral, is best appreciated on the lateral view. Small left pleural effusion stable. Moderate to severe enlargement of the cardiac silhouette unchanged. No pulmonary edema. " 3ce3d9d9-685c9628-847d4ffe-8ca87e3c-3eea10da.jpg,validate/p12/p12503315/s58699644/3ce3d9d9-685c9628-847d4ffe-8ca87e3c-3eea10da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recurrent effusion s/p pleurodesis. // ?effusion, ?removal of catheter. ?effusion, ?removal of catheter. COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Large right pleural effusion has begun to reaccumulate since ___ following removal of the large right thoracostomy tube ; a smaller right pleural drain remains in place. . Small left pleural effusion is stable or slightly increased. Since the mediastinum remains midline, the volume of new pleural fluid is matched by equivalent volume loss in the severely consolidated right lung. It is also possible that the mediastinum is fixed in position, since fullness in the right lower paratracheal station suggests adenopathy. " 8da41505-78dd52e8-15cba1e1-374a6a68-549c67f5.jpg,validate/p10/p10232271/s52993689/8da41505-78dd52e8-15cba1e1-374a6a68-549c67f5.jpg,validation," FINAL REPORT INDICATION: ___F w/ h/o avm, recent ICA embolization, with fever, altered mental status, recent fall // assess for ICH TECHNIQUE: AP and lateral views the chest. COMPARISON: ___. FINDINGS: There is dense consolidation in the right mid lung likely localizing right middle lobe. More streaky opacity noted at the left lung base, potentially atelectasis. Elsewhere, lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: New right mid lung opacity worrisome for pneumonia in the proper clinical setting. Recommend repeat after treatment to document resolution. " 55b08e3d-7dcb891a-41b0025c-725688a4-20059824.jpg,validate/p19/p19027210/s53071616/55b08e3d-7dcb891a-41b0025c-725688a4-20059824.jpg,validation," FINAL REPORT INDICATION: Patient with three-week history of cough and new-onset fatigue. Assess for pneumonia. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Linear opacity in the right lung base likely represents atelectasis. There is no focal consolidation. There is slight elevation of the right hemidiaphragm, which likely reflects eventration. There is no pneumothorax. Hilar and mediastinal silhouettes are unchanged. Heart size is top normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " d92995fa-c77d1fc9-df28070d-5d80bc29-06b58799.jpg,validate/p12/p12414328/s50417877/d92995fa-c77d1fc9-df28070d-5d80bc29-06b58799.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Status post arrest. COMPARISON: None. FINDINGS: Single AP portable view of the chest was obtained. The patient is status post median sternotomy. There is mild-to-moderate pulmonary edema. The cardiac silhouette is mildly enlarged. No large pleural effusions are seen, but small pleural effusions to be difficult to exclude. Right base opacity most likely represents a prominent vascular structure, although underlying consolidation due to aspiration or infection not excluded. Mediastinum is within normal limits. IMPRESSION: Pulmonary edema and mild cardiomegaly. Difficult to exclude small pleural effusions. Patchy right base opacity may relate to prominent vascular structures, although underlying consolidation from aspiration or infection may be present. " f771cf94-7ce4827d-30b3261e-e6627129-53bc0764.jpg,validate/p17/p17748848/s51755089/f771cf94-7ce4827d-30b3261e-e6627129-53bc0764.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with history of MI, now with chest pain and productive cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: There is mild diffuse interstitial prominence. No discrete focal consolidation, pleural effusion, or pneumothorax is detected. Heart and mediastinal contours are within normal limits. IMPRESSION: Mild interstitial prominence, which could be secondary to a viral or atypical infection. Findings reported to ___ by ___ by telephone at 14:42 on ___ at the time of initial review of the study. " 19bff8c6-35f4f798-3a5d511a-1a770be2-39618263.jpg,validate/p18/p18240093/s59767421/19bff8c6-35f4f798-3a5d511a-1a770be2-39618263.jpg,validation," FINAL REPORT INDICATION: Syncope. COMPARISON: ___. SEMI-UPRIGHT AP VIEW OF THE CHEST: The cardiac silhouette size is markedly enlarged but unchanged. The mediastinal and hilar contours are also stable. There is no pulmonary vascular congestion, definite focal consolidation, or pleural effusion. The study is somewhat limited due to underpenetration. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Unchanged cardiomegaly without evidence of congestive heart failure or pneumonia. " 91fbd571-fb8ac029-dd381279-a6635517-beef3ea5.jpg,validate/p18/p18358382/s51589294/91fbd571-fb8ac029-dd381279-a6635517-beef3ea5.jpg,validation," WET READ: ___ ___ ___ 9:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph Frontal and lateral chest radiograph INDICATION: Diaphoretic and weak. Assess for acute process. COMPARISON: Chest radiograph ___. FINDINGS: The lungs are hyperexpanded and the diaphragms are flattened. The cardiomediastinal silhouette is unchanged, without frank cardiac enlargement. Again seen are are intact median sternotomy wires with mediastinal clips. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy is detected. No CHF, pleural effusion or pneumothorax. Minimal atelectasis or scarring at the right lung base is unchanged. The extreme right costophrenic angle is excluded from the film. IMPRESSION: No acute pulmonary process. No significant change compared with ___. " f8a913da-5b2ee755-2f8df63b-b9882284-7ae56501.jpg,validate/p19/p19072817/s52983532/f8a913da-5b2ee755-2f8df63b-b9882284-7ae56501.jpg,validation," FINAL REPORT HISTORY: Altered mental status, right-sided weakness and left facial droop. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: CT torso ___ and chest radiograph ___. FINDINGS: The heart size remains mildly enlarged. The aorta is diffusely calcified and mildly tortuous. The hilar contours are unchanged. The pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is identified. Minimal interstitial opacity within the lung bases likely reflect chronic changes. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 10a2c9a9-197a62f6-feebeee8-78650b49-c9c85b22.jpg,validate/p10/p10547178/s51980327/10a2c9a9-197a62f6-feebeee8-78650b49-c9c85b22.jpg,validation," FINAL REPORT HISTORY: Chronic nightsweats with recent worsening. COMPARISON: Chest radiograph ___, ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion or pneumothorax. Mild cardiomegaly is unchanged. Median sternotomy wires are intact after CABG. Hilar contours are normal. IMPRESSION: No pneumonia, edema, or effusion. No evidence of TB. " 9c6590be-2aadaa6a-517214a0-7318baf1-6670a830.jpg,validate/p10/p10791554/s55902777/9c6590be-2aadaa6a-517214a0-7318baf1-6670a830.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Post-bronchoscopy, evaluation for pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No compelling evidence for pneumothorax after bronchoscopy. A lucency along the posterior aspect of the fourth rib on the left is likely caused by soft tissues. The appearance and subsequent absence of pneumothorax should be confirmed on short-term radiographic followup. Unchanged atelectatic lung areas at the right lung bases. Borderline size of the cardiac silhouette without pulmonary edema. " 978c94ae-8ba400d8-2d54bcdd-54495ea9-7545efed.jpg,validate/p10/p10150563/s53487364/978c94ae-8ba400d8-2d54bcdd-54495ea9-7545efed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with previous independent living, rapid mental status change 5 days ago TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size is normal. There is likely a small hiatal hernia accounting for prominence of the right lower mediastinal contour. Mediastinal and hilar contours are otherwise unremarkable. Scarring within the apices is re- demonstrated. Lungs are clear. No pleural effusion or pneumothorax is seen. Osseous structures are diffusely demineralized without an acute abnormality. IMPRESSION: No acute cardiopulmonary abnormality. " d0611143-fba1863e-217d37ab-33782190-e05fde96.jpg,validate/p19/p19758044/s55985157/d0611143-fba1863e-217d37ab-33782190-e05fde96.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o L lung empyema, MRSA bacteremia // please evaluated L lung abscess. Patient has h/o IV drug abuse, hep C, and MRSA bacteremia TECHNIQUE: frontal and lateral views of the chest COMPARISON: ___. IMPRESSION: Loculated right pleural effusion has decreased. Right lower lobe atelectasis have improved. Cardiomediastinal contours are normal. There is no evident pneumothorax. " 4e9a9d9f-f0f7c5a6-fa078fd8-b9148a42-396a1303.jpg,validate/p17/p17224335/s51244742/4e9a9d9f-f0f7c5a6-fa078fd8-b9148a42-396a1303.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with s/p cardiac surgery // evaluate dob hoff placement TECHNIQUE: Portable FINDINGS: As compared to chest radiograph from 1 day prior, the tip of the Dobhoff tube is in the body of the stomach. Given for differences in patient positioning the Swan-Ganz catheter endotracheal tube and left IJ remain in similar position. Severe cardiomegaly pulmonary edema retrocardiac opacity not substantially changed. No pneumothorax. IMPRESSION: Doppler off tube is in the distal body of the stomach. " 8d5372ce-36a57721-b3e5989e-737749c5-57079d83.jpg,validate/p12/p12047822/s57005012/8d5372ce-36a57721-b3e5989e-737749c5-57079d83.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hyponatremia ?SIADH // acute lung patholgy causing SIADH acute lung patholgy causing SIADH IMPRESSION: In comparison with the study of ___, the patient has taken a much poor inspiration an the chin obscures much of the upper lungs. There is stable enlargement of the cardiac silhouette with substantial unfolding of the aorta. Minimal prominence of interstitial markings could reflect some elevated pulmonary venous pressure or chronic lung disease. No definite acute focal pneumonia. " 320d1441-5ca6303c-27d5fc26-47b6908c-5b9764ce.jpg,validate/p15/p15442180/s51834993/320d1441-5ca6303c-27d5fc26-47b6908c-5b9764ce.jpg,validation," 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. " 582872a0-5d5256c1-6a49f1c4-a3d48527-80814bf3.jpg,validate/p10/p10158544/s53229002/582872a0-5d5256c1-6a49f1c4-a3d48527-80814bf3.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray PA and INDICATION: ___ year old man with a history of sternal wound infection s/p flap closure // Please assess for evidence of sternal instability TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made to chest x-rays dating from ___ through ___. FINDINGS: The heart size is top normal in with evidence of prior CABG. Normal postoperative changes are noted overlying the sternum and retrosternum with no air-fluid levels seen in the retrosternal space. No focal opacities, pleural effusions, pneumothorax, or pulmonary edema are seen. IMPRESSION: No evidence of sternal instability. " 51d4d6b1-1193d88d-56f4c27d-774d20ba-86d4ab67.jpg,validate/p17/p17585916/s58796334/51d4d6b1-1193d88d-56f4c27d-774d20ba-86d4ab67.jpg,validation," WET READ: ___ ___ ___ 8:33 AM Exam again limited secondary to patient positioning and persistently low lung volumes. The exam is overall similar to multiple prior studies, with increased opacity in the right hemi thorax, but improved aeration of the left lung. WET READ VERSION #1 ___ ___ ___ 5:51 PM Exam again limited secondary to patient positioning and persistently low lung volumes. The exam is overall similar to multiple prior studies, with increased opacity in the right hemi thorax, but improved aeration of the left lung. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with tachypnea // eval for interval change COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous image, very limited technical quality of the examination. Low lung volumes. Elevation of the right hemidiaphragm. Moderate cardiomegaly. Mild fluid overload. Compression atelectasis at the right lung bases. The left lung bases appears minimally in better ventilated than at the previous examination. " c8df18a4-ef0ed19e-f8945a1e-3c4dbac1-995c0720.jpg,validate/p17/p17554575/s50799102/c8df18a4-ef0ed19e-f8945a1e-3c4dbac1-995c0720.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, diabetes, not feeling well // r/o infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: SUBSTANTIAL HIATAL HERNIA IS UNCHANGED. HEART SIZE IS NORMAL. LUNGS ARE ESSENTIALLY CLEAR. NO PLEURAL EFFUSION OR PNEUMOTHORAX IS PRESENT. " a3cb446a-a6bdcc24-46eca107-a2bc06de-56c70244.jpg,validate/p11/p11354070/s56123827/a3cb446a-a6bdcc24-46eca107-a2bc06de-56c70244.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with right upper quadrant 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. Osseous and soft tissue structures are unremarkable. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 7777033a-1b0cc815-88566eb1-9345b13c-ccb87aa2.jpg,validate/p10/p10978131/s55658799/7777033a-1b0cc815-88566eb1-9345b13c-ccb87aa2.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with Confirm tube placement s/p intubation // Confirm tube placement s/p intubation TECHNIQUE: AP portable supine view of the chest. COMPARISON: Chest radiograph dated ___ at 20:38. FINDINGS: Interval placement of an endotracheal tube terminating approximately 3.7 cm above the level of the carina. A nasogastric tube has also been placed, with tip projecting over the left upper quadrant. The lungs are well expanded and multiple airspace opacities are again noted within the right upper and bilateral lower lobes with slight improvement. There is no large pleural effusion or pneumothorax identified. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Slightly improved appearance of multifocal pneumonia. 2. Interval placement of an ETT, in appropriate position. " f5fe9d46-4a9e26ce-74be6d35-029fe992-eaea2d13.jpg,validate/p14/p14860633/s56752774/f5fe9d46-4a9e26ce-74be6d35-029fe992-eaea2d13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 2 days of cough and Chest pain and wheezing // R/O Pneumonia COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous image. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. No pleural effusions. No pneumonia, no pulmonary edema. " a7e2f95e-21e02755-b74d32cf-7704f7b0-9cf72375.jpg,validate/p18/p18979163/s54950927/a7e2f95e-21e02755-b74d32cf-7704f7b0-9cf72375.jpg,validation," FINAL REPORT HISTORY: Positive PPD. FINDINGS: In comparison with the study of ___, there is no evidence of acute cardiopulmonary disease or old granulomatous disease. " 0bb423c1-dadeec5c-284e902e-9d9add96-7dcd5195.jpg,validate/p16/p16441660/s55247577/0bb423c1-dadeec5c-284e902e-9d9add96-7dcd5195.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior CTA torso from ___ and chest radiograph from ___. CLINICAL HISTORY: Chest pain radiating to left shoulder. FINDINGS: PA and lateral views of the chest were provided. AICD pack and leads are unchanged and appear contiguous. The lungs are clear, though volumes are low. No definite sign of pneumonia or CHF. No effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: No acute findings in the chest. " 932ff844-0068778d-089df67a-3284480f-ad58a12f.jpg,validate/p10/p10061468/s50197892/932ff844-0068778d-089df67a-3284480f-ad58a12f.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with failure to thrive and leukocytosis. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Heart size and cardiomediastinal contours are unremarkable. Diffusely increased interstitial markings are chronic. No focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 0e39840b-24e7c4c5-b05e2bf9-f6aab11a-dc323629.jpg,validate/p13/p13659269/s52836486/0e39840b-24e7c4c5-b05e2bf9-f6aab11a-dc323629.jpg,validation," WET READ: ___ ___ ___ 6:51 PM Multifocal parenchymal opacities are more pronounced than on the recent comparison. Given the short time course this likely reflects worsening of pulmonary edema superimposed on a background of multifocal pneumonia (though pulmonary hemorrhage can also evolve in a short time course). Small left pleural effusion is unchanged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxia, pulmonary edema. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, there is an increase in severity of the bilateral parenchymal opacities, with newly appeared consolidations in the retrocardiac lung areas that are likely atelectatic in nature. The size of the cardiac silhouette is unchanged. No pneumothorax. " ac60add2-fccb3a6b-037da71b-6e015756-03d8e8a2.jpg,validate/p15/p15652922/s54625895/ac60add2-fccb3a6b-037da71b-6e015756-03d8e8a2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new fevers // ?consolidation ?consolidation IMPRESSION: Compared to chest radiographs ___ through ___. Previously collapsed right lower lobe has re-expanded, is not fully aerated, but contains sufficient consolidation to raise concern for new pneumonia. Lungs otherwise clear. Borderline cardiomegaly unchanged. No pneumothorax. ET tube in standard placement. Nasogastric drainage tube can be traced clearly as far as the low esophagus, but it is probably continuous with a section of tubing that ends in the distal stomach " bade4844-ff986487-933dff35-210f0995-98c4a833.jpg,validate/p13/p13854570/s50527059/bade4844-ff986487-933dff35-210f0995-98c4a833.jpg,validation," FINAL REPORT INDICATION: Left upper sharp chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. The mediastinal and hilar contours are unremarkable. Increased interstitial opacities are noted predominantly within the lung bases, not significantly changed from prior, with an area of linear atelectasis noted in the right lower lobe. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Increased interstitial markings within the lung bases which appear relatively similar when compared to the prior study, and may reflect chronic changes. Subsegmental atelectasis in the right lower lobe. " ae8c5b54-80679d1f-eaa38f6f-cf516fc0-125205ec.jpg,validate/p15/p15803381/s51860826/ae8c5b54-80679d1f-eaa38f6f-cf516fc0-125205ec.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Interval placement of endotracheal tube, with tip terminating about 6 cm above the carina. Otherwise, no relevant short interval changes since the recent radiograph performed a few hours earlier. " c2a7e70f-f4ac12f5-a4917eba-33f874e6-9d7bb433.jpg,validate/p19/p19509250/s51237289/c2a7e70f-f4ac12f5-a4917eba-33f874e6-9d7bb433.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with fall, hypotension // presence of infiltrate, effusion, ptx COMPARISON: Prior exam from ___. FINDINGS: AP portable semi upright view of the chest. Patient's position limits evaluation. The lungs appear grossly clear aside from mild basilar atelectasis. The heart appears moderately enlarged though unchanged. The mediastinal contour cannot be assessed. Bony structures appear grossly intact with kyphotic angulation of the T-spine. IMPRESSION: Limited exam with mild basilar atelectasis and kyphosis of the T-spine. " e4a53bf9-f553a1e9-ba373556-c444f401-0116258f.jpg,validate/p15/p15957987/s55279406/e4a53bf9-f553a1e9-ba373556-c444f401-0116258f.jpg,validation," FINAL REPORT HISTORY: Interval evaluation of bilateral effusions. CHEST, SINGLE AP PORTABLE VIEW. An esophageal stent is present, unchanged. Compared with ___ at 6:13 a.m., the right effusion has decreased in size. Right base pigtail catheter is again noted. Hazy opacity in the right mid zone likely represents fluid extending along the minor fissure. There is some residual collapse and/or consolidation at the right lung base. No significant upper zone redistribution. Small left effusion again noted. Collapse/consolidation at the left medial base is similar, perhaps slightly worse. The left base pigtail catheter is again noted. No pneumothorax is detected on either side. IMPRESSION: Interval improvement in right-sided effusion and underlying right base collapse/consolidation. Changes at the left base are similar, possibly slightly worse. " 693bf081-281cbe29-38baf9c6-19b7fed4-7b707d65.jpg,validate/p19/p19963140/s57661538/693bf081-281cbe29-38baf9c6-19b7fed4-7b707d65.jpg,validation," 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. " 72d0801b-e7d1e67c-81efabaf-616d1ebf-18038702.jpg,validate/p14/p14001478/s59091904/72d0801b-e7d1e67c-81efabaf-616d1ebf-18038702.jpg,validation," FINAL REPORT HISTORY: Overdose, to assess for pneumonia. FINDINGS: In comparison with the study of ___, there is little change. Monitoring and support devices remain in place. Retrocardiac opacification again most likely reflects atelectasis. However, in view of the clinical history, the possibility of supervening aspiration must be considered. " 433de6b6-d2676577-389f9296-78432108-db755de6.jpg,validate/p19/p19874473/s56596262/433de6b6-d2676577-389f9296-78432108-db755de6.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with recent right middle and right lower lobe pneumonia, now with worsening symptoms. COMPARISON: Multiple prior chest radiographs, most recently dated ___. FINDINGS: Frontal and lateral views of the chest were obtained. Heart size and cardiomediastinal contours are normal. Multifocal pneumonia has virtually cleared since ___. Lungs are otherwise clear and there is no pleural effusion. IMPRESSION: Nearly resolved pneumonia. No new consolidation or pleural effusion. No indication for radiographic followup. " db2a34b6-ac3e58e7-e22c3ddf-d74883a3-2cf3579d.jpg,validate/p16/p16359994/s58908246/db2a34b6-ac3e58e7-e22c3ddf-d74883a3-2cf3579d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (8 P AND LAT) INDICATION: ___F with fatigue and pre-syncope. // ?PNA COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. Retrocardiac opacity is noted which could reflect the presence of known hiatal hernia. No convincing signs of pneumonia or edema. No large effusion or pneumothorax. The heart appears mildly enlarged. Aortic calcification is noted. The mediastinal contour is unchanged. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Retrocardiac opacity likely reflects known hiatal hernia. Mild cardiomegaly. " 3735add4-a4b3c9f4-52f4a80e-6ba4461f-b9292c4d.jpg,validate/p15/p15534382/s58400611/3735add4-a4b3c9f4-52f4a80e-6ba4461f-b9292c4d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___ year old woman with hx of melanoma // please evaluate disease status 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 or intrathoracic malignancy. " b8a40f27-bca24eb0-254330ff-dc84e072-a2645414.jpg,validate/p15/p15014371/s55624738/b8a40f27-bca24eb0-254330ff-dc84e072-a2645414.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with sCHF who presented w/ CP, SOB ___ home Lasix being held // interval change to previous xray in volume overload TECHNIQUE: Chest two views COMPARISON: ___ 17:53 FINDINGS: Moderate pleural effusions, stable. Increased heart size, pulmonary vascularity, stable. Bibasilar opacities, likely atelectasis, stable on the left, mildly improved on the right. Cardiac pacemaker. IMPRESSION: Mild improvement right basilar atelectasis. " d6578a26-c6384eff-9c8f4ab6-bfb13557-27002f4f.jpg,validate/p19/p19358609/s51015335/d6578a26-c6384eff-9c8f4ab6-bfb13557-27002f4f.jpg,validation," FINAL REPORT INDICATION: Chest pain, COPD, aspiration question new consolidation or pneumothorax. COMPARISON: Chest CT dated ___ and chest radiographs dating back to ___. FINDINGS: Portable frontal radiograph of the chest demonstrates a consolidation in the left lower lobe which is slightly increased compared to the recent CT. Parenchymal opacification in the right lower lobe likely reflects aspiration. Diffusely abnormal background parenchymal changes are again seen. The bilateral pleural effusions have decreased in size. There is an unchanged rounded structure in the right costophrenic sinus which was masked by the pleural effusion on the prior CT exam. There is stable deformity of the left thoracic cage. No pneumothorax. " 7ce04865-20308f68-a2ef4b31-fb977338-e3151f0e.jpg,validate/p11/p11701953/s51820285/7ce04865-20308f68-a2ef4b31-fb977338-e3151f0e.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON: None. INDICATION: ___-year-old with chronic pleuritic chest pain, intermittent shortness of breath. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear. There is no pulmonary edema, pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " 449d8b01-17a548f2-72fba88f-7b7316c6-04e5d3bd.jpg,validate/p16/p16087436/s53772252/449d8b01-17a548f2-72fba88f-7b7316c6-04e5d3bd.jpg,validation," 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 constant. The generalized opacities in the right lung as well as the basal opacities are constant in appearance. Normal size of the cardiac silhouette. No pulmonary edema. No pleural effusions. No pneumothorax. " 68bc44fd-d69d3d1c-d0719aa2-24ddeba0-644edbe0.jpg,validate/p11/p11589493/s56057665/68bc44fd-d69d3d1c-d0719aa2-24ddeba0-644edbe0.jpg,validation," 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 cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 2aaff1a6-c1958c59-72a430fd-4f8e8661-9bfb7542.jpg,validate/p18/p18708396/s53629890/2aaff1a6-c1958c59-72a430fd-4f8e8661-9bfb7542.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with increased shortness of breath. Evaluate for infection. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___, ___ and ___. FINDINGS: The cardiac silhouette continues to be enlarged with hilar congestion and mild edema noted. A left retrocardiac opacity may reflect atelectasis. No pleural effusion or pneumothorax is noted. IMPRESSION: Cardiomegaly with mild congestion. Left retrocardiac opacity likely reflects atelectasis, though a consolidation is not excluded in the appropriate clinical setting. " 3bb4b8d6-ac7ecece-6adb0b5e-e352e5a3-616d5b8d.jpg,validate/p14/p14766138/s56388072/3bb4b8d6-ac7ecece-6adb0b5e-e352e5a3-616d5b8d.jpg,validation," FINAL REPORT HISTORY: Acute shortness of breath since last night with cough. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate an unchanged dialysis catheter with the tip in the right atrium. There is mild left upper lobe scarring as well as a right lower lobe calcified granuloma, both of which are unchanged. No acute consolidation, pleural effusion, or pneumothorax is detected. The cardiac silhouette is slightly enlarged, although unchanged from the prior radiograph. IMPRESSION: No acute consolidation, pleural effusion, or pneumothorax. These findings were relayed to Dr. ___, at 11:18 a.m., as requested. " 968da78b-f92b7f2d-dde43f42-dea61410-f9a465e6.jpg,validate/p18/p18232511/s59002707/968da78b-f92b7f2d-dde43f42-dea61410-f9a465e6.jpg,validation," FINAL REPORT AP CHEST, 5:34 A.M., ___ HISTORY: Epidural hematoma. IMPRESSION: AP chest compared to ___: Patient is rotated severely to the right, enlarging the apparent diameter of the cardiomediastinal silhouette, and obscuring what is now a densely consolidated right lower lobe. It also reveals severely consolidated left lower lobe. At best, these are areas of lobar collapse, but pneumonia may well be present, particularly on the right. Left pleural tube in place. Skinfold should not be mistaken for pneumothorax; there is none. There is likely small-to-moderate bilateral pleural effusion. ET tube is in standard placement. Left jugular catheter ends at the origin of the left brachiocephalic vein as before. Nasogastric tube probably ends in the distal esophagus, although on ___ it clearly ended in the gastric fundus. For that reason, I would strongly recommend repeat chest radiographs carefully positioned, collimated to the ___ the chest to improve imaging of the nasogastric tube and a more reliable depiction of both the mediastinum and both lower lobes. " c6fa3a38-ec6b4a52-d5db430d-7b66f74d-175d1a3f.jpg,validate/p10/p10809830/s56639998/c6fa3a38-ec6b4a52-d5db430d-7b66f74d-175d1a3f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with bilateral lower leg edema // eval for pulmonary edema vs pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The patient's chin overlies the medial lung apices. The patient is also somewhat rotated. Given the above, there are low lung volumes with persistent elevation of the right hemidiaphragm. No large pleural effusion is seen. The cardiac and mediastinal silhouettes are stable. The patient is status post median sternotomy and cardiac valve replacement. There is left mid lung linear atelectasis/ scarring. Mild to moderate interstitial edema is seen. IMPRESSION: Mild to moderate interstitial edema may be slightly exaggerated due to low lung volumes. Persistent elevation of the right hemidiaphragm. " 4b21b5ba-e93fa14f-dca58e98-b8cfb680-e5d6cca4.jpg,validate/p14/p14325424/s52683844/4b21b5ba-e93fa14f-dca58e98-b8cfb680-e5d6cca4.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with shortness of breath, status post intubation. COMPARISON: None. FINDINGS: Single portable view of the chest. Endotracheal tube is seen with tip at the level of the carina and should be withdrawn several centimeters for optimal positioning. Enteric tube is seen to the level of the GE junction, but not clearly passing off the inferior field of view, although this region is not well seen secondary to technique. Given slight respiratory motion, the lungs are grossly clear. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcification is seen in the thoracic aorta. Degenerative changes are seen at the shoulders. No definite acute osseous abnormality visualized. IMPRESSION: Endotracheal tube tip at the carina and should be withdrawn several centimeters. Enteric tube seen to the region of the GE junction potentially, but not definitely passing off the inferior field of view. This can be followed in subsequent exam. Dr. ___ was paged at 11:35 a.m. on ___. " 348f3eed-da1ebadd-299453af-2815a018-c5e092ba.jpg,validate/p17/p17922388/s55091422/348f3eed-da1ebadd-299453af-2815a018-c5e092ba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Scleroderma, NSIP, evaluation for acute changes. COMPARISON: No comparison available at the time of dictation. The most recent previous material is a CT examination from ___. FINDINGS: The patient has known and documented lung fibrosis, with small lung volumes and reticular opacities. There is no chest radiographic evidence of new or additional parenchymal changes. Notably, there are no changes suggesting acute lung disease. Borderline size of the cardiac silhouette. No evidence of pleural effusions. " 0a425287-65d6a9a9-cfc582dc-1c67a0de-c854054a.jpg,validate/p17/p17642642/s55999595/0a425287-65d6a9a9-cfc582dc-1c67a0de-c854054a.jpg,validation," FINAL REPORT INDICATION: ___M with picc, evaluate position.. COMPARISON: Chest radiograph ___, CT chest ___. TECHNIQUE Frontal and lateral view of the chest. FINDINGS: Since prior, a right-sided PICC has been retracted with the tip now projecting in the midclavicular line. There is no pneumothorax. Reticular appearance of the lungs, likely reflects underlying emphysematous changes. The cardiomediastinal and hilar contours are normal. There is no pleural effusion. Visualized osseous structures are unremarkable. IMPRESSION: Right PICC has been retracted with the tip now projecting over the right midclavicular line. " 95332c55-9f6e0c76-3950628b-4c71c0ab-1e296b9e.jpg,validate/p13/p13202799/s55078975/95332c55-9f6e0c76-3950628b-4c71c0ab-1e296b9e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with left sided pleuritic chest pain and desaturation to ___% with ambulation. // R/o source of desaturation and symptoms. TECHNIQUE: PA and lateral view radiographs of the chest. COMPARISON: None. FINDINGS: The aorta is tortuous with a right-sided arch. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " e80cdbb9-6cd9f5a4-c4764503-9bf94d0e-1d7c89b5.jpg,validate/p10/p10755736/s52822410/e80cdbb9-6cd9f5a4-c4764503-9bf94d0e-1d7c89b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with R chest port for chemo, need confirmation of position in order to use overnight // eval line position eval line position COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Left subclavian infusion port ends in the low SVC. No pneumothorax pleural effusion or mediastinal widening. Lungs clear. Heart size normal. Healed left rib fractures are long-standing. " de3c86fe-c541e197-20472e8d-3fc377d3-1ea915a7.jpg,validate/p10/p10635380/s54274306/de3c86fe-c541e197-20472e8d-3fc377d3-1ea915a7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Feeling unwell with nausea, vomiting, question acute process in the chest. FINDINGS: PA and lateral views of the chest are provided. A stable area of scarring in the right upper lobe appears unchanged from a remote chest radiograph dated ___. Lungs are hyperinflated. No focal consolidation, effusion, or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute findings in the chest. " 76ce432a-5900476a-6c5f1504-12fcd411-f2004f8e.jpg,validate/p19/p19151721/s51572633/76ce432a-5900476a-6c5f1504-12fcd411-f2004f8e.jpg,validation," WET READ: ___ ___ ___ 9:53 PM Increased retrocardiac opacity is likely atelectasis. Possible new small right pleural effusion. ___ p___WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Increased oxygen requirement, diminished breath sounds, questionable pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated. The right internal jugular vein catheter has also been removed. There is a minimal atelectasis in the retrocardiac lung areas, the presence of a minimal right pleural effusion cannot be excluded. No other abnormalities are currently noted. " 8a86ce55-39217d78-345fdda7-370a47b2-0089c184.jpg,validate/p11/p11095895/s52754108/8a86ce55-39217d78-345fdda7-370a47b2-0089c184.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough. COMPARISON: None available. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is focal anterior elevation of the right hemidiaphragm, suggestive of eventration or liver abnormality. No focal pulmonary consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits. Dilated proximal esophagus may represent focal dilation or Zenker's diverticulum. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. Upper esophageal dilation or Zenkers diverticulum. Right diaphragmatic eventration or liver enlargement. Findings reported to ___ by ___ by phone at 8:05 a.m. on ___ after attending radiologist review. " 95afb91d-10bbccd3-e016b86c-6d276df5-56d05bfd.jpg,validate/p11/p11201441/s56723302/95afb91d-10bbccd3-e016b86c-6d276df5-56d05bfd.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM, ___ AT 1:36 A.M. CLINICAL INDICATION: Reassess chest tube position. Comparison to prior study dated ___ at 20:50. Single portable supine chest film ___ at 1:36 a.m. is submitted. IMPRESSION: Interval pullback of the right chest tube which now has its tip overlying the right mid lung, but the side port now projects over the lateral ribs and subcutaneous tissues. Advancement of 1-2 cm would be advised. This recommendation was called to the patient's nurse, ___, on ___ at 10:05 a.m. who states that the housestaff are aware. There is persistent layering right effusion and layering left effusion with more focal persistent airspace consolidation in the left base with associated air bronchograms. Although this may represent compressive atelectasis, basilar pneumonia cannot be excluded. Linear opacity in the left mid lung persists and likely reflects subsegmental atelectasis. There is also likely mild vascular congestion. The tracheostomy tube and right subclavian central line are unchanged in position. Overall, cardiac and mediastinal contours are likely stable given differences in positioning between studies. The evaluation for pneumothorax is limited given supine technique. " 05cd4547-fd737291-342a9694-b9728ae7-74c033ea.jpg,validate/p14/p14124506/s51780423/05cd4547-fd737291-342a9694-b9728ae7-74c033ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with infectious pneumonia; ? PCP // please eval for interval change please eval for interval change IMPRESSION: In comparison with the study of ___, there is little overall change in the diffuse bilateral pulmonary opacifications again, the appearance is concerning for infectious or inflammatory process, possibly with some element of elevated pulmonary venous pressure. " 0ad90746-881b377f-1facef59-0c639cdf-110745ad.jpg,validate/p15/p15937283/s52705599/0ad90746-881b377f-1facef59-0c639cdf-110745ad.jpg,validation," FINAL REPORT INDICATION: ___F with LLQ renal transplant w/ tenderness and incerased Cr // eval pna, eval renal blood flow in new kidney TECHNIQUE: AP and lateral views the chest. COMPARISON: Multiple films dating back to ___ with most recent from ___. FINDINGS: The right lower lobe consolidation has not significantly changed. There is no new region of consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Coronary artery stents are noted. No acute osseous abnormalities, mid thoracic dextroscoliosis is noted. IMPRESSION: Unchanged right basilar opacity when compared to prior compatible with patient's history of pneumonia. " aaeaf086-8c5eda46-8b9d7830-b1b4e6c1-c032c03b.jpg,validate/p15/p15103276/s56445234/aaeaf086-8c5eda46-8b9d7830-b1b4e6c1-c032c03b.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 31e5a10f-2ec60848-664d852e-033995c3-c0069b48.jpg,validate/p14/p14426231/s57521544/31e5a10f-2ec60848-664d852e-033995c3-c0069b48.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness and pre-syncopal // r/o pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Linear opacities at the lung bases bilaterally reflect a combination of scarring and atelectasis as seen on a prior cross-sectional study of the chest. There is no new focal consolidation, pleural effusion, or pneumothorax. Heart size and mediastinal contours are stable. Osseous structures appear intact. IMPRESSION: Mild bibasilar scarring/ atelectasis, but no evidence of pneumonia. " 37c8b818-f9d0f7cc-74815508-811433b8-d8e3ca54.jpg,validate/p11/p11849423/s50128390/37c8b818-f9d0f7cc-74815508-811433b8-d8e3ca54.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with shortness of breath // eval for pna TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: There are low lung volumes, which accentuate bronchovascular markings. Mild bibasilar opacities may be due to combination of low lung volumes and atelectasis, but aspiration or pneumonia is not excluded in the appropriate clinical setting. Again seen linear scarring in the right right mid and lower lung. No large pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. IMPRESSION: Low lung volumes. Mild bibasilar opacities could be due to low lung volumes and atelectasis, but pneumonia or aspiration is not excluded in the appropriate clinical setting. " 735c0af7-bcd1e1a0-3fbd426b-ebceeb21-a7458a2c.jpg,validate/p10/p10134328/s50760734/735c0af7-bcd1e1a0-3fbd426b-ebceeb21-a7458a2c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with long smoking history, has had dull pressure in chest for 10 days, non pleuritic, productive sputum // eval for PNA or other cause eval for PNA or other cause IMPRESSION: Compared to chest radiographs ___, read in conjunction with chest CT scans most additionally ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 686d4507-1d896399-9392e8f0-491c5dfc-7a575c7d.jpg,validate/p14/p14827673/s53521546/686d4507-1d896399-9392e8f0-491c5dfc-7a575c7d.jpg,validation," FINAL REPORT HISTORY: Status post endoscopy and colonoscopy, now requiring assessment for free air or perforation. COMPARISON: Comparison made with chest radiographs from ___ and ___. FINDINGS: PA and lateral chest. The lungs are well expanded and clear. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is mildly enlarged. The free air is seen under the diaphragm. IMPRESSION: No acute cardiopulmonary process. No free air under the diaphragm. " 6303ef3a-d7e78699-f7ccaeab-4ee2d808-8ad3a45a.jpg,validate/p13/p13961236/s52823730/6303ef3a-d7e78699-f7ccaeab-4ee2d808-8ad3a45a.jpg,validation," FINAL REPORT HISTORY: Hypoxia. Evaluate for worsening venous congestion or effusion. TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: Multiple prior radiographs of the chest most recent ___. FINDINGS: Lung volumes remain low. Severe cardiomegaly is re- demonstrated. The large left pleural is larger, layering along the left lateral chest wall. The moderate right pleural effusion is minimally increased. Bibasilar atelectasis is worse. Mild pulmonary congestion is not appreciably changed. A new right PICC line terminates in the mid SVC. A left pacer lead terminates in the right ventricle. There is no pneumothorax. IMPRESSION: 1. Large left pleural effusion is increased, and moderate right pleural effusion is minimally increased. 2. Bibasilar atelectasis is worse and mild pulmonary edema is unchanged. " 6ae1dbaa-86bf3581-e0669ae4-decf875b-3dec2f28.jpg,validate/p17/p17926625/s56958762/6ae1dbaa-86bf3581-e0669ae4-decf875b-3dec2f28.jpg,validation," 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. " 9e70433a-61f0a8f1-639273f7-c5bdd15c-8c59ed3d.jpg,validate/p13/p13518071/s55068679/9e70433a-61f0a8f1-639273f7-c5bdd15c-8c59ed3d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Fatigue with decreased p.o. intake, question pneumonia. FINDINGS: PA and lateral views of the chest were provided. Dual-lead pacer is unchanged with aortic endograft again seen with unchanged positions. Lung volumes are low. There is a similar appearance of bilateral reticulonodular opacities as compared with the prior radiograph, which may represent mild edema. No large effusion or pneumothorax is seen. Overall, cardiomediastinal silhouette appears stable. Bony structures are intact. IMPRESSION: No significant interval change with bilateral reticulonodular opacities, possibly reflective of edema, though consideration may be given to benefit of a chest CT for further characterization. " 489a6144-50a3d006-69ddb9a4-43d73329-f63bdb51.jpg,validate/p12/p12189597/s59878983/489a6144-50a3d006-69ddb9a4-43d73329-f63bdb51.jpg,validation," FINAL REPORT INDICATION: History: ___M with chest pain // Please evaluate for acute infectious etiology TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___ FINDINGS: PA and lateral chest radiograph is compared to radiograph performed ___. The overall appearance of the chest is unchanged though lung volumes are slightly lower. Mild emphysematous changes are noted with flattened diaphragms. Cardiomediastinal and hilar contours are stable. Bibasilar atelectasis is present on the frontal projection but does not persist on the lateral where there is better inspiratory effort. There is no evidence of pleural effusion, pneumothorax, or pulmonary edema. IMPRESSION: No acute intrathoracic abnormality. Emphysematous changes. " ed811b8e-780b5e27-8ea552ec-ca11c041-cab96487.jpg,validate/p18/p18458646/s53500901/ed811b8e-780b5e27-8ea552ec-ca11c041-cab96487.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Abdominal pain, colectomy, diarrhea with abdominal pain. FINDINGS: AP upright and lateral views of the chest were provided. The lungs are clear. No signs of pneumonia or CHF. No free air below the right hemidiaphragm. The cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute findings. " 2172c773-8b8837eb-77b60f36-a12cb626-14d3e6d9.jpg,validate/p18/p18829550/s53495826/2172c773-8b8837eb-77b60f36-a12cb626-14d3e6d9.jpg,validation," FINAL REPORT INDICATION: ___ year old man with osteomyelitis receiving ABX via PICC line, slightly pulled out during dressing change // confirm PICC placement TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The right PICC line terminates in mid SVC, slightly changed from prior. 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: 1. The right PICC line terminates in mid SVC. 2. No acute cardiopulmonary process. " 808f427b-cff2c9e6-9ad045af-42945b9a-e6c8a277.jpg,validate/p13/p13912710/s57974189/808f427b-cff2c9e6-9ad045af-42945b9a-e6c8a277.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute liver failure, intubated // cardiopulmonary process COMPARISON: ___. IMPRESSION: The endotracheal tube is still slightly 2 high. The other monitoring and support devices are also constant. The patient now shows mild pulmonary edema and an increasing retrocardiac atelectasis. The presence of small pleural effusions cannot be excluded. No pneumonia. " c5ca65f1-d74e4794-121e1762-7b3aef3e-9b93f619.jpg,validate/p18/p18687937/s52942645/c5ca65f1-d74e4794-121e1762-7b3aef3e-9b93f619.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with h/o SLE and PE and now has cough // persistant cough COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. " 0f365737-729ece4e-71aade4c-f26508e8-3d4ec241.jpg,validate/p13/p13413453/s53896838/0f365737-729ece4e-71aade4c-f26508e8-3d4ec241.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old man with esophageal cancer, and with PICC line // Assess position of PICC line after repositioning Assess position of PICC line after repositioning IMPRESSION: Comparison to ___. The right PICC line is unchanged in position. The looping at the lower aspect of the internal right jugular vein is also unchanged. The current tip projects at the level of the azygos vein. " 92104a74-78d6ae95-2b62a235-6f522a7c-13202ce0.jpg,validate/p16/p16508811/s51985577/92104a74-78d6ae95-2b62a235-6f522a7c-13202ce0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ with ESRD s/p renal transplant x2 (___; ___) now with CKD with baseline Cr ___.4, diastoilc CHF, DM, HTN, HLD, PVD who is admitted to FICU for management ___ ___ on CKD. Now febrile with leukocytosis // please eval for consolidation, edema, or other abnormality please eval for consolidation, edema, or other abnormality IMPRESSION: In comparison with the study of ___, there is decrease in the diffuse bilateral pulmonary opacifications. This most likely represents improving pulmonary vascular status. Monitoring and support devices are unchanged. " bd1a6094-1e34808a-b0f6ac20-c7012cff-1c2f1598.jpg,validate/p12/p12817683/s50324505/bd1a6094-1e34808a-b0f6ac20-c7012cff-1c2f1598.jpg,validation," 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. " 0f9d1431-ed9b4147-116d6708-e270ece2-840de6e6.jpg,validate/p16/p16783051/s52828177/0f9d1431-ed9b4147-116d6708-e270ece2-840de6e6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP // ptx TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Heart size is normal. Widened appearance of the mediastinum likely due to unfolded thoracic aorta, though dissection cannot be excluded. IMPRESSION: Widened appearance of the mediastinum likely due to unfolded thoracic aorta. Aortic dissection cannot be excluded on a conventional radiograph, but there are no findings to suggest that diagnosis on this study. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 8:34 AM, 2 minutes after discovery of the findings. " 2aaeb11d-f05df35e-80396f49-5eb9ea6b-01148e8a.jpg,validate/p19/p19347794/s56085009/2aaeb11d-f05df35e-80396f49-5eb9ea6b-01148e8a.jpg,validation," FINAL REPORT CLINICAL HISTORY: Patient intubated, check position of endotracheal tube. CHEST The endotracheal tube lies 18 mm from the carinal angle and should be re-positioned. The position of the dialysis catheter and IJ line are unchanged. Diffuse bilateral pulmonary opacities are again noted and allowing for differences in penetration, they are probably unchanged. Probable cause remains pulmonary edema. IMPRESSION: Endotracheal tube 18 mm from carinal angle and should be re-positioned. " 820f4dc1-29182d31-4bc4c76d-d32f4304-37a96d56.jpg,validate/p16/p16658959/s54694693/820f4dc1-29182d31-4bc4c76d-d32f4304-37a96d56.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with abd pain, likely obstruction // Please eval NGT placement COMPARISON: None FINDINGS: AP UPRIGHT VIEW 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. Staple lines project over the epigastrium. Nasogastric tube terminates in the stomach. IMPRESSION: 1. Nasogastric tube terminates in the stomach. 2. A small opacity is seen in the right midlung. This may be secondary to aspiration, inflammation or atelectasis. Short-term follow-up radiographs are recommended to reassess. If it were to fail to resolve, chest CT might be then appropriate. " 57907775-2fedc7c2-1aece061-14231133-9f34feeb.jpg,validate/p15/p15614172/s57018315/57907775-2fedc7c2-1aece061-14231133-9f34feeb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes and the appearance of the cardiac silhouette are unchanged. There is unchanged mild tortuosity of the thoracic aorta. The subtle opacity at the right lung base, described on the previous image from ___, is no longer visible. No pleural effusions. No pneumothorax. No pulmonary edema. No pneumonia. " b0223f99-ebf92e14-9022721f-a80563e0-b5df522d.jpg,validate/p14/p14061397/s53107391/b0223f99-ebf92e14-9022721f-a80563e0-b5df522d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with somolence, hypoxia, minor crackles // r/o acute pna TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: The appearance of the large bore catheter are with stent is unchanged. There is volume loss most marked in the retrocardiac region is similar in appearance compared to prior an underlying infiltrate in the retrocardiac region cannot be excluded. This also increased opacity at the right base slightly more prominent than prior. IMPRESSION: Volume loss in both lower lobes. An underlying infectious infiltrate can't be excluded. Appearance is slightly worse compared to prior " 8caabae7-17015cc0-2f1a4af4-7b16b53b-3ba3b74d.jpg,validate/p15/p15566010/s58328933/8caabae7-17015cc0-2f1a4af4-7b16b53b-3ba3b74d.jpg,validation," 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. " e0ea157f-f527326f-cedc7bec-8c0fa364-82672ee5.jpg,validate/p19/p19650702/s55181731/e0ea157f-f527326f-cedc7bec-8c0fa364-82672ee5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p tracheoplasty // interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Persistent low lung volumes. ET tube has been removed. Vascular congestion has improved. Right chest tube remains in place. Right chest wall subcutaneous emphysema has decreased. Left lower lobe opacities have increased consistent wake atelectasis. Widened mediastinum is stable. No enlarging pneumothorax pleural effusions " d563a9f0-07bcea13-df3a47eb-1fe23a66-b7b5f9a0.jpg,validate/p15/p15005501/s51353768/d563a9f0-07bcea13-df3a47eb-1fe23a66-b7b5f9a0.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hx of myeloma. Confusion with new neutropenia. Please further evaluation // ___ year old man with hx of myeloma. Confusion with new neutropenia. Please further evaluation TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Incidentally noted are bilateral cervical ribs. No acute osseous abnormality identified. IMPRESSION: No acute cardiopulmonary process. " 2cbbc1a3-2ca45f43-51c3bd46-bb92dbe5-ef4ae42e.jpg,validate/p13/p13048289/s57567591/2cbbc1a3-2ca45f43-51c3bd46-bb92dbe5-ef4ae42e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with asthma s/p intubation during EGD. // Please eval for ET tube placement and pulmonary process. ___ year old woman with asthma s/p bronch and ET tube reposition. // Please eval for RUL change and ET tube placement. TECHNIQUE: Two portable AP radiographs of the chest. COMPARISON: ___. FINDINGS: The initial radiograph from ___ shows interval placement of an endotracheal tube whose tip terminates above the clavicles. Advancement by 1-2 cm would provide more effective ventilation. There is also new right upper lobe atelectasis with associated volume loss. The left lung is clear. The heart and mediastinum are magnified by the projection. A nasogastric tube coils in the stomach, distal tip not visualized. The follow-up radiograph from ___ shows slight advancement of the endotracheal tube. The right upper lobe has re-expanded, but lung volumes remain low. There are new bilateral airspace opacities which are most likely due to pulmonary edema. Small bilateral pleural effusions are also new. Increased retrocardiac opacification is most likely due to atelectasis. Heart size has increased. IMPRESSION: Right upper lobe atelectasis has resolved, but there is new pulmonary edema with small bilateral pleural effusions. " 42916def-32a2b792-4bbb18ee-b59574a0-e6261512.jpg,validate/p17/p17079941/s56899217/42916def-32a2b792-4bbb18ee-b59574a0-e6261512.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Mechanical ventilation, evaluation for endotracheal tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the position of the endotracheal tube is unchanged. The tip projects 3.8 cm above the carina. The other monitoring and support devices, including the Dobbhoff catheter are also in unchanged position. Unchanged appearance of the lung parenchyma, with widespread predominantly reticular parenchymal opacities and mild elevation of the right hemidiaphragm. Size of the cardiac silhouette. No pleural effusions. " 1df96751-811a2c86-1e4b79f5-20a7b0b0-36c647b0.jpg,validate/p10/p10382464/s58829526/1df96751-811a2c86-1e4b79f5-20a7b0b0-36c647b0.jpg,validation," WET READ: ___ ___ 7:57 AM 1. Unchanged position of left-sided dual-chamber pacemaker with the leads terminating in the expected location of the right atrium and right ventricle. 2. Mild blunting of the right costophrenic angle could relate to small right-sided pleural effusion. 3. Prominent right hilum, could be secondary to lymphadenopathy. Further evaluation with CT can be considered. Findings discussed with ___ team via telephone on ___ at 11:00 AM. *** ___ URGENT ATTENTION *** WET READ VERSION #1 ___ ___ ___ 10:53 AM 1. Unchanged position of left-sided dual-chamber pacemaker with the leads terminating in the expected location of the right atrium and right ventricle. 2. Mild blunting of the right costophrenic angle could relate to small right-sided pleural effusion. 3. Prominent right hilum, could be secondary to lymphadenopathy. Further evaluation with CT recommended. *** ___ URGENT ATTENTION *** WET READ VERSION #2 ___ ___ ___ 11:02 AM 1. Unchanged position of left-sided dual-chamber pacemaker with the leads terminating in the expected location of the right atrium and right ventricle. 2. Mild blunting of the right costophrenic angle could relate to small right-sided pleural effusion. 3. Prominent right hilum, could be secondary to lymphadenopathy. Further evaluation with CT recommended. Findings discussed with ___ team via telephone on ___ at 11:00 AM. *** ___ URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Dyspnea. Question acute cardiopulmonary disease, migration of pacer wires. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___ and ___. FINDINGS: Left-sided dual chamber pacemaker remains in unchanged position with wires terminating in the right atrium and right ventricle, expected location and unchanged since ___. Cardiomegaly is unchanged. Prominence of the right hilar region is likely secondary to patient's positioning. Blunting of the right costophrenic angle could relate to a small amount of pleural effusion. There is no focal consolidation or pneumothorax. IMPRESSION: 1. Unchanged position of left-sided dual-chamber pacemaker with the leads terminating in the expected location of the right atrium and right ventricle. 2. Mild blunting of the right costophrenic angle could relate to small right-sided pleural effusion. 3. Prominence of right hilum, is secondary to patient positioning. NOTIFICATION: FInding #3 discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:18 PM. " 701d2752-dc56be29-8c6a6c0a-2c5bd2ec-ef639414.jpg,validate/p14/p14508231/s50490369/701d2752-dc56be29-8c6a6c0a-2c5bd2ec-ef639414.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, cough TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and chest CTA ___ FINDINGS: Cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Curvilinear and linear opacities within both lower lobes likely reflect subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Lungs remain hyperinflated with attenuation of pulmonary vascular markings towards the apices compatible with emphysema. No acute osseous abnormalities identified. Cervical spinal fusion hardware is not completely assessed on this exam. IMPRESSION: No acute cardiopulmonary process. " 4eb0bcfb-82503150-5d1da3cb-40f52928-20830e97.jpg,validate/p11/p11042561/s51240692/4eb0bcfb-82503150-5d1da3cb-40f52928-20830e97.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with one week of cough and fever // Please assess 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. " cb421c82-2debeee5-ac457dcf-a435ce2e-2cb712c4.jpg,validate/p10/p10161112/s58694232/cb421c82-2debeee5-ac457dcf-a435ce2e-2cb712c4.jpg,validation," FINAL REPORT HISTORY: Left upper lobe endobronchial tumor status post sleeve resection, rule out pneumothorax. CHEST, TWO VIEWS. COMPARISON: Chest x-ray from ___ at 7:35 a.m. Compared with the prior film, one left-sided chest tube is present, another appears to have been removed. The left lung is relatively well expanded, allowing for elevation of the left hemidiaphragm. The mediastinum appears midline. Again seen is some hazy opacity and pleural fluid or thickening at the left base, considerably improved compared with earlier the same day. There is also slight pleural fluid and/or thickening and hazy opacity at the left upper zone. No obvious pneumothorax. Previous lucency seen at the left lung base is no longer visualized. Considerable subcutaneous emphysema along the left chest wall and along the upper aspect of the left chest is again seen. Minimal pleural thickening along the lateral left chest wall is also present. The right lung is grossly clear, without CHF, focal consolidation or effusion. Minimal atelectasis at the right base is probably present. IMPRESSION: Interval removal of one of the two left-sided chest tubes. No obvious pneumothorax. Partial interval improvement in opacity at the left base compared with prior film. " ebf59356-e6eefddd-6a7a652a-2e944605-9a8e9aac.jpg,validate/p16/p16957926/s52488358/ebf59356-e6eefddd-6a7a652a-2e944605-9a8e9aac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M intubated, hypoxic TECHNIQUE: Supine AP view of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Assessment of the chest is limited by overlying trauma board and external devices. Endotracheal tube tip is slightly high, approximately 8.6 cm from the carina. Enteric tube tip terminates in the stomach, however the side port is above the gastroesophageal junction. Heart size is mildly enlarged. Widening of the superior mediastinum may be due to low lung volumes, supine positioning, and AP technique. Ill-defined opacities are seen within both upper lobes and likely within the medial aspect of the right lung base, which may reflect areas of aspiration. No large pleural effusion or pneumothorax is identified on this supine exam. There is no overt pulmonary edema identified. No displaced fractures are evident. IMPRESSION: 1. Study limited by overlying trauma board and external devices. 2. Endotracheal tube tip is high terminating approximately 8.6 cm from the carina and would recommend advancement by at least 3 cm. 3. Enteric tube tip is within the stomach though side port is above the gastroesophageal junction, and would recommend advancement by at least 7 cm. 4. Ill-defined opacities in both upper lobes and likely within the medial aspect of the right lung base may reflect areas of aspiration. " 0aa05c69-2203afc7-111d0047-76b73526-396cfba3.jpg,validate/p13/p13548972/s51826497/0aa05c69-2203afc7-111d0047-76b73526-396cfba3.jpg,validation," FINAL REPORT INDICATION: ___F with cough, fever // r/o infiltrate TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Relative elevation of the right hemidiaphragm is again seen. There is secondary right basilar atelectasis. There is no allergic also consolidation, effusion or overt pulmonary edema. The cardiomediastinal silhouette is stable. IMPRESSION: Low lung volumes without acute cardiopulmonary process. " 649093a8-d4c5d5c0-35b16909-b275dce5-8c49c91a.jpg,validate/p12/p12648465/s55117363/649093a8-d4c5d5c0-35b16909-b275dce5-8c49c91a.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with likely small-bowel obstruction status post NG tube placement. COMPARISON: ___. FINDINGS: Single portable view of the chest. The lungs are clear of focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Nasogastric tube seen passing into the gastric body with side port past the GE junction. No free intraperitoneal air identified. IMPRESSION: NG tube in appropriate position. " 917c2527-9f6d448d-b44883db-98400c71-5afabb8b.jpg,validate/p19/p19747837/s56992794/917c2527-9f6d448d-b44883db-98400c71-5afabb8b.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with right pleuritic chest pain. IMPRESSION: PA and lateral chest compared to ___: Consolidation at the base of the right lung is more pronounced, consistent with worsening pneumonia. Small bilateral pleural effusions, right greater than left, should be followed to see if the right-sided component is related to infection. Mild cardiomegaly is stable. No pulmonary edema. Dr. ___ was paged at noon when the findings were recognized. " 7692080a-44a537f6-b06726ab-9a0ff32e-1901353f.jpg,validate/p15/p15808548/s52858671/7692080a-44a537f6-b06726ab-9a0ff32e-1901353f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with bilateral pleural effusions, left greater than right noted on ___ CXR // One month interval study for evaluation bilateral pleural effusions. One month interval study for evaluation bilateral pleural effusions. IMPRESSION: In comparison with the study of ___, the degree of opacification at the left base has decreased. Even though this is now an upright view, the left pleural effusion is smaller. Some residual atelectatic changes is seen at the base. Blunting of the right costophrenic angle with mild atelectatic changes is also seen. There is enlargement of the cardiac silhouette and hyperexpansion of the lungs. Some prominence of interstitial markings could reflect elevation of pulmonary venous pressure, chronic lung disease, or both. " 8142a5f2-3d0277be-3b393268-1fa38628-d6fd7922.jpg,validate/p12/p12590117/s56498109/8142a5f2-3d0277be-3b393268-1fa38628-d6fd7922.jpg,validation," FINAL REPORT AP CHEST, 5:50 A.M. ON ___ CLINICAL HISTORY: ___-year-old man with polytrauma. Check endotracheal and chest tubes. IMPRESSION: AP chest compared to ___:50 p.m.: Very small right pneumothorax is decreasing, pleural tube unchanged in position in the right upper hemithorax. Tubular lucency to the left of the midline from the aortic knob to the level of the diaphragm is probably a medial pneumothorax, alternatively a distended esophagus. It is not pneumomediastinum, which would have migrated over the past several hours. Left lower lobe atelectasis is improving. ET tube is in standard placement. Nasogastric tube has been advanced to the upper stomach. ET tube is in standard placement. Left subclavian vascular introducer is unchanged in position. Many rib fractures are present on both sides of the chest, involving at least the right sixth through ninth and left sixth and seventh, but conventional radiographs will consistently underestimate the number of fractures and are inadequate to assess changing displacements. " 8f1401f7-f2d26c95-08bfe688-3d4dbb23-0f4883ac.jpg,validate/p11/p11896718/s59297943/8f1401f7-f2d26c95-08bfe688-3d4dbb23-0f4883ac.jpg,validation," FINAL REPORT INDICATION: Epigastric pain, fever and pneumonia. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. Mediastinal and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. There is no free air under the diaphragms. IMPRESSION: No acute cardiopulmonary abnormality. " cc38a37d-8cded9df-95e6b227-79e3c100-b49e4818.jpg,validate/p16/p16377954/s58693790/cc38a37d-8cded9df-95e6b227-79e3c100-b49e4818.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with neutropenic fever and productive cough // Please eval for acute cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: A left-sided PICC is unchanged in position. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. The perihilar area on the right appears denser than on the prior exam which could represent pneumonia. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Increased opacity at the right perihilar region, which could represent pneumonia. " 5f536f9c-409d4010-1302e0c0-200ef208-042196d0.jpg,validate/p12/p12292383/s56462170/5f536f9c-409d4010-1302e0c0-200ef208-042196d0.jpg,validation," FINAL REPORT HISTORY: CHF presenting with cough and chest pain. TECHNIQUE: PA and lateral chest radiograph, 2 views. COMPARISON: ___, ___. FINDINGS: Cardiac silhouette is mildly enlarged, unchanged from prior exam. Mediastinal silhouette and hilar contours are stable. A left pectoral AICD is unchanged in position. Lungs are clear. There is no pleural effusion or pneumothorax. Mild blunting of bilateral costophrenic angles are likely due to pleural thickening. IMPRESSION: No acute cardiopulmonary process; specifically, no evidence of pneumonia or edema. " 3b8a8bd8-7922028c-fd9f8959-a3a63639-01ae0720.jpg,validate/p17/p17175688/s55829245/3b8a8bd8-7922028c-fd9f8959-a3a63639-01ae0720.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CHF // repeat for ovoid finding on CXR TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomegaly is again noted. Unfolding of the aortic arch. Prominence of the pulmonary arteries. Mild cephalization of pulmonary blood vessels. No pulmonary edema. Bilateral nipple densities are visualized. No airspace consolidation. The previously noted nodular density on the lateral radiograph just anterior to the proximal descending thoracic aorta is no longer visualized and was most likely composite in nature. Round metallic density seen in the upper abdomen just anterior to the spine is of indeterminate etiology and is seen on radiographs since ___. IMPRESSION: Cardiomegaly. Mild cephalic redistribution of pulmonary blood flow in keeping with mild cardiac decompensation. No overt pulmonary edema. No pneumonia. The previously noted nodule seen on the lateral just anterior to the proximal descending thoracic aorta view is thought to have been projectional in nature. Round metallic density seen in the upper abdomen just anterior to the spine is of indeterminate etiology and is seen on radiographs since ___. NOTIFICATION: A notification was posted on the ___ Record of notifications of critical radiology findings. " fa5a1694-989f7596-c9141140-4fe7509e-8fd97507.jpg,validate/p16/p16833478/s56943317/fa5a1694-989f7596-c9141140-4fe7509e-8fd97507.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p Whipple now with fever and SOB // r/o PNA TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: Right basilar opacity and left pleural effusion have improved since ___. There is no pulmonary edema, pleural effusion or pneumothorax. The heart size is top normal. The mediastinal contours are normal. There is no free air beneath the diaphragm. IMPRESSION: Interval improvement of the previously seen right basilar opacity and left pleural effusion. No new opacity. " b889c6b6-7a2fe380-d125e39c-6cdb22e1-4b4d9851.jpg,validate/p14/p14105959/s53494319/b889c6b6-7a2fe380-d125e39c-6cdb22e1-4b4d9851.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: An electronic device projects over the subcutaneous fat along the upper left chest. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The chest appears hyperinflated. Moderate degenerative changes are similar along the mid thoracic spine. IMPRESSION: No evidence of acute disease. " 0cce2654-5fda307a-5dc42c47-7bf1f5d0-6ff61a4b.jpg,validate/p10/p10873553/s57366673/0cce2654-5fda307a-5dc42c47-7bf1f5d0-6ff61a4b.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with history of bronchiectasis; cough and wheezing > 1 week. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs were obtained. The heart is normal size and cardiomediastinal contours are unremarkable. Dextroscoliosis of the spine is unchanged. Lungs are well expanded and clear with no focal consolidation to suggest pneumonia. No pleural effusions and no pneumothorax. IMPRESSION: No radiographic evidence of pneumonia. " 6dea90fe-32c6686a-c1f4d3df-dceab00a-bed50fbe.jpg,validate/p11/p11262041/s53109491/6dea90fe-32c6686a-c1f4d3df-dceab00a-bed50fbe.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with AMS // 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 stable. IMPRESSION: No acute cardiopulmonary process. " 5b876837-e88679ee-e1c07f3d-c56e6a5d-2808a8cf.jpg,validate/p11/p11287191/s55484222/5b876837-e88679ee-e1c07f3d-c56e6a5d-2808a8cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with fever, leukocytosis // eval for pna COMPARISON: ___. CT chest from ___. FINDINGS: AP upright and lateral views of the chest provided. Previously noted skin ___ overlying the right axilla and chest wall have been removed. Increased hazy opacity projecting over the right upper lung likely reflects known seroma in the right chest wall areas of scarring in the right perihilar region appears unchanged. Areas of peripheral scarring in both lungs as better assessed on prior CT appear relatively unchanged. The cardiomediastinal silhouette is stable. Imaged bony structures are intact. IMPRESSION: Findings as above. No convincing evidence for pneumonia. " cdb5a123-5f72e4f8-c8972df4-f08fc299-307ad1ae.jpg,validate/p14/p14546527/s59452187/cdb5a123-5f72e4f8-c8972df4-f08fc299-307ad1ae.jpg,validation," 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. " 01333584-2ebbca3f-3136e1be-5fd064dc-d79f6e49.jpg,validate/p14/p14062229/s55856355/01333584-2ebbca3f-3136e1be-5fd064dc-d79f6e49.jpg,validation," 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. " 66e29754-9ca1aa94-8744ea4e-714ddbe4-d4c71a87.jpg,validate/p16/p16881590/s56995462/66e29754-9ca1aa94-8744ea4e-714ddbe4-d4c71a87.jpg,validation," WET READ: ___ ___ 12:59 PM Distinct right upper lobe consolidation worrisome for infection in the background of pulmonary edema. Possible left-sided patchy consolidations and difficult to differentiate from background edema. ______________________________________________________________________________ FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Multiple chest radiographs dating back to ___. FINDINGS: The heart size is mildly enlarged. Prominent perihilar and basilar pulmonary vasculature is suggestive of pulmonary edema. There is a focal consolidation in the right upper lobe worrisome for infection. There are possible, subtle patchy consolidations in the left lung difficult to differentiate from underlying edema. No acute bony change is identified. IMPRESSION: Distinct right upper lobe consolidation worrisome for infection in the background of pulmonary edema. " 48c4feb0-9bfb8c66-dd279ca1-e9e0d2e0-424dc2ed.jpg,validate/p11/p11799619/s53309985/48c4feb0-9bfb8c66-dd279ca1-e9e0d2e0-424dc2ed.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Followup of pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there still is evidence of a right basal opacity that could represent chronic or slowly healing pneumonia. The parenchymal changes are minimally denser than at the last examination. Otherwise, the lung parenchyma is unchanged. Moderate overinflation and hyperlucent lung apices, indicative of pulmonary emphysema. No new parenchymal opacities. Unchanged normal size of the cardiac silhouette without evidence of pulmonary edema. " 602c5557-545a26c7-1ffae7e5-889fd9b6-f5070261.jpg,validate/p12/p12452998/s55213686/602c5557-545a26c7-1ffae7e5-889fd9b6-f5070261.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M w/ cp x 20 minutes and severe pvd. History of infrarenal aortic aneurysm. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. The lungs again appear hyperinflated and lucent compatible with known emphysema. Subsegmental atelectasis is noted at the right lung base. No convincing signs of pneumonia or edema. No convincing signs of edema or congestion. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: As above. " 0740a4d5-472d6e0e-1b26027b-dd53d322-40be89ad.jpg,validate/p11/p11619572/s57050199/0740a4d5-472d6e0e-1b26027b-dd53d322-40be89ad.jpg,validation," FINAL REPORT HISTORY: Right SC joint debridement. FINDINGS: In comparison with study of ___, there is extensive opaque material overlying the medial portion of the right clavicle and the sternoclavicular joint. No evidence of pneumothorax or acute focal pneumonia. " 7e1dacf0-12717a87-f80f6863-d5ebe8bc-8c28998b.jpg,validate/p10/p10699336/s55288563/7e1dacf0-12717a87-f80f6863-d5ebe8bc-8c28998b.jpg,validation," 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 c/b quadraplegia, R pneumothorax s/p right pigtail // interval cxr IMPRESSION: Allowing for differences in technique, there has not been a substantial change in the appearance of the chest since the previous radiograph performed 1 day earlier. " 86d7711e-fdd2ed85-4cb12af9-7b6c3076-10c50b7c.jpg,validate/p11/p11052292/s58916712/86d7711e-fdd2ed85-4cb12af9-7b6c3076-10c50b7c.jpg,validation," FINAL REPORT HISTORY: Fever and prolonged intubation. Evaluate for interval change or evidence of pneumonia. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: A portable frontal chest radiograph demonstrates the right central catheter with the tip in the low SVC, the endotracheal tube unchanged in position, and the nasogastric tube extending at least into the stomach. The cardiomediastinal silhouette is unchanged. There is increased retrocardiac and lingular opacity, concerning for pneumonia. There is also superimposed bibasilar atelectasis and a new left pleural effusion. There is no pneumothorax. IMPRESSION: Increased retrocardiac and lingular opacity, concerning for pneumonia. Additionally, superimposed bibasilar atelectasis and a new left pleural effusion. These findings were communicated via telephone by Dr. ___ to Dr. ___ at ___ on ___. " 3de84c94-87acc02e-c7bec71e-d491f681-c0f44423.jpg,validate/p18/p18886299/s51761616/3de84c94-87acc02e-c7bec71e-d491f681-c0f44423.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with angioedema // ? pulmonary infiltrate, edema, effusion ? pulmonary infiltrate, edema, effusion IMPRESSION: In comparison with study of ___, the cardiac silhouette remains within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 20670f90-926aa906-8077b83e-2aeac33d-98fb8eb7.jpg,validate/p11/p11093194/s51477666/20670f90-926aa906-8077b83e-2aeac33d-98fb8eb7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with alc hep, ___ on hd, rising wbc deteriorating clinical status // previous lul lesion previous lul lesion IMPRESSION: In comparison with the study ___ ___, there again are low lung volumes that accentuate the transverse diameter of the heart. There may be mild elevation of pulmonary venous pressure. Monitoring and support devices are unchanged. There is some increased opacification at the left base, consistent with mild pleural fluid and atelectatic changes. " 8e2cd5ec-05d7a9e5-d0e22df5-599d0341-39d1831c.jpg,validate/p15/p15461830/s53534196/8e2cd5ec-05d7a9e5-d0e22df5-599d0341-39d1831c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chest pain, DOE // any worrisome lesion? COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Scoliosis with degenerative vertebral disease, causing slight asymmetry of the ribcage. No pneumonia. No pleural effusions. No pneumothorax. No pulmonary edema. " 98568307-494160b7-d622e0e7-8564350d-a261471e.jpg,validate/p19/p19026714/s53303300/98568307-494160b7-d622e0e7-8564350d-a261471e.jpg,validation," FINAL REPORT INDICATION: Pneumonia, status post diaphragmatic plication. Assess interval change. COMPARISON: Chest radiographs ___, CTA chest ___. FINDINGS: The cardiomediastinal and hilar contours are normal. Again seen is a right PICC line with tip terminating at the cavoatrial junction. Cardiomediastinal and hilar contours remain stable. The left pleural effusion has resolved, but a small right pleural effusion remains, stable compared to yesterday's study. Mild pulmonary edema persists. Heterogeneous opacities in the right lung continue to improve. Retained barium in the stomach and small bowel from recent study is noted. IMPRESSION: Continued improvement in right lung opacities. " 8a29e778-5d160625-eac7c596-5c5b637c-1cdeef15.jpg,validate/p12/p12850832/s58122777/8a29e778-5d160625-eac7c596-5c5b637c-1cdeef15.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with dry cough, fever and left shift. Evaluation for pneumonia. COMPARISON: Comparison is made to radiograph of the chest from ___. FINDINGS: PA and lateral views of the chest are obtained. The lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. The visualized osseous structures are also unremarkable. A slight impression on the right side of the cervical trachea is again seen. CONCLUSION: No acute cardiopulmonary disease. Slight impression on the right side of lower cervical trachea may represent a thyroid nodule. " 2a2992bc-ce749b7a-090a94a3-80d7d59c-039fc25f.jpg,validate/p18/p18692222/s51299913/2a2992bc-ce749b7a-090a94a3-80d7d59c-039fc25f.jpg,validation," WET READ: ___ ___ 2:27 AM possible early CHF, not florid. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with shortness of breath. COMPARISON: PA and lateral chest radiograph ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: There has been interval increase in cardiomegaly with increased prominence of mediastinal veins and prominence of peripheral interstitium consistent with pulmonary edema. There is a homogeneous opacity seen in the left lower lobe concerning for infection. Seen again is left pectoral implant pacer device with leads in unchanged position terminating within the right ventricle and atrium. There is no pleural effusion or pneumothorax. The patient has significant pectus excavatum, otherwise, the osseous structures are unremarkable. IMPRESSION: 1. Increased cardiomegaly and pulmonary edema consistent with CHF. 2. Left lower lobe pneumonia. " ed56691a-114d7fd8-00d62204-ea689584-6096bf3f.jpg,validate/p15/p15426827/s54367897/ed56691a-114d7fd8-00d62204-ea689584-6096bf3f.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cirrhosis. Evaluate for 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 clear without focal or diffuse abnormality. A feeding tube terminates below the diaphragm. No new radiopaque foreign body. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0b61ab57-8dc2afdd-4e0abd04-7cd26095-1133783b.jpg,validate/p10/p10940509/s58985964/0b61ab57-8dc2afdd-4e0abd04-7cd26095-1133783b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with HIV and latent TB, subjective fever + bodyache + cough x 4 days, weight loss. // r/o pulm disease TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is upper limits of normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear except for focal linear scar atelectasis at the left base. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 01ecc4b5-fc3b01c2-9f2268ae-697b9bf9-97836e87.jpg,validate/p13/p13999026/s50875344/01ecc4b5-fc3b01c2-9f2268ae-697b9bf9-97836e87.jpg,validation," FINAL REPORT INDICATION: Alcoholic cirrhosis and variceal bleed, now with low-grade temperatures. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Small left pleural effusion and trace left pleural effusion is unchanged. Opacification of the left lung base is unchanged and likely represents atelectasis. Heart size is top normal. The upper lungs are clear. No pneumothorax. IMPRESSION: No change in small left pleural effusion with adjacent atelectasis and trace right pleural effusion. " 1778b463-92ca77c3-d0eb5e5e-d7a381d5-8b24a073.jpg,validate/p16/p16401890/s57148435/1778b463-92ca77c3-d0eb5e5e-d7a381d5-8b24a073.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest discomfort // eval for cardiopulm 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. " efa769ae-46e57ded-48ef01a2-1238c91d-cc76947f.jpg,validate/p19/p19213399/s52328652/efa769ae-46e57ded-48ef01a2-1238c91d-cc76947f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with weakness // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is bibasilar atelectasis/scarring. No definite focal consolidation is seen. The lungs remain hyperinflated. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Bibasilar atelectasis/ scarring without focal consolidation. " 9c6ed906-8225ec22-caca8c8d-6446b75f-c15d5ea5.jpg,validate/p14/p14565909/s55685144/9c6ed906-8225ec22-caca8c8d-6446b75f-c15d5ea5.jpg,validation," WET READ: ___ ___ ___ 11:21 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F w/hx of PE in ___ and stable liver hemangiomas who presents with R flank pain/lateral chest pain. // eval for infection 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 focal consolidation. IMPRESSION: No acute cardiopulmonary process. " 236021ed-12a93d03-66e9d449-816e1a9d-3828d740.jpg,validate/p11/p11190372/s56170215/236021ed-12a93d03-66e9d449-816e1a9d-3828d740.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with chough and mid scapular back pain in the setting of known Aortic aneurysm // please evaluate for pulmo etiology and also for mediastinal widening TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear. The hila and pulmonary vasculature are normal. No pleural effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. No obvious osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. No mediastinal widening. " 3e41a51f-bc78364f-70710dc5-6ad25742-4c091d43.jpg,validate/p14/p14265178/s58714145/3e41a51f-bc78364f-70710dc5-6ad25742-4c091d43.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain and shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of consolidation or effusion. Cardiac silhouette is enlarged but unchanged. Widening of the left AC joint again noted. No acute osseous abnormality detected. IMPRESSION: Cardiomegaly without definite acute cardiopulmonary process. " a22a10b6-efa39507-c28ef38a-098b7f0e-053b3bde.jpg,validate/p16/p16817573/s53703343/a22a10b6-efa39507-c28ef38a-098b7f0e-053b3bde.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: Patient with pneumothorax. Evaluate interval change. FINDINGS: Comparison is made to previous study from ___. There is again seen a small right-sided pneumothorax, mostly along the superior lateral chest wall. This is unchanged in position. There is again seen nodular and airspace opacities throughout both lung fields, most prominent within the right base. Right-sided pleural effusion is again seen. Overall, there has been no interval change. The heart size is upper limits of normal but stable. There are degenerative changes and a compression deformity of a mid thoracic vertebral body. " 02f921f6-ddd0f547-7522d603-eb9e8266-99aadaa6.jpg,validate/p14/p14178898/s56783367/02f921f6-ddd0f547-7522d603-eb9e8266-99aadaa6.jpg,validation," FINAL REPORT HISTORY: Cardiac surgery, to assess for pneumothorax. FINDINGS: There may be a tiny residual right apical pneumothorax. Opacification at the right base is slightly decreased, with continued atelectasis and effusion. Left hemidiaphragm is not seen, consistent with volume loss at the left base and probable small effusion. There is a more coalescent area of opacification in the right mid-to-lower lung that is somewhat worrisome for developing consolidation. The right IJ sheath is unchanged, though there is kinking at apparently the level of skin insertion. " 318fbdaf-75e1063c-a93325cd-042079b9-9c97da20.jpg,validate/p10/p10024982/s52024751/318fbdaf-75e1063c-a93325cd-042079b9-9c97da20.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M CAD, Afib here with NSTEMI and occlusion of SVG-OM which was deemed not intervenable now with PEA arrest after respiratory distress and intubation. // interval changes interval changes COMPARISON: Prior chest radiographs ___ through ___. Greater opacification at the right lung base is probably due to increasing moderate right pleural effusion. Severe cardiomegaly has progressed. Left lower lobe collapse and moderate left pleural effusion have improved. ET tube, right subclavian infusion port, transvenous right atrial right ventricular pacer leads, are in standard placements and a nasogastric drainage tube passes into the stomach and out of view. " d0c20851-4936986a-e0a6aad6-cb370e58-38ca0ed4.jpg,validate/p15/p15303810/s53427977/d0c20851-4936986a-e0a6aad6-cb370e58-38ca0ed4.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Breakthrough seizure activity, evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. Dual-lead left-sided pacemaker is again seen with leads unchanged in position. There is biapical pleural thickening. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable, as are the hilar contours. IMPRESSION: No acute cardiopulmonary process. " e6cb9c98-35511614-545de804-41a15741-6521c596.jpg,validate/p19/p19025684/s57738454/e6cb9c98-35511614-545de804-41a15741-6521c596.jpg,validation," 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. " d75418ed-b7523dcb-fdb3b7e6-39badd29-fd626c1d.jpg,validate/p15/p15805011/s52112718/d75418ed-b7523dcb-fdb3b7e6-39badd29-fd626c1d.jpg,validation," FINAL REPORT INDICATION: Chest pain with wheezing and rhonchi on physical exam on the right greater than the left, here to evaluate for pneumonia. COMPARISON: Chest radiograph, last performed on ___. FINDINGS: AP frontal and lateral radiographs of the chest with the patient lying in the stretcher were obtained. Evaluation of the heart and lungs is limited due to technique and patient rotation. Within these limitations, there is blunting of the right costophrenic angle with opacification of the right minor fissure suggesting pleural fluid. No focal consolidation concerning for pneumonia or significant pneumothorax is detected. The cardiac silhouette is normal in size allowing for rotation and low inspiratory lung volumes. The mediastinum is within normal limits. The visualized upper abdomen is gasless. IMPRESSION: New or increased small right pleural effusion. Lungs clear. " 446d9c81-38ffefa1-6a4c7b4d-71798e0e-81ed30d2.jpg,validate/p15/p15584013/s55726451/446d9c81-38ffefa1-6a4c7b4d-71798e0e-81ed30d2.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with AML. To be assessed prior to initiation on clinical trial. // To be assessed prior to initiation on clinical trial. TECHNIQUE: Chest PA and lateral FINDINGS: Port-A-Cath catheter tip is at the lower SVC. Heart size and mediastinum are stable. Upper lung interstitial opacities are unchanged in the lower lobes are clear. No focal consolidations that a new seen. No pleural effusion or pneumothorax is noted. IMPRESSION: Residual interstitial opacities in the right upper lobe are likely sequelae of prior infection/lung injury. No acute cardiopulmonary process. " cf7b1bfa-efcd707c-c20ca18c-1f692882-dca97cef.jpg,validate/p11/p11962176/s54201013/cf7b1bfa-efcd707c-c20ca18c-1f692882-dca97cef.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___F with ESRD status post renal transplant now with right flank and back pain for 1 week and positive urinalysis TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged. The aorta is diffusely calcified and tortuous. Mediastinal and hilar contours are relatively unchanged. Low lung volumes cause crowding of the bronchovascular structures without overt pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. Mild atelectasis is noted in the lung bases. Degenerative changes are again seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " eb4b359b-29d211dd-21d920a9-6dca450e-d31e1d81.jpg,validate/p15/p15435415/s51451963/eb4b359b-29d211dd-21d920a9-6dca450e-d31e1d81.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p PA catheter repositioning // PA catheter position TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate to severe cardiomegaly is stable. Swan-Ganz catheter tip is in the main pulmonary artery. Mild vascular congestion has almost completely resolved. Bilateral pleural effusions have decrease, the are small associated with minimal adjacent atelectasis. There is no evident pneumothorax. Widening mediastinum is stable. Sternal wires are intact " efd75e4b-0a1d8d72-17e596c3-f81109f7-2357f4bf.jpg,validate/p14/p14648269/s55367721/efd75e4b-0a1d8d72-17e596c3-f81109f7-2357f4bf.jpg,validation," FINAL REPORT INDICATION: Left-sided chest pain. COMPARISONS: ___ and ___. FINDINGS: PA and lateral chest radiographs. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. No acute fracture is seen. IMPRESSION: No acute cardiopulmonary process. " b14e1b60-13ee7e29-47e3c90f-9fbda168-593c7d4f.jpg,validate/p15/p15142292/s58970144/b14e1b60-13ee7e29-47e3c90f-9fbda168-593c7d4f.jpg,validation," FINAL REPORT INDICATION: Fever. Evaluate for pneumonia. COMPARISON: Chest radiographs from for ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate interval removal of the right hepatic. The cardiomediastinal silhouette is normal and the lungs are clear, without focal consolidation, pleural effusion, or pneumothorax. Visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 4ec8c1db-c12128ff-855de54d-a2d8fa50-b650735d.jpg,validate/p19/p19671277/s52134301/4ec8c1db-c12128ff-855de54d-a2d8fa50-b650735d.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with known head and neck carcinoma, now presenting with fever, though no cough. COMPARISON: None available in the ___ system. AP AND LATERAL CHEST RADIOGRAPHS: A right-sided central venous catheter terminates in the region of the right atrium. Bibasilar opacities likely reflect atelectasis. No pneumothorax is identified. There is no vascular congestion or pleural effusions. Mediastinal and hilar contours are within normal limits. Hyperdense nodules within the mediastinum likely reflect prior granulomatous disease. The cardiac silhouette is mildly enlarged. The lateral view is difficult to evaluate given the arm-down positioning. IMPRESSION: 1. Right-sided central venous catheter terminating in the region of the right atrium 2. Bibasilar atelectasis 3. Mild cardiomegaly " c80a623a-7ea71710-9c6f4d0c-0358651d-403a66b6.jpg,validate/p12/p12525702/s54304035/c80a623a-7ea71710-9c6f4d0c-0358651d-403a66b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new BiVICD implant // penumothorax and lead placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Mild to moderate cardiomegaly is stable. There is no pneumothorax. Pacemaker leads are in standard position in the right atrium, right ventricle and through the coronary sinus. The lungs are clear. There is no pleural effusion. " 172858ca-5cbc198a-199cf125-c1eb54b4-617fd088.jpg,validate/p18/p18817171/s56209283/172858ca-5cbc198a-199cf125-c1eb54b4-617fd088.jpg,validation," FINAL REPORT AP CHEST, 3:21 A.M., ___ HISTORY: A ___-year-old man with pericardial effusion after pericardiocentesis. IMPRESSION: AP chest compared to ___: Cardiac silhouette may be slightly smaller today than on ___ following the apparent insertion of pericardiocentesis catheter. Moderate right pleural effusion has increased and there is more opacification in the lower lungs, vascular congestion in the upper lungs and in the mediastinum suggesting development of left heart failure. No pneumothorax. This examination was presented for review on ___ " c65676fe-ffe15f9a-cf87ac9c-2fcc8d24-bb6a6287.jpg,validate/p18/p18391447/s56144441/c65676fe-ffe15f9a-cf87ac9c-2fcc8d24-bb6a6287.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with s/o fall down stairs COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Lung volumes are low. Overlying EKG leads are present. There is mild bibasilar atelectasis. No focal consolidation, large effusion or pneumothorax is seen. The heart size appears top-normal. Mediastinal contour appears within normal limits. No acute osseous abnormality is seen. IMPRESSION: As above. " 384fc3b0-df2a1515-6e1efb11-09a41ff8-28eb2833.jpg,validate/p10/p10577647/s50563275/384fc3b0-df2a1515-6e1efb11-09a41ff8-28eb2833.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with new L IJ CVL // Eval for CVL placement TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: The left internal jugular central venous catheter is not in appropriate position and courses into the left subclavian vein. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Malppositioned left internal jugular central venous catheter which takes the incorrect course and courses into the left subclavian vein. Recommend removal and repositioning. Discussed with Dr. ___ at 19:10 on ___ via telephone. Clear lungs. No evidence of pneumothorax. " 936e933a-d4e3b83f-8796d3a6-9f1cde6a-485ae78d.jpg,validate/p18/p18296202/s58611090/936e933a-d4e3b83f-8796d3a6-9f1cde6a-485ae78d.jpg,validation," FINAL REPORT INDICATION: Hypoxia. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The lung volumes are low. The heart size is normal. The mediastinal and hilar contours are unremarkable. There is persistent elevation of the right hemidiaphragm which is chronic. Linear opacities in the lung bases are compatible with subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Subsegmental atelectasis in the lung bases with chronic elevation of the right hemidiaphragm. No acute cardiopulmonary abnormality otherwise identified. " a135d3f0-0cbab629-13b2d81e-6947cad2-488c20ef.jpg,validate/p12/p12503315/s53075043/a135d3f0-0cbab629-13b2d81e-6947cad2-488c20ef.jpg,validation," 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. " 11b75c83-aef97fb7-804b6888-9b4cdd97-757a83e6.jpg,validate/p15/p15752845/s53039720/11b75c83-aef97fb7-804b6888-9b4cdd97-757a83e6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with rectal cancer now with shortness of breath and cough // does this patient have pneumonia or pulmonary edema COMPARISON: Chest x-ray dated ___. Targeted review of chest CT from ___. FINDINGS: There are multiple nodular densities seen throughout both lungs, the largest measuring approximately 22 mm, seen at the left lung base. These are depicted in greater detail on the chest CT from ___. There is mild cardiomegaly. Low inspiratory volumes may contribute to accentuation of the cardiac silhouette. There is upper zone redistribution, without overt CHF. There is subsegmental atelectasis at the left lung base and trace atelectasis at the right lung base. No frank consolidation or gross effusion is identified. Probable trace right pleural effusion. Tiny left effusion cannot be excluded. No pneumothorax detected. There right-sided indwelling catheter is present, tip at SVC/RA junction. IMPRESSION: Multiple bilateral pulmonary nodules measuring up to 22 mm at the left base, better depicted on CT from ___. Upper zone redistribution, without other evidence of CHF. Subsegmental atelectasis at left and (minimal) at right lung base. Trace right pleural effusion. No frank consolidation to suggest pneumonic infiltrate. The possibility of an early pneumonic infiltrate at the left lung base cannot be entirely excluded, but is considered less likely. " 74e98fda-bdda54e7-a6a7bf5b-07529f0f-59b25bba.jpg,validate/p13/p13136121/s59118009/74e98fda-bdda54e7-a6a7bf5b-07529f0f-59b25bba.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain. Eval for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph of ___ 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 pneumothorax or other acute cardiopulmonary process. " 29564327-b9fac0b3-18e54906-983f6e05-3552be15.jpg,validate/p15/p15613908/s51881215/29564327-b9fac0b3-18e54906-983f6e05-3552be15.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with COPD, schizophrenia w/ acute desat to ___% // eval for new infiltrate, acute changed TECHNIQUE: Portable frontal view of the chest. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: Pulmonary vascular congestion has increased since ___. No focal opacity concerning for pneumonia is identified. There is no pleural effusion or pneumothorax. Prominence of the pulmonary arteries could relate to chronic lung disease or chronic pulmonary emboli. The heart size is normal. IMPRESSION: Pulmonary vascular congestion has increased since ___. Prominence of the pulmonary arteries could relate to chronic lung disease or chronic pulmonary emboli in the correct clinical setting. " a9176fb7-e8e053a3-3377f0d4-45dd63e2-fabf1330.jpg,validate/p18/p18082575/s57812697/a9176fb7-e8e053a3-3377f0d4-45dd63e2-fabf1330.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with NGT placement // NGT placement COMPARISON: Chest radiographs ___ and ___:05. IMPRESSION: Lung apices are excluded from this study centered at the level of the diaphragm. Nasogastric tube ends above the level of the gastroesophageal junction, and would need to be advanced at least 10 cm to enter the mid portion of the stomach. Combination of mild edema and pleural effusion in the right hemi thorax has improved. Opacification of the left hemi thorax due to previous pneumonectomy is inseparable from what might be a distended or displaced stomach. Right central infusion port and ET tube are in standard placements. There is probably no substantial pneumothorax. " 52fac9ef-0bf5a0a8-f3614247-ad81ec4e-a8611af8.jpg,validate/p14/p14450867/s50557110/52fac9ef-0bf5a0a8-f3614247-ad81ec4e-a8611af8.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Heart surgery. IMPRESSION: AP and lateral chest compared to ___: Pulmonary edema has not recurred and pulmonary vascular engorgement has improved. Severe cardiomegaly is stable. Small right and moderate left pleural effusion are stable, left lower lobe collapse is more pronounced. No pneumothorax. Transvenous right ventricular pacer lead may pass into the coronary sinus, but it does not traverse the ring of the tricuspid valve prosthesis. ___ was paged. " 9d7eff85-5943634c-173f40a7-818c7ff7-bac4a42f.jpg,validate/p16/p16783674/s54280555/9d7eff85-5943634c-173f40a7-818c7ff7-bac4a42f.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Hemorrhagic CVA, assess for pneumonia or aspiration. Comparison is made with prior study, ___. Moderate cardiomegaly is stable. There are low lung volumes. Aside from minimal atelectasis in the left lower lobe and left upper lobe, the lungs are clear. There is no pneumothorax or pleural effusion. Sternal wires are aligned. " 15462bec-c98cdd8b-e207ae7f-2740c1e4-edd2ad5a.jpg,validate/p18/p18448597/s55719219/15462bec-c98cdd8b-e207ae7f-2740c1e4-edd2ad5a.jpg,validation," 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. " 0a110056-7024a9e1-50877102-357623eb-81f2a7b0.jpg,validate/p17/p17622322/s54199941/0a110056-7024a9e1-50877102-357623eb-81f2a7b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with left chest, clavicle pain, reproducible with palpation and left shoulder ROM, MVC 2 weeks ago // R/O pneumonia, CHF R/O pneumonia, CHF IMPRESSION: No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 03599fd8-e9ae20d5-9903eda2-86a503f6-b1589eb5.jpg,validate/p10/p10427568/s50170109/03599fd8-e9ae20d5-9903eda2-86a503f6-b1589eb5.jpg,validation," WET READ: ___ ___ ___ 7:24 AM Patchy bibasilar opacities could reflect atelectasis though an infection cannot be excluded. Recommend clinical correlation. WET READ VERSION #1 ___ ___ ___ 3:45 AM Right infrahilar opacity, similar to ___, concerning for pneumonia. ______________________________________________________________________________ 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: Radiograph from ___ and ___. FINDINGS: There is patchy bibasilar opacities that could reflect atelectasis though infection cannot be excluded. There is no pleural effusion or pulmonary edema is seen. The heart is normal in size. IMPRESSION: Patchy bibasilar opacities most likely reflect atelectasis though an infection cannot be excluded. Recommend clinical correlation. " b7f81332-9e882be9-70acea58-5fea12a9-31d6c831.jpg,validate/p14/p14736565/s52221546/b7f81332-9e882be9-70acea58-5fea12a9-31d6c831.jpg,validation," 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. " 7290a7cd-87276b34-0dd02af0-113d3a4e-ee0bf35e.jpg,validate/p15/p15273409/s52828414/7290a7cd-87276b34-0dd02af0-113d3a4e-ee0bf35e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with fever and cough. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: ___. FINDINGS: No focal consolidation or pneumothorax is detected. Heart and mediastinal contours are stable with aortic tortuosity. Trace unilateral pleural effusion, probably on the left but evident on lateral view only, is new compared to prior. IMPRESSION: New trace unilateral pleural effusion. " e46d2401-a6bf77d4-6edec144-10f6d23c-d027ad83.jpg,validate/p13/p13495297/s52135144/e46d2401-a6bf77d4-6edec144-10f6d23c-d027ad83.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chest pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 27dcd94a-6b061a56-ed1f1856-c87f0768-5eba8d16.jpg,validate/p10/p10175233/s54499674/27dcd94a-6b061a56-ed1f1856-c87f0768-5eba8d16.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with weight loss and recent cough. COMPARISON: Multiple prior radiographs dating back to ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal heart size. Mediastinal and hilar contours are within normal limits. Atherosclerotic calcifications are present in the aortic arch. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. There is no evidence of nodule or mass. Mild lower thoracic spondylosis is present. IMPRESSION: No acute cardiopulmonary process such as pneumonia. " 3ba8fbbe-989e2f64-3cf29b67-e6b2c2c1-d0887a73.jpg,validate/p10/p10410641/s56031350/3ba8fbbe-989e2f64-3cf29b67-e6b2c2c1-d0887a73.jpg,validation," 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. " 4b2cd77d-ec360e64-251d1fbf-c301174d-de52c500.jpg,validate/p17/p17717605/s56944344/4b2cd77d-ec360e64-251d1fbf-c301174d-de52c500.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // ? acute cardiopulm abnormality TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There are low lung volumes. No definite focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 6482e3e2-2e146e14-4a3e397b-25672660-60744e45.jpg,validate/p10/p10807406/s52888492/6482e3e2-2e146e14-4a3e397b-25672660-60744e45.jpg,validation," WET READ: ___ ___ ___ 9:05 PM PA and lateral chest radiograph were provided. Cardiomediastinal and hilar contours are within normal limits. There is no evidence of pulmonary edema. No findings convincing for pneumonia are present. There is no pneumothorax or pleural effusion. Imaged osseous structures and upper abdomen are without an acute abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new fever // r/o pneumonia r/o pneumonia COMPARISON: Chest CT ___. IMPRESSION: Emphysema is demonstrated more convincingly on the recent chest CT, which also showed punctate lung nodules too small to detect on this study and dilatation of the aortic annulus, also not revealed by this study. There are no findings to suggest pneumonia. No pleural abnormality. Heart size is normal. " 8f86cead-169b0889-85665292-16f7e569-be1d3761.jpg,validate/p15/p15058800/s50685021/8f86cead-169b0889-85665292-16f7e569-be1d3761.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough // eval infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patchy E right PAs, right lower lobe opacity is worrisome for pneumonia. There is also left mid lung opacity in a relative linear configuration which may be due to atelectasis. . No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. The cardiac silhouette remains enlarged. IMPRESSION: Right base opacity is concerning for pneumonia. Lingular opacity most likely due to atelectasis although a second site of infection is not excluded. " 1d908292-07eaf2b0-6dee1461-3c42307d-90d508e2.jpg,validate/p18/p18628502/s50066129/1d908292-07eaf2b0-6dee1461-3c42307d-90d508e2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Severe cough, temperature. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have increased, given a better inspiratory effort of the patient. No pleural effusions. No pneumonia, no pulmonary edema. Borderline size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. " 02b9c627-880bc5d1-3a5fa44a-bdc92e52-66c95d23.jpg,validate/p14/p14068639/s50697804/02b9c627-880bc5d1-3a5fa44a-bdc92e52-66c95d23.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CTA chest from ___ and chest radiograph from ___. CLINICAL HISTORY: Chest pain, assess pleural effusion. FINDINGS: PA and lateral views of the chest provided. An AICD is unchanged in position with lead tip extending to the region of the right ventricle. Clips are noted in the left upper quadrant. Lung volumes are low. There is linear opacity in the lower lungs, left greater than right, likely representing plate-like atelectasis. No convincing signs of pneumonia or CHF. No large effusion or pneumothorax is seen. The cardiomediastinal silhouette is stable. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild bibasilar atelectasis, no convincing signs of pneumonia. " bee916ce-035d337b-97d09bab-06dd69bb-e535f0b8.jpg,validate/p11/p11962176/s58719958/bee916ce-035d337b-97d09bab-06dd69bb-e535f0b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with immunosuppression, abdominal pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Mild cardiomegaly is present. The aorta is tortuous and diffusely calcified. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is seen. Ovoid opacity projecting over the right lateral lung base is likely reflective of overlapping soft tissue. No acute osseous abnormalities detected. The distal right clavicle appears to have been surgically resected. IMPRESSION: No acute cardiopulmonary abnormality. " 0c8a7bae-4fb4e45d-f1273cd9-a0847312-03918537.jpg,validate/p16/p16526693/s56052498/0c8a7bae-4fb4e45d-f1273cd9-a0847312-03918537.jpg,validation," FINAL REPORT INDICATION: History: ___M with SOB, hypoxia // ? pulmonary edema TECHNIQUE: Portable AP semi upright view of the chest COMPARISON: Multiple prior radiographs, most recently ___ FINDINGS: In comparison to the most recent study, the heart is slightly larger and there are increased perihilar and bibasilar interstitial opacities, consistent with mild pulmonary edema. There is no focal consolidation. A small left pleural effusion is probably unchanged. No pneumothorax. IMPRESSION: 1. Interval development of mild pulmonary edema. 2. Stable small left pleural effusion. " 5303013b-859a78da-7fcdb510-2f69c3f6-0a93e56b.jpg,validate/p12/p12472166/s56098035/5303013b-859a78da-7fcdb510-2f69c3f6-0a93e56b.jpg,validation," FINAL REPORT INDICATION: ___F with acute cough // r/o PNA 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. " 41cd67db-71073692-c6d3c255-ce5a017d-5f3da994.jpg,validate/p16/p16931692/s52761258/41cd67db-71073692-c6d3c255-ce5a017d-5f3da994.jpg,validation," FINAL REPORT INDICATION: History of fever of unknown origin with desaturations while attempted LP, now tachypneic. COMPARISONS: Chest radiograph from ___ and chest CT from ___. FINDINGS: A left subclavian line terminates in the mid SVC. There is no focal consolidation, pleural effusion or pneumothorax. The heart is stably enlarged. Image quality is slightly improved; however, the patient is still minimally rotated. IMPRESSION: No evidence of pneumonia. " 89c60866-100348e0-c367f975-2309f0a7-a5546694.jpg,validate/p11/p11084812/s55142486/89c60866-100348e0-c367f975-2309f0a7-a5546694.jpg,validation," 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. " 2722e58a-3fa96d09-b68c17b1-2c4d4dd5-20fedafe.jpg,validate/p14/p14958899/s54637614/2722e58a-3fa96d09-b68c17b1-2c4d4dd5-20fedafe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with pleuritic chest pain x 3 days, fever and complex medical history. 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. " 6ae196bc-90523728-3a2a05db-aa536ed7-5164c31f.jpg,validate/p15/p15957987/s56860768/6ae196bc-90523728-3a2a05db-aa536ed7-5164c31f.jpg,validation," WET READ: ___ ___ ___ 6:44 PM Decrease in left effusion after thoracentesis without evidence of pneumothorax. Right effusion is unchanged. Esophageal stent, left chest tube and port noted. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Bilateral pleural effusions, rule out pneumothorax. COMPARISON: ___. FINDINGS: The left chest tube is in unchanged position. There is moderate decrease of the pre-existing left pleural effusion. No evidence of a left-sided pneumothorax. The esophageal stent is in unchanged position. On the right, the extent of the effusion has also decreased. The parenchymal opacities and consolidations at both lung bases persist. Unchanged moderate cardiomegaly. " b6d20dc0-7ca25dbd-b9b9c242-641cd3b7-13118b53.jpg,validate/p17/p17925184/s54217409/b6d20dc0-7ca25dbd-b9b9c242-641cd3b7-13118b53.jpg,validation," FINAL REPORT HISTORY: Altered mental status with resolving opacities. FINDINGS: In comparison with the study of ___, the right PICC line has been removed. The patient has taken a somewhat better inspiration. Hazy opacifications are again seen bilaterally at the bases, consistent with layering effusions and compressive atelectasis at the bases, most prominent on the left. The patchy opacifications seen previously are less prominent, suggesting that much of this appearance reflected vascular congestion that is resolving. " 4c38d7e1-94b1fd4c-c0c35a9d-8bae8e44-b00038c4.jpg,validate/p14/p14730883/s53616400/4c38d7e1-94b1fd4c-c0c35a9d-8bae8e44-b00038c4.jpg,validation," 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. " 10e5f7a1-c9648858-f2831841-e578d26f-1bf14aac.jpg,validate/p18/p18406213/s50831730/10e5f7a1-c9648858-f2831841-e578d26f-1bf14aac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ___ // eval for interval change/ett placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There are persistent low lung volumes. Extensive bilateral lung opacities are grossly unchanged, of note the component of atelectasis in the retrocardiac region though has improved. NG tube tip is out of view below the diaphragm. ET tube is in standard position. Right IJ catheter tip in the lower right atrium " 4411ecc0-f972e134-d0f5ea81-d70b75f1-29b16342.jpg,validate/p19/p19453522/s52740577/4411ecc0-f972e134-d0f5ea81-d70b75f1-29b16342.jpg,validation," FINAL REPORT EXAMINATION: Chest (PA and lateral) INDICATION: ___ year old man with recurrent effusion s/p thoracentesis; evaluate for PTX TECHNIQUE: PA and lateral chest radiograph from ___. COMPARISON: ___ and dating back to ___. FINDINGS: The right pleural effusion has decreased in size since the prior exam and is now small. There is no left pleural effusion. The lungs are clear. There is no pneumothorax. Bones and soft tissues are normal. Contrast from a recently performed CT scan opacifies the partially imaged colon. IMPRESSION: Decreased right pleural effusion which is now small. Clear lungs. " 8bdf47ed-a24f804e-451e1049-d33d5b7c-f7a698e5.jpg,validate/p14/p14997223/s53421628/8bdf47ed-a24f804e-451e1049-d33d5b7c-f7a698e5.jpg,validation," 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. " d7009c93-51b3df89-c1c70580-feeb9b5d-fe20107b.jpg,validate/p18/p18988341/s51645424/d7009c93-51b3df89-c1c70580-feeb9b5d-fe20107b.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain, chills and cough. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrate clear lungs bilaterally. Cardiac silhouette is mildly enlarged. Upper lobe pulmonary vasculature is equivalent in caliber to lower lobe vessels. There is no pulmonary edema. There is no pleural effusion or pneumothorax.No air under the right hemidiaphragm is identified. IMPRESSION: Mild cardiomegaly and/or pericardial effusion. No focal opacity convincing for pneumonia. NOTIFICATION: Dr. ___ reported the findings to Dr. ___ by telephone on ___ at 8:44 AM, 4 minutes after discovery of the findings. " f4ed46af-ff2980dc-aa8a6e2a-9b3105e3-29bc988d.jpg,validate/p12/p12546874/s58737158/f4ed46af-ff2980dc-aa8a6e2a-9b3105e3-29bc988d.jpg,validation," FINAL REPORT INDICATION: Dyspnea, here to evaluate for pneumonia. COMPARISON: No prior studies available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The inspiratory lung volumes are decreased with mild bibasilar atelectasis. No focal consolidation concerning for pneumonia, pleural effusion or pneumothorax is detected. There is no overt pulmonary edema. 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. IMPRESSION: Low lung volumes with mild bibasilar atelectasis but no focal consolidation concerning for pneumonia. " 87f7fe70-3893b673-4ba168fc-88cc2225-9304ab07.jpg,validate/p19/p19496992/s57129642/87f7fe70-3893b673-4ba168fc-88cc2225-9304ab07.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH ___ INDICATION: History: ___M with dyspnea // eval pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: Outside hospital radiograph obtained 4 hr prior. FINDINGS: A right chest wall pulse generator is in place, with unchanged position of 3 pacer/defibrillator leads. Mediastinal clips and median sternotomy wires are present, with fracture of the superior most 2 wires. The heart is mildly enlarged. Moderate bilateral pleural effusions are noted, with peribronchial cuffing, and pulmonary vasculature bilaterally, compatible with mild pulmonary edema. There is no pneumothorax or focal consolidation. There are most likely post-radiation changes see along the mediastinum bilaterally IMPRESSION: Moderate bilateral pleural effusions and mild pulmonary edema. " 12355cd0-302e4317-ace90551-0086dec7-3bcf3a38.jpg,validate/p12/p12854165/s57865259/12355cd0-302e4317-ace90551-0086dec7-3bcf3a38.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with b/l pleural effusions // ?resolution or improvement of pleural effusions COMPARISON: Chest radiographs IMPRESSION: Moderate bilateral pleural effusions common decreased substantially on the right, minimally on the left since ___. Aside from secondary bibasilar atelectasis, lungs are clear. No pneumothorax. Cardiac silhouette largely obscured by pleural effusion. No evidence of mediastinal venous engorgement. " 190f03d6-7041ad92-19bc8c9d-f3e26e25-774b3beb.jpg,validate/p16/p16262598/s53586472/190f03d6-7041ad92-19bc8c9d-f3e26e25-774b3beb.jpg,validation," FINAL REPORT INDICATION: Chest tube removal. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal chest radiograph. FINDINGS: A left-sided pacemaker is unchanged in configuration. There is been interval extubation and removal an orogastric tube, mediastinal drains, left thoracostomy tube, and Swan-Ganz catheter. There is no pneumothorax. There is increased atelectasis at the right and left lung bases secondary to lower lung volumes. Extensive pleural base calcifications across the left hemithorax are again seen. IMPRESSION: Interval removal of multiple support lines and devices. No pneumothorax. " 39d6684d-4d02b105-11b9f004-9745ee62-a73e6b5f.jpg,validate/p15/p15248985/s58580309/39d6684d-4d02b105-11b9f004-9745ee62-a73e6b5f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia, hypoxia // interval change TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___ and dating back to ___. FINDINGS: Faint bilateral airspace opacities corresponding to multifocal pneumonia and bibasilar subsegmental atelectasis are not appreciably changed. The left PICC line terminates in the low SVC. There is no pneumothorax. The heart and mediastinum are magnified by the projection. IMPRESSION: No significant interval change. " 6354f984-675be7cf-bf0d0c57-6d4b7603-ba87d9db.jpg,validate/p15/p15399088/s50799017/6354f984-675be7cf-bf0d0c57-6d4b7603-ba87d9db.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with elevated white count, IPH // eval for pneumonia IMPRESSION: As compared to ___ radiograph, no new focal areas of consolidation are identified to suggest the presence of pneumonia. " 8ff993b7-2464a8ec-f4781c7d-45ba34d1-eafec0d5.jpg,validate/p15/p15426535/s57822115/8ff993b7-2464a8ec-f4781c7d-45ba34d1-eafec0d5.jpg,validation," FINAL REPORT HISTORY: Fever, cough. TECHNIQUE: Chest: Frontal and lateral views. COMPARISON: None. FINDINGS: No focal consolidation, pleural effusion, underline evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable, as are the hilar contours. IMPRESSION: No acute cardiopulmonary process. " 9c422c45-6a043363-a875ad25-d9ebf6c9-f76be26a.jpg,validate/p18/p18826698/s50460965/9c422c45-6a043363-a875ad25-d9ebf6c9-f76be26a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Feeling unwell with possible seizure activity, question pneumonia or aspiration. FINDINGS: AP upright and lateral views of the chest were provided. Lung volumes are low, and the heart appears top normal in size. There is crowding of bronchovasculature in the lower lungs likely accounting for the subtle increased opacity without definite signs of aspiration or pneumonia. No effusion or pneumothorax is detected. Bony structures appear intact. Bony hypertrophy at the left distal clavicle is partially imaged, though represents a chronic abnormality as seen on multiple prior radiographs. " a3aef151-bf8625a1-679432ed-40ee9dfe-5f777859.jpg,validate/p12/p12807885/s51980585/a3aef151-bf8625a1-679432ed-40ee9dfe-5f777859.jpg,validation," FINAL REPORT INDICATION: ___M hx of IVDU p/w occlusion of the terminal L ICA, affecting flow to the L ACA, L MCA, and the fetal L PCA, now s/p left craniectomy // Dobhoff placement COMPARISON: Radiographs from ___ at 05:23. IMPRESSION: Endotracheal tube and both nasogastric tubes have been removed. There has been placement of a new Dobbhoff tube which is too high and the distal tip is in the mid esophagus. This should be removed or advanced at least 20 cm. There is an unchanged left-sided PICC line with distal lead tip in the mid SVC. Heart size is within normal limits. Lungs are grossly clear. There are no pneumothoraces. " f7ae83d8-06bbf34f-a0832c77-3a472637-77fd358e.jpg,validate/p16/p16136367/s51424724/f7ae83d8-06bbf34f-a0832c77-3a472637-77fd358e.jpg,validation," FINAL REPORT HISTORY: Nausea. Assess for pneumonia. COMPARISON: ___. FINDINGS: 2 views of the chest. Port-A-Cath terminates in the distal SVC. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are unremarkable. IMPRESSION: No acute intrathoracic process. " ad3a4fd2-88c68a70-b77a6176-338d30ca-bd98a235.jpg,validate/p15/p15560336/s51524822/ad3a4fd2-88c68a70-b77a6176-338d30ca-bd98a235.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Persistent cough. IMPRESSION: PA and lateral chest compared to ___: Moderately severe scoliosis distorts the chest cage anatomy, but aside from mild left basal atelectasis the lungs are clear and there is no pleural abnormality or evidence of central mass. The heart is normal in size. A moderate-sized hiatus hernia is still present. " 3b446127-28b61a6f-9ca8faff-a2e5262d-ed738eb0.jpg,validate/p11/p11888614/s55606743/3b446127-28b61a6f-9ca8faff-a2e5262d-ed738eb0.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with seizures, multifocal consolidations, and currently spiking fevers. AP radiograph of the chest was compared to ___. The ET tube tip is 5 cm above the carina. The NG tube tip is in the stomach. Heart size and mediastinum appear unchanged. There is interval progression of widespread multifocal opacities, highly concerning for multifocal pneumonia, potential aspiration in origin. Small amount of bilateral pleural effusion, left more than right, cannot be excluded. There is no pneumothorax. " 084231b4-9eda2db8-afd4b6f6-09bc34b7-078713ed.jpg,validate/p18/p18832012/s57408716/084231b4-9eda2db8-afd4b6f6-09bc34b7-078713ed.jpg,validation," WET READ: ___ ___ 12:49 PM Possible tiny right pleural effusion versus pleural thickening. Posterior opacity projecting over the spine, not fully assessed, requires further evaluation with nonemergent CT chest. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with weakness // acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is mild blunting of the right CP angle on the frontal view, possibly indicating a tiny effusion or pleural thickening. On the lateral view there is a convex bulge noted posteriorly partially overlapping with the lower thoracic spine which requires further evaluation with nonemergent CT chest. No signs of pneumonia or edema. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Possible tiny right pleural effusion versus pleural thickening. Posterior opacity projecting over the spine, not fully assessed, requires further evaluation with nonemergent CT chest. " c7d79663-40c21a4e-e98b4205-3a47bd87-87fc2dd4.jpg,validate/p10/p10429638/s58216387/c7d79663-40c21a4e-e98b4205-3a47bd87-87fc2dd4.jpg,validation," FINAL REPORT INDICATION: History of recurrent fever and shortness of breath. Assess for acute infiltrate. COMPARISON: Comparison is made to CT abdomen and pelvis performed the same day. FINDINGS: Frontal and lateral chest radiograph demonstrates unremarkable cardiomediastinal contours with a slight prominence of the hila bilaterally. There are Kerley B lines consistent with smooth septal thickening as well as trace fluid tracking along the pleural fissure. No large pleural effusion or pneumothorax evident. IMPRESSION: Fluid overload with interstitial edema. No focal opacification concerning for pneumonia. No large pleural effusion. " 11a4bcc1-219d87c1-3332b649-b084cd45-ec7399c3.jpg,validate/p13/p13562117/s59569749/11a4bcc1-219d87c1-3332b649-b084cd45-ec7399c3.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fever and weakness. COMPARISON: Chest radiograph from ___ FRONTAL AND LATERAL CHEST RADIOGRAPHS: A linear opacity within the right lung base likely reflects scarring. No confluent consolidation is identified. There is no pulmonary edema or large pleural effusions. No pneumothorax is evident. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process " 847a6e8a-c833a4d2-9282cecd-d48da68b-203c015e.jpg,validate/p19/p19262119/s53154367/847a6e8a-c833a4d2-9282cecd-d48da68b-203c015e.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Lower extremity swelling. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. There is slight unfolding of the thoracic aorta. The mediastinal and hilar contours are otherwise unremarkable. There are multiple nodular opacities in each lung, the most prominent of which projects over the left mid-to-upper lung with a rounded contour. There is no pleural effusion or pneumothorax. Mild degenerative changes are noted along the thoracic spine. IMPRESSION: No findings suggestive of congestive heart failure, but multiple nodular opacities, worrisome for malignancy, although other etiologies could be considered. Correlation with clinical history and chest CT are suggested if the etiology for these is unknown. Findings discussed with Dr. ___ at 1:10 am by telephone on ___. " 2f0bd18d-d7eabe62-85edb63f-489ef671-5f39a045.jpg,validate/p14/p14398566/s56668806/2f0bd18d-d7eabe62-85edb63f-489ef671-5f39a045.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with HIV and altered mental status, now intubated, hypothermic // interval change interval change IMPRESSION: Compared to prior chest radiographs since ___, most recently ___ and ___. Severe pulmonary edema may have improved slightly and mild cardiomegaly has decreased. Pleural effusions are presumed, but not substantial. Right PIC line ends close to the superior cavoatrial junction comment ETT is in standard placement an nasogastric drainage tube runs into the stomach and out of view. " 5758c614-9c4b234b-a4724d10-fd0ec8d3-6e2da141.jpg,validate/p19/p19517789/s54562327/5758c614-9c4b234b-a4724d10-fd0ec8d3-6e2da141.jpg,validation," 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. " 747a0a6a-f41b7af3-5acfb922-a00c73c5-47a67b26.jpg,validate/p15/p15227454/s50055774/747a0a6a-f41b7af3-5acfb922-a00c73c5-47a67b26.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p R VATS wedge resection // interval change interval change TECHNIQUE: Portable AP upright chest radiograph COMPARISON: Frontal chest radiograph ___ FINDINGS: Previously described small right pneumothorax has resolved. Right chest tube is unchanged in positioning. Small amount of subcutaneous air overlying the right hemi thorax is unchanged. Postsurgical changes in the left hilar, left apical, and left upper mediastinum are unchanged. There is unchanged hyper inflation of the left apex. Accounting for low inspiratory volumes, heart is borderline enlarged. Pulmonary right hemithorax pulmonary vasculature is enlarged. The left mid and lower lung patchy opacities may be secondary to atelectasis from low inspiratory. IMPRESSION: 1. Resolution of small right pneumothorax. 2. Unchanged right pulmonary edema. " 68bdf27f-1354ec44-64222012-e565c33f-f38dc778.jpg,validate/p10/p10008304/s50053244/68bdf27f-1354ec44-64222012-e565c33f-f38dc778.jpg,validation," 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. " cafe7513-6225af63-f26e431a-72ba8cc9-6b4e961f.jpg,validate/p13/p13031024/s50742387/cafe7513-6225af63-f26e431a-72ba8cc9-6b4e961f.jpg,validation," 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. " 010882c2-c761165c-8e9f6c55-453573af-0468f5e6.jpg,validate/p12/p12753744/s59408233/010882c2-c761165c-8e9f6c55-453573af-0468f5e6.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with aspiration pneumonia. FINDINGS: Comparison is made to prior study from ___. There has been development of airspace opacities within the body of the right lung. These findings are suspicious for aspiration pneumonia given the clinical history. Left lung is relatively clear. There is a right IJ central venous line with distal lead tip in the distal SVC. Cardiac silhouette is within normal limits. " 9ac597c1-aefa5353-686580a3-38bac61d-057f4842.jpg,validate/p13/p13174810/s59526384/9ac597c1-aefa5353-686580a3-38bac61d-057f4842.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Trauma, intubated patient. Comparison is made with prior study, ___ and ___. Cardiac size is top normal. Mediastinal silhouette is stable. Previously visualized left pneumothorax is not seen in the current study. ET tube is in a standard position. Right PICC tip is in the upper-to-mid SVC. Right chest tube is in unchanged position. NG tube tip is in the stomach. Multiple surgical clips project in the right upper and mid thorax. Left apical chest tube is present. Bibasilar opacities, larger on the left side, and right upper lobe peripheral opacity are unchanged. There are no new lung abnormalities or increasing pleural effusion. IMPRESSION: Opacity in the right upper lobe at the periphery is located in the previously seen pulmonary laceration. lower lobe opacities could correspond to atelectasis and/or pneumonia. " 1fb3a502-68786132-ccd8ce60-7f999e0f-07be4dcb.jpg,validate/p16/p16753046/s50937364/1fb3a502-68786132-ccd8ce60-7f999e0f-07be4dcb.jpg,validation," WET READ: ___ ___ ___ 4:49 AM 4 cm lobulated opacity projecting over the lower thoracic spine may be a left paraspinal lesion. A chest CT is recommended for further evaluation. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest pain COMPARISON: ___ through ___. Chest CT ___ FINDINGS: AP and lateral chest radiographs were obtained. Lung volumes are mildly decreased. Blunting of the right costophrenic angle is stable. There is a 2 x 4 cm lobulated opacity projecting over the lower thoracic spine on the lateral view. This appears to correlate with a left paraspinal contour on the frontal view. This was definitely not present in ___, the last time that a true lateral radiograph was obtained. Further imaging evaluation with CT should be considered. No pulmonary edema or pneumothorax. IMPRESSION: Questioned lobulated opacity projecting over the lower thoracic spine may correspond to a left paraspinal lesion. A chest CT is recommended for further evaluation. " 2eadd271-639247c6-56063242-fd5b944b-d24b43ef.jpg,validate/p11/p11868667/s50149850/2eadd271-639247c6-56063242-fd5b944b-d24b43ef.jpg,validation," FINAL REPORT INDICATION: Dyspnea, evaluate for pulmonary edema versus pneumonia. COMPARISON: Comparison is made to chest radiograph performed ___ FINDINGS: Frontal and lateral chest radiograph demonstrates unremarkable cardiomediastinal contours. The lungs are clear. No pleural effusion or pneumothorax evident. Pacemaker leads terminate in the right atrium and ventricle. IMPRESSION: No acute intrathoracic process. " 91b8f23b-0d810ff8-8ae8f7da-902b54e6-a3a5b481.jpg,validate/p17/p17461135/s54984735/91b8f23b-0d810ff8-8ae8f7da-902b54e6-a3a5b481.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough, acute onset hallucinations. Evidence of infection. COMPARISON: None. FINDINGS: AP and lateral upright radiographs of the chest were obtained. The lungs are normally expanded and clear. The cardiomediastinal silhouette and hilar contours are normal. There is no focal airspace consolidation. The osseous structures are grossly intact. IMPRESSION: No acute cardiopulmonary abnormality. " d8b61c3d-4f8d3ab3-48fb43fb-42d5ef4f-5412091f.jpg,validate/p10/p10983729/s55252449/d8b61c3d-4f8d3ab3-48fb43fb-42d5ef4f-5412091f.jpg,validation," FINAL REPORT HISTORY: Fatigue, edema, and dyspnea on exertion. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to a CT abdomen pelvis dated ___, and chest radiographs dated ___. FINDINGS: There are decreased lung volumes. Redemonstrated is atelectasis of the left lower lobe. There is mild, linear atelectatic changes seen within the right lower lobe. There may be a small left pleural effusion, seen only on the lateral projection. No focal consolidation, pneumothorax, or pulmonary edema is identified. The heart size is at the top end of normal. The aorta is mildly tortuous. There are moderate to severe degenerative changes noted within the lower thoracic spine. IMPRESSION: Minimal bibasilar atelectasis and a small left pleural effusion. " 5c1ebdbe-f7834fbb-a2869781-9138d6d2-e5cdd28f.jpg,validate/p16/p16662264/s59191421/5c1ebdbe-f7834fbb-a2869781-9138d6d2-e5cdd28f.jpg,validation," WET READ: ___ ___ ___ 2:37 PM Obscuration of the left heart could reflect lingular pneumonia in the correct clinical setting. ______________________________________________________________________________ FINAL REPORT HISTORY: Prior renal transplant with recent pneumonia now presenting with pleuritic back pain for 3 days. Evaluate for pneumonia. COMPARISON: Chest radiographs ___ and ___. CT Chest ___ FRONTAL AND LATERAL VIEWS OF THE CHEST: A right upper extremity PICC has been removed in the interim. There is obscuration of the left heart border, likely scarring from prior infection. There is no pleural effusion or pneumothorax. The heart size is normal. The mediastinal and hilar structures are unremarkable. IMPRESSION: Obscuration of the left heart is probably reflects scarring. " 241ac209-ee8412ac-2d6132bc-60083271-02cfaf11.jpg,validate/p13/p13479418/s57813782/241ac209-ee8412ac-2d6132bc-60083271-02cfaf11.jpg,validation," FINAL REPORT INDICATION: Cryptogenic organizing pneumonia with stable symptoms and tapering steroid dose. COMPARISON: Chest radiographs dating back to ___. Chest CT ___. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. There is no new focal consolidation concerning for pneumonia. There are stable emphysematous changes of right upper lobe with chronic fibrosis of the right upper lobe medially, presumably due to prior radiation treatment. The left lower lobe opacity has apparently resolved, which would be better assessed by chest CT. IMPRESSION: No new consolidation concerning for pneumonia. " 8bb961f0-0f791cfb-b006ae19-23334a22-01c2fec0.jpg,validate/p13/p13040755/s58289244/8bb961f0-0f791cfb-b006ae19-23334a22-01c2fec0.jpg,validation," FINAL REPORT EXAMINATION: The narrowing night you that Chest: Frontal and lateral views INDICATION: History: ___F with chest tube on L // Please eval for any interval change TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ at 06:24 FINDINGS: Chest tube coiled the medial left lower hemi thorax without increasing pneumothorax. The appearance of the lung fields is without significant change. There may be slight increase in blunting of the left costophrenic angle, may be due to atelectasis or small pleural effusion. Otherwise, no significant interval change. IMPRESSION: Possible slight the increase in blunting of the left costophrenic angle which may be due to a small pleural effusion or atelectasis. No other significant change. " 4b757141-7d10157c-5ca8c98c-c1ae3716-3b90ce91.jpg,validate/p15/p15797232/s52879776/4b757141-7d10157c-5ca8c98c-c1ae3716-3b90ce91.jpg,validation," FINAL REPORT PORTABLE CHEST FROM ___ AT 06:21 CLINICAL INDICATION: ___-year-old intubated for ICH, question infiltrate. Comparison is made to the patient's prior study of ___ at 05:35. Portable semi-erect chest film ___ at 06:21 is submitted. IMPRESSION: 1. Lung volumes remain markedly diminished with crowding of the vasculature. No evidence of pulmonary edema, focal airspace consolidation to suggest pneumonia, pleural effusions or pneumothorax. The endotracheal tube continues to lie above the carina and close to the orifice of the right main stem bronchus. Housestaff have been previously notified of the need for repositioning. Left subclavian central line has its tip in the distal SVC. There is a nasogastric tube coursing below the diaphragm with the tip identified. Cardiac and mediastinal contours are stable. No pneumothorax. " c716977b-721563de-bccf0bba-26f0940c-85ac6ef6.jpg,validate/p10/p10816395/s50458058/c716977b-721563de-bccf0bba-26f0940c-85ac6ef6.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Heart size is normal. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " aa787a6b-6ffdf2bd-7bcbfc18-8340a3a1-69870f64.jpg,validate/p12/p12156452/s51114919/aa787a6b-6ffdf2bd-7bcbfc18-8340a3a1-69870f64.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ Crohn's psoriatic arthritis s/p ex-lap, LOA, reduction of parastomal hernia, and wound vac with open abdomen ___ now s/p SBR, hernia repair, and primary abdomen closure // NGT placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The nasogastric tube remains in situ. The lung volumes have decreased. Moderate left pleural effusion with subsequent atelectasis. Minimal right pleural effusion. Moderate cardiomegaly without pulmonary edema persists. " 6183fed6-15c3e73a-ddb078b5-e494dd54-96c5013e.jpg,validate/p10/p10706411/s57110677/6183fed6-15c3e73a-ddb078b5-e494dd54-96c5013e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female status post suicide attempt and aspiration. Assess interval change. COMPARISON: Chest radiograph ___, ___, ___. TECHNIQUE: Single portable frontal chest radiograph. FINDINGS: Moderate interval increase in diffuse bilateral heterogeneous opacities with air bronchograms and focal increased opacity in the right lower lobe. Heart size, mediastinal contour are obscured by the pleural parenchymal process. No pneumothorax or large pleural effusion. No bony abnormality. IMPRESSION: 1. Worsening diffuse pulmonary opacities, which appear to wax and wane on serial radiographs, most likely due to pulmonary edema. Consider followup chest radiographs to assess for clearing status post diuresis. 2. Focal right lower lobe opacity may be related to history of aspiration pneumonia. Results conveyed to the primary team by Dr. ___ on ___ at 1:20 p.m. within five minutes of observation of findings. " 589d868f-df7ace6c-50224df2-b5020631-e87fb08d.jpg,validate/p10/p10310938/s56914260/589d868f-df7ace6c-50224df2-b5020631-e87fb08d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with 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. " 39c86c72-acbbd731-d8f23b14-8f929b3c-60601b7f.jpg,validate/p12/p12989631/s53597410/39c86c72-acbbd731-d8f23b14-8f929b3c-60601b7f.jpg,validation," FINAL REPORT HISTORY: Female with new pacemaker. Assess for lead placement and pneumothorax. COMPARISON: Chest radiograph, ___. TECHNIQUE: Frontal and lateral chest radiographs. FINDINGS: Dual-chamber pacemaker with generator is in left pectoral region with leads ending in right ventricle and body of right atrium. Distal tip of right internal jugular line is at origin of right brachiocephalic vein. Sternotomy wires are in correct placement. Increase in bilateral basilar pleural effusions left greater then right. No focal consolidation, pulmonary edema, or pneumothorax. Heart size and mediastinal contours are normal. IMPRESSION: Bilateral pleural effusions, left greater than right. Cannot exclude bleeding; however, concurrent increase in pleural effusion on both sides argue against this. Results were conveyed via telephone to Dr. ___ at 11:20 a.m. on ___ by Dr. ___ within 15 minutes of results. " ba6d5d1c-2aa382d6-e0727e4e-5a9e27ee-994e8f73.jpg,validate/p10/p10900387/s55834379/ba6d5d1c-2aa382d6-e0727e4e-5a9e27ee-994e8f73.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever through Tylenol // please evalute for PNA TECHNIQUE: Portable AP view of the chest. COMPARISON: Chest radiographs from ___ through ___ FINDINGS: A right-sided PICC terminates at the cavoatrial junction and is stable. 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. " 6ee1fc70-ae4b2d16-66aee982-3d3473c7-c3fd3b6f.jpg,validate/p12/p12503315/s58807202/6ee1fc70-ae4b2d16-66aee982-3d3473c7-c3fd3b6f.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___ year old woman with metastatic cancer // Assess right lung and chest tubes and concern for PTX COMPARISON: Chest radiograph dated ___ and ___ at 1518h. CTA dated ___. FINDINGS: A pigtail catheter projects over the right mid upper hemithorax and another projects over the left lower hemithorax, unchanged in position overall. Tiny right apical pneumothorax without evidence of tension has perhaps decreased in size, but is not larger and has been replaced in part by fluid. Large right pleural effusion with severe atelectasis has decreased since yesterday but is still substantial. The heart size cannot be adequately assessed, but is probably moderately enlarged and overall unchanged. No appreciable left pleural effusion. Lung volumes remain low. No left pneumothorax. Interval decrease in left edema. The possibility of lymphangitic spread cannot be excluded given the clinical history. Prominence of the right hilar region may reflect lymphadenopathy given history of metastatic cancer and recent CTA. IMPRESSION: Persistent but improved large right pleural effusion and small right pneumothorax and left edema vs lymphangitic spread. " 9d05ba11-8871f353-d7c53fd1-a2d81e77-bae52331.jpg,validate/p11/p11410945/s59653300/9d05ba11-8871f353-d7c53fd1-a2d81e77-bae52331.jpg,validation," FINAL REPORT HISTORY: Latent TB. FINDINGS: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. Hyperexpansion of the lungs is again consistent with chronic changes. However, no evidence of old tuberculous disease or reactivation. " 49460f71-6ccb6d35-0d06e5ba-f37c889e-aa8cedea.jpg,validate/p14/p14438417/s59601421/49460f71-6ccb6d35-0d06e5ba-f37c889e-aa8cedea.jpg,validation," FINAL REPORT HISTORY: Sternal chest pain and fatigue. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. The lungs are low in volume with linear right greater than left basal atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. The heart is stably enlarged with tortuous aortic contour. No free intraperitoneal air is seen. IMPRESSION: Bibasilar atelectasis without acute process. " fb12c9e2-9b36d40e-57fb22e7-11eef4a3-0e73512d.jpg,validate/p13/p13325402/s57589679/fb12c9e2-9b36d40e-57fb22e7-11eef4a3-0e73512d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ESRD ___ HTN s/p deceased donor kidney transplant in ___ (on tacro and prednisone, baseline Cr 2.5-3.0), CVA, seizure d/o on Keppra and postpartum CM who p/w SOB and ___ ___ acute dHF exacerbation as well as acute on chronic anemia. Symptoms improving with diuresis, now on room air and approaching euvolemia. // Assess for interval change in pulmonary edema TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is enlarged, unchanged. The aortic knob is prominent, unchanged. Lungs are overall clear with no evidence of pulmonary edema. No pleural effusion or pneumothorax is appreciated although small amount of pleural fluid cannot be excluded. " 7c8d58c7-477b8a2a-64da62b1-e14f618b-dbd1cd6c.jpg,validate/p14/p14345122/s57336209/7c8d58c7-477b8a2a-64da62b1-e14f618b-dbd1cd6c.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with altered mental status. Evaluate for pneumonia. TECHNIQUE: Single AP view of the chest. COMPARISON: Chest x-ray 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 acute cardiopulmonary process. " 5f705281-32f39d28-ab2e7194-92d75dd8-72d86487.jpg,validate/p12/p12385857/s59638367/5f705281-32f39d28-ab2e7194-92d75dd8-72d86487.jpg,validation," FINAL REPORT HISTORY: Cough and weakness COMPARISON: Chest radiograph ___, ___. CTA torso ___. FINDINGS: AP and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well expanded with no focal consolidation concerning for pneumonia. A rounded opacity in the left mid lung zone is new since ___ but similar to the study in ___. IMPRESSION: 1. No findings conerning for pneumonia. 2. Round opacity in the left mid lung zone. Chest CT is recommended for further evaluation. " 89bd6980-87ade0e1-8a8cdae5-7033cb31-edec0aa2.jpg,validate/p17/p17478781/s57543551/89bd6980-87ade0e1-8a8cdae5-7033cb31-edec0aa2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old female with pancreatitis. Evaluate for pleural effusion. 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 identified. IMPRESSION: No pleural effusion. " 6966ad1e-7165a7d6-d648ad9c-70ceffd3-5cfc2135.jpg,validate/p17/p17635650/s59483605/6966ad1e-7165a7d6-d648ad9c-70ceffd3-5cfc2135.jpg,validation," 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. " d5c2652d-3f2725cb-8e7152a4-74f3ed3f-c86cd468.jpg,validate/p12/p12320644/s57547044/d5c2652d-3f2725cb-8e7152a4-74f3ed3f-c86cd468.jpg,validation," 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. " eb3d1b58-b1f547c9-3a143d03-7bea23d7-dc566164.jpg,validate/p16/p16992997/s54137790/eb3d1b58-b1f547c9-3a143d03-7bea23d7-dc566164.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F neutropenic with fever 100.___F // ___F neutropenic with fever 100.___F ___F neutropenic with fever 100.___F IMPRESSION: Compared to chest radiographs since ___, most recently ___. There is no focal consolidation or interstitial abnormality to suggest pneumonia. Heart size is normal. There is no pleural abnormality. Chronic hiatus hernia is moderate size. Right supraclavicular central venous infusion port catheter ends in the low SVC. Thoracolumbar scoliosis is severe. " a7340b4e-98412361-4d8e235e-4ad55946-2ffe1e58.jpg,validate/p17/p17132641/s53954498/a7340b4e-98412361-4d8e235e-4ad55946-2ffe1e58.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough, fever // ?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. " edbdcbb7-11a28b92-e2f0a2d0-32405334-618c40f8.jpg,validate/p14/p14997223/s57988370/edbdcbb7-11a28b92-e2f0a2d0-32405334-618c40f8.jpg,validation," FINAL REPORT HISTORY: atrial fibrillation COMPARISON: ___ through ___. Chest CT ___ 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. The right hemidiaphragm remains elevated. There is normal pacing leads project over the left chest. Vertebra plana of T9 is stable since at least ___. IMPRESSION: No acute cardiopulmonary process. " c6b79b72-1b308982-1eec12dc-4d7fb7a8-3628153f.jpg,validate/p19/p19776354/s54187458/c6b79b72-1b308982-1eec12dc-4d7fb7a8-3628153f.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with epigastric pain and history of ulcer. 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. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 21c8a4ff-af47899d-9a6ec140-b041ddf4-0af031eb.jpg,validate/p14/p14453887/s52377134/21c8a4ff-af47899d-9a6ec140-b041ddf4-0af031eb.jpg,validation," WET READ: ___ ___ 7:54 AM Difficult to interpret radiograph in the setting of prior pleurodesis with dense calcification of the pleura of the right hemithorax. Bilateral opacities concerning for multifocal pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with hypotension and fever // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Right shoulder radiograph dated ___ FINDINGS: Dense calcification along the pleura of the right hemithorax consistent with history of pleurodesis somewhat limits evaluation of the right lung. There are patchy opacities in the left mid and upper lung and likely in the right mid lung. There may be small effusions. There are severe degenerative changes of the right shoulder with deformity of the right humeral head related to prior healed fracture. IMPRESSION: Difficult to interpret radiograph in the setting of prior pleurodesis with dense calcification of the pleura of the right hemithorax. Bilateral opacities concerning for multifocal pneumonia. " dbca122d-890807d5-6f35dce4-d4c47702-fe9fe3d0.jpg,validate/p10/p10274736/s51343658/dbca122d-890807d5-6f35dce4-d4c47702-fe9fe3d0.jpg,validation," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old male with chest pressure and shortness of breath. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. There is no consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " cf85ad05-11574785-5d5c24bc-5931200b-df7f068a.jpg,validate/p19/p19499595/s58099159/cf85ad05-11574785-5d5c24bc-5931200b-df7f068a.jpg,validation," FINAL REPORT INDICATION: Altered mental status. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation. There is no pleural effusion or pneumothorax. The heart is mildly enlarged. The mediastinal contours are normal. The median sternotomy wires are again seen, three of which are fractured. The wire located third from the top has a fracture fragment oriented posteriorly. The mediastinal clips are stable. IMPRESSION: 1. No acute cardiopulmonary process. 2. Three fractured median sternotomy wires. The wire located third from the top has a fracture fragment oriented posteriorly. " a3694b5e-bd9ce540-8ee95b44-5ca1185f-65a380f0.jpg,validate/p16/p16209892/s52317497/a3694b5e-bd9ce540-8ee95b44-5ca1185f-65a380f0.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with neck hematoma and ventilator dependence // interval change TECHNIQUE: Frontal view of the chest COMPARISON: ___ FINDINGS: ET tube terminates 2.2 cm above the carina. Lung volume is low. Right lower lobe opacity is increased compared to ___. Left lower lobe opacity is similar to before and is probably atelectasis. Enlarged cardiac silhouette there is no pneumothorax or large pleural effusion. Left pleural effusion is small. IMPRESSION: 1. Increasing right lower lobe opacity is suspicious for pneumonia. NOTIFICATION: The findings were discussed with ___, N.P. by ___, M.D. on the telephone on ___ at 5:31 PM, 45 minutes after discovery of the findings. " ad417156-1d1afa4a-5a65f131-1a51710e-ed4bfdb8.jpg,validate/p12/p12620123/s51151455/ad417156-1d1afa4a-5a65f131-1a51710e-ed4bfdb8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with submassive PE s/p clot retrieval, ongoing hypoxia // Evaluate for pulmonary infarct, infiltrate, edema Evaluate for pulmonary infarct, infiltrate, edema IMPRESSION: Right internal jugular line terminates at the level superior SVC. Heart size and mediastinum are stable. Bibasal opacities have slightly progressed in the interim. No pulmonary edema is seen. No pneumothorax is seen. No interval increase in pleural effusion. " 10561087-a30561b8-71f5b0c1-a3f45556-f436f658.jpg,validate/p13/p13535801/s52820076/10561087-a30561b8-71f5b0c1-a3f45556-f436f658.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with shortness of breath. Evaluate for acute process. COMPARISON: ___. TECHNIQUE: AP upright portable chest radiograph. FINDINGS: The lungs are well expanded and clear. There has been interval resolution of prior opacity in the right lung base. Heart size is also improved. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 92d17ebe-ad9079be-2eb87258-f24becac-3244c000.jpg,validate/p18/p18264883/s58660699/92d17ebe-ad9079be-2eb87258-f24becac-3244c000.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with acute hypoxia/dyspnea // acute process TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: There is moderate to severe cardiomegaly. Extensive bilateral peribronchial consolidations are larger in the left lung, likely represent pulmonary edema. There is no pneumothorax or large effusions " 7610a410-98fc73bc-56f3b32f-b51461a8-73f09f41.jpg,validate/p10/p10708287/s50479869/7610a410-98fc73bc-56f3b32f-b51461a8-73f09f41.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Bleeding and clots from PICC line. Assess position. IMPRESSION: PA and lateral chest compared to ___: Previous left axillary PICC line has been removed. New right PICC line ends in the upper-to-mid SVC. No pneumothorax, pleural effusion or mediastinal widening. Lungs fully expanded and clear. Heart size normal. " d9473820-a09ecbf3-b7e457ed-8d528328-7a029205.jpg,validate/p12/p12033805/s55249581/d9473820-a09ecbf3-b7e457ed-8d528328-7a029205.jpg,validation," FINAL REPORT INDICATION: ___F with URI sxs x 6 days, initially improving now w/ 24 hrs nausea, malaise, R sided wheezing on exam // eval ? R PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is right basilar opacity on the frontal view without localization on the lateral. Elsewhere, lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Right basilar opacity on the frontal view potentially atelectasis noting that infection cannot be excluded. " ed2bcd52-15cca021-4dd94728-d1f73653-cdc87cb2.jpg,validate/p14/p14014950/s52083797/ed2bcd52-15cca021-4dd94728-d1f73653-cdc87cb2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p cabg with new complaints of sob // eval for effusion TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Small right pneumothorax is a stable. Large bilateral effusions larger on the left are grossly unchanged. Vascular congestion mildly increased. Cardiac size cannot be evaluated. Pacer leads are in standard position. " 46196bea-0ab24d96-dcc3eb21-56b888b3-3b13f9eb.jpg,validate/p14/p14912045/s59752564/46196bea-0ab24d96-dcc3eb21-56b888b3-3b13f9eb.jpg,validation," FINAL REPORT INDICATION: Mitral valve repair. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal chest radiograph. FINDINGS: The patient has been extubated. The orogastric tube has been removed. A right thoracostomy tube and mediastinal drain are unchanged in position. There is no pneumothorax, focal consolidation, or pleural effusion. The cardiac and mediastinal contours remain unchanged. IMPRESSION: Interval extubation. No pneumothorax, focal consolidation, or pleural effusion. " 7facd178-160eb115-1b0a5e4a-c4781d44-d353bf6b.jpg,validate/p10/p10591828/s58915054/7facd178-160eb115-1b0a5e4a-c4781d44-d353bf6b.jpg,validation," FINAL REPORT HISTORY: Recent abdominal surgery with shortness of breath. COMPARISON: None available. FINDINGS: The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fractures are identified. Free air is noted under the right hemi-diaphragm, likely from recent surgery. IMPRESSION: No acute cardiopulmonary process. Free air is noted under the right hemi-diaphragm, likely from recent surgery. " 494ea81c-c3a670b0-321a1aa5-99b014fb-a37ab0c9.jpg,validate/p15/p15658016/s55928185/494ea81c-c3a670b0-321a1aa5-99b014fb-a37ab0c9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M s/p left nephrectomy, open. Chest tube removed ___. // Assess for interval change. Assess for interval change. IMPRESSION: Compared to chest radiographs ___ through ___. Low lung volumes are slightly improved, moderate bibasilar atelectasis persists. Upper lungs clear. Heart size is normal. Pleural effusion minimal if any. " e2e9c885-51bf6cbe-738d0caa-debfd581-4b5460b3.jpg,validate/p12/p12431768/s54832754/e2e9c885-51bf6cbe-738d0caa-debfd581-4b5460b3.jpg,validation," FINAL REPORT INDICATION: Increased jaundice and weakness. Evaluate for pneumonia. COMPARISON: ___ TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Heart size is moderately enlarged. Bilateral pulmonary vascular congestion is similar to ___, allowing for differences in lung volumes. No focal consolidation concerning for pneumonia is seen. No pleural effusions are appreciated. Hilar and mediastinal contour is normal. IMPRESSION: Interval increase in lung volumes since ___ with continued bronchovascular crowding and no pleural effusions or consolidations. " 4929dd1d-6f3137e8-89b7bc3e-ea418f54-4cbc69c7.jpg,validate/p18/p18438381/s51443342/4929dd1d-6f3137e8-89b7bc3e-ea418f54-4cbc69c7.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with foreign body sensation in throat. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: The lungs are hyperinflated with underlying emphysema. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. 8 mm nodular opacity projecting over the left lower lung field likely represents a prominent left nipple. No radiopaque foreign body is seen projecting over the expected course of the esophagus. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. No radiopaque foreign body projecting over the expected course of the esophagus. " 35f52e8f-8beafa09-0e542fdb-d0830846-c5fb9371.jpg,validate/p18/p18700390/s55161968/35f52e8f-8beafa09-0e542fdb-d0830846-c5fb9371.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with c/o CP and palpitations // ? 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 top-normal. Mediastinal contours are not widened. No pulmonary edema is seen. IMPRESSION: Top-normal cardiac silhouette size without pulmonary edema. No focal consolidation to suggest pneumonia. " c7781dd4-6da31969-28e34c44-7235af81-a07d6eed.jpg,validate/p17/p17013671/s57002637/c7781dd4-6da31969-28e34c44-7235af81-a07d6eed.jpg,validation," 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. " d8b9ba7e-284daaf0-667b112b-2d6d9d54-aede32d1.jpg,validate/p10/p10157508/s52148300/d8b9ba7e-284daaf0-667b112b-2d6d9d54-aede32d1.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hx of melanoma // please evaluate disease status TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs dated ___ through ___.. FINDINGS: Frontal and lateral radiographs of the chest demonstrate hyperexpanded, clear lungs. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. IMPRESSION: No evidence of intrathoracic malignancy. " 430197b5-bcf99118-097de82d-09e14b64-e4e47a96.jpg,validate/p19/p19623096/s54477528/430197b5-bcf99118-097de82d-09e14b64-e4e47a96.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath and fever. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is normal. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0b18cef1-d31e15f8-0c91093e-06b7a030-bfdfa1d0.jpg,validate/p13/p13060009/s50912136/0b18cef1-d31e15f8-0c91093e-06b7a030-bfdfa1d0.jpg,validation," FINAL REPORT HISTORY: Cough x 2 weeks with developing wheezing and decreased bibasilar breath sounds. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Given the patient's body habitus, evaluation is extremely limited. Frontal and lateral chest radiographs demonstrate chronic scoliosis and a mildly enlarged cardiac silhouette which is unchanged from prior radiographs. Low lung volumes make evaluation difficult, but a focal opacity in the left lower lung probably represents atelectasis. There is no pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: A left lower lung opacity probably represents atelectasis. " 902c41c7-bd77f819-ecd1b697-63282992-62237683.jpg,validate/p15/p15015008/s59484116/902c41c7-bd77f819-ecd1b697-63282992-62237683.jpg,validation," FINAL REPORT INDICATION: Cardiomyopathy. Evaluation for interval change. TECHNIQUE: Portable AP chest radiograph. COMPARISON: Multiple priors, most recently on ___. FINDINGS: The right internal jugular central catheter terminates in the right atrium. The ET tube terminates in standard position. The NG tube terminates in the region of the left hemidiaphragm and the sidehole is probably above the diaphgram. Bilateral opacifications consistent with large pleural effusions greater on the right is unchanged. The cardiomediastinal silhouette is not significantly changed. IMPRESSION: 1. NG tube side hole is probably above the diaphragm. 2. Right IJ catheter is likely in the right atrium. Recommend withdrawing it 3 cm. Findings discussed with ___ by phone at 10:57 a.m. on ___. " 6f8ba755-a2cc958c-998725bc-dff63ad0-51aab1ef.jpg,validate/p15/p15290263/s51390740/6f8ba755-a2cc958c-998725bc-dff63ad0-51aab1ef.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Atrial fibrillation, rapid and previous pleural effusions, difficulty to control atrial fibrillation. Portable AP radiograph of the chest was compared to ___. Current study demonstrates interval development of overt severe alveolar pulmonary edema. The right PICC line tip is at the level of superior SVC. Heart size and mediastinum are stable in appearance. There is no pneumothorax. The findings were made at 10:45 a.m. on ___. Findings were discussed at the same time with Dr. ___ ___ the phone by Dr. ___. " c26314cf-ae5cf887-193dd2ef-2595b36b-be551361.jpg,validate/p15/p15937283/s52287569/c26314cf-ae5cf887-193dd2ef-2595b36b-be551361.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Kidney and pancreas transplant with fatigue and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal right base atelectasis without definite focal consolidation. The left lung is clear. There is no pleural effusion or pneumothorax. The cardiac silhouette is not enlarged. Mediastinal contours are unremarkable. Thoracic scoliosis is again seen. Coronary artery calcification/stenting seen. IMPRESSION: Right base atelectasis without definite focal consolidation. " c8bfb656-2a4cdcb3-87b45981-22517d8c-cc74baf8.jpg,validate/p16/p16825136/s51933270/c8bfb656-2a4cdcb3-87b45981-22517d8c-cc74baf8.jpg,validation," 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. " 7669d4ba-dfebda66-482f7ba1-70346227-2f7f6c23.jpg,validate/p12/p12580125/s59629751/7669d4ba-dfebda66-482f7ba1-70346227-2f7f6c23.jpg,validation," 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. " 6876ea6a-aaa4e564-630c99da-9125386b-8c1e6d9d.jpg,validate/p19/p19699616/s53376014/6876ea6a-aaa4e564-630c99da-9125386b-8c1e6d9d.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after chest tube removal. AP radiograph of the chest was reviewed in comparison to ___ obtained at 08:21 a.m. Left chest tube has been removed. There is minimal apical pneumothorax demonstrated on the left. The left retrocardiac consolidation is unchanged. Right PIC line tip is unchanged in position in the mid SVC. Small amount of right basal opacity is redemonstrated. " a475adc9-90d36bc0-7983fd30-7da1f9d2-97ca213f.jpg,validate/p18/p18531743/s58123741/a475adc9-90d36bc0-7983fd30-7da1f9d2-97ca213f.jpg,validation," FINAL REPORT HISTORY: Epigastric and right upper quadrant pain. Evaluate for free air. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph ___ at ___. FINDINGS: There is no free intra-abdominal air. There is no pleural effusion, pneumothorax or focal airspace consolidation. There is likely an epicardial fat pad. The patient is status post a midline sternotomy. IMPRESSION: No free air is seen underneath the diaphragms. " 60c6bfdb-ca662bad-e1056fc7-53b2228c-f6d61c80.jpg,validate/p11/p11944377/s52168364/60c6bfdb-ca662bad-e1056fc7-53b2228c-f6d61c80.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with difficulty extubating // ? change in pulm status ? change in pulm status IMPRESSION: Comparison to ___. The bilateral chest tubes remain in unchanged position. Unchanged course of the nasogastric tube and of the endotracheal tube. Mild cardiomegaly with mild fluid overload but no overt pulmonary edema. No areas of atelectasis, except for a small retrocardiac lung parenchymal collapse. No pleural effusions. No visible pneumothorax. No pneumonia. " 2cd40f06-305f4348-a4077aa1-9319da52-48001f68.jpg,validate/p14/p14726463/s50310449/2cd40f06-305f4348-a4077aa1-9319da52-48001f68.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with possible aspiration pneumonia in the setting of UTI and recent seizure, assess for resolution of right-sided aspiration. COMPARISONS: ___. FINDINGS: The patient is rotated with endotracheal tube 5.1 cm above the carina and unchanged position of nasogastric tube. Asymmetric, right greater than left, pulmonary opacities are in total unchanged allowing for differences in lung volumes. Small right pleural effusion tracks along the minor fissure. Cardiomediastinal silhouette is unchanged. IMPRESSION: Unchanged mild pulmonary edema and right basal opacity. While aspiration was suspected on the prior examination, the lack of significant change in 24 hours raises concern for possible developing pneumonia. Findings were discussed with Dr. ___ by Dr. ___ at ___ on ___ by phone. " 34d8b50b-f2f78c47-7fd4374f-ab7f602d-053c596e.jpg,validate/p10/p10678758/s50510284/34d8b50b-f2f78c47-7fd4374f-ab7f602d-053c596e.jpg,validation," FINAL REPORT HISTORY: CABG. FINDINGS: In comparison with study of ___, the patient has taken a better inspiration. Post-surgical changes are again seen, though the right IJ sheath has been removed. Opacification persists at the left base, consistent with pleural fluid and left lower lobe atelectatic change. Small right pleural effusion is also appreciated on the lateral view. No evidence of pulmonary vascular congestion. " e068bfe1-cf1dab9f-2180278a-19884bdd-029a421e.jpg,validate/p11/p11585485/s57743481/e068bfe1-cf1dab9f-2180278a-19884bdd-029a421e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, neutropenia // cxr: eval for pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Small right pleural effusion is re- demonstrated. Basilar atelectasis is seen. No new focal consolidation is seen. There is no pneumothorax. Mild to moderate enlargement of the cardiac silhouette is re- demonstrated. Cardiac and mediastinal contours are stable. No overt pulmonary edema is seen. IMPRESSION: Again seen small right pleural effusion with overlying atelectasis. No definite focal consolidation. Cardiomegaly without pulmonary edema. " 6feeedf3-ef02dca8-a4095e6a-4fbc7f88-9633861f.jpg,validate/p10/p10203607/s54343285/6feeedf3-ef02dca8-a4095e6a-4fbc7f88-9633861f.jpg,validation," FINAL REPORT INDICATION: History: ___M with several days of hemoptysis // evaluate for pneumonia, acute process COMPARISON: ___. 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. " 0574b2ae-ee5c8296-2f8fb759-9a7c4cbf-d300a408.jpg,validate/p19/p19497735/s56262777/0574b2ae-ee5c8296-2f8fb759-9a7c4cbf-d300a408.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stage IV cholangioCA and multiple PEs s/p intubation // interval change interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. Hazy opacification at the bases is consistent with pleural effusions and substantial volume loss in the lower lungs. " f1f15a19-5cafc196-b9f2dee3-8e0653f0-bd9b4864.jpg,validate/p19/p19976500/s55246937/f1f15a19-5cafc196-b9f2dee3-8e0653f0-bd9b4864.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with renal cell carcinoma. Please evaluate for abnormalities. COMPARISON: Today's abdominal CT, chest x-ray of ___. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: There is no evidence of intrathoracic malignancy. " ff6d5f47-a260dca1-ccab3807-19c45207-c64ce27a.jpg,validate/p16/p16006840/s53093776/ff6d5f47-a260dca1-ccab3807-19c45207-c64ce27a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes. Borderline size of the cardiac silhouette. No overt pulmonary edema. No pleural effusions. No pneumonia. " 76d1dd72-92dbd8c3-dac78e6e-7fb4d03e-879e3fbc.jpg,validate/p18/p18758286/s56630796/76d1dd72-92dbd8c3-dac78e6e-7fb4d03e-879e3fbc.jpg,validation," WET READ: ___ ___ ___ 2:14 PM New right IJ central venous catheter seen with tip projecting over the right atrium. Retraction by approximately 3-4 cm would put the tip closer to the RA SVC junction. no pneumothorax. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with hyponatremia , sz, s/p RIJ placement // eval ? RIJ placement TECHNIQUE: Single portable view of the chest. COMPARISON: Film from earlier the same day at 10:02. FINDINGS: New right IJ central venous catheter seen with tip projecting over the right atrium. Retraction by approximately 3-4 cm would put the tip closer to the RA SVC junction. Otherwise, no change. There is no pneumothorax. " 3470d736-53ab4170-ab83b760-57a5b839-c7302405.jpg,validate/p11/p11212873/s59983953/3470d736-53ab4170-ab83b760-57a5b839-c7302405.jpg,validation," FINAL REPORT INDICATION: Status post CABG. COMPARISON: Chest radiograph ___ at 13:18. Chest radiograph ___. FINDINGS: An endotracheal tube approximately 7 cm from the carina and at the level of the clavicular head is in proper position. A feeding tube is seen within the stomach with the tip out of the field of view. A left chest tube is present. Mediastinal drains are in place. Sternal wires with a stabilizing device are present. A Swan-Ganz catheter is seen within the right atrium, but the distal tip cannot be traced further due to the overlying structures. The cardiomediastinal silhouette has the normal postoperative appearance. There is mild bibasilar atelectasis and right upper lobe atelectasis. There are no pleural effusions or pulmonary edema. The previously seen pulmonary edema has resolved. There is no pneumothorax. IMPRESSION: 1. Bibasilar and right upper lobe atelectasis. 2. Endotracheal tube, chest tube, mediastinal drains and Swan-Ganz catheter appear to be in the proper positions. " 637ffdbf-4427b427-47f9c4dd-fb6aed19-218a92c2.jpg,validate/p16/p16508811/s51162875/637ffdbf-4427b427-47f9c4dd-fb6aed19-218a92c2.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M on immunosuppressant recently in hospital with cough // PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Mild left base atelectasis/scarring is seen. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. There may be mild pulmonary vascular congestion. Mitral annulus calcification is re- demonstrated. The cardiac silhouette remains top-normal in size. Mediastinal contours are unremarkable. IMPRESSION: Possible mild vascular congestion. No definite focal consolidation. " 5bc36cf1-8e2ec4ca-1d301820-1e5361a8-73cc172d.jpg,validate/p19/p19927870/s57703187/5bc36cf1-8e2ec4ca-1d301820-1e5361a8-73cc172d.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Allowing for patient rotation, cardiomediastinal contours are stable in appearance, with normal heart size and tortuous thoracic aorta. Pulmonary vascularity is normal, and lungs are grossly clear. Minimal blunting of posterior costophrenic angles is new and suggestive of small pleural effusions. " 58b45840-cdf7000f-9b0cdfeb-55e5d7ba-7dd9557b.jpg,validate/p17/p17789657/s54316367/58b45840-cdf7000f-9b0cdfeb-55e5d7ba-7dd9557b.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with mechanical fall two weeks ago with question of splenic injury, status post head trauma yesterday. Please evaluate for splenic injury. 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. " 913838eb-3621f1e8-40e82854-522c135e-ce5d35ef.jpg,validate/p18/p18705722/s55909759/913838eb-3621f1e8-40e82854-522c135e-ce5d35ef.jpg,validation," 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. " 242be3e2-1edf90d7-3750de94-3740ca10-333b7dec.jpg,validate/p10/p10905663/s53697477/242be3e2-1edf90d7-3750de94-3740ca10-333b7dec.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post right IJ attempt. Assess for pneumothorax. There is no pneumothorax. There is right basilar atelectasis. NG tube tip is in the stomach. Mild cardiomegaly is stable. " a79d67e8-1124a6bc-fac79a6b-dc115f7c-07fe070d.jpg,validate/p17/p17477304/s52902901/a79d67e8-1124a6bc-fac79a6b-dc115f7c-07fe070d.jpg,validation," FINAL REPORT INDICATION: Fever, evaluate for pneumonia. TECHNIQUE: AP and lateral views of the chest. COMPARISON: CT torso from ___ and chest radiograph from ___. FINDINGS: Compared to prior study from ___, there has been no significant interval change. There are mildly prominent interstitial markings. No focal consolidation is identified. The cardiac silhouette remains mildly enlarged. There is persistent eventration of the left hemidiaphragm. There is no pleural effusion or pneumothorax. Sclerotic appearance of the bones again suggests renal osteodystrophy. IMPRESSION: Mild pulmonary edema, no focal consolidation. " 021db5ff-9dfa621b-451edbbc-fb4b1ffa-f7850ae7.jpg,validate/p10/p10509294/s59648455/021db5ff-9dfa621b-451edbbc-fb4b1ffa-f7850ae7.jpg,validation," WET READ: ___ ___ ___ 7:25 PM Platelike atelectasis in right costophrenic angle. No focal consolidation concerning for pneumonia. No pleural effusion or PTX. Wetread placed in CCC. ______________________________________________________________________________ FINAL REPORT INDICATION: Fever. COMPARISONS: CT abdomen and pelvis ___. Chest radiograph ___. FINDINGS: There is linear atelectasis at the right base. The lungs are otherwise clear without consolidation, pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Right basilar atelectasis. No evidence of pneumonia. " d2eb672d-b2cc0c9d-c26474cd-f309fc8a-0461d7fb.jpg,validate/p17/p17294132/s58567308/d2eb672d-b2cc0c9d-c26474cd-f309fc8a-0461d7fb.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___F with abdominal pain s/p EGD and Colonoscopy TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal contours are within normal limits. No free subdiaphragmatic air is identified. IMPRESSION: No acute cardiopulmonary process or free subdiaphragmatic air. " 01e52257-64027fd0-dc806897-d723009b-5bf0c51f.jpg,validate/p14/p14702995/s56778086/01e52257-64027fd0-dc806897-d723009b-5bf0c51f.jpg,validation," 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. " 16306733-63730211-9b1d6ff7-e63b5f04-9d090964.jpg,validate/p14/p14856020/s56619498/16306733-63730211-9b1d6ff7-e63b5f04-9d090964.jpg,validation," FINAL REPORT HISTORY: Mid left back pain with fever. TECHNIQUE: PA and lateral chest radiograph. 2 views. COMPARISON: ___. FINDINGS: Heart size is top normal. Cardiomediastinal silhouette and hilar contours are unchanged and unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax. Surgical clips project over the thyroid bed, bilaterally. IMPRESSION: No acute cardiopulmonary process. " 79c691b4-6aa737c6-7ece99ad-0c61b780-da58b38a.jpg,validate/p17/p17471483/s59567776/79c691b4-6aa737c6-7ece99ad-0c61b780-da58b38a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p resection of kidney tumor in ___. // r/o lung metastases (routine surveillance) r/o lung metastases (routine surveillance) IMPRESSION: In comparison with the study of ___, there is an no change or evidence of acute pneumonia, vascular congestion, or pleural effusion. Given the resolution limitation of plain radiography, there is no evidence of pulmonary or skeletal metastases. " 9a7a1654-5da26ade-7f82b607-5eccb48c-ee758f0f.jpg,validate/p10/p10394530/s53738159/9a7a1654-5da26ade-7f82b607-5eccb48c-ee758f0f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient treated with amiodarone for atrial fibrillation. PA and lateral upright chest radiographs were reviewed in comparison to ___. The heart size is normal. The mediastinum is normal. The lungs are clear. No pleural effusion or pneumothorax is seen. IMPRESSION: No acute cardiopulmonary process. No radiographic evidence of acute process. " b8b47e6b-296d7df9-b1c6b29b-94824580-dba14e3d.jpg,validate/p12/p12731439/s51184221/b8b47e6b-296d7df9-b1c6b29b-94824580-dba14e3d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with breast cancer metastatic to the lung, new coughing and wheezing // assess for pulmonary edema, infection, new infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is top-normal is overall unremarkable. There are extensive interstitial changes within the lungs, left more than right involving both apex and lower lobes with honeycomb being and potentially traction bronchiectasis, reflecting known fibrosis. No new abnormalities to suggest interval development of infectious process demonstrated. Postradiation changes in the left upper lobe are re- demonstrated. " 9bcda1cf-4fe7792a-f0854055-2e7371e5-237a1cab.jpg,validate/p13/p13300396/s51268943/9bcda1cf-4fe7792a-f0854055-2e7371e5-237a1cab.jpg,validation," WET READ: ___ ___ 8:53 PM There is mild pulmonary vascular engorgement. Tiny bilateral pleural effusions are present. There is no pneumothorax. No endotracheal tube is visualized (subsequent discussion with the internal on-call revealed the patient was extubated prior to film acquisition). The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 8:48 PM, 5 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p intubation for angioedema with ongoing wheezing and sputum production // Eval for cardiopulmonary process TECHNIQUE: CHEST (PA AND LAT) IMPRESSION: There is mild pulmonary vascular engorgement. Tiny bilateral pleural effusions are present. There is no pneumothorax. No endotracheal tube is visualized (subsequent discussion with the internal on-call revealed the patient was extubated prior to film acquisition). " 1541056f-0dc49273-cafaa625-1cb84fff-d28391cd.jpg,validate/p17/p17997554/s53334129/1541056f-0dc49273-cafaa625-1cb84fff-d28391cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fall, trauma, respiratory distress // Please evaluate for interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Unchanged appearance of the lung parenchyma. No pleural effusions. No change in appearance of the cardiac silhouette. Unchanged position of the monitoring and support devices. " 0b19c612-e5df938c-9fcb845a-52b5c3a9-118a30f2.jpg,validate/p13/p13262324/s53474828/0b19c612-e5df938c-9fcb845a-52b5c3a9-118a30f2.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with abnormal EKG. Evaluate for acute process. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral radiographs demonstrate clear lungs and normal hilar and cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. Mild atherosclerotic plaques can be seen in the aortic arch. There are degenerative changes of the thoracic spine with kyphosis. IMPRESSION: No acute cardiopulmonary process. " 04aa3404-6d7d90b2-e2c136c9-9c47ba7b-938ced47.jpg,validate/p18/p18497352/s58361195/04aa3404-6d7d90b2-e2c136c9-9c47ba7b-938ced47.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with sarcoid and new bibasilar crackles on lung exam, question parenchymal disease. PA and lateral views of the chest show evidence of previous right upper lobe pulmonary surgery. There is bilateral hyperinflation noted with depressed, flattened hemidiaphragms and blunted costophrenic angles. No hilar enlargement. A posterior pleural-based mass on the right is again seen and was previously evident on prior chest CTs from ___ and ___ where it appeared to represent some fluid and rounded atelectasis. This does not appear significantly different compared to ___. No new focal nodularity is identified and the heart and mediastinal contours are stable as is positioning and appearance of the patient's left-sided pacemaker with a single intact lead. CONCLUSION: No suspicious interval change from baseline hyperinflation with blunted costophrenic angles and in posterior pleural-based mass/rounded atelectasis. No superimposed new nodularity or interstitial abnormality. " b096e7a0-e9177eac-cd0aeec4-8ca46c9d-31809397.jpg,validate/p12/p12559662/s57423393/b096e7a0-e9177eac-cd0aeec4-8ca46c9d-31809397.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Dementia and altered speech, question pneumonia. FINDINGS: Frontal and lateral views of the chest were provided. Lung volumes are low. Basilar atelectasis is noted with no convincing signs of pneumonia. No large effusions or pneumothorax. The heart size cannot be assessed due to low lung volumes. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Low lung volumes, no convincing signs of pneumonia. " cffac969-896153e8-00b91bad-258b866a-6e4ebb39.jpg,validate/p17/p17370561/s50633674/cffac969-896153e8-00b91bad-258b866a-6e4ebb39.jpg,validation," 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. " 3e1b48f7-0429c689-0a5fc581-6a74303e-f2ddc80d.jpg,validate/p10/p10675468/s50627495/3e1b48f7-0429c689-0a5fc581-6a74303e-f2ddc80d.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with lethargy, evaluate for pneumonia. COMPARISON: Chest radiographs ___ and ___. AP AND LATERAL VIEWS OF THE CHEST: There is no pneumothorax. Tiny bilateral pleural effusions are seen. The cardiac silhouette is top normal in size but unchanged from prior. There is no focal airspace consolidation to suggest pneumonia. Calcifications are seen within the aortic arch. Otherwise, the mediastinal contour is normal. Degenerative changes of the right glenohumeral joint are incompletely evaluated. IMPRESSION: No acute process. " d8eff3a9-42c7aa88-a85e1447-bacca79e-02e0204a.jpg,validate/p17/p17994012/s55955657/d8eff3a9-42c7aa88-a85e1447-bacca79e-02e0204a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // ?pleural effusion, cardiomegaly 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. Mild dextroscoliosis of the T-spine is unchanged. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 1e21bcb4-27cecd5a-fef5893c-9170cc33-cce1470b.jpg,validate/p10/p10427787/s57572386/1e21bcb4-27cecd5a-fef5893c-9170cc33-cce1470b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ___ y/o man with shortness of breath, history of asbestos exposure // evaluate for infiltrates. Some diffuse wheezing on exam evaluate for infiltrates. Some diffuse wheezing on exam IMPRESSION: In comparison with the study of ___, the cardiac silhouette again is at the upper limits of normal in size or mildly enlarged. No vascular congestion, pleural effusion, or acute focal pneumonia. " b55ac577-c03391e4-210dd606-df1b1e17-4d3f1711.jpg,validate/p11/p11884841/s57547085/b55ac577-c03391e4-210dd606-df1b1e17-4d3f1711.jpg,validation," 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. " af9ec549-54055a25-2cb337f7-730d5c37-243bd7bc.jpg,validate/p12/p12667651/s54624153/af9ec549-54055a25-2cb337f7-730d5c37-243bd7bc.jpg,validation," 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. " 615ea00f-764b10e7-9e238d41-277a2954-824e77a3.jpg,validate/p12/p12369744/s57461105/615ea00f-764b10e7-9e238d41-277a2954-824e77a3.jpg,validation," WET READ: ___ ___ ___ 8:12 AM Series of 3 images demonstrating placement of a Dobbhoff tube with the final image showing it terminating within the gastric body within the gastric body. Bilateral lobar consolidations, cardiomegaly, and pleural effusions are grossly unchanged compared with prior CT from ___. WET READ VERSION #1 ___ ___ ___ 11:21 PM Series of 3 images demonstrating placement of a Dobbhoff tube with the final image showing it terminating within the gastric body within the gastric body. Bilateral lobar consolidations, cardiomegaly, and pleural effusions are grossly unchanged compared with prior CT from ___. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NG placement // ng placement TECHNIQUE: Chest single view COMPARISON: ___. IMPRESSION: Series of 3 images demonstrating placement of a Dobbhoff tube with the final image showing it terminating within the gastric body . Bilateral lobar consolidations, cardiomegaly, and pleural effusions are grossly unchanged compared with prior CT from ___ " 8e4d27b2-750d6ebc-88718192-d2ca5c87-ab2b4641.jpg,validate/p18/p18408877/s56383000/8e4d27b2-750d6ebc-88718192-d2ca5c87-ab2b4641.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, cough, shortness of breath // any infiltrate any infiltrate IMPRESSION: In comparison with the study of ___, there has been further decrease in the opacification involving the right mid and lower lung zones. There is residual reticular opacifications at both bases, most likely representing scarring or interstitial changes related to the patient's known COPD. " cba15da0-b199f528-a85374a6-46e0c7e0-f6e2ae19.jpg,validate/p13/p13417577/s53261149/cba15da0-b199f528-a85374a6-46e0c7e0-f6e2ae19.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with known pneumothorax on the left. Evaluation for size of pneumothorax. COMPARISON: Comparison is made to outside radiograph of the chest from two hours prior (___) as well as chest radiographs from ___. This study is read in conjunction with outside CT of the chest from ___ obtained on ___. FINDINGS: AP and lateral views of the chest demonstrate a moderate-sized left pneumothorax, not significantly changed since the prior outside study. There is no significant mediastinal shift or signs of tension. A small left pleural effusion is noted. Severe background emphysema is again seen. The cardiomediastinal silhouette is unremarkable. No focal consolidation is present. IMPRESSION: Moderate left pneumothorax and small left pleural effusion, not significantly changed from two hours ago. Severe emphysema. " 6bacd974-e4b8d169-9f17fd30-c93d797b-ddebc1c7.jpg,validate/p19/p19975796/s52082171/6bacd974-e4b8d169-9f17fd30-c93d797b-ddebc1c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD, increase SOB, phlegm, cough // r/o pneumonia r/o pneumonia FINDINGS: In comparison with the study of ___, there has been the development of a large right hilar and suprahilar mass measuring approximately 6 cm in diameter with fibrotic stranding extending to a region of pleural thickening in the lateral chest wall. This most likely represents a malignancy. Hyperexpansion of the lungs is consistent with the clinical diagnosis of COPD. There is a right pleural effusion with suggestion of some apical thickening on the side. No evidence of vascular congestion or acute focal pneumonia. IMPRESSION: Large right hilar mass most likely representing malignancy RECOMMENDATION(S): CT for further evaluation NOTIFICATION: Dr. ___ " 3d729ac7-25fca31c-e10c73e1-0b275b2d-cddbc13c.jpg,validate/p16/p16814932/s58707681/3d729ac7-25fca31c-e10c73e1-0b275b2d-cddbc13c.jpg,validation," WET READ: ___ ___ ___ 9:55 PM cardiomegaly w/ low lung volumes and diffuse interstitial opacity representing either pulmonary edema, interstitial lung disease, or componenets of both. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Shortness of breath, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient still has very low lung volumes and a moderate cardiomegaly. The diameter of the vascular structures is at the upper range of normal, potentially suggesting mild fluid overload. No evidence of pneumonia. No larger pleural effusions. " 4f5dce13-8911bb0e-c9fec07f-caa2680e-7b36e1de.jpg,validate/p12/p12902491/s59626609/4f5dce13-8911bb0e-c9fec07f-caa2680e-7b36e1de.jpg,validation," FINAL REPORT HISTORY: History of coronary artery disease and CHF status post PEA arrest treated with coiling and rewarming currently on mechanical ventilation, here to evaluate for interval change. COMPARISON: Chest radiograph was performed on ___ at 08:07. Technique: Portable frontal radiograph of the chest. FINDINGS: A left pectoral pacemaker is unchanged with a single lead terminating in the right ventricular apex. A tracheostomy tube is in place. There is bi apical capping on the right greater than left, which may represent pleural fluid. A moderate sized layering right pleural effusion with underlying atelectasis is slightly decreased in size. A small left pleural effusion and associated atelectasis is slightly decreased in size. Improved aeration of the bilateral lung bases may also reflect differences in position between studies with more dependent pleural fluid on today's examination. No pneumothorax is detected. The cardiac silhouette is incompletely evaluated. The mediastinal contours are prominent but stable with tortuosity of the thoracic aorta and calcification of the aortic knob. IMPRESSION: Minimal change with persistent bilateral pleural effusions on the right greater than left and underlying atelectasis. " 62660d99-555cda2b-e0b23ef1-37249deb-4472a6d4.jpg,validate/p17/p17968028/s58643890/62660d99-555cda2b-e0b23ef1-37249deb-4472a6d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with dyspnea, lower extremity swelling, fever TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Heart size appears mildly enlarged. The mediastinal and hilar contours are unremarkable. There is mild pulmonary vascular congestion, with patchy bibasilar atelectasis, more pronounced on the right. No pleural effusion or pneumothorax is present. No acute osseous abnormalities identified. Degenerative changes are seen in the thoracic spine. IMPRESSION: Mild pulmonary edema and bibasilar atelectasis. " f59eb5e3-46f9ba01-d97a1d3c-310edae8-635be132.jpg,validate/p18/p18015293/s52097367/f59eb5e3-46f9ba01-d97a1d3c-310edae8-635be132.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with with SIADH // R/o lung tumor R/o lung tumor COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Marked hyperinflation is chronic, suggesting severe emphysema. No focal pulmonary abnormality is seen. Cardiomediastinal and hilar silhouettes and pleural surfaces are essentially normal. " ec3e90a6-7b076c84-89b210ce-1b67b116-6653bc33.jpg,validate/p17/p17391196/s52397878/ec3e90a6-7b076c84-89b210ce-1b67b116-6653bc33.jpg,validation," FINAL REPORT HISTORY: CABG. CHEST, TWO VIEWS. COMPARISON: Chest x-ray from ___. Cardiomediastinal silhouette is enlarged, with sternotomy wires, but unchanged. Mediastinum remains midline. Compared with the prior study, upper zone re-distribution and opacities at the left and right bases have improved slightly. Again seen is a small left effusion, with underlying collapse and/or consolidation, and some scarring and subsegmental atelectasis at the right lung base. Noteis again made of prior partial resection of the right 5th rib. Surgical sutures again seen along the right superior mediastinal/hilar areawith some pleural thickening along the right upper lobe, unchanged. Additional surgical clips noted along the right heart border. IMPRESSION: Slight interval improvement in bibasilar opacities and small effusions. " ff86a4b8-8249bedf-dbacbcd4-c009bc04-b156214b.jpg,validate/p13/p13013799/s53228608/ff86a4b8-8249bedf-dbacbcd4-c009bc04-b156214b.jpg,validation," 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. " 99f98fa3-f2241bd4-09aac985-64064853-4d158313.jpg,validate/p11/p11597221/s50052032/99f98fa3-f2241bd4-09aac985-64064853-4d158313.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with sudden onset chest pain and nonspecific EKG changes. COMPARISON: None. FINDINGS: PA and lateral views of the chest demonstrate well-expanded and clear lungs. Heart is larger than expected, but pulmonary vasculature are within normal limits. Mediastinal contour is unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: 1. No acute intrathoracic abnormality. 2. Heart is larger than expected, but no evidence of congestive failure. " 613bab9b-3fd3e8b0-91f7eb55-ae822930-4d2b2dd6.jpg,validate/p15/p15702975/s56877507/613bab9b-3fd3e8b0-91f7eb55-ae822930-4d2b2dd6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, fever 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. " 113f90ff-3ce20f1e-16a9064a-1f6362f0-0bbf0986.jpg,validate/p13/p13305035/s52369224/113f90ff-3ce20f1e-16a9064a-1f6362f0-0bbf0986.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Nausea and vomiting in a patient with diabetes mellitus and new paroxysmal atrial fibrillation. AP and lateral views were reviewed in comparison to ___ with multiple prior studies. There is a gradual progression of bilateral pleural effusions and bibasal opacities, left more than right, worrisome in particular on the left for infectious process. Since the most recent prior radiograph obtained yesterday there is interval resolution, almost complete, of pulmonary edema. There is no pneumothorax. Left PICC line tip can be seen at the level of mid low SVC. " 089bdb14-d777926d-758cf6f3-494f1087-d73f8124.jpg,validate/p10/p10455192/s56329898/089bdb14-d777926d-758cf6f3-494f1087-d73f8124.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with fevers, assessment for pneumonia. COMPARISON: Exam is compared to ___. FINDINGS: The ET tube ends at 2 cm from carina bifurcation and can be withdrawn 2 cm. The NG tube ends in proximal gastric cavity, likely in the fundus of the stomach. The left PICC ends in upper SVC. Lung volumes are persistently low with bibasilar consolidation, suspicious for pneumonia. Cardiomediastinal silhouette is normal. There is mild vascular engorgement. There is no pneumothorax. IMPRESSION: Status quo. " befc7bde-45c1e8d5-462490db-d7d3a67e-83033a5f.jpg,validate/p16/p16818299/s53854646/befc7bde-45c1e8d5-462490db-d7d3a67e-83033a5f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man w/ L hemoptx, L clavicle fx, 1st rib fx // Is hemopneumothorax resolving with chest tube to water seal? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Left apical pneumothorax is small. The degree of pleural fluid at the left lung base is similar, small. Right lung is clear. Left lower lobe atelectasis, sternal wires, and aortic valve replacement are similar to the prior radiograph. Mildly displaced left mid-clavicular fracture is unchanged in alignment and displacement from the prior radiographs. Known 1st rib fracture is not well seen. IMPRESSION: Similar appearance compared to ___:00, with small left apical pneumothorax and small left pleural effusion. " f43cba6a-918a1d0e-0e357d2b-56f428ca-2a2ae529.jpg,validate/p17/p17079941/s55309721/f43cba6a-918a1d0e-0e357d2b-56f428ca-2a2ae529.jpg,validation," FINAL REPORT AP CHEST, 4:20 A.M. ON ___. HISTORY: ___-year-old woman with respiratory failure, question interval change. IMPRESSION: AP chest compared to ___ through ___: Diffuse infiltrative pulmonary abnormality present for more than a week, worsened since ___. New opacification in the right lower lung could be either atelectasis or concurrent pneumonia, also explaining worsening consolidation at the left base. Mild enlargement of the cardiac silhouette is stable. Pleural effusions are presumed, but not large. No pneumothorax. ET tube in standard placement. Right jugular line ends in the low SVC, and feeding and upper enteric tubes both pass into the stomach. " 82b4761f-2cd9eeec-72e85e2e-f347ce6a-5e8ee4c7.jpg,validate/p19/p19818900/s57678511/82b4761f-2cd9eeec-72e85e2e-f347ce6a-5e8ee4c7.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Fever and loss of appetite. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. Osseous structures are unremarkable. IMPRESSION: No evidence of acute cardiopulmonary abnormalities. " f5609e98-b76e8ef4-07df329f-d27389ad-001f9fcb.jpg,validate/p13/p13207656/s53789293/f5609e98-b76e8ef4-07df329f-d27389ad-001f9fcb.jpg,validation," WET READ: ___ ___ ___ 7:25 PM No definite change in right pneumothorax since study two hours prior. No evidence of tension. - ___ _________________________________________________________________________________ FINAL REPORT HISTORY: Recent thoracentesis question pneumothorax. TECHNIQUE: Portable AP upright view of the chest obtained at 19:12. COMPARISON: Chest radiograph from ___ ___ at 17:45. FINDINGS: There has been no significant change in the small right pneumothorax compared to 2 hours prior. No evidence of tension. IMPRESSION: No interval change from 2 hr prior. " afbf034a-4bc8ab6c-3b693194-93c6c1a8-16a608c6.jpg,validate/p10/p10425845/s58708711/afbf034a-4bc8ab6c-3b693194-93c6c1a8-16a608c6.jpg,validation," FINAL REPORT HISTORY: Intubated. TECHNIQUE: Portable AP view of the chest. COMPARISON: None. The patient is listed as EU critical at the time of study interpretation. FINDINGS: Endotracheal tube tip terminates approximately 5.2 cm from the carina. Enteric tube is noted with tip located within the stomach. The heart size is top normal. The aorta is tortuous and diffusely calcified. Mediastinal and hilar contours are otherwise unremarkable. There is no pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Acute fractures of the right ___ and ___ lateral ribs are noted. Remote fracture of the left ___ lateral rib and ___ right posterior rib are also demonstrated. Partially imaged is hardware within the right humeral head. IMPRESSION: 1. Standard positioning of the endotracheal and enteric tubes. 2. Right ___ and ___ acute lateral rib fractures. " 29764061-edecbfa8-3ebd42b3-dd2616fd-20d3636d.jpg,validate/p18/p18068560/s54999260/29764061-edecbfa8-3ebd42b3-dd2616fd-20d3636d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with LLL mass and s/p rigid bronchoscopy and jet ventillation // r/p Ptx TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ 08:15 FINDINGS: As compared to ___ 08:15, there is a new small right pleural effusion and right mild pulmonary interstitial edema. There is a left endobronchial blocker terminating in the left mainstem bronchus. Endotracheal tube is in appropriate position. Left jugular venous catheter ends in the mid SVC. Unchanged left pulmonary edema with increasing left lower lobe atelectasis. No pneumothorax. IMPRESSION: No pneumothorax. Since ___ 8:15 AM, new mild pulmonary edema in the right lung field and new right pleural effusion. Unchanged left pulmonary edema with increasing left lower lobe atelectasis. " 4af95385-3c51102e-2b551dac-cc9f7cf0-2ddaf007.jpg,validate/p15/p15481018/s51929906/4af95385-3c51102e-2b551dac-cc9f7cf0-2ddaf007.jpg,validation," WET READ: ___ ___ ___ 6:07 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___M w/ NASH cirrhosis worsening fogginess in the past day r/o pna. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiographs FINDINGS: Lungs are fully expanded and clear. No pleural abnormalities. Heart size is top-normal. Cardiomediastinal and hilar silhouettes are normal. IMPRESSION: No acute cardiopulmonary abnormality. " de88d697-61807bbd-c5fccfa8-76174ba5-fe1230a4.jpg,validate/p16/p16818103/s58077197/de88d697-61807bbd-c5fccfa8-76174ba5-fe1230a4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with no pulmonary symptoms; needs CXR for placement. // **** PLEASE PAGE NURSE TO SCHEDULE, MUST BE A FEMALE TECH ***Please evalute for acute processes. Please perform PA and lateral if possible, must be portable due to seclusion. COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Borderline diameter of both the left and the right pulmonary artery, without correlate of at change in diameter of the pulmonary vessels. No pleural effusions. No pulmonary edema, no pneumonia. Food and air filled gastric bubble. Normal size of the cardiac silhouette. Correlation with a frontal and lateral radiograph would be helpful to further worked up the bilateral region of the pulmonary arteries ends to exclude coexisting lymphadenopathy. " 51ce2d83-e59c3e4d-38384552-e65dba9a-aae7d592.jpg,validate/p12/p12521370/s56849679/51ce2d83-e59c3e4d-38384552-e65dba9a-aae7d592.jpg,validation," WET READ: ___ ___ ___ 12:01 AM Low lung volumes an portable semi upright technique accentuate moderate cardiomegaly and crowd the hilar structures. Allowing for differences in position compared to the prior study from ___, degree of vascular congestion is similar. Right pleural effusion now layers posteriorly. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dCHF and fluids for hypercalcemia // effusion, increase pulm vasc congestion? effusion, increase pulm vasc congestion? IMPRESSION: Port-A-Cath catheter tip terminates at the level of mid SVC. Cardiomegaly is unchanged. Mediastinal silhouette is stable. There is interval increase in bilateral pleural effusions as well as development of interstitial pulmonary edema, mild to moderate. " d15317dd-d258cd5d-f1314e19-32752f9b-c0438c5d.jpg,validate/p13/p13120691/s58914394/d15317dd-d258cd5d-f1314e19-32752f9b-c0438c5d.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with chest pain. The patient has history of lung cancer. COMPARISON: PET-CT ___. FINDINGS: Frontal and lateral views of the chest were obtained. Again seen is a rounded lesion in the lingula, which was FDG-avid on recent chest CT. Increased opacity at the left lung base is likely due to mediastinal fat. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is within normal limits. The mediastinal silhouette and hilar contours are normal. No acute osseous abnormality is identified. IMPRESSION: No acute intrathoracic process. " 18735717-b4de78fd-5ef9c040-17339e8d-a6ac6f88.jpg,validate/p17/p17731768/s58252979/18735717-b4de78fd-5ef9c040-17339e8d-a6ac6f88.jpg,validation," 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. " 26d84d57-dd7ce7ae-59278c93-2706c629-9412461a.jpg,validate/p13/p13505755/s59331240/26d84d57-dd7ce7ae-59278c93-2706c629-9412461a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxic respiratory failure, currently intubated // Please assess for interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomegaly is stable. right lower lobe opacities have increased consistent with increasing effusion and adjacent atelectasis. Mild pulmonary edema has increased. Left lower lobe opacity a combination of small left effusion and retrocardiac atelectasis have increased. Right IJ catheter tip is in the cavoatrial junction. ET tube is in standard position. NG tube tip is difficult to assess given technique can be followed only to the level of the diaphragm " ff15f1dc-8a01f427-f53c27a4-6c77efa2-5d4bfb0e.jpg,validate/p14/p14526991/s51699633/ff15f1dc-8a01f427-f53c27a4-6c77efa2-5d4bfb0e.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with syncope and desaturation. COMPARISON: None. FINDINGS: Single portable view of the chest. The lungs are clear. The cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 65a342a2-41b6adc9-78a20fd7-77f6efdd-e581259b.jpg,validate/p13/p13119723/s50535510/65a342a2-41b6adc9-78a20fd7-77f6efdd-e581259b.jpg,validation," WET READ: ___ ___ ___ 11:16 PM 1. No acute cardiopulmonary process. 2. No displaced rib fracture. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M s/p MVC complaining of right sided pain with inspiration, evaluate for rib fracture, pneumothorax TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal. There is no displaced rib fracture. IMPRESSION: 1. No acute cardiopulmonary process. 2. No displaced rib fracture. " 62f0cca7-b81a148b-c2e2eb4b-374c8cb2-0c38c66d.jpg,validate/p14/p14772351/s53964063/62f0cca7-b81a148b-c2e2eb4b-374c8cb2-0c38c66d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fatigue and lightheadedness. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Again low lung volumes are seen. The lungs, however, are clear of consolidation. There is no effusion. Increased opacity projecting over left upper lung is compatible with asymmetric degenerative changes at the costochondral junction of the first rib which is more clearly delineated on prior exam secondary to different technique. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are otherwise unremarkable. IMPRESSION: No acute cardiopulmonary process. " bc0c5943-88482939-df6dc5a8-f26930e8-98a46559.jpg,validate/p18/p18903299/s59408540/bc0c5943-88482939-df6dc5a8-f26930e8-98a46559.jpg,validation," FINAL REPORT HISTORY: Epiglottitis and pneumonia. FINDINGS: In comparison with the study of ___, there is continued opacification at the right base, consistent with pleural fluid and atelectasis, though in the appropriate clinical setting, supervening pneumonia would have to be considered. The right base opacification is improving. There is still probably some small effusion with atelectatic change. Elevation of pulmonary venous pressure persists. The tracheal tube remains in place. " 5cf2a673-12d0b4d1-7beb9a0e-5cc1a807-14b3eb5c.jpg,validate/p17/p17535980/s59676163/5cf2a673-12d0b4d1-7beb9a0e-5cc1a807-14b3eb5c.jpg,validation," 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. " d7713c77-f3b64317-afc32e7d-c4ac6c38-5551165d.jpg,validate/p16/p16444272/s57613281/d7713c77-f3b64317-afc32e7d-c4ac6c38-5551165d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Rule out pneumonia. TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiograph from ___. FINDINGS: Lung volumes are low. Sutures in the right upper and lower lungs are consistent with lung resections. Right costophrenic angle is blunted, possibly from chronic effusion which has worsened since ___. Any concurrent underlying infection cannot be ruled out. The aorta is remarkable for mild tortuosity with moderate-to-severe intimal calcification. Heart size is top normal but stable. Effusion on the left side. There is no pneumothorax. Right-sided moderate pleural effusion has increased since ___. Any concurrently associated infection cannot be ruled out. However, rest of the lungs do not demonstrate any opacities concerning for pneumonia. Findings were discussed with Dr. ___ on ___ at approximately 4:00 p.m. " 5947717c-e927fa1c-9389822c-ae98306d-c020d24d.jpg,validate/p14/p14976271/s52629886/5947717c-e927fa1c-9389822c-ae98306d-c020d24d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with bilateral lower extremity edema. COMPARISON: None. FINDINGS: AP and lateral views of the chest. Lateral view is limited secondary to significant respiratory motion. On the frontal, there are bibasilar opacities, right greater than left potentially due to atelectasis given relatively low lung volumes. Cardiac silhouette is moderately enlarged. Descending thoracic aorta is tortuous. No acute osseous abnormality is identified. IMPRESSION: Bibasilar opacities, potentially atelectasis, although infection is not excluded. Mild cardiomegaly. " f063b9ca-7e732b44-6dabb8b9-1f0e5824-78c5fa1f.jpg,validate/p10/p10877695/s58918832/f063b9ca-7e732b44-6dabb8b9-1f0e5824-78c5fa1f.jpg,validation," FINAL REPORT INDICATION: ___F with shortness of breath x 2 weeks // eval for CHF/pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Hiatal hernia is noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 12773d35-9a059600-279fe245-ecace21c-657ed452.jpg,validate/p14/p14098347/s55263686/12773d35-9a059600-279fe245-ecace21c-657ed452.jpg,validation," FINAL REPORT EXAMINATION: AP chest radiograph INDICATION: ___ year old woman with Multiple Myeloma. // Post-op fever, r/o PNA. TECHNIQUE: Portable AP chest radiograph COMPARISON: Radiograph from ___ FINDINGS: Right-sided chest wall Port-A-Cath, tip projects over the right atrium. Shallow breath. New mild bibasilar opacities, may represent atelectasis. Normal cardiomediastinal silhouette. Deformity of a posterior left rib, chronic. Scoliosis. This preliminary report was reviewed with Dr. ___, ___ radiologist. IMPRESSION: New mild bibasilar opacities, may represent atelectasis. " 52b01aae-96e07504-ffc3d0b9-a05c3312-b01d8387.jpg,validate/p13/p13690191/s55490363/52b01aae-96e07504-ffc3d0b9-a05c3312-b01d8387.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, fever // r/p CAP COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. There is no evidence of pneumonia or pulmonary edema. No pleural effusions. Normal size of the heart. The lateral radiograph shows flattening of the hemidiaphragms, likely caused by mild overinflation. " 012ed04b-ea13009a-c8a53fd6-f744d1d5-1065e9f0.jpg,validate/p16/p16026540/s54909474/012ed04b-ea13009a-c8a53fd6-f744d1d5-1065e9f0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with seizures. // ?PNA ?PNA IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lungs fully expanded and clear. Normal cardiomediastinal and hilar silhouettes and pleural surfaces. Stimulator lead extends from the left pectoral generator to the left cervicothoracic region. " 08de0048-0aa80f59-3e89567e-5eeafc52-7f216a9d.jpg,validate/p10/p10737302/s57139374/08de0048-0aa80f59-3e89567e-5eeafc52-7f216a9d.jpg,validation," 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. " e07be36c-1a9196e5-6bf80e1b-b24dfab2-9d5d09a4.jpg,validate/p12/p12895467/s53713688/e07be36c-1a9196e5-6bf80e1b-b24dfab2-9d5d09a4.jpg,validation," WET READ: ___ ___ 3:31 PM Right lower lobe opacity most consistent with pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old man with fever and chest pain, evaluate for pneumonia. COMPARISONS: None. FINDINGS: PA and lateral views of the chest were provided. There is a patchy infiltrate in the right lower lobe concerning for pneumonia. There is no pleural effusion or pneumothorax. The lungs are well aerated. The cardiomediastinal silhouette is unremarkable. Osseous structures are unremarkable. IMPRESSION: Right lower lobe opacity most consistent with pneumonia. Follow up radiograph after appropriate therapy recommended to document resolution. " 74aeceba-780a29d1-fc519350-982cc057-53615370.jpg,validate/p15/p15570344/s51226604/74aeceba-780a29d1-fc519350-982cc057-53615370.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior study from ___. CLINICAL HISTORY: ___-year-old woman with cough and fever, question acute process. FINDINGS: AP upright and lateral views of the chest were obtained. Limited study due to low lung volumes. There is diffuse pulmonary vascular congestion compatible with mild pulmonary edema. Small bilateral pleural effusions impossible to exclude. Cardiomediastinal silhouette appears grossly stable with mild atherosclerotic calcifications along the aortic knob. Bony structures are intact. IMPRESSION: Pulmonary interstitial edema with trace bilateral pleural effusions. " ac676a99-ab2720a7-d269e532-4020f4ae-b8ab6b74.jpg,validate/p14/p14755254/s52371152/ac676a99-ab2720a7-d269e532-4020f4ae-b8ab6b74.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with seizures // assess lungs lines and tubes assess lungs lines and tubes IMPRESSION: Compared to chest radiographs ___ through ___. Mild pulmonary edema which recurred on ___ has remained stable, along with severe chronic cardiomegaly. Pleural effusions small if any. No focal pulmonary abnormality. Feeding tube passes below the diaphragm and out of view. Left trans subclavian right atrial pacer and right ventricular pacer leads are continuous from the left pectoral generator. A remnant of a third wire remains. " a7019805-59078e14-becde825-4ce3001b-e3da1796.jpg,validate/p19/p19022682/s54558048/a7019805-59078e14-becde825-4ce3001b-e3da1796.jpg,validation," 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. " 911b13b4-f91c8faf-258be47f-d3c9b13c-8822083b.jpg,validate/p10/p10966036/s54728705/911b13b4-f91c8faf-258be47f-d3c9b13c-8822083b.jpg,validation," FINAL REPORT INDICATION: ___-year-old with endocarditis and fever. TECHNIQUE: Frontal and lateral radiographs of the chest. FINDINGS: No comparison studies. There are multifocal bilateral nodular ground-glass opacities. Concurrent CTA of the chest better evaluates this. The cardiomediastinal shilhouette and hila are normal. No pleural effusion, no pneumothorax. " a17f128b-4c1e2ac4-a05c6294-3ea2d93d-de711300.jpg,validate/p15/p15006805/s56940997/a17f128b-4c1e2ac4-a05c6294-3ea2d93d-de711300.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with history of intermittent fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size remains mildly enlarged with a left ventricular predominance. Aortic core valve device is re- demonstrated in unchanged position. Extensive atherosclerotic calcifications of the thoracic aorta are again noted. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 94998ddb-11e60f59-97aaaf3a-345bbe54-b9412ec1.jpg,validate/p17/p17698189/s59673919/94998ddb-11e60f59-97aaaf3a-345bbe54-b9412ec1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dyspnea, cough, recent pna // 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. " 57d5c3ef-ddbb03e2-9bde6248-eed52105-3c1b3e45.jpg,validate/p18/p18691929/s59372742/57d5c3ef-ddbb03e2-9bde6248-eed52105-3c1b3e45.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with lung nodules concerning for metastasis // eval post op chnge following wedge resection COMPARISON: Previous chest x-rays on PACs record for comparison. Targeted review of chest CT from ___. FINDINGS: The cardiomediastinal silhouette is within normal limits for age and technique and remains midline. There is atelectasis in the right upper zone, with several bandlike opacities. The right hemidiaphragm is probably slightly elevated. There is atelectasis at both lung bases. More hazy opacity at right base may reflect the presence of a small effusion. Mild vascular plethora is noted, consistent with mild CHF. A left chest tube is present. No pneumothorax is detected. IMPRESSION: Atelectasis in the right upper zone, as well as left base. CHF with interstitial edema. Possible small right effusion. " 5db0ab7d-8b53f7e8-25444ffe-64f1e229-ba7a464e.jpg,validate/p15/p15130456/s51105799/5db0ab7d-8b53f7e8-25444ffe-64f1e229-ba7a464e.jpg,validation," FINAL REPORT INDICATION: Chest pain, evaluate for pneumothorax. COMPARISON: No prior studies available for comparison. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal and hilar contours. The linear opacifications within the bilateral lung bases likely reflect atelectasis due to poor lung volumes. No pleural effusion or pneumothorax identified. IMPRESSION: Poor inspiratory effort limiting evaluation of the lungs. No pneumothorax or pleural effusion. No cardiomegaly. " 8457ba16-fad7eeb0-2f699130-7af010a8-d988c280.jpg,validate/p17/p17473651/s55484280/8457ba16-fad7eeb0-2f699130-7af010a8-d988c280.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p R VATS wedge // R/O PTX post CT removal R/O PTX post CT removal IMPRESSION: Heart size and mediastinum are stable. Apical pneumothorax is small on the right after removal of the right chest tube. Minimal widening of the right upper mediastinum most likely represent postsurgical hematoma. Attention to this area on the subsequent studies is recommended. " c4142015-dcc27bca-92b11671-4bcfbdfd-57ad6687.jpg,validate/p15/p15971063/s53218018/c4142015-dcc27bca-92b11671-4bcfbdfd-57ad6687.jpg,validation," FINAL REPORT INDICATION: Left chest tube, evaluate for pneumothorax or hemothorax. COMPARISON: Chest radiograph on ___ at 03:59. FINDINGS: An endotracheal tube ends 5 cm from the carina. An enteric tube ends off the imaged portion of the screen. Left-sided chest tube has been placed and subsequently advanced on subsequent images on this study. The left lower lobe opacity is again seen, which is more apparent compared to prior study and likely represents a component of aspiration or pneumonia. There may also be a small right pleural effusion. Tiny left apical pneumothorax. There is some subcutaneous emphysema on the left. IMPRESSION: Increased opacification in the left lower lung consistent with aspiration or pneumonia. Likely small left pleural effusion. Tiny left apical pneumothorax. Left chest tube is in place. " 1ce032ae-c653384c-b9fcfb22-a09a75d5-f0349075.jpg,validate/p19/p19786788/s59678473/1ce032ae-c653384c-b9fcfb22-a09a75d5-f0349075.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: ___. CLINICAL HISTORY: Weakness, assess for pneumonia or cardiomegaly. FINDINGS: PA and lateral views of the chest were obtained demonstrating clear well-expanded lungs without 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 acute intrathoracic process. " 607ad797-eca69a65-8511faab-d22d45af-fc308417.jpg,validate/p10/p10788730/s50593890/607ad797-eca69a65-8511faab-d22d45af-fc308417.jpg,validation," FINAL REPORT INDICATION: Fall off bike with loss of consciousness and right shoulder chest wall pain. COMPARISON: None. SUPINE AP VIEW OF THE CHEST: There are low lung volumes. The heart size is normal. There is crowding of the bronchovascular structures. Otherwise the mediastinal and hilar contours are unremarkable. There is likely atelectasis at the lung bases. No focal consolidation, large pleural effusion or pneumothorax is identified, though the left costophrenic angle is excluded from the field of view. There are no acute osseous abnormalities. Degenerative changes of both glenohumeral joints are noted. IMPRESSION: Low lung volumes with bibasilar atelectasis. " 42b829ca-df121584-92d28dfe-fb4b54d6-b5aac67e.jpg,validate/p17/p17763728/s52764325/42b829ca-df121584-92d28dfe-fb4b54d6-b5aac67e.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Evaluate retrocardiac opacity seen in prior study. Patient with HIV, on HAART. Comparison is made with prior study, ___. There is moderate cardiomegaly. Small bilateral pleural effusions are larger on the left side and are associated with adjacent opacities, most likely atelectases, though superimposed infection cannot be totally excluded. There is mild vascular congestion with no pneumothorax. " d5ffaa04-fd7164de-edb19f37-17fb105f-592f708c.jpg,validate/p14/p14916430/s55373775/d5ffaa04-fd7164de-edb19f37-17fb105f-592f708c.jpg,validation," FINAL REPORT HISTORY: Lethargy, hyperglycemia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Heart size remains moderately enlarged. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Minimal patchy opacity is seen within the left lung base, possibly reflective of atelectasis. No pleural effusion or pneumothorax is seen. The osseous structures are diffusely demineralized. IMPRESSION: Patchy left basilar opacity most likely reflective of atelectasis. Infection however is not completely excluded. " eeb4b22b-027e181d-cca1b54a-20d6bb7a-161e1e22.jpg,validate/p10/p10784538/s55098658/eeb4b22b-027e181d-cca1b54a-20d6bb7a-161e1e22.jpg,validation," FINAL REPORT HISTORY: Dizziness and syncope. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The cardiac, mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is present. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. " 225358df-ef64d720-2c40f12c-90e078ed-70f14a08.jpg,validate/p19/p19861375/s56654877/225358df-ef64d720-2c40f12c-90e078ed-70f14a08.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new OGT placement // OGT location OGT location IMPRESSION: In comparison with the study of ___, there is an placement of a nasogastric tube that extends at least to the mid portion of the stomach, where it crosses the lower margin of the image. Endotracheal tube tip is in the clavicular region, approximately 8 cm above the carina. Little change in the appearance of the heart and lungs. Hyperexpansion of the lungs with prominence of interstitial markings that could reflect chronic lung disease, elevated pulmonary venous pressure, or both. " b070fc05-5b8d54fc-e0c9e63d-07a6c395-bde1b7ea.jpg,validate/p14/p14888722/s51409071/b070fc05-5b8d54fc-e0c9e63d-07a6c395-bde1b7ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NGT // NGT placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are constant. Moderate cardiomegaly persists. Moderate retrocardiac atelectasis, mild to moderate pulmonary edema with a small interstitial component. No new focal parenchymal opacities suggesting pneumonia. The course of the nasogastric tube is unremarkable, the tip is not included on the image. " b409a9dc-012a613c-543dad19-f623add7-ba0d73b6.jpg,validate/p13/p13193136/s51173257/b409a9dc-012a613c-543dad19-f623add7-ba0d73b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with atrial fibrillation on amiodarone // asses for amiodarone effect COMPARISON: ___. IMPRESSION: No relevant change as compared to the previous image. Minimal atelectasis at the right lung bases. No evidence of pulmonary fibrosis. Borderline size of the cardiac silhouette with mild elongation of the descending aorta. No pneumonia. Unchanged course of the pacemaker leads. " 44b94202-c8076f61-57647a07-0c63f5dd-22d1e12a.jpg,validate/p10/p10610628/s58978199/44b94202-c8076f61-57647a07-0c63f5dd-22d1e12a.jpg,validation," WET READ: ___ ___ 3:41 PM Regions of scarring and pleural califications at the right lung base and apex, as on prior. More conspicuous opacities at the left lung apex and at the costophrenic angle may be due to progression of underlying lung disease and scarring, although infection cannot be excluded. ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old male with altered mental status and low oxygen saturation. Evaluate for pneumonia versus CHF. COMPARISON: Multiple prior chest radiographs, most recent on ___ and chest CT from ___. TECHNIQUE: Portable semi-upright chest radiograph. FINDINGS: Assessment is limited due to poor positioning. Confluent opacity at the right lung base is unchanged since ___ and likely represents scarring and previously seen posterior plueral calcifications. Left apical parechymal opacities have progresed since ___ and there is mild opacity at the left costophrenic angle as well. Right lung apex is obscured by patient's chin. Mild-to-moderate cardiomegaly is again seen, but not clearly assessed due to poor positioning and rotation. There might be small bilateral pleural effusions. The aorta is tortuous with significant atherosclerotic calcifications seen at the aortic knob, stable from ___. Lumbar spine hardware is partially visualized. Multiple old right-sided rib fractures are redemonstrated. IMPRESSION: Regions of scarring and pleural califications at the right lung base and apex, as on prior. More conspicuous opacities at the left lung apex and at the costophrenic angle may be due to progression of underlying lung disease and scarring, although infection cannot be excluded. " 7a49fd1f-4e229cc7-14aade9c-ddf50081-7c23f16a.jpg,validate/p18/p18092965/s58729999/7a49fd1f-4e229cc7-14aade9c-ddf50081-7c23f16a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pneumothorax- now clamped chest tube. Please evaluate pneumothorax. TECHNIQUE: Portable AP upright chest radiograph COMPARISON: 06:00 on the same morning FINDINGS: If there is a residual pneumothorax, it is very small. Endobronchial stents are unchanged in position, as is the right apical pleural catheter. Remainder the lungs are clear but hyperinflated. No pleural effusion. Fullness of the right hilum is consistent with lymphadenopathy and known right apical nodule is seen to better detail on recent CT. IMPRESSION: No significant residual pneumothorax. " 8969d567-82c08b1e-77f0d7ad-450bcffc-4277cfc4.jpg,validate/p12/p12479159/s58742169/8969d567-82c08b1e-77f0d7ad-450bcffc-4277cfc4.jpg,validation," FINAL REPORT EXAM: AP and lateral views of the chest. CLINICAL INFORMATION: Fever, cough, history of stroke with worsening right-sided weakness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There are bibasilar opacities, right greater than left, worrisome for aspiration and/or infection. There is slight prominence of the central pulmonary vasculature, which may be due to mild pulmonary vascular congestion. No large pleural effusion is seen. There is no pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Right greater than left bibasilar opacities concerning for underlying pneumonia and/or aspiration. Mild pulmonary vascular congestion. " 84de51d5-54839a3b-f75b7b42-c86f2c08-fd7652b0.jpg,validate/p10/p10380616/s54366774/84de51d5-54839a3b-f75b7b42-c86f2c08-fd7652b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with TBM // s/p airway Y stent COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received an airway stent. Low lung volumes. Unchanged bilateral apical scarring and enlargement of the vascular structures at the left and right hilus. No atelectasis. No new parenchymal opacity. No pleural effusions. No pulmonary edema. " 6944cb6f-de8be6e2-a6b8a56c-ab493a75-a63d5d17.jpg,validate/p14/p14698539/s55924734/6944cb6f-de8be6e2-a6b8a56c-ab493a75-a63d5d17.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o F w/ SBO s/p NGT placement // confirm NGT in gastrum confirm NGT in gastrum COMPARISON: ___ obtained at 02:31 IMPRESSION: Type of tube passes below the diaphragm terminating in the stomach. Heart size and mediastinum are stable. Lungs overall clear except for minimal left basal atelectasis. No appreciable pneumothorax. Hardware in the cervical spine is noted. " b19d3aea-2ff2e411-2728a609-1b69bbad-8438719f.jpg,validate/p12/p12725568/s58102933/b19d3aea-2ff2e411-2728a609-1b69bbad-8438719f.jpg,validation," FINAL REPORT HISTORY: Epigastric pain and melena. COMPARISON: Chest radiograph ___. FINDINGS: PA and lateral views of the chest were viewed. The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear. Vasculature is within normal limits. There is no free air under diaphragm. IMPRESSION: No acute cardiopulmonary process. " deb99332-3e2c56fd-79da44f4-00d08d88-37de77d2.jpg,validate/p15/p15619921/s54566105/deb99332-3e2c56fd-79da44f4-00d08d88-37de77d2.jpg,validation," 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. " dedd0d10-2b7f6f6e-2824de5b-ff96e878-08732d7b.jpg,validate/p14/p14997223/s57523310/dedd0d10-2b7f6f6e-2824de5b-ff96e878-08732d7b.jpg,validation," WET READ: ___ ___ ___ 12:07 AM Interval decrease in size of right pleural effusion status post thoracentesis without evidence of pneumothorax. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Hepatic hydrothorax, status post thoracocentesis, questionable pneumothorax. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has undergone right thoracocentesis. There is considerable decrease in extent of the pre-existing right pleural effusion that is now limited to the region of the costophrenic sinus. No evidence of pneumothorax or other complications. Borderline size of the cardiac silhouette with enlargement of the left ventricle. Normal appearance of the left lung. " 21873e20-06719b59-a53331d0-da3b52f3-e02dc524.jpg,validate/p15/p15713699/s58337300/21873e20-06719b59-a53331d0-da3b52f3-e02dc524.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough // acute process? COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Diffuse airspace opacities highly concerning for multifocal pneumonia. No large effusion or pneumothorax. The heart size appears borderline enlarged. Mediastinal contour appears normal. Hila appear prominent which could be due to enlarged lymph nodes or hilar congestion. Bony structures are intact. IMPRESSION: Findings concerning for multifocal pneumonia. Followup to resolution advised. " 4b5c79b5-6ebaa0ce-1fe1d8e8-6cb188e7-c4179c59.jpg,validate/p13/p13307649/s54563436/4b5c79b5-6ebaa0ce-1fe1d8e8-6cb188e7-c4179c59.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Coronary artery disease and diabetic, presenting with 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 overt pulmonary edema is seen. Aortic knob is calcified but does not appear dilated. IMPRESSION: No acute cardiopulmonary process. " 46ca5235-da02ef6c-eb621013-55f6bbf1-2e5c6247.jpg,validate/p13/p13364829/s56459024/46ca5235-da02ef6c-eb621013-55f6bbf1-2e5c6247.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: NG tube placement. AP view of the chest was reviewed in comparison to prior study obtained at 02:16 a.m. The newly inserted NG tube is coiled in the esophagus and should be repositioned. " c1d445e0-e12b2962-8c7b6c32-c8baf914-088e821e.jpg,validate/p18/p18874436/s59202927/c1d445e0-e12b2962-8c7b6c32-c8baf914-088e821e.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old man with decompensated cirrhosis, Dobhoff for lactulose administration // Evaluate Dobhoff placement Evaluate Dobhoff placement IMPRESSION: Double tube tip is in the stomach. Stomach is substantially distended. There is interval increase in right lung opacification which is no completely opacified with the left mediastinal shift, findings which are consistent with substantial increase in the right pleural effusion potentially with some degree of atelectasis. Left lung is overall clear. There is no pneumothorax. There is no appreciable left pleural effusion. " 2d82d21e-45e2b9e0-f8e915d5-8cd53b9e-c230efd9.jpg,validate/p16/p16057835/s54507211/2d82d21e-45e2b9e0-f8e915d5-8cd53b9e-c230efd9.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Shortness of breath with increasing work of breathing in a patient with multifocal pneumonia. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size and mediastinum are unchanged. Bilateral pleural effusions and bibasal left more than right consolidations are unchanged. Left upper lung consolidation is redemonstrated, unchanged. There is no interval development of pneumothorax or pulmonary edema as well as no radiographic evidence of progressive worsening of the consolidations within the limitations of this study technique. " d0fa3018-cfd667d0-b1a147ee-162e398f-4b28e8b6.jpg,validate/p10/p10772100/s53880548/d0fa3018-cfd667d0-b1a147ee-162e398f-4b28e8b6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with Right MCA stroke // interval changes interval changes IMPRESSION: ET TUBE TIP IS CTS. NG TUBE TIP IS IN THE STOMACH. LEFT MEDIASTINUM IS IS UNCHANGED. MILD VASCULAR CONGESTION IS UNCHANGED. " 0c972388-ae1da0f5-901866a5-9b39d4a6-f467d2d5.jpg,validate/p14/p14749066/s57107770/0c972388-ae1da0f5-901866a5-9b39d4a6-f467d2d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with a history of CHF presenting with worsening dyspnea and dyspnea on exertion. Evaluate for evidence of CHF exacerbation. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear. SINCE ___ PULMONARY EDEMA HAS CLEARED. SEVERE ENLARGEMENT OF THE CARDIAC SILHOUETTE IS STABLE, CONSISTENT WITH CARDIOMEGALY AND/OR PERICARDIAL EFFUSION. STABLE MODERATE DISTENSION OF MEDIASTINAL VEINS SUGGESTS THAT IF PERICARDIAL EFFUSION IS PRESENT IT IS NOT HEMODYNAMICALLY SIGNIFICANT. Otherwise, the hilar and mediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No evidence of decompensated congestive heart failure. " 5bfdbbe6-92be7934-02a0a644-a5fcc70e-ed316053.jpg,validate/p10/p10476869/s51289697/5bfdbbe6-92be7934-02a0a644-a5fcc70e-ed316053.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post left thoracotomy, status post left upper lobectomy. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is now unchanged a normal post-surgical appearance of the left hemithorax with ___ in expected position and mild elevation of the left hemidiaphragm. No acute changes in the left lung parenchyma. Unchanged normal appearance of the right lung. " 342148b9-a14a6e4b-411ceb37-25e66d0e-af259b47.jpg,validate/p10/p10765644/s53707634/342148b9-a14a6e4b-411ceb37-25e66d0e-af259b47.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with complicated right pleural effusion status post chest tube placement. COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: Single frontal image of the chest demonstrates interval placement of a right-sided chest tube and reduction of right pleural effusion. There appears to be some gas in the right lower chest, likely represents a pocket of air within a loculated effusion. There is no evidence of pneumothorax or other complications. Cardiac silhouette is unchanged. IMPRESSION: Improvement in right pleural effusion status post chest tube placement. Otherwise, essentially unchanged chest radiograph from previous imaging. " 82b33d99-50216b09-149cb0b6-9180a785-fcf1ba3e.jpg,validate/p14/p14505714/s56305231/82b33d99-50216b09-149cb0b6-9180a785-fcf1ba3e.jpg,validation," 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. " ad9e9977-8cc4d30e-77bcf1f2-a75bbf99-b32d80e1.jpg,validate/p13/p13477622/s57525753/ad9e9977-8cc4d30e-77bcf1f2-a75bbf99-b32d80e1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with esophageal ca, POD___ s/p MIE // eval for PTX, conduit, and position of chest tubes, NGT COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient develops bilateral parenchymal areas of atelectasis, right more than left. Pneumoperitoneum after esophageal surgery is still visualized. There is no evidence for pneumothorax. Moderate cardiomegaly persists. No pulmonary edema. The nasogastric tube and the left cervical clips are constant in appearance. Unchanged appearance of the other monitoring and support devices. " 76e7553d-b059c7c8-744b02b0-1aa44a0d-69045adc.jpg,validate/p14/p14375008/s56848635/76e7553d-b059c7c8-744b02b0-1aa44a0d-69045adc.jpg,validation," 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. " fb01e2af-3d8b9c38-1ef3fa24-9b762273-4d831986.jpg,validate/p15/p15982138/s51870657/fb01e2af-3d8b9c38-1ef3fa24-9b762273-4d831986.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. 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. " 037b0605-747c0df0-a0db14a8-f6d34ca9-739d2c18.jpg,validate/p15/p15421124/s55692990/037b0605-747c0df0-a0db14a8-f6d34ca9-739d2c18.jpg,validation," FINAL REPORT HISTORY: Ovarian cancer, Cough and shortness of breath. COMPARISON: CT torso ___. FINDINGS: A large right pleural effusion is grossly similar to appearance on ___, after adjusting for differences in technique. The left lung is clear. Heart size is normal. IMPRESSION: Grossly stable size of a large right pleural effusion. " ed03f6bd-547cd5f9-01e9ecb4-aeb2281d-93e9409d.jpg,validate/p16/p16151261/s58286772/ed03f6bd-547cd5f9-01e9ecb4-aeb2281d-93e9409d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure s/p trach, copious secretions, evaluate after bronchoscopy ___ // evaluate for change post-bronch evaluate for change post-bronch COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Persistent left lower lobe collapse has not resolved since ___. Right lung and left upper lobe are clear. Pleural effusion is small if any. Heart size and mediastinum are normal. Tracheostomy tube midline. Left PIC line ends close to the superior cavoatrial junction. No pneumothorax. " 3994368b-54310e35-98615320-ec3ba851-8574db50.jpg,validate/p16/p16731058/s59069362/3994368b-54310e35-98615320-ec3ba851-8574db50.jpg,validation," FINAL REPORT HISTORY: ___-year-old female status post fall from ladder with known bilateral non-displaced rib fractures, assess for hemothorax. COMPARISON: Outside hospital chest CT from ___ and chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: The lungs are clear without confluent opacity. No pulmonary edema or pleural effusions are identified. Cardiomediastinal and hilar contours are within normal limits. Known numerous non-displaced primarily anterior rib fractures are not well characterized on this radiographic examination. IMPRESSION: No acute cardiopulmonary process. No pleural effusion to suggest hemothorax. " ba00ca5c-bc1d13cd-f94e0eb2-16ce130f-5a56dda1.jpg,validate/p18/p18251740/s52953840/ba00ca5c-bc1d13cd-f94e0eb2-16ce130f-5a56dda1.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old female with weakness. Evaluate for evidence of pneumonia. TECHNIQUE: PA and lateral chest radiographs COMPARISON: Prior chest radiograph from ___ and dating back to ___. FINDINGS: The lungs are well expanded and clear. Minimal leftward tracheal deviation has been present since at least the radiograph from ___ and may be related to goiter. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of acute cardiopulmonary process. " 7a0f90c8-d424d7f8-a6d3958b-cc51eb83-d9d3d086.jpg,validate/p16/p16926132/s58416683/7a0f90c8-d424d7f8-a6d3958b-cc51eb83-d9d3d086.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chest pain. FINDINGS: PA and lateral views of the chest. No prior. The lungs are clear of consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. Anterior cervicothoracic vertebral body hardware is visualized. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 1d4707ad-8703c966-1aa64564-a4aa7735-54fa4316.jpg,validate/p11/p11902171/s56969020/1d4707ad-8703c966-1aa64564-a4aa7735-54fa4316.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with PICC line reported to be 10cm out COMPARISON: ___ FINDINGS: AP portable upright view of the chest. Left upper extremity access PICC line is now seen with its tip projecting over the left clavicular head/neck, approximately ___-11 cm retracted from its previous location. Lungs remain clear. Clips are seen projecting over the right humerus. IMPRESSION: Retraction of the left PICC line now seen with its tip over the left clavicular head. " 65a1aba5-c1b4b501-5655da71-6eb4628c-bf125719.jpg,validate/p12/p12938515/s56787583/65a1aba5-c1b4b501-5655da71-6eb4628c-bf125719.jpg,validation," FINAL REPORT HISTORY: Pulmonary edema. FINDINGS: In comparison with the study of ___, the cardiac silhouette is at the upper limits of normal in size. There is some indistinctness of pulmonary vessels with Kerley lines, consistent with elevated pulmonary venous pressure. Right IJ catheter is unchanged. " 9e2c5469-3d350881-51e075d7-cac53bd5-b311db35.jpg,validate/p18/p18868527/s59088473/9e2c5469-3d350881-51e075d7-cac53bd5-b311db35.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with h/o UC s/p lap TAC w end ileostomy (___); lap proctectomy, j-pouch w loop ileostomy (___) s/p ileostomy takedown with low O2 sat, tachycardia, and low grade temperature // please evaluate for possible penumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs on ___ and ___ 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 is small volume pneumoperitoneum, consistent with recent abdominal surgery. IMPRESSION: No evidence of pneumonia. Small volume pneumoperitoneum is consistent with recent ileostomy take-down on ___. " 499bb691-a870a1f6-04eb8660-8523e964-df8bb1fb.jpg,validate/p17/p17318449/s57272372/499bb691-a870a1f6-04eb8660-8523e964-df8bb1fb.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with chills and weakness. COMPARISON: Chest x-ray from ___. FINDINGS: AP and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. Cardiac silhouette is mildly enlarged, similar to priors. Hypertrophic changes noted in the spine. Median sternotomy wires are again noted. IMPRESSION: No acute cardiopulmonary process. " f28bae3f-f4fc8fbf-74e70189-14e72c96-8d30b50c.jpg,validate/p17/p17288913/s56359048/f28bae3f-f4fc8fbf-74e70189-14e72c96-8d30b50c.jpg,validation," 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. " 3dd94746-7ca5c237-d62a5509-faf56ed2-f7e437d8.jpg,validate/p16/p16135813/s51370362/3dd94746-7ca5c237-d62a5509-faf56ed2-f7e437d8.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with ?new brain mass // ?infection TECHNIQUE: Chest PA and lateral IMPRESSION: As compared to ___ radiograph, appearance of the chest is similar with no new areas of consolidation to suggest the presence of pneumonia. " 0092a295-92d7ab7c-354e54a7-faec6a7a-3ddb9a6f.jpg,validate/p19/p19343087/s55170606/0092a295-92d7ab7c-354e54a7-faec6a7a-3ddb9a6f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval COMPARISON: Multiple chest radiographs, most recent ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The heart is somewhat smaller in size compared to ___, though still mildly enlarged. Moderate left pleural effusion is larger. Small right effusion has improved. Lung volumes remain low. There is a homogeneous area of opacification within the left lower lobe, likely atelectasis. No pneumothorax or pulmonary edema. IMPRESSION: Previously moderate left pleural effusion is larger and small right effusion has improved. Homogeneous area of opacification of the left lower lobe, likely atelectasis. Heart size is mildly enlarged, though smaller compared to ___. " e114315e-5ec36707-01fc9311-d416d631-a48cafd1.jpg,validate/p10/p10314252/s53271837/e114315e-5ec36707-01fc9311-d416d631-a48cafd1.jpg,validation," FINAL REPORT EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old woman with chest tightness and shortness of breath. Evaluate for evidence of pneumonia. TECHNIQUE: Chest PA and lateral. COMPARISON: Chest radiograph from ___. FINDINGS: Normal cardiomediastinal and hilar contours. Lungs are clear and mildly hyperinflated. Stable, moderate scoliosis. Normal pleural surfaces. IMPRESSION: No acute cardiopulmonary process. " 4f91d8b5-8edc06e2-3d1be753-1def49f7-e495ea8d.jpg,validate/p17/p17451713/s54404607/4f91d8b5-8edc06e2-3d1be753-1def49f7-e495ea8d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___F with nausea, mild ""trouble breathing"" // evaluate for pneumonia, acute process COMPARISON: Prior exam dated ___. FINDINGS: AP upright and lateral views of the chest provided. Again noted is a dextroscoliosis of the thoracic spine. The lungs appear hyperinflated and somewhat lucent suggesting underlying emphysema. No large effusion or pneumothorax. The cardiomediastinal silhouette is stable. No acute osseous injury. IMPRESSION: No acute findings. Hyperinflated lungs without superimposed acute process. " ded0625a-35f4fda8-91106ec1-7a3d10f3-de30a453.jpg,validate/p16/p16740922/s57990551/ded0625a-35f4fda8-91106ec1-7a3d10f3-de30a453.jpg,validation," WET READ: ___ ___ ___ 10:55 PM No acute cardiopulmonary process WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Post-operative fever, assessment for pneumonia. COMPARISON: No comparison available at the time of dictation. FINDINGS: The lung volumes are normal. Borderline size of the cardiac silhouette without pulmonary edema. No pneumonia, no pleural effusions. No pneumothorax. Normal hilar and mediastinal contours. " 246f113b-33ffb219-44787c21-3790d6bd-60b0a006.jpg,validate/p15/p15614172/s53554673/246f113b-33ffb219-44787c21-3790d6bd-60b0a006.jpg,validation," FINAL REPORT INDICATION: Altered mental status and lethargy. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. Chest radiograph from ___. PET-CT from ___. TECHNIQUE: AP and lateral views of the chest were obtained with a total of three exposures. FINDINGS: The lung volumes are low, and the patient is slightly rotated. There is a new retrocardiac opacity which obscures the left hemidiaphragm. No other focal opacities are identified. There is no pulmonary edema, pleural effusion, or pneumothorax. The aorta is tortuous and calcified, unchanged from prior exams. The heart size is mildly enlarged, and also unchanged from prior exams. IMPRESSION: Retrocardiac opacity. This may represent infection or atelectasis. " 15141b3d-130081f5-cdfbda2b-ac64123d-2958993f.jpg,validate/p13/p13992060/s55300989/15141b3d-130081f5-cdfbda2b-ac64123d-2958993f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ongoing cough of several weeks p/w syncope // r/o infection TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is normal. The mediastinal and hilar contours are remarkable for tortuosity of the thoracic aorta. The pulmonary vasculature is normal. Lungs are clear except for new peribronchiolar opacities in the retrocardiac portion of the left lower lobe. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: New peribronchial left lower lobe opacities are concerning for developing pneumonia or an acute aspiration event. " ad25cb61-9f5c8483-d8e51b5c-1ebb2340-33541bf0.jpg,validate/p10/p10287440/s52945262/ad25cb61-9f5c8483-d8e51b5c-1ebb2340-33541bf0.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: An ___-year-old woman with cough and low-grade lymphoma. IMPRESSION: PA and lateral chest compared to ___ through ___: Aside from minimal scarring in the right mid lung, lungs are clear. Heart size is normal. There is no evidence of central adenopathy or pleural abnormality. Moderate sized hiatus hernia is stable. " 150d61b5-d9c73aa3-dd91033e-f62ad3de-025adf0b.jpg,validate/p15/p15818567/s56004447/150d61b5-d9c73aa3-dd91033e-f62ad3de-025adf0b.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with nausea, vomiting and diarrhea for several days now with decreasing saturation. FINDINGS: Single portable view of the chest is compared to previous exam from ___. Exam is limited secondary to patient positioning, her chin overlies the right upper lung and jewelry obscures the left upper lung. There is suggestion of faint patchy opacity in the retrocardiac region. This could potentially represent atelectasis; however, developing consolidation is not excluded. Nodular opacity identified at the right lung base. Included visualization of the right lung is otherwise grossly clear. Cardiac silhouette is stable. Post-vertebroplasty changes identified in the lower thoracic spine. Osseous structures are otherwise grossly unremarkable. IMPRESSION: Possible left basilar atelectasis versus consolidation. Suggestion of nodule at the right lung base. When patient is amenable, two-view chest may help further characterize these findings. " 39cd42e6-e138160d-9bea72b3-2c307a9e-7f4a266b.jpg,validate/p11/p11372885/s59009398/39cd42e6-e138160d-9bea72b3-2c307a9e-7f4a266b.jpg,validation," FINAL REPORT INDICATION: History: ___F with sob, cough // ? pneumonia TECHNIQUE: Two views COMPARISON: ___ FINDINGS: Lungs: The lungs are well inflated. Minimal patchy density seen in the right base. The right hilus in suprahilar region is not well delineated and there is increased density when compared to the previous study. Pleura: No pleural effusion is seen. Heart: The heart is not enlarged. Mediastinum and hila: There is no mediastinal mass. Osseous structures: The osseous structures are normal for age. Other findings: None IMPRESSION: Right does suprahilar parahilar infiltrate is well as minimal patchy density in the right base. " 0b6820f6-fc04a4d8-01b00779-3c9114d8-b6593360.jpg,validate/p16/p16912984/s51249103/0b6820f6-fc04a4d8-01b00779-3c9114d8-b6593360.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p CABG // eval for effusion eval for effusion IMPRESSION: In comparison with the study of ___, there again are low lung volumes. Cardiac silhouette is enlarged, but there is no evidence of vascular congestion. Opacification at the left base most likely reflects a combination of pleural fluid and volume loss in the left lower lobe. However, in the appropriate clinical setting, the possibility of superimposed pneumonia would have to be considered. " 320d9097-ad294b32-7a428baa-73e648d1-47964156.jpg,validate/p19/p19904800/s56730999/320d9097-ad294b32-7a428baa-73e648d1-47964156.jpg,validation," WET READ: ___ ___ ___ 9:38 AM No pneumothorax or pleural effusion. The right Port-A-Cath again appears to be kinked, similar to the prior exam from ___. WET READ VERSION #1 ___ ___ ___ 10:13 PM No pneumothorax or pleural effusion. The right Port-A-Cath again appears to be kinked, similar to the prior exam from ___. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with port for chemotherapy. Evaluate for pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___. FINDINGS: Compare ___, there is no significant change.Heart size is within normal limits.Mediastinal and hilar lymphadenopathy previously seen on CT from ___, is not well seen on this exam. There is no evidence for pulmonary edema, pulmonary consolidation, pleural effusion, or pneumothorax.Right-sided Port-A-Cath is mostly unchanged, now located between posterior fourth and fifth rib space, previously between fifth and sixth. The tip of the Port-A-Cath is likely in mid SVC, unchanged from prior. There continues to be kinked appearance of the catheter near the clavicle. IMPRESSION: No pneumothorax. No significant short-term interval change. " 7de1d2bf-bc8f6cfe-14771eb4-b2f7f273-65660861.jpg,validate/p10/p10320599/s57140965/7de1d2bf-bc8f6cfe-14771eb4-b2f7f273-65660861.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cancer s/p thoracentesis and development of small PTX. // Evaluate for larger PTX Evaluate for larger PTX IMPRESSION: Compared to chest radiographs since ___ most recently ___. Large region of consolidation in the right midlung has progressed since thoracentesis on ___ and a new region has developed at the right lung base suggesting multifocal pneumonia or pulmonary hemorrhage. Small right apical pneumothorax unchanged. Small right pleural effusion increased. " ec887931-ecd73d95-9837e77b-08917adb-fdc8ad32.jpg,validate/p14/p14753846/s56081041/ec887931-ecd73d95-9837e77b-08917adb-fdc8ad32.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Hemoptysis, assessment for pneumonia or pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, all pre-existing parenchymal opacities have almost completely cleared. Moderate cardiomegaly persists. Minimal atelectasis in the retrocardiac lung regions. No other changes. " fa996a42-44c475ce-d496e037-e781b057-e243c9f5.jpg,validate/p16/p16296993/s53011402/fa996a42-44c475ce-d496e037-e781b057-e243c9f5.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: ___-year-old woman with asthma exacerbation and possible lung infiltrate. IMPRESSION: AP chest compared to ___: Small region of opacification at the left lung base is more likely atelectasis than pneumonia. Severe cardiomegaly is more pronounced. There is no pulmonary edema. Pleural effusion is small if any, on the left. No pneumothorax. " 09936501-17577b1b-7fc9e459-333b2836-0773aba1.jpg,validate/p14/p14145108/s51854756/09936501-17577b1b-7fc9e459-333b2836-0773aba1.jpg,validation," 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. " 42828320-0e8f42ed-7b878504-c9619e8f-3760e6f9.jpg,validate/p19/p19398915/s55235408/42828320-0e8f42ed-7b878504-c9619e8f-3760e6f9.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with cirrhosis, for pre-liver transplant evaluation. COMPARISON: None. FINDINGS: Frontal and lateral radiographs of the chest demonstrate complete opacification of the right hemithorax consistent with a combination of pleural effusion and collapse of the right lung. There is no shift of the mediastinum. The left lung is clear. There is no pneumothorax. IMPRESSION: Complete opacification of the right hemithorax consistent with a combination of pleural effusion and collapse of the right lung. COMMENTS: These findings were discussed with ___ (transplant nurse) by Dr. ___ ___ telephone at 3:20pm on ___, 1 hour after discovery. " b3915925-9a483e4b-705af5ab-e5611e60-14cf0ff8.jpg,validate/p15/p15005501/s53887580/b3915925-9a483e4b-705af5ab-e5611e60-14cf0ff8.jpg,validation," 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. " 1dc234ca-e5772bbf-bc252ee9-9c59b726-017004dd.jpg,validate/p16/p16453939/s55699267/1dc234ca-e5772bbf-bc252ee9-9c59b726-017004dd.jpg,validation," FINAL REPORT INDICATION: ___F with early dementia and multiple prior SAH/cerebral aneurysm was found agonal breathing by her husband and is thought to be septic from a GI source. // please eval for interval change 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 a few cm. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces. " 5cff9491-c426304d-3307b95b-7aeeec42-25652b06.jpg,validate/p14/p14709712/s58049151/5cff9491-c426304d-3307b95b-7aeeec42-25652b06.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man diabetic, vasculopath s/p recent aortofemoral bypass with L calf graft and L heel ulcer who p/w AMS, hypotension now with SOB, chest heaviness // eval for pna, pulm edema, pneumothorax eval for pna, pulm edema, pneumothorax IMPRESSION: Comparison to ___. No relevant change. Mild elevation of the right hemidiaphragm. Moderate cardiomegaly. No pulmonary edema. No pneumonia, no pleural effusions. Stable appearance of the right internal jugular " 9e6da287-66b7afc0-19b8b623-2ef9be10-f7d2ea64.jpg,validate/p17/p17501651/s50011073/9e6da287-66b7afc0-19b8b623-2ef9be10-f7d2ea64.jpg,validation," FINAL REPORT INDICATION: History: ___M with intubation TECHNIQUE: Semi-upright AP view of the chest COMPARISON: Scout view from CTA head ___ at 15:53 FINDINGS: Endotracheal tube tip terminates approximately 5 cm from the carina. An enteric tube tip is within the stomach. The heart size is normal. Mediastinal and hilar contours are unremarkable. There is mild pulmonary vascular congestion with trace left pleural effusion. Patchy atelectasis is likely present in the lung bases. No pneumothorax is identified. No acute osseous abnormalities are present. Punctate radiopaque densities are seen projecting over the left axilla, not seen on the scout view from the previous head CTA. IMPRESSION: 1. Standard positioning of the endotracheal and enteric tubes. 2. Mild pulmonary vascular congestion and trace left pleural effusion. 3. Punctate radiopaque densities projecting over the left axilla, likely external to the patient, as these were not seen on the scout view from the previous head CTA. " 4d8392c8-7530e1e9-ed311b53-96124daa-b1f8d970.jpg,validate/p17/p17525907/s52640635/4d8392c8-7530e1e9-ed311b53-96124daa-b1f8d970.jpg,validation," FINAL REPORT INDICATION: Influenza like illness with hemoptysis. COMPARISON: None. FINDINGS: PA and lateral views of the chest were reviewed. The lungs are clear without focal consolidation, pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: No radiographic evidence of pneumonia. COMMENT: Findings were telephoned to ___ by Dr. ___ at 2:34, 20 minutes after the time of discovery. " 7fcf0384-53f17b91-91afa88f-17b67d6a-1cd16eec.jpg,validate/p15/p15623355/s50172343/7fcf0384-53f17b91-91afa88f-17b67d6a-1cd16eec.jpg,validation," 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. Lungs are essentially clear. There is no pleural effusion or pneumothorax. " dd09f22c-0d9e8428-b6f63734-d051385b-1adc9477.jpg,validate/p18/p18705015/s50910143/dd09f22c-0d9e8428-b6f63734-d051385b-1adc9477.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough, malaise // r/o PNA, effusion, mass 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. " db648201-c2b025e3-6946db45-6bd8bcca-71ed3bf5.jpg,validate/p17/p17133357/s58325150/db648201-c2b025e3-6946db45-6bd8bcca-71ed3bf5.jpg,validation," 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. " fc540df5-793e985c-3cecc663-90a65109-b1a701ee.jpg,validate/p17/p17981662/s54975447/fc540df5-793e985c-3cecc663-90a65109-b1a701ee.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: New left ventricular lead, evaluation of lead placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The new lead is in unchanged position. A linear structure seen on yesterday's radiograph is no longer visible and there currently is no safe evidence for pneumothorax. No pleural effusions. Normal size of the cardiac silhouette. No pulmonary edema. " 6524ef78-d846d5c1-c54cb292-5cfae5a5-51f0f991.jpg,validate/p14/p14349552/s54990919/6524ef78-d846d5c1-c54cb292-5cfae5a5-51f0f991.jpg,validation," FINAL REPORT HISTORY: Patient with cough, rule out pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Bilateral perihilar regions appear less well aerated with slightly increased opacification. The heart is mildly enlarged. The mediastinal and hilar contours are stable. There is no pleural effusion, pneumothorax, or pulmonary edema. IMPRESSION: Possible perihilar pneumonia. Oblique views may be obtained for confirmation now, otherwise we suggest a repeat study in 24 hours if patient does not declare clinically. " f3b79ddb-e1f88ba8-c7e239a6-7d4ef68f-daa6efd0.jpg,validate/p14/p14808365/s59768654/f3b79ddb-e1f88ba8-c7e239a6-7d4ef68f-daa6efd0.jpg,validation," FINAL REPORT INDICATION: Status post right internal jugular line placement. COMPARISON: None available. FINDINGS: A portable frontal chest radiograph demonstrates a right internal jugular line, with the tip terminating in the distal SVC. A device projecting over the left scapula may represent a nerve stimulator. Lung volumes are low, with bibasilar atelectasis. The cardiomediastinal silhouette is prominent, also likely related to low lung volumes. The visualized upper abdomen is unremarkable. IMPRESSION: 1. Right internal jugular line terminating in the distal SVC. 2. Low lung volumes, with prominence of the cardiac silhouette and bibasilar atelectasis. Superimposed consolidation cannot be excluded. " 6404e974-084b93aa-b208b613-51f64491-9e2b40d9.jpg,validate/p14/p14648269/s54553509/6404e974-084b93aa-b208b613-51f64491-9e2b40d9.jpg,validation," FINAL REPORT INDICATION: Cough and shortness breath. Evaluate pneumonia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. Chest radiograph from ___. FINDINGS: On the lateral view only, there is a linear opacity projecting posteriorly at the base. This is new from the prior lateral radiograph. It does not have a definite correlate on the frontal radiograph, though may represent an early pneumonia. The rest of the lungs are clear. There is no pulmonary edema, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Possible lower lobe pneumonia, seen only on the lateral view, as described above. NOTIFICATION: The findings were discussed by Dr. ___ with the medical student caring for the patient in person on ___ at 2:15 AM, 2 minutes after discovery of the findings. " 38a6d21d-d6d10ac8-92c9907e-a0bf52bc-b7c774c7.jpg,validate/p17/p17444669/s51552380/38a6d21d-d6d10ac8-92c9907e-a0bf52bc-b7c774c7.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with pre-syncope, pls eval for pna vs edema // History: ___M with pre-syncope, pls eval for pna vs edema TECHNIQUE: Chest PA and lateral COMPARISON: None available. 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. " 62e3674d-afac250f-d811c679-b3d23831-079443b5.jpg,validate/p15/p15270331/s58455857/62e3674d-afac250f-d811c679-b3d23831-079443b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic clear cell uterine cancer with lung metastases now with new fever // Evidence of infection Evidence of infection COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: There is no pneumonia, pneumothorax, pleural effusion or pulmonary edema. Lungs are filled multiple large metastases, unchanged since at least ___. Subcarinal adenopathy is substantial. Heart size normal. New right supraclavicular central venous catheter ends in the low SVC. " 78de6636-41f2a21f-2578c352-5ffffb4b-bc003e91.jpg,validate/p16/p16088589/s53939537/78de6636-41f2a21f-2578c352-5ffffb4b-bc003e91.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion s/p chest tube removal // CT out, please evaluate for interval change. Please perform exam at ___ on ___. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: Chest radiograph ___ FINDINGS: There has been interval removal of a right-sided chest strain. No pneumothorax seen. Lung volumes remain low particularly on the right. No consolidation or pneumothorax seen. Tiny right pleural effusion. Previous median sternotomy and coronary artery bypass graft noted. Old fracture of the right surgical neck of humerus is again seen. IMPRESSION: No pneumothorax seen following chest drain removal. " 97c55a2d-7adb9d72-61a20bba-83adf6c0-7b8103bf.jpg,validate/p13/p13174810/s58984255/97c55a2d-7adb9d72-61a20bba-83adf6c0-7b8103bf.jpg,validation," FINAL REPORT CHEST HISTORY: Trauma. FINDINGS: The heart is mildly enlarged. There is dense retrocardiac opacity compatible with volume loss/infiltrate/effusion. There is new tracheostomy tube in good location. Left-sided chest tube is again visualized. There is a small left apical pneumothorax. The fractured left first and second ribs are again visualized. The right IJ line, right chest tube, right lateral pleural-based opacity are unchanged. There is increased volume loss in the right lower lobe and right middle lobe. " d1871dea-b2050102-dc842e4b-7ca11638-c516aa54.jpg,validate/p17/p17824494/s56711851/d1871dea-b2050102-dc842e4b-7ca11638-c516aa54.jpg,validation," FINAL REPORT HISTORY: Bilateral lower extremity swelling, history of cancer and left upper extremity swelling. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___, ___. FINDINGS: Heart size is moderately enlarged. Mediastinal contours unremarkable. Hyperinflation of the lungs is suggestive of underlying chronic obstructive pulmonary disease. Large left pleural effusion is noted with retrocardiac opacity likely reflective of atelectasis. Infection is not excluded. No pneumothorax is noted. Mild pulmonary vascular congestion may be present. The right lung is grossly clear. No acute osseous abnormalities seen. Multiple left axillary clips are demonstrated. IMPRESSION: Large left pleural effusion with left basilar opacity likely reflective of atelectasis though infection is not excluded. Probable mild pulmonary vascular congestion. " 5c5c4d61-2662c381-6606e68a-b27aa900-6dcc0fef.jpg,validate/p19/p19484821/s50384882/5c5c4d61-2662c381-6606e68a-b27aa900-6dcc0fef.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with 36 hours anuria. TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph, ___ chest CTA FINDINGS: Lungs are hyperinflated with emphysematous changes again noted, most pronounced in the lung apices. Cardiac, mediastinal and hilar contours are unchanged without evidence for pulmonary edema. Known esophageal malignancy is better assessed on the prior CT. Streaky opacities in the lung bases may reflect aspiration, atelectasis or infection. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities identified. IMPRESSION: Bibasilar patchy opacities could reflect aspiration, atelectasis or infection. Severe emphysema. Known esophageal malignancy better assessed on prior CT. " 2d4f7c91-c052b541-cd2dcce1-2bd21de4-b3d04161.jpg,validate/p13/p13224377/s54915675/2d4f7c91-c052b541-cd2dcce1-2bd21de4-b3d04161.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with AML s/p cord transplant day +6 with AMS concerning for infectious process. // ? Pulmonary infiltrate TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates very low lung volumes which results in bronchovascular crowding. Extensive bilateral infiltrates are consistent with multifocal pneumonia and/or pulmonary edema. Bibasilar atelectasis with likely small bilateral pleural effusions are new over the interval. Cardiomediastinal and hilar contours are unchanged. The tunneled central venous line the mid SVC. IMPRESSION: 1. Extensive bilateral infiltrates are consistent with multifocal pneumonia and/or pulmonary edema. 2. Bibasilar atelectasis with likely small bilateral pleural effusions are new over the interval. " 6d2f86b1-bbea7de8-1fc821c0-beada8be-098dcd4b.jpg,validate/p10/p10250159/s58366619/6d2f86b1-bbea7de8-1fc821c0-beada8be-098dcd4b.jpg,validation," FINAL REPORT INDICATION: Cough and chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Cardiac silhouette size is top normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is visualized. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. " a165e5d7-25acadf8-b5b77b5a-a99f5df8-2f443ea1.jpg,validate/p14/p14887253/s52640189/a165e5d7-25acadf8-b5b77b5a-a99f5df8-2f443ea1.jpg,validation," FINAL REPORT HISTORY: Persistent cough after recent hospital acquired pneumonia. COMPARISON: Chest radiographs from ___, ___, and ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a left-sided PICC with the tip in the low SVC and a normal cardiomediastinal silhouette. A retrocardiac opacity is persistent but improved compared to ___. There is no new focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: Persistent but improved left lower lobe pneumonia. No new focal consolidation. A preliminary read was provided by Dr. ___ to Dr. ___ at ___ on ___. " 28538916-a546a3cc-a7249c1c-90cf3099-3d119ef5.jpg,validate/p15/p15510911/s56425269/28538916-a546a3cc-a7249c1c-90cf3099-3d119ef5.jpg,validation," FINAL REPORT TECHNIQUE: Frontal chest radiographs. COMPARISON: Chest radiographs from ___. CT examination from ___. FINDINGS: The patient is slightly rotated. An endotracheal tube terminates approximately 4.2 cm above the carina. A left subclavian central venous catheter terminates at the lower SVC. An orogastric tube extends to the stomach. The heart size is normal. The hilar and mediastinal contours are within normal limits. A trace left pneumothorax is incidentally noted. Bilateral thoracostomy tubes are appropriately positioned. IMPRESSION: Trace left pneumothorax. Bilateral thoracostomy tubes are appropriately positioned. " bed38592-d1a5e571-b437c014-7cc3da3c-36dce362.jpg,validate/p14/p14661372/s52957169/bed38592-d1a5e571-b437c014-7cc3da3c-36dce362.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with prolonged cough and right lower lobe crackles. COMPARISONS: ___ to ___. FINDINGS: The lungs are well inflated and clear. No focal consolidation, effusion, or pneumothorax is present. The cardiac and mediastinal contours are normal. IMPRESSION: Normal chest radiograph. Findings were discussed with Dr. ___ via telephone at ___ on ___. " 766a5fcd-2f67ed59-a4c85f6b-ef3918cf-e24a1e08.jpg,validate/p17/p17593711/s53935798/766a5fcd-2f67ed59-a4c85f6b-ef3918cf-e24a1e08.jpg,validation," FINAL REPORT INDICATION: COPD and worsening shortness of breath. COMPARISON: Chest radiograph ___. FINDINGS: The heart size is normal. The mediastinal contours are unremarkable. There is new fullness in the AP window concerning for lymphadenopathy. There is no pleural effusion or pneumothorax. A partly circumscribed soft tissue density mass measuring approximately 2.8 cm in maximum diameter in the left lower lung zone is new since the prior study. Slightly increased opacity of the right lower lung is also present. Pulmonary vasculature is within normal limits. Multiple new compression deformities with resultant kyphosis is present in the thoracic spine. There is stable appearance of an ovoid densely calcified focal lesion in the right humeral metadiaphysis, consistent with an enchondroma. IMPRESSION: 1. New fullness in the AP window, concerning for lymphadenopathy as well as a large nodule in the left lower lung. Chest CT is recommended for further evaluation. 2. Slight increased opacity at the right lower lobe, which may represent infection. 3. New compression deformities in the thoracic spine. Dr. ___ ___ these recommendations into the Critical Results Dashboard on ___ at 4:30 PM. " d5250217-f5dec6da-55602365-ff708115-eb361d7a.jpg,validate/p14/p14816630/s51389776/d5250217-f5dec6da-55602365-ff708115-eb361d7a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p cardiac surgery, CTs d/c'd // evaluate for pneumothorax evaluate for pneumothorax IMPRESSION: There to chest radiographs ___ through ___:04. Postoperative appearance of the large heart and widened upper mediastinum is stable. Left lower lobe still collapsed. Moderate left pleural effusion has increased following removal of the left pleural drain. No pneumothorax. No appreciable right pleural effusion. " 175ab7df-1ef590e8-435a1548-f2c8ba4f-11c53749.jpg,validate/p19/p19960115/s55981954/175ab7df-1ef590e8-435a1548-f2c8ba4f-11c53749.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with for Dobhoff placement // tachycardia tachycardia COMPARISON: Prior chest radiographs ___. IMPRESSION: Lung volumes remain quite low, exaggerating the severity of minimal residual edema. Combination of moderate right lower lobe atelectasis and some right pleural effusion has improved since ___, stable since ___. Mild cardiomegaly is unchanged. Tracheostomy tube in standard placement. Feeding tube passes into the stomach and out of view. No pneumothorax. " 1e0b0c73-71a2e5a1-ee7a49c1-c6d1216d-9bcfdfa3.jpg,validate/p17/p17001135/s50466893/1e0b0c73-71a2e5a1-ee7a49c1-c6d1216d-9bcfdfa3.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph. Chest CTA ___ at 20: ___. FINDINGS: S-shaped thoracolumbar scoliosis is again demonstrated. Heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is identified. Pulmonary vascularity is normal. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 55756cd8-e59ea474-86a6d0e5-7ca733dc-03fb8b85.jpg,validate/p12/p12800722/s59588157/55756cd8-e59ea474-86a6d0e5-7ca733dc-03fb8b85.jpg,validation," FINAL REPORT INDICATION: Altered mental status. Evaluate for pneumonia. COMPARISON: Chest radiograph from ___. TECHNIQUE: AP and lateral views of the chest were obtained. FINDINGS: The lung volumes are low. There is no focal airspace consolidation, pulmonary edema, pleural effusions or pneumothorax. The mediastinal contours are normal. The heart size is moderately enlarged, and unchanged. IMPRESSION: 1. No acute cardiopulmonary process. 2. Stable moderate cardiomegaly. " dd705480-878e445d-f8e0d13f-57a6cc63-1d5cb1ed.jpg,validate/p19/p19995210/s59552720/dd705480-878e445d-f8e0d13f-57a6cc63-1d5cb1ed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with hypoxia, anxiety, LOC wtih headstrike // 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. " 9463e438-92961ce9-a3dc5c33-29a4970e-2dc10618.jpg,validate/p17/p17268630/s59871718/9463e438-92961ce9-a3dc5c33-29a4970e-2dc10618.jpg,validation," 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. " 9a5306f8-3aa00722-7e295ade-189db650-90c13ab8.jpg,validate/p17/p17604134/s57776509/9a5306f8-3aa00722-7e295ade-189db650-90c13ab8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea // eval heart and lungs TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are clear.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. Left humeral head prosthesis is partially imaged. IMPRESSION: No acute cardiopulmonary process. " 93be0b44-6370f8cd-72514bb2-d0fde8b9-b8a43701.jpg,validate/p18/p18016603/s51106928/93be0b44-6370f8cd-72514bb2-d0fde8b9-b8a43701.jpg,validation," FINAL REPORT INDICATION: Syncope, dizziness, right leg swelling and pain. Assess for acute cardiac or pulmonary process. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Lung volumes are slightly low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. There is subsegmental left mid and lower lung linear atelectasis. The lungs are otherwise clear. Mild-to-moderate cardiomegaly is not significantly changed compared to the radiographs from ___. There are no pleural effusions. No pneumothorax is seen. Aortic calcifications are re-demonstrated. Multilevel degenerative changes of the thoracolumbar spine are again seen. Heterotopic calcification in the left cervical region could be within the left common carotid artery, unchanged. IMPRESSION: 1. No acute cardiac or pulmonary process. 2. Mild-to-moderate cardiomegaly, not significantly changed. " 733b79ca-2acd5741-045d6d45-a7be14e0-20510440.jpg,validate/p12/p12210893/s59895285/733b79ca-2acd5741-045d6d45-a7be14e0-20510440.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with malaise, nausea. COMPARISON: None FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are 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 " bc015490-6ad4ec20-3daa1f25-90b06b90-1265fa31.jpg,validate/p16/p16960594/s56881631/bc015490-6ad4ec20-3daa1f25-90b06b90-1265fa31.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain and dyspnea. COMPARISON: ___. FINDINGS: PA and lateral views of the chest demonstrate well-expanded and clear lungs. The heart is normal in size and cardiomediastinal contour is stable. There is no pleural effusion or pneumothorax. IMPRESSION: No evidence of pneumonia. " 853571d3-7f394938-f8af19e8-45dabe45-ce22cf51.jpg,validate/p13/p13637250/s55718805/853571d3-7f394938-f8af19e8-45dabe45-ce22cf51.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: Chest tightness, nausea, vomiting and upper back 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. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " c91de89d-406e97b7-102b2eb9-e8f2bff7-c1fc1b02.jpg,validate/p13/p13270008/s55664506/c91de89d-406e97b7-102b2eb9-e8f2bff7-c1fc1b02.jpg,validation," FINAL REPORT INDICATION: History of ankle fracture. Evaluate for preop surgery. COMPARISON: Chest radiograph from ___. FINDINGS: Single portable chest radiograph was provided. Lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact. IMPRESSION: No acute cardiopulmonary process. " 0b2509bb-39b168be-df1c91af-ce9597f9-ac9ce957.jpg,validate/p17/p17254594/s51916128/0b2509bb-39b168be-df1c91af-ce9597f9-ac9ce957.jpg,validation," FINAL REPORT HISTORY: COPD, increased sputum, wheezing throughout, elevated BNP and possible NSTEMI. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: The heart size appears mildly enlarged, unchanged. Mediastinal contours are unremarkable. Perihilar haziness is noted with mild pulmonary vascular congestion. Focal patchy opacity within the right upper to mid lung field is again noted. Patchy opacity is also demonstrated within the left lung base. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. Bilateral breast implants are re- demonstrated. IMPRESSION: Mild pulmonary vascular congestion. Patchy opacities within the left lung base and right upper to mid lung field are nonspecific, and could reflect areas of infection. " 79a5bb53-199466e2-cf2bd495-759e0eb0-3993bacc.jpg,validate/p18/p18068831/s57134562/79a5bb53-199466e2-cf2bd495-759e0eb0-3993bacc.jpg,validation," FINAL REPORT INDICATION: Fall with trauma and pain over chest. COMPARISON: No prior studies available for comparison. FINDINGS: Chest PA and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. Lungs are clear. No pleural effusion or pneumothorax is evident. No displaced rib fractures identified. IMPRESSION: No acute intrathoracic process. " 93eadce9-96221756-7f94cbcd-f525746d-22d1caf9.jpg,validate/p14/p14047315/s50311629/93eadce9-96221756-7f94cbcd-f525746d-22d1caf9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH, being cooled, paralyzed for increased ICPs // assess tubes and lungs assess tubes and lungs COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Moderate right and small left pleural effusions are new and/or increased. Heart size is top-normal. Severe consolidation in the lower lungs unchanged. Heart size normal. No pneumothorax. ET tube, left subclavian line, and nasogastric tube are all in standard placements respectively " bed9ba90-d7ec59a3-0c21ee53-a152aa48-b484fe60.jpg,validate/p13/p13365915/s57854794/bed9ba90-d7ec59a3-0c21ee53-a152aa48-b484fe60.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain. FINDINGS: Portable AP upright chest radiograph provided. The lungs are clear. No focal consolidation, effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air is seen below the right hemidiaphragm. " 81efea13-cd5a6d35-fb07541f-7f4a17c9-87e2984c.jpg,validate/p15/p15346117/s50757923/81efea13-cd5a6d35-fb07541f-7f4a17c9-87e2984c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with ___ edema and elevated JVP. // volume overload? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Right-sided PICC is seen, low in position, appears to terminate in the deep right atrium, possibly extending into the IVC. The cardiac and mediastinal silhouettes are stable. There is moderate pulmonary edema. Scattered areas of atelectasis are noted including in the left mid lung and right lung base. No large pleural effusion is seen. No evidence of pneumothorax. IMPRESSION: Moderate pulmonary edema. Low lying PICC extends at least into the deep right atrium. RECOMMENDATION(S): Recommend withdrawal of PICC by approximately 6 cm and then repeat chest radiograph to assess position. NOTIFICATION: Low lying PICC position discussed with Dr. ___ at 21:45 on ___ via telephone by Dr. ___. " 216d37c0-2c5368e0-c8894725-28e8905d-aba07e3b.jpg,validate/p16/p16518293/s51096707/216d37c0-2c5368e0-c8894725-28e8905d-aba07e3b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Radical cystectomy, preoperative chest x-ray. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of lung parenchymal abnormality. No pleural effusions. " d73bd4b6-549c89ab-b25e6c1e-1b6b91fd-55d380fd.jpg,validate/p11/p11453452/s51665165/d73bd4b6-549c89ab-b25e6c1e-1b6b91fd-55d380fd.jpg,validation," WET READ: ___ ___ ___ 8:45 AM Lung volumes are decreased. There is mild pulmonary vascular congestion. Blunting of the left costophrenic angle is worse as compared to prior and could reflect effusion and or atelectasis. WET READ VERSION #1 ___ ___ ___ 9:26 PM Lung volumes are decreased. There is mild pulmonary vascular congestion. Blunting of the left costophrenic angle is worse as compared to prior and could reflect effusion and or atelectasis. WET READ VERSION #2 ___ ___ 8:32 AM Lung volumes are decreased. There is mild pulmonary vascular congestion. Blunting of the left costophrenic angle is worse as compared to prior and could reflect effusion and or atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with diastolic disfunction s/p Ventral Hernia repair with low oxygen saturation // R/o pulmonary process R/o pulmonary process COMPARISON: Comparison to prior study dated ___ at ___ FINDINGS: Portable AP upright chest film ___ at 18 58 is submitted. IMPRESSION: Lung volumes are low with bibasilar patchy opacities likely reflecting atelectasis, although pneumonia or aspiration cannot be entirely excluded. There is likely a small layering left effusion. Given the low lung volumes, assessment of the cardiac and mediastinal contours is difficult. There is crowding of the pulmonary vasculature with no overt pulmonary edema appreciated. No pneumothorax. " b59422ab-d48b7ba3-35e62db9-0e41dc01-1f11a031.jpg,validate/p13/p13035993/s58891375/b59422ab-d48b7ba3-35e62db9-0e41dc01-1f11a031.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with dizziness. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. Blunting of lateral costophrenic angles is thought to be due to overlying soft tissues. Posterior costophrenic angles are sharp without evidence of effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unchanged, noting degenerative changes at the glenohumeral joints bilaterally. IMPRESSION: No acute cardiopulmonary process. " c05d8a90-1f901864-f6f6c5a5-fe1fbd1b-4428b3ae.jpg,validate/p14/p14376085/s52827580/c05d8a90-1f901864-f6f6c5a5-fe1fbd1b-4428b3ae.jpg,validation," FINAL REPORT INDICATION: ___M with chest crackles on exam, chest pain. // Evaluate for pneumonia TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: There is mild pulmonary vascular congestion without overt edema. There is no focal consolidation or large effusion. There is moderate cardiac enlargement and a coronary artery stent identified. Atherosclerotic calcifications are noted in the thoracic aorta. Degenerative changes are noted at the left shoulder. IMPRESSION: Pulmonary vascular congestion and cardiomegaly without focal consolidation or overt edema. " 1f0ea91b-cc535202-83d10136-8d9d2fb7-8ce7ec38.jpg,validate/p11/p11194247/s53292412/1f0ea91b-cc535202-83d10136-8d9d2fb7-8ce7ec38.jpg,validation," FINAL REPORT AP CHEST, 10:55 A.M. ON ___ HISTORY: Lung mass following biopsies. IMPRESSION: AP chest compared to ___: Right lung might be collapsed around the large right upper lobe mass. There is no pneumothorax or pleural effusion. Left lung is clear, and the heart size is normal. " c8982d1e-5e5cebbb-dddc9044-da5408b5-e67283d9.jpg,validate/p11/p11842879/s53848103/c8982d1e-5e5cebbb-dddc9044-da5408b5-e67283d9.jpg,validation," FINAL REPORT HISTORY: Dermatomyositis and shortness of breath. COMPARISON: ___. FINDINGS: AP and lateral views of the chest again demonstrate dense right lower lobe consolidation, which appears increased in size since the prior study. New since the prior study is a left lower lobe consolidation which may represent atelectasis or developing pneumonia. Lung volumes are decreased since the prior study. Cardiac size is normal accounting for difference in technique. The hilar and mediastinal contours are within normal limits. No pleural effusion or pneumothorax. Pocket of air in the left upper quadrant is extraluminal, as seen on the recent abdomen CT. IMPRESSION: Enlarged right lower lobe opacity and new left lower lobe opacity concerning for new pneumonia or atelectasis. Extraluminal free-air in the left upper quadrant seen on the recent CT. " e845a61d-58538f92-306be1ed-847462eb-db05aeeb.jpg,validate/p17/p17636445/s58191022/e845a61d-58538f92-306be1ed-847462eb-db05aeeb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: heart failure, asymmetric crackles on exam // ? pulmonary edema, effusion ? pulmonary edema, effusion IMPRESSION: Comparison with the study of ___, there is continued enlargement of the cardiac silhouette. The pulmonary vasculature is essentially within normal limits. No evidence of acute pneumonia or pleural effusion. " 1cf007f5-ede5b945-ae828a2c-a3c512d9-9b0618e3.jpg,validate/p12/p12435705/s59988680/1cf007f5-ede5b945-ae828a2c-a3c512d9-9b0618e3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusion, b/l PNA, chest tube in place // chest tube placement, interval changes TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. Bibasal consolidations appear to be unchanged but there is overall improvement in pulmonary edema. No pneumothorax is seen. " a4bb268e-ad8e5055-ef620ea8-bf791fd8-59a258eb.jpg,validate/p13/p13622559/s59464853/a4bb268e-ad8e5055-ef620ea8-bf791fd8-59a258eb.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with HIV and possible small-bowel obstruction, NG tube placement. FINDINGS: AP single view of the chest has been obtained with patient in supine position. An NG tube is seen to pass through the esophagus and reaching well into the stomach area. However, the line is folded up and reverses so that the tip is located still in the lower esophagus. Adjustment of tube position preferentially under fluoroscopic control is recommended. In the abdominal area, rather marked gas distended large bowel loops are identified. This speaks against the clinical assumption of small-bowel obstruction. No acute pulmonary infiltrates are seen, and short of a thin plate atelectasis on the left base. " 4d31cde5-94cb3669-7c068681-616e9e29-663dcc6d.jpg,validate/p14/p14591676/s59812882/4d31cde5-94cb3669-7c068681-616e9e29-663dcc6d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with hx of recurrent pleural effusion // pleural effusion pleural effusion IMPRESSION: Compared to chest radiographs ___ through ___. Large left pleural effusion has increased in volume, obscuring the cardiac apex, but there is no contralateral mediastinal shift, indicating severe left basal atelectasis has worsened to an equivalent degree. Right lung clear. No right pleural effusion. Transvenous right atrial and right ventricular pacer leads follow their expected courses from the right pectoral generator. No pneumothorax. " 92512adf-227e9c36-53610aa2-960c5f9d-3bd5809f.jpg,validate/p10/p10743605/s55517364/92512adf-227e9c36-53610aa2-960c5f9d-3bd5809f.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with new diagnosis of SLE and dyspnea on exertion. Study requested for evaluation of pleural effusion. 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 are no focal consolidations. There are no pleural effusions. There is no pneumothorax. Visualized osseous structures are grossly intact. IMPRESSION: No radiographic evidence of an acute cardiopulmonary process, no pleural effusions. " 39edad73-caab4a84-fd869624-34496fce-42e48a78.jpg,validate/p19/p19718329/s54305903/39edad73-caab4a84-fd869624-34496fce-42e48a78.jpg,validation," FINAL REPORT HISTORY: Palpitations. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There is no pulmonary edema. The cardiac and mediastinal silhouettes are unremarkable. Osteophytes are seen along the spine. Surgical clips are seen in the right upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 1c9d1d2e-611fd199-037c548f-115f51d2-c09cdac8.jpg,validate/p12/p12479159/s57126624/1c9d1d2e-611fd199-037c548f-115f51d2-c09cdac8.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with stroke symptoms, question cardiomegaly. COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are low in volume and clear. The cardiac silhouette is normal. The mediastinal silhouette and hilar contours are normal. No pleural effusions or pneumothorax is present. IMPRESSION: No acute intrathoracic process. " 01398bcb-53e4965f-f81020bc-29112eab-e241b35b.jpg,validate/p15/p15133460/s57026660/01398bcb-53e4965f-f81020bc-29112eab-e241b35b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever 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. " bf7935c0-8b564931-8c20d8e9-7e6eb94b-ffca2d67.jpg,validate/p11/p11926973/s59591399/bf7935c0-8b564931-8c20d8e9-7e6eb94b-ffca2d67.jpg,validation," FINAL REPORT INDICATION: ___ yo with left sided chest pain. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: There are no prior studies for comparison available. 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. " aef794cc-2bd3032d-3749bb00-1ae05887-1c090a6d.jpg,validate/p16/p16388704/s53288044/aef794cc-2bd3032d-3749bb00-1ae05887-1c090a6d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: ___-year-old woman with pneumonia, rhonchi; please evaluate for interval changes. TECHNIQUE: PA and lateral chest views were read in comparison with the prior chest radiograph done ___ hours apart. FINDINGS: Since prior radiograph, the right PICC line has been repositioned and now the tip ends approximately 3-3.2 cm below the carina in the lower SVC/cavoatrial junction. Tiny left pleural effusion is unchanged. Heart size is normal. Mediastinal and hilar contours are unchanged. No pleural abnormality on the right side. There are no other interval changes in the lung. IMPRESSION: Following repositioning, the right PICC line tip now ends approximately 3.2 cm below the carina, which is in the lower SVC/cavoatrial junction. " 388543d0-b466f4f3-51dfc4de-98164ac9-715d2fac.jpg,validate/p10/p10021927/s55422556/388543d0-b466f4f3-51dfc4de-98164ac9-715d2fac.jpg,validation," 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. " 112a2089-5579024b-a1844e1a-3dadd3e2-acfb1518.jpg,validate/p13/p13174181/s56693722/112a2089-5579024b-a1844e1a-3dadd3e2-acfb1518.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with smoke inhalation. // eval for acute process 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 acute osseous abnormalities are identified. Mild dextrocurvature of the thoracolumbar spine is noted. IMPRESSION: No acute cardiopulmonary process. " 1fba6020-ff5af8d1-cecd0eef-7546863c-e07aa63f.jpg,validate/p10/p10570398/s56466948/1fba6020-ff5af8d1-cecd0eef-7546863c-e07aa63f.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Evaluation for interval change. COMPARISON: ___. FINDINGS: Recent sternotomy was done for CABG. There is no significant change since prior exam with bilateral moderate pleural effusions and bibasilar atelectasis. Mediastinal and cardiac contours are stable. Right jugular line ends in cavoatrial junction. There is no pneumothorax. CONCLUSION: There is no significant change since prior exam in this patient with recent CABG. " f0a2d188-75405135-ac9f9deb-345cb65c-3b7e7fb6.jpg,validate/p15/p15957987/s51292408/f0a2d188-75405135-ac9f9deb-345cb65c-3b7e7fb6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Esophageal cancer and bilateral pleural effusions, reassessment. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the esophageal stent and the left pectoral Port-A-Cath are in unchanged position. Unchanged size of the cardiac silhouette. Unchanged bilateral areas of atelectasis. The extent of the bilateral pleural effusions is also unchanged. No parenchymal opacities have newly occurred in the interval. " e8234b20-c4e82711-bb98db24-e4247a70-27a5345b.jpg,validate/p16/p16830759/s58728955/e8234b20-c4e82711-bb98db24-e4247a70-27a5345b.jpg,validation," FINAL REPORT HISTORY: Patient with fever status post liver and kidney transplant, assess for pulmonary process. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. A Dobbhoff tube courses beyond the antrum of the stomach with the tip out of the view of this exam. The right IJ line has been removed. A left infrahilar opacity is associated with ipsilateral hilar depression, likely secondary to atelectasis in the left lower lobe. Small bilateral pleural effusions are relatively new. The cardiac silhouette is stable. There is no pneumothorax. IMPRESSION: 1. Left lower lobe atelectasis. 2. Small bilateral pleural effusions. " 57ca31e8-a8d7c416-19b9835a-f2d1b9c8-d2c654c8.jpg,validate/p13/p13023241/s52023734/57ca31e8-a8d7c416-19b9835a-f2d1b9c8-d2c654c8.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Syncope. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is rotated slightly to the right. There is bibasilar atelectasis. Interstitial opacities at the lung bases may relate to patient's known interstitial lung disease. The cardiac and mediastinal silhouettes are stable. There is no large pleural effusion or pneumothorax. " 06af0228-3bf24ce0-6b6dff25-8277fb1b-14bd3ca7.jpg,validate/p15/p15442180/s52135814/06af0228-3bf24ce0-6b6dff25-8277fb1b-14bd3ca7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF, influenza, hypoxemic respiratory failure now intubated // please assess location of ET tube please assess location of ET tube IMPRESSION: Compared to prior chest radiographs. New ET tube in standard placement. Even the patient has been intubated lung volumes have improved, severe heterogeneous infiltrative pulmonary abnormality is no better, probably worse. Although some of it may be pulmonary edema the heterogeneity is strongly suggestive of concurrent pneumonia. Heart size is normal. Mediastinal veins are not engorged. Bilateral pleural effusion is at least small. No pneumothorax. Nasogastric drainage tube ends in the stomach. Right jugular line ends in the low SVC. RECOMMENDATION(S): It is important to obtain prior chest imaging to assess the radiographic history of recurrent abnormalities. " 7ea7bafd-55b3eb3d-f9ab71ac-d9a7bd86-1faf4ad5.jpg,validate/p10/p10161112/s54966823/7ea7bafd-55b3eb3d-f9ab71ac-d9a7bd86-1faf4ad5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough TECHNIQUE: PA and lateral views of the chest COMPARISON: Chest CT ___, chest radiograph ___ FINDINGS: The patient is status post left upper lobectomy with clips noted in the left hilar region. There is unchanged leftward shift of the mediastinal structures with left sided volume loss. There is focal opacification within the left mid lung field, which could reflect an area of pneumonia though recurrent malignancy is not excluded. Blunting of the left costophrenic sulcus is unchanged compatible with a small pleural effusion, similar to prior. There is no pulmonary vascular congestion. The right lung is clear. Cardiac and mediastinal contours are unchanged with a small hiatal hernia re- demonstrated. No acute osseous abnormalities seen. IMPRESSION: Focal opacification within the left mid lung field concerning for pneumonia, but recurrent malignancy is not excluded. Recommend followup radiographs after treatment to assess for interval resolution. " dd5cf329-d4d02289-c5effeb9-f09c08d0-98aa2a35.jpg,validate/p12/p12519260/s56053564/dd5cf329-d4d02289-c5effeb9-f09c08d0-98aa2a35.jpg,validation," FINAL REPORT INDICATION: ___ year old man with recent URI sx and left sided chest discomfort. // r/o 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. " 5e68e7de-8b99241c-6341c996-e5adbf86-9edeec06.jpg,validate/p16/p16998152/s55214030/5e68e7de-8b99241c-6341c996-e5adbf86-9edeec06.jpg,validation," WET READ: ___ ___ 6:04 PM Interval development of focal wedge-shaped opacity in the right lung base from prior chest radiograph of ___. This could represent an area of aspiration given clinical concern for such. ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:40 P.M., ___ HISTORY: Cirrhosis and hepatic encephalopathy. Desaturating. IMPRESSION: AP chest compared to ___: Interstitial pulmonary edema is new. Focal opacification at the right lung base could be atelectasis, infection or even early infarction. Mediastinal venous engorgement indicates volume overload. Heart size top normal. Pleural effusions are presumed, but not substantial. " 85ec88e1-750e15f1-1cf19418-0b77b906-a5e6bc37.jpg,validate/p11/p11459120/s54407986/85ec88e1-750e15f1-1cf19418-0b77b906-a5e6bc37.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with shortness of breath and wheezing. Evaluate for pneumonia. COMPARISON: ___. FINDINGS: AP AND LATERAL VIEWS OF THE CHEST: There are bilateral hazy pulmonary opacities, greater on the right than left, concerning for pulmonary edema. There is also cardiomegaly. Pacemaker with leads terminating in the right atrium and right ventricle are noted. Left-sided shoulder replacement is noted. Also seen are more peripheral vague opacities on the right. Likely small bilateral pleural effusions as well. IMPRESSION: Mild asymmetric pulmonary edema. Additional more peripheral opacities on the right could be concerning for an underlying infectious process. Recommend follow up radiographs after diuresis. " ca18c2c9-627d505a-39edcc64-724a7f5b-4ee7d49b.jpg,validate/p10/p10577647/s54883962/ca18c2c9-627d505a-39edcc64-724a7f5b-4ee7d49b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with altered mental status // please eval for infection TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right PICC line has been discontinued. Cardiomegaly is mild, unchanged. Mediastinum is stable. Lungs are essentially clear with no focal consolidations to suggest interval development of infectious process. " 643ac480-73cfe93c-27cea4d8-84722781-97d03ed4.jpg,validate/p12/p12221629/s56707998/643ac480-73cfe93c-27cea4d8-84722781-97d03ed4.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with worsening LLL consolidation // pneumonia, CHF TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph ___. FINDINGS: Improved lung volumes bilaterally. Interval increase in left pleural effusion and persistent small right pleural effusion. Bibasilar opacities left greater than right is unchanged. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unchanged. Dual lead pacemaker with pacer leads in the right atrium right ventricle in expected positions. IMPRESSION: Increase in moderate left pleural effusion and persistent small right pleural effusion. No significant change in left lower lobe consolidation. " 5221ace5-78664502-cb81884d-3d088865-a09a6f21.jpg,validate/p18/p18812673/s52339838/5221ace5-78664502-cb81884d-3d088865-a09a6f21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with fevers, cough 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. " 04030630-473c5e40-8abed695-17b67d96-53e56b2b.jpg,validate/p12/p12780512/s58317424/04030630-473c5e40-8abed695-17b67d96-53e56b2b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with empyema s/p chest tube placement. // Please evaluate for pneumothorax. TECHNIQUE: Single frontal view of the chest. COMPARISON: Multiple prior chest radiographs dating back to ___, most recently ___. FINDINGS: Compared to radiographs from ___, there has been interval placement of the right-sided chest tube with mild interval improvement of a loculated right effusion. No pneumothorax. Small left pleural effusion has decreased, now trace. Lung volumes have improved, though remain low overall. There is no focal airspace consolidation. No central vascular congestion or overt pulmonary edema. Right PICC line tip terminates at the cavoatrial junction/right atrium. Nasogastric tube extends below diaphragm and terminates in the distal stomach. IMPRESSION: 1. Status post placement of right-sided chest tube with mild interval improvement of loculated right pleural effusion. No pneumothorax. 2. Mildly improved left pleural effusion, now trace. " 78cc89c4-9a9395d1-e1546461-60238ad6-c5b6d214.jpg,validate/p17/p17967918/s59644718/78cc89c4-9a9395d1-e1546461-60238ad6-c5b6d214.jpg,validation," FINAL REPORT INDICATION: Smoker with cough, assess for pneumonia. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISONS: None available. FINDINGS: Lungs are clear. There is no pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal silhouette. IMPRESSION: No acute intrathoracic process. " 38336a73-dec7b7e6-f9f6dd9e-e70bbaf9-d9726e31.jpg,validate/p15/p15341255/s51641090/38336a73-dec7b7e6-f9f6dd9e-e70bbaf9-d9726e31.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with legionella PNA, R IJ may be slightly pulled out. // IJ placement TECHNIQUE: Portable chest radiograph COMPARISON: Chest radiograph ___ at 05:42, outside facility chest CT ___ FINDINGS: Right internal jugular catheter terminates at the mid SVC, little changed from the prior radiograph on ___. Tip of the endotracheal tube is normal visualize, but terminates around the mid thoracic trachea. Sternal wires are intact. Enteric tube is partially visualized. Heterogeneous areas of right lung opacification, more pronounced at the lung base, consistent with known pneumonia. Left retrocardiac opacity is new from the prior chest CT on ___, and likely represents atelectasis. Left upper lung is clear. Small layering pleural effusions are noted bilaterally. No pneumothorax. Cardiomediastinal contours are unchanged. IMPRESSION: 1. Right IJ catheter terminates in the mid SVC, little changed from the prior study. 2. Heterogeneous areas of basilar predominant right lung consolidation, consistent with known pneumonia. 3. Small bilateral layering pleural effusions. " 44893dd0-cb1910c2-500222bb-f71d0ddf-9d048cbf.jpg,validate/p14/p14394983/s54972593/44893dd0-cb1910c2-500222bb-f71d0ddf-9d048cbf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with question of congestion on previous x-ray with poor inspiration TECHNIQUE: Chest PA and lateral COMPARISON: ___ at 03:18 FINDINGS: Degree of lung inflation has improved in the interval. Cardiac, mediastinal and hilar contours are unchanged with the heart size within normal limits. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 0bd1e3dd-627a1117-3fa25159-650f7cc4-85d880e8.jpg,validate/p18/p18692222/s54353913/0bd1e3dd-627a1117-3fa25159-650f7cc4-85d880e8.jpg,validation," FINAL REPORT INDICATION: Left arm pain. Evaluate for cardiopulmonary process. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. Left-sided pacemaker is in place, and the leads are stable in position. There is no focal consolidation, pleural effusion, or pneumothorax. There is mild to moderate cardiomegaly, unchanged. The mediastinal and hilar contours are normal. IMPRESSION: Persistent cardiomegaly. No acute cardiopulmonary process. " 92d6cc97-a4564a12-3473ca2a-88560364-dc743aae.jpg,validate/p10/p10976602/s57753813/92d6cc97-a4564a12-3473ca2a-88560364-dc743aae.jpg,validation," 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. " a8626c7f-92dbdaa6-d4739f9a-cc3b6fa5-3be8bb00.jpg,validate/p16/p16707063/s58620158/a8626c7f-92dbdaa6-d4739f9a-cc3b6fa5-3be8bb00.jpg,validation," FINAL REPORT EXAM: Chest, single AP upright portable view. CLINICAL INFORMATION: ___-year-old male with history of rigors. COMPARISON: ___. FINDINGS: Single AP upright portable view of the chest was obtained. There is mild bibasilar atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The previously seen small left pleural effusion was only appreciated on the lateral view and the lateral view was obtained today. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " a65d5954-773a4f62-8e30a86b-60f5377e-f7cf4d93.jpg,validate/p14/p14675220/s59807408/a65d5954-773a4f62-8e30a86b-60f5377e-f7cf4d93.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with cough and chest pain. COMPARISON: None. FINDINGS: PA and lateral radiographs of the chest demonstrates clear lungs. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Normal radiographs of the chest. " 9fa80bbb-479fee8b-c6d5ffe6-cb1db9c1-c04fb27d.jpg,validate/p17/p17582515/s54410466/9fa80bbb-479fee8b-c6d5ffe6-cb1db9c1-c04fb27d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with intubated transfer // eval ETT placement TECHNIQUE: Single frontal view of the chest COMPARISON: None FINDINGS: Endotracheal tube terminates approximately 5.1 cm above the carina. No focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac silhouette is mildly enlarged, likely accentuated by AP, portable technique. IMPRESSION: Endotracheal tube terminates 5.1 cm above the carina. " 75c5a3a1-63e507e2-0a2ac1da-9992be70-32d732c8.jpg,validate/p10/p10236621/s50975406/75c5a3a1-63e507e2-0a2ac1da-9992be70-32d732c8.jpg,validation," 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. " cd8c9201-075b5e58-f5628b2e-0043dab4-53570281.jpg,validate/p10/p10894562/s51759603/cd8c9201-075b5e58-f5628b2e-0043dab4-53570281.jpg,validation," WET READ: ___ ___ ___ 8:43 AM No focal consolidation to suggest pneumonia. WET READ VERSION #1 ___ ___ ___ 6:13 PM No focal consolidation to suggest pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: fatigue productive cough for 1 week // pls eval for infectious process COMPARISON: No comparison IMPRESSION: Normal lung volumes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pleural effusions. No pneumonia, no pulmonary edema. " 44fc2308-6f41aa99-c1bd8148-b40043e1-2e2464c7.jpg,validate/p11/p11201441/s50265561/44fc2308-6f41aa99-c1bd8148-b40043e1-2e2464c7.jpg,validation," FINAL REPORT AP CHEST, 5:20 AM ON ___ HISTORY: Fall from ladder. Mediastinal hematoma, pulmonary contusion, and pneumothorax. Ventilator-associated pneumonia. IMPRESSION: AP chest compared to ___: Tracheostomy tube ends in standard position. Right subclavian line ends near just beyond the estimated location of the superior cavoatrial junction. Large gas collection in the upper abdomen could be free pneumoperitoneum. Large right pleural effusion has increased since ___. Moderate left pleural effusion stable. Lung bases are obscured by overlying abnormality; whether pneumonia or atelectasis is present is radiographically indeterminate, but vascular congestion is seen in the left upper lung. The heart is probably unchanged in standard size. No definite pneumothorax. I discussed findings with house officer caring for this person at the time of dictation. " 9057e5b0-c8763df8-1828a70c-20aa06cf-80ba287e.jpg,validate/p11/p11328811/s56939537/9057e5b0-c8763df8-1828a70c-20aa06cf-80ba287e.jpg,validation," WET READ: ___ ___ ___ 11:55 AM A 7 mm pulmonary nodule projecting over the right upper lung requires nonemergent chest CT to further assess. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest discomfort, tachycardia COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Overlying EKG leads are present. There is a small rounded pulmonary nodule projecting over the right upper lung between the right fourth and fifth posterior rib arches, appears new from prior exam measuring approximately 7 mm. Otherwise the lungs are clear. No large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Imaged bony structures are intact. IMPRESSION: 7 mm pulmonary nodule projecting over the right upper lung requires nonemergent chest CT to further assess. " 5932603f-64abd8a2-713ef8b9-907f95b0-106004c5.jpg,validate/p19/p19720782/s53035658/5932603f-64abd8a2-713ef8b9-907f95b0-106004c5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest CT from ___. CLINICAL HISTORY: Shortness of breath, hypoxia, history of nonsmall cell lung cancer. FINDINGS: AP portable upright chest radiograph was provided. Loculated right pleural effusion is again seen, with compressive lower lobe atelectasis unchanged. There is right perihilar opacity which likely reflects known fibrosis as seen on prior CT. New consolidation is seen. No pneumothorax. Overall, cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Unchanged appearance of the chest with findings of right pleural effusion, loculated and lower lobe atelectasis as well as right perihilar fibrosis is unchanged. Please refer to subsequent CTA chest for further details. " 4c940923-a59ab393-7984e607-b473ed13-af98d60c.jpg,validate/p11/p11413236/s58800563/4c940923-a59ab393-7984e607-b473ed13-af98d60c.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath, sudden onset. COMPARISON: ___. FINDINGS: Single portable view of the chest. Right chest wall port is again seen. Streaky left basilar and right upper lung opacities are seen suggestive of atelectasis or scarring. Calcified mediastinal nodes are again seen. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " ab7baf11-aa879c30-9ecf0eb3-b806617a-4b2cf54b.jpg,validate/p19/p19153742/s52618202/ab7baf11-aa879c30-9ecf0eb3-b806617a-4b2cf54b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left sided chest pain, anterior, under breast 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. " ea311925-3ea9c9fa-1940a130-d184a7f3-f3e9fb7e.jpg,validate/p10/p10909149/s53577436/ea311925-3ea9c9fa-1940a130-d184a7f3-f3e9fb7e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of cough, fever, weakness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Large area of right middle lobe and right lower lobe consolidation is worrisome for pneumonia with mild left base atelectasis. No large pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Right middle and lower lobe pneumonia. Recommend followup to resolution " 59d88b4f-d3f301aa-d8188e16-02d0b72c-2eee7f6b.jpg,validate/p17/p17452697/s50782856/59d88b4f-d3f301aa-d8188e16-02d0b72c-2eee7f6b.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with hypoxia. STUDY: PA AND LATERAL CHEST RADIOGRAPH. COMPARISON: None. FINDINGS: The heart and mediastinal contours are within normal limits. The lungs demonstrate a subtle streaky linear-like airspace opacity within the anterior segment of the right upper lobe. There is no pleural effusion or pneumothorax. Degenerative changes are present in the thoracic spine, primarily in the form of anterior osteophytes. IMPRESSION: Right upper lobe airspace opacity, in the appropriate clinical setting, compatible with pneumonia or aspiration, although scarring or atelectasis are possibilities; follow-up radiography to ensure resolution is recommended. " 944c6964-466ca488-79454770-2cfbcfc6-2cd28380.jpg,validate/p12/p12503315/s53958521/944c6964-466ca488-79454770-2cfbcfc6-2cd28380.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recurrent R pleural effusion s/p R chest tube x2 today. // Please assess pleural effusions. Please perform prior to 7AM as results are crucial to determining whether or not to re-tap effusion. Thank you! IMPRESSION: As compared to ___ chest radiograph, right-sided chest tubes and pleural catheter remain in place, with a moderate right pleural effusion and a small right apical hydro pneumothorax. Worsening atelectasis in the right mid and lower lung. Left lung is remarkable for improving left basilar atelectasis and slight decrease in small pleural effusion. " c6c6bfde-27a00249-01cf29c7-f46b69ae-119fbe6b.jpg,validate/p10/p10610461/s53184080/c6c6bfde-27a00249-01cf29c7-f46b69ae-119fbe6b.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___-year-old female with worsening cough and shortness of breath. Evaluate for infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Subtle prominence of bronchovascular markings at the medial right lung base appear unchanged from prior. No pulmonary edema is seen. The heart size is normal, and the mediastinal contours are normal. No acute osseous abnormality is seen. IMPRESSION: No acute intrathoracic process. " 7e76cf53-38f95a37-e54095cf-9fef6040-037d7353.jpg,validate/p14/p14082459/s53452888/7e76cf53-38f95a37-e54095cf-9fef6040-037d7353.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with 2 weeks of tachycardia, 4 days of right lower quadrant pain TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Lungs are clear. Mild elevation of the right hemidiaphragm may be due to a small subpulmonic effusion or subdiaphragmatic process if acute, though the chronicity of this finding is unknown without prior imaging. No left-sided pleural effusion is demonstrated. There is no pneumothorax. No acute osseous abnormalities seen. IMPRESSION: Mild elevation of the right hemidiaphragm, of unknown chronicity. This could be due to a small subpulmonic effusion or subdiaphragmatic process if acute. " 7c8be447-4a5fc350-a4765a79-cc9640fe-43a51005.jpg,validate/p16/p16036071/s52659122/7c8be447-4a5fc350-a4765a79-cc9640fe-43a51005.jpg,validation," FINAL REPORT INDICATION: ___F with AMS, s/p med ingestion // evidence of bleed, fracture TECHNIQUE: Single portable view of the chest COMPARISON: None FINDINGS: An ET tube terminates approximately 3 cm above the carinal. An NG tube is in the stomach. There is no large pleural effusion. The cardiac size is within normal limits. There is no pneumothorax. There is no evidence of pneumonia. No evidence of aspiration or pneumonia. IMPRESSION: Support devices in appropriate position. No evidence for acute cardiopulmonary process. " 0ff0b770-6e68b31f-2c78c280-14bfb8b3-a52624eb.jpg,validate/p16/p16289699/s57072584/0ff0b770-6e68b31f-2c78c280-14bfb8b3-a52624eb.jpg,validation," FINAL REPORT HISTORY: CHF. COMPARISON: ___. FINDINGS: The right hemidiaphragm. Tip continues to be elevated with probable subpulmonic effusion there is indistinct pulmonary vasculature predominantly on the right. However, the alveolar infiltrate on the right has improved the heart continues to be severely enlarged. Pacemaker and leads are unchanged. Left IJ line is unchanged. IMPRESSION: slight improvement in CHF with subpulmonic effusion on the right. " b0b14535-bcb81925-6a87fba8-5bfaf420-d002e092.jpg,validate/p18/p18634144/s54467640/b0b14535-bcb81925-6a87fba8-5bfaf420-d002e092.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of 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, as are the hilar contours. There are no displaced fractures seen. IMPRESSION: No acute cardiopulmonary process. " 038546db-14d87d68-6f296345-c882ed44-586d8c2e.jpg,validate/p16/p16026540/s53572702/038546db-14d87d68-6f296345-c882ed44-586d8c2e.jpg,validation," FINAL REPORT INDICATION: Escalating frequency of seizures. COMPARISON: None. 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 present. A stimulator device is noted in the left chest wall with lead coursing cephalad into the left aspect of the neck. There are mild degenerative changes in the thoracic spine, but no acute osseous abnormalities are seen. Remote right-sided rib fracture is present. IMPRESSION: No acute cardiopulmonary process. " b70961c0-547a6938-46ef8f30-9342d24c-7a3c4fc0.jpg,validate/p12/p12563019/s55470904/b70961c0-547a6938-46ef8f30-9342d24c-7a3c4fc0.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with right foot gangrene and currently cough. AP and lateral radiographs of the chest were reviewed in comparison to ___ and CT abdomen from ___. Heart size is normal. Mediastinum is normal. Left basal pleural thickening is noted, but better appreciated on the CT abdomen as well as minimal amount of pleural effusion. Lungs are essentially clear and there is no pneumothorax demonstrated. " 2a26033e-4daca38b-f31061cf-371385c4-52c7ac6b.jpg,validate/p15/p15002645/s59560956/2a26033e-4daca38b-f31061cf-371385c4-52c7ac6b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with CP // evidence of pneumothorax 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. No evidence of pneumothorax. " 7479df46-e50f43b6-2d508fd1-e74a15de-d5587ff3.jpg,validate/p12/p12885815/s54576516/7479df46-e50f43b6-2d508fd1-e74a15de-d5587ff3.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with PMHx MS, ?stroke, now with worsening gait instability and word finding difficulty // r/o infiltrate TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Minimal lateral left base atelectasis is noted. No focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Anterior osteophytes seen at several levels along the thoracic spine. Partially imaged, there may be an ovoid calcification projecting over the soft tissue lateral to the right humeral head, could relate to calcific tendinosis, not well assessed on this study. IMPRESSION: No acute cardiopulmonary process. Partially imaged, there may be an ovoid calcification projecting over the soft tissue lateral to the right humeral head, could relate to calcific tendinosis, not well assessed on this study. " acf38c33-57c55785-87f81a36-6620356a-fef7aa3b.jpg,validate/p16/p16833478/s54195424/acf38c33-57c55785-87f81a36-6620356a-fef7aa3b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left pleural effusion s/p chest tube removal // eval for interval change IMPRESSION: Since ___, left pigtail pleural catheter has been removed, with persistent tiny left apical pneumothorax and slight increase in size of moderate left pleural effusion with adjacent atelectasis and or consolidation. Lung volumes are slightly increased with associated improved aeration of the right lung base. No other relevant changes. " 391d2a3d-5b8c342b-9a8dceda-789e10f7-d3504138.jpg,validate/p12/p12022180/s54735934/391d2a3d-5b8c342b-9a8dceda-789e10f7-d3504138.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Assess enlarged hilum seen on prior chest x-ray of ___. Cardiac size is normal. The appearance of bilateral hila is unchanged. There are no new lung abnormalities. The lungs are clear. There is no pleural effusion or pneumothorax. The osseous structures are unremarkable. IMPRESSION: Stable minimally increase in size of the left hilum. " 46d098ca-856a1d69-1884acb7-bfa27c1d-515ca58d.jpg,validate/p19/p19204138/s56512557/46d098ca-856a1d69-1884acb7-bfa27c1d-515ca58d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with SOB // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: A mild background generalized interstitial abnormality is identified. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Scoliosis is noted centered within the mid thoracic spine. IMPRESSION: Age-indeterminate mild generalized background interstitial abnormality. " 55788e57-a2624a3e-a4078815-348de48f-c0b58a01.jpg,validate/p14/p14552554/s53734835/55788e57-a2624a3e-a4078815-348de48f-c0b58a01.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with question of pneumoperitoneum. Evaluate for free air. TECHNIQUE: Portable upright frontal radiograph view of the chest. COMPARISON: Chest radiograph dated ___. Limited reference is made to the CT abdomen and pelvis from an outside facility dated ___ and uploaded onto PACS. FINDINGS: Midline sternotomy wires again noted with partially imaged hardware stable as Ing the lumbar spine. Again noted is complete opacification of the left hemithorax and leftward shift of the mediastinum in this patient status post prior left pneumonectomy. Hiatal hernia is better appreciated on the prior CT. The right lung is clear. No pneumothorax. The heart and mediastinum cannot be assessed. Residual barium noted within upper abdominal bowel loops. No evidence of subdiaphragmatic free air. Dextroconvex scoliosis of the upper thoracic spine is more pronounced. Clips projecting over the left hemithorax are unchanged. IMPRESSION: 1. No subdiaphragmatic free air. 2. Right lung is clear. Post left pneumonectomy changes. " 89d2a94f-6fd1ffdf-c8f5de58-0abbb9fd-33db4ae1.jpg,validate/p12/p12392656/s59986465/89d2a94f-6fd1ffdf-c8f5de58-0abbb9fd-33db4ae1.jpg,validation," 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. " 61cbdabf-206407b5-8214cc67-e3ab27ff-316d9103.jpg,validate/p14/p14760981/s58786985/61cbdabf-206407b5-8214cc67-e3ab27ff-316d9103.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with restrained driver low speed rear-ended MVA, has a right body pain. No prior examinations for comparison. CHEST, PA AND LATERAL: The lungs are clear. Cardiomediastinal and hilar contours are normal. No pleural effusions or pneumothorax. No displaced rib fractures are identified. IMPRESSION: No radiographic evidence of injury. If patient has focal pain, dedicated rib series can be ordered. " 358ba324-6af3ee4f-ee4bc47b-27ff4b45-2a634164.jpg,validate/p16/p16454913/s51216010/358ba324-6af3ee4f-ee4bc47b-27ff4b45-2a634164.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___. COMPARISON: ___ radiograph. FINDINGS: Interval removal of right internal jugular vascular catheter sheath with no visible pneumothorax. Cardiomediastinal contours are stable in appearance. Persistent pulmonary vascular congestion accompanied by worsening predominantly right-sided airspace opacities, potentially due to asymmetrical pulmonary edema, but infection in the right lung could produce a similar radiographic appearance. Marked improvement in left retrocardiac opacity consistent with decreasing effusion and atelectasis. Right pleural effusion has also decreased in size with associated slight improvement in adjacent right basilar atelectasis. " df42d4ec-547c36d7-7318a257-b203d7da-8f651495.jpg,validate/p11/p11898730/s59074997/df42d4ec-547c36d7-7318a257-b203d7da-8f651495.jpg,validation," FINAL REPORT HISTORY: Intermittent chest pain, dyspnea on exertion for 3 weeks. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CTA ___ and chest CTA ___. FINDINGS: Heart size is normal. The aorta is mildly tortuous. The mediastinal and hilar contours are otherwise unremarkable. The 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. " f10be203-d4187a1c-9e51fdcf-9047149e-ff576ba9.jpg,validate/p16/p16723173/s52436590/f10be203-d4187a1c-9e51fdcf-9047149e-ff576ba9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with wheezing, hypoxia // presence of infiltrate TECHNIQUE: Single upright portable view of the chest was obtained. COMPARISON: Chest Radiographs: ___ FINDINGS: The lung volumes are low, with bibasilar atelectasis, accentuating the heart size and crowding the pulmonary vasculature. There is an apparent left pleural effusion. The heart is top-normal in size. There is no pneumothorax or overt pulmonary edema. Moderate gaseous distension of the stomach is noted. IMPRESSION: Low lung volumes with bibasilar atelectasis and left pleural effusion. Underlying infection cannot be excluded in the appropriate clinical setting. " 2dcbd4f6-0c675c19-00dff07e-f670060a-aa64d1a8.jpg,validate/p10/p10012498/s55812956/2dcbd4f6-0c675c19-00dff07e-f670060a-aa64d1a8.jpg,validation," WET READ: ___ ___ ___ 9:42 PM Left lower lobe consolidation compatible with pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with fevers, productive for 3 days // Eval for Pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: There is focal consolidation in the left lower lobe. Elsewhere, the lungs are clear. There is no effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Left lower lobe consolidation compatible with pneumonia. " cbcf9bcd-da2519bd-3a030e4f-f39d100e-a9686980.jpg,validate/p16/p16132012/s58538911/cbcf9bcd-da2519bd-3a030e4f-f39d100e-a9686980.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated with PNA // eval interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Bilateral multifocal consolidations have worsened consistent with worsening pneumonia. Lines and tubes are in unchanged standard position. There is no pneumothorax. Small left effusion is unchanged. Left rib fractures are again noted " 275440ec-8517bfc3-67eabb95-39367705-cbdde6ad.jpg,validate/p18/p18754895/s59735477/275440ec-8517bfc3-67eabb95-39367705-cbdde6ad.jpg,validation," FINAL REPORT CHEST TWO VIEWS: ___. HISTORY: ___-year-old male with sudden onset of right chest pain. Question pneumothorax. FINDINGS: PA and lateral views of the chest were compared to previous exam from ___. As on prior, there is elevation of the right hemidiaphragm. The lungs, however, remain clear. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 99472656-65ff14d7-33c7126c-3ad92ea6-71f71452.jpg,validate/p14/p14206476/s56054391/99472656-65ff14d7-33c7126c-3ad92ea6-71f71452.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Epigastric pain and chest discomfort radiating to the right shoulder. 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. " ca9f3de0-1f633196-49ce17b7-d9a1eeaf-09c59ceb.jpg,validate/p15/p15483051/s55178923/ca9f3de0-1f633196-49ce17b7-d9a1eeaf-09c59ceb.jpg,validation," WET READ: ___ ___ ___ 6:22 AM Rounded densities at the lung bases likely represent nipple shadows, however oblique views are recommended for confirmation. No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with meth ingestion, some CP // acute intrathoracic process? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Rounded densities projecting over the lung bases likely represent nipple shadows. The lung fields are otherwise clear. Cardiomediastinal silhouette is unremarkable. IMPRESSION: AT NIPPLE SHADOW SHOULD NOT BE MISTAKEN FOR LUNG NODULES. PREVIOUS ___ NOTED THE LEFT LOWER LOBE ___ NODULE ON THAT CHEST CT IN ___ DOES NOT REQUIRE FOLLOW-UP. " ade78d77-6420ca33-e3767ecc-b5f8084f-88890660.jpg,validate/p11/p11005665/s51514112/ade78d77-6420ca33-e3767ecc-b5f8084f-88890660.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with L lung injury after aortic graft // eval for interval change s/p bronch COMPARISON: ___, 19:12 IMPRESSION: As compared to the previous radiograph, there is on going improved ventilation of the left lung. . The volume of the left lung has increased. Unchanged appearance of the chest wall of the aortic graft placement. The sternal fixation devices are in unchanged position. Unchanged size of the cardiac silhouette. Unchanged appearance of the normal right lung. " e6289d20-e3ffc1ff-d94db20b-191c5d7a-9c734bf8.jpg,validate/p18/p18831735/s51872734/e6289d20-e3ffc1ff-d94db20b-191c5d7a-9c734bf8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with fever and pneumonia // Interval change Interval change IMPRESSION: In comparison with the study of ___, there is little interval change. Again there is substantial enlargement of the cardiac silhouette with pulmonary edema and layering pleural effusion on the right with compressive atelectasis at the base. This appearance is all superimposed on chronic interstitial lung disease. Given the extensive pulmonary changes, it would be impossible to exclude superimposed pneumonia in the appropriate clinical setting. " e5198572-f8b7280d-0722e666-0ccad6a5-6297644e.jpg,validate/p15/p15831124/s59856331/e5198572-f8b7280d-0722e666-0ccad6a5-6297644e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old female status post gastrectomy for ulcer with open abdominal wound and pulmonary edema. TECHNIQUE: Portable AP radiograph of the chest from ___. COMPARISON: ___. FINDINGS: The right IJ central line has been removed. The tip of an endotracheal tube is at the level of the clavicles. A left IJ central line is unchanged in position, likely terminating at the superior cavoatrial junction. An enteric tube remains in place, but is only visualized to the level of the mid esophagus. Despite low lung volumes, pulmonary edema has increased since ___. Increased opacification of the left hemithorax may be due in part to the more supine position of the patient with resultant narrowing of a small left pleural effusion. There is no pneumothorax. The heart appears enlarged despite the projection. The median contour is stable. IMPRESSION: Worsening pulmonary edema. Stable small left layering pleural effusion. ET and left IJ central lines in satisfactory position. Tip of enteric tube not visualized. A repeat frontal radiograph may be performed for more definitive assessment of its position. " 2b84cf51-a0ce92da-9c16aca8-c9a12508-27ae594c.jpg,validate/p10/p10956814/s51072126/2b84cf51-a0ce92da-9c16aca8-c9a12508-27ae594c.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___. FINDINGS: Left lower lobe is completely collapsed, likely on the basis of mucous plugging as the left lower lobe bronchus appears opacified. Small pleural effusions are present bilaterally. Cardiac silhouette is mildly enlarged, and accompanied by pulmonary vascular congestion and minimal interstitial edema. " 48804937-b435e2e7-407ab24e-4a028b6a-59800f1d.jpg,validate/p14/p14668516/s55794427/48804937-b435e2e7-407ab24e-4a028b6a-59800f1d.jpg,validation," FINAL REPORT INDICATION: Shortness of breath. Evaluate for pulmonary edema. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without a consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 383b880b-445edcf6-0ae00377-9ea0e463-e86f19f7.jpg,validate/p18/p18065731/s55889791/383b880b-445edcf6-0ae00377-9ea0e463-e86f19f7.jpg,validation," 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. " 222a5d40-8c486fb4-0b9e6fc1-e4725014-41225d92.jpg,validate/p11/p11658675/s50428728/222a5d40-8c486fb4-0b9e6fc1-e4725014-41225d92.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Hypoxia. Evaluate for pneumonia, aspiration, chronic eosinophilic lung disease. Comparison is made with prior study performed the day before. Right lower lobe opacities is consistent with improved component of atelectasis, superimposed infection cannot be totally excluded, the upper lungs are clear. Right lower lobe atelectasis has improved. There are low lung volumes. Cardiac size is normal. " 543e0770-7b65eba8-959bd5d6-6f3a3645-44a01a5e.jpg,validate/p13/p13050559/s54502891/543e0770-7b65eba8-959bd5d6-6f3a3645-44a01a5e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC line // please evalute line position COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the right PICC line is in unchanged position, with the tip projecting over the mid to low SVC. The course of the line is also are none changed. Right upper mediastinal widening as well as the parenchymal consolidation in the right upper lobe is constant in appearance. The paramediastinal clips are constant. No new parenchymal opacities. No change in appearance of the cardiac silhouette. " c436e0b5-dff8450b-0eee1ab4-69423175-de2ad1c7.jpg,validate/p17/p17396346/s58386338/c436e0b5-dff8450b-0eee1ab4-69423175-de2ad1c7.jpg,validation," FINAL REPORT INDICATION: Syncope. Evaluate for CHF. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: AP and lateral chest radiographs. FINDINGS: Bibasilar opacities are likely due to overlying soft tissues. The cardiac silhouette remains enlarged. There has been interval removal of a right-sided IJ central venous catheter. There is mild pulmonary edema. No new focal consolidation is identified. There is no pneumothorax. IMPRESSION: Cardiomegaly with mild pulmonary edema. " 1e6b8f83-fbf23e36-08314d13-73b5af13-6e5e4b66.jpg,validate/p17/p17999946/s58619815/1e6b8f83-fbf23e36-08314d13-73b5af13-6e5e4b66.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Palpitations and chest pressure. COMPARISON: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The aortic arch shows patchy calcification. Mild subpleural thickening is unchanged at each lung apex for the most part, but there is an apparent increase in density in the left upper lung over about 1 cm region. Otherwise, the lung fields appear clear. There are no pleural effusions or pneumothorax. IMPRESSION: 1. No evidence of acute cardiopulmonary disease. 2. Possible new left apical lung nodule. Follow-up chest CT is recommended when clinically appropriate. " 4c07c940-c62de8cd-110835d2-4b3b949b-74082bb9.jpg,validate/p16/p16659884/s56307321/4c07c940-c62de8cd-110835d2-4b3b949b-74082bb9.jpg,validation," FINAL REPORT HISTORY: Daytime sleepiness, high hematocrit. 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. Heart size is normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: Normal chest radiographs. " 1fea6fd2-91ae6a99-4e4f0eb1-cd62222e-3206eb0b.jpg,validate/p17/p17547176/s57827526/1fea6fd2-91ae6a99-4e4f0eb1-cd62222e-3206eb0b.jpg,validation," 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. " eb3cc754-643d9c6b-3601e25c-078b70ed-f6a7081f.jpg,validate/p12/p12648465/s58697632/eb3cc754-643d9c6b-3601e25c-078b70ed-f6a7081f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest CT from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Past medical history of gastric bypass and multiple abdominal surgeries with recent pneumonia, who presents with chest pain, assess for pneumonia or free air. FINDINGS: AP upright and lateral views of the chest were provided. Lungs appear clear bilaterally without focal consolidation, effusion or pneumothorax. There is no free air below the right hemidiaphragm. The cardiomediastinal silhouette is normal. The bony structures are intact. IMPRESSION: No acute findings. " 066c8654-1ea0ea8e-c2babb8f-55b9579f-2dca4893.jpg,validate/p19/p19972786/s51969527/066c8654-1ea0ea8e-c2babb8f-55b9579f-2dca4893.jpg,validation," FINAL REPORT INDICATION: Dyspnea. Rule out pneumonia or cardiomegaly. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___. FINDINGS: The heart is moderately enlarged, unchanged from ___. There is mild pulmonary edema. There are small bilateral pleural effusions with fluid tracking along the right costophrenic sulcus. Bilateral basilar opacities are likely atelectasis. There is no pneumothorax. The mediastinal and hilar contours are unchanged. Eventration of the right hemidiaphragm is less conspicuous on this study. IMPRESSION: Moderate cardiomegaly with mild pulmonary edema, small bilateral pleural effusions, and bibasilar atelectasis. " 77563f1c-dcd8ce99-5475baca-e7ecef89-37c50978.jpg,validate/p12/p12132246/s59994128/77563f1c-dcd8ce99-5475baca-e7ecef89-37c50978.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient status post valve sparing root replacement. Coronary artery re-implantation, evaluate for post-operative fever source. 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 ___. Status post sternotomy and remaining significant enlargement of the heart silhouette remains. The pulmonary vascular pattern does not show increased congestion and is practically unaltered in comparison with the next preceding examination. The left-sided basal and retrocardiac positioned atelectatic left lower lung changes have regressed moderately and show improved aeration. Similarly basal densities on the right base appear more translucent and the right lateral pleural sinus remains free. On the lateral view, the mostly posteriorly located atelectatic densities demonstrate some degree of improved central aeration. No new other parenchymal infiltrates are seen and no pneumothorax remains in the apical area. Progressively improving bilateral basal atelectasis which appeared post-operatively. Improvement is observed during the latest two-day examination interval but some atelectatic changes remain. Additional comparison is made with the pre-operative chest examination of ___, it can be noted that moderate cardiac enlargement existed already on the pre-operative chest examination. The atelectatic changes on both bases, however, did not exist at that time. " 1a03ae96-c938d929-aa9355a3-aa3170a2-0522a621.jpg,validate/p16/p16441660/s51755928/1a03ae96-c938d929-aa9355a3-aa3170a2-0522a621.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old male patient with ventricular tachycardia, ICD on amiodarone, evaluate for infiltrate related to amiodarone toxicity. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding PA and lateral chest examination of ___. On the present frontal view, the patient makes a very poor inspirational effort resulting in high positioned diaphragms and thereto related crowded appearance of the basal pulmonary vasculature. Heart size is not increased and no pulmonary vascular congestion has developed. As before, a permanent pacer is located in left anterior axillary position being connected to a total of three intracavitary electrodes. One of these is an ICD device that terminates in the right ventricle. A second line is a probably abandoned old right ventricular electrode. A third electrode terminates in the right atrium lateral posterior wall area and is located in unchanged position and comparison is made with the previous examination one and a half years ago. Appearance of lungs is unchanged paying attention to differences in inspiratory degree. Acute parenchymal infiltrates or interstitial fibrosis changes cannot be identified. No pneumothorax is seen in the apical area. The lateral and posterior pleural sinuses remain free. IMPRESSION: Stable chest findings, no significant interval change since ___. No suspicious findings for amiodarone toxicity. " bed34c62-7da4e69c-cc7868e6-4ec2dfde-49eda066.jpg,validate/p17/p17196497/s59802203/bed34c62-7da4e69c-cc7868e6-4ec2dfde-49eda066.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion. FINDINGS: In comparison with the study of ___, there is little overall change except for better inspiration. Cardiac silhouette is at the upper limits of normal in size or slightly enlarged with evidence of elevated pulmonary venous pressure and dual-channel pacer with leads extending to the right atrium and apex of the right ventricle. No definite vascular congestion. " 2db8365a-678c1d98-4c6e9b7b-3eb4c8f2-ed6976a9.jpg,validate/p10/p10074908/s51534562/2db8365a-678c1d98-4c6e9b7b-3eb4c8f2-ed6976a9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman found down on the floor with unclear history // Please evaluate for any intrathoracic process, rib fracture Please evaluate for any intrathoracic process, rib fracture IMPRESSION: In comparison with the study ___ ___, the endotracheal and nasogastric tubes have been removed. There are lower lung volumes, but no evidence of acute pneumonia, vascular congestion, or pleural effusion. Ventriculoperitoneal shunt is unchanged. Single frontal view shows old healed rib fractures on the left without definite acute fracture or pneumothorax. " 3a9b2d8f-fed084d3-c351224c-88f695d0-3c08685e.jpg,validate/p16/p16132910/s51595397/3a9b2d8f-fed084d3-c351224c-88f695d0-3c08685e.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with lung mass, status post biopsy. COMPARISON: None. TECHNIQUE: Single portable view of the chest. FINDINGS: There is no evidence of pneumothorax. The lung volumes are low accentuating cardiovascular markings. The lungs are otherwise clear. No pleural effusions seen. IMPRESSION: No evidence of pneumothorax. " c06f6f5e-29fb47f1-6513f253-66faecd4-087e4715.jpg,validate/p15/p15035317/s52362125/c06f6f5e-29fb47f1-6513f253-66faecd4-087e4715.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with MDS // pre bmt eval pre bmt eval IMPRESSION: In comparison with the study of ___, the cardiac size remains at the upper limits of normal. No vascular congestion, pleural effusion, or acute focal pneumonia. " 624c7caf-dfe83ade-8e4c399d-c4a6f821-b33bf70a.jpg,validate/p12/p12263171/s55647518/624c7caf-dfe83ade-8e4c399d-c4a6f821-b33bf70a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PICC which was pulled back accidentally. Assess placement // Please assess PICC location COMPARISON: Chest x-ray from ___ FINDINGS: Compared with the prior film, the right subclavian line has been retracted. The tip now overlies the proximal SVC, probably near the junction with the innominate vessel. No pneumothorax is detected. Again seen is atelectasis at the left base, with an elevated left hemidiaphragm. The degree of left base opacity is slightly worse, but overall similar. Mild prominence of the upper zone vessels is similar to the prior exam and likely accentuated by low inspiratory volumes. Doubt overt CHF. Left axillary clips again noted. The patient's known left breast implant is not well appreciated radiographically. IMPRESSION: Interval retraction of right subclavian line, with tip now overlying the proximal SVC. " 1d707e19-a4f97cb5-c7c8b262-3f4749a7-2f93a3d6.jpg,validate/p19/p19548303/s53563725/1d707e19-a4f97cb5-c7c8b262-3f4749a7-2f93a3d6.jpg,validation," FINAL REPORT HISTORY: COPD with increasing shortness of breath. TECHNIQUE: PA 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. The lungs are hyperinflated with lucency of the lung apices and attenuation of the pulmonary vascular markings compatible with severe bullous emphysema. No focal consolidation, pleural effusion or pneumothorax is identified. There are degenerative changes in the thoracic spine with anterior bridging osteophytes. IMPRESSION: Severe bullous emphysema but no acute cardiopulmonary abnormality. " a9169b2c-1ed5d65c-1e70b1df-bb0d34f1-fa639c14.jpg,validate/p12/p12043836/s56577977/a9169b2c-1ed5d65c-1e70b1df-bb0d34f1-fa639c14.jpg,validation," WET READ: ___ ___ ___ 9:03 AM Right pigtail catheter is in similar position along the right lung base. Following pigtail repositioning, a moderate pneumothorax is seen with collapse of the right lower lobe. Similar cardiomegaly. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:56 PM, 3 minutes after discovery of the findings. WET READ VERSION #1 ___ ___ ___ 5:57 PM Right pigtail catheter is in similar position along the right lung base. Following pigtail repositioning, a moderate pneumothorax is seen with collapse of the right lower lobe. Similar cardiomegaly. The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:56 PM, 3 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ___ with pigtail, now pigtail dislodged // please eval pigtail placement COMPARISON: ___. IMPRESSION: As compared to the previous image, a relatively extensive right pneumothorax has developed. A small amount of right pleural fluid persists. No change in appearance of the heart and of the left lung. " 8dff4526-9cb4d9fd-7422811e-f63eeb2d-039a8377.jpg,validate/p10/p10577647/s50822594/8dff4526-9cb4d9fd-7422811e-f63eeb2d-039a8377.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Subclavian line placement. TECHNIQUE: Chest, AP portable. COMPARISON: ___. FINDINGS: A right subclavian central venous catheter terminates at the cavoatrial junction. The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: Central line terminating at the cavoatrial junction. No evidence of acute cardiopulmonary disease. " b4aca6b2-98b1302d-88944126-d378cda0-cb9c2002.jpg,validate/p17/p17135687/s59929422/b4aca6b2-98b1302d-88944126-d378cda0-cb9c2002.jpg,validation," WET READ: ___ ___ ___ 8:37 PM Left apical pneumothorax is slightly larger than the prior study. Tiny right apical pneumothorax is unchanged. There is increasing left lower lobe consolidation which may represent atelectasis or effusion. The findings were discussed by Dr. ___ with Dr. ___ on ___ at 8:36 PM, 2 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bilateral chest tubes to water seal // ?ptx TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___. FINDINGS: Right subclavian central venous catheter, bilateral chest tubes, and metallic fragments are unchanged in position. The known left pneumothorax has increased. There is worsening predominantly left lower lobe atelectasis with leftward deviation of the cardiomediastinal structures. The tiny right apical pneumothorax is stable. The right lung is clear. IMPRESSION: Interval increase in moderate left pneumothorax. Stable tiny right apical pneumothorax. Increased predominantly left lower lobe atelectasis. " 3bfa0713-852810c9-e770e947-13310a3e-ce926658.jpg,validate/p18/p18458646/s54142680/3bfa0713-852810c9-e770e947-13310a3e-ce926658.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: CLL and 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, as are the hilar contours. IMPRESSION: No significant interval change. " 5ad0389c-28718a57-b0e9064e-18668534-6c78e372.jpg,validate/p15/p15355458/s58200412/5ad0389c-28718a57-b0e9064e-18668534-6c78e372.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Status post malposition of chest tube. COMPARISON: ___, 12:19. FINDINGS: As compared to the previous radiograph, the endotracheal tube has been pulled back. The tip of the tube now projects approximately 2 cm above the carina. There is no evidence of complications, in particular no pneumothorax. The appearance of the lung parenchyma is without substantial change. " cb8ca65c-54d5f2a5-943b9630-8a731d94-49fb7a28.jpg,validate/p11/p11770965/s57848819/cb8ca65c-54d5f2a5-943b9630-8a731d94-49fb7a28.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: AVR, MVR. Check CHF. IMPRESSION: AP chest compared to ___ through ___: Moderate-to-severe generalized infiltrative pulmonary abnormality been present for several days, presumably edema, has improved since ___. Postoperative cardiomediastinal silhouette which widened between ___ and ___, subsequently narrowed, and is now improved since ___. Left pleural effusion, small to moderate, collected laterally, presumably loculated, stable since ___. No pneumothorax. Left subclavian line ends in the mid SVC, right internal jugular dual-channel dialysis catheter ends in the upper right atrium. No pneumothorax. " 79a1daac-28114e80-140bc08c-5b0afb50-835dbaf4.jpg,validate/p12/p12822417/s52615193/79a1daac-28114e80-140bc08c-5b0afb50-835dbaf4.jpg,validation," FINAL REPORT INDICATION: ___ year old man with repositioning of PA catheter // position of PA catheter COMPARISON: Compared to prior radiographs performed 1 earlier. IMPRESSION: The Swan-Ganz catheter has been advanced approximately 2.5 cm and is now pointing towards the right main pulmonary artery. Endotracheal tube and feeding tube are unchanged. The side port of the nasogastric tube is again above the GE junction and should be advanced several centimeters. Lungs are clear. There are no pneumothoraces. Heart size is normal. " eb5da064-81894335-e84536fc-1b6b7c27-5f04e7c0.jpg,validate/p16/p16108772/s50312535/eb5da064-81894335-e84536fc-1b6b7c27-5f04e7c0.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. 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 unchanged. The same holds for the markedly generally widened and elongated thoracic aorta. Pulmonary vasculature is not congested. No signs of acute or chronic pulmonary parenchymal infiltrates can be identified and the lateral and posterior pleural sinuses are free. The on next previous chest examinations of ___ and ___, identified retrocardiac parenchymal densities have now cleared up completely. As the patient has a significant right-sided convex scoliosis in the thoracic area, the retrocardiac parenchymal density could only be identified on the lateral view as the heart shadow was obscuring major portions of the retrocardiac area. Comparison of the lateral views ascertains that the density has now been normalized. IMPRESSION: Moderate cardiac enlargement but no evidence of advanced interstitial or alveolar edema or pleural effusion. No remaining evidence of retro- cardiac parenchymal density observed on previous examinations. " 17d981d9-900043ba-799e611f-48085ab3-fa20e8ef.jpg,validate/p11/p11459120/s51394967/17d981d9-900043ba-799e611f-48085ab3-fa20e8ef.jpg,validation," FINAL REPORT HISTORY: Falls. Evaluate for pneumonia. COMPARISON: Chest radiograph ___ and ___. FINDINGS: FRONTAL AND LATERAL VIEWS OF THE CHEST: A left pectoral pacemaker is unchanged with leads terminating in the low right atrium and right ventricle. Left humeral hardware is partially imaged. The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. Heart size is top-normal. Pulmonary venous pressure has normalized. Mediastinal and hilar structures are unremarkable. " 8d1934bb-77ec4758-644a2794-612fcba8-56aa6f5b.jpg,validate/p14/p14556716/s51484603/8d1934bb-77ec4758-644a2794-612fcba8-56aa6f5b.jpg,validation," FINAL REPORT INDICATION: Fever and productive cough, question pneumonia. 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. There is an opacity adjacent to the right heart border. IMPRESSION: Opacity adjacent to the right heart border, which may represent a benign fat collection or benign cyst. No pneumonia. " 1d1cf1c0-41ce88bf-faae528b-ad97724c-c802411b.jpg,validate/p16/p16199597/s53646950/1d1cf1c0-41ce88bf-faae528b-ad97724c-c802411b.jpg,validation," WET READ: ___ ___ ___ 5:23 PM 1. Right basilar atelectasis 2. Blunting of the right greater than left posterior costophrenic angles may be compatible with bilateral trace pleural effusions. 3. No focal consolidation. WET READ VERSION #___ ___ ___ ___ 4:41 PM 1. Right basilar atelectasis 2. No focal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // chest pain COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. Radiopaque aortic valve replacement is noted. Lung volumes are low. Linear opacities in the right lower lobe likely represent basilar atelectasis. There is blunting of the right greater than left posterior costophrenic angles which may represent trace bilateral pleural effusions. There is no focal consolidation or pneumothorax. Heart size is top normal. Median sternotomy wires are noted. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: 1. Right basilar atelectasis 2. Blunting of the right greater than left posterior costophrenic angles may be compatible with bilateral trace pleural effusions. 3. No focal consolidation. " 95653ea4-00db0057-0041d022-50687183-2d115855.jpg,validate/p18/p18553055/s57048679/95653ea4-00db0057-0041d022-50687183-2d115855.jpg,validation," FINAL REPORT HISTORY: Fever, cough. Question infiltrate. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The heart is top-normal in size. The lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. There is redemonstration of a dense calcification in the upper abdomen consistent with known renal mass. IMPRESSION: No acute cardiopulmonary process. " e9ed9c98-b1f1b45e-a7946217-cf942724-5d8afa9b.jpg,validate/p19/p19526851/s52567001/e9ed9c98-b1f1b45e-a7946217-cf942724-5d8afa9b.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Congestive heart failure, presenting with shortness of breath. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: A dialysis catheter terminates at the cavoatrial junction. The heart is moderately enlarged as before. The mediastinal and hilar contours appear unchanged. Aside from a patchy left basilar opacity suggesting minor atelectasis, the lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable. IMPRESSION: No evidence of acute disease. " e67c0a5e-a84f42c5-e5303e77-207aeed9-750eeeec.jpg,validate/p14/p14212970/s55634848/e67c0a5e-a84f42c5-e5303e77-207aeed9-750eeeec.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dizziness // eval for consolidation COMPARISON: No priors FINDINGS: PA and lateral views of the chest provided. A linear radiodense structure projecting over the right heart should be correlated clinically. 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. " 12a6f2d2-f0d9ebca-e67deca5-0efc8f76-98d41904.jpg,validate/p17/p17159286/s57990782/12a6f2d2-f0d9ebca-e67deca5-0efc8f76-98d41904.jpg,validation," WET READ: ___ ___ ___ 7:07 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M CKD pt on dialysis presents with flapping tremor and productive cough // ?PNA 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 identified. Right midclavicular deformity could represent prior trauma. IMPRESSION: No acute cardiopulmonary process. " 527df2c5-85186282-3fb1e6e6-d1936528-b521b137.jpg,validate/p14/p14300020/s57090708/527df2c5-85186282-3fb1e6e6-d1936528-b521b137.jpg,validation," FINAL REPORT INDICATION: ___ year old man with cough // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: In comparison to the prior study there is no substantial change. Heart is normal in size and cardiomediastinal contours stable. There is no focal consolidation, pleural effusion, or pneumothorax. IMPRESSION: No evidence of pneumonia. NOTIFICATION: Findings were discussed by Dr. ___ with Dr. ___ ___ , on ___ at 3:00p, via telephone, as requested. " 95430081-efe112db-d8c7098b-a3afe8ff-1b81c00b.jpg,validate/p12/p12176298/s54550209/95430081-efe112db-d8c7098b-a3afe8ff-1b81c00b.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY ON ___ It is compared to multiple studies dating between ___, ___. FINDINGS: The patient is status post previous right upper lobe resection with similar postoperative volume loss and extensive apical thickening on the right compared to prior studies. Widespread airspace opacities in the right lung appear slightly improved in the right lung base, and combined alveolar and interstitial pattern in the left lung appears relatively similar to the prior study. Moderate right and small left pleural effusions are probably unchanged. Diffuse haziness throughout the imaged portion of upper abdomen is suggestive of ascites. " 839108b4-d273ef7b-6c937c63-c72189be-00b89f01.jpg,validate/p14/p14397935/s52486647/839108b4-d273ef7b-6c937c63-c72189be-00b89f01.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of chest pain, dyspnea, cough. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. The right costophrenic angle is not fully included on the images. Given this, there is eventration of the left hemidiaphragm. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. There are degenerative changes at the acromioclavicular joints. IMPRESSION: Right costophrenic angle not fully included on the image. Otherwise, no acute cardiopulmonary process. " 50d8a93b-8c2056b5-0d9eb1b6-fe08ecbf-f52eb172.jpg,validate/p18/p18221698/s52209576/50d8a93b-8c2056b5-0d9eb1b6-fe08ecbf-f52eb172.jpg,validation," FINAL REPORT HISTORY: Shortness of breath with history of CHF and PE. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph on ___. FINDINGS: There is cardiomegaly as well as diffuse alveolar opacities and septal thickening consistent with mild pulmonary edema. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are normal without effusion or pneumothorax. IMPRESSION: Mild pulmonary edema and cardiomegaly. " c808738b-e94a93cd-e9db1948-6f3add26-7da779ee.jpg,validate/p11/p11629754/s54979089/c808738b-e94a93cd-e9db1948-6f3add26-7da779ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman with Dobhoff tube placed // Dobhoff tube placement COMPARISON: Chest radiographs since ___. IMPRESSION: Feeding tube with the wire stylet in place ends at the gastroesophageal junction would need to be advanced 10 cm to move it fully into the stomach. Lungs are well expanded and clear. Tiny pleural effusions may be present. Heart size is normal. There is no pneumothorax. " acede858-eb296d64-2ca31ce1-8b0a07b6-e28bd0d7.jpg,validate/p12/p12450697/s55549715/acede858-eb296d64-2ca31ce1-8b0a07b6-e28bd0d7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History of arrhythmias, dyspnea on exertion for 1 month TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___, chest radiograph ___. FINDINGS: Heart size is mild to moderately enlarged, unchanged. Mediastinal and hilar contours are within normal limits. Linear and streaky opacities in the lung bases appear relatively unchanged compared to the previous exam with minimal increased atelectasis noted at the right lung base. No focal consolidation, pleural effusion or pneumothorax is identified. There is no pulmonary edema. No acute osseous abnormality seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: Slightly increased right basilar atelectasis. " 6f5fced8-3da5a2ed-e4e2ad8d-4c207190-29b8613f.jpg,validate/p15/p15297415/s52658218/6f5fced8-3da5a2ed-e4e2ad8d-4c207190-29b8613f.jpg,validation," WET READ: ___ ___ ___ 8:02 AM Dobbhoff tube position within the stomach. WET READ VERSION #1 ___ ___ 7:13 PM Dobbhoff tube position within the stomach. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETOH cirrhosis, Dobhoff just broke and needed to be replaced. // Positioning of dobhoff IMPRESSION: As compared to previous study from earlier the same date, a feeding tube has been advanced within the proximal stomach. Within the image portion of the chest, persistent right basilar hydro pneumothorax is noted with adjacent atelectasis, similar to the recent radiograph of 1 hr earlier. " 41bd716f-b27df541-fa288893-67c63530-deaf508b.jpg,validate/p15/p15501234/s57262284/41bd716f-b27df541-fa288893-67c63530-deaf508b.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: 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. IMPRESSION: No evidence of acute disease. " 3c29224b-98e0cdb6-6738f7a2-6720e085-5b229f92.jpg,validate/p14/p14804548/s58561756/3c29224b-98e0cdb6-6738f7a2-6720e085-5b229f92.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dyspnea. // interval change, pulmonary vascular congestion interval change, pulmonary vascular congestion IMPRESSION: In comparison with the study of ___, there is little interval change. The cardiac silhouette is at the upper limits of normal in size and there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. Streak of atelectasis is seen at the left base. " 330dc201-1e767db2-4a683910-431dbb2a-8dd34784.jpg,validate/p14/p14206119/s55863403/330dc201-1e767db2-4a683910-431dbb2a-8dd34784.jpg,validation," FINAL REPORT HISTORY: Status post mitral valve repair, eval for pneumothorax. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. There is no pneumothorax. The small region of opacification at the base of the left lung has essentially cleared. A tiny left pleural effusion is stable. Normal postoperative cardiomediastinal silhouette. IMPRESSION: No pneumothorax. Lungs are clear, with persistent tiny left pleural effusion. " c6bb157e-fdb0cfa9-ad661a29-144f31f3-f0b1aba7.jpg,validate/p10/p10747985/s51938674/c6bb157e-fdb0cfa9-ad661a29-144f31f3-f0b1aba7.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: There is little change compared to prior examination with redemonstration of significant cardiomegaly and postoperative mediastinal contour. A central vascular congestion with upper zone redistribution is again noted without frank interstitial edema. There is redemonstration of a retrocardiac consolidation which obscures the left hemidiaphragm. A right-sided PICC terminates in the low SVC. There is no large effusion or pneumothorax. IMPRESSION: Retrocardiac consolidation which may be atelectasis or pneumonia. Conventional lateral view may be helpful for further evaluation. Vascular congestion without frank edema. " 14e9ddc9-fc97a4d8-0b8d6819-b4df2abe-c5f4aba3.jpg,validate/p10/p10817855/s50854874/14e9ddc9-fc97a4d8-0b8d6819-b4df2abe-c5f4aba3.jpg,validation," WET READ: ___ ___ ___ 6:36 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M transferred from OSH with left mid tibial fracture // ?ortho work up TECHNIQUE: AP and lateral views. 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. IMPRESSION: No acute cardiopulmonary abnormality. " f6d77c40-8263f4ff-785ea275-f5ac6afa-a478a310.jpg,validate/p16/p16669225/s58711504/f6d77c40-8263f4ff-785ea275-f5ac6afa-a478a310.jpg,validation," 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. " b5a52dff-18199ce0-77053c1e-f25bc95c-35826f46.jpg,validate/p15/p15276734/s56471956/b5a52dff-18199ce0-77053c1e-f25bc95c-35826f46.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with sepsis, intubated TECHNIQUE: Portable supine AP view of the chest COMPARISON: None. FINDINGS: Endotracheal tube tip terminates approximately 6.5 cm from the carina. The heart size is normal. The aorta is diffusely calcified. Mediastinal contours are unremarkable. Hilar contours are prominent, suggestive of underlying enlargement of the pulmonary arteries. Severe emphysema is seen within the lung apices, more pronounced on the right. Patchy opacity in the left lower lobe is concerning for an area of infection. No pleural effusion or pneumothorax is identified. No acute osseous abnormality is detected. IMPRESSION: Endotracheal tube in standard position. Patchy left basilar opacity concerning for infection. Severe emphysema. " 1b8e0fff-cfcab093-66f80fe6-648d3291-1267ef6b.jpg,validate/p14/p14689761/s59058460/1b8e0fff-cfcab093-66f80fe6-648d3291-1267ef6b.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest burning. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: There has been a decrease in right hilar and subcarinal fullness since that examination. However, a number of nodular foci appear increased or new in each lung; these are otherwise hard to assess in detail. The minor fissure shows new thickening. There is no pleural effusion or pneumothorax. IMPRESSION: Apparent increase in size and number of pulmonary nodules. When clinically appropriate, correlation with chest CT is recommended. Persistent but decreased hilar and subcarinal soft tissue fullness reflecting a probable reduction in lymphadenopathy. " ed44747a-6e07b89e-f4eddecf-a489d4d4-b8ba17d6.jpg,validate/p12/p12366744/s50184936/ed44747a-6e07b89e-f4eddecf-a489d4d4-b8ba17d6.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with fever, tachy // eval for 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. " ddd77e27-486b81a3-aab61bb4-5da5ca73-c481e7a0.jpg,validate/p18/p18968637/s53669622/ddd77e27-486b81a3-aab61bb4-5da5ca73-c481e7a0.jpg,validation," FINAL REPORT INDICATION: ___M s/p CABG ___ now w/ afib w/ RVR // eval ? effusion, infiltrate TECHNIQUE: AP and lateral views of the chest COMPARISON: Prior radiographs most recent on ___ FINDINGS: The patient is status post median sternotomy and CABG. The cardiomediastinal and hilar contours are within normal limits. The aorta is tortuous. Lung volumes are somewhat low. There is a small right pleural effusion and minimal right lower lobe atelectasis, not significantly changed from the prior examination. A small linear opacity adjacent to the left hilum is consistent with some platelike atelectasis. There is no pneumothorax. IMPRESSION: Small right pleural effusion and adjacent pulmonary opacity suggesting atelectasis not significantly changed from the prior examination. Small platelike opacity in the left midlung is consistent with atelectasis. " 9431f1f6-81be3ca7-f740c79e-2232e3d7-b6578fad.jpg,validate/p14/p14449195/s59179499/9431f1f6-81be3ca7-f740c79e-2232e3d7-b6578fad.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with left leg pain and swelling, erythema. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Lower lung volumes seen on the current exam. There are increased interstitial markings without frank evidence of consolidation or effusion. Cardiac silhouette is enlarged but not changed given differences in positioning and technique. Calcification projecting over the right lung apex could be due to calcification/scarring versus due to overlying vascular calcifications. Osseous and soft tissue structures are unremarkable. IMPRESSION: No significant interval change. Mild interstitial edema and cardiomegaly. No evidence of consolidation. " be3afa09-5f61174f-94907fee-406f604d-6e543f20.jpg,validate/p10/p10449408/s55750250/be3afa09-5f61174f-94907fee-406f604d-6e543f20.jpg,validation," FINAL REPORT HISTORY: Cirrhosis, status post multiple products, question pulmonary edema. CHEST, SINGLE PORTAL VW An ET tube is present, tip at the level of the mid-clavicular heads approximately 4.2 cm above the carina. A left-sided PICC line is present, tip over mid SVC. The patient is rotated. Allowing for this, there is asymmetric vascular plethora and interstitial edema, and, at the lung base, more confluent opacity, all more pronounced on the right side. This may represent asymmetric CHF. There is also atelectasis and ? small effusion at the right base. There is increased retrocardiac opacity and obscuration of the left hemidiaphragm, consistent with left lower lobe collapse and/or consolidation. Compared with ___ at 14:38 p.m., the CHF findings are similar. Left base opacity has progressed. The orogastric tube has been removed. " 0a7b1607-37f15f37-5fd0e0f8-6264db33-548922db.jpg,validate/p18/p18909627/s56171119/0a7b1607-37f15f37-5fd0e0f8-6264db33-548922db.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with osteomyelitis status post corpectomy. TECHNIQUE: Single frontal chest radiograph was obtained portably with the patient in a semi erect position. COMPARISON: ___. FINDINGS: There has been interval removal of the endotracheal tube. An esophageal catheter courses below the diaphragm with tip out of view. Left subclavian catheter appears similarly positioned. Sternal wires and cervical spine hardware appear similarly positioned on this frontal view. There is slightly improved aeration at the right lung base. Hazy opacification of the right lower lung field is likely secondary to pleural fluid. No pneumothorax is detected. Heart and mediastinal contours are stable. IMPRESSION: Interval extubation with slightly improved aeration at the right lung base. Right pleural effusion. " c940042e-e9c87c0f-35a08d5d-5e8b1c38-3393626f.jpg,validate/p17/p17165725/s57611639/c940042e-e9c87c0f-35a08d5d-5e8b1c38-3393626f.jpg,validation," WET READ: ___ ___ ___ 9:23 PM Status post removal of the right pigtail catheter. Other line and tubes in satisfactory position. Tiny right apical pneumothorax. Otherwise unchanged radiograph. Results discussed with Dr. ___ at 920 PM on ___ via telephone by Dr. ___ at the time the findings were discovered. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST 6:28 P.M. ___ HISTORY: Chest tube removed. Is there pneumothorax. IMPRESSION: AP chest compared to ___, 10:12 a.m.: There has been no appreciable change in small residual right pleural effusion, or development of pneumothorax, since ___, 10:12 a.m. and removal of the right pleural pigtail catheter. Mild edema and vascular congestion in the right lung persists. Moderate-to-severe cardiomegaly is chronic. There is no edema or pneumonia on the left. A right PIC line ends in the mid SVC alongside a right internal jugular line. Upper enteric feeding tube passes into the stomach and out of view. No pneumothorax. " 40e563b7-3050e886-4ec3ea0a-d9e2e7a5-99569292.jpg,validate/p16/p16209336/s50080804/40e563b7-3050e886-4ec3ea0a-d9e2e7a5-99569292.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with respiratory failure, intubated // interval change, tube placement interval change, tube placement IMPRESSION: In comparison with the study of the ___ and ___, the cardiac silhouette is slightly more prominent and there is some indistinctness of pulmonary vessels that could reflect elevated pulmonary venous pressure. No evidence of acute focal pneumonia or pleural effusion. There is an endotracheal tube in place with its tip approximately 3.7 cm above the carina. Nasogastric tube extends at least to the upper stomach, were crosses the lower margin of the image. " 28e7ccb8-a40ae620-cc76e7dd-788fc221-1396f3f7.jpg,validate/p14/p14766138/s59533605/28e7ccb8-a40ae620-cc76e7dd-788fc221-1396f3f7.jpg,validation," WET READ: ___ ___ ___ 9:22 AM Left-sided pleural effusion may be minimally decreased in size from the prior examination done on ___. No other significant change from the prior exam. WET READ VERSION #___ ___ ___ ___ 10:00 PM Left-sided pleural effusion may be minimally decreased in size from the prior examination done on ___. No other significant change from the prior exam. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest tube for parapneumonic effusion // interval change and tube placement COMPARISON: ___ IMPRESSION: Unchanged position of the left chest tube. No pneumothorax. Minimal decrease of the left pleural fluid collection. Subsequent areas of left basilar atelectasis are constant. Unchanged appearance of the right lung and of the cardiac silhouette. " 9058e39e-faa9337d-e6a213e2-efb2e934-85dcf1c3.jpg,validate/p13/p13626140/s58914773/9058e39e-faa9337d-e6a213e2-efb2e934-85dcf1c3.jpg,validation," 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. " fabc247f-822c14c7-eb2d3eec-973b6d41-7e02d68b.jpg,validate/p14/p14309697/s54674227/fabc247f-822c14c7-eb2d3eec-973b6d41-7e02d68b.jpg,validation," FINAL REPORT HISTORY: Pre-syncope. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. No evidence of pneumonia, vascular congestion, or pleural effusion. " 43d4732e-f7a32cb2-0d8a40b3-cfee32b3-a9a79b6e.jpg,validate/p13/p13870142/s58778336/43d4732e-f7a32cb2-0d8a40b3-cfee32b3-a9a79b6e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of chest pain, shortness of breath. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal left base atelectasis. No focal consolidation, pleural effusion, or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " aebfbc4a-94be6db4-67fbde6d-fb477933-2a131c65.jpg,validate/p11/p11000566/s50230446/aebfbc4a-94be6db4-67fbde6d-fb477933-2a131c65.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new dyspnea and tachycardia // r/o infection vs pulm edema COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. The position of the right central venous access is constant. No pleural effusions. No cardiomegaly. No pneumothorax. No pulmonary edema. No pneumonia. " 234662da-445e6478-ec0e4e63-2ca4547e-b45182b5.jpg,validate/p11/p11943583/s55919805/234662da-445e6478-ec0e4e63-2ca4547e-b45182b5.jpg,validation," FINAL REPORT HISTORY: Recurrent pleural effusion status post thoracentesis x2, followup effusion. COMPARISON: Chest radiographs from ___ through ___. FINDINGS: Frontal and lateral views of the chest demonstrates an opacification of the right lung base, which likely represents chronic right pleural effusion, and is essentially unchanged from ___. The lungs are otherwise clear. The heart is stably enlarged. The mediastinal and hilar contours are unchanged. There is no pneumothorax. There is no left pleural effusion. IMPRESSION: Opacification of the right lung base present and essentially unchanged since ___, likely represents a chronic right pleural effusion. " e4e2439c-5bfc8142-94019938-d1e904fa-8be92c01.jpg,validate/p17/p17402090/s53275687/e4e2439c-5bfc8142-94019938-d1e904fa-8be92c01.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COPD // RENEW study screening for patients with severe emphysema COMPARISON: No comparison IMPRESSION: The lung volumes are large and the shape of the hemidiaphragms indicate massive overinflation. There is paucity of lung structure at apices, suggesting massive pulmonary emphysema. In addition, bilateral partly calcified parenchymal scars are seen, both on the lung bases and at the lung apices. All these changes are better displayed on a CT examination previously performed on ___. No pleural effusions. Normal size of the cardiac silhouette. " e5542923-e937d464-ec67a05f-fa71b4ea-a60cab02.jpg,validate/p14/p14421594/s58219265/e5542923-e937d464-ec67a05f-fa71b4ea-a60cab02.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with cough, fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Heart size appears borderline enlarged, likely accentuated due to low lung volumes. Mediastinal and hilar contours are unremarkable with mild atherosclerotic calcifications noted at the aortic knob. Pulmonary vasculature is normal. Patchy opacities are demonstrated in the lung bases likely reflective of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities demonstrated. IMPRESSION: Low lung volumes with bibasilar patchy opacities likely atelectasis. " c667ff3f-083681db-f3671e5f-bccecc2d-8d11e74a.jpg,validate/p10/p10449408/s55013844/c667ff3f-083681db-f3671e5f-bccecc2d-8d11e74a.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with volume overload and renal failure, now on CVVH. Please evaluate for interval change. TECHNIQUE: Portable semi-erect frontal chest radiograph is obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Right central venous line ends at the mid-to-lower SVC, and the left hemodialysis catheter ends at the mid-to-upper SVC. The endotracheal tube ends in the trachea approximately 6 cm above the carina. Bilateral pulmonary opacification, consistent with pulmonary edema, is mildly improved. Nasogastric tube is in the stomach and ends outside the view of the radiograph. Cardiomegaly continues to be seen. IMPRESSION: Minimal improvement in pulmonary edema. " 47522e8a-c4a61c00-fd27e115-1339c2c1-89514bf8.jpg,validate/p17/p17975710/s56475366/47522e8a-c4a61c00-fd27e115-1339c2c1-89514bf8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with history of asthma and sarcoidosis. // evaluate for interval change, ? sarcoidosis evolving evaluate for interval change, ? sarcoidosis evolving IMPRESSION: In comparison with the study of ___, there is little interval change. Post surgical or procedure changes are seen at the right base with no evidence of pneumothorax. There is stable prominence of the pulmonary outflow tract on the left. No vascular congestion or acute pneumonia. " 4de001e6-4ea5e597-29d9140b-13c765e6-5acc945d.jpg,validate/p12/p12857399/s56610784/4de001e6-4ea5e597-29d9140b-13c765e6-5acc945d.jpg,validation," WET READ: ___ ___ 6:25 PM Calcified enlarged mediastinal and hilar nodes raising the possibility for diagnosis such as sarcoidosis or prior granulomatous disease. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with chest pain // ?pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear of focal consolidation, effusion, or pneumothorax. The cardiac silhouette is within normal limits. There are calcified bilateral hilar and right paratracheal nodes which are enlarged. No acute osseous abnormalities identified. IMPRESSION: Calcified enlarged mediastinal and hilar nodes raising the possibility for diagnosis such as sarcoidosis or prior granulomatous disease. No acute cardiopulmonary process. " cfc5f6b6-2c7ddc4f-f34bdcc8-2880d8b7-54333272.jpg,validate/p14/p14501307/s51916515/cfc5f6b6-2c7ddc4f-f34bdcc8-2880d8b7-54333272.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypertensive urgency. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The heart appears top normal in size. Mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Top normal heart size. Otherwise, unremarkable. Clinical correlation is advised given patient's age. " ea95e945-e66f2be3-e8b7f72a-c353dab7-910b08c9.jpg,validate/p15/p15217519/s51762694/ea95e945-e66f2be3-e8b7f72a-c353dab7-910b08c9.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Lung volumes are low. Heart size is accentuated as a result, appearing borderline enlarged. Mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Low lung volumes. No acute cardiopulmonary abnormality. " 392a6347-a7eaa76d-23714162-bdf7a518-e0393663.jpg,validate/p11/p11200755/s56356351/392a6347-a7eaa76d-23714162-bdf7a518-e0393663.jpg,validation," WET READ: ___ ___ 11:04 PM Low lung volumes. Probable peribronchial cuffing. No definite consolidation concerning for pneumonia. -NSR WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with severe persistent asthma, admitted for exacerbation in setting of URI. IMPRESSION: PA and lateral chest compared to ___. Normal heart, lungs, hila, mediastinum and pleural surfaces. " 42021727-cd3fe90e-df6758d1-f91aad81-7ff3d08d.jpg,validate/p17/p17653729/s59624417/42021727-cd3fe90e-df6758d1-f91aad81-7ff3d08d.jpg,validation," FINAL REPORT Stone EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___F h/o asthma/COPD, Afib, CVA with residual left sided weakness, PAD s/p left AKA in ___, seizure disorder and recurrent C. Diff w/ recent sigmoid perforation s/p exlap, repair of sigmoid perforation and small bowel resection now with respiratory distress and right lung collapse now s/p intubation with persistent pulmonary edema, cholecystitis: // interval cahnges COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Mild pulmonary edema worsened on ___, minimally improved since ___:30. Mild to moderate enlargement of the cardiac silhouette is stable. Small pleural effusions are presumed, and may have increased in the antrum. There is no pneumothorax. ET tube, right PIC line, are in standard placements and nasogastric tube passes below the diaphragm and out of view. " e8768b2f-80e503d8-bf0a8380-52d7e1e4-2ed0249b.jpg,validate/p11/p11164411/s50295939/e8768b2f-80e503d8-bf0a8380-52d7e1e4-2ed0249b.jpg,validation," FINAL REPORT HISTORY: Cough and fever. COMPARISON: Multiple prior examinations, most recently ___. FINDINGS: Frontal and lateral views of the chest were obtained. Sternotomy cerclage wires and prosthetic cardiac valve are intact and in stable position. Left ventricular configuration of the heart is unchanged. Atelectasis and scarring in the lower lobes is similar to prior. Left hemidiaphragm remains mildly elevated. No focal consolidation, pleural effusion, or pneumothorax. Thoracic levoscoliosis is unchanged. IMPRESSION: No acute cardiopulmonary process. " e3829e03-d3ad2abb-dbe59957-ccf0388b-635599fc.jpg,validate/p14/p14997223/s53774123/e3829e03-d3ad2abb-dbe59957-ccf0388b-635599fc.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Dobbhoff placement. AP radiograph of the abdomen, focusing on the upper abdomen, was reviewed. The Dobbhoff tube tip is most likely in the distal duodenum/proximal jejunum. The bowel gas is nonspecific. " 7a561e9b-8a53216a-bb2050de-17df0f14-86525c32.jpg,validate/p10/p10532853/s54450283/7a561e9b-8a53216a-bb2050de-17df0f14-86525c32.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: None. FINDINGS: PA and lateral images of the chest. The lungs are without definite infiltrate. There is mild increase density of the posterior lower lung on the lateral view which may be due to atelectasis. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. " a553dad1-a315e903-2d7a2782-031af0e5-f8eb2290.jpg,validate/p17/p17737380/s58112364/a553dad1-a315e903-2d7a2782-031af0e5-f8eb2290.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Weight loss, history of chronic smoking, family history of cancer, rule out abnormality. COMPARISON: ___. FINDINGS: There is a new ill-defined opacity measuring 2.5 cm at the right lower lung that is not visible on the lateral view. It could possibly represent the nipple. The rest of the lung is unremarkable. The mediastinal and cardiac contour are within normal limits. There is no pneumothorax or pleural effusion. CONCLUSION: New right basal opacity that could represent the nipple. Shallow oblique views with nipple markers is suggested. The results have been submitted to the radiology dashboard ___ at 18h32. " 1cbb26ef-f3e11e54-71eff05c-26c7860b-a692ae8a.jpg,validate/p12/p12949882/s51738368/1cbb26ef-f3e11e54-71eff05c-26c7860b-a692ae8a.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of ___, there is little interval change. Enlargement of the cardiac silhouette with left ventricular prominence persists. No definite vascular congestion or pleural effusion. There is a suggestion of some increased opacification at the right base, though this was also seen on the previous study. In the appropriate clinical situation, an early consolidation could be considered. " 37c1ffe1-dc5c7d9f-67ae1ee0-57de3db5-48310418.jpg,validate/p13/p13652184/s54481565/37c1ffe1-dc5c7d9f-67ae1ee0-57de3db5-48310418.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Motor vehicle collision. Left pneumothorax. IMPRESSION: AP chest compared to ___: Moderate left pleural effusion probably unchanged since ___. No pneumothorax. Right lung clear. Left basal atelectasis stable. Extent of the displacement of lateral left lower rib fractures, is considerable but unchanged. " 3aec04a8-470b1170-fafd2a3c-010fcbca-4ddf9c35.jpg,validate/p19/p19955348/s57122040/3aec04a8-470b1170-fafd2a3c-010fcbca-4ddf9c35.jpg,validation," 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. " 7595f670-78a4b927-fe87d492-a517af7f-7c1ba4ac.jpg,validate/p11/p11172882/s55435472/7595f670-78a4b927-fe87d492-a517af7f-7c1ba4ac.jpg,validation," FINAL REPORT INDICATION: Nasogastric tube pulled out. Evaluate NJT placement. COMPARISON: ___ at 9:43 a.m. FRONTAL SUPINE PORTABLE CHEST: Nasogastric tube ends 2.2 cm above the carina. Right internal jugular catheter ends in the mid SVC. A nasoenteric tube follows the expected course, with the tube in the region of the pylorus or first part of the duodenum. The visualized bowel gas pattern is non-obstructive. Pulmonary edema is unchanged. There is a small right pleural effusion. No substantial pneumothorax. Cardiac and mediastinal silhouettes are stable. " 9f0f33c8-7505df7b-3cd05f2b-9738e728-178bae59.jpg,validate/p15/p15366293/s58316268/9f0f33c8-7505df7b-3cd05f2b-9738e728-178bae59.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tracheal stenosis s/p stent placement // tracheal stent TECHNIQUE: Chest single view COMPARISON: ___ 04:32 FINDINGS: Tracheal stenosis has improved with stent in place. No pneumothorax. No pneumomediastinum. Linear band of atelectasis left lower lung base medially. Normal heart size, pulmonary vascularity. Right lung is clear. IMPRESSION: Tracheal stent in place. " 35e3fe9d-5097aea7-51363348-f46dd261-ec357a6c.jpg,validate/p18/p18862368/s53081922/35e3fe9d-5097aea7-51363348-f46dd261-ec357a6c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with syncope // ? infectious process TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are hyperinflated and diaphragms are flattened, consistent with COPD. There is probable cardiomegaly. The aorta is calcified and unfolded. No CHF, focal consolidation, pleural effusion or pneumothorax is detected. Minimal atelectasis and possible minimal blunting of left costophrenic angle. There is a moderately large hiatal hernia. Probable diffuse osteopenia. Note, there is a severe compression fracture (near vertebral plana) in the low thoracic spine that results in thoracic kyphosis. IMPRESSION: 1. No evidence of pneumonia. 2. Background COPD. Probable cardiomegaly. 3. Moderately large hiatal hernia. 4. Severe compression fracture in a low thoracic vertebral body, associated with accentuated kyphosis. This is of uncertain acuity. If the patient has new onset focal symptoms in this area, the possibility of a recent thoracic spine fracture would be difficult to exclude and further assessment with MRI or CT would be useful. " 052bac51-20a0d917-0ab433a1-1acd1ca0-f62d1ce1.jpg,validate/p12/p12457907/s55418070/052bac51-20a0d917-0ab433a1-1acd1ca0-f62d1ce1.jpg,validation," FINAL REPORT INDICATION: ___-year-old male post-right upper lobectomy, with chest tube clamped. COMPARISON: ___. CHEST, PA AND LATERAL: Thoracostomy tube terminates at the right lung apex. Right upper lobectomy changes, with ipsilateral volume loss and mediastinal shift. Minimal residual pneumothorax, but with continued extrapleural air in the right chest wall. Small amount of fluid outlines the right major fissure. The left lung is well expended and clear. Heart size is top normal. IMPRESSION: Minimal residual right pneumothorax. " c735f2cb-29cb2bb5-a4517085-2e95398c-2391e945.jpg,validate/p19/p19891610/s52480678/c735f2cb-29cb2bb5-a4517085-2e95398c-2391e945.jpg,validation," 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. " e003447c-669619fd-cb6792cc-b638632c-7f616840.jpg,validate/p15/p15573773/s50244256/e003447c-669619fd-cb6792cc-b638632c-7f616840.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with hypoxia. COMPARISON: Chest radiograph from ___ and ___ and chest CT from ___. PORTABLE UPRIGHT AP CHEST RADIOGRAPH: The patient has chronic atelectasis in the lung bases as evidenced by chest CT from ___. A rounded dense opacity in the right lung base corresponds with an area of rounded atelectasis on prior CT. The right-sided pleural effusion has increased in size, now moderate, where as aeration of the left lung base has improved. No definite superimposed consolidation is identified. A right-sided central venous catheter terminates in the expected location of the cavoatrial junction. There is no pneumothorax. The heart size remains moderately enlarged. IMPRESSION: 1. Stable chronic bibasilar atelectasis with more focal rounded atelectasis in the right lung base. 2. Increasing right pleural effusion, now moderate. 3. No definite new superimposed consolidation. 4. Right central venous catheter terminating at the cavoatrial junction. " 13dd1476-136857fc-a39deb53-0283957b-7eca1744.jpg,validate/p10/p10056441/s57565663/13dd1476-136857fc-a39deb53-0283957b-7eca1744.jpg,validation," 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. Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " dd429e2a-b3c5be4b-4ffbe024-79cc1d13-a5b2638c.jpg,validate/p14/p14452024/s50373399/dd429e2a-b3c5be4b-4ffbe024-79cc1d13-a5b2638c.jpg,validation," FINAL REPORT HISTORY: Cough, fever, and chest pain. COMPARISON: None. 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. " 565a6469-475363e9-c297db14-35f46a2e-8f190da1.jpg,validate/p14/p14393219/s51510745/565a6469-475363e9-c297db14-35f46a2e-8f190da1.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p whipple now with increased wbc and fever, ? pna on portable cxr // please evaluate for possible pna EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There are persistent opacities in the right infrahilar region and retrocardiac region left lower lobe, suspicious for aspiration pneumonia. There is no pulmonary edema or pneumothorax. There is trace left pleural effusion. Left infusion port terminates in mid SVC. Pneumoperitoneum under the right hemidiaphragm is consistent with recent abdominal surgery. IMPRESSION: There are persistent opacities in the right infrahilar region and retrocardiac region left lower lobe, suspicious for aspiration pneumonia. " 7ca619cc-472ea095-8739b082-2f10e479-7cd5fb50.jpg,validate/p11/p11966980/s50568299/7ca619cc-472ea095-8739b082-2f10e479-7cd5fb50.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post surgery, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in constant position. Bilateral areas of atelectasis in both the retrocardiac lung region and the right lung bases. No newly appeared focal parenchymal opacities. No pneumothorax. " f48dbb39-55fa1cfc-8e054e7c-796b441d-bf053af4.jpg,validate/p16/p16974695/s50826592/f48dbb39-55fa1cfc-8e054e7c-796b441d-bf053af4.jpg,validation," WET READ: ___ ___ 4:24 AM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___F with hypotension n/v abdominal pain jaundice // eval for pna cxr eval for abdominal pathology TECHNIQUE: Chest AP and lateral COMPARISON: None. FINDINGS: There is platelike atelectasis at the right lung base. Lung volumes are low. There is mild reticulation at the lung bases bilaterally. The heart size is normal. No pneumothorax. There is mild apical capping at the left lung apex. IMPRESSION: Questionable appearance of the lower lungs is probably due to low lung volumes when comparing with CT from the same date. " 514aad53-49adef0e-09c6efad-1ef73a93-ee1529b2.jpg,validate/p13/p13297743/s59544193/514aad53-49adef0e-09c6efad-1ef73a93-ee1529b2.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia or pleural effusion in a ___-year-old woman with epigastric and right lower quadrant pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs again demonstrate a right chest wall port, with the catheter terminating at in the low SVC. The cardiomediastinal silhouette is normal and the lungs well-aerated, without focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 888fdb98-e69e366d-5e7eea80-7ed9da3a-f2296c9a.jpg,validate/p16/p16055506/s56157121/888fdb98-e69e366d-5e7eea80-7ed9da3a-f2296c9a.jpg,validation," FINAL REPORT PORTABLE CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with stab wounds, evaluate pneumothorax. Comparison to prior study dated ___ at ___. Portable AP upright chest film ___ at ___ is submitted. IMPRESSION: 1. A left pigtail pleural catheter remains in place. No pneumothorax is seen. The left hemidiaphragm remains slightly elevated with a prominent amount of gas within the stomach. Patchy opacity at the left base likely reflects atelectasis, though an early infectious process should also be considered. Overall, cardiac and mediastinal contours are stable. A minimal amount of air within the left lateral chest wall soft tissues is again seen. " 48448ff7-b6fcd4cd-f4000cf9-ae77f5fb-8628aeb6.jpg,validate/p15/p15474097/s56392430/48448ff7-b6fcd4cd-f4000cf9-ae77f5fb-8628aeb6.jpg,validation," FINAL REPORT HISTORY: CABG 3 weeks ago with nausea and weakness for 3 weeks. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy and CABG. The cardiac silhouette size appears unchanged, mildly enlarged. The mediastinal and hilar contours are stable. The pulmonary vascularity is normal. Small bilateral pleural effusions have decreased in size compared to the prior exam. Minimal streaky opacity in the left lung base is compatible with atelectasis. There is no focal consolidation. No pneumothorax is identified. There are multilevel degenerative changes in the thoracic spine. IMPRESSION: Small bilateral pleural effusions, decreased from the prior study, with minimal left basilar atelectasis. " 9efe5b61-73543f58-b96d0fb6-78e9fd28-137c024c.jpg,validate/p12/p12537194/s50054354/9efe5b61-73543f58-b96d0fb6-78e9fd28-137c024c.jpg,validation," FINAL REPORT INDICATION: ___ year old man with sob/back pain found to have R pleural effusion and widespread mets. // Trend pleural effusion TECHNIQUE: Portable AP chest radiograph COMPARISON: Chest radiographs since ___, most recently ___. FINDINGS: The right chest tube is unchanged in position and the large right pleural effusion is smaller than on ___, consistent with interval partial drainage. The pleural space previously filled with fluid is now filled with air and the nearly completely collapsed right lung has not reexpanded, unchanged since ___. Mediastinal contours and cardiomegaly are stable. The left lung is well expanded and clear. No left pleural effusion. IMPRESSION: Decreased size of the large right pleural effusion since ___ without re-expansion of the nearly completely collapsed right lung. Moderate-to-large amount of air in the right apical pleural space is unchanged from ___. " 44f72e9d-710d2bc8-85280f4d-9494ac89-bbd3b7d8.jpg,validate/p12/p12785654/s50041954/44f72e9d-710d2bc8-85280f4d-9494ac89-bbd3b7d8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with trach, hypercarbia, frequent suctioning // pneumonia? edema? TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed the same day earlier in the morning FINDINGS: There are persistent low lung volumes. Retrocardiac opacities have improved. Right lower lobe atelectasis are stable. There is no pneumothorax. Cardiomegaly is a stable. Tracheostomy tube is in standard position. IMPRESSION: Improved left lower lobe opacities. " 1bb1504d-78e4598e-5a6cc597-b2aa2903-2eaf6964.jpg,validate/p17/p17374306/s50406408/1bb1504d-78e4598e-5a6cc597-b2aa2903-2eaf6964.jpg,validation," FINAL REPORT INDICATION: ___M with SB, bibasilar crackles // cardiomegaly/ Pleural effusions? pulm edema? TECHNIQUE: Frontal 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. " 52ed5ad3-1923ffd2-4c5bc04b-6da6ad26-abaf639e.jpg,validate/p18/p18090640/s55215555/52ed5ad3-1923ffd2-4c5bc04b-6da6ad26-abaf639e.jpg,validation," FINAL REPORT INDICATION: Patient with right lung findings on ___ radiograph, who presents for further evaluation. COMPARISONS: Chest radiographs of ___, ___ and CT chest of ___. FINDINGS: AP and apical lordotic views are provided. Right apical opacity seen on ___ exam is not seen on the AP view. A small stellate scar is noted in the right apex on the lordotic view. Lung volumes are normal. No pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are normal. No pulmonary edema. Heart size is normal. Partially imaged upper abdomen is unremarkable. IMPRESSION: Right apical opacity seen on ___ exam, is not visualized on AP view. Apical lordotic view demonstrates a small stellate scar in the right lung apex. " 77205e07-de6b4752-e1d5a86c-dec68423-84f4f787.jpg,validate/p16/p16847478/s51442589/77205e07-de6b4752-e1d5a86c-dec68423-84f4f787.jpg,validation," WET READ: ___ ___ 8:06 AM Low lung volumes without focal consolidation. Fractures of right lateral ribs 3 through 4 and 6 through 7. No pneumothorax. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT TECHNIQUE: Chest AP view. COMPARISON: Outside hospital chest CT ___. FINDINGS: Heart size is top normal. Apparent mediastinal widening is accounted for by mediastinal lipomatosis, as seen on recent CT. There is no pneumothorax or large pleural effusion. Lung volumes are low, but there is no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. There are acute nondisplaced fractures of right lateral ribs 3, 4, 6, and 7. No other fractures are visualized. IMPRESSION: 1. Acute fractures of right lateral ribs 3, 4, 6, and 7. No pneumothorax. 2. Low lung volumes without focal consolidation. " 85584bbb-d7a194a7-a8c71e34-1cc065b9-269bd17b.jpg,validate/p10/p10106244/s55172864/85584bbb-d7a194a7-a8c71e34-1cc065b9-269bd17b.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with asthma, is c/o SOB and some wheezing, r/o pneumonia // patient is Asthmatic, c/o some SOB and wheezing at times has been on antibiotics for about 2 weeks, with no change TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___ through ___ FINDINGS: The lungs are normally hyperexpanded but clear. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: Mild hyper expansion of the lungs. No evidence of pneumonia. " 0811b7a5-eed5dca8-54bb7134-231e9c91-b45f93ec.jpg,validate/p15/p15672432/s55983343/0811b7a5-eed5dca8-54bb7134-231e9c91-b45f93ec.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with a history of CABG here with cough and dyspnea, evaluate for left lower lobe pneumonia. TECHNIQUE: AP and lateral upright radiographs of the chest. COMPARISON: Chest x-ray ___ at 06:15. FINDINGS: The cardiomediastinal silhouette is unchanged, suggestive of mild cardiomegaly. Median sternotomy wires and mediastinal surgical clips are re- demonstrated. The hila are within normal limits. There is central prominence of the pulmonary interstitium and pulmonary vasculature, suggestive of pulmonary vascular congestion. No overt edema. Lungs are mildly hypoinflated. There is no focal lung consolidation. There is no pneumothorax. There may be trace bilateral pleural effusions. IMPRESSION: Unchanged cardiomegaly and mild pulmonary vascular congestion. No focal lung consolidation. Trace bilateral pleural effusions. " e522d281-9ad018aa-f6a057d9-06c88988-d2a523bf.jpg,validate/p19/p19969918/s53824651/e522d281-9ad018aa-f6a057d9-06c88988-d2a523bf.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient with MS, now status post aspiration pneumonia, evaluate for interval change. FINDINGS: AP single view of the chest obtained with patient in sitting semi-upright position. Analyzed in direct comparison with the next preceding similar study of ___. Tracheostomy as before. Unchanged position of right-sided PICC line. The previously described bilateral basal densities persist and may even have increased. Diffuse haze over the bases suggests pleural effusions that probably are layering mostly in the posterior compartments as the patient is in semi-erect position only. No pneumothorax has developed. IMPRESSION: Persistent and somewhat increased bilateral parenchymal densities. " 0c8718df-3a30677c-16bc9224-7c96e690-3209e612.jpg,validate/p14/p14317457/s51041901/0c8718df-3a30677c-16bc9224-7c96e690-3209e612.jpg,validation," FINAL REPORT INDICATION: ___F with recent fall, pleuritic pain in side. // Please assess for rib fracture or other abnormality TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. Right shoulder arthroplasty is noted. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. " d6356b39-ddaaaf29-9543c846-f9579416-3fc10fb9.jpg,validate/p16/p16952127/s58287899/d6356b39-ddaaaf29-9543c846-f9579416-3fc10fb9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with dyspnea, hypoxia, aortic stenosis TECHNIQUE: Portable supine AP view of the chest COMPARISON: ___ at 05:18 FINDINGS: Moderate enlargement of the cardiac silhouette is re- demonstrated. The mediastinal contour is unchanged with atherosclerotic calcifications noted at the aortic knob. Moderate to severe pulmonary edema appears minimally worse compared to the previous study with continued small bilateral pleural effusions. More focal opacities at the lung bases may reflect areas of atelectasis. No pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Slight interval worsening of moderate to severe pulmonary edema and continued small bilateral pleural effusions. " 4449baca-c4d42eb4-796804dd-d4d66cdf-af658da5.jpg,validate/p16/p16458013/s55448576/4449baca-c4d42eb4-796804dd-d4d66cdf-af658da5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with elevated D-dimer TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are hyperinflated but clear. No pleural effusion or pneumothorax is present. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary abnormality. RECOMMENDATION(S): If there is suspicion for pulmonary embolism, CTA of the chest is recommended. " 8a79b066-6f90fdcd-aedc1761-d54e1946-ece60e4a.jpg,validate/p19/p19590214/s59444424/8a79b066-6f90fdcd-aedc1761-d54e1946-ece60e4a.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with fever. 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. A left Port-A-Cath terminates in the mid SVC. There is retrosternal calcification near the sternomanubrial junction best seen on the lateral radiograph, and a calcified right hilar lymph node is noted. IMPRESSION: No acute cardiopulmonary process. Retrosternal calcification near the sternomanubrial junction and calcified right hilar lymph node. Recommend correlation with prior imaging. " ca1c7324-d0f2652d-0eba5603-5ddc89dd-12fa4ba5.jpg,validate/p16/p16342554/s55268764/ca1c7324-d0f2652d-0eba5603-5ddc89dd-12fa4ba5.jpg,validation," FINAL REPORT HISTORY: Zoster infection. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities present. IMPRESSION: Normal chest radiograph. " 86552e05-86d6c4d1-445ddf65-2a6b52c5-d2d8b714.jpg,validate/p14/p14393979/s55317242/86552e05-86d6c4d1-445ddf65-2a6b52c5-d2d8b714.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with back pain // evidence of pneumo or pneumonia COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. There is chronic elevation of left hemidiaphragm with chronic atelectasis in the left lower lobe. There is slight rightward patient rotation with shift of the cardiomediastinal silhouette slightly to the right. The right lung appears essentially clear. No large effusion or pneumothorax is seen. The mediastinal contour appears grossly stable. No acute bony abnormalities. IMPRESSION: No acute intrathoracic process. Please refer to subsequent CT chest for further details appear " b3f2af78-4bd2fe32-2d7e7dec-204a4dfd-3aa544dd.jpg,validate/p11/p11104877/s50279544/b3f2af78-4bd2fe32-2d7e7dec-204a4dfd-3aa544dd.jpg,validation," FINAL REPORT INDICATION: History: ___M with intubated, hct 7, upper GI bleed. // eval acute process -- eval tube placement TECHNIQUE: Portable AP semi-upright view of the chest COMPARISON: Portable radiograph from earlier today at 06:22 am FINDINGS: In comparison to the prior radiograph from several hours prior, lung volumes remain very low. There is mild pulmonary vascular congestion. Endotracheal tube terminates 2.2 cm above the carina. Endotracheal tube cuff appears overinflated. ___ tube projects over the esophagus with tip below the diaphragm and excluded from the image. Cardiomediastinal silhouette is stable. Patchy bibasilar opacities, particularly in the left lower lung are unchanged, probably represent atelectasis. There is no large pleural effusion or pneumothorax. IMPRESSION: 1. Persistent low lung volumes, atelectasis, and pulmonary vascular congestion. 2. Endotracheal tube terminates approximately 2.2 cm above the carina. Endotracheal tube cuff appears overinflated. " e0b333b7-97238427-abafa7cd-364c39c2-4a00c238.jpg,validate/p11/p11129757/s51951755/e0b333b7-97238427-abafa7cd-364c39c2-4a00c238.jpg,validation," FINAL REPORT EXAM: Chest, AP upright portable view. CLINICAL INFORMATION: Stage IV ovarian cancer, history of pulmonary embolism, now acute onset dyspnea on exertion with crackles on exam. COMPARISON: ___. FINDINGS: Left-sided Port-A-Cath is again seen with catheter terminating in the low SVC, without evidence of pneumothorax. There is a moderate left pleural effusion with overlying atelectasis, underlying consolidation is not excluded. The right lung is clear. The cardiac and mediastinal silhouettes are grossly stable given that the left heart border is not fully evaluated given the left base opacity. IMPRESSION: Moderate left pleural effusion with overlying atelectasis, underlying consolidation is not excluded. " 0503ec15-d8c021e0-6d026f13-c0052829-ead12a06.jpg,validate/p13/p13188852/s55907452/0503ec15-d8c021e0-6d026f13-c0052829-ead12a06.jpg,validation," FINAL REPORT EXAM: CHEST, FRONTAL AND LATERAL VIEWS. CLINICAL INFORMATION: Fevers, chills, on chemotherapy. Question consolidation. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There is slight prominence of interstitial markings diffusely which could be due to mild fluid overload or atypical infection. No lobar consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Slight increase in interstitial markings bilaterally which may be due to mild fluid overload, though atypical infection is not excluded in the appropriate clinical setting. No lobar consolidation. " 4db9416c-7581c49c-c3f0149f-2ab627a2-553b5d8f.jpg,validate/p17/p17975710/s54990319/4db9416c-7581c49c-c3f0149f-2ab627a2-553b5d8f.jpg,validation," WET READ: ___ ___ ___:___ PM Possible small right apical ptx s/p CT removal. ___ d/w Dr. ___ by Dr. ___ by telephone at 5p on the day of the exam. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after right middle lobe wedge biopsy. PA and lateral upright chest radiographs were reviewed. There is small amount of right apical pneumothorax that appears to be minimally increased/unchanged after discontinuation of the right chest tube. Slight interval increase in right pleural effusion is demonstrated. Subcutaneous air is noted within the left chest wall, decreased since the prior study. " 11b8c2f3-52e140ec-302b771e-8b553708-b714ab61.jpg,validate/p15/p15586571/s51658928/11b8c2f3-52e140ec-302b771e-8b553708-b714ab61.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever and WBC // PNA? PNA? IMPRESSION: Comparison to ___. The pre described left perihilar and left basal parenchymal opacity is unchanged in extent and severity. The morphology and extent of the opacity is suspicious for pneumonia. No pulmonary edema. No pleural effusions. Normal size of the cardiac silhouette. " e8194009-4e1ef7f4-cafc5758-302faf43-f50556fe.jpg,validate/p17/p17288913/s51680460/e8194009-4e1ef7f4-cafc5758-302faf43-f50556fe.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with chest pain and shortness of breath. STUDY: PA and lateral chest radiograph. COMPARISON: ___ chest radiograph and chest CT. FINDINGS: The heart size is within normal limits. The mediastinal and hilar contours demonstrate a prominent right hilar lymph node seen on prior CT. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " 8c8b2d3d-bf44e70e-4b5bd143-cc163c4d-9ff93a69.jpg,validate/p13/p13648900/s50425979/8c8b2d3d-bf44e70e-4b5bd143-cc163c4d-9ff93a69.jpg,validation," FINAL REPORT INDICATION: ___F with cough and fever // r/o pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Left chest wall dual lead pacing device is again seen. The lungs are clear of focal consolidation, effusion or edema. The cardiomediastinal silhouette is within normal limits. Tortuosity of the descending thoracic aorta is again noted. No acute osseous abnormality seen, right humeral head orthopedic hardware noted. IMPRESSION: No acute cardiopulmonary process. " ab76d4a1-2c044dc1-809c50f9-e1e11b13-c1cd5b2e.jpg,validate/p13/p13224377/s52021659/ab76d4a1-2c044dc1-809c50f9-e1e11b13-c1cd5b2e.jpg,validation," FINAL REPORT HISTORY: Dyspnea. COMPARISON: Same-day outside hospital chest radiograph. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: There is no change from earlier same day examination with redemonstration of mild cardiomegaly, central pulmonary vascular congestion and mild interstitial pulmonary edema. There are linear areas of right greater than left bibasilar atelectasis. There is no large pleural effusion or pneumothorax. IMPRESSION: Mild cardiomegaly with central pulmonary vascular congestion and interstitial edema. Concurrent infection cannot be excluded given the proper clinical presentation. " ab314c6b-491c2ccb-69264aa6-1f74cc28-c46f94f5.jpg,validate/p10/p10791554/s58312006/ab314c6b-491c2ccb-69264aa6-1f74cc28-c46f94f5.jpg,validation," 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. " 6805c077-45b4abbf-70a75f8c-3742b595-066450cc.jpg,validate/p18/p18678399/s59210529/6805c077-45b4abbf-70a75f8c-3742b595-066450cc.jpg,validation," FINAL REPORT INDICATION: History of pleural effusions. Please evaluate. COMPARISONS: Chest radiographs dated back to ___, most recently from ___ and chest CT from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Mild left basilar atelectasis is persistent. Mild cardiomegaly is unchanged compared to exams dated back to ___. Overall, there has been interval improvement in the small bilateral pleural effusions with residual small right pleural effusion. No focal consolidations concerning for pneumonia are identified. There is no evidence of a pneumothorax. The visualized osseous structures are unremarkable. IMPRESSION: Interval improvement of small bilateral pleural effusions with a residual small right effusion. " 2b07039a-bc1d9771-dbd57107-e7f0f850-92e62f31.jpg,validate/p19/p19296934/s57568014/2b07039a-bc1d9771-dbd57107-e7f0f850-92e62f31.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " bc183b47-7d43c1a0-dbf6e44e-231816af-5a012160.jpg,validate/p10/p10113898/s56310595/bc183b47-7d43c1a0-dbf6e44e-231816af-5a012160.jpg,validation," FINAL REPORT HISTORY: Status post right thoracotomy with resection of mediastinal mass. Evaluate for interval change. COMPARISON: ___. FINDINGS: PA and lateral radiographs of the chest. There is interval resolution of the fullness of the right mediastinum, with interval improvement in the right basilar atelectasis. Surgical clips are seen overlying the right mediastinum, reflective of previous surgery. No acute consolidation is identified. No pleural effusion or pneumothorax is detected. The cardiac contour is normal. Persistent elevation of the right hemidiaphragm is again noted, possibly related to phrenic nerve injury. The trachea is midline. IMPRESSION: 1. Interval improvement in right mediastinal fullness with now midline trachea. 2. Interval improvement in right basilar atelectasis. 3. No focal consolidation. 4. Continued elevation of right hemidiaphragm. " ebd0060e-e176fb85-82520724-bef023f0-4f102117.jpg,validate/p11/p11744921/s54000464/ebd0060e-e176fb85-82520724-bef023f0-4f102117.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with hx asthma/DM2/morbid obesity presenting with RUQ pain. // pneumonia or rib pathology? TECHNIQUE: AP and lateral views 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 process. " 9fffa7a7-efcd29b9-3b9af6e1-947a8673-40d364c5.jpg,validate/p18/p18773317/s57841399/9fffa7a7-efcd29b9-3b9af6e1-947a8673-40d364c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with left sided weakness ?recrudescence // ?infiltrate ?infiltrate IMPRESSION: In comparison with the study of ___, allowing for the AP portable technique, there is little change. Cardiac silhouette is within upper limits of normal in size. No vascular congestion, pleural effusion, or acute focal pneumonia. " 99d1bd4c-e95bd781-bc81ef1b-4e7658c5-0559b7de.jpg,validate/p13/p13689901/s50385953/99d1bd4c-e95bd781-bc81ef1b-4e7658c5-0559b7de.jpg,validation," FINAL REPORT HISTORY: Persistent cough. FINDINGS: No previous images. The cardiac silhouette is within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Area of somewhat ill-defined opacification is seen in the left apical region laterally. This could well represent some calcifications related to old tuberculous disease. Comparison with previous studies from any outside facility would be most helpful. " dc968bfb-8dd70f9e-62065eb4-04f7e873-2d46549b.jpg,validate/p11/p11828962/s54007056/dc968bfb-8dd70f9e-62065eb4-04f7e873-2d46549b.jpg,validation," FINAL REPORT HISTORY: Chest tube removal, to assess for pneumothorax. FINDINGS: In comparison with study of ___, the chest tubes have been removed from the left. No definite pneumothorax is seen. Little overall change in the appearance of the heart and lungs, with opacification persisting at the left base consistent with effusion and atelectasis. " 6bd4315b-986f4b5d-236cdfe6-05e12ec8-627e4090.jpg,validate/p11/p11026100/s57996390/6bd4315b-986f4b5d-236cdfe6-05e12ec8-627e4090.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with pyelonephritis, now with slight wheeze on exam. Evaluate for fluid overload. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Single frontal upright view of the chest was obtained. Mild pulmonary edema is new since ___. Indistinct costophrenic angles may represent small pleural effusions. No pneumothorax. The cardiomediastinal silhouette is mildly enlarged, similar to prior. No radiopaque foreign body. IMPRESSION: Interval development of mild pulmonary edema with small bilateral pleural effusions and stable mild cardiomegaly. Recommend reevaluation after diuresis. " 0c7fa3b9-b9d75ebc-6e04a755-d38115f1-12359eae.jpg,validate/p10/p10119094/s52202735/0c7fa3b9-b9d75ebc-6e04a755-d38115f1-12359eae.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Heart size is top normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities demonstrated. Minimal degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 34942575-4dc8169a-52b14f2c-070ec1ab-21a9ccd8.jpg,validate/p15/p15502354/s57687288/34942575-4dc8169a-52b14f2c-070ec1ab-21a9ccd8.jpg,validation," FINAL REPORT HISTORY: Obese woman with shortness of breath after surgery. FINDINGS: In comparison with study of ___, there again are low lung volumes. Substantial cardiomegaly again seen with some pulmonary vascular congestion. No acute focal pneumonia, though this could be hidden given the substrate of pulmonary markings. " 2833d426-c2e7faec-c0b9c42b-43c8534b-74a823bf.jpg,validate/p18/p18692227/s53636861/2833d426-c2e7faec-c0b9c42b-43c8534b-74a823bf.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with increasing confusion. COMPARISON: None. CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are clear without consolidation, pleural effusion or pneumothorax. Mild degenerative changes are seen in the thoracic spine. IMPRESSION: No acute cardiopulmonary pathology. " 87490914-39806b59-90eef4e7-25a50555-2f313bdc.jpg,validate/p14/p14630468/s52072935/87490914-39806b59-90eef4e7-25a50555-2f313bdc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with trach, now with increased shortness of breath and increased secretions // ?interval change ?infiltrate COMPARISON: ___ IMPRESSION: No relevant change as compared to the prior image. Normal size of the cardiac silhouette. Mild to moderate right pleural effusion with subsequent right basilar atelectasis. Tracheostomy tube and left PICC line are in correct position. No new parenchymal opacities. No pneumothorax. No pulmonary edema. " c3abe41e-b63d37e8-d7e5b590-a27c19d8-96fc0c9e.jpg,validate/p19/p19197903/s51197065/c3abe41e-b63d37e8-d7e5b590-a27c19d8-96fc0c9e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of idiopathic lung fibrosis, new opacity seen on previous chest film. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is a substantial decrease in extent of the pre-existing left lower lobe opacity. Remnant opacities are seen only in the peribronchial lung areas. No other changes. No progression of fibrosis. No newly appeared lung parenchymal changes. Unchanged size of the cardiac silhouette. " c57b5b15-d6948571-c4fa14c0-b9e22e4b-5323ff39.jpg,validate/p18/p18914461/s57426587/c57b5b15-d6948571-c4fa14c0-b9e22e4b-5323ff39.jpg,validation," FINAL REPORT INDICATION: Presyncope and palpitations. 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, mediastinal and pleural surface contours are normal. IMPRESSION: Normal radiographs of the chest. " d2e30f74-a600c0a6-4063e519-552e7338-61b32664.jpg,validate/p19/p19911133/s57690627/d2e30f74-a600c0a6-4063e519-552e7338-61b32664.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Portable upright AP view of the chest. COMPARISON: ___. FINDINGS: Left-sided dual-chamber pacemaker with leads terminating in the right atrium and right ventricle is unchanged. The heart is mild to moderately enlarged, with mild pulmonary vascular congestion noted. Diffuse atherosclerotic calcifications of the aorta are seen. Retrocardiac opacity may reflect atelectasis or infection. Small left pleural effusion is relatively similar compared to the prior study, as is a tiny right pleural effusion. There is no pneumothorax. IMPRESSION: Mild pulmonary vascular congestion with small bilateral pleural effusions, left greater than right. Retrocardiac opacity may reflect atelectasis though infection is difficult to exclude. " 5a7acaca-e62a424e-c8f8d3bf-9fe033e7-95139398.jpg,validate/p15/p15345492/s59918288/5a7acaca-e62a424e-c8f8d3bf-9fe033e7-95139398.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 2:32 PM IMPRESSION: Subtle right costophrenic angle and retrocardiac opacities, with trace pleural effusion may represent pneumonia. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old female with Plasmodium falciparum. STUDY: PA and lateral chest radiograph. COMPARISON: None. FINDINGS: The cardiomediastinal and hilar contours are normal. Subtle opacity at the right costophrenic angle is noted as well as in the retrocardiac space. There is no pneumothorax. There may be trace pleural effusion on the right. IMPRESSION: Subtle right costophrenic angle and retrocardiac opacities, with trace pleural effusion may represent pneumonia. " a2a3b061-3a3ad2f5-47d21f3d-35b1a4d7-0b6a69e0.jpg,validate/p18/p18408877/s56296921/a2a3b061-3a3ad2f5-47d21f3d-35b1a4d7-0b6a69e0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Pt is a ___ yo F w/PMHx significant for COPD with 4L home O2 requirement, CHF w/cor pulmonale, HTN, hx DVT on coumadin, chronic pancreatitis and diabetes who presents for evaluation of worsening dyspnea and was admitted to ICU for respiratory distress requiring NIPPV thought to be ___ COPD exacerbation. // Interval change COMPARISON: ___ IMPRESSION: As compared to the previous examination, there is a minimal increase in extent and severity of the known right basal parenchymal opacity. The retrocardiac opacity is constant. Minimal blunting of the costophrenic sinuses could suggest presence of minimal pleural effusions. Unchanged size of the cardiac silhouette. Unchanged course of the left PICC line. " 989de54b-59bde1c2-3a7173b3-ce7df37f-94452418.jpg,validate/p15/p15111021/s57700485/989de54b-59bde1c2-3a7173b3-ce7df37f-94452418.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: ___-year-old male with tracheostomy with increased shortness of breath. TECHNIQUE: PA and lateral chest radiographs COMPARISON: ___. FINDINGS: Lungs are well expanded. There are new patchy opacities in the right mid lung, right lower lung, and the left lower lung. Cardiomediastinum and hilar contours unremarkable. There is no pleural effusion or pneumothorax. Tracheostomy tube in place. IMPRESSION: Findings compatible with multifocal pneumonia. " f6946294-c097987d-8b437db8-57b7dc2b-30ae3727.jpg,validate/p10/p10226617/s58143357/f6946294-c097987d-8b437db8-57b7dc2b-30ae3727.jpg,validation," FINAL REPORT HISTORY: ___-year-old female status post fall with bruising around ___ metacarpal. Question rib fracture. COMPARISON: None. FINDINGS: AP and lateral chest radiographs were provided. Lungs are well expanded. There is no focal consolidation, pleural effusion or pneumothorax. A left chest wall pacemaker is seen with leads within the right atrium and right ventricle. The cardiomediastinal silhouette is notable for calcified aortic arch. There are no displaced rib fractures. The imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process or displaced rib fractures. " 1bb39496-ff854e51-e93da442-22cf8296-fd582d2f.jpg,validate/p14/p14887838/s57273757/1bb39496-ff854e51-e93da442-22cf8296-fd582d2f.jpg,validation," FINAL REPORT INDICATION: Dizziness and chest pain, here to evaluate for pneumonia. COMPARISON: Chest radiograph, last performed on ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Note is again made of a 10 mm calcified nodular density in the left lower lobe most likely representing a calcified granuloma. The lungs are otherwise clear without focal consolidation concerning for pneumonia, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. There is no free air beneath the right hemidiaphragm. No acute osseous abnormality is detected. IMPRESSION: 1. No focal consolidation concerning for pneumonia. 2. Stable left lower lobe calcified nodule compatible with a granuloma. " 07927d96-1447aa62-614f926a-546c2446-dc240932.jpg,validate/p16/p16864004/s50372308/07927d96-1447aa62-614f926a-546c2446-dc240932.jpg,validation," FINAL REPORT HISTORY: Dyspnea on exertion. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made to radiographs dated ___. FINDINGS: Multiple time calcified granulomas, more completed evaluated on prior chest CT examination, are seen within the right lung. 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 acute cardiopulmonary disease. " 0b3595df-0a95d334-2862fa53-60dcccd9-fc4f9453.jpg,validate/p17/p17846957/s54760653/0b3595df-0a95d334-2862fa53-60dcccd9-fc4f9453.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with abdominal mass // ? lung mets TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest x-ray and CT torso ___ FINDINGS: Cardiomediastinal contours are stable with cardiac size normal and tortuous aorta. . 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 or evidence of large lung nodules " e2e20dd8-2226cd62-ab0c8370-96a498d7-e18a3eab.jpg,validate/p14/p14245215/s59530412/e2e20dd8-2226cd62-ab0c8370-96a498d7-e18a3eab.jpg,validation," FINAL REPORT HISTORY: Concern for foreign body on prior chest x-ray. CHEST, TWO PORTABLE VIEWS, AN AP VIEW AND A STEEP OBLIQUE VIEW TO INCLUDE THE NECK. No foreign body was visualized. COMPARISON: Chest x-ray from earlier the same day at 10:11 a.m. On the current exam, the complete metallic foreign body is seen superimposed over the left neck. It liesto the left of the midline chest tube and extends from the approximate C3-C5 level, with its inferior edge overlying the upper portion of the left piriform sinus. On the oblique view, it overlies the chest tube and extends slightly anterior and posterior to it. A chest x-ray obtained at 2:25 a.m. on ___ shows the same anatomic area, with the ET and NG tibes both present, but with no abnormal radiopaque foreign body visible. A scout image from a ___ head CT showed extensive metal in the maxillary teeth, some of which is no longer visible in the mouth. Some residual dental metallic densities are seen at both right and left extreme edges of the maxillary teeth with an additional stable focus in the lower right mandible teeth. IMPRESSION: Apparent dislodgement of maxillary dental metal - ? amalgam, bridge or other dental appliance -- that is now superimposed over the airway in the left neck. Further evaluation of the patient to confirm that this does not lie outside the patient is requested, but this appearance otherwise suggests that this dental metal foreign body lies within the hypopharanx. These findings were discussed with Dr. ___ at the time of discovery at approximately 3:15 p.m. on the day of the exam, by Dr. ___ by phone. " d76706f7-10776c8c-ef2f8716-2e350c51-e86d79c2.jpg,validate/p17/p17792822/s51331316/d76706f7-10776c8c-ef2f8716-2e350c51-e86d79c2.jpg,validation," 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. " 539f4bec-a407309b-687d473e-aa866b72-5f536f6e.jpg,validate/p11/p11845452/s52615651/539f4bec-a407309b-687d473e-aa866b72-5f536f6e.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with recent cath and substernal chest pain. Please evaluate for acute process. COMPARISON: Multiple chest radiographs, the latest 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. " 79022b96-f3c8f4ee-fa749aa3-8134368c-8fb15da3.jpg,validate/p10/p10088966/s59763427/79022b96-f3c8f4ee-fa749aa3-8134368c-8fb15da3.jpg,validation," 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. " 1c0afb41-3ef280dd-1c4abaa2-23bcae6b-7af59416.jpg,validate/p15/p15964158/s59177200/1c0afb41-3ef280dd-1c4abaa2-23bcae6b-7af59416.jpg,validation," FINAL REPORT HISTORY: Altered mental status. COMPARISON: ___ FINDINGS: AP frontal view of the chest demonstrates hyperinflated lungs. There is no consolidation, pleural effusion, or pneumothorax. The cardiomediastinal contours are normal. Right ribcage deformity noted. IMPRESSION: No acute cardiopulmonary abnormalities. " 84d43759-b12e13d4-cafcc956-11ab56c8-3a2aa40d.jpg,validate/p13/p13687044/s53724907/84d43759-b12e13d4-cafcc956-11ab56c8-3a2aa40d.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain and shortness of breath. COMPARISON: None available. PORTABLE AP CHEST RADIOGRAPH: The cardiomediastinal and hilar contours are normal, with the heart in the upper limits of normal. The lungs are clear. No consolidations, pleural effusion, or pneumothorax are seen. Left basal atelectasis is present. There is no evidence of pulmonary edema. IMPRESSION: No acute cardiopulmonary pathology. " 2e610f76-bf8f453f-f1670b11-21a96001-aadaa31f.jpg,validate/p10/p10207925/s51395634/2e610f76-bf8f453f-f1670b11-21a96001-aadaa31f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with intermittent cough, h/o chf // intermittent cough TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Cardiomegaly is substantial but improved as compared to previous examination. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. No focal abnormalities overall that can explain patient's symptoms demonstrated " 521d7488-3ca8deb7-6d758fa6-5bc6e941-29114414.jpg,validate/p19/p19850525/s57535489/521d7488-3ca8deb7-6d758fa6-5bc6e941-29114414.jpg,validation," FINAL REPORT INDICATION: Shortness of breath with history of CHF and ischemic cardiomyopathy. COMPARISON: Chest radiograph ___; ___. FINDINGS: The heart remains moderately enlarged. There is no pleural effusion or pneumothorax. The lungs are well expanded with interstitial edema, which is new since the prior study. IMPRESSION: New interstitial pulmonary edema with stable moderate cardiomegaly. " 8e47c45b-d933e890-e328157c-23128978-7a593726.jpg,validate/p18/p18628529/s50516086/8e47c45b-d933e890-e328157c-23128978-7a593726.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Back pain, sickle cell disease. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Left-sided Port-A-Cath is again seen, terminating in the low SVC. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable. There is no overt pulmonary edema. IMPRESSION: No acute cardiopulmonary process. " 12607145-e950f70e-0e4bf936-256d9df9-d43ce813.jpg,validate/p16/p16263026/s50136206/12607145-e950f70e-0e4bf936-256d9df9-d43ce813.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with history of hodgkins lymphoma years ago sp treatment who has right sided flutter sensation in her chest on deep inspiraiton, lung exam not impressive, peak flow a bit down. evalute for pulmonary process // infection? mass? TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ FINDINGS: There is an well-circumscribed irregular opacity in the right upper lobe that was not seen on ___. This can represent a pulmonary nodule in the right upper lobe vs right upper lobe pneumonia vs focal mediastinal calcification from radiation therapy. The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumothorax. No pulmonary edema. No pleural effusions. IMPRESSION: Well circumscribed irregular opacity in the right upper lobe, not seen on ___. This can represent a lung nodule vs right upper lobe pneumonia vs focal mediastinal calcifications in the setting of radiation therapy given patient's history of lymphoma. Correlation with prior chest imaging is recommended. If prior imaging cannot be obtained, chest CT is recommended. " 876e7989-266ac9f1-1f35230f-294ea5c1-6e2f98ff.jpg,validate/p17/p17018837/s52654162/876e7989-266ac9f1-1f35230f-294ea5c1-6e2f98ff.jpg,validation," FINAL REPORT INDICATION: Status post left upper lobectomy. Evaluate for postoperative changes appear TECHNIQUE: Bedside frontal chest radiograph. COMPARISON: Preoperative chest radiograph ___. FINDINGS: Patient status post a left upper lobectomy which has resulted in volume loss of the left hemithorax and shift of the mediastinum to the left. A left chest tube is in place and left side chest wall subcutaneous air is not unexpected. There is a small left apical pneumothorax. Clips are seen at the mediastinum. There is no pleural effusion or focal airspace consolidation worrisome for pneumonia. The right lung is clear. Heart is normal size. The aorta is mildly calcified but unchanged. IMPRESSION: Small left pneumothorax after left upper lobectomy. " 49abf814-dd4261f8-974c9e22-e25143c2-d64cc3f5.jpg,validate/p14/p14591676/s50686365/49abf814-dd4261f8-974c9e22-e25143c2-d64cc3f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HFpEF, recurrent L pleural effusion. // interval change in L effusion? interval change in L effusion? IMPRESSION: In comparison with the study of ___, there is little change in the large left pleural effusion with substantial volume loss in the left lung. The right lung is clear and there is no vascular congestion. " ae88d93b-afdc0748-ebc05747-316b1a1a-27128efd.jpg,validate/p15/p15110728/s56994551/ae88d93b-afdc0748-ebc05747-316b1a1a-27128efd.jpg,validation," FINAL REPORT STUDY: Chest radiograph. INDICATION: Chest pain, multiple MIs. Query widened mediastinum. The patient has a pacemaker and AICD in good position. Heart size is normal. Mediastinal size as questioned is normal. The lungs are grossly clear. No good evidence of failure. Degenerative change in the thoracic spine. CONCLUSION: No acute cardiopulmonary findings. " f845ad66-716c76dd-da718912-8b0ff596-b30d25cb.jpg,validate/p13/p13628037/s54872639/f845ad66-716c76dd-da718912-8b0ff596-b30d25cb.jpg,validation," 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. " 5c0d5f29-cf77bfd5-30c2fb19-37e0b0fc-785ccb34.jpg,validate/p13/p13767558/s56326397/5c0d5f29-cf77bfd5-30c2fb19-37e0b0fc-785ccb34.jpg,validation," FINAL REPORT HISTORY: 3 day history of cough, status post kidney transplant on chronic immunosuppressive therapy. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. FINDINGS: The patient is status post median sternotomy and CABG. The heart size is top normal, unchanged. Mediastinal and hilar contours are unchanged, and there is no pulmonary vascular congestion. Linear scarring in the left lung base is re- demonstrated as is scarring within the lung apices. No focal consolidation, pleural effusion or pneumothorax is seen. There are multilevel degenerative changes in the thoracic spine, but no acute abnormalities are seen within the osseous structures. IMPRESSION: No acute cardiopulmonary abnormality. " 69b9ad14-f37b743a-8cec249e-2a251a66-bd9a4f7f.jpg,validate/p15/p15353344/s51998965/69b9ad14-f37b743a-8cec249e-2a251a66-bd9a4f7f.jpg,validation," FINAL REPORT INDICATION: ___-year-old female admitted for renal cyst fat stranding, found to have a left lower lobe pneumonia on CT, who presents for evaluation. COMPARISONS: CT abdomen and pelvis from ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: There is an opacity in the left lower lobe which is suggestive of a pneumonia. There is also a faint opacity in the right lower lobe which may correspond to pneumonia. No other focal opacities are seen. The heart size is normal. The hilar and mediastinal contours are unremarkable. The visualized osseous structures are unremarkable. There is no evidence of pneumothorax or pleural effusions. IMPRESSION: Left lower lobe pneumonia. Probable right lower lobe pneumonia. These findings were discussed with Dr. ___ at 12:22pm by Dr. ___ by telephone. " f2f3942e-8dabd115-616cf382-ee390625-227483da.jpg,validate/p14/p14324761/s51908966/f2f3942e-8dabd115-616cf382-ee390625-227483da.jpg,validation," FINAL REPORT INDICATION: Fever and history of pneumonia with ongoing cough. COMPARISONS: Chest radiograph ___. Chest radiograph ___. FINDINGS: The right middle lobe opacity has resolved. No new opacities identified. The pleural effusions have also resolved. There is no pulmonary edema or pneumothorax. A curvilinear dense opacity overlying the left mid lung zone is unchanged and may represent a calcified granuloma or small AVM. The cardiomediastinal silhouette is normal. There is no free air below the hemidiaphragms. IMPRESSION: 1. Resolution of right middle lobe pneumonia. No new pneumonia is identified. 2. Resolution of bilateral pleural effusions. 3. Stable curvilinear density in the left mid lung zone, likely a calcified granuloma or AVM. " da2e3e79-fa783a0c-e967067b-0eaa187e-08909193.jpg,validate/p11/p11667043/s53200216/da2e3e79-fa783a0c-e967067b-0eaa187e-08909193.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fall and head strike, feeling unsteady with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable. Dense atherosclerotic calcification is noted at the aortic arch. No acute osseous abnormality identified. IMPRESSION: No acute cardiopulmonary process. " 89003154-1c7320b9-c2e1ad41-1c239f86-b94b4099.jpg,validate/p10/p10781468/s56816123/89003154-1c7320b9-c2e1ad41-1c239f86-b94b4099.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST. REASON FOR EXAM: Hypoxia, rales, assess for pneumonia. Comparison is made with prior study, ___. Mild interstitial edema is new. Cardiomegaly is stable. There is no pneumothorax. Small bilateral effusions are new. " e602d5b7-84c7b3c4-ba077f8c-5ecd7ad5-69909cf4.jpg,validate/p16/p16352630/s57067582/e602d5b7-84c7b3c4-ba077f8c-5ecd7ad5-69909cf4.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with recent hx pna, today more cough and sob // please evaluate for infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Single a left-sided pacer is seen with lead extending to the expected location of the right ventricle. There is mild basilar atelectasis without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Degenerative changes are again seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 12c76730-58f52c4e-b260e005-7e019bd8-ef907c3f.jpg,validate/p10/p10670085/s52848854/12c76730-58f52c4e-b260e005-7e019bd8-ef907c3f.jpg,validation," FINAL REPORT HISTORY: ___ year old man with fever. COMPARISON: Multiple prior chest radiographs, the most recent of ___. FINDINGS: Frontal lateral views of the chest. And external fixation device remains status post aortic valve replacement. The cardiac and mediastinal contours are stable. Mild vascular congestion is relatively unchanged since ___. No new focal opacity identified. Small bilateral effusions have decreased since ___. No pneumothorax is identified. IMPRESSION: Stable mild vascular congestion and cardiomegaly. Interval decrease in small bilateral pleural effusions. " e01f7af4-28f6c5e9-7f658720-e447f368-37fd9c04.jpg,validate/p19/p19655310/s54961684/e01f7af4-28f6c5e9-7f658720-e447f368-37fd9c04.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with end-stage renal disease secondary to SLE, starting dialysis. This is a pre-procedure chest radiograph. COMPARISON: No relevant comparisons available. FINDINGS: Frontal and lateral views of the chest were obtained. Low lung volumes result in bronchovascular crowding. A dialysis catheter ends in the mid SVC. There is no focal consolidation, pleural effusion, or pneumothorax. Heart size and pulmonary vasculature are normal. Mediastinal silhouette and hilar contours are normal. IMPRESSION: No pneumonia, edema or effusion. " 95bd0834-35a00983-30483289-19df20b0-da67e337.jpg,validate/p12/p12646269/s57596752/95bd0834-35a00983-30483289-19df20b0-da67e337.jpg,validation," FINAL REPORT INDICATION: Syncope. COMPARISONS: ___ to ___. FINDINGS: Single portable AP chest radiograph was obtained. Elevation of the right hemidiaphragm is chronic. Lung volumes are low. There is no focal consolidation, effusion, or pneumothorax. Moderate cardiomegaly is unchanged. Intact lumbar spinal fusion hardware is noted. IMPRESSION: Chronically elevated hemidiaphragm. " 6088ca36-b4c751d1-2f2651a6-9f4d66e2-053cae95.jpg,validate/p19/p19711702/s57173268/6088ca36-b4c751d1-2f2651a6-9f4d66e2-053cae95.jpg,validation," FINAL REPORT HISTORY: Lymphoma with cough and rales. FINDINGS: In comparison with the study of ___, the right, mid and lower lung consolidation has cleared. There is no evidence of acute pneumonia, vascular congestion, or pleural effusion. No evidence of hilar or mediastinal adenopathy. " b62334e2-a59065fa-c7c78a35-bcf4d194-1f7e251a.jpg,validate/p14/p14240547/s50211520/b62334e2-a59065fa-c7c78a35-bcf4d194-1f7e251a.jpg,validation," 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. " 7e3ac0d7-5eae3db1-7f9b5f57-f1c12914-222405e8.jpg,validate/p16/p16132012/s53921486/7e3ac0d7-5eae3db1-7f9b5f57-f1c12914-222405e8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o M MML/myelodysplastic syndrome, s/p TAC/ileostomy s/p reversal in setting of ulcerative colitis vs c diff, h/o DVT/PE on Rivaroxaban, nephrolithiasis s/p stenting, PAD s/p R BKA due to chronic ulcer, and multiple recent prolonged hospitalizations at ___ now w/concern for aspiration pna // evaluate interval change COMPARISON: None. FINDINGS: Compared with ___ at 04:41 and allowing for technical differences, the overall appearance is quite similar. Again seen is a left-sided PICC line, tip over proximal/mid SVC. No pneumothorax detected. Again seen is a left effusion with underlying collapse and/or consolidation and obscuration of the left hemidiaphragm, as well as persistent retrocardiac opacity. Patchy opacities at the right base medially and laterally are also similar. The cardiomediastinal silhouette is unchanged. Vascular plethora and mild vascular blurring is similar to the prior study. IMPRESSION: Overall similar to 1 day earlier. " 175c39c9-da406e71-ba80152e-8a031fdc-a669edcb.jpg,validate/p16/p16289299/s57384817/175c39c9-da406e71-ba80152e-8a031fdc-a669edcb.jpg,validation," FINAL REPORT INDICATION: ___F with back pain // ? pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Increased interstitial markings are seen throughout the lungs suggesting pulmonary vascular congestion. There is no overt edema or effusion. Linear right basilar opacity suggests atelectasis or scarring. Cardiomediastinal silhouette is stable. IMPRESSION: Mild pulmonary vascular congestion. No focal consolidation. " 4cff5dc2-91ac5f59-c534833a-b81dcc76-007ce868.jpg,validate/p10/p10696644/s53131588/4cff5dc2-91ac5f59-c534833a-b81dcc76-007ce868.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypoxia, CAD, assess for pulmonary edema. FINDINGS: PA and lateral views of the chest provided demonstrate mild pulmonary edema with increased lower lung opacities which could represent pneumonia in the correct clinical setting. Evaluation for effusion is somewhat limited though no large effusion is seen. No pneumothorax. Overall, cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Mild pulmonary edema with lower lung opacities which raise concern for superimposed pneumonia. Post-diuresis films would be helpful to further assess. " 7e5e8a64-a5d6a9ec-f717c49c-670c799e-f612fdc6.jpg,validate/p18/p18462894/s58502741/7e5e8a64-a5d6a9ec-f717c49c-670c799e-f612fdc6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough recent flu and abnl xray few days ago // ? worse pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous image, the pre described opacity in the right lung is completely resolved. No opacities are seen on the current image. No pneumonia, no pleural effusions. Persistent tortuous thoracic aorta and small eventration of the medial aspect of the left hemidiaphragm. Degenerative right shoulder disease. " 900bdb3a-141f4b16-f52e9e34-f02e1a2b-11dfceed.jpg,validate/p12/p12801699/s59805907/900bdb3a-141f4b16-f52e9e34-f02e1a2b-11dfceed.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // ? acute process COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. The heart appears mildly enlarged. The lung volumes are low though the lungs appear clear. Mediastinal contour is normal. Bony structures intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild cardiomegaly. Given patient's age, a full workup is advised. " b003ecb3-c4806512-1d9660e7-a46f2e11-f57e44c1.jpg,validate/p18/p18450763/s50131296/b003ecb3-c4806512-1d9660e7-a46f2e11-f57e44c1.jpg,validation," FINAL REPORT HISTORY: Palpitations, fever. Evaluate for cardiopulmonary process. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___, PET-CT from ___ and CT from ___. FINDINGS: There is a left lower lobe retrocardiac opacity, more pronounced from ___, which is concerning for developing pneumonia rather than atelectasis superimposed on a pre-existing lesion as seen on the prior PET-CT. A subtle right apical opacity is again seen and may relate to apical pleural thickening. The lungs continue to be hyperinflated, likely representing chronic obstructive pulmonary disease. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are within normal limits. IMPRESSION: Increased left lower lobe retrocardiac opacity is concerning for developing pneumonia rather than atelectasis superimposed on a pre-existing lesion as seen on the prior PET-CT. " b13c2253-1192f05a-eed31689-24de3598-65ae4d91.jpg,validate/p19/p19132043/s52081244/b13c2253-1192f05a-eed31689-24de3598-65ae4d91.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Tachypnea. Comparison is made to the prior study, ___. Moderate-to-severe cardiomegaly is stable. The aorta is elongated. Lines and tubes are in unchanged standard position. There is no pneumothorax. Bilateral effusions with adjacent atelectasis, larger on the left side, are grossly unchanged allowing the difference in positioning of the patient. " fe751152-0594a3dd-d20152d6-006cda33-b0b7d3f0.jpg,validate/p18/p18982551/s54329867/fe751152-0594a3dd-d20152d6-006cda33-b0b7d3f0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with old pacing wire // post removal of old pacing wire rule out pericardial effusioj COMPARISON: ___. IMPRESSION: As compared to the previous image, 1 old pacing wire was removed. No evidence of complications such as pneumothorax or pericardial effusion. Mild cardiomegaly. Unchanged normal alignment of the sternal wires. No pleural effusions. " 27e30d56-e2f5407c-0a9c0781-a8637ae7-97802664.jpg,validate/p16/p16417985/s53339849/27e30d56-e2f5407c-0a9c0781-a8637ae7-97802664.jpg,validation," 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. " 268cca37-29575408-91089ad5-f20c9b4e-6b1d1b1d.jpg,validate/p12/p12724643/s51453018/268cca37-29575408-91089ad5-f20c9b4e-6b1d1b1d.jpg,validation," FINAL REPORT HISTORY: Pleural effusion, to assess for congestive failure. FINDINGS: In comparison with the study of ___, there is little change. There is again top normal or mildly enlarged heart without vascular congestion or acute focal pneumonia. Blunting of the costophrenic angles persists. " 10fb6dea-1d3b4512-0f0996be-3db1d155-51b3dc40.jpg,validate/p13/p13659269/s54630884/10fb6dea-1d3b4512-0f0996be-3db1d155-51b3dc40.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with DM, dCHF, p/w hypertesive urgency and decompensated CHF, CXR showed widened mediastium // eval if widen mediastium is indeed due to technique TECHNIQUE: Chest PA and lateral COMPARISON: ___ ___ and ___. FINDINGS: Cardiomediastinal silhouette is unchanged with Cardiac size is top normal and stable appearance of the mediastinal and hilar contours. The upper lungs are clear. There is no pneumothorax . Small bilateral pleural effusions are associated with minimal adjacent atelectasis. There are moderate degenerative changes in the thoracic spine IMPRESSION: Small bilateral effusions with adjacent atelectasis Stable cardiomediastinal silhouette. " cf1bda59-e526b088-4b9fd13d-fb777c12-e8231b7d.jpg,validate/p16/p16435907/s52843634/cf1bda59-e526b088-4b9fd13d-fb777c12-e8231b7d.jpg,validation," FINAL REPORT HISTORY: Syncope. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Mild enlargement of cardiac silhouette is unchanged. The mediastinal and hilar contours are stable. There is diffuse atherosclerotic calcification of the thoracic aorta. The pulmonary vasculature is normal. Lungs remain hyperinflated with diffuse increased interstitial markings, similar to the previous exam, suggestive of a mild chronic interstitial lung disease. No new focal consolidation ,left-sided pleural effusion, or pneumothorax is present. Blunting of the right costophrenic angle on the lateral view may suggest the presence of a trace pleural effusion. There is diffuse demineralization of the osseous structures. Compression deformity of a mid thoracic vertebral body appears new when compared to the previous exam. An inferior vena cava filter is partially imaged within the upper abdomen. There are clips noted within the left axilla and postoperative changes in the left breast. IMPRESSION: Blunting of the right costophrenic angle suggestive of a trace pleural effusion. Findings suggestive of mild chronic interstitial lung disease, but no acute process is otherwise identified. Mild compression deformity of a mid thoracic vertebral body which appears new when compared to the previous exam. " dc207579-aac69108-9e91f3b2-da50062a-eafba9f2.jpg,validate/p15/p15470171/s51519387/dc207579-aac69108-9e91f3b2-da50062a-eafba9f2.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with AAA rupture and line placement. COMPARISON: ___. FINDINGS: A single portable semi-upright view of the chest was obtained. Cardiomediastinal silhouette is stable. Allowing for slightly rotated positioning, a right-sided internal jugular central venous catheter or sheath terminates in the upper SVC. Lungs are grossly clear, without CJF or focal infiltrate. There is no pleural effusion or pneumothorax. Hyperinflation is suggestive of background COPD. IMPRESSION: Right internal jugular central venous catheter terminates in the upper SVC. " 95c1f164-3a5df609-8b482e7f-377f5b55-0b648f62.jpg,validate/p16/p16449983/s56038157/95c1f164-3a5df609-8b482e7f-377f5b55-0b648f62.jpg,validation," FINAL REPORT HISTORY: ___-year-old with systolic CHF being treated for urinary tract infection and pneumonia. Evaluate possible improvement in pulmonary congestion or infiltrate. COMPARISON: ___ through ___. FINDINGS: IMPRESSION: Mild pulmonary edema has resolved since ___. Bibasilar atelectasis has worsened, and small bilateral pleural effusions are no smaller. The cardiac silhouette is partially obscured by atelectasis but persistently moderately enlarged. No pneumothorax. Right PICC line ends in the upper SVC. " 58f65482-84050390-3c15df1f-0ea1a8f4-46002a3f.jpg,validate/p12/p12379221/s54571182/58f65482-84050390-3c15df1f-0ea1a8f4-46002a3f.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old man with hypoxia and chest pain concerning for PE. In anticipation of VQ scan. // Please eval for abnormalities. TECHNIQUE: Portable chest radiograph COMPARISON: Chest x-ray ___ FINDINGS: Bronchovascular markings are accentuated by very low lung volumes. Bibasilar atelectasis is noted. No pulmonary edema, large pleural effusions or pneumothorax. Stable cardiomediastinal silhouette. No acute osseous abnormalities. IMPRESSION: There is bibasilar atelectasis. No acute intrapulmonary process. " be071093-cf6e15c8-c9dfb290-5f961950-37237202.jpg,validate/p17/p17165725/s58326103/be071093-cf6e15c8-c9dfb290-5f961950-37237202.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: ___. FINDINGS: Indwelling support and monitoring devices are in standard position, and cardiomediastinal contours are stable. Pulmonary vascular congestion and interstitial edema are present as well as a moderate-to-large layering right pleural effusion with persistent adjacent right basilar lung opacity. " 401a70f0-8b1be98c-93f5bfc9-4661e836-45878ab5.jpg,validate/p16/p16615356/s50610220/401a70f0-8b1be98c-93f5bfc9-4661e836-45878ab5.jpg,validation," WET READ: ___ ___ ___ 11:16 PM Minimal retrocardiac opacification is not significantly changed compared to prior likely reflect atelectasis. No definite evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT HISTORY: Neutropenic with cough and difficulty breathing as well as malaise for the past one and half weeks. Evaluate for acute infection. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest demonstrate clear lungs with minimal retrocardiac opacification which is similar to the prior radiograph. No definite evidence of pneumonia. The cardiac and mediastinal contours are normal. No pleural abnormality is detected. IMPRESSION: Unchanged retrocardiac opacification since ___, with no definite evidence of pneumonia. " 0312b916-03befb7e-380f4191-470d1db0-c41448ad.jpg,validate/p13/p13565659/s53669619/0312b916-03befb7e-380f4191-470d1db0-c41448ad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with rib contusion vs fracture from MVA. Initial XR in ED was negative according to patient. Pain with breathing. // ___ year old woman with rib contusion vs fracture from MVA. Initial XR in ED was negative according to patient. Pain with breathing. ___ year old woman with rib contusion vs fracture from MVA. Initial XR in ED was negative according to patient. Pain with breathing. IMPRESSION: In comparison with study of ___, there is little interval change. Cardiac silhouette is within normal limits and there is moderate tortuosity of the descending aorta. No vascular congestion, pleural effusion, acute focal pneumonia, or pneumothorax. " 6cf05586-a5cb041c-9553f41d-6b802ccd-02a4ce31.jpg,validate/p10/p10987724/s51268698/6cf05586-a5cb041c-9553f41d-6b802ccd-02a4ce31.jpg,validation," WET READ: ___ ___ ___ 4:46 AM Low lung volumes. Left basilar atelectasis. Streaky opacities in the right apex also likely represent atelectasis. Well-delineated radiodensity overlying the right hilum represents a large pulmonary artery seen on prior CT. Trace pneumoperitoneum consistent with recent laparoscopic surgery. D/w Dr. ___ at 4:40 a.m.. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Postoperative day 1 after laparoscopy, desaturation. Evaluation. COMPARISON: No direct comparison available at the time of dictation. An old radiograph from ___ is used for comparison. FINDINGS: The lung volumes are low. There is both left and right basal atelectasis. Moreover, an area of band-like opacities has newly appeared in the right upper lobe. Given lower lung volumes, the hilar structures appear slightly larger than on the previous image. Minimal pneumoperitoneum of the laparoscopy, as manifested by some amount of infradiaphragmatic air. Normal size of the cardiac silhouette. No pneumothorax. No pulmonary edema. " 0d8229ea-5adcb1e1-3a9951aa-09bd3d71-8f7ec16c.jpg,validate/p17/p17598360/s50826574/0d8229ea-5adcb1e1-3a9951aa-09bd3d71-8f7ec16c.jpg,validation," FINAL ADDENDUM ADDENDUM: The results of the recent three radiographs were discussed with Dr. ___ ___ the phone by Dr. ___ at 10:05 a.m. on ___. ______________________________________________________________________________ WET READ: ___ ___ ___ 12:44 AM ET tube terminates 3.6 cm above the carina. There appears to be slight interval improvement in the diffuse bilateral parenchymal opacities, likely secondary to pulmonary edema. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Hypoxemic respiratory distress. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is approximately 4 cm above the carina. The NG tube tip passes below the diaphragm terminating in the stomach. There is interval substantial progression of currently severe interstitial pulmonary edema associated with bilateral pleural effusions. " 26cd4845-5c52d871-e5d996d0-a2113787-630c0309.jpg,validate/p18/p18517718/s56047116/26cd4845-5c52d871-e5d996d0-a2113787-630c0309.jpg,validation," WET READ: ___ ___ ___ 9:33 PM NG and ET tube appropriate. Mild bibasilar atelectasis. A ___ ______________________________________________________________________________ FINAL REPORT HISTORY: For ET tube placement. FINDINGS: In comparison with study of earlier in this date, the tip of the endotracheal tube measures approximately 4.6 cm above the carina. Nasogastric tube extends into the stomach, with the tip crossing the lower margin of the image. Increased opacification is seen at the right base medially. It is unclear whether this represents crowding of pulmonary vessels, atelectasis, or, in the appropriate clinical setting, a developing consolidation. " 9af13279-8600a462-1ecfe770-2f17098a-6080d438.jpg,validate/p13/p13577794/s55842002/9af13279-8600a462-1ecfe770-2f17098a-6080d438.jpg,validation," FINAL REPORT HISTORY: history of lymphoma with cough and fever, assess for pneumonia. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate clear lungs. The cardiomediastinal and hilar contours are normal. The previously seen adenopathy most pronounced in the right paratracheal region has improved. There is no pneumothorax or pleural effusion. Pleural surfaces are normal. IMPRESSION: No evidence of pneumonia. Improved hilar adenopathy. " 5f9d8f52-df82a028-a7270eb6-27ff7c05-a6fb694f.jpg,validate/p14/p14725980/s57588617/5f9d8f52-df82a028-a7270eb6-27ff7c05-a6fb694f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with low sats. // ETT position. review lung fields ETT position. review lung fields COMPARISON: ___ IMPRESSION: ET tube tip is 5.6 cm above the carinal. NG tube tip is in the stomach. Heart size and mediastinum are stable. Minimal bibasal atelectasis is new. There is also left supra-aortic opacity that might potentially represent area of atelectasis or infection. No appreciable pleural effusion or pneumothorax is seen. " 1f64bae1-c1fef485-9e339dd2-62aba273-a88bc414.jpg,validate/p14/p14586198/s57739861/1f64bae1-c1fef485-9e339dd2-62aba273-a88bc414.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with a fib sick sinus with pace maker placed ___, not willing to go for PA and lat. // Evaluation of pace maker placement from ___. COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the recently placed left pectoral pacemaker is in unchanged position. The known left-sided pneumothorax has increased in extent and severity. The pneumothorax has now an apical diameter of approximately 1.5-2 cm an is also visualized at the medial aspects of the left lung base. No evidence of tension. The air collection in the left soft tissues is constant. " d998f3d2-fdb84866-a2a6d9fe-b9163d04-cf95673b.jpg,validate/p12/p12764457/s50905722/d998f3d2-fdb84866-a2a6d9fe-b9163d04-cf95673b.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: Chest radiograph on ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiac, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The previously seen reticulonudar opacities are not well seen on today's study. IMPRESSION: No acute cardiopulmonary process. The previously seen reticulonudar opacities are not well seen on today's study. " cf1b8e9d-4f84cf87-e2281943-859fbd1a-ec648bdf.jpg,validate/p17/p17622916/s50758668/cf1b8e9d-4f84cf87-e2281943-859fbd1a-ec648bdf.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST AP PORTABLE SINGLE VIEW. INDICATION: ___-year-old female patient status post Whipple, now with increased oxygen requirements and white blood count increased. Evaluate for possible new pulmonary process. FINDINGS: AP single view of the chest has been obtained with patient in sitting upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. High-positioned diaphragms conceal major portion of cardiac silhouette, but significant cardiac enlargement is unlikely. The thoracic aorta is mildly widened and elongated but does not demonstrate any local contour abnormalities. The pulmonary vasculature is not congested. There exists bilateral plate thin atelectasis. There is no evidence of any new discrete pulmonary parenchymal infiltrate of pneumonic nature. Also, the lateral pleural sinuses are free, which excludes major pleural effusion. No pneumothorax identified in right apical area. A right internal jugular approach central venous line remains similar as on the preceding study. IMPRESSION: Bilateral basal plate atelectasis, high-positioned diaphragms, no evidence of new acute parenchymal infiltrates or pleural effusion. No pneumothorax. " 41051998-bad6259a-67125757-bff1cc45-ed6920cd.jpg,validate/p19/p19642544/s51051157/41051998-bad6259a-67125757-bff1cc45-ed6920cd.jpg,validation," FINAL REPORT STUDY: PA AND LATERAL CHEST, ___. CLINICAL HISTORY: ___-year-old man with rib fracture. FINDINGS: Comparison is made to prior radiographs from ___ at 2:34 a.m. There is again seen a right apical pneumothorax, which is stable when compared to the prior radiograph from six hours earlier; however, this has increased slightly since the previous radiograph from ___. There are again seen low lung volumes, atelectasis at the lung bases. Heart size is within normal limits. There are unchanged right mid clavicular shaft fracture and right lower rib cage fractures. " bd2678e4-9ed3904d-b38b390a-d8432f22-6f094829.jpg,validate/p15/p15502354/s57396288/bd2678e4-9ed3904d-b38b390a-d8432f22-6f094829.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___ chest radiograph. FINDINGS: AP and lateral views of the chest. Moderate-to-severe cardiomegaly is unchanged. The aorta is tortuous. Slight increase in interstitial markings compared to prior study which likely indicates mild interstitial pulmonary edema. No pleural effusions. No pneumothorax. No focal consolidation. IMPRESSION: Slight increase in interstitial markings compared to prior study likely indicates mild interstitial pulmonary edema. Moderate-to-severe cardiomegaly is unchanged. " a93bbcc2-23c01996-01c19fdf-ffb8938a-da9631bd.jpg,validate/p11/p11595140/s55953556/a93bbcc2-23c01996-01c19fdf-ffb8938a-da9631bd.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with metastatic neuroendocrine tumor, now with crackles at the right base. Evaluate for pulmonary effusion. COMPARISON: 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 unchanged. Again seen is prominence of the bilatearl hila, right greater than left, unchanged. No pneumothorax, pleural effusion, or consolidation. Left-sided PICC line ends at the mid SVC. IMPRESSION: No pleural effusion. " 0036d15d-0dbe7749-0720804e-6da0988e-5edbf55c.jpg,validate/p19/p19108524/s52067712/0036d15d-0dbe7749-0720804e-6da0988e-5edbf55c.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with cough since a month. COMPARISON: There are no prior chest x-ray for comparison at the time of dictation. FINDINGS: PA and lateral views of the chest show normal lung volumes without consolidation or nodules. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest x-ray. " 55b7792a-9e728fd1-c23f8b3f-c7f9fa05-48f505ff.jpg,validate/p16/p16519629/s58932456/55b7792a-9e728fd1-c23f8b3f-c7f9fa05-48f505ff.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with one day of weakness and dyspnea on exertion, experiencing chest tightness. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear. The cardiomediastinal silhouette is normal. The osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " b1e613d7-98b2e3bf-4e1bb97f-c0f1ae3a-8bf33a0c.jpg,validate/p11/p11563883/s52167363/b1e613d7-98b2e3bf-4e1bb97f-c0f1ae3a-8bf33a0c.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cough and night sweats. 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. " 9b2e1dca-5a4166ad-31b7180b-c707a230-745e651b.jpg,validate/p13/p13416533/s51927188/9b2e1dca-5a4166ad-31b7180b-c707a230-745e651b.jpg,validation," WET READ: ___ ___ ___ 10:17 AM Findings compatible with COPD with superimposed acute bilateral process predominantly in the lower lungs, potentially edema or atypical infection. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough and fever r/o pna TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT from ___. Chest x-ray from ___. FINDINGS: The lungs are hyperinflated as on prior. Increased interstitial markings seen throughout the lungs predominantly in the lower lung distribution. Irregularity of the interstitial markings elsewhere is compatible with underlying changes of known COPD. There is no large effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: Findings compatible with COPD with superimposed acute bilateral process predominantly in the lower lungs, potentially edema or atypical infection. " 23eebbf2-fa64b01b-1f5e41bc-ff2f996c-7fb4d355.jpg,validate/p16/p16321585/s59101557/23eebbf2-fa64b01b-1f5e41bc-ff2f996c-7fb4d355.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with T102.7. // ? infectious process ? infectious process IMPRESSION: In comparison with the study of ___, there is little change and no evidence of pneumonia or vascular congestion. There is some blunting of the left costophrenic angle consistent with pleural effusion. " 3fb2c25c-51086dad-e70ca94a-384f5e59-bfca7def.jpg,validate/p11/p11663899/s51017071/3fb2c25c-51086dad-e70ca94a-384f5e59-bfca7def.jpg,validation," FINAL REPORT INDICATION: Chest tightness and palpitations in a patient status post ablation for ___-___-___ syndrome. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal and well-aerated lungs which are clear. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable. IMPRESSION: Normal chest radiographs. " 41ab73d1-ca318f54-500a495d-09a00a61-702e0877.jpg,validate/p13/p13999026/s59038341/41ab73d1-ca318f54-500a495d-09a00a61-702e0877.jpg,validation," FINAL REPORT INDICATION: ___ year old man with tachypnea // Pleural effusions? TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: There is bilateral parahilar airspace opacification in a typical batwing distribution with associated bilateral pleural effusions (right larger than left). Transverse cardiomegaly. Right-sided IJV CVP in situ and with the tip 2 cm distal to the cavoatrial junction. The previously noted pulmonary airspace consolidation/ nodule on CT in the left upper lobe is not clearly visualized on this study. Spondylotic changes of the thoracic spine. IMPRESSION: Pulmonary edema with pleural effusions which shows a waxing and waning course, but has progressed compared to prior image ___. " 462ab7f9-39459c02-818703ea-acf5760d-8cc496cb.jpg,validate/p16/p16679893/s56950088/462ab7f9-39459c02-818703ea-acf5760d-8cc496cb.jpg,validation," FINAL REPORT INDICATION: Evaluate for interval change, in a patient intubated with lung collapse. COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: A portable semi-erect frontal chest radiograph again demonstrates an endotracheal tube terminating in the mid thoracic trachea, left PICC terminating in the upper SVC, and enteric tube extending below the diaphragm and off the inferior edge of the image. There is now complete collapse of the right lung, with rightward shift of the mediastinum. The left lung is clear, without focal consolidation, pleural effusion, or pneumothorax, unchanged since ___ but improved since ___. The visualized upper abdomen is unremarkable. IMPRESSION: Interval collapse of the entire right lung, with rightward shift of the mediastinum. NOTIFICATION: These findings were communicated via telephone by Dr. ___ ___ to Dr. ___ at 10:19 on ___. " bb4cda98-15c46874-4b890c12-d4049d97-17f3c3d9.jpg,validate/p11/p11586698/s51010693/bb4cda98-15c46874-4b890c12-d4049d97-17f3c3d9.jpg,validation," FINAL REPORT INDICATION: History of vasculitis, pneumonia. Please evaluate for interval change. COMPARISONS: Multiple prior chest radiographs dated back to ___ and chest CT from ___. TECHNIQUE: Single AP portable radiograph of the chest. FINDINGS: Overall, there has been no significant interval change of the bilateral perihilar and lower lung opacities, right greater than left, compared to the most recent prior radiograph. Small bilateral pleural effusions are persistent. There is no pneumothorax. Visualized osseous structures are unremarkable. The cardiomediastinal silhouette is unchanged compared to exams dated back to ___. IMPRESSION: Stable bilateral perihilar and lower lung opacities, right greater than left, compared to the prior radiograph from ___. " 74e97bd6-fa8aa61f-0ce0cd10-17e25c8d-1c4b8dfa.jpg,validate/p17/p17396346/s56062302/74e97bd6-fa8aa61f-0ce0cd10-17e25c8d-1c4b8dfa.jpg,validation," FINAL REPORT HISTORY: Pneumonia, to assess for change. FINDINGS: In comparison with the study of ___, there is again substantial enlargement of the cardiac silhouette with pulmonary vascular congestion that appears to be less prominent, especially on the right. The right costophrenic angle is sharply seen. Mild atelectatic changes are seen at both bases. No definite pneumonia is appreciated, though this could be obscured by the cardiomegaly and vascular congestion. " fbf9cc4b-23aa2534-9be4c67f-86e13272-5b315bfc.jpg,validate/p15/p15432819/s55784512/fbf9cc4b-23aa2534-9be4c67f-86e13272-5b315bfc.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with chronic cough // r/o mass TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs from ___, ___, ___ CT chest without contrast ___ FINDINGS: Mild bibasilar atelectasis is noted. Chronic elevation of the right hemidiaphragm is unchanged. The cardiomediastinal silhouette and hilar contours are unremarkable. No pneumothorax, pulmonary edema, or pneumonia. IMPRESSION: 1. No evidence of mass lesion or acute cardiopulmonary process. " b4044414-100334a0-2f49c69e-7c0fce26-d332f756.jpg,validate/p10/p10008304/s52686646/b4044414-100334a0-2f49c69e-7c0fce26-d332f756.jpg,validation," FINAL REPORT INDICATION: History: ___M with fever, cough TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Lung volumes are slightly low. This accentuates the size of the cardiac silhouette which is likely top normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. There are mild degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 7d6e0af4-10d1e0cd-33b98c3c-8c10a346-f857776b.jpg,validate/p14/p14785071/s55909926/7d6e0af4-10d1e0cd-33b98c3c-8c10a346-f857776b.jpg,validation," FINAL REPORT INDICATION: Shortness of breath and new cough, assess for pneumonia. COMPARISON: ___. FINDINGS: Two views were obtained of the chest. Interstitial abnormality is likely unchanged and probably relates to extensive paraseptal emphysema seen on the prior chest CT. There is no right pleural effusion with perhaps trace left pleural effusion. The heart is normal in size and normal mediastinal and hilar contours. No pneumothorax is seen. IMPRESSION: Perhaps trace left pleural effusion without acute intrathoracic process. " cbd04380-f794ceeb-ed909bfe-72b6750e-1fd2d97a.jpg,validate/p16/p16244108/s57466732/cbd04380-f794ceeb-ed909bfe-72b6750e-1fd2d97a.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and chills, rule out pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate clear lungs, without effusion, focal consolidation, or pneumothorax. Note is made of bilateral nipple shadows. Multiple surgical clips project over the left chest consistent with history of prior lumpectomy. The cardiac silhouette is normal in size, the mediastinal contours are normal. The pulmonary vasculature is normal. IMPRESSION: No acute chest abnormality. " bfaa9424-e8f8ea8b-96be1d66-f18406ed-2b95b5e9.jpg,validate/p18/p18358382/s54987116/bfaa9424-e8f8ea8b-96be1d66-f18406ed-2b95b5e9.jpg,validation," FINAL REPORT INDICATION: ___M with cp // eval fopr pulm edema/ptx TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. There is no pneumothorax. The cardiomediastinal silhouette is within normal limits. Median sternotomy wires and mediastinal clips are noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " dbce6802-fcd8a805-bbad6b0c-5bf1a62d-10c34443.jpg,validate/p16/p16069646/s51240793/dbce6802-fcd8a805-bbad6b0c-5bf1a62d-10c34443.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with history of atrial fibrillation, now with tachycardia, fevers, chronic cough // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CT ___ FINDINGS: Mild cardiomegaly is re- demonstrated. The aorta is tortuous with atherosclerotic calcifications noted at the aortic knob. Ascending aortic aneurysm is better assessed on the previous chest CT. Hilar contours are normal. Pulmonary vasculature is normal. Elevation of the right hemidiaphragm is unchanged. Trace bilateral pleural effusions are demonstrated, new in the interval with subsegmental atelectasis seen in the right lung base. 14 mm right upper lobe pulmonary nodule is unchanged. No focal consolidation or pneumothorax is seen. Multiple clips and coils are noted projecting over the lower mediastinum and gastroesophageal junction. IMPRESSION: 1. Small bilateral pleural effusions. No pneumonia. 2. Unchanged right upper lobe pulmonary nodule. 3. Known ascending aortic aneurysm is better assessed on previous chest CT. " ef4012cd-154697b7-5b56207b-71e862b7-d00e0a76.jpg,validate/p18/p18857939/s58945113/ef4012cd-154697b7-5b56207b-71e862b7-d00e0a76.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with leukocytosis, evaluate for pneumonia. COMPARISON: Portable chest radiograph, ___. PA AND LATERAL CHEST RADIOGRAPHS: Nasogastric tube passes below the diaphragm with tip within the expected region of the stomach. A right PICC line tip projects over the expected region of the distal SVC. Bilateral low lung volumes are noted with crowding of bronchovascular markings. No consolidation or pneumothorax is noted. Mild blunting of posterior pleural spaces may represent small bilateral pleural effusion/scarring. " 5d0dbaad-1c871b11-82c8f7e9-0f6fb9ce-8660e0e7.jpg,validate/p16/p16949700/s53498550/5d0dbaad-1c871b11-82c8f7e9-0f6fb9ce-8660e0e7.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: New ICD device placement. COMPARISON: ___. There is interval placement of the pacemaker defibrillator with its leads terminating in the expected location of right atrium and right ventricle. Heart size is mildly enlarged. Mediastinum is unremarkable. There is no pleural effusion or pneumothorax. The patient most likely has had CABG, and the lack of the sternal wires might suggest prior sternectomy or removal of the wires. There is no pneumothorax. " 1b0126eb-adc3c8d9-3563c459-4a23b5ed-ac8870e4.jpg,validate/p12/p12347056/s58760242/1b0126eb-adc3c8d9-3563c459-4a23b5ed-ac8870e4.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: No previous images. Cardiac silhouette is within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " df26912c-4e88ad49-d7725ca2-94d834c3-812aa136.jpg,validate/p19/p19415089/s52052446/df26912c-4e88ad49-d7725ca2-94d834c3-812aa136.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with history of recurrent pneumonia, cough. Rule out 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. " 8f248eab-03528b58-19da5185-953fb93f-fdc737ab.jpg,validate/p15/p15289901/s50170208/8f248eab-03528b58-19da5185-953fb93f-fdc737ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with s/p cabg // eval for effusion eval for effusion IMPRESSION: Compared to chest radiographs ___ through ___. Moderate pulmonary edema has worsened again and a small bilateral pleural effusions have increased. Widening of the upper mediastinum reflects pulmonary venous engorgement due to elevated central venous pressure or volume. Moderate to severe cardiomegaly is stable. " 42780692-d7916f4e-d55b224f-f744c3f3-60781886.jpg,validate/p14/p14540556/s57939575/42780692-d7916f4e-d55b224f-f744c3f3-60781886.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with HIV (CD4 >900) w/ productive cough x 2 weeks. // r/o pneumonia r/o pneumonia IMPRESSION: No previous images. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 4ccf834b-dfea1f06-9ba5d7e4-87154511-115ebba8.jpg,validate/p18/p18131667/s54937440/4ccf834b-dfea1f06-9ba5d7e4-87154511-115ebba8.jpg,validation," 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 " 84cfc7df-951b8ecc-5139708f-4cb7ddcf-154dbed2.jpg,validate/p18/p18654576/s51884901/84cfc7df-951b8ecc-5139708f-4cb7ddcf-154dbed2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest pain, sickle cell disease // infiltrate infiltrate IMPRESSION: Compared to prior chest radiographs since ___ most recently ___. Mild cardiomegaly has increased since ___ but there is no pulmonary edema, vascular engorgement, or more than a minimal left pleural effusion. Lungs are essentially clear. " 1ca82672-e7465387-c09bed25-f8a7f7ac-7faae93e.jpg,validate/p14/p14714280/s53145553/1ca82672-e7465387-c09bed25-f8a7f7ac-7faae93e.jpg,validation," FINAL REPORT HISTORY: ___F with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided demonstrate no focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette is normal. No bony abnormalities are seen. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 82ad2ca9-526fce62-1cd34ced-61ced71d-cda79c23.jpg,validate/p16/p16696931/s57336416/82ad2ca9-526fce62-1cd34ced-61ced71d-cda79c23.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with right sided chest pain and previous congestive heart failure 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. No pulmonary edema. " 61bcfa60-66620b9f-4ebbfdff-ed4f5ade-0b0c586c.jpg,validate/p10/p10900387/s54976834/61bcfa60-66620b9f-4ebbfdff-ed4f5ade-0b0c586c.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___ year old man with anoxic brain injury intubated due to respiratory distress ___ L mainstem bronchus occlusion with mucous plug // Improvement of L atelectasis and pleural effusion? Improvement of L atelectasis and pleural effusion? TECHNIQUE: AP view of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Endotracheal tube terminates 5.7 cm above the carina. Right-sided PICC line terminates at the low SVC. An orogastric tube courses below the diaphragm, tip is not included in this examination. The left lung is re-expanded. There is residual retrocardiac opacity, which likely reflects a combination of atelectasis and fluid. The right lung is clear. The cardiac silhouette is enlarged. IMPRESSION: Re-expansion of the left lung with residual retrocardiac opacity which likely reflects a combination of atelectasis and pleural fluid. " d7fd350b-d318c024-63ec0634-7a5c36ff-550584d4.jpg,validate/p19/p19417241/s51489772/d7fd350b-d318c024-63ec0634-7a5c36ff-550584d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with tachypnea, new lower extremity edema // eval for pulmonary edema eval for pulmonary edema IMPRESSION: In comparison with the study of ___, the endotracheal tube and nasogastric tube have been removed. There are extremely low lung volumes that further accentuate the prominence of the transverse diameter of the heart. Continued pulmonary vascular congestion. The hemidiaphragms are quite well seen, suggesting improvement in the lower lung atelectatic changes. " 27053ea1-72742374-8a4ae247-bfca1f43-ba20e349.jpg,validate/p12/p12391735/s50124915/27053ea1-72742374-8a4ae247-bfca1f43-ba20e349.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old maen with known L frontal AVM, seizure disorder, s/p fall, now with pna at OSH. // evaluate for pneumonia, volume status TECHNIQUE: CHEST (PA AND LAT) COMPARISON: None IMPRESSION: Heart size is mildly enlarged. Mediastinum is overall unremarkable. Lung volumes are low. Left retrocardiac opacity is concerning for left lower lobe pneumonia associated with small amount of pleural effusion. " 17cc5548-ad8b75d9-12d0a209-193abe89-4956a1c7.jpg,validate/p18/p18927537/s50557267/17cc5548-ad8b75d9-12d0a209-193abe89-4956a1c7.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. 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 seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " 3988870e-79948020-f569904f-54ed762d-5a060dd2.jpg,validate/p12/p12945037/s52255855/3988870e-79948020-f569904f-54ed762d-5a060dd2.jpg,validation," 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. " b3de5efd-b5305ed1-f0c4e1e7-70232283-676f02f0.jpg,validate/p11/p11146315/s53965521/b3de5efd-b5305ed1-f0c4e1e7-70232283-676f02f0.jpg,validation," FINAL REPORT INDICATION: ___ year old man with SOB and cough // any acute pulmonary process? COMPARISON: Radiographs from ___ IMPRESSION: Right-sided Port-A-Cath is unchanged position. Cardiomediastinal silhouette is within normal limits. There is some atelectasis and a small left-sided pleural effusion which has developed since the previous study. There are no pneumothoraces. " 0f3bfcbc-f47049bb-89d2c4b9-577c29f7-21b668d6.jpg,validate/p15/p15299325/s56872369/0f3bfcbc-f47049bb-89d2c4b9-577c29f7-21b668d6.jpg,validation," 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 unremarkable. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are moderate multilevel degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 13e86ff0-85c996da-a178d287-1ae7a4f5-8b92fdcf.jpg,validate/p13/p13747567/s50118415/13e86ff0-85c996da-a178d287-1ae7a4f5-8b92fdcf.jpg,validation," FINAL REPORT INDICATION: Fever. Evaluate for pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. The heart is normal size. The mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " d1febc00-7b754b59-ee2ad800-0cfb647e-652b6691.jpg,validate/p13/p13643894/s50955198/d1febc00-7b754b59-ee2ad800-0cfb647e-652b6691.jpg,validation," FINAL REPORT INDICATION: ___M with worsening dyspnea // ? acute cardiopulm process TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Small bilateral pleural effusions have slightly increased. Cardiomegaly is again noted. There is mild pulmonary edema. There is no focal consolidation Hypertrophic changes seen in the spine. IMPRESSION: Slightly increased size of small bilateral effusions and mild pulmonary edema " db5d21d7-996191d5-840a37e2-82597176-22992567.jpg,validate/p15/p15299249/s59811854/db5d21d7-996191d5-840a37e2-82597176-22992567.jpg,validation," FINAL REPORT HISTORY: Fall with right rib pain. TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is top normal. The aorta is mildly tortuous and demonstrates calcifications of the aortic knob. The pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is identified. No displaced rib fractures are seen. IMPRESSION: No acute cardiopulmonary abnormality. No displaced rib fractures are identified. If there is continued clinical concern for rib fracture, then a dedicated rib series is recommended. " ef2d84b5-a7c0a537-91c9e342-dd5776b2-c156651c.jpg,validate/p17/p17868309/s57145876/ef2d84b5-a7c0a537-91c9e342-dd5776b2-c156651c.jpg,validation," FINAL REPORT HISTORY: Astrocytoma with herpes zoster, to assess for lung involvement. FINDINGS: In comparison with study of ___, there is little change. Slightly lower lung volumes but no evidence of acute pneumonia, vascular congestion, or pleural effusion. Mild atelectatic changes at the left base. " ec355ccc-b5f7d922-fde5ad17-4c98c75a-f4a2b974.jpg,validate/p12/p12108423/s53079880/ec355ccc-b5f7d922-fde5ad17-4c98c75a-f4a2b974.jpg,validation," FINAL REPORT EXAMINATION: Portable chest x-ray INDICATION: ___F presenting intubated from OSGH, would like to eval tube placement. ET tube placement TECHNIQUE: AP radiograph of the chest, semi upright. COMPARISON: None FINDINGS: The endotracheal tube terminates 3 cm above the carina. The enteric tube is seen terminating below left hemidiaphragm. Lung volumes are markedly low with atelectasis in the lower lungs. The heart appears enlarged though poorly assessed. The upper lungs appear well aerated. There is dextroscoliosis of thoracic spine, otherwise bones soft tissue structures are unremarkable. The trachea is midline. IMPRESSION: 1. Endotracheal tube terminates 3 cm above the carina. 2. Enteric tube is seen below the left hemidiaphragm. 3. Bibasilar atelectasis. " 0e33de73-6ee3c195-8dfc5f91-1d8bff71-a34f97f1.jpg,validate/p19/p19928728/s56341407/0e33de73-6ee3c195-8dfc5f91-1d8bff71-a34f97f1.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with subarachnoid hemorrhage. Spinal fusion. Portable AP radiograph of the chest was reviewed in comparison to ___. The NG tube tip is in the stomach. Heart size and mediastinum are unchanged in appearance as well as there is no change in pulmonary edema. " ece613f8-0bc96f3b-899831f1-203b4738-7c8a2b0a.jpg,validate/p17/p17062932/s54809063/ece613f8-0bc96f3b-899831f1-203b4738-7c8a2b0a.jpg,validation," WET READ: ___ ___ ___ 8:53 PM No pneumothorax after chest tube placement. Right pleural effusion has nearly resolved. Moderate left pleural effusion persists. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Right pleural effusion, questionable pneumothorax, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a pigtail catheter was inserted into the right pleural space. The right pleural effusion is completely drained. There is no evidence for the presence of a right pneumothorax. On the left, the pleural effusion persists in unchanged manner. The effusion causes atelectasis at the level of the left lower lobe. The heart is unchanged in size. Unchanged are the other monitoring and support devices. " d3e8fc04-74fae9fb-787da683-4705e3a6-8e7dd7a6.jpg,validate/p17/p17617589/s53371757/d3e8fc04-74fae9fb-787da683-4705e3a6-8e7dd7a6.jpg,validation," WET READ: ___ ___ 6:23 AM Right mainstem intubation. Recommend repositioning. ______________________________________________________________________________ FINAL REPORT INDICATION: Sudden unresponsiveness requiring intubation, here to evaluate ET tube position. COMPARISON: No prior studies available. TECHNIQUE: Portable semi-erect frontal radiograph of the chest. FINDINGS: An endotracheal tube terminates at the orifice of right mainstem bronchus. An enteric tube passes far into the stomach. Evaluation of the chest is limited due to multiple overlying lines and tubes. Within this limitation, there are widespread interstitial opacities throughout the right lung with a basilar predominance as well as the left lung base. There is mild pulmonary vascular congestion and subtle Kerley B lines suggesting interstitial edema. A small right pleural effusion cannot be excluded. No pneumothorax is detected on this semi-erect view. The cardiac silhouette is incompletely visualized in the setting of bibasilar opacities. The mediastinal contours are prominent due to tortuosity of the thoracic aorta with partial calcification of the aortic knob. Densities projecting over the right humerus and soft tissues of the upper arm are likely external to the patient. IMPRESSION: 1. Right mainstem intubation. Recommend re-positioning. 2. Asymmetric pulmonary interstitial edema and vascular congestion on the right greater than the left. Superimposed infection cannot be excluded in the appropriate clinical context. " 0bca5e79-4c18632c-fb8dfbda-b817c928-a2046178.jpg,validate/p19/p19244907/s54516640/0bca5e79-4c18632c-fb8dfbda-b817c928-a2046178.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with chronic pseudomonas colonization now p/w c/f pna with new effusion // Chest tube in place? Chest tube in place? COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Since ___ following insertion of a pigtail pleural drainage catheter at the base of the left hemi thorax, the volume of left pleural fluid has decreased, but is probably still substantial and there is probably still considerable left lower lobe atelectasis. Conventional radiographs including lateral and possibly oblique views would be very helpful in assessing the extent of pleural abnormality and the position of the drainage tube which could lie either anterior or posterior to the heart. subsegmental atelectasis at the right base has increased. The heart is normal size. Tracheostomy tube is midline. Right PIC line ends in the low SVC. There is no pneumothorax on either side. " eb5dfa41-82c6ee18-e05b426d-47893ea1-a03f7788.jpg,validate/p12/p12201410/s51711627/eb5dfa41-82c6ee18-e05b426d-47893ea1-a03f7788.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with subjective fevers, fall one week ago. COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest were obtained. Lung volumes are low. Heart is top normal in size, and cardiomediastinal contour is unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. Vascular graft partially seen in the upper abdomen. IMPRESSION: Low lung volumes. Otherwise, no acute intrathoracic abnormality. " ad29045a-ced7e458-8314c443-908b0976-ded096fe.jpg,validate/p11/p11214611/s57657996/ad29045a-ced7e458-8314c443-908b0976-ded096fe.jpg,validation," FINAL REPORT INDICATION: ___ year old man with stage III esophageal adenocarcinoma and para-tracheal SCC, TE fistula, bronchial stent and trach. Fever and 'choking' sensation // Eval fever. ? aspiration COMPARISON: ___. IMPRESSION: There is a right-sided Port-A-Cath with the distal lead tip in the distal SVC. Tracheostomy tube is unchanged position. There is cardiomegaly and a left retrocardiac opacity, unchanged. There is a partially loculated left-sided pleural effusion. There has been worsening of the right lower lobe opacity which may represent aspiration or atelectasis. " 54833aa0-7bac5000-e32a7ecf-109e7548-30f7a7e9.jpg,validate/p11/p11825167/s58778173/54833aa0-7bac5000-e32a7ecf-109e7548-30f7a7e9.jpg,validation," FINAL REPORT INDICATION: Chest pain. Evaluate for an acute process. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 8ae1cc47-54fbdf5c-8051d83e-352e4182-60902e63.jpg,validate/p14/p14497007/s58755240/8ae1cc47-54fbdf5c-8051d83e-352e4182-60902e63.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple myeloma p/w fevers and urinary incontinence on room air, now with new oxygen requirement. // ? effusions vs atelectasis vs pna (working up cause for hypoxia) ? effusions vs atelectasis vs pna (working up cause for hypoxia) IMPRESSION: Comparison to ___. Stable extent of a pre-existing left pleural effusion with subsequent retrocardiac atelectasis. Increasing opacities at the right lung bases, adjacent to the heart right heart border, consistent with pneumonia in the appropriate clinical setting. Stable size of the heart. Stable position of the right pectoral Port-A-Cath and of the vertebral stabilization devices. " 5953c416-364a6902-2c56b800-c8687c4a-9f1cb672.jpg,validate/p15/p15460343/s56165024/5953c416-364a6902-2c56b800-c8687c4a-9f1cb672.jpg,validation," WET READ: ___ ___ ___ 9:06 AM Right mid lung opacity may represent pneumonia. Follow up films are recommended in ___ weeks to document resolution. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M w/ COPD, here w/ right sided chest pain earlier today with cough/congestion for 1 week // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___, ___, CTA chest ___ FINDINGS: The cardiac silhouette is enlarged. There is severe emphysema. Diffuse, increased interstitial opacities are seen, unchanged since the prior examination. Right mid lung opacity is noted, which may represent pneumonia in the appropriate clinical context. Multiple thoracic spinal compression deformities are noted, similar to the prior examination. Rib fractures are not able to be assessed on this examination. IMPRESSION: Right mid lung opacity may represent pneumonia. Follow up films are recommended in ___ weeks to document resolution. NOTIFICATION: Updated wet read results were discussed with Dr. ___ ___, M.D. by ___, M.D. on the telephone on ___ at 9:03 AM, 20 minutes after discussion with the attending, Dr. ___. " 286bed0e-53b10ad0-3ce8ca94-c41bda08-0695e988.jpg,validate/p15/p15245907/s54164695/286bed0e-53b10ad0-3ce8ca94-c41bda08-0695e988.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure // Interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the extent of the right pleural effusion is slightly increased. The left effusion is unchanged. Unchanged are the areas of bilateral basal parenchymal opacities. Moderate pulmonary edema persists. Unchanged moderate cardiomegaly. The tracheostomy tube and the left PICC line are constant. " b988129f-28c83ee9-9f8067e3-3613b3ed-3c1532c8.jpg,validate/p12/p12763897/s57671565/b988129f-28c83ee9-9f8067e3-3613b3ed-3c1532c8.jpg,validation," FINAL REPORT PORTABLE CHEST OF ___ COMPARISON: ___. FINDINGS: Interval worsening of diffuse alveolar opacities most likely due to pulmonary edema. Otherwise, no relevant short interval change. " 0acf647d-3a7a9a9e-eeefb9b0-8e046cde-cae3bc18.jpg,validate/p18/p18868892/s57694556/0acf647d-3a7a9a9e-eeefb9b0-8e046cde-cae3bc18.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with metastatic colon cancer to the lungs, now with nausea. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Chest wall port is again seen with catheter tip projecting over the right atrium. Diffusely increased interstitial markings which are somewhat nodular are unchanged in appearance and perhaps slightly improved at the right lung base when compared to prior chest x-ray, not significantly changed from scout from CT dated ___. There is no new large confluent consolidation. Cardiomediastinal silhouette is stable. Osseous and soft tissue structures are essentially unremarkable. IMPRESSION: Stable appearance of the chest with diffuse bilateral parenchymal disease potentially from metastatic disease. No evidence of new large confluent consolidation. " 0135f1a0-279100aa-b1d13470-f41411f3-eb88af69.jpg,validate/p11/p11579432/s57665947/0135f1a0-279100aa-b1d13470-f41411f3-eb88af69.jpg,validation," FINAL REPORT HISTORY: Positive PPD. Rule out TB. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest again demonstrate thoracic spinal stabilization. The lungs are clear. The cardiac and mediastinal contours are normal. No pleural abnormality is seen. IMPRESSION: No evidence of active or latent tuberculosis infection. " 3dfbf955-0c63e1b0-a5466bd6-2866fadf-80a1d263.jpg,validate/p12/p12862864/s50648983/3dfbf955-0c63e1b0-a5466bd6-2866fadf-80a1d263.jpg,validation," FINAL REPORT HISTORY: Fever and cough. COMPARISON: None available. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Heart size is top normal. Mediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 8ac339b6-ee33ab44-a3fee9f0-c009fb5d-9bc6023c.jpg,validate/p10/p10915432/s51138533/8ac339b6-ee33ab44-a3fee9f0-c009fb5d-9bc6023c.jpg,validation," WET READ: ___ ___ ___ 8:35 PM Dobhoff tube in the distal stomach. Normal bowel gas pattern.No free air. ______________________________________________________________________________ FINAL REPORT HISTORY: Dobbhoff tube. FINDINGS: Tip of the Dobbhoff tube extends to the distal stomach. Otherwise, little change. " a05295d0-dd1ad93b-50ed7b5f-87a7669f-ea333567.jpg,validate/p15/p15554295/s50754466/a05295d0-dd1ad93b-50ed7b5f-87a7669f-ea333567.jpg,validation," 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. " cb23e3ab-613a24c9-0902e724-2e05d7a0-110ece2f.jpg,validate/p11/p11472206/s50732097/cb23e3ab-613a24c9-0902e724-2e05d7a0-110ece2f.jpg,validation," 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. " 2ba833ab-abf01228-a9cd3813-ac2f5ff7-be6297c3.jpg,validate/p14/p14597448/s57245306/2ba833ab-abf01228-a9cd3813-ac2f5ff7-be6297c3.jpg,validation," FINAL REPORT INDICATION: History of aplastic anemia, pre-allo DMT workup. COMPARISON: ___. FINDINGS: Bilateral multifocal opacities are unchanged compared to ___. There are no new opacities. No pleural effusion or pneumothorax. Cardiomediastinal and hilar contours are stable. IMPRESSION: No change in multifocal opacities. No new opacities identified. " c703d663-21352973-ffd13fef-0505e5b4-f009de53.jpg,validate/p14/p14235312/s55767304/c703d663-21352973-ffd13fef-0505e5b4-f009de53.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new onset fever, intubated x2 days. No definitive recent aspiration, though new cerebral hemorrhage. // eval for PNA TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 5.3 cm above the carinal. NG tube tip passes below the diaphragm terminating in the stomach but the side hole is a right at the gastroesophageal junction and might be further advanced. Central venous line tip is at the level superior SVC. Overall the lungs are essentially clear. And no pleural effusion or pneumothorax is seen. " 13e69e6f-a9412eca-6958eec6-833e6982-cb46aae1.jpg,validate/p11/p11951880/s50850155/13e69e6f-a9412eca-6958eec6-833e6982-cb46aae1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough, oncology patient // eval acute process, PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ chest radiographs. Reference made to chest CT from ___. FINDINGS: As compared to the prior chest radiograph from ___, there has been significant interval decrease in apparent number of pulmonary nodules, however, pulmonary nodules overall appear increased in size with more recent progression of metastatic disease seen on recent CT. Pulmonary nodules on current radiography were better assessed on CT. No definite new focal consolidation is seen. There is no pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are ear similar to scout radiograph from chest CT from ___ right-sided Port-A-Cath terminates at the proximal right atrium. . IMPRESSION: Multiple bilateral pulmonary nodules consistent with patient's known pulmonary metastases, better assessed on recent chest CT. No definite new focal consolidation. " 2b38f9b2-8b4181e6-1de1442a-88af56aa-b96461f6.jpg,validate/p13/p13748721/s59952449/2b38f9b2-8b4181e6-1de1442a-88af56aa-b96461f6.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain and headache. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is at the upper limits of normal size. The mediastinal and hilar contours appear unchanged. The lungs appear clear. There are no pleural effusions or pneumothorax. Slight degenerative changes are present along the thoracic spine. There has been no significant change. IMPRESSION: No evidence of acute disease. " fecda8e7-b7726dee-311569d9-d25b5657-81d2ae16.jpg,validate/p16/p16590876/s52817041/fecda8e7-b7726dee-311569d9-d25b5657-81d2ae16.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with presyncope. COMPARISON: Multiple prior exams, most recently of ___. FINDINGS: Frontal and lateral views of the chest. Bilateral calcified granulomas are unchanged. No focal consolidation, pleural effusion, or pneumothorax. Mild cardiac enlargement is similar to prior. Aortic calcifications are unchanged. The mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. Stable mild cardiomegaly. " 2a5ae6db-977e69f8-c2a0a843-4ec17243-8392d331.jpg,validate/p17/p17705162/s50141198/2a5ae6db-977e69f8-c2a0a843-4ec17243-8392d331.jpg,validation," 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. " 5e2e3ec6-e59d9849-c1d3053f-5341af87-c0366a27.jpg,validate/p15/p15993000/s55320147/5e2e3ec6-e59d9849-c1d3053f-5341af87-c0366a27.jpg,validation," FINAL REPORT INDICATION: Nausea, vomiting, chest pain. COMPARISON: Chest radiograph ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unchanged with mild tortuosity of the thoracic aorta again noted. There is diffuse calcification of the aorta. The pulmonary vascularity is not engorged. Streaky opacity in the left lung base likely reflects atelectasis. There is mild elevation of the left hemidiaphragm. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Mild atelectasis in the left lung base. Chronic elevation of the left hemidiaphragm. " 38fe86a3-10a7bf1d-52946dd4-aae9eebe-50cd849b.jpg,validate/p17/p17924012/s55895082/38fe86a3-10a7bf1d-52946dd4-aae9eebe-50cd849b.jpg,validation," FINAL REPORT PORTABLE CHEST FILM, ___ AT 10:08 CLINICAL INDICATION: ___-year-old with new oxygen requirement, question pneumonia, question aspiration. Comparison is made to the patient's previous study dated ___ at 8:12. Portable upright chest film, ___ at 10:08 is submitted. IMPRESSION: 1. Left-sided pacer remains in place. The heart remains enlarged, which could reflect cardiomegaly, although a pericardial effusion should also be considered. There is bilateral airspace disease, which is not significantly changed, but would favor pulmonary edema rather than diffuse pneumonia. Retrocardiac area is not well evaluated due to the enlarged heart. There is possibly a left effusion. No pneumothorax. A spherical calcification in the left upper quadrant again seen and may be splenic in etiology. " 0cb13173-ea9e1e9d-16fd06b7-a5068cee-6ef055d8.jpg,validate/p18/p18058493/s59438769/0cb13173-ea9e1e9d-16fd06b7-a5068cee-6ef055d8.jpg,validation," WET READ: ___ ___ ___ 6:43 PM Malpositioned right internal jugular central venous catheter with tip terminating in the region of the left subclavian vein. ______________________________________________________________________________ FINAL REPORT HISTORY: Right internal jugular central line placement. TECHNIQUE: Upright AP view of the chest. COMPARISON: ___ at 17:30. FINDINGS: The right internal jugular central venous catheter tip is malpositioned, with the catheter coursing across midline through the left brachiocephalic vein, and terminating in the region of the left subclavian vein. No pneumothorax is identified. The remainder of the chest is unchanged. No pneumothorax is identified. IMPRESSION: Malpositioned right internal jugular central venous catheter with tip terminating in the region of the left subclavian vein. " abbee220-aa15a2e2-bca708dd-5bef6907-14a81690.jpg,validate/p11/p11967908/s53930672/abbee220-aa15a2e2-bca708dd-5bef6907-14a81690.jpg,validation," 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. " 83fe468b-36b0e9fe-216e41d5-a146bef0-b1aa8cd1.jpg,validate/p13/p13031024/s51574435/83fe468b-36b0e9fe-216e41d5-a146bef0-b1aa8cd1.jpg,validation," WET READ: ___ ___ ___ 3:55 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with chest pain and dyspnea // r/o acute infection TECHNIQUE: PA image 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. IMPRESSION: No acute cardiopulmonary process. " f1f745c3-64504c5a-ae69730f-a806ee70-8fbff8e7.jpg,validate/p17/p17182076/s54578058/f1f745c3-64504c5a-ae69730f-a806ee70-8fbff8e7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with fever, concern for aspiration // eval for infiltrate COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous image. The lung volumes are large. Mild flattening of the hemidiaphragms could suggest overinflation. No focal parenchymal opacities suggesting pneumonia or aspiration. Mild bilateral apical thickening, symmetrical in distribution. Normal size of the cardiac silhouette. Mild elongation of the descending aorta. " c1882ca6-839586d1-90ad51e6-30573922-ce23905b.jpg,validate/p13/p13135946/s54379083/c1882ca6-839586d1-90ad51e6-30573922-ce23905b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after mitral valve replacement and CABG. Portable AP radiograph of the chest was reviewed in comparison to prior study obtained the same day earlier. The ET tube tip is 5 cm above the carina. The right subclavian line tip is at the level of cavoatrial junction. The Dobbhoff tube tip is in the stomach. Heart size and mediastinum are stable. There is substantial interval improvement of pulmonary edema. Left lower lobe opacity and bilateral pleural effusions are noted. " 5ed802ac-b1399f54-1d30a823-323df2d8-0364453b.jpg,validate/p16/p16354216/s57327197/5ed802ac-b1399f54-1d30a823-323df2d8-0364453b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with intubation TECHNIQUE: Supine AP view of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Endotracheal tube tip terminates approximately 6 cm from the carina. An enteric tube tip is within the stomach. Lung volumes are low. Heart size is normal. Mediastinal and hilar contours are unremarkable. Patchy opacities in the lung bases likely reflect areas of atelectasis. No large pleural effusion or pneumothorax is seen on this supine exam. No acute osseous abnormalities demonstrated. IMPRESSION: Standard positions of the endotracheal and enteric tubes. Low lung volumes with probable bibasilar atelectasis. " c75a67a0-2c63a3ed-a7963d9f-285b47bd-303346e7.jpg,validate/p14/p14325424/s53903384/c75a67a0-2c63a3ed-a7963d9f-285b47bd-303346e7.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with new left subclavian central venous line. COMPARISON: Earlier film from 1:12 p.m. FINDINGS: Single portable view of the chest. Left-sided chest tube is again seen with catheter tip projecting over the mediastinum. The endotracheal tube is in close proximity to the carina, approximately 1 cm from the carina. Enteric tube tip is in the gastric fundus with side port likely in the distal esophagus. Left-sided pneumothorax is again seen which is large in size with no significant change in reexpansion of the left lung. New left subclavian central venous catheter is seen with tip in the upper SVC. " bfbb00fe-20a2fc1d-f039f5a8-780d9811-4ef5d989.jpg,validate/p13/p13877204/s50535826/bfbb00fe-20a2fc1d-f039f5a8-780d9811-4ef5d989.jpg,validation," FINAL ADDENDUM ADDENDUM: Findings were discussed with Dr. ___ ___ the phone by Dr. ___ at 2:20 p.m. on ___. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with AML and fevers. PA and lateral upright chest radiographs were reviewed in comparison to ___. Left basal linear opacity reflects area of atelectasis and less likely to represent an infectious process. On the other hand, there is right upper lobe opacity that appears to be new and may reflect infection. Heart size and mediastinum are stable. Pacemaker leads terminate in the right atrium and right ventricle. No appreciable pleural effusion is seen. IMPRESSION: Suspicion for right upper lobe pneumonia. Discussed with Dr ___ ___ the phone by Dr ___ on ___ approximately at 4 pm. " 13edbfc9-67ac11d1-50632f9b-5ba2dc1e-4f828192.jpg,validate/p19/p19954256/s52793759/13edbfc9-67ac11d1-50632f9b-5ba2dc1e-4f828192.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with history of stage IA breast cancer presenting with cough and wheezing // any pna? 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. Regional bones and soft tissues are unremarkable. IMPRESSION: Clear lungs with no evidence of pneumonia. " c5f82fe0-ea8d6933-cacd150c-29e069b2-80029fe8.jpg,validate/p10/p10831202/s50371495/c5f82fe0-ea8d6933-cacd150c-29e069b2-80029fe8.jpg,validation," FINAL REPORT INDICATION: Recent fall with left rib cage pain and cough. COMPARISONS: ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusions, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Again seen old left-sided seventh rib fracture. IMPRESSION: No evidence of acute cardiopulmonary process. " 0aad2551-d0bf5031-73e3ee66-0866631b-72a5e9f0.jpg,validate/p17/p17734241/s50209970/0aad2551-d0bf5031-73e3ee66-0866631b-72a5e9f0.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of colon cancer, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Borderline size of the cardiac silhouette without pulmonary edema. Hiatal hernia with air-fluid level. No evidence of acute lung disease, in particular no pneumonia and no pulmonary nodules or masses. No pleural effusion. Unchanged tortuosity of the thoracic aorta, unchanged severe scoliosis. " b32dd2a4-068058d3-7795cdef-4bc6b838-251f2a33.jpg,validate/p19/p19489906/s57560730/b32dd2a4-068058d3-7795cdef-4bc6b838-251f2a33.jpg,validation," FINAL REPORT CHEST, TWO VIEWS. HISTORY: ___-year-old female with history of right pleuritic chest pain. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear of consolidation or pneumothorax. There is mild blunting of one of the posterior costophrenic angles, potentially due to trace effusion, likely on the right. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. IMPRESSION: Trace probable right pleural effusion without other acute cardiopulmonary process. " 6c3035d5-dbbc6a9e-3b5796ef-f195ba93-208fdd84.jpg,validate/p19/p19751455/s55257684/6c3035d5-dbbc6a9e-3b5796ef-f195ba93-208fdd84.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with hypoxia // r/o acute process COMPARISON: ___. CT chest dated ___. FINDINGS: PA and lateral views of the chest provided. Overall, no significant change is seen with severe emphysema again noted. There has been prior resection of the left upper lobe which accounts for the left apical cap and the slight upward retraction of the left hilum. A subtle nodular opacity is seen projecting over the left mid to upper lung which measures approximately 18 mm, and is better characterized on the prior CT chest dated ___. No superimposed pneumonia, effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Stable appearance of the chest with severe emphysema, left upper lung nodule. No superimposed pneumonia. " 6865fe67-b383b42d-3cb5e4b6-35158b0e-c329142d.jpg,validate/p11/p11661520/s58314058/6865fe67-b383b42d-3cb5e4b6-35158b0e-c329142d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary edema, evaluation for interval change. COMPARISON: ___, 1:14 a.m. FINDINGS: As compared to the previous radiograph, the transparency of the lung parenchyma has slightly increased. On the other hand, the pre-existing bilateral pleural effusions have slightly increased in extent. The size of the cardiac silhouette is constant. " 030035b7-dbaf9773-76fdd81b-98b766d5-f5cbba71.jpg,validate/p10/p10110724/s57443261/030035b7-dbaf9773-76fdd81b-98b766d5-f5cbba71.jpg,validation," 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. " 08da5e58-24771f8c-4235fe33-b507836e-668a435c.jpg,validate/p10/p10831202/s58408806/08da5e58-24771f8c-4235fe33-b507836e-668a435c.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Trauma. COMPARISONS: None. 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. Allowing for low lung volumes, vague lower lung opacities are probably due to minor atelectasis. The right shoulder is not fully imaged, but there is an indication that the acromion may be depressed with respect to the right clavicle, although the appearance may be essentially a projectional artifact. Bony structures are otherwise unremarkable. IMPRESSION: No evidence of acute disease or chest injury. Mild apparent relative depression of the right acromion with respect to the distal right clavicle; if pain refers to the site and there is a clinical possibility of shoulder separation, then dedicated radiographic assessment could be considered. " 5bc02f5a-1e94959a-1ac0e22f-835540d1-ac35c42e.jpg,validate/p13/p13858072/s51785684/5bc02f5a-1e94959a-1ac0e22f-835540d1-ac35c42e.jpg,validation," FINAL REPORT HISTORY: Recently diagnosed multiple myeloma, now hypoxia, question pneumonia, CHF. CHEST, TWO VIEWS. Lateral view is limited by overlying materials and blurring due to respiratory motion. On the AP view, there are low inspiratory volumes, with patchy opacities at both bases, including retrocardiac density and obscuration of the left hemidiaphragm. The cardiomediastinal silhouette is not frankly enlarged, though there is a left ventricular configuration. There is upper zone redistribution and mild vascular plethora, likely accentuated by low inspiratory volumes. Doubt gross effusion. Probable diffuse osteopenia of the spine, which is not well visualized on this exam. IMPRESSION: 1. Low inspiratory volumes, worse than on ___. 2. Otherwise, the findings are similar, though with slightly worse left lower lobe collapse and/or consolidation. Patchy right cardiophrenic opacity again noted. 3. Upper zone redistribution. Allowing for low lung volumes, no definite evidence of more extensive volume overload. " 673cbd1e-cf5e96cd-e5c1c1dc-d76b8fca-750d5a33.jpg,validate/p19/p19494284/s51641440/673cbd1e-cf5e96cd-e5c1c1dc-d76b8fca-750d5a33.jpg,validation," FINAL REPORT TWO-VIEW CHEST ___, ___ COMPARISON: ___ radiograph. FINDINGS: Heart is mildly enlarged but stable in size. Pulmonary vascularity is normal. Left hemidiaphragm remains mildly elevated with adjacent linear area of atelectasis or scarring. No focal areas of consolidation have developed to suggest an acute pneumonia, and there are no pleural effusions. IMPRESSION: Elevated left hemidiaphragm with adjacent left basilar scar or atelectasis. " 4fe182c6-0921d4bf-29d2d986-5bed4c50-60d1550a.jpg,validate/p17/p17652927/s59393916/4fe182c6-0921d4bf-29d2d986-5bed4c50-60d1550a.jpg,validation," FINAL REPORT AP CHEST, 10:07 A.M., ___ HISTORY: ___-year-old man with CHF and shortness of breath. IMPRESSION: AP chest compared to ___: Severe cardiomegaly is chronic. Pulmonary vasculature is unremarkable, lungs are clear and there is no pneumothorax. Transvenous right ventricular pacer defibrillator lead is in standard position, unchanged. " 83101558-580fe066-31bb0ae3-d8aad803-6087eb2a.jpg,validate/p13/p13834043/s56069305/83101558-580fe066-31bb0ae3-d8aad803-6087eb2a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with SOB // infiltrate COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are low. There is a retrocardiac opacity containing air-fluid level consistent with a large hiatal hernia as seen on prior. There is mild streaky left basal opacity abutting the hiatal hernia, which could represent atelectasis versus an early pneumonia/aspiration. Right lung is clear. No large effusion or pneumothorax. Scoliotic deformity of the lumbar spine is partially visualized. IMPRESSION: Left lower lobe opacity abutting the hiatal hernia, question atelectasis versus early pneumonia/aspiration. " b8e34b0b-0f0aad2a-db4bd2e2-2bfb1c6b-30193233.jpg,validate/p17/p17988248/s59984728/b8e34b0b-0f0aad2a-db4bd2e2-2bfb1c6b-30193233.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ CLINICAL HISTORY: ___-year-old woman with cancer of the lung. IMPRESSION: PA and lateral chest compared to ___: Severe hyperinflation reflects emphysema. Previous moderate right pleural effusion has resolved. Severe consolidation persists in the right lower lobe around a previous lung mass, presumably undergoing interval treatment. Heart is not enlarged. No central venous lines are noted. " a05e9d29-031af306-5e6ffa34-4ae4277d-25f87948.jpg,validate/p17/p17169886/s59331339/a05e9d29-031af306-5e6ffa34-4ae4277d-25f87948.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Restrictive pulmonary function tests. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant change is seen. Cervical stabilization devices in situ. Moderate cardiomegaly and scoliosis, causing slight asymmetry of the rib cage. No pulmonary edema. No pneumonia, no pleural effusions. " 28f8b27a-cebec768-4bd49271-add82073-be7af52c.jpg,validate/p14/p14061397/s58232887/28f8b27a-cebec768-4bd49271-add82073-be7af52c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with ESRD, CAD, CVA, pAfib presents with emesis and diarrhea. // r/o volume overload TECHNIQUE: Single frontal view of the chest COMPARISON: ___ and ___ FINDINGS: Left subclavian dialysis catheter is again seen, similar in position, distal aspect is not well seen but likely terminates cavoatrial junction/proximal right atrium. A vascular stent is again seen within the left brachiocephalic vein, somewhat under prior. Lung volumes remain low and there is likely bibasilar atelectasis. There is persistent blunting of the right costophrenic angle, subtle, and trace right pleural effusion is not excluded. The cardiac and mediastinal silhouettes are grossly stable. Prominence of the right hilum is also stable, particular in comparison to ___ IMPRESSION: No significant change compared to ___ " 78e2333a-c28af3b2-2edbef14-90a70908-b9f517d6.jpg,validate/p11/p11862577/s54363394/78e2333a-c28af3b2-2edbef14-90a70908-b9f517d6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with new seizure // eval for infiltrate 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. " 8386fe2b-70be36ef-7ee0a05f-217f08ab-9835c27b.jpg,validate/p16/p16454913/s52010975/8386fe2b-70be36ef-7ee0a05f-217f08ab-9835c27b.jpg,validation," 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. " e0eded74-abab2ae5-5e726b98-8db767da-e4f09c0d.jpg,validate/p18/p18576755/s51198785/e0eded74-abab2ae5-5e726b98-8db767da-e4f09c0d.jpg,validation," FINAL REPORT INDICATION: ___M with palpitations // eval for cardiomegaly TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Slight tortuosity of the descending thoracic aorta is noted. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 90037081-26043ea6-d0ea14c4-5f8f5d4d-c67fa241.jpg,validate/p10/p10232271/s51683847/90037081-26043ea6-d0ea14c4-5f8f5d4d-c67fa241.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with PNA, pulmonary edema // interval change IMPRESSION: In comparison to ___ chest radiograph, extensive airspace opacities are unchanged on the right and slightly improved on the left. Bilateral pleural effusions have apparently decreased in size, but positional differences limit comparison. No other relevant change. " 9b64176a-5bf5c490-686d3d22-4bf0cca2-45835a82.jpg,validate/p17/p17148408/s52657021/9b64176a-5bf5c490-686d3d22-4bf0cca2-45835a82.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with worsening dyspnea. COMPARISON: None. FINDINGS: PA and lateral views of the chest. Linear left basilar opacity is seen potentially due to atelectasis. The lungs are otherwise clear, there is no effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " b4e53d97-53edfbf9-b6ca2a84-cafcfdaf-58b5f09b.jpg,validate/p16/p16660343/s51138011/b4e53d97-53edfbf9-b6ca2a84-cafcfdaf-58b5f09b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dobbhoff placement. COMPARISON: ___. FINDINGS: Compared to the previous radiograph, the Dobbhoff catheter is malpositioned in the right main bronchus. Immediate repositioning is required (a later radiograph from the same patient, taken at 2:11, documents this repositioning). No evidence of complications such as pneumothorax. " 16db06f3-e6ca7fef-3449d925-28b5c5f2-5ecb7141.jpg,validate/p17/p17967970/s56018583/16db06f3-e6ca7fef-3449d925-28b5c5f2-5ecb7141.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HCT drop POD ___ s/p R thoracotomy // Please assess for interval change Please assess for interval change IMPRESSION: Compared to chest radiographs since ___, most recently ___. A large volume of subcutaneous air has increased substantially in the right breast and chest wall suggesting a pleuroparenchymal cutaneous connection, most likely are around the insertion sites of the 2 right apical thoracostomy tubes . Right apical pneumothorax is small, and there is only a small volume of any of right pleural effusion if any. Atelectasis in the right lower lung is mild. Left lung is clear. Heart size is normal. Extent of rightward mediastinal shift is mild and unchanged. ET tube in standard placement. Right jugular line ends in the low SVC. 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 4:45 PM, 1 minutes after discovery of the findings. " b26dcaf8-77397847-044b3ad0-b7416821-7a08fb53.jpg,validate/p14/p14631354/s59043080/b26dcaf8-77397847-044b3ad0-b7416821-7a08fb53.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Palpable bony mass at the sternal area adjacent to head of the clavicle on the left. PA and lateral upright chest radiographs were reviewed. Within the limitations of the study technique, there is no abnormality to explain patient's symptoms demonstrated. Lungs are clear. There is no pleural effusion or pneumothorax. Heart size and mediastinum are normal in diameter. Bone structures are unremarkable. Further assessment with chest CT is required to exclude the possibility of radiographically occult lesion. " dc48dbae-b0f48334-93c142df-7de134cf-314940c3.jpg,validate/p14/p14558830/s56395048/dc48dbae-b0f48334-93c142df-7de134cf-314940c3.jpg,validation," FINAL REPORT STUDY: PA and lateral chest radiograph. COMPARISON EXAM: PA and lateral chest radiograph, ___. Portable AP chest ___, ___. INDICATION: ___-year-old with Pleurx catheter followup. FINDINGS: There has been interval removal of a left-sided PICC line. Cardiomediastinal and hilar contours are unchanged. The Pleurx catheter is seen extending posteriorly.There is a loculated pleural air inclusion on the right. There is no pneumothorax. Sternotomy wires are aligned. IMPRESSION: 1. Loculated pleural air inclusion on the right. 2. Pleurx catheter in good position. " 3a92731e-3151f160-e9bf1625-ea98ca9e-1b58292e.jpg,validate/p11/p11868766/s53359298/3a92731e-3151f160-e9bf1625-ea98ca9e-1b58292e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with 9cm thoracic aneurysm and type B dissection from left subclavian to right iliac s/p open thoracoabdominal repair // eval PNA vs atelectasis eval PNA vs atelectasis IMPRESSION: In comparison with the study of ___, the right IJ sheath has been removed. The right subclavian PICC line again extends to the lower SVC. Cardiomediastinal silhouette is the stable and there is no definite vascular congestion. Continued retrocardiac opacification is consistent with substantial volume loss in the left lower lobe and probable small effusion. Mild atelectasis and possible small effusion is seen on the right. " 8e23825a-07d6a911-70d9fd4d-a25b8bab-32da6338.jpg,validate/p14/p14852399/s55244424/8e23825a-07d6a911-70d9fd4d-a25b8bab-32da6338.jpg,validation," FINAL REPORT HISTORY: Weakness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. CT torso ___. FINDINGS: The heart size remains mildly enlarged. The mediastinal and hilar contours are unremarkable. Several clips are demonstrated within the right neck compatible prior partial thyroidectomy. Lungs are clear. No pleural effusion, pneumothorax, or pulmonary edema is present. Several clips are demonstrated within the mid upper abdomen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " f7857bc0-c751502d-86a5ad21-3969756b-cd30e396.jpg,validate/p13/p13774492/s54636286/f7857bc0-c751502d-86a5ad21-3969756b-cd30e396.jpg,validation," WET READ: ___ ___ ___ 4:17 PM Persistent right middle lobe atelectasis. Pneumonia is not excluded. A chest CT should be considered for further assessment to exclude an underlying obstructive endobronchial lesion. ______________________________________________________________________________ FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are hyperinflated. Atelectatic changes are again noted within the right middle lobe, similar compared to the prior exam. No pleural effusion or pneumothorax is present. The heart size is normal. Mediastinal and hilar contours are unremarkable. There is no pulmonary edema. No acute osseous abnormalities demonstrated. IMPRESSION: Persistent right middle lobe atelectasis. Pneumonia is not excluded. A chest CT should be considered for further assessment to exclude an underlying obstructive endobronchial lesion. " 9cc0ecd1-7485ba4b-381e4ae3-e1b6ce54-686f3266.jpg,validate/p17/p17653729/s50437827/9cc0ecd1-7485ba4b-381e4ae3-e1b6ce54-686f3266.jpg,validation," WET READ: ___ ___ ___ 7:42 PM Worsening pulmonary edema in the right lung. No pneumothorax or large pleural effusion. No new focal consolidation. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hx of aspiration pna, now with altered mental status and leukocytosis // please evaluate for pna, aspiration COMPARISON: Chest radiographs ___ through ___ at 00:22. IMPRESSION: Progressive heterogeneous opacification of right lung probably pneumonia, although the heart is larger, and small right pleural effusion is presumed. No pneumothorax. Ascending thoracic aorta is heavily calcified. There is sufficient vascular congestion in the lungs and in the mediastinal veins to indicate mild cardiac decompensation, " c913203e-c9a4ac1b-89ab7da7-4e2c2bd3-1bd1b33a.jpg,validate/p14/p14741471/s59492263/c913203e-c9a4ac1b-89ab7da7-4e2c2bd3-1bd1b33a.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of hepatocellular cancer, three weeks with right back pain. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are essentially clear. Calcification is projecting over the dome of the liver, consistent with findings seen on the prior CT abdomen. " 358b3687-53570f02-c87df032-e8a9ccc1-09e64548.jpg,validate/p18/p18682902/s54089266/358b3687-53570f02-c87df032-e8a9ccc1-09e64548.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for days, SOB, fatigue // r/o pna TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is normal. Large hiatal hernia demonstrated. Lungs are clear. There is no pleural effusion or pneumothorax. No overt bone abnormalities demonstrated. " b28d19f6-406e1aa6-1b7ab2b6-adea05c4-494d052e.jpg,validate/p16/p16901713/s53334248/b28d19f6-406e1aa6-1b7ab2b6-adea05c4-494d052e.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with wheezing. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, or pneumothorax is seen. Heart and mediastinal contours are stable. Pulmonary vascular cephalization is seen. IMPRESSION: No radiographic evidence for acute change. " 1a16cc1a-c411c2ce-5b183fdb-d070d522-8273b7b3.jpg,validate/p10/p10594556/s55320026/1a16cc1a-c411c2ce-5b183fdb-d070d522-8273b7b3.jpg,validation," FINAL REPORT INDICATION: Known lung carcinoma, now with cough for seven days and low-grade temperature with increased shortness of breath. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, the most recent radiographs dated ___ and review of PET-CT dated ___. FINDINGS AND IMPRESSION: Loculated pleural effusion is increased with increased pleural thickening at the left apex and along the left mediastinal contour. There remains dense opacification at the left base; however, there is now a retrocardiac air fluid level suggestive of necrosis/cavitation in the lung mass. There is new patchy opacity with air bronchograms extending from the left hilum throughout the left lung which has the appearance of infection. No pneumothorax is present. The right lung is clear. Surgical clips are noted along the right lateral chest wall. " 7e5cc619-31bb36b3-3bb6b010-4c9c0d59-9f7552f8.jpg,validate/p15/p15823696/s54663028/7e5cc619-31bb36b3-3bb6b010-4c9c0d59-9f7552f8.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman s/p earring ingestion with hemoptysis // Please evaluate for esophageal injury. 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. No pneumomediastinum, pleural effusions, or metallic foreign body is identified. IMPRESSION: Normal. No evidence of esophageal injury. " c49567da-96a62b28-49838f2a-56ce4335-887f2cd8.jpg,validate/p17/p17421663/s53139578/c49567da-96a62b28-49838f2a-56ce4335-887f2cd8.jpg,validation," 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. " c63a41a2-e7dbaab0-d0f2f0f4-23faea2c-046028b0.jpg,validate/p14/p14173834/s51551277/c63a41a2-e7dbaab0-d0f2f0f4-23faea2c-046028b0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with large right lung mass now with new afib rvr // evaluate for edema vs. effusion vs. infiltrate evaluate for edema vs. effusion vs. infiltrate COMPARISON: Chest radiographs ___ through ___. IMPRESSION: There is no pulmonary edema, although cardiomegaly is moderate to severe and pulmonary vasculature is mildly engorged, all without change since ___. No pneumothorax or appreciable pleural effusion. Elevation of the right lung base is presumably a function of the huge right juxta mediastinal mass and/or adenopathy impinging on the phrenic nerve or an enlarged liver. Left lung is clear. " b0da1f22-dd7b6d85-aef6a4f7-883d99cf-145c1cc4.jpg,validate/p18/p18568294/s56464851/b0da1f22-dd7b6d85-aef6a4f7-883d99cf-145c1cc4.jpg,validation," FINAL REPORT INDICATION: Cough and fever. 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. " 5e40a49e-e24072c3-9d9fdba6-1316ede6-d9609646.jpg,validate/p14/p14740322/s56891684/5e40a49e-e24072c3-9d9fdba6-1316ede6-d9609646.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new dobhoff placement. Needs for seizure medications. // evaluate placement evaluate placement IMPRESSION: Compared to chest radiographs ___ through ___. Nasogastric feeding tube with the wire stylet in place ends in the upper stomach. Severe opacification of the left lower lobe is new, accompanied by ipsilateral mediastinal shift, probably largely atelectasis. There may be a small accompanying left pleural effusion. Right lung clear. Heart size top-normal unchanged. Left PIC line ends in the right atrium, approximately 2.5 cm below the estimated location of the superior cavoatrial junction. " f22ce138-8a031f98-0f20b62f-4cdee8b6-d62358b4.jpg,validate/p14/p14065514/s54615396/f22ce138-8a031f98-0f20b62f-4cdee8b6-d62358b4.jpg,validation," FINAL REPORT HISTORY: Esophageal cancer, productive cough, shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT and chest radiograph ___. FINDINGS: Left-sided Port-A-Cath tip terminates within the SVC. Cardiac, mediastinal and hilar contours are unchanged with evidence of prior esophagectomy and gastric pull-through. The pulmonary vascularity is not engorged. Persistent small bilateral pleural effusions, right greater than left are again noted, with the amount of fluid loculated laterally on the right decreased compared to the prior study. Previously noted right basilar atelectasis subjacent to the partially loculated pleural effusion appears improved. No new focal areas of consolidation are present. No pneumothorax is present in the osseous structures are unremarkable. IMPRESSION: Persistent small bilateral pleural effusions, with slight interval decrease in the amount of loculated fluid laterally on the right and improvement in aeration of the right lung base. " 4cd8f982-9626bf6c-121ad675-13b40157-929fbadf.jpg,validate/p13/p13598803/s57702265/4cd8f982-9626bf6c-121ad675-13b40157-929fbadf.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: A ___-year-old woman with COPD and multiple aspergillomas as well as recurrent lower respiratory infections. Now has chest pain. IMPRESSION: PA and lateral chest compared to ___ through ___: Compared to the most recent chest radiograph, the contents of both large upper lobe cystic spaces, the extent of right apical pleural thickening, and bronchiectasis and nodulation outside the left apical cavities have all improved over the past three months. The cardiomediastinal contour, though obscured by the severely retracted hila, have not changed, and there is no pleural effusion. In short, there is no radiographic explanation for chest pain and aspergilloma involvement in the upper lobe spaces is less pronounced. " 2d3dd317-c1ee8643-9f3b3c41-85a8b827-7573db5d.jpg,validate/p11/p11573149/s52632580/2d3dd317-c1ee8643-9f3b3c41-85a8b827-7573db5d.jpg,validation," FINAL REPORT HISTORY: Pulmonary edema with aggressive diuresis. FINDINGS: In comparison with the study of ___, there is little change in the pulmonary edema pattern. Cardiomediastinal silhouette is unchanged. The left IJ catheter is presumably within a persistent left superior vena cava. " 94494bc7-9c1ce0c8-6663313d-e9bbeee9-167d67ee.jpg,validate/p17/p17974632/s52974055/94494bc7-9c1ce0c8-6663313d-e9bbeee9-167d67ee.jpg,validation," FINAL REPORT INDICATION: Dyspnea and vomiting. COMPARISON: None available. 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. " 298dbe05-9f829707-76083b37-94cdd3ad-b1cf5ec4.jpg,validate/p17/p17876274/s53044059/298dbe05-9f829707-76083b37-94cdd3ad-b1cf5ec4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lung cancer presents for recent hospitalization follow-up. Pt receives his care in ___, recently underwent a CT guided needle biopsy of the left upper lung with an accidental puncture of the lung itself. Pt developed a 'bubble' in the left upper lung that remained stable during his hospitalization, he is now due for repeat chest x-ray. Awaiting medical records from ___. // eval (as below) COMPARISON: CT chest with contrast ___ FINDINGS: PA and lateral views of the chest provided. Re- demonstrated central left upper lobe pulmonary mass with probable left hilar and mediastinal nodes. There is no focal consolidation or effusion. Equivocal left pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: 1. Re-demonstrated central left upper lobe pulmonary mass with left hilar and mediastinal lymphadenopathy. 2. Equivocal left pneumothorax. Consider follow-up radiograph to assess for resolution. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___ NP on the telephoneon ___ at 4:22 PM, 3 minutes after discovery of the findings. " f4c7a007-f8d366bb-a9e3a870-06e71549-75516552.jpg,validate/p10/p10065383/s55539498/f4c7a007-f8d366bb-a9e3a870-06e71549-75516552.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Patient with pulmonary blastomycosis, on VA-ECMO. Assess lung abnormalities. Comparison is made with prior study performed 11 hours earlier. There has been no interval change in diffuse bilateral lung opacities. Cardiac size is obscured by the lung abnormalities. ECMO catheter tip is in the IVC, unchanged. Other lines and tubes are in unchanged position. There is no pneumothorax. Amount of pleural effusion cannot be assessed. " 40b8e130-f2bb3b30-9b781f4d-b3abb950-badcf33d.jpg,validate/p13/p13515776/s55277434/40b8e130-f2bb3b30-9b781f4d-b3abb950-badcf33d.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: PA and lateral chest x-ray ___. INDICATION: ___-year-old with productive cough for a month. FINDINGS: The cardiomediastinal and hilar contours are normal. There is continued hyperexpansion of the lungs, and the lungs are clear. There is no pulmonary edema, pleural effusion or pneumothorax. IMPRESSION: 1. Lung hyperexpansion with no consolidation. " 7f5dd01f-0702533c-1cd37c95-c9d5fe29-7be59ecb.jpg,validate/p16/p16566006/s54191789/7f5dd01f-0702533c-1cd37c95-c9d5fe29-7be59ecb.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Multiple CVAs with altered mental status. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The patient is status post median sternotomy and CABG. The cardiomediastinal silhouette is stable, as are the hilar contours. There is persistent blunting of the left costophrenic angle. No large pleural effusion is seen. There is no focal consolidation or evidence of pneumothorax. No pulmonary edema is seen. Overall, there has been no significant interval change. IMPRESSION: No significant interval change. " 2a774f26-e346239b-cc53c40a-0633120d-079a23b2.jpg,validate/p17/p17276457/s51383142/2a774f26-e346239b-cc53c40a-0633120d-079a23b2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with back pain w/ inspiration. 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. IMPRESSION: No acute cardiopulmonary process. " da192c4e-1f80eb9b-e973f2b1-877ec9cc-55b7bcf0.jpg,validate/p19/p19974520/s58949848/da192c4e-1f80eb9b-e973f2b1-877ec9cc-55b7bcf0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with bronchiectasis and multifocal pneumonia in mid ___, somewhat improved by CXR on ___ // assess for more extensive clearing of infiltrates and small left parapneumonic effusion assess for more extensive clearing of infiltrates and small left parapneumonic effusion IMPRESSION: In comparison with the study ___, there has been substantial clearing of the bilateral areas of pulmonary opacification. Scattered areas of fibrotic change are seen, especially in the right upper zone laterally. The left hemidiaphragm is now sharply seen and there is no evidence of appreciable if fusion. No acute focal pneumonia or vascular congestion at this time. " 81c421f3-39db8cf9-4188608e-506f6c6d-636cb3ee.jpg,validate/p11/p11276090/s52961561/81c421f3-39db8cf9-4188608e-506f6c6d-636cb3ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cirrhosis, ascites, shortness of breath, decompensation unknown mechanism COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Coarsened interstitial markings may reflect underlying emphysema. No convincing evidence for pneumonia edema effusion or pneumothorax. Heart and mediastinal contours are stable. Bony structures are intact. IMPRESSION: No acute findings. Probable underlying emphysema. " fdd61eb7-99b19034-f447d2f8-8ff94324-b21c3c21.jpg,validate/p16/p16763981/s58309766/fdd61eb7-99b19034-f447d2f8-8ff94324-b21c3c21.jpg,validation," 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 ___. " bebd4798-cb4ad6ea-0d25a26b-97456a15-acdd4c8c.jpg,validate/p11/p11967908/s52133674/bebd4798-cb4ad6ea-0d25a26b-97456a15-acdd4c8c.jpg,validation," 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. " 87c987cb-bf4d5e2a-f57b9ffb-a5d3f1b3-2a752ed8.jpg,validate/p11/p11778596/s52620709/87c987cb-bf4d5e2a-f57b9ffb-a5d3f1b3-2a752ed8.jpg,validation," 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. " 28e15f14-8693da1e-9572d9e4-d906ac50-b3d46e0a.jpg,validate/p12/p12749689/s58900629/28e15f14-8693da1e-9572d9e4-d906ac50-b3d46e0a.jpg,validation," FINAL REPORT INDICATION: ___ year old man with new PICC line placement. // Please evaluate location of PICC line. TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: Interval placement of a right PICC, the tip projecting over the upper SVC. The tip of the endotracheal tube projects over the mid thoracic trachea. A nasogastric tube extends below the level of the diaphragms but beyond the field of view of this radiograph. No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiomediastinal silhouette is within normal limits. IMPRESSION: The tip of the new right PICC line projects over the upper SVC. Advancement by approximately 6.8 cm would place the tip in the region of the cavoatrial junction. " fdd5078c-17e761ad-fefc77c9-652264ce-070e3ff7.jpg,validate/p19/p19629694/s51557669/fdd5078c-17e761ad-fefc77c9-652264ce-070e3ff7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Right-sided pleuritic chest pain, wheezing, assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained. Lung volumes are low which limits evaluation. Jewelry in the left nipple projects over the left lung base. There is subtle increased opacity in the lower lungs which could represent crowding of bronchovasculature, though the possibility of an early pneumonia is impossible to exclude. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Subtle opacities in the lower lungs bilaterally could represent early pneumonia in the correct clinical context. Low lung volumes limit the evaluation. " 75bc396f-d058cba5-36b13861-0f459d57-8a21b484.jpg,validate/p10/p10727938/s50687422/75bc396f-d058cba5-36b13861-0f459d57-8a21b484.jpg,validation," FINAL REPORT INDICATION: History of cough for one month. Smoking history. Status post assault tonight. COMPARISONS: None. FINDINGS: The re is a mild diffuse interstitial abnormality, which is of uncertain etiology and chronicity. The abnormality is more pronounce in the right lung. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Mild diffuse interstitial abnormality, which may be chronic, although an acute atypical infection cannot be excluded. " 4a099283-79e2b09b-893d979f-4d805b98-d4068ea0.jpg,validate/p10/p10676537/s58631297/4a099283-79e2b09b-893d979f-4d805b98-d4068ea0.jpg,validation," WET READ: ___ ___ 8:52 PM Possible mild pulmonary vascular congestion/edema with bilateral small effusions. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with dyspnea on exertion, ___ edema for past 5 days, new symptoms. Please evaluate for volume overload, effusion, infiltrate. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The heart size is top normal. Mediastinal silhouettes are normal. Bilateral pleural effusions are small, if any, with possible mild pulmonary vascular congestion. No evidence of pneumothorax or focal consolidation. Levoscoliosis of the thoracic spine is noted. IMPRESSION: Possible mild pulmonary vascular congestion/edema with bilateral small effusions. " a7fb0fa6-0e4c5704-13e993c5-9593a451-535ab834.jpg,validate/p13/p13593747/s54840009/a7fb0fa6-0e4c5704-13e993c5-9593a451-535ab834.jpg,validation," FINAL REPORT INDICATION: ___-year-old with productive cough, low WBC and shortness of breath, question pneumonia. COMPARISON: Prior radiograph from ___. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unremarkable. There is moderate dextroscoliosis of the thoracic spine. Osseous structures are otherwise unremarkable. There is a nerve stimulator in the left hemithorax, the lead coursing into the neck. IMPRESSION: No acute cardiopulmonary process. " e800936c-b7b98777-bfa178d1-5905cd43-c53a616e.jpg,validate/p19/p19343878/s53183554/e800936c-b7b98777-bfa178d1-5905cd43-c53a616e.jpg,validation," WET READ: ___ ___ ___ 6:07 PM Mild improvement of interstitial pulmonary edema. No other significant interval change. ______________________________________________________________________________ FINAL REPORT CHEST ON ___ HISTORY: Pulmonary edema with fever. FINDINGS: There is some mild improvement with decreased central vascular engorgement and slight decrease in cardiac silhouette. There is a small left pleural effusion and mild pulmonary vascular redistribution. IMPRESSION: Changing appearance of mild CHF. " 612ef14f-ae114a74-84bd094f-18b19dec-60d7ca46.jpg,validate/p14/p14644600/s56727154/612ef14f-ae114a74-84bd094f-18b19dec-60d7ca46.jpg,validation," 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. " 09667196-f82997d9-038368f9-b2abd302-2ddc0bfd.jpg,validate/p18/p18394695/s53704018/09667196-f82997d9-038368f9-b2abd302-2ddc0bfd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LATERAL) INDICATION: History: ___M with fever TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: Assessment is somewhat limited due to patient rotation. Heart size appears mildly enlarged, increased compared to the previous exam. The aorta is diffusely calcified. Bronchiectasis with architectural distortion, scarring, and calcifications involving the right apex and left mid lung field as well as superior retraction of the right hila are again noted along with calcified mediastinal and right hilar lymph nodes, findings compatible with the sequela of prior granulomatous infection. New mild pulmonary edema is present. No pleural effusion or pneumothorax is identified. Multiple punctate radiopaque densities again are seen overlying the left superior chest. No acute osseous abnormality is detected. Calcifications in the right upper quadrant of the abdomen are compatible with gallstones. IMPRESSION: 1. Interval development of mild pulmonary edema. 2. Findings compatible with prior granulomatous infection. " c64526c4-db2a1da0-b4f10fa0-8a865d3f-317753bf.jpg,validate/p11/p11609880/s59194491/c64526c4-db2a1da0-b4f10fa0-8a865d3f-317753bf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dCHF, PAH, sepsis with dyspnea. NG placement // acute process, NG placement COMPARISON: ___ IMPRESSION: As compared to the previous image, the patient has received the new nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the proximal parts of the stomach. The tube should be advanced by approximately 5 cm, to be securely positioned in the middle parts of the stomach. The patient is of the valvular replacement. The sternotomy wires are in correct alignment. Unchanged moderate cardiomegaly with mild pulmonary fluid overload. The circumscribed parenchymal opacity at the level of the right hilus, seen on the previous examination, is no longer present today. However, areas of bilateral parenchymal atelectasis have developed and are more severe on the right than on the left. No larger pleural effusions. " 48bf0fbc-6cb01fd8-dbc65d38-44b02474-a828f1a6.jpg,validate/p11/p11658675/s58271084/48bf0fbc-6cb01fd8-dbc65d38-44b02474-a828f1a6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Hypoxia. History of aspiration. COMPARISONS: ___. TECHNIQUE: Chest, supine AP portable. FINDINGS: Allowing for technique, the cardiac, mediastinal and hilar contours are unremarkable. There are opacities in both lower lungs, more extensive on the left than right, suggesting pneumonia, although aspiration is also a possibility to consider in the appropriate clinical setting. There is no definite pleural effusion or pneumothorax. IMPRESSION: Opacities at the lung bases, greater on the left than right, suggesting pneumonia or potentially aspiration could be considered. " ea1e3898-66cbf88c-6467f252-d24f54af-9ef65f50.jpg,validate/p11/p11975330/s56843011/ea1e3898-66cbf88c-6467f252-d24f54af-9ef65f50.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with diminished right breath sounds. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Radiograph dated ___. FINDINGS: PA and lateral chest radiograph demonstrate low lung volumes. Relative to prior radiograph dated ___, there has been little interval changes. The right hemidiaphragm appears elevated. The heart is enlarged though stable when compared to prior study. Hilar and mediastinal contours are within normal limits. Lungs demonstrate no focal opacity convincing for pneumonia. Several healed right rib fractures are noted. No acute osseous abnormality is detected. There is no pneumothorax or pleural effusion. IMPRESSION: No acute intrathoracic abnormality. " 16696395-f3eb9658-a00ca6cf-a9eb429a-ec30a19d.jpg,validate/p12/p12156452/s51817619/16696395-f3eb9658-a00ca6cf-a9eb429a-ec30a19d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M h/o iatrogenic sigmoid perf s/p prior ___'s, revision ___ n/w SBO x1d s/p exlap, LOA, hernia reduction, open abd now s/p SBR, parastomal hernia repair, closure // assess for abnormalities in the setting of AMS assess for abnormalities in the setting of AMS COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Mild pulmonary edema has changed in distribution but not in overall severity. Combination of left lower lobe atelectasis and small to moderate left pleural effusion has increased. Right pleural effusion small if any. Mild cardiomegaly unchanged. Right PIC line ends in the low SVC. " bb5338a8-fe4ca076-8fb103a4-058ee874-5164477c.jpg,validate/p11/p11017660/s53446434/bb5338a8-fe4ca076-8fb103a4-058ee874-5164477c.jpg,validation," WET READ: ___ ___ ___ 12:15 PM Normal radiograph of the chest. ______________________________________________________________________________ FINAL REPORT HISTORY: Cough x3 weeks, immunosuppressed. Please evaluate for pneumonia. TECHNIQUE: Upright AP and lateral radiographs of the chest. COMPARISON: None. FINDINGS: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours, pleural surfaces are normal. No pleural effusion or pneumothorax present. Deformity of the right posterior 7th rib likely prior healed rib fracture. IMPRESSION: Normal radiograph of the chest. " d7a477c0-054dc480-77a5550a-2a314a44-c0bade78.jpg,validate/p13/p13325402/s53420046/d7a477c0-054dc480-77a5550a-2a314a44-c0bade78.jpg,validation," 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. " f60f14cd-5d8ba86e-e1f44890-c2c472bd-a78cf32d.jpg,validate/p12/p12450697/s57025844/f60f14cd-5d8ba86e-e1f44890-c2c472bd-a78cf32d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with shortness of breath, recent CABG TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The patient is status post median sternotomy and CABG. Heart size remains moderately enlarged. Mediastinal and hilar contours are relatively unchanged. A moderate to large left pleural effusion appears minimally increased in size compared to the prior study. Compressive atelectasis is noted in the left lung base. Trace right pleural effusion is also demonstrated, unchanged. No pulmonary edema or pneumothorax is present. There are moderate multilevel degenerative changes seen in the thoracic spine. IMPRESSION: Slightly increased size of moderate to large left pleural effusion and unchanged trace right pleural effusion. Left basilar compressive atelectasis. " 496ebcb7-9301e90b-7a78eb70-c4524beb-0b253e2a.jpg,validate/p19/p19695893/s59922165/496ebcb7-9301e90b-7a78eb70-c4524beb-0b253e2a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with CP, sob // PNA? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs 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. " 03a76799-9e456afe-03d63f14-475b3e31-871812ee.jpg,validate/p18/p18933552/s59360799/03a76799-9e456afe-03d63f14-475b3e31-871812ee.jpg,validation," FINAL REPORT INDICATION: ___M with SOB // SOB/DOE TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiographs dating back to ___. FINDINGS: Continued opacity obscuring the left heart border and left costophrenic angle is compatible with pleural effusion and associated compressive atelectasis, similar to ___. The cardiac and mediastinal silhouette is unchanged. Faint increased linear opacities in the right upper lobe may reflect atelectasis and early pneumonia cannot be excluded. IMPRESSION: Similar left pleural effusion with associated compressive atelectasis. Faint linear opacities in the right upper lobe is non-specific and may reflect atelectasis though early pneumonia cannot be excluded. " b70ad0ff-7a4c540b-37a4d4d6-de25ad7c-e0336114.jpg,validate/p10/p10486955/s57123200/b70ad0ff-7a4c540b-37a4d4d6-de25ad7c-e0336114.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Atypical left chest pain. IMPRESSION: PA and lateral chest compared to ___, when the patient had large left lower lobe pneumonia. Today, the lungs are fully expanded, cardiomediastinal and hilar silhouettes and pleural surfaces are normal. I do not see any chest cage abnormality, but this study is not designed for detection of subtle rib lesions. If there are focal findings, then detailed views of those areas should be obtained. " 34313160-4a7377f8-ab5198a7-b5acaafb-654fc696.jpg,validate/p11/p11646138/s55611365/34313160-4a7377f8-ab5198a7-b5acaafb-654fc696.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dysphagia in setting of medullary lesion s/p resection // Please confirm dobhoff placement Please confirm dobhoff placement IMPRESSION: Comparison to ___. The patient has been extubated. In the interval, the patient has received a feeding tube. 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. Normal size of the heart. No pneumonia. " d458d42a-01de9096-dbf64bb5-985d5480-0ecda8b2.jpg,validate/p12/p12964757/s56459814/d458d42a-01de9096-dbf64bb5-985d5480-0ecda8b2.jpg,validation," WET READ: ___ ___ 9:29 PM Low lung volumes. Stable cardiomegaly with mild edema. Small left pleural effusion. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypotension, evaluation for pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is an almost unchanged presentation. Mild fluid overload, borderline size of the cardiac silhouette without pleural effusions. Mild retrocardiac atelectasis and absence of parenchymal opacities suggestive of pneumonia. " 6bef6235-baccab3d-bce66450-68ff5b79-3ee1e59a.jpg,validate/p10/p10305617/s53921578/6bef6235-baccab3d-bce66450-68ff5b79-3ee1e59a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with chest pain // chest pain chest pain 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. . " 0697dcbe-79da671a-11c32478-323c8302-417c2a25.jpg,validate/p12/p12668116/s51246745/0697dcbe-79da671a-11c32478-323c8302-417c2a25.jpg,validation," FINAL REPORT HISTORY: ___-year-old man status post right radical nephrectomy, please evaluate for effusion. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest are provided. Again, there is a mild-to-moderate right-sided layering pleural effusion with adjacent streaky opacities consistent with atelectasis. In the left lung at least two nodules, the larger up to 2.1 cm, are better evaluated on the ___ CT. No pneumothorax is identified. Cardiomediastinal silhouettes and hilar contours are stable. IMPRESSION: Stable mild-to-moderate right pleural effusion. " 36efae0b-04fb90b0-40644d67-ec4455e1-a5545780.jpg,validate/p10/p10385319/s56757382/36efae0b-04fb90b0-40644d67-ec4455e1-a5545780.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY. INDICATION: Patient with assault, facial bone fracture, aspiration, intubated. Rule out interval change. COMPARISON: Chest x-ray of ___, CT torso of ___. FINDINGS: Bilateral lower lobe consolidations seen on recent CT were probably related to lung collapse. This has significantly improved on today's chest x-ray. ET tube ends 3.7 cm above the carina. NG tube is in stomach. There is no pneumothorax or pleural effusion. CONCLUSION: Bibasilar consolidation has significantly improved since CT torso. These consolidations on the CT look like lobar collapse. " cc264f34-7a4ff5f7-512ee1a3-71bd9066-86cb21b9.jpg,validate/p14/p14021217/s51279017/cc264f34-7a4ff5f7-512ee1a3-71bd9066-86cb21b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with confusion TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: ___ FINDINGS: Assessment of the chest is somewhat limited by patient rotation. Lung volumes are low. Heart size is mildly enlarged but not substantially changed in the interval. Mediastinal and hilar contours are grossly unchanged. Pulmonary vasculature is not engorged. Minimal streaky right opacity in the right lung base likely reflects an area of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities identified. IMPRESSION: Limited study due to patient rotation. Minimal atelectasis in the right lung base. " b42f4e6d-a1a926da-06639abd-b374c583-c1c5d024.jpg,validate/p16/p16615356/s51141100/b42f4e6d-a1a926da-06639abd-b374c583-c1c5d024.jpg,validation," WET READ: ___ ___ ___ 5:56 AM Right AC joint separation. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: ___-year-old with alcohol abuse and trauma. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. FINDINGS: There is separation of the right AC joint by 11 mm, unchanged since ___, but new since ___. No acute fracture. Cardiomediastinal silhouette and hila are normal. No pleural effusion and no pneumothorax. " 2d85b8e7-39304adf-53f650ba-bd2d4d6d-4f6626ea.jpg,validate/p16/p16749930/s55081917/2d85b8e7-39304adf-53f650ba-bd2d4d6d-4f6626ea.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with sudden onset right lateral chest pain, evaluate for pneumonia versus pneumothorax. COMPARISON: None. FINDINGS: PA and lateral views of the chest were provided. Lung volumes are slightly low and there is atelectasis at the lung bases. There is no focal consolidation, pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable. Osseous structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. Atelectasis at the lung bases. " b3acaca3-bae495f4-906623a9-307cd174-30286194.jpg,validate/p10/p10088966/s54520029/b3acaca3-bae495f4-906623a9-307cd174-30286194.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with fall with head injury on coumadin // concern for intracranial bleed and neck trauma TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy, CABG, and mitral valve replacement. The left-sided Port-A-Cath tip terminates in the low SVC, unchanged. Mild cardiac enlargement is re- demonstrated along with mild pulmonary vascular congestion. The mediastinal and hilar contours are unchanged. No pulmonary edema is present. Mild atelectasis is again noted within the lung bases, without focal consolidation. No pleural effusion or pneumothorax is present. Compression deformity involving a vertebral body at the thoracolumbar junction is unchanged. IMPRESSION: Mild bibasilar atelectasis. Mild cardiomegaly with mild pulmonary vascular congestion. " 6881b743-16a9d078-7912b005-b5e674c1-69ad39cf.jpg,validate/p19/p19687841/s53124142/6881b743-16a9d078-7912b005-b5e674c1-69ad39cf.jpg,validation," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with hemoptysis this morning. Question obvious mass. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Lung volumes are low, linear retrocardiac opacity seen only on the frontal, most likely due to atelectasis. Lungs are otherwise clear. Costophrenic angles are sharp. Cardiomediastinal silhouette is within normal limits as are osseous and soft tissue structures. IMPRESSION: No acute cardiopulmonary process. " 943e0fbc-283b347a-fa1a947f-c3c38c68-4404458a.jpg,validate/p13/p13113283/s54850074/943e0fbc-283b347a-fa1a947f-c3c38c68-4404458a.jpg,validation," FINAL REPORT AP CHEST, 8:57 A.M., ___ HISTORY: A ___-year-old man with abdominal trauma after laparotomy, now desaturated. IMPRESSION: AP chest compared to ___: Moderate right and small left pleural effusion, and severe left lower lobe consolidation are new and there is also new pulmonary vascular and mediastinal venous engorgement. All the findings could be due to volume overload with secondary cardiac decompensation and left lower lobe atelectasis, but there is no way to exclude pneumonia concurrently, particularly in the left lower lobe. Dr. ___ ___ I discussed the findings by telephone one minute after I recognized them. " d0945a27-b21dd043-33dbc378-b0877ed4-a21a789f.jpg,validate/p12/p12189597/s51872126/d0945a27-b21dd043-33dbc378-b0877ed4-a21a789f.jpg,validation," FINAL REPORT INDICATION: History: ___M with 5 minute episode of CP this AM, eval for mediastinal widening TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded clear without focal consolidation. The upper abdomen is unremarkable. Height loss of several mid and lower thoracic vertebral bodies is similar to ___. IMPRESSION: No acute cardiopulmonary process. " bf776ed7-dfff33f5-9dd03fa5-36c5dd4c-735995e3.jpg,validate/p15/p15202542/s57602418/bf776ed7-dfff33f5-9dd03fa5-36c5dd4c-735995e3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with septic shock secondary to meningitis, pneumonia, bacteremia, now all resolving on antibiotic therapy, on the floor getting blood transfusion. Worsening respiratory distress. Please eval for TACO. // volume overload? volume overload? COMPARISON: Comparison to ___ at 15:36 and 09:07. FINDINGS: Portable AP upright chest film ___ at 17:53 is submitted. IMPRESSION: Left subclavian PICC line has its tip in the distal SVC near the cavoatrial junction. Left internal jugular central line has its tip in the proximal SVC. Overall cardiac and mediastinal contours are stable. There are layering bilateral effusions with bibasilar opacities likely reflecting compressive lower lobe atelectasis. Overall, when compared to prior breast to studies from earlier in the day, the pulmonary edema has substantially improved. No pneumothorax. " 53312eaa-f31b5570-83f6c3b5-f7b3ee92-b63f19bc.jpg,validate/p18/p18785003/s52602366/53312eaa-f31b5570-83f6c3b5-f7b3ee92-b63f19bc.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient status post ex lap for perforated bowel. Study requested for assessment of ET tube position, effusion, consolidations, and NG tube position. COMPARISON: Prior chest radiographs from ___. TECHNIQUE: Portable upright AP chest radiograph. FINDINGS: An ET tube terminates proximal to the carina. An enteric tube probably terminates in the stomach, however, the tip is not included in this examination. As compared to prior chest radiographs from ___, there has been resolution of free intra-abdominal air. Lung volumes remain low. There is bibasilar atelectasis, worse on the right. No new focal consolidations are identified. IMPRESSION: 1. Resolution of free intrabdominal air. 2. ET tube terminates proximal to the carina, withdrawal of at least 4 cm is recommended. These findings were discussed with ___, NP by Dr. ___ via telephone on ___ at 11:27 a.m., at the time of discovery. " 4d4ce934-2c35b4e7-82a2ae7e-3401af8f-77c6ade7.jpg,validate/p14/p14536823/s52720987/4d4ce934-2c35b4e7-82a2ae7e-3401af8f-77c6ade7.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with left-sided flank pain over the past ___ days // Please evaluate for basilar pneumonia 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. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:45 PM, 5 minutes after discovery of the findings. " 2b466fda-28cd67fd-ac3b6718-8055c7ad-76d50c57.jpg,validate/p13/p13940027/s53316203/2b466fda-28cd67fd-ac3b6718-8055c7ad-76d50c57.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with CODP and 1 day of Chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lungs are hyperinflated consistent with severe emphysema. No focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette is unchanged in within normal limits. Bony structures appear grossly intact. IMPRESSION: Emphysema without superimposed acute process. " 1fcd0aef-8762fc72-c3f2f5cb-fcd38662-b382dfbd.jpg,validate/p15/p15805011/s56760355/1fcd0aef-8762fc72-c3f2f5cb-fcd38662-b382dfbd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with a prior chest radiograph from ___ as well as a chest CT from ___. CLINICAL HISTORY: Wheezing, chest pain. 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 appear normal. Bony structures are intact. IMPRESSION: No acute intrathoracic process. " b054fa08-a6a157b2-5bea5478-a94a9925-9363f824.jpg,validate/p13/p13762124/s57544487/b054fa08-a6a157b2-5bea5478-a94a9925-9363f824.jpg,validation," FINAL REPORT AP CHEST, 7:56 A.M., ___ HISTORY: ___-year-old female with chronic immunosuppression, with shortness of breath. IMPRESSION: AP chest compared to ___: Very extensive infiltrative pulmonary abnormality has not changed since ___. In the right lung, it is confluent centrally but at the periphery and throughout the left lung very heterogeneous, with suggestion of cystic lucencies and nodules which point to disseminated infection rather than simple pulmonary edema. This process has been present since a CT of the chest performed ___ at ___. Interestingly, the patient had a similar though less severe pulmonary abnormality documented on the chest CT performed ___, which subsequently improved. Either she had widespread infection at that time, in which case the current pathogen should be the same, e.g., fungus, or she has a recurrent inflammatory condition such as cryptogenic organizing pneumonia or therapy responsve nonspecific interstitial pneumonitis. Correlation of current conditions and imaging with previous clinical findings and concurrent imaging should be extremely helpful. " 6ffc752d-0616be4a-1b5f4a17-b6e00f1f-2c613d7a.jpg,validate/p16/p16545530/s55355830/6ffc752d-0616be4a-1b5f4a17-b6e00f1f-2c613d7a.jpg,validation," FINAL REPORT AP CHEST, 4:37 A.M. ON ___ HISTORY: ___-year-old woman with acute ingestion. Assess volume status. IMPRESSION: AP chest compared to ___: Lung volumes have improved and pulmonary vasculature has decreased, but the heart is still at least mildly enlarged. Opacification at the left lung base is probably atelectasis. I see no good evidence for pneumonia. Previously severe gaseous and fluid distention of the stomach has improved. " caff4fc3-aee417da-f2d7f79e-c407fe0c-30d5a58b.jpg,validate/p13/p13718764/s59169026/caff4fc3-aee417da-f2d7f79e-c407fe0c-30d5a58b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with fever, cough // ? pneumonia COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Cardiomegaly is again seen. Mild hilar congestion is noted without frank edema. No definite signs of pneumonia, effusion or pneumothorax. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Cardiomegaly unchanged. Mild hilar congestion. No evidence of pneumonia. " ab53b26b-05fd2a36-cb4631b8-50dd04de-f68c8e8f.jpg,validate/p12/p12763939/s50578135/ab53b26b-05fd2a36-cb4631b8-50dd04de-f68c8e8f.jpg,validation," FINAL REPORT AP CHEST, 4:58 AM, ___ HISTORY: ___-year-old man with a new tracheostomy and chest tubes to waterseal. IMPRESSION: AP chest compared to ___ through ___ at 5:25 a.m. The patient is rotated to the right. Tracheostomy appears to be in standard position. There is no pneumothorax or appreciable mediastinal widening. Two upper elementary tubes pass to the level of the diaphragm. One is presumably the feeding tube, is looped in the hypopharynx, as noted on the report of yesterday's chest radiograph. There is no appreciable pleural effusion. Heart size is normal. Right subclavian catheter ends in the upper right atrium, unchanged. Perihilar opacification in both lungs could be atelectasis or pneumonia, worsened on the right and improved on the left since ___. Dr. ___ and I discussed the findings by telephone. " 4be158e3-c19c14a1-39220711-a18d5000-d825bbc1.jpg,validate/p15/p15534375/s54271922/4be158e3-c19c14a1-39220711-a18d5000-d825bbc1.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with hypertension, presyncope, question pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. Cardiomediastinal silhouette and hilar contours are unremarkable. No effusion or pneumothorax. Aorta is tortuous. IMPRESSION: No evidence of acute cardiopulmonary process. " 5dbc134c-a3d7163a-50946606-72992116-9659f7c9.jpg,validate/p19/p19761472/s55976557/5dbc134c-a3d7163a-50946606-72992116-9659f7c9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with chest pain // eval for chest pain eval for chest pain COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Postoperative cardiomediastinal silhouette, including moderate cardiomegaly, is stable since ___. There is no pleural effusion or pneumothorax. Pulmonary vasculature is unremarkable and there is no edema. " b7a172b8-14eded21-3284771d-9b42a991-73a42478.jpg,validate/p11/p11846868/s59812516/b7a172b8-14eded21-3284771d-9b42a991-73a42478.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with multiple seizures. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest dated ___. Chest radiograph dated ___. FINDINGS: Lungs are well-expanded and clear. No focal consolidation, edema, effusion, or pneumothorax. The heart is normal in size. No mediastinal widening. No acute osseous abnormality. Degenerative changes in the lower thoracic spine are moderate. IMPRESSION: No pneumonia. " 75b21785-a2a24b94-7647cafb-da8d9866-9e13f18e.jpg,validate/p13/p13071917/s50148430/75b21785-a2a24b94-7647cafb-da8d9866-9e13f18e.jpg,validation," FINAL REPORT INDICATION: History: ___F with cp // r/o infiltrate COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: There is hyperinflation. There is a large hiatal hernia. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. " f2eac925-3b4d88cb-2b704a39-f774c52b-2232625a.jpg,validate/p19/p19391932/s56888274/f2eac925-3b4d88cb-2b704a39-f774c52b-2232625a.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. FINDINGS: 2 views were obtained of the chest. Right malpositioned PICC has been removed. Bilateral small pleural effusions and accompanying atelectasis are improved from the previous examination. The remainder of the lungs are clear. The heart and mediastinal contours are stable. There is no pneumothorax. IMPRESSION: Decreased, small bilateral pleural effusions. " 8700bbc8-695f1be0-e8a4ee34-57753b5f-a4bae2d4.jpg,validate/p19/p19101665/s58516137/8700bbc8-695f1be0-e8a4ee34-57753b5f-a4bae2d4.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: PIC line placement. FINDINGS: The right-sided PIC line tip is in the subclavian vein. It has been pulled back slightly compared to the prior study from ___. Lung volumes are low. There is pulmonary vascular congestion and heart size is moderately enlarged. Compared to the prior study, the pulmonary status appears slightly worse. " e56a1af0-170679d0-9bbec0a4-f9cf5fda-515b117c.jpg,validate/p13/p13585638/s58979901/e56a1af0-170679d0-9bbec0a4-f9cf5fda-515b117c.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ___ ___ COMPARISON: ___ radiographs. FINDINGS: Lung volumes are low, crowding and accentuating the bronchovascular structures. New patchy and linear bibasilar opacities likely represent atelectasis in the setting of low lung volumes. Lungs are otherwise clear, and there are no pleural effusions or pneumothoraces. Heart size, mediastinal and hilar contours are unremarkable. " 2a8ff4c8-e4a6d26f-c538b6c9-f96597e0-dd1f5d57.jpg,validate/p10/p10531660/s56520830/2a8ff4c8-e4a6d26f-c538b6c9-f96597e0-dd1f5d57.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Chest pain. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. Slight scarring in the right mid and left lower lungs is stable. Mild degenerative changes are similar along the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. " 0582a2ce-20a868a8-26451178-c53fd535-903631e3.jpg,validate/p11/p11551769/s54383084/0582a2ce-20a868a8-26451178-c53fd535-903631e3.jpg,validation," 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 ___. " feda68a3-8c812c93-5222d482-4e2f5fcb-862a68e7.jpg,validate/p17/p17269824/s51373029/feda68a3-8c812c93-5222d482-4e2f5fcb-862a68e7.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with hemoptysis and SOB // nodule, PNA TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs ___, ___, ___ CT chest with contrast from ___ FINDINGS: Prior right-sided lobectomy is responsible for pleural scarring at the base of the right hemithorax and elevation of right hemidiaphragm. Left lung and pleural space are normal. Normal cardiomediastinal and hilar silhouettes. No evidence of intrathoracic infection, recurrent or new malignancy. IMPRESSION: No evidence of intrathoracic infection, recurrent or new malignancy. " 6e86932e-ce857cf0-1c06ec93-6451a938-84b250e4.jpg,validate/p19/p19975796/s55902775/6e86932e-ce857cf0-1c06ec93-6451a938-84b250e4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with chest pain and palpitations // eval for pneumonia, CHF TECHNIQUE: Single frontal view of the chest COMPARISON: ___ and chest CT from ___ FINDINGS: Similar to scout image from ___, there is large area of opacity in the right upper hemi thorax in right perihilar region concerning for postobstructive pneumonia secondary to known large juxta hilar mass. The left lung remains hyperinflated. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Large area of right upper hemi thorax and right juxta hilar opacity, grossly similar in distribution as compared to the prior CT, although with possibly slightly more fluid in the right lung apex, overall worrisome for postobstructive pneumonia secondary to right juxta hilar mass. Reported right chest wall metastasis on prior CT better assessed on CT. " cb5c989b-7edb53a6-20b433a5-c325c160-4a28dd1b.jpg,validate/p12/p12043836/s57095442/cb5c989b-7edb53a6-20b433a5-c325c160-4a28dd1b.jpg,validation," WET READ: ___ ___ ___ 10:28 PM Interval removal of a right pigtail catheter. Mild interval increase in size of a small to moderate right apical pneumothorax. New moderate to large right pleural effusion. Dr. ___ discussed with Dr. ___ ___ the telephone on ___ at 17:45, 5 minutes after findings were made. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with right sided pleural effusion drain via chest tube that was removed today. // any complications of chest tube removal? TECHNIQUE: AP chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: Status post right thorax pigtail catheter removal, there is mild interval increase in size of a small to moderate right apical pneumothorax. Also new is a right moderate to large pleural effusion. The trachea and mediastinum are midline. Median sternotomy wires are in good alignment and intact. A small left pleural effusion is present. IMPRESSION: 1. Post right chest tube removal, there is mild interval increase in size of small to moderate right apical pneumothorax. 2. Increased right moderate to large pleural effusion. " 5a782154-aeae6e6a-d7724847-f51bbd00-0441bfc9.jpg,validate/p12/p12363889/s54535429/5a782154-aeae6e6a-d7724847-f51bbd00-0441bfc9.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman status post D&C, porta laparoscopic cholecystectomy with new oxygen requirement. Evaluate for interval change. COMPARISON: ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Previously seen bibasilar atelectasis has resolved. There are trace bilateral pleural effusions. No pneumothorax. Cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. Resolution of bibasilar atelectasis. 2. Trace bilateral pleural effusions. " 7b3c4054-e704c37f-4403e66c-f81c5592-7f813596.jpg,validate/p15/p15910448/s53307827/7b3c4054-e704c37f-4403e66c-f81c5592-7f813596.jpg,validation," FINAL REPORT INDICATION: ___ year old man from ___with positive IGRA // active TB TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lung volumes are stable. The cardiomediastinal and hilar contours are normal. The pleural surfaces are normal. No focal consolidations or cavitary lesions. IMPRESSION: No acute cardiopulmonary process. " 98a6d63e-a7f6dd30-34fc0751-5cf95da6-a77806a8.jpg,validate/p14/p14828338/s53877380/98a6d63e-a7f6dd30-34fc0751-5cf95da6-a77806a8.jpg,validation," 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. " 63276db1-461c6edc-267c9f27-ec376926-bc96c012.jpg,validate/p11/p11776988/s55200537/63276db1-461c6edc-267c9f27-ec376926-bc96c012.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Sudden onset of 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 disease. " 5af5ff1e-9f15b6c4-b94cd72c-d602753f-a149477c.jpg,validate/p10/p10952156/s52989986/5af5ff1e-9f15b6c4-b94cd72c-d602753f-a149477c.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Chest pain. PA and lateral upright chest radiographs were reviewed in comparison to ___ and chest CT from ___. Heart size is enlarged. The aorta is tortuous but unchanged in appearance. Global enlargement of the left ventricle is redemonstrated. Lobulation of left hemidiaphragm is seen. Lungs are essentially clear with no pleural effusion or pneumothorax. Overall, no abnormality to explain patient's symptoms have been demonstrated. " 29a0eae2-48ab5ccd-ad234bd9-eb4817e6-5f126cf1.jpg,validate/p15/p15869811/s59250380/29a0eae2-48ab5ccd-ad234bd9-eb4817e6-5f126cf1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with chest wall pain S/P trauma COMPARISON: Prior study from ___ and ___ FINDINGS: AP upright and lateral views of the chest provided. The lungs appear clear without focal consolidation, large effusion or pneumothorax. The hila appear somewhat prominent though likely due to technique. The heart size and mediastinal contour stable. Bony structures appear intact. IMPRESSION: No acute findings allowing for technique. " d8a6467d-394121f9-e0a93449-d6494537-d43c08ae.jpg,validate/p14/p14624317/s54149668/d8a6467d-394121f9-e0a93449-d6494537-d43c08ae.jpg,validation," 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. " 2cbcf083-35341ae2-47c31331-7f5e112c-e645af77.jpg,validate/p11/p11179313/s51262556/2cbcf083-35341ae2-47c31331-7f5e112c-e645af77.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with cough and fever // r/o PNA COMPARISON: Prior study from ___. FINDINGS: PA and lateral views of the chest provided. There is now 0 8 left chest wall pacer device with leads extending into the region of the right atrium and right ventricle. Overall, the heart size appears normal. There is a subtle retrocardiac opacity which is concerning for pneumonia. No large effusion or pneumothorax. Mediastinal contour appears unchanged. Bony structures are intact. IMPRESSION: Left lower lobe consolidation concerning for pneumonia. " 26fec1c4-66ff4748-defaf018-b5889b26-ecb0e263.jpg,validate/p15/p15353701/s57127670/26fec1c4-66ff4748-defaf018-b5889b26-ecb0e263.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe MR ___/p mitraClip ___ // worsening pulmonary edema? worsening pulmonary edema? IMPRESSION: Compared to prior chest radiographs, ___ through ___. . Previous moderate pulmonary edema has improved substantially, and right upper lobe consolidation is less pronounced as well. It is unclear whether this is concurrent pneumonia, or more likely given its parallel fluctuation with edema elsewhere, or asymmetric edema, often seen with mitral regurgitation. Left lower lobe atelectasis has increased, following extubation. Moderate right and small left pleural effusions are unchanged. Heart size top-normal. Right jugular line ends close to the superior cavoatrial junction. Left PIC line ends in the upper SVC. No pneumothorax. " 6340cd6e-afefc08f-ac308d3a-52d05175-0a7bb04d.jpg,validate/p13/p13215261/s56615118/6340cd6e-afefc08f-ac308d3a-52d05175-0a7bb04d.jpg,validation," FINAL REPORT AP CHEST, 2:46 A.M., ___ HISTORY: Intubated. Epistaxis. IMPRESSION: AP chest compared to ___: ET tube is in standard placement, nasogastric tube ends in the upper stomach, transvenous right atrial and left ventricular pacer leads and right ventricular pacer defibrillator lead are in standard placements. Severe cardiomegaly is slightly worse today than yesterday and there has been an increase in the severity of moderate pulmonary edema and the volume of moderate right pleural effusion. No pneumothorax. " 02949e55-67096fc8-f048b09c-04082a20-55e0af57.jpg,validate/p19/p19020115/s50912346/02949e55-67096fc8-f048b09c-04082a20-55e0af57.jpg,validation," FINAL REPORT INDICATION: ___ year old man with cirrhosis, UGIB, now with NGT placement // Eval NGT placement TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Endotracheal tube in-situ with the tip at the level of the medial clavicles. 2 enteric tubes in situ in the stomach, 1 coursing out of sight inferiorly. Mild pulmonary edema, which is slightly increased compared to prior. Subsegmental atelectasis in the lower lung zones. IMPRESSION: 2 enteric tubes in situ in the stomach, 1 coursing out of sight inferiorly. " d6bf5e79-23987785-077f35b2-0ef83eac-4d4305c0.jpg,validate/p11/p11084812/s55038356/d6bf5e79-23987785-077f35b2-0ef83eac-4d4305c0.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with shortness of breath and productive cough and fever. FINDINGS: AP and lateral views of the chest are compared to previous exam from ___. Exam is again limited secondary to patient body habitus. There is no definite confluent consolidation. Increased interstitial markings are likely in part technical in nature. There is no effusion. Cardiomediastinal silhouette is unremarkable as are the osseous and soft tissue structures. IMPRESSION: No definite acute cardiopulmonary process based on this limited examination. " afeef60e-2e32b767-cd8deba5-af9e6964-1dfe33f7.jpg,validate/p14/p14659758/s53223268/afeef60e-2e32b767-cd8deba5-af9e6964-1dfe33f7.jpg,validation," FINAL REPORT CLINICAL INDICATION: Assault with complaint of head, face, neck and left-sided chest pain. Evaluate for fractures. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: Linear opacity at the left lung base likely represents atelectasis, otherwise, normal heart, lungs, pleural and mediastinal surfaces. No rib fracture is identified. If there are focal areas of pain, dedicated views of those areas are recommended. IMPRESSION: Opacity in the left lung base is new since ___ and most likely represents atelectasis, however, aspiration could have a similar appearance. " d06a5c8b-5b9e0d3f-4e670c58-2e1fba67-fc699dbb.jpg,validate/p12/p12156923/s50267246/d06a5c8b-5b9e0d3f-4e670c58-2e1fba67-fc699dbb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year y/o F w/ left chest tube self-dislodgement and removal // interval change interval change IMPRESSION: In comparison with the study of ___, there are improved lung volumes. With the removal of the left pigtail catheter, there is little change in the tiny left apical pneumothorax. Little overall change in the appearance the heart and lungs. " 488103fd-5f9204f0-903482a5-485f1bb9-c32b0c0b.jpg,validate/p13/p13515776/s55277434/488103fd-5f9204f0-903482a5-485f1bb9-c32b0c0b.jpg,validation," FINAL REPORT STUDY: PA and lateral chest x-ray. COMPARISON EXAM: PA and lateral chest x-ray ___. INDICATION: ___-year-old with productive cough for a month. FINDINGS: The cardiomediastinal and hilar contours are normal. There is continued hyperexpansion of the lungs, and the lungs are clear. There is no pulmonary edema, pleural effusion or pneumothorax. IMPRESSION: 1. Lung hyperexpansion with no consolidation. " fbcb54fa-04468392-bd4df386-8edab3fe-9a63caee.jpg,validate/p12/p12579975/s59372385/fbcb54fa-04468392-bd4df386-8edab3fe-9a63caee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with smoker with productive cough 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. Right shoulder prosthesis is partially imaged. IMPRESSION: No acute cardiopulmonary abnormality. " eb8355a7-12f4aaa3-2f055c16-13421735-d64288af.jpg,validate/p16/p16040005/s55142303/eb8355a7-12f4aaa3-2f055c16-13421735-d64288af.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Shortness of breath. History of COPD and pneumothorax. COMPARISONS: ___. 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. The chest is hyperinflated. IMPRESSION: No evidence of acute cardiopulmonary disease. " 85996245-44f16752-8767ff74-cfbd9208-e26ad645.jpg,validate/p15/p15432819/s55383575/85996245-44f16752-8767ff74-cfbd9208-e26ad645.jpg,validation," FINAL REPORT HISTORY: Patient with aortic stenosis and cough, rule out infiltrate or CHF. COMPARISON: CT chest from ___ and radiograph. FINDINGS: Frontal and lateral chest radiographs were obtained. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart is severely enlarged but stable. Mediastinal and hilar contours are stable. Diffuse dense calcifications are again visualized in the aortic valve. Moderate-to-severe degenerative changes in the thoracic spine. IMPRESSION: 1. No focal consolidation to suggest pneumonia. 2. Stable severe cardiomegaly with aortic valve calcification, no pulmonary edema. " 3adbe978-b2f65a78-496e461a-9cf063fc-1954c2dc.jpg,validate/p19/p19822093/s53923112/3adbe978-b2f65a78-496e461a-9cf063fc-1954c2dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PICC placement, going fgr day surg // PICC placement Surg: ___ (Foot debridement) COMPARISON: ___. IMPRESSION: Right PICC line. The line shows a normal course, the tip projects over the mid SVC. No evidence of complications, notably no pneumothorax. Otherwise unchanged normal radiograph. " 5abbfd91-57ab30f3-231c4823-f55fbfa9-5d5300a8.jpg,validate/p15/p15809646/s57014765/5abbfd91-57ab30f3-231c4823-f55fbfa9-5d5300a8.jpg,validation," FINAL REPORT PA AND LATERAL CHEST RADIOGRAPH OF ___ COMPARISON: ___ as well as older chest radiographs dating to ___. FINDINGS: Heart is upper limits of normal in size, stable compared to prior studies. Aorta is tortuous. Pulmonary vascularity is normal. Bilateral pleural thickening and plaques are present, in keeping with history of previous asbestos exposure. Additionally, a linearly oriented opacity is present in the lingula, previously attributed to an area of round atelectasis on prior CT chest of ___. Multifocal areas of linear scarring and/or atelectasis are also present predominantly in the mid and lower lungs. No superimposed areas of consolidation are identified to suggest an acute pneumonia. IMPRESSION: Asbestos-related pleural disease with adjacent foci of parenchymal scarring and/or atelectasis. No evidence of acute pneumonia, but a subtle pneumonia may be difficult to detect in the setting of chronic pleural and parenchymal disease. " d95bd9f4-853ea66c-ce53fe92-ab29d389-528727b6.jpg,validate/p15/p15676084/s55452683/d95bd9f4-853ea66c-ce53fe92-ab29d389-528727b6.jpg,validation," WET READ: ___ ___ 12:11 AM Small right apical pneumothorax. No signs of midline shift or tension. Atelectasis at the right base. Unchanged appearance of left pleural effusion and atelectasis. Telephone notification to Dr. ___ by Dr. ___ at 00:05 on ___ at time of review of study. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with recent minimally invasive esophagectomy and new tachycardia. COMPARISON: ___ obtained at 08:29 a.m. Since the prior study, there is interval development of small right apical pneumothorax (that has demonstrated to be decreased in size on the followup examination). There is no evidence of interstitial pulmonary edema. Bibasal areas of atelectasis are stable. Small amount of pleural effusion is seen bilaterally. The neoesophageal contour is within the expected limits. " 5f3aad5a-7979a21a-7e7b8035-dc810879-c1f1fa46.jpg,validate/p11/p11230772/s52933132/5f3aad5a-7979a21a-7e7b8035-dc810879-c1f1fa46.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with epigastric chest pain // ?cause of chest pain TECHNIQUE: Chest PA and lateral COMPARISON: CTA chest 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. " 0882dc3b-a7a6d18c-718e097a-c9ae5fce-4e7a3814.jpg,validate/p10/p10667727/s55228222/0882dc3b-a7a6d18c-718e097a-c9ae5fce-4e7a3814.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with RV failure and MRSA bacteremia. Intubated for respiratory distress. // Please eval interval change Please eval interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Small bilateral effusions processed and there is no evidence of pneumothorax. Marked enlargement of the cardiac silhouette is again seen without much elevation in pulmonary venous pressure. This raises the possibility of underlying cardiomyopathy or even pericardial effusion. " 5854f8e8-b247f991-e75c6be8-3fe2db5f-c13d8ff7.jpg,validate/p16/p16969166/s55515452/5854f8e8-b247f991-e75c6be8-3fe2db5f-c13d8ff7.jpg,validation," FINAL REPORT INDICATION: Abdominal pain, nausea and vomiting. Evaluate for free air. COMPARISON: Chest radiograph, ___. FINDINGS: The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. There is no free air below the hemidiaphragms. IMPRESSION: 1. No acute cardiopulmonary process. 2. No evidence of free air below the hemidiaphragms. " e49c50b1-8cbb5e3d-fe98d526-c01822eb-4f6f0884.jpg,validate/p17/p17737168/s51172781/e49c50b1-8cbb5e3d-fe98d526-c01822eb-4f6f0884.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with bilateral flank and RUQ/LUQ pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ and chest radiograph ___. . FINDINGS: Heart is top-normal in size. There is no focal lung consolidation. There is no pleural effusion or pneumothorax. There is no acute osseous abnormality. Surgical clips are noted in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " ae25ab53-728bd61d-0b368ab8-cb45d8ea-8d6cf993.jpg,validate/p15/p15793456/s58627159/ae25ab53-728bd61d-0b368ab8-cb45d8ea-8d6cf993.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with COPD s/p trach // Please assess for interval change Please assess for interval change IMPRESSION: In comparison with the study of ___, there appears to be a tracheostomy tube in place. Otherwise, little change. Prominence of central pulmonary arteries is consistent with pulmonary arterial hypertension. Severe emphysema with lucency especially involving the left lower lung. As previously noted, this could be consistent with prominent bullous formation in the region or possibly alpha 1 antitrypsin deficiency. " 1d2fb80b-a0b13bf2-67958d66-f5cf25d3-11e7d5b5.jpg,validate/p13/p13567471/s55621635/1d2fb80b-a0b13bf2-67958d66-f5cf25d3-11e7d5b5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with MRSA bacteremia and now with fever. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size and mediastinum are stable in appearance. Post-sternotomy wires are unremarkable. Lungs are hyperinflated, but essentially clear with no evidence of pneumonia. " 8851be56-64ff92ba-9410eec0-e5b5be8f-66ca8610.jpg,validate/p11/p11306899/s51634957/8851be56-64ff92ba-9410eec0-e5b5be8f-66ca8610.jpg,validation," FINAL REPORT INDICATION: Malignant effusion and aspiration status post thoracentesis, evaluate pleural effusions. COMPARISONS: Chest radiograph from ___. FINDINGS: Chain sutures are present in the right mid lung. There has been no significant change in the extent of the pre-existing pleural effusions. There is no new pneumonia, pulmonary edema or pneumothorax. Mediastinal silhouette including the median sternotomy wires and valve replacement are stable. IMPRESSION: No significant change in moderate bilateral pleural effusions. " 2f3270b0-b47a2a64-42fd6b7c-a97c5e7b-519cdb4f.jpg,validate/p18/p18576755/s52943598/2f3270b0-b47a2a64-42fd6b7c-a97c5e7b-519cdb4f.jpg,validation," FINAL REPORT INDICATION: ___ year old man never smoker with well controlled HIV with 2mo of cough, clear lungs // r/o infiltrate, lesion TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ and ___ FINDINGS: The lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. IMPRESSION: No acute cardiopulmonary process. " f91f8902-c57ceb6c-e216f9cc-1dcf033c-0a940d8b.jpg,validate/p12/p12940106/s56094010/f91f8902-c57ceb6c-e216f9cc-1dcf033c-0a940d8b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p OGT readjustment // please confirm correct placement of OGT TECHNIQUE: Frontal chest radiograph COMPARISON: ___ FINDINGS: The NG tube is seen coiling in the hiatal hernia. On the radiograph dated ___, there is suggestion of tube coiling in the pharynx. Left subclavian line and ET tube are unchanged in position. The lungs, pleural surfaces and cardiomediastinal silhouette are unchanged. IMPRESSION: The NG tube is seen coiling in the hiatal hernia. On the radiograph dated ___, there is suggestion of tube coiling in the pharynx. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:09 PM, a few minutes after discovery of the findings. " 54fb4cf5-5bd44e1e-c2a68e48-b39720b0-a2b19bde.jpg,validate/p13/p13279382/s56812405/54fb4cf5-5bd44e1e-c2a68e48-b39720b0-a2b19bde.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough/ aspiration COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation. Pulmonary vasculature is normal. Heart size is normal. Old right-sided rib and clavicular fractures are again seen. Sternotomy wires are in unchanged positions. IMPRESSION: No acute pneumonia. " b02eea3c-3cac2920-71868eb7-0629d0f8-e800bb95.jpg,validate/p15/p15014371/s54418531/b02eea3c-3cac2920-71868eb7-0629d0f8-e800bb95.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p extubation, with right middle lobe opacity noted yesterday. // Interval changes TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph dated ___. FINDINGS: The right upper lung opacity has decreased in size and density. There is increased pulmonary venous congestion. No pleural effusion. Bilateral lower lobe atelectasis has increased slightly. No new consolidation. The cardiomediastinal silhouette is unchanged. No pneumothorax. IMPRESSION: Improved right upper lobe opacity. RECOMMENDATION(S): Please continue to follow the right upper lobe opacity until resolution. " 88c6f365-f5f5f229-e2147412-a1a8c21b-bae4e295.jpg,validate/p11/p11123733/s56456208/88c6f365-f5f5f229-e2147412-a1a8c21b-bae4e295.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post CABG, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the Swan-Ganz catheter has been removed. The pre-existing bilateral pleural effusions have decreased in extent but remain clearly visible on both the frontal and the lateral radiograph. The effusions are of moderate severity. The size of the cardiac silhouette remains enlarged, but there is no evidence of overt pulmonary edema. No pneumothorax, pneumonia. Atelectasis at both lung bases persist. " 602cb783-c4a9d5f6-7458757a-bffb30b8-b76065b6.jpg,validate/p15/p15199994/s59965744/602cb783-c4a9d5f6-7458757a-bffb30b8-b76065b6.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with seizures and suspected aspiration event. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. Lungs are slightly hyperinflated with unchanged bilateral predominantly basal opacities. No pleural effusion or pneumothorax is seen. No definite evidence of aspiration event is present. " dd419b30-f0c1ca58-f74e0bfd-2283bceb-c0589890.jpg,validate/p15/p15860820/s59681164/dd419b30-f0c1ca58-f74e0bfd-2283bceb-c0589890.jpg,validation," WET READ: ___ ___ ___ 8:28 PM No consolidation, pleural effusion, or pneumothorax. R PICC in low SVC. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new fever to 101.2 // ?pneumonia COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Right-sided PICC line. Normal size of the cardiac silhouette. No pleural effusions, no pneumonia, no pulmonary edema. " c89502cd-0ebfb7b3-1205a33b-c23170f6-a171021b.jpg,validate/p18/p18036909/s59619795/c89502cd-0ebfb7b3-1205a33b-c23170f6-a171021b.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with shortness of breath. STUDY: Upright PA and lateral chest radiographs. COMPARISON: None. FINDINGS: The heart size is at the upper limits of normal, likely exaggerated by the low lung volumes. The mediastinal and hilar contours are normal. The lung volumes are low but clear of consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: Low lung volumes, but no acute cardiopulmonary process. " 675b40c0-2fe3f643-8a14fac8-ca1b0070-5fb44929.jpg,validate/p15/p15792067/s54078825/675b40c0-2fe3f643-8a14fac8-ca1b0070-5fb44929.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough and fever. Please perform a lateral view to evaluate for pneumonia. COMPARISON: Frontal chest radiograph performed approximately one hour prior to this exam. TECHNIQUE: A leftward rotated AP view and a lateral view of the chest were obtained. FINDINGS: The frontal view is extremely rotated to the left, with complete projection of the mediastinum over the left lung, which limits assessment. The expanded right lung is unremarkable. Assessment in the lateral view is also limited due to superimposition of the arms, but allowing for technical limitations, there is no spine sign, pleural effusion, or abnormality in the anterior mediastinum. No pneumothorax is identified. Artifacts from external hair devices are again seen. IMPRESSION: Limited examination. No evidence of acute cardiopulmonary process. " c93cbb3d-eed8b4c8-7d9bc38b-baf5c098-abcb9712.jpg,validate/p15/p15805011/s53237329/c93cbb3d-eed8b4c8-7d9bc38b-baf5c098-abcb9712.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. Question acute process. COMPARISON: ___ and ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear without pneumothorax or pleural effusion, although the extreme right costophrenic angle is excluded. Again noted is asymmetric left lateral pleural thickening in the left base, similar as compared to ___, but new since ___. IMPRESSION: 1. No acute cardiopulmonary process. 2. Redemonstration of asymmetric left basal lateral pleural thickening. Further assessment by cross-sectional imaging should be considered to exclude underlying neoplasm. " 0fe8e400-4e488c0d-281eec9e-face731b-137ff5ec.jpg,validate/p18/p18120578/s55519484/0fe8e400-4e488c0d-281eec9e-face731b-137ff5ec.jpg,validation," FINAL REPORT INDICATION: ___-year-old with fever. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: There is no pleural effusion. Atelectatic changes are seen at the right lung base. Cardiomediastinal silhouette and hila are normal. No pneumothorax. " 432f5b8d-dbf9d5f6-b2ae5422-ee46f656-00caa39c.jpg,validate/p16/p16662264/s50111035/432f5b8d-dbf9d5f6-b2ae5422-ee46f656-00caa39c.jpg,validation," FINAL REPORT HISTORY: Respiratory failure. COMPARISON: ___ to ___. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: Heart size remains enlarged. Hilar contours are unchanged. Endotracheal tube, upper enteric tube and left PICC remain in unchanged position. Widespread multifocal parenchymal opacities remain unchanged from immediate prior study. Subtle lobulated lucencies in the right mid lung are suggestive of pneumatoceles. Left-sided pleural effusion is improved. There is no pneumothorax. IMPRESSION: Multifocal lung infection persists, with possible pneumatoceles, but with some improvement of left pleural effusion. If clinical improvement is uncertain, CT may be helpful to document changes. " 62969c3a-e3c22e1f-1e3ca640-6a048fac-c5b86dbe.jpg,validate/p18/p18615099/s59417593/62969c3a-e3c22e1f-1e3ca640-6a048fac-c5b86dbe.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary edema, intubation, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is an increase in extent of the pre-existing bilateral pleural effusions. The signs of moderate pulmonary edema are unchanged. Increasing extent of the pre-existing basilar areas of atelectasis. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices. " 1371e2f9-2165a0b7-40f5f49c-703a297c-16bf49ca.jpg,validate/p18/p18001786/s51462360/1371e2f9-2165a0b7-40f5f49c-703a297c-16bf49ca.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with left chest pain and SOB // Eval for infiltrates vs small pneumo TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No new focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. Hilar contours are stable. IMPRESSION: No significant interval change. " 8bd08c70-fbb6e2dc-4a5730ee-8a7a80b5-c496867e.jpg,validate/p10/p10569231/s55488757/8bd08c70-fbb6e2dc-4a5730ee-8a7a80b5-c496867e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with seizure // eval for pna COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Large body habitus and underpenetrated technique limits assessment. Allowing for technical limitations, the lungs are clear. Heart is mildly enlarged. Mediastinal contour is normal. No large effusion or pneumothorax. Bony structures are intact. IMPRESSION: Mild cardiomegaly. No overt signs of edema or pneumonia. " 3531f7f5-a10bcf5a-f21c569f-4653c94f-ecc97802.jpg,validate/p13/p13687044/s57651715/3531f7f5-a10bcf5a-f21c569f-4653c94f-ecc97802.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with shock, intubated and sedated, check endotracheal tube placement. CHEST, SEMI-ERECT: The patient is significantly rotated. The tip of the endotracheal tube lies 4.5 cm from the carinal angle and remains in satisfactory position. The position of the tip of the Swan-Ganz catheter is also unchanged as is that of the right IJ line. Opacification of the left base is again noted, probably unchanged. A pigtail catheter is present at the right base, unchanged in position since the previous chest. No pneumothorax is identified on this side. IMPRESSION: No change since prior chest x-ray. " 1fcbd44b-fe0f46da-00f8e524-c1189681-6681727e.jpg,validate/p18/p18345333/s57333417/1fcbd44b-fe0f46da-00f8e524-c1189681-6681727e.jpg,validation," WET READ: ___ ___ ___ 8:42 AM Low lung volumes accentuate the heart size and crowds the pulmonary vascular structures. Bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleurtic chest pain // r/o pneumonia, widened mediastinum (aortic dissection) COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased. There are bilateral areas of atelectasis. At the lung bases. No larger pleural effusions are seen on the frontal and the lateral radiograph. Moderate cardiomegaly without pulmonary edema. Mild elongation of the descending aorta. No pneumonia, no mediastinal widening " fecb2900-8d03a45f-8e915564-c0bdd2d5-c48313b2.jpg,validate/p19/p19680450/s50781761/fecb2900-8d03a45f-8e915564-c0bdd2d5-c48313b2.jpg,validation," 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. " c98a4bfa-4bd71f1d-7d23f70e-04130d0d-eb9041e2.jpg,validate/p14/p14074252/s57045165/c98a4bfa-4bd71f1d-7d23f70e-04130d0d-eb9041e2.jpg,validation," FINAL REPORT HISTORY: Chest pain COMPARISON: None FINDINGS: PA and lateral chest radiographs. The lungs are hyperinflated. There is no focal consolidation, effusion, or pneumothorax. Cardiomegaly is mild. There are minimal aortic arch calcifications. IMPRESSION: Emphysema. No pneumonia or CHF. Borderline cardiomegaly. Possible small airway obstruction. " 0af91c96-10c7e0fd-39f5bada-554cd942-dd6fdc5e.jpg,validate/p11/p11910993/s57196074/0af91c96-10c7e0fd-39f5bada-554cd942-dd6fdc5e.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with worsening CHF and shortness of breath. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: Four frontal images of the chest were obtained. Two of the images demonstrate low lung volumes likely due to poor inspiration. The other two images demonstrate well-expanded lungs. There appears to be improvement of the right base opacification since previous imaging. The left-sided opacification appears similar to previous exams. There is no pneumothorax. There is no pleural effusion on the right. The cardiomediastinal silhouette is consistent with the previously identified massively unfolded aorta and aneurysmal aortic arch and proximal descending thoracic aorta. Aortic calcifications are seen. The aortic valve has been replaced with a porcine valve. Left basilar opacities prohibit full assessment of the cardiac size. IMPRESSION: Right basilar opacity improved since prior imaging. Persistent left basilar opacity. Otherwise, essentially unchanged chest radiograph from prior imaging. " 208f8b8c-3466daf0-00a8e44d-09b9b189-1682527c.jpg,validate/p13/p13990571/s58943432/208f8b8c-3466daf0-00a8e44d-09b9b189-1682527c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough and right crackles // evaluate evaluate TECHNIQUE: PA and lateral views COMPARISON: Radiographs dating back to ___. FINDINGS: There is no pleural effusion or pneumothorax. There is an apical to basilar gradient of subpleural interstitial opacities. The cardiomediastinal silhouette is similar to prior examination done ___. Midline left lateral surgical materials are seen which likely represent hiatal hernia repair as noted in the patient's chart history and seen in CT chest dated ___. IMPRESSION: Apical to basilar gradient of subpleural interstitial opacities suggesting either NSIP or UIP, follow up with CT ___ year can be considered. " 7da72b72-ca150c1c-6666ff94-ac4d7fe2-34b3d95d.jpg,validate/p15/p15823696/s51240251/7da72b72-ca150c1c-6666ff94-ac4d7fe2-34b3d95d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hematemesis // ? esophageal perforation, rupture ? esophageal perforation, rupture IMPRESSION: Compared to prior chest radiographs, most recently ___. Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. . No pleural effusion or mediastinal widening or pneumomediastinum. " f8d01583-82cf9c38-cef1f3e3-e399283e-b12554c9.jpg,validate/p11/p11068569/s53519006/f8d01583-82cf9c38-cef1f3e3-e399283e-b12554c9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with positive blood culture, malaise, low grade temps TECHNIQUE: Chest PA and lateral COMPARISON: ___ chest radiograph FINDINGS: Cardiac silhouette size remains mild to moderately enlarged. The mediastinal contour is unchanged. Mild pulmonary vascular congestion is re- demonstrated. Lung volumes are low without focal consolidation. Patchy right basilar opacity may reflect atelectasis, but infection cannot be completely excluded. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. IMPRESSION: Mild pulmonary vascular congestion. Patchy right basilar opacity may reflect atelectasis, however infection is not excluded in the correct clinical setting. " 5efc5ad5-c9831301-2101314f-d26c6e41-4d53aec7.jpg,validate/p15/p15640564/s52259359/5efc5ad5-c9831301-2101314f-d26c6e41-4d53aec7.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Chest, AP semi-upright portable. TECHNIQUE: Chest, portable AP portable. FINDINGS: Lung volumes are low. The cardiac contours are not well delineated. There is opacification of the right lower hemithorax suggesting a combination of atelectasis, possibly pneumonic consolidation and potentially pleural effusion although not well delineated. Nonspecific patchy left infrahilar opacity is also noted. Allowing for AP portable technique, there is no definite cardiac failure. There is no evidence for pleural effusion on the left. There is no pneumothorax. IMPRESSION: Basilar opacities, right greater than left, worrisome for pneumonia in the appropriate clinical setting. Particularly on the right a pleural effusion is possible and cannot be excluded. " 54555d46-75be7aad-1847782e-55cff018-2a00c2c9.jpg,validate/p14/p14860633/s52800467/54555d46-75be7aad-1847782e-55cff018-2a00c2c9.jpg,validation," FINAL REPORT HISTORY: Cough, shortness of breath. 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 silhouette is top-normal. The mediastinal and hilar contours are stable. There may be minimal left base atelectasis. IMPRESSION: Possible mild left base atelectasis without definite focal consolidation seen. " dc9ad7f8-03b30a28-e38fc525-aee82045-897845cd.jpg,validate/p11/p11552741/s50125446/dc9ad7f8-03b30a28-e38fc525-aee82045-897845cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic lung cancer, intubated, pleural effusion s/p ___ // eval for RIJ placement, also s/p left chest tube placement eval for RIJ placement, also s/p left chest tube placement COMPARISON: Prior chest radiographs ___, most recently 03:58. IMPRESSION: I do not see a radio-opaque pleural drainage tube. There is no pneumothorax. Large right and moderate left pleural effusion are still present and bibasilar atelectasis is still severe. Heart is shifted to the left. With the chin partially flexed, the ET tube, tip 3.5 cm from the carina, is in standard placement. Right jugular line ends in the low SVC. " 4795bfda-10a91884-e7f05244-945d9331-290938d3.jpg,validate/p19/p19314531/s56768274/4795bfda-10a91884-e7f05244-945d9331-290938d3.jpg,validation," 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. " 58310432-268ac953-7d4d8c1c-63c92567-4a524eda.jpg,validate/p18/p18126920/s56930681/58310432-268ac953-7d4d8c1c-63c92567-4a524eda.jpg,validation," FINAL REPORT EXAMINATION: Chest two views. INDICATION: Cough. TECHNIQUE: Chest PA and lateral COMPARISON: Lung views from CT scan on ___. FINDINGS: The pleural thickening seen on the CT scan is better visualized on that cross sectional study. A smaller ple loss in the lower lungs left greater than right ural thickening seen in the left CP angle. The lungs are otherwise clear without infiltrate or effusion. There is some minimal volume IMPRESSION: No infiltrate " 4f0dffa2-15a3df86-2339733e-fe788b18-c3a948dc.jpg,validate/p15/p15938425/s51450769/4f0dffa2-15a3df86-2339733e-fe788b18-c3a948dc.jpg,validation," FINAL REPORT HISTORY: Left calf pain and chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest CTA and chest radiograph. FINDINGS: Heart size is mildly enlarged, unchanged. Mediastinal and hilar contours are within normal limits. The patient is status post median sternotomy with multiple mediastinal clips noted anteriorly. Pulmonary vascularity is normal. The lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. Clips are re- demonstrated within the right upper quadrant of the abdomen compatible with prior cholecystectomy. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary abnormality. " 5c60c42a-cda5fcc6-7d17ef9f-f51ea29c-f4ead48b.jpg,validate/p13/p13217869/s59331202/5c60c42a-cda5fcc6-7d17ef9f-f51ea29c-f4ead48b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F pedestrian struck by car onto hood, left sided rib pain // eval for acute 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 rib fracture is identified. IMPRESSION: No acute cardiopulmonary process. No displaced rib fracture seen. If clinical concern for fracture is high, dedicated rib series or CT is more sensitive. " 49ca7d9b-bc04d399-5b46f7ca-e6cf182a-b2b69889.jpg,validate/p10/p10278344/s50549655/49ca7d9b-bc04d399-5b46f7ca-e6cf182a-b2b69889.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with s/p fall, shortness of breath, chills // eval for trauma COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. There is no focal consolidation, effusion or pneumothorax. Pulmonary vascular congestion and edema are mild. Moderate cardiomegaly. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Pulmonary edema is mild. " 8f8743c9-60c0e9fe-a4ee5e16-35e7f88d-e04adeb9.jpg,validate/p17/p17934404/s52471624/8f8743c9-60c0e9fe-a4ee5e16-35e7f88d-e04adeb9.jpg,validation," FINAL REPORT INDICATION: SVT. No comparison studies available. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The cardiac silhouette is enlarged. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. IMPRESSION: Enlarged cardiac silhouette without overt pulmonary edema. " 4d4530ec-247edb16-22096546-4b506b52-ffca9102.jpg,validate/p19/p19302735/s52669373/4d4530ec-247edb16-22096546-4b506b52-ffca9102.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old status post CABG with pericardial rub, assess for interval change, widening of the mediastinum. Comparison to prior study of ___ at ___. PA and lateral views of the chest ___ at ___ are submitted. IMPRESSION: 1. Status post median sternotomy with a stable post-operative appearance to the cardiac and mediastinal contours status post CABG. There continue to be small bilateral effusions, left greater than right with streaky bibasilar opacities most likely representing a patchy atelectasis. No evidence of pulmonary edema or pneumothorax. " af514769-0af6fa57-e4d92ddb-658755cc-c7ecc4b5.jpg,validate/p14/p14979348/s50769354/af514769-0af6fa57-e4d92ddb-658755cc-c7ecc4b5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with altered mental status, drooling, cough TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ at 16:30 FINDINGS: The patient is status post median sternotomy and CABG. Moderate to severe enlargement of the cardiac silhouette is unchanged, with a slightly globular configuration. The aorta is tortuous and diffusely calcified. Mild pulmonary vascular congestion is unchanged. No focal consolidation, pleural effusion or pneumothorax is seen. Patchy opacities in the lung bases are not substantially changed in the interval, potentially atelectasis, but infection or aspiration cannot be excluded. There are no acute osseous abnormalities. IMPRESSION: 1. No substantial interval change from the prior exam obtained earlier in the day. Mild pulmonary vascular congestion with patchy opacities in lung bases, potentially atelectasis, but infection or aspiration cannot be excluded. 2. Moderate to severe enlargement of the cardiac silhouette with a somewhat globular configuration raises the possibility for the presence of a pericardial effusion and consider echocardiography for further assessment. " 784e63c2-ee0604ff-60b23e70-c1cb4947-d13d178d.jpg,validate/p14/p14412978/s56270038/784e63c2-ee0604ff-60b23e70-c1cb4947-d13d178d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p MVR // please do CXR at 2pm today, eval for ptx with CT on waterseal. IMPRESSION: Since ___, endotracheal tube and Swan-Ganz catheter and nasogastric tube have been removed. Midline drain and right chest tube remain in place. Right pneumothorax is no longer visualized. Questionable tiny left apical pneumothorax. Cardiomediastinal contours are stable. Bibasilar atelectasis has slightly worsened on the right and improved on the left. Small pleural effusions are again demonstrated. " 1fc2b29b-2cf19f4b-2dc73d36-6c4ccbc2-aebb2bf1.jpg,validate/p12/p12734486/s51609214/1fc2b29b-2cf19f4b-2dc73d36-6c4ccbc2-aebb2bf1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NGT // ?positioning TECHNIQUE: Portable AP chest radiograph. COMPARISON: Chest radiograph ___ FINDINGS: The patient's head obscures most of the right lung and the left upper lung is not visualized. A nasogastric tube terminates in the stomach. Assessment of the additional support lines and tubing is extremely limited. Visualized portions of the lungs are grossly clear. An IVC filter is noted. IMPRESSION: The nasogastric tube terminates in the stomach. " 55bb52bf-d1234e8e-ce6ac34e-075ebba2-87a2bfe3.jpg,validate/p12/p12184220/s52064879/55bb52bf-d1234e8e-ce6ac34e-075ebba2-87a2bfe3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with possible Sjogren's syndrome and abnormal submandibular gland ultrasound consistent with Sjogren's or sarcoid // r/o changes of interstitial lung disease, nodules, or other changes suggestive of Sjogren's or sarcoidosis. Compare with prior studies r/o changes of interstitial lung disease, nodules, or other changes suggestive of Sjogren's or sarcoidosis. Compare with prior studies IMPRESSION: Comparison to ___ and ___. No relevant change. No evidence of lung nodules or masses. Unchanged appearance of the anterior mediastinum on the lateral view. No pneumonia, no lung nodules. No pulmonary edema. No pleural effusions. " 5969ecaa-d8f3805b-f6445a12-0097d80a-f21c045e.jpg,validate/p14/p14698539/s51817963/5969ecaa-d8f3805b-f6445a12-0097d80a-f21c045e.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with interval ETT exchange // ___ year old woman with interval ETT exchange COMPARISON: The comparison is made with prior studies including ___ there at 07:40. IMPRESSION: This study is somewhat limited due to patient rotation to the right. An endotracheal tube is present the tip is 3 cm above the carina. The nasogastric tube is present the tip is in the stomach. Central line tip is unchanged. There is no pneumothorax. There is some increase in the patchy density previously noted in the right mid and lower lung zones. There is no CHF. " 0f0d8d54-b7c9f23a-539fa08b-f9be49b7-b0c42de3.jpg,validate/p18/p18176683/s58582206/0f0d8d54-b7c9f23a-539fa08b-f9be49b7-b0c42de3.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Portable frontal chest radiograph. COMPARISON: Chest radiograph ___ and ___. FINDINGS: There are moderate bilateral pleural effusions, enlarged since priors. There is no evidence for pulmonary edema. The cardiac silhouette is normal and unchanged. The mediastinal contours are unremarkable. Clips are noted within the upper abdomen. IMPRESSION: Enlarged now moderate bilateral pleural effusions. " 48c1e612-1c9dfa97-1bf7af7b-e23075b8-cdb2e972.jpg,validate/p13/p13840464/s52408063/48c1e612-1c9dfa97-1bf7af7b-e23075b8-cdb2e972.jpg,validation," FINAL REPORT HISTORY: Chest pain, shortness of breath, crackles on exam. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: There low lung volumes. Subtel retrocardiac opacity is likely atelectasis. There is no pulmonary edema or pleural effusion. There is no pneumothorax. Massive cardiomegaly is again seen, similar to prior exam. IMPRESSION: No acute cardiopulmonary process. Stable enlargement of the cardiac silhouette. " 9292c4f8-f1485cdd-e380621c-a82eba5b-176488ad.jpg,validate/p19/p19404491/s50212291/9292c4f8-f1485cdd-e380621c-a82eba5b-176488ad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with asthma, hx adenopathy. Please compare w/ prior films. // Any new lesions? COUGH;SOB;ANY NEW LESIONS? TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs from ___ to ___. FINDINGS: Moderate hyperexpansion of the lungs has increased compared with prior studies, suggestive of small airways disease. There is no suspicious mass, focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. IMPRESSION: 1. No suspicious nodules or masses. 2. Moderate hyperexpansion has increased. " 3121b72d-aba888bb-cff66c82-4fcf662a-6f502651.jpg,validate/p12/p12016129/s54415065/3121b72d-aba888bb-cff66c82-4fcf662a-6f502651.jpg,validation," 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. " 46874243-2c97704c-f58e5585-737d10d2-b5e53e0b.jpg,validate/p15/p15571899/s54526831/46874243-2c97704c-f58e5585-737d10d2-b5e53e0b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest radiograph dated ___. CLINICAL HISTORY: Fever and confusion. 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 is seen. IMPRESSION: No acute intrathoracic process. " 63fdfcfa-c1e4a5ce-e724ed21-58b8b885-b59c4175.jpg,validate/p13/p13733398/s51951019/63fdfcfa-c1e4a5ce-e724ed21-58b8b885-b59c4175.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old male with HIV, one week of cough, aches and weakness. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs remain clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 4af78491-269ad708-3f6880a7-aa478e31-94e060d8.jpg,validate/p17/p17003536/s53818182/4af78491-269ad708-3f6880a7-aa478e31-94e060d8.jpg,validation," FINAL REPORT INDICATION: Recent craniotomy, presenting with pleuritic chest pain. COMPARISON: Chest radiographs from ___. FINDINGS: PA and lateral radiographs were acquired. As before, there is hyperinflation of the lungs with flattening of the hemidiaphragms and widening of the retrosternal airspace, consistent with COPD. Aside from minimal bibasilar linear atelectasis, the lungs are clear. The cardiac and mediastinal contours are normal. There are no definite pleural effusions. No pneumothorax. Minimal biapical pleural thickening is unchanged. IMPRESSION: Minimal bibasilar atelectasis, COPD. " 91a6ba5e-915dc6b7-bac6a875-2f5214f2-691a8417.jpg,validate/p16/p16829042/s59404565/91a6ba5e-915dc6b7-bac6a875-2f5214f2-691a8417.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Fatigue and dizziness. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The lung volumes are low. The heart is at the upper limits of normal size. The mediastinal and hilar contours are unremarkable. The lungs appear clear. There are no pleural effusions or pneumothorax. Small anterior osteophytes are present along the lower thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. " f8945fe7-c9ea0829-ed54d1d7-7c58f261-38416020.jpg,validate/p18/p18160222/s59135977/f8945fe7-c9ea0829-ed54d1d7-7c58f261-38416020.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is stable noting mild cardiomegaly. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " 5211f48c-79500ac6-6ece05ae-67eecf9a-27895242.jpg,validate/p17/p17845849/s57990242/5211f48c-79500ac6-6ece05ae-67eecf9a-27895242.jpg,validation," WET READ: ___ ___ ___ 4:00 PM No acute intrathoracic process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest tightness // acute cardiopulmonary abnormality TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: None provided. FINDINGS: Lung volumes are normal. 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. " 532b9dec-ab7940a0-d63eaec7-86dd6a1e-f84bc48c.jpg,validate/p19/p19376171/s54854294/532b9dec-ab7940a0-d63eaec7-86dd6a1e-f84bc48c.jpg,validation," 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. " f3d59025-24107fe7-dc596959-357f0ac4-8b870a91.jpg,validate/p19/p19673689/s52552110/f3d59025-24107fe7-dc596959-357f0ac4-8b870a91.jpg,validation," FINAL REPORT HISTORY: Patient with rheumatoid arthritis and cough, evaluate for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The lungs are fully expanded and clear. The heart is moderately enlarged but stable. Mediastinal and hilar contours are unchanged. There is no pleural effusion or pneumothorax. IMPRESSION: No focal consolidation to suggest pneumonia. " 5873b69b-6eb4a8e7-2813251e-431c5969-2aab2c66.jpg,validate/p17/p17464246/s57160253/5873b69b-6eb4a8e7-2813251e-431c5969-2aab2c66.jpg,validation," FINAL REPORT HISTORY: Patient with history of melanoma, eval disease status. COMPARISON: ___. FINDINGS: Lungs are fully expanded and clear. Cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No radiographic evidence for intrathoracic metastases. " 9e2ef671-465862eb-a92a9498-30f37edc-5066c795.jpg,validate/p13/p13310560/s54335383/9e2ef671-465862eb-a92a9498-30f37edc-5066c795.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with new CS lead, subclavian access // lead placement lead placement IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lungs are mildly hyperinflated, and clear. Previous mild pulmonary edema has resolved moderate cardiomegaly is chronic. Left trans subclavian right atrial pacer and right ventricular pacer leads follow their expected courses from the left pectoral generator. The distal segment of the left ventricular lead is circuitous. Clinical assessment is recommended. " adad6ebd-0986c29e-c8a1b1b9-22f405d2-01aad32e.jpg,validate/p13/p13299285/s53781679/adad6ebd-0986c29e-c8a1b1b9-22f405d2-01aad32e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ETT, pleural pigtail // cardiopulmonary process cardiopulmonary process COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Small residual right pleural effusion unchanged, pigtail pleural drainage catheter in place. No pneumothorax. Mild to moderate cardiomegaly stable. Thoracic aorta is generally large. Lungs grossly clear. No pneumothorax. ET tube in standard placement. Nasogastric drainage and feeding tube is coiled in the stomach and passes out of view. Left jugular line ends in the upper SVC, right supraclavicular central venous infusion port ends in the upper right atrium. " e2269474-2b929fd5-738eb27a-a4720140-015831fd.jpg,validate/p17/p17348907/s53287405/e2269474-2b929fd5-738eb27a-a4720140-015831fd.jpg,validation," WET READ: ___ ___ ___ 5:37 PM Unchanged cardiomegaly. No evidence of pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with STEMI now with increasing leukocytosis // evidence of new infiltrate evidence of new infiltrate IMPRESSION: Comparison to ___. No relevant change. Vertebral fixation devices. Normal lung volumes. Mild cardiomegaly without pulmonary edema. No pleural effusions. No pneumonia. " 389d6e54-7af5309c-0da2c916-f872f5ff-0c0a2f49.jpg,validate/p17/p17079941/s53991573/389d6e54-7af5309c-0da2c916-f872f5ff-0c0a2f49.jpg,validation," FINAL REPORT INDICATION: Cirrhosis, respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in unchanged position. The extensive bilateral parenchymal opacities are minimally less severe than on the previous image. The retrocardiac lung portions are minimally better ventilated. Otherwise, the radiograph is unchanged. " 02ec7e01-769b663f-c3bfa6a4-7838c2f2-cdb0d73b.jpg,validate/p16/p16518377/s58122273/02ec7e01-769b663f-c3bfa6a4-7838c2f2-cdb0d73b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain // ?Pneumonia ?Pneumonia IMPRESSION: Compared to chest radiographs since ___, most recently ___. Mild cardiomegaly is chronic. There is no pulmonary edema or vascular congestion. Thoracic aorta is tortuous but not dilated. There is no pleural effusion. Large cervicothoracic mass moderately narrowing and deviating the trachea to the left is long-standing, presumably a goiter. " 8784a107-e08d5b94-b8f265c6-243d0087-0e18b36f.jpg,validate/p17/p17043794/s51533008/8784a107-e08d5b94-b8f265c6-243d0087-0e18b36f.jpg,validation," WET READ: ___ ___ ___ 10:05 AM Hyperinflated lungs, compatible with emphysema or small airways obstruction. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with ankle fracture // pre-op CXR TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Hyperinflated lungs noted. The lungs are otherwise clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pulmonary edema, pleural effusion, or pneumothorax. No focal consolidations are seen. IMPRESSION: Clear lungs. " a552ad33-2143894f-bc6447b7-7787ef1e-8638473d.jpg,validate/p19/p19955348/s56165419/a552ad33-2143894f-bc6447b7-7787ef1e-8638473d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with recent chest tube placement now removed. Evaluate for residual apical ptx, reaccumulation of fluid // ? ptx, pleural effusion ? ptx, pleural effusion IMPRESSION: In comparison with the study of ___, there is little change. Again there is a tiny right apical pneumothorax. No definite reaccumulation of pleural fluid. " 399a82f9-4e678baf-a8f15f85-28bf9800-c23d917a.jpg,validate/p14/p14863177/s53809561/399a82f9-4e678baf-a8f15f85-28bf9800-c23d917a.jpg,validation," FINAL REPORT INDICATION: ___ year old man with severe asthma, heart failure with preserved ejection fraction that had gastric sleeve operation on ___ with ? pericardial and ? pleural effusions noted on CXR. Feeling better. // evaluate if has persistent pleural effusions post-operatively or other abnormalities like CHF EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___, CT chest ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. There is no pulmonary edema. Cardiac silhouette is mildly enlarged and larger compared to ___. Left pulmonary artery also appears larger. Right pulmonary artery size is stable. IMPRESSION: Left pulmonary artery is larger compared to prior CT from ___, which may be due to acute left-sided pulmonary embolism. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:52 PM, 10 minutes after discovery of the findings. " f9610dc3-1caecc35-6a7e1b45-8aea6af1-b01e0331.jpg,validate/p16/p16207152/s59058578/f9610dc3-1caecc35-6a7e1b45-8aea6af1-b01e0331.jpg,validation," FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___ year old woman with nausea and hyponatremia // ?any acute process TECHNIQUE: Portable chest x-ray COMPARISON: None available FINDINGS: There is a 7 x 8mm nodule in the left upper lobe with irregular borders. No prior chest imaging is available for comparison. There is bibasilar atelectasis. An opacity at the right cardiophrenic angle represents prominent pericardial fat, better demonstrated on CT abdomen performed the same date. No pneumothorax or large pleural effusions. Mediastinum, hila and heart are within normal limits. Mild dextroscoliosis. No acute osseous abnormalities. IMPRESSION: There is a LUL parenchymal nodule with irregular borders. Recommend CT Chest for evaluation. NOTIFICATION: Findings telephoned to Dr. ___ by Dr. ___ on ___ at 11:35am, approximately 15 minutes after discovery. " 558818e0-f7671efa-9ded3487-5701a321-029f1c40.jpg,validate/p19/p19791816/s54355673/558818e0-f7671efa-9ded3487-5701a321-029f1c40.jpg,validation," WET READ: ___ ___ ___ 9:06 AM Appearance of the heart and lungs overall unchanged from multiple prior studies, including the CT from ___. There are small bilateral pleural effusions as well as extensive pleural calcification on the right. There is no evidence of pulmonary edema or new airspace consolidation. Preliminary findings were communicated to Dr. ___ by Dr. ___, ___ phone on ___ at 3:00 AM, 1 minute(s) after discovery. WET READ VERSION #1 ___ ___ ___ 3:02 AM Appearance of the heart and lungs overall unchanged from multiple prior studies, including the CT from ___. There are small bilateral pleural effusions as well as extensive pleural calcification on the right. There is no evidence of pulmonary edema or new airspace consolidation. Preliminary findings were communicated to Dr. ___ by Dr. ___, ___ phone on ___ at 3:00 AM, 1 minute(s) after discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SOB // ? pulmonary edema, interval change in effusions COMPARISON: ___ IMPRESSION: As compared to the previous studies, no relevant change is seen. Unchanged pleural calcifications, right more than left, and pleural effusions, left more than right. Moderate cardiomegaly persists. The monitoring and support devices are constant. " 59211f37-6086cb33-3d691398-13ff812e-a70a22a2.jpg,validate/p15/p15993209/s51796740/59211f37-6086cb33-3d691398-13ff812e-a70a22a2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest tightness now resolved TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Patient is status post median sternotomy and CABG. Cardiac silhouette size is top normal with the left ventricular predominance. The aorta is calcified and mildly tortuous. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Hypertrophic changes are seen throughout the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 97fbd8e0-a066c064-5adf24e2-154e4d6b-0c771c07.jpg,validate/p12/p12878814/s56687445/97fbd8e0-a066c064-5adf24e2-154e4d6b-0c771c07.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with follicular lymphoma s/p allo SCT who p/w epididymitis and fever now with wheezing and SOB. // acute cardiopulmonary process acute cardiopulmonary process IMPRESSION: In comparison with the study of ___, on the lateral view the right hemidiaphragm is not well seen, though this is not confirmed on the frontal view. Nevertheless, in view of the clinical history, all lower lung pneumonia would have to be seriously considered. Otherwise little change. " 3b3036a3-bec1157b-4af0f88c-a08fde50-e4a9a10f.jpg,validate/p12/p12878814/s52469737/3b3036a3-bec1157b-4af0f88c-a08fde50-e4a9a10f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleural effusions s/p chest tube placement // pneumothorax, interval changes IMPRESSION: Since the prior radiograph of 1 day earlier, a left pleural catheter has apparently slightly changed in position, and left pleural effusion has decreased in size. Moderate to large right pleural effusion is probably similar in size considering differences in positioning between the exams, with right pleural catheter remaining in place. Remainder of exam is unchanged since recent study. " 0eca1b22-4c26b2ce-a91be5d7-09df850c-04e64569.jpg,validate/p12/p12674071/s59382564/0eca1b22-4c26b2ce-a91be5d7-09df850c-04e64569.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior CT exam from ___. CLINICAL HISTORY: Cough and fever, assess pneumonia. FINDINGS: PA and lateral views of the chest were provided. The patient is known to have extensive pulmonary fibrosis, which in comparison with a prior chest radiograph from ___ appears similar in overall extent and severity. No definite evidence for a superimposed pneumonia. No effusion or pneumothorax is seen. Overall, cardiomediastinal silhouette appears grossly stable. The bony structures are intact. IMPRESSION: Extensive pulmonary fibrosis, similar to examinations. " 9b4b7592-3a868d74-f50ee8f2-60f3cd64-5a5d4cfa.jpg,validate/p15/p15937283/s52287569/9b4b7592-3a868d74-f50ee8f2-60f3cd64-5a5d4cfa.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Kidney and pancreas transplant with fatigue and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is minimal right base atelectasis without definite focal consolidation. The left lung is clear. There is no pleural effusion or pneumothorax. The cardiac silhouette is not enlarged. Mediastinal contours are unremarkable. Thoracic scoliosis is again seen. Coronary artery calcification/stenting seen. IMPRESSION: Right base atelectasis without definite focal consolidation. " 23987f84-d2f2a75e-6405ab7b-0aa86b63-a5b1100e.jpg,validate/p19/p19725697/s53567043/23987f84-d2f2a75e-6405ab7b-0aa86b63-a5b1100e.jpg,validation," FINAL REPORT HISTORY: Dural hematoma, for evaluation of endotracheal tube placement. COMPARISON: Chest radiograph from the same day from outside hospital. FINDINGS: An endotracheal tube is noted in the upper trachea at 6.5 cm from the carina. Enteric tube traverses to the stomach. The lungs are clear. There is no pleural effusion or pneumothorax. No acute fractures are identified. IMPRESSION: The endotracheal tube is in the upper trachea at 6.5 cm from the carina. " 0ee7636a-f9d7c051-5be80847-dae33031-b5d0d4aa.jpg,validate/p14/p14599517/s50914195/0ee7636a-f9d7c051-5be80847-dae33031-b5d0d4aa.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with HIV and fever. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " cd253245-0a27ece6-d3d20370-fd18d8bd-6e89e925.jpg,validate/p16/p16648886/s54644861/cd253245-0a27ece6-d3d20370-fd18d8bd-6e89e925.jpg,validation," FINAL REPORT HISTORY: Esophageal cancer with acute jaundice and increased white blood cell count. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: PET CT ___ and chest radiograph ___. FINDINGS: Left-sided Port-A-Cath tip terminates in the mid to low SVC. Heart size is top normal with a left ventricular configuration. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Patchy opacities are seen within the right lower lobe with a possible trace pleural effusion. The left lung is clear. No pneumothorax is identified. IMPRESSION: Patchy right lower lobe opacity is concerning for infection with a possible trace right pleural effusion. " e4c9018e-d3549c04-6f59ebbf-71a2cacb-51b7c918.jpg,validate/p17/p17288913/s53214337/e4c9018e-d3549c04-6f59ebbf-71a2cacb-51b7c918.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pressure. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion or pneumothorax is detected. There is no evidence for pulmonary edema. Heart and mediastinal contours are within normal limits with aortic calcifications. Increased density in the region of the right hilum likely corresponds to lymphadenopathy, as seen on prior CT, and appears similar compared to multiple recent prior exams. Widening of the acromioclavicular joints, right greater than left, with soft tissue mineralization, appears similar compared to multiple prior exams. IMPRESSION: Stable chest radiographs without radiographic evidence for acute cardiopulmonary process. " c54fe4fc-e254f4cc-e83960cb-bf370df1-377f96c1.jpg,validate/p16/p16519016/s51030836/c54fe4fc-e254f4cc-e83960cb-bf370df1-377f96c1.jpg,validation," WET READ: ___ ___ 2:30 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with patient endorsing chest pain and SOB r/o PNA or other intrathoracic process // Patient endorsing chest pain and SOB r/o PNA or other intrathoracic process TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: Lung volumes are slightly low, resulting in bronchovascular crowding. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures identified. IMPRESSION: No acute cardiopulmonary process. " fcd0c926-f28d5b26-341d9daf-65f96413-1805c121.jpg,validate/p17/p17285723/s57299642/fcd0c926-f28d5b26-341d9daf-65f96413-1805c121.jpg,validation," WET READ: ___ ___ ___ 11:47 AM Blunting of the right costophrenic angle is new, and likely represents a small pleural effusion. No overt pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with chest pain // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CTA of the chest dated ___. FINDINGS: There is blunting of the right costophrenic angle, consistent with a small right pleural effusion, which is new over the interval. No overt pulmonary edema. The cardiomediastinal silhouette is unchanged. No pneumothorax or consolidation. Note is made of severe S-shaped scoliosis. Spinal fusion hardware is partially imaged. No acute displaced rib fractures identified. IMPRESSION: Blunting of the right costophrenic angle is new, and likely represents a small pleural effusion. No overt pulmonary edema. " 56b6b8c9-2d4be9d9-c934ce9d-bcb9a80c-87faca5f.jpg,validate/p14/p14519466/s53103839/56b6b8c9-2d4be9d9-c934ce9d-bcb9a80c-87faca5f.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with productive cough and body aches for one month. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is a new left lower lobe consolidation and possible new right lower lobe consolidation compared to 13 days prior. No large pleural effusion or pneumothorax is detected. Heart and mediastinal contours are within normal limits. IMPRESSION: New left lower lobe consolidation and possible new right lower lobe consolidation compared to ___. Findings are concerning for pneumonia. Findings were reported to ___ by ___ by telephone at 4:34 p.m. on ___ at the time of discovery of these findings. " 7f252c67-80ccc6cf-d6dd0342-03f80c0f-fd05b568.jpg,validate/p16/p16614879/s55083071/7f252c67-80ccc6cf-d6dd0342-03f80c0f-fd05b568.jpg,validation," 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. " 5e700afb-69c72aec-7489ccb8-b4361806-612a6c02.jpg,validate/p13/p13434398/s56398440/5e700afb-69c72aec-7489ccb8-b4361806-612a6c02.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with CHF, dyspnea // eval for pulm edema COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. The heart remains mildly enlarged with a left ventricular configuration. There is mild interstitial pulmonary edema without large effusion or pneumothorax. Mediastinal contour stable. Bony structures intact. IMPRESSION: Cardiomegaly with mild edema. " 8f6a81d8-ae94757e-888a3229-e11b5ab7-5d005a79.jpg,validate/p15/p15180409/s53693590/8f6a81d8-ae94757e-888a3229-e11b5ab7-5d005a79.jpg,validation," FINAL REPORT HISTORY: Bilateral leg swelling. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Mild to moderate enlargement of cardiac silhouette is relatively unchanged compared to the prior study. The aorta remains unfolded. Lung volumes are low with crowding of the bronchovascular structures. Additionally, there is mild pulmonary vascular congestion. No focal consolidation, pleural effusion or pneumothorax is present. Diffuse demineralization of the osseous structures is noted. Mild loss of height of at least 2 low thoracic vertebral bodies appears unchanged. IMPRESSION: Low lung volumes with mild pulmonary vascular engorgement. " 122ad23b-e4ac1b59-64c565a9-9d8b8081-ea91e1cc.jpg,validate/p12/p12938377/s50692381/122ad23b-e4ac1b59-64c565a9-9d8b8081-ea91e1cc.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with epigastric pain and complicated hepatobiliary history. 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. There has been interval removal of a right internal jugular central venous line and enteric tube. IMPRESSION: No acute cardiopulmonary process. " 8bea27b6-da18cac1-0a2fccb1-d1abeeaf-584d12e0.jpg,validate/p13/p13306576/s57308767/8bea27b6-da18cac1-0a2fccb1-d1abeeaf-584d12e0.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Manic episode, needs medical clearance. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Subtle opacity projecting over the anterior left rib likely relates to prominence of that rib and is stable since the prior, no underlying consolidation was seen on CT from ___. Degenerative changes are seen along the spine including anterior osteophytosis. IMPRESSION: No acute cardiopulmonary process. " 6118cff5-4784a121-4b7f7d63-4f4e4675-4a4b03a1.jpg,validate/p15/p15510911/s50023788/6118cff5-4784a121-4b7f7d63-4f4e4675-4a4b03a1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p transport to OR for facial laceration repair // Eval for ETT positioning, OGT positioning Eval for ETT positioning, OGT positioning IMPRESSION: Comparison to ___. No relevant change is noted. The position of the left chest tube is stable. The right upper lobe opacity is stable in extent and severity. The opacity needs to be monitoring until complete resolution. Retrocardiac atelectasis is slightly improved. No pleural effusions. " 11305324-57ea60fb-90912686-cbd8f9de-ca677c54.jpg,validate/p10/p10175233/s54499674/11305324-57ea60fb-90912686-cbd8f9de-ca677c54.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with weight loss and recent cough. COMPARISON: Multiple prior radiographs dating back to ___. FINDINGS: Frontal and lateral views of the chest demonstrate normal heart size. Mediastinal and hilar contours are within normal limits. Atherosclerotic calcifications are present in the aortic arch. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. There is no evidence of nodule or mass. Mild lower thoracic spondylosis is present. IMPRESSION: No acute cardiopulmonary process such as pneumonia. " 4083d53f-d20da109-9c71181d-56d20b3a-21a4be16.jpg,validate/p14/p14875942/s56594395/4083d53f-d20da109-9c71181d-56d20b3a-21a4be16.jpg,validation," FINAL REPORT INDICATION: Chronic chest wall pain, mainly anterior, but also left thoracic pain, known old T6 fracture. Please evaluate for any rib fractures. COMPARISON: Comparison is made to chest radiograph performed ___. CHEST PA AND LATERAL RADIOGRAPH: Demonstrates stable enlarged cardiac silhouette with a left-sided single-lead pacemaker with tip terminating in the right ventricle. Low lung volumes are noted with stable bibasilar atelectasis. No focal opacities concerning for pneumonia present. No pleural effusion or pneumothorax is evident. Evaluation of the ribs is limited due to body habitus as well as patient position. No displaced rib fracture evident. IMPRESSION: Severely limited evaluation of the ribs. If continued concern for rib fracture, recommend dedicated rib series. " 9437c189-7ae35746-af07ce1f-119de5e4-cc343d56.jpg,validate/p18/p18798540/s57583627/9437c189-7ae35746-af07ce1f-119de5e4-cc343d56.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with flank pain, UTI // stone vs acute intraabd process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Mild right middle lobe linear atelectasis is seen with mild elevation of the right hemidiaphragm. There is no definite focal consolidation. The left lung is clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: Mild right middle lobe atelectasis without definite focal consolidation. " 99c96954-a953d254-adcc16c0-fb5ad66f-2ecb29d4.jpg,validate/p11/p11798125/s55694522/99c96954-a953d254-adcc16c0-fb5ad66f-2ecb29d4.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: ___. FINDINGS: Interval removal of various support and monitoring devices with residual right internal jugular vascular sheath in place. No evidence of pneumothorax. Stable postoperative appearance of cardiomediastinal contours. Persistent bibasilar retrocardiac atelectasis and small pleural effusions. " 05dad5f1-e33191fc-c4063ab8-15fcf471-3f82205d.jpg,validate/p10/p10410641/s59146650/05dad5f1-e33191fc-c4063ab8-15fcf471-3f82205d.jpg,validation," FINAL REPORT HISTORY: Recurrent left effusion with catheter placement, to assess for pneumothorax. FINDINGS: In comparison with study of ___, there is a Pleurx catheter in place. No evidence of pneumothorax. Bibasilar opacification is consistent with atelectasis and effusion. Indistinctness of pulmonary vessels is consistent with elevated pulmonary venous pressure. " 3004d8c9-5c9c0a35-2b1b694d-db3a9693-590e7825.jpg,validate/p14/p14090374/s59546614/3004d8c9-5c9c0a35-2b1b694d-db3a9693-590e7825.jpg,validation," FINAL REPORT INDICATION: History: ___F with chest pain // ? pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Normal heart size, mediastinal and hilar contours. Calcification of the aortic arch is not significantly changed. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: No acute process. " c2426ec7-251634d2-a8f71676-a9ea7cdb-10a0afc7.jpg,validate/p19/p19802708/s53682749/c2426ec7-251634d2-a8f71676-a9ea7cdb-10a0afc7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with testicular cancer // mets mets IMPRESSION: No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. At the limits of plain radiography, there are no definite parenchymal metastases. However, CT is much more sensitive for detection of such lesions. " dd93f132-aa8166f4-b2ce4d02-146a8d19-01ca8110.jpg,validate/p13/p13894338/s55227901/dd93f132-aa8166f4-b2ce4d02-146a8d19-01ca8110.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with TBP // sp tbp sp tbp IMPRESSION: Compared to prior chest radiographs since ___, most recently ___, following thoracotomy and tracheal surgery. Small right pneumothorax is slightly larger. Midline drainage tube still in place. Subcutaneous emphysema in the right chest wall has migrated but probably not increased. Right pleural effusion small if any. Lungs grossly clear. Normal postoperative mediastinal appearance. Heart normal size. " 8ff26883-be6a97da-daf4fd00-b85f35c1-ff87532f.jpg,validate/p11/p11107643/s56417983/8ff26883-be6a97da-daf4fd00-b85f35c1-ff87532f.jpg,validation," WET READ: ___ ___ ___ 3:01 PM No consolidation concerning for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (frontal AND LAT) INDICATION: ___F with tremulous and abd pain, with cardiac history question pneumonia. TECHNIQUE: Chest frontal and lateral radiographs COMPARISON: Chest radiograph dated ___. CTA chest dated ___. FINDINGS: Left chest wall dual lead cardiac pacemaker has leads terminating in the right atrium and right ventricle. The heart is top-normal. The cardiomediastinal silhouette is unchanged. There is no focal consolidation, large effusion or pneumothorax. IMPRESSION: No consolidation concerning for pneumonia. " cd30203a-8fd325cf-4cec8c36-59b283a9-a2f3c8ad.jpg,validate/p18/p18524078/s59540185/cd30203a-8fd325cf-4cec8c36-59b283a9-a2f3c8ad.jpg,validation," FINAL REPORT INDICATION: Abdominal pain. COMPARISON: Chest radiograph ___, ___. TECHNIQUE: Frontal and lateral views of the chest were obtained. FINDINGS: Heart size is top normal. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no focal consolidation concerning for pneumonia. There is no pneumoperitoneum. Small bowel air-fluid levels are noted on the lateral view. IMPRESSION: 1. No acute cardiopulmonary process. 2. Air fluid levels in the small bowel. Correlation with same day CT scan of the abdomen and pelvis recommended. " e2792c56-c11d3e9a-99233301-ae944fa0-ab4173c3.jpg,validate/p13/p13364829/s52440344/e2792c56-c11d3e9a-99233301-ae944fa0-ab4173c3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with mild hypoxia, h/o CHF. 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. Top normal heart size. " 767cd9c3-8caf2110-f11cf960-646d6d9d-68579570.jpg,validate/p17/p17794482/s53955174/767cd9c3-8caf2110-f11cf960-646d6d9d-68579570.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pancreatic cancer. Leukocytosis and malaise. // evaluate for pneumonia, acute process evaluate for pneumonia, acute process IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. Specifically, no pneumonia or vascular congestion. Central catheter extends to the level of the cavoatrial junction. " cc3329d8-d6275d72-70e4293b-9a2163c6-88f13949.jpg,validate/p11/p11730422/s57186402/cc3329d8-d6275d72-70e4293b-9a2163c6-88f13949.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p L thoracotomy decortication, superior segmentectomy of the left lower lobe, mediastinal lymph node dissection and wedge resection of lingula for FDG-avid nodule in the superior segment of the left lower lobe. This was c/b left hemothorax s/p evacuation // please eval for CT position and interval change please eval for CT position and interval change COMPARISON: ___ IMPRESSION: No short interval change demonstrated in the appearance of the left hemi thorax. Position of the left chest tubes is similar to previous examination. On the other hand there is interval development of pulmonary edema, diffuse, moderate. No change in the right small pleural effusion demonstrated. " 9fda78bd-973b1bc1-19ed2b23-cabb56dd-69a46219.jpg,validate/p11/p11068569/s53322729/9fda78bd-973b1bc1-19ed2b23-cabb56dd-69a46219.jpg,validation," WET READ: ___ ___ 10:30 AM There are focal consolidations in the right middle lobe and left lower lobe, compatible with pneumonia. Heart is mildly enlarged. There is pulmonary vascular congestion, but no overt pulmonary edema. WET READ VERSION #1 ___ ___ ___ 7:23 PM There are focal consolidations in the right middle lobe and left lower lobe, compatible with pneumonia. Heart is mildly enlarged. There is pulmonary vascular congestion, but no overt pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with PNA, hypoxia, nephrolithiasis on IVF // ?pulm edema, LLL PNA COMPARISON: Radiographs from ___ IMPRESSION: There are new areas of consolidation within the right middle lobe and left lower lobe suggestive of pneumonia. Heart size is prominent but stable. There is mild prominence of the pulmonary vascular markings. There are no pneumothoraces. " bd3cffc4-3efb444c-cb36064a-b0eadbae-bb4f8a20.jpg,validate/p15/p15934572/s50381837/bd3cffc4-3efb444c-cb36064a-b0eadbae-bb4f8a20.jpg,validation," 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 ___. " eff66490-bbd69358-a1150032-46e1829a-4cfbe671.jpg,validate/p11/p11589621/s51036805/eff66490-bbd69358-a1150032-46e1829a-4cfbe671.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___. HISTORY: ___-year-old with chronic cough, but no fever or shortness of breath. IMPRESSION: PA and lateral chest compared to ___: Normal heart, lungs, hila, mediastinum and pleural surfaces. The conventional chest radiograph does not constitute a full survey of the airways either central or peripheral. " 40178974-33d8800a-f740e346-539ed18c-2a748f0a.jpg,validate/p16/p16824240/s52845104/40178974-33d8800a-f740e346-539ed18c-2a748f0a.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Cough, question pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate diffuse pulmonary opacity involving the mid to lower lung, superimposed on a background of interstitial lung disease. No large effusion is seen. No pneumothorax is present. Heart size appears grossly unremarkable, though difficult to visualize on the lateral view. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Findings concerning for pulmonary fibrosis with superimposed pneumonia in the mid-to-lower lungs. Followup to resolution is advised. " 0de745eb-4a42ec67-b2385648-7e4919b9-f9ceb7ce.jpg,validate/p15/p15154432/s56786275/0de745eb-4a42ec67-b2385648-7e4919b9-f9ceb7ce.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with an ett // evaluate lungs COMPARISON: The comparison is made with prior studies including ___ endotracheal tube tip is 5 cm above the carina. Nasogastric tube tip is beyond the GE junction the on the edge of the film. Right central line tip projects in the region of the proximal right atrium.. There are bilateral pleural effusions present. There is slight improvement in aeration as compared to the earlier study. There is no pneumothorax. IMPRESSION: The lungs are clear. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. " d1b39e32-0bc6b6ce-14400d87-724f1105-8f8addf9.jpg,validate/p10/p10374990/s50168233/d1b39e32-0bc6b6ce-14400d87-724f1105-8f8addf9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CHF s/p hardware removal of spine // eval interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: Mild vascular congestion is stable. Small to moderate right and large left pleural effusions have improved on the left. Aeration of the left lung has improved. Aortic stent is in unchanged position. Cardiac size cannot be evaluated. Appearance of the mediastinum is unchanged. Multiple drains / catheters projecting in the upper chest are in unchanged position. There is no evident pneumothorax. Left IJ catheter tip is in the mid SVC. " 5110e14f-931e60fb-0c8de132-c6cd9e53-77f6d498.jpg,validate/p13/p13687936/s52182849/5110e14f-931e60fb-0c8de132-c6cd9e53-77f6d498.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT) INDICATION: ___ yo female with lymphoma, with recurrent fevers, r/o infectious process // ___ yo female with lymphoma, with recurrent fevers, r/o infectious process COMPARISON: Chest radiographs ___. IMPRESSION: The only area pulmonary abnormality is seen only on the lateral view, small areas of possible consolidation projecting over the heart shadow at the level of the pulmonary outflow tract. Lungs are otherwise clear. Moderate enlarged of the cardiac silhouette is chronic. Pulmonary vasculature is unremarkable. There is no pulmonary edema or pleural effusion or evidence of central adenopathy. " 8861af98-8078f516-b34e43c4-71c12199-0c1a87ce.jpg,validate/p11/p11343910/s51055442/8861af98-8078f516-b34e43c4-71c12199-0c1a87ce.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with sob - prior to V/Q scan // prior to V/Q scan prior to V/Q scan TECHNIQUE: PA and lateral views COMPARISON: CT chest dated ___ and chest x-ray dated ___ FINDINGS: There is a moderate to severe cardiomegaly without vascular congestion. The lungs, pleura and mediastinal contours are unremarkable. IMPRESSION: Moderate to severe cardiomegaly without vascular congestion, suggesting the possibility of a pericardial effusion or cardiomyopathy. The lungs are clear bilaterally. " dbf3b497-7723f8f0-1e3ac6c5-99eede6b-8d873ad5.jpg,validate/p15/p15336847/s55707299/dbf3b497-7723f8f0-1e3ac6c5-99eede6b-8d873ad5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p surgery // pre extubation TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: ET tube tip is 4.3 cm above the carinal. Right internal jugular line tip is at the cavoatrial junction. Heart size and mediastinum are stable. Lungs are essentially clear. There is no pleural effusion or pneumothorax. " b208fc53-e15b6be8-384b2927-469083d3-bc30ab63.jpg,validate/p16/p16770700/s58304814/b208fc53-e15b6be8-384b2927-469083d3-bc30ab63.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Stroke, new Dobbhoff tube placement. Portable AP radiograph of the chest was reviewed in comparison to ___. The Dobbhoff tube is coiled in the proximal esophagus. Cardiomegaly is substantial and there are multiple bilateral foci of opacification that might reflect aspiration versus pneumonia. " f1582d36-e8c732b6-7b1285a5-273ee448-214d0c71.jpg,validate/p17/p17098669/s58160392/f1582d36-e8c732b6-7b1285a5-273ee448-214d0c71.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with neuromuscular problem of swallowing s/p NG tube placement // NG tube placement COMPARISON: ___. IMPRESSION: As compared to the previous image, the patient has a new nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. No evidence of complications, notably no pneumothorax. The known pre-existing bilateral parenchymal opacities are unchanged in extent and severity. " 1561a3a6-1daa121c-95451fdb-9371c3a8-162b0589.jpg,validate/p11/p11138910/s53078881/1561a3a6-1daa121c-95451fdb-9371c3a8-162b0589.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p left sided pacemaker via axillary vein // r/o PTX; check leads COMPARISON: None. FINDINGS: A DUAL LEAD LEFT-SIDED PACEMAKER IS PRESENT, LEAD TIPS OVERLYING THE RIGHT ATRIUM AND RIGHT VENTRICLE. NO PNEUMOTHORAX IS DETECTED. DOUBT SIGNIFICANT INTERVAL CHANGE. PROBABLE BACKGROUND COPD. NO CHF OR FOCAL CONSOLIDATION DETECTED. MINIMAL ATELECTASIS IN THE RIGHT CARDIOPHRENIC REGION AND BLUNTING OF THE COSTOPHRENIC ANGLES POSTERIORLY. IMPRESSION: AS ABOVE.. " b0c5fa6c-b7bdae9e-9138a2d2-a0173ce2-c20fc6cd.jpg,validate/p12/p12200987/s54357372/b0c5fa6c-b7bdae9e-9138a2d2-a0173ce2-c20fc6cd.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain, shortness of breath and leg swelling // R/O CHF 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. " 8a686941-45a93f60-2111bfa6-8a1de441-118062cf.jpg,validate/p18/p18831735/s58103795/8a686941-45a93f60-2111bfa6-8a1de441-118062cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man adm aspiration PNA, overall clinically stable and labs improved, continued tachypnea // please evaluate for interval change TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " a68e33b1-d32848b0-d261a3df-7597a9b1-feb2aba5.jpg,validate/p11/p11984732/s51762718/a68e33b1-d32848b0-d261a3df-7597a9b1-feb2aba5.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with shortness of breath and chest pain. FINDINGS: Frontal and lateral views of the chest are compared to previous exam from ___. The lungs are clear. There is trace blunting of posterior costophrenic angles, which may represent small effusions. Cardiac silhouette is enlarged but stable in configuration. No pulmonary vascular congestion. Post-CABG changes are noted and dual-lead pacing device which are stable in position. IMPRESSION: Trace pleural effusions. Otherwise, no significant change since prior without definite acute cardiopulmonary process. " b64baa3b-e46a3c68-b193b28e-00fa2f4f-0b4f0feb.jpg,validate/p18/p18567979/s57841971/b64baa3b-e46a3c68-b193b28e-00fa2f4f-0b4f0feb.jpg,validation," FINAL REPORT INDICATION: Fall. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: Mild cardiomegaly is again seen. There are unchanged small bilateral pleural effusions. The central pulmonary vessels are engorged, and there is mild superimposed edema. Moderate bibasilar atelectasis is again seen. There is no pneumothorax. IMPRESSION: Mild cardiomegaly, with central pulmonary vascular congestion and mild interstitial edema, and unchanged small bilateral pleural effusions. " d8c05d35-dacc1ffa-eb4bbaa7-7887b4e1-caceb6c3.jpg,validate/p18/p18708817/s57901676/d8c05d35-dacc1ffa-eb4bbaa7-7887b4e1-caceb6c3.jpg,validation," WET READ: ___ ___ ___ 8:00 PM Lateral chest radiograph not performed. Ill-defined opacity overlying the left hemidiaphragm has improved, consistent with atelectasis. Otherwise, no significant change from 6 hr prior. ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with AMS, concern for ill-defined opacity on recent portable, assess for pneumonia. Comparison is made to the patient's prior study of ___ at ___. Portable AP semi-erect chest film ___ at ___ is submitted. IMPRESSION: 1. The heart remains markedly enlarged, which may represent cardiomegaly, although pericardial effusion should also be considered. There are stably enlarged pulmonary arteries consistent with underlying pulmonary arterial hypertension. There is improving aeration at the left lung base consistent with resolving atelectasis. Mild pulmonary vascular congestion is stable. No pleural effusions or pneumothorax. " 8bda72d2-94193c91-04ec4bb6-1147673b-bf7902d5.jpg,validate/p14/p14134981/s58398453/8bda72d2-94193c91-04ec4bb6-1147673b-bf7902d5.jpg,validation," FINAL REPORT HISTORY: Sore throat, wheeze, fever. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The heart size is normal. The mediastinal and hilar contours are unremarkable. The 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 abnormality. " b88bab32-ab6327a1-272c11d2-0aefb9ae-924e1644.jpg,validate/p15/p15937283/s51262284/b88bab32-ab6327a1-272c11d2-0aefb9ae-924e1644.jpg,validation," 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. " 23b02ea5-85a0dcac-b376329c-2d5192be-fdf7cace.jpg,validate/p11/p11620903/s52764386/23b02ea5-85a0dcac-b376329c-2d5192be-fdf7cace.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with hypotension. COMPARISON: Chest radiograph from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: 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 " cd72da96-dc05de2b-d6eb064d-439ff132-e41b7696.jpg,validate/p16/p16581134/s56106647/cd72da96-dc05de2b-d6eb064d-439ff132-e41b7696.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated // any change in bibasilar opacities, ETT? any change in bibasilar opacities, ETT? IMPRESSION: Comparison to ___. No relevant change is noted. Stable correct position of the monitoring and support devices. Mild cardiomegaly. Elevation of the right hemidiaphragm. Mild fluid overload but no overt pulmonary edema. No larger pleural effusions. " 797ee5fb-c7cbf0e6-d8de1d51-24a47657-3b053920.jpg,validate/p15/p15571899/s53863653/797ee5fb-c7cbf0e6-d8de1d51-24a47657-3b053920.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p CABG // eval for pneumothorax TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Moderate cardiomegaly is stable. Right IJ catheter tip is in the cavoatrial junction. There is mild vascular congestion. Bibasilar atelectasis larger on the left have increased. Small bilateral effusions have minimally increased. There is no evident pneumothorax. Sternal wires are aligned. " 033119e4-e2bf5b9e-85d841ab-fd886d00-33646217.jpg,validate/p14/p14709655/s51699250/033119e4-e2bf5b9e-85d841ab-fd886d00-33646217.jpg,validation," FINAL REPORT HISTORY: For possible liver transplant. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute cardiopulmonary disease. There may be minimal atelectatic changes at the bases, but no acute pneumonia or vascular congestion. " 15dea30d-81fd45f1-f71fa14a-2acc9275-0d659acb.jpg,validate/p11/p11456281/s52151220/15dea30d-81fd45f1-f71fa14a-2acc9275-0d659acb.jpg,validation," 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. " 95a5acd6-11a1fbc8-0bc8e99d-fe397805-8b1a63db.jpg,validate/p15/p15180359/s53958746/95a5acd6-11a1fbc8-0bc8e99d-fe397805-8b1a63db.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with DLBCL who presents with AMS in setting of new intracranial lesions, likely progression of disease // Risk of aspiration in setting of seizure, increased O2requirement Risk of aspiration in setting of seizure, increased O2requirement IMPRESSION: Comparison to ___. Lung volumes have decreased. Moderate cardiomegaly has developed. Mild pulmonary edema is present on today's examination. No larger pleural effusions. No pneumonia, no pneumothorax. " 43398dbb-90cb23b1-9cffc63c-2fad2433-bd20f629.jpg,validate/p13/p13277640/s54242803/43398dbb-90cb23b1-9cffc63c-2fad2433-bd20f629.jpg,validation," 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. " 104de432-70864030-bbe632e8-291fd42c-8622c087.jpg,validate/p13/p13201526/s54929552/104de432-70864030-bbe632e8-291fd42c-8622c087.jpg,validation," FINAL REPORT HISTORY: Back pain, fever, cough, fatigue. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Right mid lung opacity best seen on the frontal view is worrisome for pneumonia. The left lung is clear. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Right mid lung patchy opacity best seen on the frontal view, worrisome for pneumonia. Recommend followup to resolution. " 5da4b16e-586db921-5c81744e-8d6b5c88-9baf3ac1.jpg,validate/p14/p14771174/s50157787/5da4b16e-586db921-5c81744e-8d6b5c88-9baf3ac1.jpg,validation," FINAL REPORT INDICATION: Two days nausea and vomiting with history of type A dissection repair. COMPARISON: Chest radiograph ___, CTA torso ___. FINDINGS: PA and lateral views were reviewed. The cardiomediastinal and hilar contours are stable with a tortuous enlarged descending aorta, compatible with known aortic dissection status post repair. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear. Pulmonary vasculature is within normal limits. The patient is status post median sternotomy with surgical clips overlying the mediastinum and right axilla. A left posterior rib defect is also likely post surgical. IMPRESSION: No acute cardiopulmonary process. " 765bddaf-8ecfe25d-8eb7a2a5-43c1e078-e4dc2600.jpg,validate/p11/p11296936/s59372823/765bddaf-8ecfe25d-8eb7a2a5-43c1e078-e4dc2600.jpg,validation," FINAL REPORT CLINICAL INDICATION: ___-year-old male with chest pain. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Compared to most recent prior exam, there has been interval resolution of pulmonary edema. Linear density along the minor fissure may represent residual fluid or scarring. No pleural effusion or pneumothorax is seen. No focal consolidation is seen, although lateral evaluation is slightly limited due to low lung volumes. Heart size is enlarged. Mediastinal contours are within normal limits. A left-sided subclavian line is in similar position. IMPRESSION: Interval resolution of pulmonary edema with persistent borderline cardiomegaly. " 39f11578-7b126b98-35296cb8-61dc4df6-38a90d78.jpg,validate/p15/p15103745/s54196563/39f11578-7b126b98-35296cb8-61dc4df6-38a90d78.jpg,validation," FINAL REPORT INDICATION: Evaluate endotracheal tube position.. COMPARISON: Chest radiograph ___. TECHNIQUE Six portable views of the chest. FINDINGS: Subsequent views of the chest demonstrates endotracheal tube repositioning. Final views demonstrate an endotracheal tube ending approximately 1.8 cm above the carina. Orogastric tube tip seems to end in the upper abdomen. Again noted, is a left lower lung base opacity. New opacification of the right lower lobe, is likely secondary to a layering pleural effusion. The costophrenic angles are blunted bilaterally. Cardiomediastinal hilar contours are unchanged. There is no pneumothorax. IMPRESSION: 1. Endotracheal tube ends approximately 1.8 cm above the carina. Orogastric tube extends to the upper abdomen. 2. Unchanged left lower lobe opacity. 3. Bilateral layering pleural effusions. " e5eec4da-2662bc39-59c05798-f97d46d6-87ac79aa.jpg,validate/p10/p10514501/s53423888/e5eec4da-2662bc39-59c05798-f97d46d6-87ac79aa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p right VATS pleurodesis and diaphragm repair // assess for interval change assess for interval change IMPRESSION: Comparison to ___. Status post right pleural basis with elevation of the right hemidiaphragm. Borderline size of the cardiac silhouette. No pulmonary edema, no pneumonia, no pleural effusions. No pneumothorax. " eeae1cc9-3c55f312-481cc23b-114c05e3-a071b506.jpg,validate/p12/p12462675/s53995042/eeae1cc9-3c55f312-481cc23b-114c05e3-a071b506.jpg,validation," FINAL REPORT HISTORY: Subarachnoid hemorrhage, status post clipping. Evaluate for pulmonary edema. COMPARISON: ___. FINDINGS: Frontal portable radiograph of the chest demonstrates the endotracheal tube tip approximately 8.5 cm from the carina. This should be advanced by roughly ___ to 20 mm for more appropriate positioning. The right internal jugular central venous line tip is at the mid portion of the SVC. The enteric tube tip is past the diaphragm and out of the field of view. As compared to the prior study, there is improvement in the pulmonary edema and right pleural effusion. Concurrent pneumonia is a possibility. The cardiomediastinal contour is unchanged. IMPRESSION: 1. Malpositioned endotracheal tube, should be advanced by roughly 2 cm for more appropriate positioning. 2. Interval improvement in pulmonary edema and right pleural effusion. These findings were relayed to the ___ nurse taking care of the patient, by Dr. ___, at 10:12 a.m. on ___. " ea5ebce7-8f4a3d5f-e250c982-830ab20f-ef3f7691.jpg,validate/p12/p12678475/s54460845/ea5ebce7-8f4a3d5f-e250c982-830ab20f-ef3f7691.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain // eval for acute process TECHNIQUE: Frontal and lateral views the chest. COMPARISON: ___. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified IMPRESSION: No acute cardiopulmonary process. " 0625da35-2268adab-7028583b-97d09c13-30c7098e.jpg,validate/p18/p18300044/s54225895/0625da35-2268adab-7028583b-97d09c13-30c7098e.jpg,validation," FINAL REPORT HISTORY: Biopsy, to assess for pneumothorax. FINDINGS: In comparison with study of ___, there is no definite evidence of post-procedure pneumothorax. Otherwise, little change except for better degree of inspiration. " 0d9a4925-87ff0eb0-47e1a7ba-dfa07b05-5280388c.jpg,validate/p16/p16511787/s55694818/0d9a4925-87ff0eb0-47e1a7ba-dfa07b05-5280388c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Cough, assess 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 is seen. IMPRESSION: No signs of pneumonia or other acute intrathoracic process. " 061b3f8f-5b457f66-014593f4-812be969-0f2ec151.jpg,validate/p12/p12823036/s50788960/061b3f8f-5b457f66-014593f4-812be969-0f2ec151.jpg,validation," 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. " 4ffc7fdf-535c473f-d277676a-14cef7ce-b01e1aae.jpg,validate/p11/p11277318/s59812848/4ffc7fdf-535c473f-d277676a-14cef7ce-b01e1aae.jpg,validation," 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. " bd0021f3-bf73717a-1199097b-40a82ab1-dc9d5557.jpg,validate/p15/p15566987/s55905825/bd0021f3-bf73717a-1199097b-40a82ab1-dc9d5557.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new O2 requirement // assess for new infiltrates assess for new infiltrates IMPRESSION: In comparison with the study of ___, the Dobbhoff tube is been removed and replaced with a nasogastric tube that extends to the lower body of the stomach. Again there are low lung volumes with little overall change in the appearance of heart and lungs. Bibasilar atelectatic changes are again seen, as is elevation of the right hemidiaphragmatic contour. " dd253648-97ef03e3-c0a9577a-b9084048-9e1630fd.jpg,validate/p18/p18389933/s58502467/dd253648-97ef03e3-c0a9577a-b9084048-9e1630fd.jpg,validation," WET READ: ___ ___ ___ 10:49 PM No acute intrathoracic process. ___ ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: T2 intradural lesion. There are no prior studies available for comparison. There is mild cardiomegaly. There are bibasilar atelectases. There is no pneumothorax. If any, there is a small left effusion. " 7fb6fe30-cf364ec8-6441013c-f8b82f0d-7aee3ef4.jpg,validate/p16/p16595826/s53866630/7fb6fe30-cf364ec8-6441013c-f8b82f0d-7aee3ef4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with COUGH x ___ weeks. H/O pneumonia in past // ? pneumonia ? pneumonia IMPRESSION: Comparison to ___. No relevant change is seen. Status post thyroid surgery. Severe degenerative changes at the level of the right shoulder. Elongation of the descending aorta. No pleural effusions. No pneumonia, no pulmonary edema. " 75681f55-f7274e77-e1cd51c9-1ca3bcad-c637a5ea.jpg,validate/p12/p12607933/s58636568/75681f55-f7274e77-e1cd51c9-1ca3bcad-c637a5ea.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right pneumothorax, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous image, the pneumothorax on the right is unchanged. No evidence of tension. No other relevant changes. Unchanged post-operative appearance of the heart and the monitoring and support devices are constant. " a1ac20d3-a80e0131-0df011c2-70d1922d-c6b3406d.jpg,validate/p12/p12230961/s57735198/a1ac20d3-a80e0131-0df011c2-70d1922d-c6b3406d.jpg,validation," WET READ: ___ ___ ___ 12:00 PM 1. Minimally displaced right seventh anterolateral rib fracture. 2. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with fall, rib pain. Assess for rib fx or pneumothorax. TECHNIQUE: Chest PA and lateral COMPARISON: CT chest with contrast ___, chest radiograph ___, ___, ___. FINDINGS: The lungs are well inflated and clear. No pleural effusion or pneumothorax. The heart is top-normal in size. Mediastinal contour, and hila are unremarkable. Aortic arch calcifications are present. Limited assessment of the osseous structures demonstrate a subtle cortical step-off along the anterolateral right seventh rib. IMPRESSION: 1. Minimally displaced right seventh anterolateral rib fracture. 2. No pneumothorax. " b1af5da6-f550c622-abea49b9-319082d5-8adddfcd.jpg,validate/p11/p11682585/s54632217/b1af5da6-f550c622-abea49b9-319082d5-8adddfcd.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman status post NG tube placement. COMPARISONS: ___ - ___. FINDINGS: A single portable upright chest radiograph was obtained. A nasoenteric tube has been placed with the tip projecting over the antrum of the stomach. Lung volumes are low. No focal consolidation, effusion or pneumothorax is present. Median sternotomy wires are intact. Right upper quadrant and numerous mediastinal surgical clips are unchanged. IMPRESSION: Appropriate position of nasoenteric tube. " 62ab325e-db4bda05-2bef7b2d-4d82e023-08eb6d45.jpg,validate/p12/p12754523/s57368585/62ab325e-db4bda05-2bef7b2d-4d82e023-08eb6d45.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Heart size, mediastinal and hilar contours are unchanged in appearance, with persistent mild elevation of both hila. Lungs are well expanded and grossly clear, and there is no evidence of pleural effusion, pneumothorax, or pneumoperitoneum. IMPRESSION: No radiographic findings to account for chest pain. " a412be83-022e7087-4d56fcbd-6e8dd1f1-34a88ea1.jpg,validate/p15/p15019924/s53567994/a412be83-022e7087-4d56fcbd-6e8dd1f1-34a88ea1.jpg,validation," FINAL REPORT EXAMINATION: PORTABLE CHEST RADIOGRAPH INDICATION: ___ y/o male with gastrointestinal bleed. Tube placement. TECHNIQUE: Frontal supine chest radiograph COMPARISON: None available FINDINGS: Assessment is limited due to positioning. Allowing for this limitation, there is no significant change compared with the recent exam performed ___ min prior. The esophageal tube ends below the GE junction, with the tip out of view. The tube is radiopaque, probably from contrast material within the tube or from tube change with a tube with radiodense walls. IMPRESSION: 1. Radiopaque esophageal tube ends below the GE junction, with the tip out of view. 2. Unchanged mild widening of the upper mediastinum as previously mentioned may be related to positioning. Trumatic injury to the mediastinum or brachiocephalic vasculature should be considered. Attention on follow up is recommended. Chest CT could be performed for further assessment if clinically indicated. " beef1eb5-2d5d5198-52d8143f-a4e1b507-ca2c2757.jpg,validate/p18/p18705722/s56155812/beef1eb5-2d5d5198-52d8143f-a4e1b507-ca2c2757.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with refractory asthma. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Cardiomegaly persists. Pulmonary vascular prominence with cephalization appears unchanged compared to prior. There is mild interstitial edema. No focal consolidation, pleural effusion, or pneumothorax is detected. Sternal wires are again noted. IMPRESSION: Cardiomegaly with pulmonary vascular re-distribution and mild interstitial edema. Findings reported to ___ by ___ by phone at 8:47 a.m. on ___ after attending radiologist review. " e47160bd-2e709335-a6a050f5-6553c743-64098aed.jpg,validate/p14/p14997223/s58200720/e47160bd-2e709335-a6a050f5-6553c743-64098aed.jpg,validation," FINAL REPORT INDICATION: Patient with shortness of breath, minimal lung sounds on right lung field to mid way. Assess effusion and atelectasis. COMPARISON: ___ and chest CTA of ___. FINDINGS: This patient had a recent liver transplant. There is a new large round right lower lobe convexity : the diaphragm contour is difficult to see. There is certainly some pleural effusion, but that does not explain all of it and the sonogram done yesterday showed only mild-to-moderate pleural effusion. The left lung is unremarkable. Mild cardiac enlargement is stable. There is no pulmonary edema. CONCLUSION: Patient with recent liver transplant. New large round density in right lower lobe . Small amount of pleural effusion seen on abdominal US most likely correspond to just part of it. Diaphragmatic eventration or infradiaphragmatic process has to be excluded. Further assessment with CT scan is suggested. Dr. ___ has been verbally contacted for the results at 4:15 p.m. Time of the exam 3:27 p.m. " 688b937e-d6edc454-3efb32ea-ccdf8e20-2ce3a971.jpg,validate/p16/p16372073/s57156476/688b937e-d6edc454-3efb32ea-ccdf8e20-2ce3a971.jpg,validation," WET READ: ___ ___ ___ 7:45 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with hx Marginal Zone B cell lymphoma, Hep C cirrhosis, now with pancytopenia (ANC410), 2 weeks severe abd pain and wt loss // Acute process, recurrence of lymphoma 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. IMPRESSION: No acute cardiopulmonary process. " eae411b9-2bbbbfec-e7a82109-a23668cf-109805d2.jpg,validate/p17/p17512510/s51959037/eae411b9-2bbbbfec-e7a82109-a23668cf-109805d2.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Severe night sweats. 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 radiographs. " 7601c72d-57de27ad-6768c68a-40117196-04e4653c.jpg,validate/p16/p16988643/s52139368/7601c72d-57de27ad-6768c68a-40117196-04e4653c.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old non-smoking male with cough for one month // r/o infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiograph from ___, ___. FINDINGS: The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No pneumothorax, pleural effusion, pneumonia, or pulmonary edema. IMPRESSION: No pneumonia or acute cardiopulmonary process. " 1d5fc699-2b3cf470-2844ec68-3446596d-788214fe.jpg,validate/p15/p15491742/s54714621/1d5fc699-2b3cf470-2844ec68-3446596d-788214fe.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Right-sided chest pain. COMPARISONS: ___, ___ and ___; ___. 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. Patchy right upper lobe opacities appear to have continuously decreased with slight residua suggesting scarring. Current findings are similar to earlier radiographs from ___, suggesting stable background scarring. IMPRESSION: No evidence of acute disease. " 871e881d-f3bc0dc5-e308dd18-51c8a46d-9d4be2f6.jpg,validate/p18/p18009858/s59569607/871e881d-f3bc0dc5-e308dd18-51c8a46d-9d4be2f6.jpg,validation," FINAL REPORT INDICATION: ___-year-old after esophagectomy, now with removal of chest tube. Evaluate for pneumothorax or significant effusions. TECHNIQUE: Frontal and lateral radiograph of the chest were obtained. COMPARISON: Chest radiograph from ___. FINDINGS: In the interval, a nasogastric tube and a left chest tube have been removed. The Port-A-Cath ends in the distal SVC. There is no pneumothorax. Small left and minimal right effusions, the left effusion slightly increased compared to the prior exam. Cardiomediastinal silhouette and hila are normal. IMPRESSION: No pneumothorax. " c2a5d527-29d06130-9813e9d4-ae438605-8789e8d4.jpg,validate/p12/p12156923/s58831425/c2a5d527-29d06130-9813e9d4-ae438605-8789e8d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ischemic colon s/p AAA repair, takeback for L iliac cutdown/thrombectomy/stent, takeback for LLE fasciotomy c/b colon ischemia s/p L hemicolectomy washout closure colostomy know with SOB // ? pulm vasc congestion vs pna ? pulm vasc congestion vs pna IMPRESSION: There to chest radiographs ___ through ___. Moderate bilateral pleural effusions and moderately severe pulmonary edema have both worsened since ___ although borderline cardiomegaly is unchanged. Patient is no longer intubated. Right PIC line ends in the low SVC. Nasogastric drainage tube ends in the mid stomach. NOTIFICATION: The findings were discussed with ___ by ___, M.D. on the telephone on ___ at 9:30 AM, 3 minutes after discovery of the findings. " 8e22d648-b7deee61-b3739e6d-74b501f2-3287fbb4.jpg,validate/p12/p12844527/s58270510/8e22d648-b7deee61-b3739e6d-74b501f2-3287fbb4.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old man with history of multiple sclerosis, presenting with acute leg weakness. FINDINGS: Cardiac silhouette and mediastinum are normal. There is tortuosity of the thoracic aorta. Lungs are clear. Bony structures demonstrate mild degenerative changes of the thoracic spine. " f52384dd-190a1afa-80e3d821-1d4f751f-2368b6a5.jpg,validate/p16/p16813573/s55290645/f52384dd-190a1afa-80e3d821-1d4f751f-2368b6a5.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with left upper quadrant pain. Please evaluate for infection or free air. COMPARISON: Chest radiograph from ___. TWO VIEWS OF THE CHEST: The lungs are well expanded and clear. The cardiac silhouette is mildly enlarged. The mediastinal silhouette, hilar contours, and pleural surfaces are normal. No pleural effusion or pneumothorax is present. Mid thoracic vertebral body compression fractures are chronic. There is diffuse calcification of mitral annulus. Note is made of a healed fracture in the right 7th rib. IMPRESSION: No acute intrathoracic process. Diffuse mitral annular calcification. " 15a89241-f6263872-9e5065cc-deb485f1-591e57bd.jpg,validate/p17/p17135687/s53516646/15a89241-f6263872-9e5065cc-deb485f1-591e57bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ GSW x 4 to chest; intubated, s/p BL CT w/ initial output approx 1 L w/ T4 paraplegia s/p trach s/p IVC filter, now rt pigtail removed // PTX? pls do it at 4 pm IMPRESSION: As compared to the previous radiograph from earlier the same date, a right pigtail pleural catheter has been removed with no visible pneumothorax. Otherwise similar appearance of the chest except for withdrawal of a feeding tube which now terminates in the proximal stomach and slight improvement an left mid and lower lung opacification. " b41ebd1d-668affd5-199237b4-038bd4d7-86d450b2.jpg,validate/p17/p17535283/s51812194/b41ebd1d-668affd5-199237b4-038bd4d7-86d450b2.jpg,validation," FINAL REPORT PORTABLE SEMI-UPRIGHT CHEST DATED ___ COMPARISON: ___ radiograph. FINDINGS: Heart size, mediastinal and hilar contours remain normal. Patchy opacities have developed in both infrahilar regions, and could potentially represent aspiration or developing infectious pneumonia in the setting of fever and cough. Patchy atelectasis is an additional consideration. No definite pleural effusion or pneumothorax. " bc0ab567-e0bb929a-f3512574-85434a47-bce66feb.jpg,validate/p13/p13189998/s51829161/bc0ab567-e0bb929a-f3512574-85434a47-bce66feb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with left face/arm/ leg weakness concern for stroke // R/O lung infections as stroke mimic R/O lung infections as stroke mimic COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 5051de0a-74dd137b-348c3c44-8827fdec-8b45fcfe.jpg,validate/p18/p18704055/s54821905/5051de0a-74dd137b-348c3c44-8827fdec-8b45fcfe.jpg,validation," 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. " d76cc63c-52685a1a-3341e6ee-b0b8050b-83e65a5a.jpg,validate/p13/p13767558/s59526943/d76cc63c-52685a1a-3341e6ee-b0b8050b-83e65a5a.jpg,validation," WET READ: ___ ___ ___ 1:04 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with chest pain, chills // pneumonia? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___, and CT chest dated ___. FINDINGS: Patient is status post median sternotomy and CABG, with persistent fracture of the inferior most sternotomy wire. Re- demonstrated is left basilar atelectasis versus scarring. Cardiomediastinal and hilar contours are unchanged. No pleural effusion, consolidation, or pneumothorax. IMPRESSION: No pneumonia. " b0da2773-11581e53-215e5884-4d504f11-e4f16b02.jpg,validate/p11/p11899569/s59585108/b0da2773-11581e53-215e5884-4d504f11-e4f16b02.jpg,validation," FINAL REPORT INDICATION: ___ year old man fall, 10th rib fracture and PTX. Chest tube pulled at 11.___ pm ___. // Interval change, PTXPlease complete at 12.___ pm COMPARISON: Radiographs from ___. IMPRESSION: The right-sided chest tube has been removed. There remains a very tiny right apical pneumothorax. There is subcutaneous emphysema. Lungs are without focal consolidation, pleural effusions, or pulmonary edema. " 4f314f5b-6f8b7a08-a81e148b-a422dbd3-9267eac1.jpg,validate/p10/p10459488/s56461935/4f314f5b-6f8b7a08-a81e148b-a422dbd3-9267eac1.jpg,validation," FINAL REPORT INDICATION: History: ___F with epigastric pain // ?cause for chest pain TECHNIQUE: Upright PA and lateral chest COMPARISON: Chest radiographs ___ through ___ 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. " baec8f71-254c2302-d79fb8c9-50626a2c-55511042.jpg,validate/p11/p11730422/s50126133/baec8f71-254c2302-d79fb8c9-50626a2c-55511042.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p b/l CT removal // ptx/effusion ptx/effusion COMPARISON: ___ IMPRESSION: 2 left chest tubes have been discontinued. There is no interval increase in left loculated hydro pneumothorax. Parenchymal opacities have minimally improved in the interim. Cardiomediastinal silhouette is unchanged. Right PICC line tip is at the level of lower SVC. " 7d57812c-ad7f6b74-e2465208-9c01c59c-55de6f40.jpg,validate/p12/p12784119/s52395704/7d57812c-ad7f6b74-e2465208-9c01c59c-55de6f40.jpg,validation," FINAL REPORT INDICATION: Patient with history of HIV positive and asthma with cough for two days. COMPARISON: Multiple prior chest radiographs, most recent ___. 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: Unremarkable chest radiographic examination. " c6770fbc-e7aeaa82-197891eb-e3ea8e07-8ce32316.jpg,validate/p11/p11753181/s53993359/c6770fbc-e7aeaa82-197891eb-e3ea8e07-8ce32316.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough 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. " c154b276-3e9ecb31-b2fe9540-94554c09-d541d5fa.jpg,validate/p11/p11607628/s52246418/c154b276-3e9ecb31-b2fe9540-94554c09-d541d5fa.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: Pericardial effusion. ICD placement recently. IMPRESSION: PA and lateral chest compared to AP chest on ___ and prior PA and lateral ___: Pulmonary vascular congestion is mild, but persistent. Relative enlargement of the cardiac silhouette compared to ___ suggests some increase in moderate cardiomegaly and/or pericardial effusion. If there is pericardial effusion it is probably not hemodynamically significant but that determination would require echocardiography. Small right pleural effusion which increased between ___ and ___ is stable. A left pleural abnormality could be due to a combination of pleural thickening and small effusion, is unchanged since ___. Transvenous right ventricular pacer lead is unchanged in position, tip projecting over the floor of the right ventricle close to the anticipated location of the apex. No pneumothorax. " 7851aace-f423a3ca-0ae326dc-7e910ae8-46969525.jpg,validate/p14/p14244279/s52728762/7851aace-f423a3ca-0ae326dc-7e910ae8-46969525.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with history of HIV and RLL PNA, treated w/ levoflox, w/ crackles at R base // ?interval changes, RLL PNA TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___, ___. FINDINGS: Right lower lobe opacification is persistent and has consolidated medially. Moderate cardiomegaly is stable and the slight pulmonary edema present on previous examination has resolved. The mediastinal contours, heart borders, and bilateral hemidiaphragms are unchanged without evidence pleural effusion or pneumothorax. Cervical spinal fusion hardware is partially visualized. IMPRESSION: Persistent right lower lobe pneumonia. Follow up chest radiograph 6 weeks after completion of treatment is recommended to ensure resolution. RECOMMENDATION(S): Follow up chest radiograph 6 weeks after completion of treatment is recommended to ensure resolution of right lower lobe pneumonia. " 036bd1af-a7f862d0-6ef243c1-51d67e9d-caabe111.jpg,validate/p13/p13874942/s57194009/036bd1af-a7f862d0-6ef243c1-51d67e9d-caabe111.jpg,validation," WET READ: ___ ___ ___ 8:31 AM Right-sided HD catheter tip is in the right atrium. Small left pleural effusion. No pneumothorax. WET READ VERSION #___ ___ ___ 7:59 PM Right-sided HD catheter tip is in the right atrium. Small left pleural effusion. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumonia, now s/p tbbx on the left. // ptx ptx IMPRESSION: In comparison with the study of ___, there has been placement of a hemodialysis catheter that extends to the cavoatrial junction or right atrium. Otherwise, little change. Specifically, no evidence of pneumothorax. " 43149b05-6744c690-0e57e2da-e87a1146-7f6631fd.jpg,validate/p19/p19931382/s52309510/43149b05-6744c690-0e57e2da-e87a1146-7f6631fd.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient who is intubated for pneumonia. COMPARISON: ___. AP chest radiograph Right lower lobe consolidation appears to be unchanged and there is currently evidence of increased pleural effusion on the right. The ET tube tip is 4.2 cm above the carina. The right internal jugular line tip is at the level of low SVC. No other abnormality is demonstrated developing in the interim. The NG tube tip passes below the diaphragm terminating in the stomach. " df462d38-35ef2ef6-b99cbafa-105632d8-4b04215f.jpg,validate/p18/p18009858/s58904161/df462d38-35ef2ef6-b99cbafa-105632d8-4b04215f.jpg,validation," FINAL REPORT HISTORY: Esophagogastrectomy with chest tube removed. FINDINGS: In comparison with study of ___, the left chest tube has been removed, and there is no evidence of pneumothorax. Little change in the post-esophagogastrectomy appearance. " 40044c1a-abc39f47-557561ca-e1cee5a8-cd6322bb.jpg,validate/p18/p18614958/s55974097/40044c1a-abc39f47-557561ca-e1cee5a8-cd6322bb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with CP, SOB COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires and mediastinal clips are again noted. The heart remains mildly enlarged. No focal consolidation, large effusion or pneumothorax. No signs of pulmonary edema or pulmonary vascular congestion. Mediastinal contour is normal. Bony structures are intact. IMPRESSION: Stable mild cardiomegaly. Otherwise unremarkable. " bd1cfe8d-f54c9fa0-cb6588ba-3ee3ae0f-542fb597.jpg,validate/p12/p12618144/s50804051/bd1cfe8d-f54c9fa0-cb6588ba-3ee3ae0f-542fb597.jpg,validation," FINAL REPORT INDICATION: Worsening volume overload, 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. No focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax is detected. The pulmonary vasculature is within normal limits. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits. The trachea is midline. The visualized upper abdomen is unremarkable. A right first cervical rib is incidentally noted. IMPRESSION: No acute cardiopulmonary process. " 036feafc-2eb0ee37-2d24ae73-dd7e1ecb-5b9b2c09.jpg,validate/p14/p14550783/s50935967/036feafc-2eb0ee37-2d24ae73-dd7e1ecb-5b9b2c09.jpg,validation," FINAL REPORT INDICATION: Cough. COMPARISON: None. FINDINGS: AP and lateral chest radiographs. The lungs are clear. There is no pleural effusion or pneumothorax. Thoracic kyphosis is exaggerated with multilevel degenerative disc disease. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 088a5a04-d24d1b59-b3c1d02b-6c36902a-cd4e5df1.jpg,validate/p19/p19777911/s59277264/088a5a04-d24d1b59-b3c1d02b-6c36902a-cd4e5df1.jpg,validation," WET READ: ___ ___ ___ 12:52 AM Left PICC ends near superior cavoatrial junction. No acute cardiac or pulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: Line placement in febrile neutropenia. FINDINGS: In comparison with study of ___, the left subclavian PICC line again extends to the lower portion of the SVC. No evidence of acute pneumonia or vascular congestion or pleural effusion. " 145bdb12-cb9d4902-53d834ee-839d5e9e-44cfa2b3.jpg,validate/p11/p11947526/s55301767/145bdb12-cb9d4902-53d834ee-839d5e9e-44cfa2b3.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain, history of polysubstance abuse, evaluate for pneumonia or pneumothorax. COMPARISON: ___. FINDINGS: PA and lateral views of the chest demonstrate well-expanded and clear lungs. The heart is normal in size and cardiomediastinal contour is unremarkable. There is no pleural effusion and no pneumothorax. IMPRESSION: No acute intrathoracic abnormality. " 2738c691-5ae644f2-df556900-5596d9a1-36d1a2ee.jpg,validate/p10/p10106244/s51679331/2738c691-5ae644f2-df556900-5596d9a1-36d1a2ee.jpg,validation," FINAL REPORT HISTORY: ___F with dyspnea. COMPARISON: ___. FINDINGS: PA and lateral views of the chest were provided. Lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette appears normal. Imaged osseous structures are intact. No free air is seen below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " 972fc879-0b097782-fd92033f-78507ff5-21e1c4bf.jpg,validate/p11/p11958913/s54757008/972fc879-0b097782-fd92033f-78507ff5-21e1c4bf.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Follow up pneumonia. Comparison is made with prior study, ___. The aorta is tortuous. Mild cardiomegaly is stable. There has been complete resolution of prior left upper lobe pneumonia. There are no new lung abnormalities, pneumothorax, or pleural effusion. " 69be5046-149f2360-9a4703d6-6f3d0f52-c7d9f00c.jpg,validate/p18/p18573535/s52690620/69be5046-149f2360-9a4703d6-6f3d0f52-c7d9f00c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with possible op w/ortho // eval for pre-op TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: Compared with ___, there is increased opacity in the right middle ___, ___ represent atelectasis, however pneumonia cannot be excluded. There is platelike atelectasis in the left lower lung, similar to prior. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unchanged. Spinal hardware is again seen overlying the thoracic lumbar spine. Surgical ___ overlie the posterior soft tissue. IMPRESSION: Increased opacity in the right middle ___ compared with prior ___ represent atelectasis, however pneumonia cannot be excluded. " 8f15521c-64ad670f-4be60d68-a832acdf-d0970fd1.jpg,validate/p12/p12997220/s56199346/8f15521c-64ad670f-4be60d68-a832acdf-d0970fd1.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with increasing non-localized discomfort. COMPARISON: Multiple chest radiographs, the latest from ___ and a CT of the abdomen and pelvis from ___. TWO VIEWS OF THE CHEST: The lungs are low in volume and show a mild opacity in the right lower lobe which is unchanged since the CT from ___ and is associated with a moderate effusion. The cardiac silhouette is normal. The mediastinal silhouette is widened likely related to a tortuous aorta as evidenced on the CT from ___. A right-sided pacer terminates with its leads in the right atrium and right ventricle. There is mild bilateral glenohumeral joint space narrowing. Mitral annular calcifications. IMPRESSION: Right lower lobe atelectasis with moderate effusion, unchanged from ___. " 738aa86a-79ba39ce-3be6935a-1bde6cc8-05923d1e.jpg,validate/p11/p11632236/s53923136/738aa86a-79ba39ce-3be6935a-1bde6cc8-05923d1e.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pneumonia, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the very extensive left-sided and right basal parenchymal opacities are unchanged in severity and extent. No evidence of new parenchymal opacities. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices. " 9ca11986-0bf17921-909ab288-3cab6754-72ece3e5.jpg,validate/p16/p16877397/s55758381/9ca11986-0bf17921-909ab288-3cab6754-72ece3e5.jpg,validation," FINAL REPORT INDICATION: Chest pain and shortness of breath, beginning two weeks ago. Evaluate for CHF. COMPARISON: None. FINDINGS: There is mild prominence of the interstitial markings without overt pulmonary edema. There are small left and trace right pleural effusions. No pneumothorax. The heart is top normal in size. The mediastinal contours are normal. Aortic calcifications are noted. Mild degenerative changes of the thoracic spine are seen. IMPRESSION: 1. No overt evidence of pulmonary edema. 2. Small left and trace right pleural effusions. " fb24b322-8797e0e8-6de12aaf-4048a73c-c919facf.jpg,validate/p16/p16143265/s51379339/fb24b322-8797e0e8-6de12aaf-4048a73c-c919facf.jpg,validation," FINAL REPORT HISTORY: Respiratory distress with flash pulmonary edema, to assess for worsening pneumonia. FINDINGS: In comparison with the study of ___, the degree of interstitial edema appears to be improving. There are continued small bilateral pleural effusions with underlying compressive atelectasis. Increased opacification in the left mid and lower lung zones again suggests supervening lower lobe pneumonia. The left PICC line is no longer seen. " 8c8bc24c-26fb4afe-9040e2cb-45893ed6-3872116c.jpg,validate/p13/p13325402/s50739747/8c8bc24c-26fb4afe-9040e2cb-45893ed6-3872116c.jpg,validation," FINAL REPORT HISTORY: PICC placement. FINDINGS: In comparison with study of ___, the right IJ catheter has been removed and replaced with a PICC line that extends to the upper portion of the SVC. Continued prominence of the cardiac silhouette without definite atelectatic change or consolidation. " 58a8e772-28ebc944-c7a5f819-ef18d7b3-cc34d48c.jpg,validate/p13/p13565659/s53669619/58a8e772-28ebc944-c7a5f819-ef18d7b3-cc34d48c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with rib contusion vs fracture from MVA. Initial XR in ED was negative according to patient. Pain with breathing. // ___ year old woman with rib contusion vs fracture from MVA. Initial XR in ED was negative according to patient. Pain with breathing. ___ year old woman with rib contusion vs fracture from MVA. Initial XR in ED was negative according to patient. Pain with breathing. IMPRESSION: In comparison with study of ___, there is little interval change. Cardiac silhouette is within normal limits and there is moderate tortuosity of the descending aorta. No vascular congestion, pleural effusion, acute focal pneumonia, or pneumothorax. " c892056c-36750b0c-0f6b9ba0-306af13f-96aa7534.jpg,validate/p13/p13569749/s58217235/c892056c-36750b0c-0f6b9ba0-306af13f-96aa7534.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: COPD, difficulty extubating after surgery. Comparison is made with prior study, ___. Improved opacities in the lower lobes bilaterally could be difference in positioning of the patient with difference in distribution of pleural effusions and adjacent atelectasis. The upper lungs are grossly clear. Right IJ catheter tip is in the right atrium, can be withdrawal a couple of centimeters to be in the more standard position. NG tube tip is out of view below the diaphragm. ET tube is in standard position. " 71e03c6c-60bd6772-66399bb8-b831f96d-c92d7e1d.jpg,validate/p15/p15111021/s56321615/71e03c6c-60bd6772-66399bb8-b831f96d-c92d7e1d.jpg,validation," WET READ: ___ ___ ___ 9:01 AM NG tube with the tip in the stomach. Contrast is noted in nondilated loops of bowel. A tracheostomy tube is in satisfactory position. No acute cardiopulmonary process. WET READ VERSION #1 ___ ___ ___ 12:35 AM NG tube with the tip in the stomach. Contrast is noted in nondilated loops of bowel. A tracheostomy tube is in satisfactory position. No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NG tube // Evaluate position COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received a tracheostomy tube. The tube is in correct position. The right internal jugular vein catheter has been removed. The course of the nasogastric tube is normal, the tip projects over the middle parts of the stomach. Borderline size of the cardiac silhouette with elongation of the descending aorta. No pleural effusions. No pneumonia. " 0c911bfb-f97964e7-2f051ed9-3eb6d14e-9a0d8a2d.jpg,validate/p15/p15937283/s53717077/0c911bfb-f97964e7-2f051ed9-3eb6d14e-9a0d8a2d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with weakness, dehydration. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. CT abdomen pelvis ___. Chest CT ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lungs are well-expanded. A small focal opacity in the right lower lung is again noted, similar in location and appearance to that seen on the chest radiograph and CT from ___ but improved compared to chest CT from ___. No other focal opacities are present. A coronary stent is noted. IMPRESSION: Small focal right lower lung opacity, similar to that seen in ___, which may represent chronic scarring from prior infectious process. An acute infectious process is not excluded. " a6ecc82d-db4260b3-db25fed8-9ea1f04a-7adc4a12.jpg,validate/p17/p17822878/s50965550/a6ecc82d-db4260b3-db25fed8-9ea1f04a-7adc4a12.jpg,validation," FINAL REPORT INDICATION: ___F with chest pain radiating to back. Evaluate for etiology of chest pain. TECHNIQUE: Chest PA and lateral COMPARISON: Chest x-ray 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 acute cardiopulmonary process. " f2bd6b63-9e8d3373-5c79a496-1e3137ed-6ba989ea.jpg,validate/p14/p14316439/s55821866/f2bd6b63-9e8d3373-5c79a496-1e3137ed-6ba989ea.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with foreign body aspiration. Evaluate for presence of foreign body. COMPARISONS: None available. Please note that comparison to prior studies can be helpful to detect subtle interval change TECHNIQUE: Portable chest radiograph. FINDINGS: The lung volumes are low, accounting for some vascular crowding. There is fullness of the right cardiphrenic angle which may represent patchy atelectasis although aspiration and/or pneumonia cannot be excluded. Subtle increased opacity of the right upper lobe abutting the minor fissure may reflect aspiration. More focal nodularity in the right upper lobe contiguous to the ___ costochondral joint is felt to be due to a combination of patient's rotation and degenerative changes. The cardiomediastinal and hilar contours are unremarkable. Heart is likely upper limits of normal in size given portable technique. There is no radiopaque foreign object visible in the thorax. IMPRESSION: No evidence of radiopaque foreign object. Subtle opacity in the right cardiphrenic angle might represent atelectasis but consolidation cannot be excluded. Increased opacity in the right upper lobe could represent aspiration or early pneumonia. Follow up with PA and lateral chest radiographs is recommneded with an appropriate inspiratory effort. " 531561a6-22f6d742-c5530893-b1ccf97e-e7fb9c0b.jpg,validate/p12/p12462675/s59316852/531561a6-22f6d742-c5530893-b1ccf97e-e7fb9c0b.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Radiograph of one day earlier. FINDINGS: As compared to the recent radiograph, there has been little change in the appearance of the chest except for improved aeration at the lung bases in association with slightly greater lung volumes. " 6bf8f88c-80c06d64-26988050-8eb8664a-21e9af9f.jpg,validate/p11/p11296936/s59372823/6bf8f88c-80c06d64-26988050-8eb8664a-21e9af9f.jpg,validation," FINAL REPORT CLINICAL INDICATION: ___-year-old male with chest pain. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: Compared to most recent prior exam, there has been interval resolution of pulmonary edema. Linear density along the minor fissure may represent residual fluid or scarring. No pleural effusion or pneumothorax is seen. No focal consolidation is seen, although lateral evaluation is slightly limited due to low lung volumes. Heart size is enlarged. Mediastinal contours are within normal limits. A left-sided subclavian line is in similar position. IMPRESSION: Interval resolution of pulmonary edema with persistent borderline cardiomegaly. " 574815e6-b12652a8-d02fd107-d552f598-c97a8016.jpg,validate/p17/p17653729/s57496579/574815e6-b12652a8-d02fd107-d552f598-c97a8016.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated, vol overload, prior mucus plugging, now w decreased R BS, decreased vol on PS // please eval fr interval changes TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 7 hours earlier FINDINGS: Right lower lobe opacity has improved. Mild to moderate pulmonary edema has minimally improved. Bilateral effusions are unchanged allowing the difference in positioning of the patient. There are no other interval changes IMPRESSION: Improved right lower lobe opacity. " 7646ecf3-59e5ee5a-9b33c2f2-23678788-9feb115b.jpg,validate/p10/p10708404/s50562155/7646ecf3-59e5ee5a-9b33c2f2-23678788-9feb115b.jpg,validation," FINAL REPORT PORTABLE CHEST: ___. HISTORY: ___-year-old female with new right subclavian line, question position. COMPARISON: None. FINDINGS: Single portable view of the chest. Endotracheal tube is seen with tip approximately 3.5 cm from the carina. NG tube passes below the inferior field of view. Right subclavian line seen with tip at the RA-SVC junction. There is no visualized pneumothorax on these supine films. There is prominence of the upper mediastinum, which could be in part projectional and due to patient positioning. Clinical correlation regarding need for additional imaging suggested. The cardiac silhouette is within normal limits for technique. No acute osseous abnormality is detected. " 9d4db71b-ebd6c346-48b1f983-a7b5f23e-adbd394b.jpg,validate/p10/p10406570/s54722646/9d4db71b-ebd6c346-48b1f983-a7b5f23e-adbd394b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever POD___ s/p left total knee arthroplasty // please evaluate for pneumonia, atelectasis please evaluate for pneumonia, atelectasis IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Cardiac silhouette is at the upper limits of normal in size and there is no evidence of appreciable vascular congestion. Streaks of atelectasis are seen at both bases and there is blunting of the costophrenic angles. New no evidence of acute focal pneumonia. " 9b327438-4528781a-0ecf9cf1-98961ff4-596da244.jpg,validate/p17/p17051517/s58313393/9b327438-4528781a-0ecf9cf1-98961ff4-596da244.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Chest CT from ___ and chest radiograph from ___. CLINICAL HISTORY: Cough, left-sided lower rib pain, fever, assess pneumonia. FINDINGS: PA and lateral views of the chest were provided. There is retrocardiac opacity concerning for pneumonia. Right lung is clear. No effusion or pneumothorax seen. Cardiomediastinal silhouette stable. Bony structures intact. IMPRESSION: Findings concerning for left lower lobe pneumonia. " b2a60c1d-f26baf95-7b0517b6-1727a10f-40467087.jpg,validate/p10/p10729873/s56840381/b2a60c1d-f26baf95-7b0517b6-1727a10f-40467087.jpg,validation," FINAL REPORT INDICATION: Discitis and osteomyelitis, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: CT C-spine from ___. FINDINGS: Paucity of pulmonary markings in the right lung apex is compatible with severe bullous emphysema as seen on concurrent CT C-spine. Subtle opacity is present at the right lung base without definite correlate on the lateral view. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Subtle opacity at the right lung base may be further evaluated with routine oblique views. 2. Severe bullous emphysema at the right lung apex. " 340b5cb1-3c1cf7c3-de840e14-de13b067-baee1328.jpg,validate/p10/p10696480/s50481007/340b5cb1-3c1cf7c3-de840e14-de13b067-baee1328.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple stab wounds // left hemothorax COMPARISON: ___ IMPRESSION: As compared to the previous image, the left parenchymal opacities, documented on the CT examination from yesterday, are unchanged in extent and severity. Left retrocardiac atelectasis is also unchanged. No pneumothorax. The larger pleural effusion on the left, documented on the CT examination, is not evident on the plain film. " 8a84c458-95725a75-8ace4801-a2f36041-e01f3869.jpg,validate/p11/p11045789/s55316196/8a84c458-95725a75-8ace4801-a2f36041-e01f3869.jpg,validation," FINAL REPORT INDICATION: ___ year old man with hand and wrist pain and bilat arrm pain. Also exertional dyspnea. Hx of hypertension // r/o cardiopulmonary lesion TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary disease. " 762c6419-06e9722a-255fc1b4-1bf55585-e7813def.jpg,validate/p12/p12582857/s56334058/762c6419-06e9722a-255fc1b4-1bf55585-e7813def.jpg,validation," CLINICAL INFORMATION & QUESTIONS TO BE ANSWERED: ______________________________________________________________________________ FINAL REPORT PORTABLE CHEST, ___ COMPARISON: Chest x-ray of earlier the same date. FINDINGS: An obliquely positioned chest radiograph is submitted for interpretation and is centered on the right lung, excluding a majority of the left lung from the field of view. The radiograph is satisfactory for assessing the newly placed right internal jugular central venous catheter, which terminates in the lower superior vena cava, but it does not allow for comprehensive assessment of the chest. There is no visible pneumothorax. Repeat radiograph with standard positioning may be helpful if there is clinical concern for any issue other than line positioning. " 7b7e29ea-2ac18b77-1cc0d568-15b34261-571d9897.jpg,validate/p15/p15929830/s55481558/7b7e29ea-2ac18b77-1cc0d568-15b34261-571d9897.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman here with cholecystitis, now with rales and SBO // please evaluate for acute process TECHNIQUE: Single AP radiograph of the chest. COMPARISON: Chest CT from outside hospital dated ___. FINDINGS: A left pectoral pacemaker is visualized with leads in appropriate positioning. Mild-to-moderate pulmonary edema. Moderate-sized left pleural effusion with associated bibasilar atelectasis. Right basilar opacification may represent pleural fluid and atelectasis, however an underlying pneumonia is difficult to exclude. Stable enlargement of the cardiomediastinal silhouette. No pneumothorax. IMPRESSION: 1. Mild to moderate pulmonary edema. 2. Stable moderate left pleural effusion. 3. Right basilar opacification may represent pleural fluid and atelectasis, however an underlying pneumonia is difficult to exclude. 4. Stable enlargement of the cardio mediastinal silhouette. " 505ff97a-11feeeee-86585d86-af04d704-982722bb.jpg,validate/p13/p13306576/s53701617/505ff97a-11feeeee-86585d86-af04d704-982722bb.jpg,validation," FINAL REPORT INDICATION: Fever. TECHNIQUE: Single frontal radiograph of the chest. COMPARISON: Multiple prior examinations, most recent dated ___. FINDINGS: No focal consolidation to suggest pneumonia is seen. No pleural effusion, pneumothorax, or pulmonary edema is present. There is likely some atelectasis at the left base. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " 188685a4-5667255c-025a1233-d915be92-35f4dc50.jpg,validate/p16/p16014438/s56074091/188685a4-5667255c-025a1233-d915be92-35f4dc50.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with h/o DM presenting with cough with some blood tinged sputum. // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: Lung volumes are low. Subtle, increased density in the right middle lobe appears increased from the prior examination, and may reflect aspiration versus developing pneumonia. There is no pleural effusion, pneumothorax, or pulmonary edema. The heart is mildly enlarged. IMPRESSION: Low lung volumes with right middle lobe airspace consolidation which appears new from the prior examination, worrisome for aspiration versus developing pneumonia. " ff3621ae-e3c908f1-1d9cca99-4db040fc-bb0b1cd0.jpg,validate/p12/p12089662/s55624908/ff3621ae-e3c908f1-1d9cca99-4db040fc-bb0b1cd0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ET tube // confirm ET tube confirm ET tube IMPRESSION: In comparison with the earlier study of this date, the endotracheal tube remains in good position about 4 cm above the carina. The right IJ catheter and nasogastric tube are essentially unchanged. The pulmonary vascularity is now essentially within normal limits and no acute pneumonia is identified. " a695e264-f2136717-3549e8ff-603e3f56-78f012d5.jpg,validate/p16/p16019229/s51208625/a695e264-f2136717-3549e8ff-603e3f56-78f012d5.jpg,validation," FINAL REPORT INDICATION: ___-year-old male patient with prior effusion and new shortness of breath. COMPARISON: Prior chest radiograph from ___ and abdominal CT from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: The cardiomediastinal silhouette is stable. Lungs are well expanded and clear. No focal consolidations concerning for pneumonia are identified. There are small bilateral pleural effusions. There is no pneumothorax. On the lateral view, there is opacification of an extrapleural mass. This finding was not identified on prior CT examination and could well be an artifact of overlying structures. Remaining osseous structures are intact. IMPRESSION: Small bilateral pleural effusions. " cdc02b11-6e676224-4f498499-efb7d4bc-d324759f.jpg,validate/p11/p11230772/s54710816/cdc02b11-6e676224-4f498499-efb7d4bc-d324759f.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with poorly controlled diabetes presenting with left-sided body pain and night sweats. Evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained. COMPARISON: Chest radiographs from ___, ___, and ___ and chest CTA 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. " dddd44dd-8c72c830-44cbd4b9-7dd1f755-52f4a557.jpg,validate/p11/p11700849/s51258474/dddd44dd-8c72c830-44cbd4b9-7dd1f755-52f4a557.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o COPD w/ SOB and productive cough // Please evaluate for PNA COMPARISON: ___ FINDINGS: A new area of segmental consolidation has developed in the anterior medial segment of the left lower lobe, and is best visualized on the lateral view. As well as a linear area of atelectasis in the lingula. Lungs are otherwise clear, and cardiomediastinal contours are stable. No definite pleural effusion or pneumothorax. IMPRESSION: Left lower lobe opacity is concerning for focal pneumonia in the setting of infectious symptoms. Followup radiographs are recommended in ___ weeks after completion of antibiotic therapy to document resolution. " 0de243b7-3495de00-e5a12532-72ec25d4-2befb335.jpg,validate/p18/p18186439/s53139084/0de243b7-3495de00-e5a12532-72ec25d4-2befb335.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with new pacemaker placement // evaluate leads TECHNIQUE: Chest PA and lateral FINDINGS: As compared to chest radiograph from 1 day prior, the dual lead pacemaker with the tips in the right atrium and right ventricle. Mild pulmonary edema has resolved. Mild cardiomegaly. Small right and moderate left pleural effusion. No pneumothorax. IMPRESSION: Dual lead pacer with the tips in good position. Improved pulmonary edema. " 9a2183b4-4fda1af6-3f0c5a30-05c2f3ab-b88dbc72.jpg,validate/p13/p13210259/s59528993/9a2183b4-4fda1af6-3f0c5a30-05c2f3ab-b88dbc72.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with CAD, CHF, CVA with acute anemia // Rule out bleed, or pnuemonia Rule out bleed, or pnuemonia IMPRESSION: In comparison with the study of ___, there is continued apical pleural thickening with a dual-channel pacer in place but no evidence of cardiomegaly or vascular congestion. Some increasing opacification at the left base is consistent with atelectasis and pleural fluid. " 5e8845ab-e594d0cb-90b2b711-78b4090d-ab7db01b.jpg,validate/p16/p16635089/s51941941/5e8845ab-e594d0cb-90b2b711-78b4090d-ab7db01b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new fever after discontinuation of abx // evaluate for infiltrate evaluate for infiltrate IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains within overall normal limits in size. Diffuse bilateral pulmonary opacifications are less prominent. This could reflect progressive clearing of the widespread pneumonia for which antibiotic therapy was instituted, though it may represent some element of pulmonary vascular congestion. The large bore catheter is unchanged. There has been placement of a smaller right IJ catheter that extends to the mid to lower portion of the SVC. " 9e40418b-cf5c48cc-88d733dc-db666e3b-09f46e67.jpg,validate/p15/p15534164/s51091753/9e40418b-cf5c48cc-88d733dc-db666e3b-09f46e67.jpg,validation," FINAL REPORT INDICATION: ___ year old man with multiple myeloma // intermittently worsening hypoxia and new crackles on RUL, please re-evaluate TECHNIQUE: AP portable chest radiograph COMPARISON: ___ and CT chest dated ___ FINDINGS: Unchanged elevation of the left hemidiaphragm with mildly increased overlying atelectasis and possible trace left pleural effusion. No pneumothorax identified. Mildly increased pulmonary vascular congestion. The size and appearance of the cardiac silhouette is unchanged. IMPRESSION: Slight interval increase in the left lower lung zone atelectasis. New mild pulmonary vascular congestion. " b2071002-08edd423-b7aba845-437de90c-f7bf9b8f.jpg,validate/p17/p17288913/s57820926/b2071002-08edd423-b7aba845-437de90c-f7bf9b8f.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Bilateral swelling. Question edema. COMPARISON: ___. TECHNIQUE: Chest, AP upright and lateral views. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is probably a small pleural effusion on the right and it is difficult to exclude a small subpulmonic effusion on the right side. The interstitium is prominent suggesting mild pulmonary edema, but there is no focal opacification. There is no pneumothorax. IMPRESSION: Findings suggest mild pulmonary edema. " 87e4d868-60ea55b1-e29c6603-85237688-1e2014f4.jpg,validate/p15/p15504063/s57077238/87e4d868-60ea55b1-e29c6603-85237688-1e2014f4.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with acute onset epigastric pain. Evaluation for free air. COMPARISON: None available. FINDINGS: Single upright portable view of the chest demonstrates relatively low lung volumes, with moderate cardiomegaly. Otherwise, the cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax, or focal airspace consolidation. No subdiaphragmatic free air is detected. IMPRESSION: Moderate cardiomegaly and low lung volumes. No subdiaphragmatic free air. " 5c41a6b4-64d444eb-790cdcac-2cb4229c-837138ad.jpg,validate/p13/p13999026/s55126254/5c41a6b4-64d444eb-790cdcac-2cb4229c-837138ad.jpg,validation," 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. . " ffcae32f-a721560f-be4b4145-9db5a85b-6a597835.jpg,validate/p17/p17267132/s56382237/ffcae32f-a721560f-be4b4145-9db5a85b-6a597835.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with SLCL and bronchial arterial bleed s/p embolization, now with sinus tachycardia unresponsive to fluids // PNA vs hemothorax TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. Right PICC and right port a cath tip are in the cavoatrial junction IMPRESSION: No acute cardiopulmonary abnormality or pneumothorax " bac81ba3-2516d764-ab0cb0b4-57f359ce-4a77f424.jpg,validate/p14/p14520814/s57687386/bac81ba3-2516d764-ab0cb0b4-57f359ce-4a77f424.jpg,validation," FINAL REPORT CLINICAL HISTORY: Chest tube removed, evaluate for pneumothorax. CHEST AP The left chest tube present on the prior x-ray has been removed. There is no pneumothorax present. Lung volumes remain low. There is evidence of pulmonary plethora suggesting a degree of failure is still present. IMPRESSION: Chest tube removed. No pneumothorax. " c0f09085-246fdee9-571d4688-2450db13-fb67b641.jpg,validate/p11/p11805011/s59624830/c0f09085-246fdee9-571d4688-2450db13-fb67b641.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dizziness, diplopia // eval for pna eval for pna IMPRESSION: In comparison with the study of ___, there again is mild enlargement of the cardiac silhouette with tortuosity of the aorta. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " 51384b1b-c5009d4c-c78c66cf-2e46a9fd-c0b2231f.jpg,validate/p17/p17473327/s54896078/51384b1b-c5009d4c-c78c66cf-2e46a9fd-c0b2231f.jpg,validation," FINAL REPORT INDICATION: Preoperative assessment before right lower extremity debridement. COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal contours are normal. Slight increased soft tissue nodularity superior to the left hilus is present. There is no pleural effusion or pneumothorax. The lungs are well expanded and clear. IMPRESSION: Increased nodularity superior to the left hilus. Shallow oblique views recommended for further evaluation. " 3afa1b71-5ebf09bb-8748f2f7-ced89854-dd12cf3f.jpg,validate/p13/p13590729/s59405396/3afa1b71-5ebf09bb-8748f2f7-ced89854-dd12cf3f.jpg,validation," FINAL REPORT HISTORY: Chest tube removal. FINDINGS: In comparison with the study of ___, there is little overall change. No evidence of pneumothorax. Continued bilateral pleural effusions. Wedging of dorsal vertebral bodies again seen, as well as several rib fractures. " b19ad8b1-77d8da80-817ee588-52c95ac7-499e0366.jpg,validate/p11/p11283326/s52140736/b19ad8b1-77d8da80-817ee588-52c95ac7-499e0366.jpg,validation," 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. " 572a3a1a-04167bad-656a0790-72d7d94c-6138230d.jpg,validate/p18/p18995100/s57897996/572a3a1a-04167bad-656a0790-72d7d94c-6138230d.jpg,validation," 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. " a12e9a58-263edbb7-1b524712-2a04d06f-5278cea8.jpg,validate/p16/p16244108/s55708443/a12e9a58-263edbb7-1b524712-2a04d06f-5278cea8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with bronchiectasis, change in sputum, shortness of breath. // ? infiltrate. 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 in the left anterior chest wall are again noted IMPRESSION: No acute cardiopulmonary abnormalities " 060b4cfd-412589ac-fed9a2a8-c40a7c4f-e086d67b.jpg,validate/p11/p11355690/s58830530/060b4cfd-412589ac-fed9a2a8-c40a7c4f-e086d67b.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with recent placement of a deep brain stimulator, extension wires placed yesterday, presents with chest pain and fever, question pneumonia. COMPARISON: None. FINDINGS: AP upright frontal and lateral views of the chest were provided. DBS implants are noted in the right and left chest wall anteriorly. Lungs are clear without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette appears normal. The imaged osseous structures appear intact. IMPRESSION: No evidence of pneumonia. " 09ec79f6-a3d9bcc5-218c1354-8d4bb7b6-8a017a3e.jpg,validate/p17/p17469724/s57172376/09ec79f6-a3d9bcc5-218c1354-8d4bb7b6-8a017a3e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with right-sided chest pain. 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. No definitive abnormality within the rib cage demonstrated. IMPRESSION: No abnormalities seen within the limitations of this study technique. " a68d02f2-a7f1840f-559e3c07-fea093c7-524f0ba4.jpg,validate/p16/p16233333/s58175417/a68d02f2-a7f1840f-559e3c07-fea093c7-524f0ba4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with ETOH abuse, cough // eval for pneumonia COMPARISON: ___. FINDINGS: Upright AP and lateral views of the chest provided. Lung volumes are somewhat low with minimal basilar atelectasis. No convincing evidence for pneumonia or edema. No large effusion or pneumothorax. The cardiomediastinal silhouette is unchanged. Bony structures are intact. IMPRESSION: Mild basilar atelectasis, no convincing evidence for pneumonia. " 7893e2e3-c8622c11-270ed86a-2ddf9132-cb9fd42c.jpg,validate/p10/p10461044/s52208937/7893e2e3-c8622c11-270ed86a-2ddf9132-cb9fd42c.jpg,validation," FINAL REPORT AP CHEST 11:36 A.M. ___ HISTORY: Pre-op emergency CABG. IMPRESSION: AP chest compared to ___: Lungs clear. Heart size normal. No pulmonary edema. No pleural effusion or pneumothorax. " a3333f9e-26188482-440ef0e7-e680209c-a0daca49.jpg,validate/p13/p13451992/s58387438/a3333f9e-26188482-440ef0e7-e680209c-a0daca49.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PAH with refractory hypoxemia // Eval for interval change Eval for interval change IMPRESSION: Comparison to ___. Decrease in extent and severity of the pre-existing predominantly interstitial pulmonary edema. The edema is now mild in severity. Partial left lower lobe atelectasis. . No larger pleural effusions. Borderline size of the cardiac silhouette. No evidence of pneumonia. " ad9d3c0e-3cc2dc64-25c09c02-a725f001-a01edf8f.jpg,validate/p18/p18458646/s53749362/ad9d3c0e-3cc2dc64-25c09c02-a725f001-a01edf8f.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with history of chronic lymphocytic leukemia and prior history of interstitial pneumonitis. Has now chest pressure and dyspnea, evaluate further. 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 and thus stable. The same holds for the thoracic aorta, which is mildly widened and elongated, but without local contour abnormalities. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses remain free. No pneumothorax in the apical area. Skeletal structures with mild pectus excavatum deformity and slightly accentuated kyphotic curvature in the thoracic spine also unchanged. IMPRESSION: Stable chest findings. No evidence of acute cardiovascular changes such as CHF, pleural effusion or pneumothorax. No new infiltrates. " 1bc494ff-2b1ef365-b839d932-970be714-f6c15fd0.jpg,validate/p11/p11209386/s52326237/1bc494ff-2b1ef365-b839d932-970be714-f6c15fd0.jpg,validation," 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 significant effusion nor pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. Lower cervical anterior fixation hardware is new since prior. IMPRESSION: No acute cardiopulmonary process. " 2d4d3dbb-39cdc11d-01294bd2-8a3904df-30e4ac9a.jpg,validate/p16/p16662264/s56951123/2d4d3dbb-39cdc11d-01294bd2-8a3904df-30e4ac9a.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Pleuritic chest pain. COMPARISON: ___ as well as ___ and ___. FINDINGS: Frontal and lateral views of the chest were obtained. There remains small residual consolidation in the lingula, which continues to decrease in size as compared to the prior studies. No definite focal consolidation is seen on the right. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: Lingular consolidation persists but continues to decrease in size as compared to the prior study. " 116b8d63-cace37f7-32c037d6-11776a66-cad0d91c.jpg,validate/p13/p13623501/s53757984/116b8d63-cace37f7-32c037d6-11776a66-cad0d91c.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough, fever and crackles. COMPARISONS: ___. TECHNIQUE: Chest, four views. FINDINGS: A Port-A-Cath terminates at the cavoatrial junction. The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The chest is hyperinflated. There is a new patchy posterior left lower lobe opacity, highly nonspecific. There is no definite pleural effusion or pneumothorax. Moderate anterior osteophytes are present along the mid to lower thoracic spine. The bones are probably demineralized to some degree. Cholecystectomy clips project over the right upper quadrant. IMPRESSION: New focal left lower lobe opacity; although morphological characteristics are somewhat suggestive of atelectasis, pneumonia could also be considered. " b6e39d26-b48a8b18-fe92b7c6-7c735481-3ffe2860.jpg,validate/p16/p16258153/s58616486/b6e39d26-b48a8b18-fe92b7c6-7c735481-3ffe2860.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p MVR/CABG // eval postop changes COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, all monitoring and support devices were removed. Moderate cardiomegaly persists. Mild retrocardiac atelectasis. No larger pleural effusions. No pneumonia, no pulmonary edema. " 0858b8a1-72adad43-c2e6aeec-d8be949a-96b59be9.jpg,validate/p17/p17527219/s56078337/0858b8a1-72adad43-c2e6aeec-d8be949a-96b59be9.jpg,validation," FINAL REPORT INDICATION: ___ year old man with CHF on tailored therapy // interval change COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: There is decrease in the CHF as compared to the prior study. Right Swan-Ganz catheter is present with the tip in the proximal right pulmonary artery. PICC line tip is in the S VC right atrial junction. There is no pneumothorax or new consolidation. There is scarring or linear atelectasis in the left base. " d443e030-76777471-42e62869-50bb79aa-039740ea.jpg,validate/p13/p13658228/s59587651/d443e030-76777471-42e62869-50bb79aa-039740ea.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough/sob/decr basilar bs // r/o basilar pna TECHNIQUE: PA and lateral views of the chest provided. COMPARISON: Chest radiograph dated ___. FINDINGS: Lungs are fully expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are normal. Heart size is normal. IMPRESSION: No evidence of pneumonia. " cf1a595a-9f448b73-577fac1a-80a6a9b5-bf2ad02b.jpg,validate/p19/p19336651/s52427288/cf1a595a-9f448b73-577fac1a-80a6a9b5-bf2ad02b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pleurX that became disconnected c/f air entrainment. // assess for PTX assess for PTX COMPARISON: Chest radiographs ___ through ___. IMPRESSION: No pneumothorax or change in the appearance of probable small residual right pleural effusion 05:00 today. PleurX catheter unchanged in intrathoracic course. Moderate left pleural effusion stable. Heart is top-normal size but pulmonary vasculature is engorged and some of the diffuse interstitial abnormality is probably acute edema. Nevertheless the remainder of the Severe infiltrative pulmonary abnormality and particularly right upper lobe consolidation are long-standing and raise the question of pulmonary drug toxicity. " b05bf312-df7c6ccf-64b2c51a-a0a85a4b-ce735ce9.jpg,validate/p10/p10532853/s52999640/b05bf312-df7c6ccf-64b2c51a-a0a85a4b-ce735ce9.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with cirrhosis, bilateral PE and exudative effusion // eval pulm effusion, chest tubes; please do in am for ct surg to eval TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, the previously seen right-sided inferior lateral hydropneumothorax is smaller than previous, and again contains an air-fluid level. Again seen is a small left pleural effusion. A right lower chest tube is unchanged in position. There is no new focal consolidation. The cardiac and mediastinal silhouettes are unchanged. IMPRESSION: Decrease in size in right-sided hydro pneumothorax. " f9191011-a9d87ee6-f9ca0b33-f97a5df2-d8a80364.jpg,validate/p10/p10800175/s51354583/f9191011-a9d87ee6-f9ca0b33-f97a5df2-d8a80364.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD and acute respiratory failure. // interval change pulmonary edema interval change pulmonary edema IMPRESSION: In comparison with the study ___ ___, there is little change. Pulmonary vascularity is now essentially within normal limits. The left infrahilar mass seen on CT is better visualized on the current study. No evidence of acute focal pneumonia. " 0ac1cea2-4365d001-575ec476-155684f3-b3e5c410.jpg,validate/p13/p13748151/s55108337/0ac1cea2-4365d001-575ec476-155684f3-b3e5c410.jpg,validation," FINAL REPORT HISTORY: Lethargy, confusion. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The patient is status post median sternotomy, CABG, and aortic and mitral valve replacement. Heart size is normal. Mediastinal and hilar contours are unremarkable. Atherosclerotic calcifications are seen throughout the aorta. The pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 444be683-06f2efb3-1f124004-458f2adf-ba5065a4.jpg,validate/p12/p12405184/s55950886/444be683-06f2efb3-1f124004-458f2adf-ba5065a4.jpg,validation," FINAL REPORT INDICATION: ___M with ?nipple shadow vs lung nodule. COMPARISON: Chest radiograph from same day. TECHNIQUE Portable view of the chest. FINDINGS: Nodular opacity projecting over the right lung base was likely due to a nipple shadow. Cardiomediastinal silhouette unchanged. There is no focal lung consolidation. There is no pneumothorax or pleural effusion. IMPRESSION: Nodular opacity on recent chest radiograph corresponds to nipple shadow. " a2b6f177-d3e64e26-2ae9c11b-cb8c9880-9446d2f7.jpg,validate/p14/p14388050/s54292001/a2b6f177-d3e64e26-2ae9c11b-cb8c9880-9446d2f7.jpg,validation," FINAL REPORT HISTORY: Fever. Rule out pneumonia, effusion. COMPARISON: Prior chest radiograph from the ___ and ___. FINDINGS: The cardiomediastinal and hilar contours are stable, with mild cardiomegaly. There is calcification of the aortic knob. There is redemonstration of a small left-sided pleural effusion. A small right-sided pleural effusion is also seen. Opacity in the right lung base appears more prominent since ___ and is concerning for an infectious process. Left basilar opacity is also unchanged and likely reflective of atelectasis. No pneumothorax is seen. There is prominence of the pulmonary vasculature. A large bore central venous catheter with the tip in the right atrium is again seen. IMPRESSION: 1. Increased opacity at the right lung base which could is concerning for an infectious process. 2. Small bilateral pleural effusions, not significantly changed since prior examination with mild interstitial pulmonary edema. " 3f9d0bfd-4c93f441-f65a6555-94ad5f2b-0d7cf5c7.jpg,validate/p16/p16257001/s50593046/3f9d0bfd-4c93f441-f65a6555-94ad5f2b-0d7cf5c7.jpg,validation," FINAL REPORT AP CHEST 4:59 A.M. ON ___ HISTORY: ___-year-old man with subarachnoid hemorrhage. Is there any pulmonary pathology. IMPRESSION: AP chest compared to ___: Mild pulmonary vascular congestion persists but there is no pulmonary edema and no consolidation to suggest pneumonia. Heart size top normal, unchanged. Tip of the endotracheal tube at the sternal notch, is no less than 7.5 cm from the carina and could be advanced 3 cm for more secured seating. No pneumothorax or appreciable pleural effusion is present. " c7fcd179-887140e4-a9fec80c-0cc50c08-79ccafbf.jpg,validate/p12/p12764457/s56826162/c7fcd179-887140e4-a9fec80c-0cc50c08-79ccafbf.jpg,validation," FINAL REPORT HISTORY: History of lymphoma. Pleuritic chest pain, swelling, and fever. COMPARISON: Chest radiograph, ___ and CT torso, ___. FINDINGS: PA and lateral chest radiographs demonstrate clear lungs. There is no pleural effusion or pneumothorax. The cardiac, hilar, and mediastinal contours are normal. The heart size is normal. IMPRESSION: No acute cardiopulmonary process. " 63e5c94c-5be82bbe-af2340b0-9aff066f-b37193c7.jpg,validate/p15/p15406041/s51714935/63e5c94c-5be82bbe-af2340b0-9aff066f-b37193c7.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: An ___-year-old man with bronchiectasis, pulmonary fibrosis and shortness of breath. IMPRESSION: PA and lateral chest compared to ___: Moderately severe pulmonary fibrosis has progressed since ___. There is no good evidence for active edema or pneumonia. Mild cardiomegaly is stable. There is no appreciable pleural effusion. Elevation of right hemidiaphragm is longstanding. " d2a2945b-d8041fb7-26d2be67-5a1c5554-94a8bfc0.jpg,validate/p10/p10899387/s58990275/d2a2945b-d8041fb7-26d2be67-5a1c5554-94a8bfc0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, hepatopulm // eval for pna eval for pna IMPRESSION: Left PICC line tip is at the level of mid SVC. Heart size and mediastinum are stable. Right lower lobe opacities concerning for pneumonia, new as compared to ___. It might potentially represent asymmetric edema but substantially less likely. No appreciable pleural effusion demonstrated. " b4428739-5efc78bc-d3648e18-7cf1e1e5-bd867a42.jpg,validate/p18/p18232489/s52573875/b4428739-5efc78bc-d3648e18-7cf1e1e5-bd867a42.jpg,validation," WET READ: ___ ___ ___ 8:14 PM Right PICC terminates at the mid SVC. Left subclavian line terminates in the mid SVC. Lungs are clear. No pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: DX CHEST PORTABLE PICC LINE PLACEMENT INDICATION: ___ year old woman with picc placed at last admission. Assess placement // picc placement picc placement COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Right PIC line ends in the mid SVC, as before, alongside the indwelling left subclavian central venous infusion port. Lungs clear. Heart size top-normal. No pleural abnormality " b3061a21-3663603b-ee5d7727-afb661d9-a4011665.jpg,validate/p18/p18539425/s51089419/b3061a21-3663603b-ee5d7727-afb661d9-a4011665.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest, PA and lateral. INDICATION: ___-year-old male patient who received allograft bone marrow transplant for MDS this past ___ with thrush, failure to thrive, recent rhinorrhea, wanting to rule out infection as source of failure to thrive. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding chest examination of ___. The heart size remains within normal limits. No configurational abnormality is identified. Thoracic aorta is mildly widened and elongated but does not show any local contour abnormalities. 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. Mild degree of degenerative changes in the thoracic spine but no evidence of vertebral body compression fracture. In comparison with the next preceding chest examinations, no new pulmonary abnormalities are seen, but a previously existing right-sided PICC line has been removed. IMPRESSION: No significant cardiovascular or pulmonary abnormalities on PA and lateral chest examination. " bc6d9534-396fa394-9f0a865b-64c98100-4341f2d0.jpg,validate/p12/p12668116/s52112405/bc6d9534-396fa394-9f0a865b-64c98100-4341f2d0.jpg,validation," FINAL REPORT HISTORY: Metastatic lung cancer and worsening shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. Chest CTA ___. FINDINGS: Re- demonstrated is extensive nodular pleural thickening involving the right lung compatible with metastatic pleural disease. Persistent opacification within the right lung base appears to represent a combination of right basilar atelectasis and small right effusion with known pleural deposits. Overall, compared to the prior chest radiograph, disease within the right lung appears to have progressed, but appears unchanged compared to the most recent chest CTA allowing for differences in technique. Multiple nodules within the left lung have also increased in size and number compared to the prior chest radiograph. Small left pleural effusion is new compared to the prior chest radiograph but was seen on the prior chest CT. The cardiac, mediastinal and hilar contours appear relatively unchanged. No pneumothorax. No acute osseous lesion is definitively noted. IMPRESSION: Compared to the prior chest radiograph, there has been interval progression of disease with increased size and number of pulmonary nodules, and worsening metastatic disease within the right hemithorax. Small left pleural effusion. Persistent right basilar opacification reflecting a combination of pleural effusion, right basilar atelectasis, and pleural based disease. " 2cdeea01-f247b008-52ef7bdf-9dece698-92403b8c.jpg,validate/p11/p11581370/s55561210/2cdeea01-f247b008-52ef7bdf-9dece698-92403b8c.jpg,validation," FINAL REPORT HISTORY: Atrial fibrillation. TECHNIQUE: PA and lateral chest radiograph 2 views. COMPARISON: None available. FINDINGS: Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax. The osseous structures are grossly unremarkable. IMPRESSION: No acute intrathoracic process. " 85dbe016-8bd01cbf-c56b68e5-9e9baadc-47844921.jpg,validate/p18/p18674922/s51649245/85dbe016-8bd01cbf-c56b68e5-9e9baadc-47844921.jpg,validation," 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 ___. " 930b935a-3c00642d-5df422d6-7e54f82e-7f9262f0.jpg,validate/p16/p16247826/s56942601/930b935a-3c00642d-5df422d6-7e54f82e-7f9262f0.jpg,validation," WET READ: ___ ___ ___ 11:59 AM Bibasilar atelectasis. No infiltrate or pleural effusion. No pulmonary edema. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: Left MCA, aspiration pneumonia. Eval for plug, PNA et al. cause of subacute respiratory (?ventilatory) decompensation this evening. SaO2 stable, but pt tachypneic with minimal BS on the left --> wheezes --> resolving with nebs (had been stable / improving x 3d on abx for PNA) COMPARISON: Chest radiograph on ___ and CT chest on ___. FINDINGS: Semi-erect portable AP view of the chest. There is a slightly deeper inspiratory effort compared to prior study. Bibasilar atelectasis has slightly improved. No infiltrate. No pleural effusion. A semicircular density overlying the cardiac shadow is consistent with mitral valve calcifications. There is no pulmonary edema. An NG tube is seen with its tip in the stomach and last side port adjacent to but below the GE junction. IMPRESSION: 1. Improvement in bibasilar atelectasis. 2. No infiltrate or pulmonary edema. 3. Mitral valve annular calcifications. " 5d6fe80a-e4cfe44e-ebfb4973-9c6cb46f-cbf9538b.jpg,validate/p14/p14614404/s52801857/5d6fe80a-e4cfe44e-ebfb4973-9c6cb46f-cbf9538b.jpg,validation," WET READ: ___ ___ ___ 7:05 PM Left pleural drains terminate in the left lung apex and deep in the posterior left costophrenic angle. Previously seen left pleural effusion has significantly decreased with residual left base atelectasis. No pneumothorax. There is slight blunting of the right costophrenic angle, but the right lung is otherwise clear. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male status post left VATS decortication. COMPARISON: Chest radiograph dated ___. FINDINGS: Portable chest radiograph demonstrates two pleural drains terminating in the left apex and posterior left costophrenic angle. There is no pneumothorax. There is a persistent left pleural effusion which appears significantly decreased. Bibasilar atelectasis persists. The right lung is grossly clear. The stomach is moderately distended. Heart size appears normal. IMPRESSION: No pneumothorax. " cb02b2d4-cddc0bfc-60143069-1a072680-fb6b28d0.jpg,validate/p11/p11235666/s56529478/cb02b2d4-cddc0bfc-60143069-1a072680-fb6b28d0.jpg,validation," FINAL REPORT HISTORY: Chest pain. COMPARISON: Comparison made with chest radiographs from ___. FINDINGS: PA and lateral images of the chest. A pacer is seen overlying the left anterior chest with intact leads in appropriate position. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " be81fa5e-085e28a7-3ec37d30-e7654841-c758c049.jpg,validate/p10/p10116621/s50558411/be81fa5e-085e28a7-3ec37d30-e7654841-c758c049.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // eval for pna or chf COMPARISON: Chest x-ray from ___ FINDINGS: Mild hyperinflation raising the question of background COPD. Heart size at the upper limits of normal with left ventricular configuration. There is upper zone redistribution, but no overt CHF. No focal infiltrate or effusion is detected. Possible fullness of the right hilum on the frontal view is slightly more pronounced than on the ___ radiograph, but is not confirmed on the lateral view. Mild degenerative changes of the thoracic spine are noted, similar to the prior film. IMPRESSION: 1. Upper zone redistribution, without overt CHF, unchanged. 2. No focal infiltrate or consolidation. " 4f0479a8-03185ce7-14b86109-fce527ce-37acea35.jpg,validate/p17/p17470135/s53934868/4f0479a8-03185ce7-14b86109-fce527ce-37acea35.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with new dual chamber PPM // assess lead position assess lead position IMPRESSION: Comparison to ___. The patient has received a left pectoral Port-A-Cath. 1 lead projects over the right atrium and 1 over the right ventricle. Moderate cardiomegaly but no evidence of pneumothorax. Status post CABG. No pulmonary edema. " 7f8228bd-3d49fb88-a6b52a2a-f5517a88-6bcf98bf.jpg,validate/p15/p15813164/s54196865/7f8228bd-3d49fb88-a6b52a2a-f5517a88-6bcf98bf.jpg,validation," FINAL REPORT STUDY: AP chest, ___. HISTORY: ___-year-old man with aortic valve replacement and acute hypoxia. Evaluate for pneumonia. FINDINGS: Comparison is made to prior study from ___. There is again seen increased some densities of both lungs, suggestive of pulmonary edema. However, this is improved since the prior study. Findings are more confluent at the bases. There is normal cardiac size and mediastinal wires. There are no pneumothoraces or pleural effusions. Calcified granuloma at the left lung base is again seen. " ae3ec694-fc355f64-a116ee57-0cc945ba-9cc64bc9.jpg,validate/p13/p13372482/s53271413/ae3ec694-fc355f64-a116ee57-0cc945ba-9cc64bc9.jpg,validation," FINAL REPORT CLINICAL HISTORY: Increasing O2 requirements postop, evaluate for pneumonia. CHEST AP Cardiac size within normal limits. Multiple areas of atelectasis are seen. Some mild blunting of both costophrenic angles is likely present. No evidence of failure or pneumonia is identified. IMPRESSION: Atelectasis, no pneumonia. " 85bbf0e2-62e724ec-a3f0bd5d-cd3dac16-de7d8b41.jpg,validate/p19/p19858494/s53311867/85bbf0e2-62e724ec-a3f0bd5d-cd3dac16-de7d8b41.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with hemorrhagic pancreatitis, respiratory failure. COMPARISON: ___. CHEST, AP: Again seen is a right subclavian catheter with tip in the deep right atrium. Small left pleural effusion persists. No significant pneumothorax. Overall low lung volumes, with increased left perihilar and persistent left lower lobe opacities. Right lung is clear. Heart size is normal. IMPRESSION: Increased left lung opacities, likely atelectasis. " d758da9f-c17e7001-43fa8c3f-3c77e3b1-b8d633e9.jpg,validate/p14/p14068639/s51687583/d758da9f-c17e7001-43fa8c3f-3c77e3b1-b8d633e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with heart failure and now with swan-___ catheter // please assess location of pulmonary artery catheter COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is unchanged looping of the Swan-Ganz catheter in the main pulmonary artery. The tip of the catheter projects over the right main pulmonary artery and is in slightly peripheral position. Neck device could be pulled back by approximately 2-3 cm. Otherwise unchanged radiograph. Minimal fluid overload. Low lung volumes. Moderate cardiomegaly. No pleural effusions. No pneumonia. " 5cc4f854-a7b4d3b6-cd9a279d-1987bd0d-0d9b89a9.jpg,validate/p10/p10331490/s55873334/5cc4f854-a7b4d3b6-cd9a279d-1987bd0d-0d9b89a9.jpg,validation," FINAL REPORT HISTORY: Epigastric pain. TECHNIQUE: PA and lateral chest radiographs. COMPARISON: None available. FINDINGS: The heart size is normal. The cardiomediastinal silhouette is unremarkable. The hilar contours unremarkable. The lungs are slightly hyperinflated but otherwise clear without focal consolidations, effusions or pneumothorax. No acute bony abnormality is identified. IMPRESSION: No acute intrathoracic process. " 89f202e1-e5cf12d7-9d1d95e7-70de63d2-f7a3a4fc.jpg,validate/p15/p15491825/s57118110/89f202e1-e5cf12d7-9d1d95e7-70de63d2-f7a3a4fc.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Cough and fever. Question pneumonia. 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 are clear. There are no pleural effusions or pneumothorax. Mid thoracic interspaces are minimally narrowed. IMPRESSION: No evidence of acute disease. " 4608c208-5ea4f156-0682978f-f29da352-063c8852.jpg,validate/p17/p17442272/s54690521/4608c208-5ea4f156-0682978f-f29da352-063c8852.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of chest pain and fever. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. Lungs are well expanded and clear. 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. " 69c07d10-c5734a1a-bd4e5960-3332ccfb-7186d125.jpg,validate/p16/p16046758/s54208064/69c07d10-c5734a1a-bd4e5960-3332ccfb-7186d125.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with history of lung cancer status post right bronchial stent on ___, with new shortness of breath. COMPARISON: Chest radiograph from ___ and CT chest from ___. FINDINGS: Again visualized is a similar appearance of right upper lobe, middle, and lower lobe opacities consistent with patient's history of known cavitary focus at the right upper lobe with loculated fluid as well as post-radiation changes at the right hilum. A right mainstem bronchus stent is now visualized, with the proximal end of the stent within the trachea at the level of the carina and the more distal portion within the right mainstem bronchus. Bibasilar opacities are noted and likely representative of bilateral pleural effusions with adjacent atelectasis. There is no evidence of pneumothorax. Cardiomediastinal silhouette is unremarkable. Multiple mediastinal and brachial tumor deposits are better delineated on dedicated CT chest from ___. IMPRESSION: 1. Stable appearance of the right lung consistent with patient's history of cavitary focus at the right apex with loculated fluid as well as post-radiation changes in the right lung and hilar tissues. 2. Right mainstem bronchus stent is now visualized, with the most proximal end of the stent within the trachea at the level of the carina and the more distal end in the right mainstem bronchus, may be more proximal in position than desired. 3. Multiple known mediastinal and pericardial tumor deposits are better delineated on dedicated chest CT from ___. " cb30bd22-6d7755a2-eee6f34d-8b0b215b-acc2edc0.jpg,validate/p11/p11708598/s59744901/cb30bd22-6d7755a2-eee6f34d-8b0b215b-acc2edc0.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old man with left rib pain. COMPARISON: None. TECHNIQUE: PA and lateral views of the chest. FINDINGS: Lung volumes are low. Cardiomediastinal silhouette and hilar contours appear unremarkable. The lungs appear clear. No obvious pleural effusion or pneumothorax. No apparent rib fractures. IMPRESSION: No evidence of acute cardiopulmonary process. " 85b728e4-89adbac7-649a6081-84c15922-cde503e2.jpg,validate/p19/p19148353/s57145158/85b728e4-89adbac7-649a6081-84c15922-cde503e2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with fever, cough COMPARISON: None available 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. " f32bfdee-1d26cca2-6a5634d3-1324c413-36a39545.jpg,validate/p19/p19387043/s54473502/f32bfdee-1d26cca2-6a5634d3-1324c413-36a39545.jpg,validation," WET READ: ___ ___ ___ 10:59 PM No acute cardiopulmonary abnormality. Clear lungs. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest x-ray. INDICATION: ___M with ETOH, cocaine use, wheezing, chest apin // eval ? infection TECHNIQUE: PA and lateral projections, upright positioning. COMPARISON: Chest x-ray ___. FINDINGS: Lower lung volumes seen on the current exam however the lungs remain clear. There is no consolidation, pneumothorax, or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. Clear lungs. " 26ceb635-e55fa6bc-384c3e4a-0fc6f9cd-9da1e721.jpg,validate/p14/p14750850/s53455831/26ceb635-e55fa6bc-384c3e4a-0fc6f9cd-9da1e721.jpg,validation," FINAL REPORT INDICATION: Patient is on prednisone for sarcoid, now with upper respiratory infection and question of pneumonia. COMPARISON: Comparison is made to multiple prior chest radiographs, most recently dated ___. FINDINGS: Frontal and lateral chest radiographs is relatively unchanged examination compared to ___ with multiple bilateral pulmonary opacifications, areas of retraction and volume loss consistent with fibrosis. Patient is status post sternotomy with sutures midline and intact. Cardiomediastinal silhouette is unchanged. IMPRESSION: Stable fibrosis related to known sarcoid. No new opacification to suggest pneumonia. " d62ec458-0377bf85-1c4f3897-719fa6d0-dfc76cd1.jpg,validate/p17/p17818027/s54489490/d62ec458-0377bf85-1c4f3897-719fa6d0-dfc76cd1.jpg,validation," FINAL REPORT HISTORY: ___-year-old male status post hemorrhoidectomy with abdominal distention and pain. COMPARISON: None listed. FINDINGS: PA and lateral views of the chest. The lungs are hyperinflated but clear consolidation or effusion. Cardiomediastinal silhouette is within normal limits. There is no free air below the diaphragm. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. No free air below the diaphragm. " a9bfcfe6-0062e8b8-a4dc9e2a-4f069b44-f76b5f53.jpg,validate/p14/p14733367/s58386522/a9bfcfe6-0062e8b8-a4dc9e2a-4f069b44-f76b5f53.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___m w/ WBC ___. Immunosuppressed. ?pna COMPARISON: Prior exam from ___ and CT dated ___. FINDINGS: PA and lateral views of the chest provided. The heart remains at the upper limits of normal. No focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax. No convincing signs of edema. There is noted aortic calcification. Bony structures are intact. No free air below the right hemidiaphragm. Elevated right hemidiaphragm is unchanged. IMPRESSION: As above. " ed7da714-e3dd12f0-cb2606aa-160cde63-8cfb667f.jpg,validate/p14/p14044722/s58442439/ed7da714-e3dd12f0-cb2606aa-160cde63-8cfb667f.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Weakness. Question pneumonia. COMPARISONS: None. TECHNIQUE: Chest, AP upright and lateral views. FINDINGS: The heart appears mildly enlarged. The aortic arch is calcified. The mediastinal and hilar contours are otherwise unremarkable. There is no pleural effusion or pneumothorax. The lungs appear clear. The bones appear demineralized. IMPRESSION: No evidence of acute cardiopulmonary disease. " e3f96eda-532461ac-6ab472f6-5fc5e251-5f41f1e8.jpg,validate/p14/p14957416/s57130363/e3f96eda-532461ac-6ab472f6-5fc5e251-5f41f1e8.jpg,validation," WET READ: ___ ___ ___ 10:11 AM No evidence of free air. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with epigastric pain, question perforated ulcer question free air under diaphragm. TECHNIQUE: Chest PA and lateral COMPARISON: CT abdomen pelvis dated ___. Portable chest radiograph dated ___. FINDINGS: PA and lateral views the chest provided demonstrate clear well expanded lungs without focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. . No free air is seen below the right hemidiaphragm. IMPRESSION: No evidence of free air. " 85e29156-47c5bfce-0a11363e-8108e62b-15c154b2.jpg,validate/p19/p19321265/s58028489/85e29156-47c5bfce-0a11363e-8108e62b-15c154b2.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with non-resolving cough, mucus production and pains on breathing over right side. // ? pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: There is a faint peribronchial opacity in the right middle lobe. The left lung is clear. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. IMPRESSION: Right middle lobe pneumonia. NOTIFICATION: The findings were discussed with ___, M.D. by ___ ___, M.D. on the telephone on ___ at 5:01 PM, 5 minutes after discovery of the findings. " e94328ad-6a9eb9c0-521f98e3-3abacbfd-1c4d674c.jpg,validate/p10/p10620020/s59189371/e94328ad-6a9eb9c0-521f98e3-3abacbfd-1c4d674c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: Cough 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. Hyperinflation of the lungs, best demonstrated on the lateral view, is suggestive of COPD in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Healed left rib fractures are incidentally noted as well as scoliosis IMPRESSION: No acute cardiopulmonary abnormality. Hyperinflated lungs, suggestive of COPD in the appropriate clinical setting. " 5306b91e-15f5313f-a52330bf-57b0fd42-916babaf.jpg,validate/p15/p15753793/s58090760/5306b91e-15f5313f-a52330bf-57b0fd42-916babaf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure, new hypotension, concern for aspiration. // aspiration pneumonitis or new pneumonia IMPRESSION: As compared to ___ chest radiograph, left internal jugular central venous catheter remains malpositioned, with tip directed cephalad in the right brachiocephalic vein, with documentation of this position noted in previous radiographs. Cardiomegaly is accompanied by pulmonary vascular congestion and improving edema. Moderate pleural effusions are persistent findings along with adjacent bibasilar atelectasis and or consolidation. " 844b5268-b24fcd3c-f11d9662-e6a39b79-22a4de83.jpg,validate/p18/p18090640/s58904786/844b5268-b24fcd3c-f11d9662-e6a39b79-22a4de83.jpg,validation," WET READ: ___ ___ 10:04 AM 1. Vague rounded opacity overlying the right first rib and clavicle, potentially external. Repeat frontal and apical lordotic views recommended to confirm. 2. No definite acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain, evaluate heart and lungs. COMPARISON: ___ radiograph and CT chest from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate well-expanded lungs. Cardiomediastinal contour is within normal limits. Vague rounded opacity overlying the right first rib and clavicle is potentially external. Lungs are otherwise clear without focal areas of consolidation. There is no pleural effusion and no pneumothorax. IMPRESSION: 1. Vague rounded opacity overlying the right first rib and clavicle is potentially external for which correlation with exam is suggested. If nothing found, repeat frontal and apical lordotic views are recommended. 2. No definite acute cardiopulmonary abnormality. " 8dc75dbb-fee7fdee-de09663a-e4226389-ebd5103b.jpg,validate/p13/p13775723/s51981196/8dc75dbb-fee7fdee-de09663a-e4226389-ebd5103b.jpg,validation," WET READ: ___ ___ ___ 7:23 PM Heart size is top normal. The mediastinal and hilar contours are unchanged. There is bibasilar atelectasis, left worse than right. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Enteric tube is seen below the diaphragm, terminating in the mid stomach with the side port approximately 4 cm from the expected location of the GE junction. The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 6:20 PM, 2 minutes after discovery of the findings. WET READ VERSION #1 ___ ___ ___ 6:40 PM Heart size is top normal. The mediastinal and hilar contours are unchanged. There is bibasilar atelectasis, left worse than right. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Enteric tube is seen below the diaphragm, terminating in the mid stomach with the side port approximately 4 cm from the expected location of the GE junction. The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 6:20 PM, 2 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with NG tube for bowel prep // NG tube placement TECHNIQUE: Portable upright chest radiographs COMPARISON: Chest radiograph from ___. FINDINGS: Heart size is top normal. The mediastinal and hilar contours are unchanged. There is bibasilar atelectasis, left worse than right. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Enteric tube is seen below the diaphragm, terminating in the mid stomach with the side port approximately 4 cm from the expected location of the GE junction. IMPRESSION: 1. No acute cardiopulmonary abnormalities. 2. Enteric tube in the mid stomach. NOTIFICATION: The findings were discussed with ___, M.D. by ___, M.D. on the telephone on ___ at 6:20 PM, 2 minutes after discovery of the findings. " c001fc7d-2b1f1709-76959604-4b78af62-ae19699b.jpg,validate/p19/p19610837/s51646655/c001fc7d-2b1f1709-76959604-4b78af62-ae19699b.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old male with fall and left shoulder pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. There are increased interstitial markings in the lungs, particularly superiorly, which could be due to chronic underlying parenchymal disease. There is no confluent consolidation nor effusion or pneumothorax. The cardiac silhouette is at upper limits of normal. Descending thoracic aorta is tortuous. No acute osseous abnormality is identified. IMPRESSION: No definite acute cardiopulmonary process. " 1c414819-2f23f79b-ea682e70-fd7dce0e-c739ad3e.jpg,validate/p16/p16636708/s51627876/1c414819-2f23f79b-ea682e70-fd7dce0e-c739ad3e.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with 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. IMPRESSION: No acute cardiopulmonary process. " c2bcaabf-d14272b1-32db971f-8a224454-7a9cf2f2.jpg,validate/p14/p14538144/s55323327/c2bcaabf-d14272b1-32db971f-8a224454-7a9cf2f2.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Fever and heavy breathing. PA and lateral upright chest radiographs were reviewed in comparison to ___. The Port-A-Cath catheter tip terminates at the cavoatrial junction. Heart size is top normal. Mediastinum is stable. There are new right basal opacities, not definitely seen on the previous study and potentially left basal opacities, findings that might be concerning for infectious process. There is no pleural effusion or pneumothorax. IMPRESSION: Suspected bibasal, in particular right lower lobe pneumonia. Right middle lobe involvement is a possibility. " 44203af1-276c693d-62a46184-291518fa-79a90aa9.jpg,validate/p19/p19199806/s51242054/44203af1-276c693d-62a46184-291518fa-79a90aa9.jpg,validation," FINAL REPORT HISTORY: Fever, cough. COMPARISON: Prior chest CT from ___ and chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph from ___, lung volumes have decreased which accentuate the cardiac silhouette and bronchovascular structures. There is no focal consolidation, pleural effusion or pneumothorax. Patient is status post lingulectomy, with surgical sutures project along the left cardiac border. IMPRESSION: No acute cardiopulmonary process. " 8a8df4ca-0f845028-833d861e-fd511b02-46dcc25d.jpg,validate/p14/p14418371/s55694258/8a8df4ca-0f845028-833d861e-fd511b02-46dcc25d.jpg,validation," FINAL REPORT INDICATION: ___M with syncope // eval for acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Opacity projecting over the thoracic spine centered at the disk on the lateral view is felt to be most likely degenerative endplate changes and overlapping ribs. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 767937cf-26d45660-05b38a60-2cf322c5-865141c3.jpg,validate/p11/p11194247/s52671118/767937cf-26d45660-05b38a60-2cf322c5-865141c3.jpg,validation," FINAL REPORT INDICATION: ___-year-old female patient post-right-sided Pleurx catheter. Study requested for evaluation of pneumothorax and/or position of the tube. COMPARISON: Prior chest radiograph from ___ through ___ and prior chest CT from ___. TECHNIQUE: Portable upright AP chest radiograph. FINDINGS: A Pleurx catheter terminates in the right basal pleura. There has been interval improvement of a moderate to large right pleural effusion with some residual fluid still present. There is no appreciable pneumothorax. The right upper lobe is now completely collapsed. The known right upper lobe mass now looks more solid, this could be attributed to loculated pleural effusion or hemorrhage in the right upper lobe. The left lung is clear. The cardiomediastinal and hilar contours are within normal limits. A left infusion port tip terminates in the mid to lower SVC. IMPRESSION: 1. Interval improvement of right pleural effusion. 2. Right upper lobe collapse. 3. Change in character of known right upper lobe mass raises the possibility of a loculated pleural effusion or hemorrhage. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone on ___ on 11:55 AM. " 698b1f26-bacee236-86eecf7c-dd7616c3-f99eb1fe.jpg,validate/p13/p13540048/s55906041/698b1f26-bacee236-86eecf7c-dd7616c3-f99eb1fe.jpg,validation," FINAL REPORT INDICATION: Three weeks of cough as well as fever and left basilar crackles. 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 process. " 268c22a4-5dc6166a-d2996aa0-5cb87476-77a13a6f.jpg,validate/p17/p17455650/s57214742/268c22a4-5dc6166a-d2996aa0-5cb87476-77a13a6f.jpg,validation," FINAL REPORT INDICATION: Chronic cough, evaluate for cause. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. No findings to explain patient's symptoms. " 81442d49-0a3434dd-747964d8-648f7c07-19e33ee7.jpg,validate/p15/p15481590/s59066656/81442d49-0a3434dd-747964d8-648f7c07-19e33ee7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old woman s/p CABG // eval ___ catheter line after repositioning COMPARISON: Chest radiographs postoperatively on ___ ET tube is in standard position IMPRESSION: ET tube in standard position. Swan-Ganz catheter is still looped distally, but the configuration is consistent with either placement close to the pulmonic valve or into the descending pulmonary artery or a small branch. Lung volumes are slightly lower than previously, exaggerating newly developed mild interstitial pulmonary edema. Cardiomediastinal silhouette is a normal postoperative appearance. There is no pneumothorax. Small pleural effusions are presumed. Mild to moderate left lower lobe atelectasis, a common postoperative finding, is stable. An esophageal drainage tube passes into the nondistended stomach and out of view. Midline and left pleural drain still in place. . NOTIFICATION: Dr. ___ reported the findings to ___ by telephone on ___ at 2:05 PM, 2 minutes after discovery of the findings. " d7b0e584-ddb5e753-38eb642e-db7576f8-6d66c2db.jpg,validate/p17/p17182744/s53049558/d7b0e584-ddb5e753-38eb642e-db7576f8-6d66c2db.jpg,validation," FINAL REPORT INDICATION: History: ___F with dyspnea // infiltrate? edema? TECHNIQUE: Frontal chest radiograph COMPARISON: ___ chest CT. ___ PET-CT. FINDINGS: Moderate sized left pleural effusion is similar to ___ with left base atelectasis. Small right base atelectasis. Multiple pulmonary nodules previously seen on better appreciated on CT. No new consolidation, large mass, pneumothorax. Heart size is normal. IMPRESSION: Moderate-sized left pleural effusion, similar to ___, with bibasilar atelectasis. Previously seen pulmonary nodules are better appreciated via CT. " fa2972cf-7bb7c5b9-582c56ae-647b15a8-f0a7263e.jpg,validate/p12/p12938515/s57372068/fa2972cf-7bb7c5b9-582c56ae-647b15a8-f0a7263e.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Renal failure, on HD. Patient with alcoholic hepatitis. Comparison is made with prior study ___. Cardiac size is top normal. Right IJ catheter tip is in the upper SVC. NG tube tip is in the stomach. There is no pneumothorax. Moderate right and small left effusions are unchanged. Right lower lobe atelectasis has increased. Moderate pulmonary edema is stable. " 8ce0168b-ec3c8a9b-368bf41e-c4457463-aecf6ae3.jpg,validate/p16/p16476559/s51559478/8ce0168b-ec3c8a9b-368bf41e-c4457463-aecf6ae3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with heart failure and new shortness of breath // Evaluate for pulmonary edema, effusions IMPRESSION: In comparison with the study of ___, the monitoring and support devices have been removed. Continued substantial enlargement of the cardiac silhouette in a patient with intact midline sternal wires. No definite vascular congestion. Area of increased opacification at the right base most likely represents streaks of atelectasis. However, in the appropriate clinical setting, supervening pneumonia would have to be considered. " 4ec5e944-0db4f99f-986b5328-2ca995de-a4ab66c9.jpg,validate/p13/p13510413/s56276202/4ec5e944-0db4f99f-986b5328-2ca995de-a4ab66c9.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Cardiac and mediastinal silhouettes are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Evidence of DISH is seen along the thoracic spine. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 2d7e9ef9-a4a84e13-9a202d2e-96b633fa-69cf50c1.jpg,validate/p14/p14714706/s57073628/2d7e9ef9-a4a84e13-9a202d2e-96b633fa-69cf50c1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with HTN, s/p AVR ___ with shortness of breath on exertion. Eval parenchymal disease. // Parenchymal disease? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, a pre-existing right pleural effusion has completely resolved. Status post CABG. The cardiac silhouette remains enlarged and the descending aorta is slightly elongated. There currently is no evidence of diffuse or focal lung parenchymal disease. No pneumonia. No abnormalities of the hilar and mediastinal contours. " 9baa104a-9f155b15-08cdc443-59f1023d-57a0e039.jpg,validate/p11/p11917950/s51446785/9baa104a-9f155b15-08cdc443-59f1023d-57a0e039.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough and fever, rule out pneumonia. 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. " a8f80566-85748f56-dd7e8c82-7880e22e-5b6f16c9.jpg,validate/p13/p13413453/s51140698/a8f80566-85748f56-dd7e8c82-7880e22e-5b6f16c9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___M with headache, visual changes. hx stroke. // recrudescence of stroke symptoms from infection? TECHNIQUE: Chest AP and lateral COMPARISON: None available. FINDINGS: There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. There is mild prominence to the central pulmonary vasculature. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " d8736740-82b3038d-18a332cc-a03563f1-fce89967.jpg,validate/p18/p18839992/s50132152/d8736740-82b3038d-18a332cc-a03563f1-fce89967.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Chest pain, assess for pneumonia or pneumothorax. FINDINGS: PA and lateral views of the chest were obtained. Lung volumes are low on the frontal radiograph. Allowing for this, there is no definite sign of pneumonia or CHF. No pleural effusion or pneumothorax is seen. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " aec12383-15271291-66da3b7a-359f9e3e-0f41f7af.jpg,validate/p16/p16934035/s57733303/aec12383-15271291-66da3b7a-359f9e3e-0f41f7af.jpg,validation," WET READ: ___ ___ ___ 8:34 PM A right chest port ends in the mid SVC. The heart size is normal. The lung fields are clear. No pneumothorax or pleural effusion. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Rule chest radiographs since ___ ___ year old man with lymphoma w/ new left femur fracture // pre-op eval Surg: ___ (left femur ORIF) CNS LYMPHOMA IMPRESSION: Prior chest radiographs ___. New right jugular central venous infusion port ends in the low SVC. No pneumothorax pleural effusion or mediastinal widening. Lungs clear. Normal hilar and mediastinal silhouettes and pleural surfaces. Is " 675990e0-b57e6331-13e4cc71-3a7116dc-aba96532.jpg,validate/p14/p14659307/s51946621/675990e0-b57e6331-13e4cc71-3a7116dc-aba96532.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with left arm and left leg weakness for ___ min at ___, concern for TIA TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is normal. Aortic knob calcifications are present. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Minimal atelectasis is noted in the retrocardiac region. Lungs are otherwise clear. No focal consolidation, pleural effusion or pneumothorax is seen. Mild to moderate degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 06d0e756-9ab20825-4f9c3ee8-5193909f-04a9adc6.jpg,validate/p12/p12221629/s50698594/06d0e756-9ab20825-4f9c3ee8-5193909f-04a9adc6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion, pneumonia // interval eval of pleural effusion and pneumonia TECHNIQUE: CHEST TWO VIEWS COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " 7c61ae17-b4689128-be552efe-d40e8f4e-b878e563.jpg,validate/p15/p15116019/s54893892/7c61ae17-b4689128-be552efe-d40e8f4e-b878e563.jpg,validation," WET READ: ___ ___ ___ 9:17 PM Extremely low lung volumes, limiting evaluation. Linear streaky bilateral opacities are likely atelectasis. Heart size is exaggerated by low lung volumes, but likely mildly enlarged, and stable. Outline of stent present with distal tip in low trachea just above the carina. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Stent. FINDINGS: The stent is difficult to see, though the tip appears to be in the lower portion of the trachea just above the carina. There are extremely low lung volumes with extensive atelectatic changes in the right mid zone. Retrocardiac atelectasis is also seen. The apparent increase in the transverse diameter of the heart most likely reflects the low lung volumes. " e357c8c9-789cf00f-0d9c032d-e850356b-901f78b9.jpg,validate/p13/p13299285/s50566895/e357c8c9-789cf00f-0d9c032d-e850356b-901f78b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: Dump off tube placement IMPRESSION: Since the previous study of earlier the same date, a dump off tube is been placed into the body of the stomach, and a left pleural catheter has apparently been repositioned. Positional differences limit comparison of the pleural effusion, but adjacent left retrocardiac atelectasis and or consolidation has slightly improved. No other relevant changes. " 299f75f0-80c8f068-48833ae7-9649d3d1-49135bb6.jpg,validate/p17/p17055354/s58402630/299f75f0-80c8f068-48833ae7-9649d3d1-49135bb6.jpg,validation," 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. " 67ff1107-1b58946d-37d3b01d-1bccafe1-e9aa1181.jpg,validate/p17/p17767787/s58232112/67ff1107-1b58946d-37d3b01d-1bccafe1-e9aa1181.jpg,validation," FINAL REPORT INDICATION: History: ___M with SOB // edema? TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior radiographs the most recent on ___ FINDINGS: Again demonstrated is a dialysis catheter terminating in the right atrium. Mild cardiomegaly is stable. There is mild interstitial and perihilar edema. No large effusions. No pneumothorax. The heart remains enlarged which may reflect cardiomegaly although pericardial effusion cannot be entirely excluded. IMPRESSION: Mild perihilar and interstitial edema. Stable cardiac enlargement. " acc833c2-96fa0eda-73bae46b-36794ef2-7b653b46.jpg,validate/p10/p10161042/s56001394/acc833c2-96fa0eda-73bae46b-36794ef2-7b653b46.jpg,validation," FINAL REPORT INDICATION: History: ___F with shortness of breath // Eval for pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ FINDINGS: Compared to the prior chest radiograph there is little change in, left greater than right, lower lobe opacities which may represent atelectasis or pneumonia. There is no pulmonary edema, pleural effusion or pneumothorax. The cardiac silhouette is top normal in size. The mediastinal and pulmonary vascular are not dilated. There is no free air beneath the right hemidiaphragm. IMPRESSION: Left greater than right, lower lobe opacities are unchanged since ___ and may represent atelectasis or pneumonia. " 4a88363e-74ca4917-ba869530-b4d69fed-86926257.jpg,validate/p10/p10405915/s52039940/4a88363e-74ca4917-ba869530-b4d69fed-86926257.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p stab x2, bilateral chest tubes, L diaphragm repair, R thorocotomy // interval change TECHNIQUE: Portable supine chest radiographs COMPARISON: Chest radiograph obtained earlier on the same date. FINDINGS: There are bilateral chest drains in-situ. These are unchanged in position when compared to the prior study. The side hole of the right-sided chest strain is close to the chest wall but appears to be within the pleural space. Small amount subcutaneous emphysema has decreased when compared to the prior study. Lung volumes remain low. No pneumothorax seen. Apparent widening of the cardiomediastinal contour is likely due to the projection. IMPRESSION: No significant interval change when compared to the prior study. The right-sided chest tube is close to the chest wall but appears to be within the pleural space. " a99317f4-c50aa883-a6518828-d44a9399-16a866ad.jpg,validate/p10/p10940509/s57285148/a99317f4-c50aa883-a6518828-d44a9399-16a866ad.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with chest pain and subjective fevers // ?pneumonia COMPARISON: Prior exam from ___ and CT of the chest from ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with borderline cardiac enlargement. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 94e863f8-08c707a8-797b3b22-130c995c-f23a1636.jpg,validate/p15/p15435415/s51198591/94e863f8-08c707a8-797b3b22-130c995c-f23a1636.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p AVR/CABG // eval for pneumo TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change with the exception of a slight decrease in the amount of pneumopericardium. . IMPRESSION: No change. " bb7bc609-0dd3101e-c853198f-ac235cd0-ce4f0e5a.jpg,validate/p13/p13411236/s52098814/bb7bc609-0dd3101e-c853198f-ac235cd0-ce4f0e5a.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p liver transplant with exchange of IJ line // right IJ triple lumen placement TECHNIQUE: Portable FINDINGS: As compared to chest radiograph from the same day Swan-Ganz catheter has been removed. Right internal jugular catheter with the tip in the right atrium. Pulmonary vascular congestion has improved. Bibasilar opacities have not substantially changed, asymmetrically worse on the right may reflect infection. No pneumothorax. IMPRESSION: Right internal jugular catheter tip in the right atrium. No pneumothorax. " 77984ed8-53acacfa-9beddbf5-c02077ba-c430d08f.jpg,validate/p12/p12785654/s53788361/77984ed8-53acacfa-9beddbf5-c02077ba-c430d08f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tongue SCC s/p trach now with COPD and ___ // interval change interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Tracheostomy tube midline. No complications. Previous pulmonary vascular engorgement and borderline edema have improved and mild cardiomegaly has decreased. Pleural effusions are small if any. No pneumothorax. Left PIC line ends in the low SVC. No pneumothorax. Healed right posterior rib fractures noted. " fdfefcf1-0054c0aa-ea1dc812-8cb33d32-48931398.jpg,validate/p14/p14593900/s55755295/fdfefcf1-0054c0aa-ea1dc812-8cb33d32-48931398.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man s/p CABG // interval change TECHNIQUE: PA and lateral chest radiograph COMPARISON: ___ FINDINGS: Lung volumes are low likely secondary to poor inspiratory effort. Atelectasis at the left lung base is noted. Widening of the cardiomediastinal silhouette silhouette is consistent with postsurgical changes. Small right pleural effusion is noted. Median sternotomy wires are intact. A right-sided central line terminates in the mid SVC. No evidence pneumothorax. IMPRESSION: 1. Left basilar atelectasis. 2. Small right pleural effusion. " 657e7e57-84ee892a-f685e5a5-2e7603e2-d32a47c2.jpg,validate/p17/p17025899/s51474055/657e7e57-84ee892a-f685e5a5-2e7603e2-d32a47c2.jpg,validation," FINAL REPORT CLINICAL HISTORY: Chest tube removed, evaluate for pneumothorax. CHEST A small apical pneumothorax is again seen, unchanged since the prior chest x-ray. Atelectasis at the left base is again noted. The right IJ line has been removed. " 064dbe65-809ba660-73f43824-b4ac2c0f-a3becbe6.jpg,validate/p15/p15438558/s51151011/064dbe65-809ba660-73f43824-b4ac2c0f-a3becbe6.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: DYSPNEA. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: A three-lead pacemaker/ICD device appears unchanged. The cardiac, mediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. IMPRESSION: No evidence of acute cardiopulmonary disease " 018d7a46-916de4df-408072bb-ca64d0fa-f91e3b8b.jpg,validate/p18/p18933476/s54805688/018d7a46-916de4df-408072bb-ca64d0fa-f91e3b8b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with L pleural effusion now p/w worsening chest pain // L pleural effusion COMPARISON: ___ IMPRESSION: The known and pre described right apical lateral pneumothorax has slightly decreased in extent. The small amount of right pleural effusion is unchanged. The right lung basis shows minimally increasing atelectasis. On the left, no relevant change is seen. The left and right chest tube as well as the left PICC line are in unchanged position. Unchanged mild retrocardiac atelectasis. Unchanged size of the cardiac silhouette. Mild gastric overdistension is noted. " 975cd07a-aacd00b7-02253852-9c105444-730fb7fd.jpg,validate/p18/p18995860/s58283606/975cd07a-aacd00b7-02253852-9c105444-730fb7fd.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest x-ray. INDICATION: A ___-year-old woman with a history of hypertrophic cardiomyopathy, now with chest pain, evaluate for infiltrate, cardiomegaly. TECHNIQUE: PA and lateral projections, upright positioning. COMPARISON: None. FINDINGS: The cardiomediastinal silhouettes are normal. The bilateral hila are unremarkable. The trachea is midline. The lungs are clear. There is no pulmonary vascular congestion. There is no pneumothorax or effusion. IMPRESSION: No acute cardiopulmonary process. " d9d164c4-7d861a26-243a12ea-c70597b7-6b9b1061.jpg,validate/p17/p17051420/s50704218/d9d164c4-7d861a26-243a12ea-c70597b7-6b9b1061.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with dyspnea. History of congestive heart failure off meds. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is moderately enlarged, similar compared to the prior study. Mediastinal contours are unchanged. Mild interstitial pulmonary edema is not substantially changed in the interval, and hilar contours are similar. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Mild interstitial pulmonary edema, not changed in the interval. " 6dc0cf3e-923dc6b4-aa5b670b-3da43103-bb9dd99e.jpg,validate/p13/p13505755/s55665855/6dc0cf3e-923dc6b4-aa5b670b-3da43103-bb9dd99e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with VDRF // Interval change IMPRESSION: As compared to ___ chest radiograph, moderate to large right pleural effusion has apparently slightly increased in size, and a small left pleural effusion has decreased in size. Cardiomegaly and pulmonary vascular congestion persist, with likely asymmetrical pulmonary edema pattern. Substantial atelectasis is demonstrated in the right mid and lower lung adjacent to the pleural effusion. " d872572e-7cf6c4b7-f9b2afb0-385da188-8fdabbd9.jpg,validate/p11/p11123733/s59420824/d872572e-7cf6c4b7-f9b2afb0-385da188-8fdabbd9.jpg,validation," FINAL REPORT INDICATION: Question stroke or pneumonia or CHF. COMPARISON: No prior studies available for comparison. FINDINGS: Chest, PA and lateral radiograph demonstrates top normal heart size. The aorta is calcifiedThere is prominence of the pulmonary vasculature, suggestiong with mild volume overload and there is mild interstitial edema. There is a trace right pleural effusion. Multilevel degenerative changes are seen along the spine. IMPRESSION: No focal opacification concerning for pneumonia. Prominence of the pulmonary vasculature and mild interstitial edema. Trace right pleural effusion. " 29369f46-b7dd8122-386d4144-be1704e6-b703041b.jpg,validate/p11/p11054595/s54380343/29369f46-b7dd8122-386d4144-be1704e6-b703041b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with new atrial fibrillation. AP radiograph of the chest was reviewed in comparison to ___ and CT of the C-spine from ___. Heart size is mildly enlarged, stable. There is substantial deviation of the trachea towards the right due to the substantial enlargement of left thyroid gland, partially imaged on ___ CT of the cervical spine. Bibasilar minimal opacities are noted, most likely reflecting areas of atelectasis. No increase in pleural effusion is demonstrated. No pulmonary edema is seen. Small amount of pleural effusion, although can be present, not clearly identified on the current examination. " e0f03aa4-3cdbb483-ec07fe0e-391bd869-e1e7b2c0.jpg,validate/p12/p12431768/s57171838/e0f03aa4-3cdbb483-ec07fe0e-391bd869-e1e7b2c0.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with productive cough and chest pain. Rule out for pneumonia. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is top normal size, exaggerated by low lung volumes. The lungs are clear. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body. IMPRESSION: Low lung volumes. No acute cardiopulmonary process. " e07acd3d-2f5658d9-e86fdcbb-b2971f68-69437b1c.jpg,validate/p17/p17517983/s57134809/e07acd3d-2f5658d9-e86fdcbb-b2971f68-69437b1c.jpg,validation," FINAL REPORT INDICATION: Leukocytosis, DKA, chills. COMPARISON: Chest radiograph ___, ___. FINDINGS: The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There is a small well defined rectangular opacity lateral to the EKG lead overlying the left upper chest wall, which is likely associated with the EKG lead. There is no other focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits. IMPRESSION: Small well demarcated focal opacity adjacent to an EKG lead along the left upper chest wall which is likely associated with the lead. However, a small focus of pneumonia cannot be excluded. Removal of the lead and repeat chest radiograph is recommended to document resolution of this opacity. Dr. ___ ___ this recommendation with the clinical team via telephone on ___ around 5 pm. " a56988f6-c322a8fb-e041f4d2-281dfce3-38f19052.jpg,validate/p18/p18123897/s50822780/a56988f6-c322a8fb-e041f4d2-281dfce3-38f19052.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness, hx of CHF // assess for edema, infiltrate, effusion COMPARISON: Chest radiograph ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Calcified granuloma projects over the left upper lung. The cardiomediastinal silhouette is normal. Imaged osseous structures are unremarkable. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process. " 49da6e3e-ed84e41e-0e785bf6-ead7e539-60b97732.jpg,validate/p17/p17530252/s57674920/49da6e3e-ed84e41e-0e785bf6-ead7e539-60b97732.jpg,validation," 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. " 0dcb7832-e09650ac-4d9ec40e-bb1b8a28-c921fb36.jpg,validate/p12/p12122134/s56969841/0dcb7832-e09650ac-4d9ec40e-bb1b8a28-c921fb36.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough, pleuritic chest pain and crackles in left lower lobe. History of tricuspid regurgitation. COMPARISON: None available. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Lungs are well expanded and clear bilaterally with no areas of focal consolidation, masses, lesions, pleural effusion or evidence of pneumothorax. The cardiomediastinal silhouette is within normal limits. Pleural surfaces are unremarkable. There is a wedge-shaped deformity in an upper lumbar vertebra of unknown chronicity. IMPRESSION: No evidence of infection or malignancy. " 5fe86ecc-4deb3718-b585c91f-6eea361c-ebd21fe6.jpg,validate/p13/p13174810/s58165801/5fe86ecc-4deb3718-b585c91f-6eea361c-ebd21fe6.jpg,validation," WET READ: ___ ___ ___ 6:43 PM Allowing for differences in degree of lordosis with the prior study there still appears to be slight interval increase in size of small left apical pneumothorax. Other findings including contusion, pulmonary edema, position of support devices and surgical ___ are stable. ___ d/w ___ ___ WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Chest tubes on waterseal. COMPARISON: ___, 4:45 a.m. FINDINGS: Allowing for differences in degree of lordosis with the prior study, there still appears a slight interval increase in size of the pre-existing small left apical pneumothorax. The other findings, including evidence of lung contusion, pulmonary edema and surgical ___ are stable. No evidence of tension. " 93a336d6-68841569-5a556e25-5cdd1c1d-e7ff3c36.jpg,validate/p16/p16140962/s56020208/93a336d6-68841569-5a556e25-5cdd1c1d-e7ff3c36.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with cough and tachycardia, evaluate for pneumonia. TECHNIQUE: PA and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: Chest radiograph from ___. FINDINGS: No focal consolidation, effusion or pulmonary edema is seen. Cardiomediastinal silhouette is normal. The dextroscoliosis is again seen. IMPRESSION: No evidence of pneumonia. Initial findings were conveyed to Dr. ___ ___ telephone at approximately 11:00 on ___ immediately following discovery. " 4647c75c-72379757-be28d679-7913268b-9bf8723d.jpg,validate/p11/p11495044/s55226318/4647c75c-72379757-be28d679-7913268b-9bf8723d.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with persisting cough and left periscapular back pain // please evaluate for pneumonia TECHNIQUE: PA and lateral views of the chest COMPARISON: ___ FINDINGS: There are new subtle airspace opacities in the left lower lung along the left heart border and at the right cardiophrenic angle. The lungs are otherwise clear. Mediastinal contours are stable. No pleural effusion or pneumothorax. IMPRESSION: Subtle airspace opacities in the lower lungs bilaterally could represent pneumonia in the appropriate clinical context. NOTIFICATION: Findings and recommendations were discussed by Dr. ___ ___ with Dr. ___ , on ___ at 1:40 pm, via telephone, ___ min after discovery, as requested. " 7ff44345-c5beaf12-ec65b858-fa34949e-fa2f7d60.jpg,validate/p19/p19152674/s53941550/7ff44345-c5beaf12-ec65b858-fa34949e-fa2f7d60.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with shortness of breath // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is minimal pulmonary vascular congestion. No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are grossly unremarkable. IMPRESSION: Minimal pulmonary vascular congestion. No focal consolidation to suggest pneumonia. " c1427de1-7c2206f0-41fce4db-8bde8358-56943674.jpg,validate/p17/p17165725/s55596205/c1427de1-7c2206f0-41fce4db-8bde8358-56943674.jpg,validation," FINAL REPORT HISTORY: Patient with ESRD, empyema, status post chest tube. Also question PICC line placement. COMPARISON: Portable chest radiograph performed earlier on the same day on ___. FINDINGS: Portable single frontal chest radiograph was obtained with the patient in supine position. A right IJ hemodialysis catheter terminates in the right atrium. The right PICC line has been pulled back slightly with the tip now terminating in the upper SVC. A small pneumothorax is again visualized at the right lung base and unchanged in size. There is no short-term interval change in the remainder of the exam. IMPRESSION: 1. Right PICC line now terminates in the upper SVC. 2. Small stable pneumothorax at the right lung base. No short-term interval change in the remainder of the exam. " cd0793d8-12fae69b-de0e4dc8-6f789b8d-65e99256.jpg,validate/p14/p14395025/s50244790/cd0793d8-12fae69b-de0e4dc8-6f789b8d-65e99256.jpg,validation," FINAL REPORT HISTORY: COPD with worsening cough and phlegm. Evaluate for pneumonia. COMPARISON: CT abdomen and pelvis ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The lungs are hyperinflated, consistent with COPD. There is increased opacity over the right mid and lower lung which is new from ___ and concerning for multifocal pneumonia. There is no pleural effusion or pneumothorax. A 4 mm nodule is seen in the left lower lung. The ascending aorta is tortuous. The heart is normal in size. There is prominence of the pulmonary arteries, suggesting underlying pulmonary arterial hypertension. These findings were discussed with Dr. ___ by Dr. ___ at 11:15 on ___ by telephone 5 minutes after discovery. " c99041ab-3b9fbe0e-38f238c9-9a44e00f-209d2f5d.jpg,validate/p12/p12852471/s54328742/c99041ab-3b9fbe0e-38f238c9-9a44e00f-209d2f5d.jpg,validation," FINAL REPORT INDICATION: Status post MVC with mid right chest wall tenderness. Question fracture. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Spinal fusion hardware is noted in the thoracolumbar spine. No displaced fractures are present. IMPRESSION: No acute cardiopulmonary process. " 40d6089f-6f4f4cb1-b0f741ab-f379f285-1209cdf0.jpg,validate/p19/p19170368/s55531691/40d6089f-6f4f4cb1-b0f741ab-f379f285-1209cdf0.jpg,validation," 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. " 1e1de419-293208cd-81de966a-704c8dfd-2b71b4c6.jpg,validate/p15/p15455450/s55194692/1e1de419-293208cd-81de966a-704c8dfd-2b71b4c6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough, dyspnea, heart failure // please eval edema, effusion, pna please eval edema, effusion, pna IMPRESSION: No comparison. Moderate left pleural effusion that occupies approximately ___% of the left hemi thorax. Subsequent left lower lobe atelectasis. Both lower changes in the well ventilated parts of the lung parenchyma. Normal size of the heart. " 2f211ac9-a161b9ae-0015740e-279336a7-a9aac0f6.jpg,validate/p18/p18879982/s55059237/2f211ac9-a161b9ae-0015740e-279336a7-a9aac0f6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Pleural effusion, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pleural drain is in unchanged position. The distribution and appearance of the left pleural effusion is constant. This is true for both the frontal and the lateral radiographs. Sternal wires in constant alignment. The size of the cardiac silhouette is unchanged. Normal appearance of the right lung. " 9ba14563-79dd5ed8-4c9a4993-755340e2-32e1eb30.jpg,validate/p10/p10415657/s54049854/9ba14563-79dd5ed8-4c9a4993-755340e2-32e1eb30.jpg,validation," FINAL REPORT HISTORY: Fever with right hand pain for 1 month. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is top normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal and the lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 39d259bc-9f56c43a-bc2d73e9-2f0266c7-6e4b9296.jpg,validate/p11/p11660675/s59615121/39d259bc-9f56c43a-bc2d73e9-2f0266c7-6e4b9296.jpg,validation," FINAL REPORT INDICATION: Patient with epigastric pain for three days. COMPARISONS: None available. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is top normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " dc99af78-00de7883-7bcc9c9b-d717a8d5-80ee98dd.jpg,validate/p10/p10114059/s57895810/dc99af78-00de7883-7bcc9c9b-d717a8d5-80ee98dd.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with epigastric / RUQ pain with ___ distension, h/o NASH cirrhosis, h/o CCY yrs ago 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 stable. IMPRESSION: No acute cardiopulmonary process. " 21b2259f-4fe2fcd5-ae96904e-37327542-80d36be9.jpg,validate/p15/p15132645/s51689009/21b2259f-4fe2fcd5-ae96904e-37327542-80d36be9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with positive quantiferon gold // r/o any evidence of active TB COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette. Mild elongation of the thoracic aorta. No pleural effusions. No pneumonia, no evidence of active or known active TB. " 1f2ef2d1-8c077611-c7e3d9d6-b5725398-fcc2f3dc.jpg,validate/p13/p13019601/s54581209/1f2ef2d1-8c077611-c7e3d9d6-b5725398-fcc2f3dc.jpg,validation," WET READ: ___ ___ ___ 11:04 PM improved but persisting pulmonary edema compared to 14:06 ___; similar- appearing L base opacity c/w pleural effusion/atelectasis. ______________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Increased oxygen requirement. Portable AP radiograph of the chest was reviewed in comparison to ___, 2:06 p.m. There is substantial interval improvement of pulmonary edema. Cardiomediastinal silhouette is unchanged including left retrocardiac atelectasis. " a7ce0289-df4d4d91-0ead35ce-68b897e9-ef939f93.jpg,validate/p18/p18123982/s58575073/a7ce0289-df4d4d91-0ead35ce-68b897e9-ef939f93.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Severe abdominal pain. TECHNIQUE: Chest, PA and lateral. COMPARISON: ___. FINDINGS: Lung volumes are low. Cardiac, mediastinal and hilar contours appear stable. There is a very small pleural effusion on the right and a small one on the left with associated opacity, probably atelectasis. Posterior left basilar opacification has increased somewhat; infectious process is not excluded. Port-A-Cath appears unchanged. IMPRESSION: Increasing left posterior basilar opacity, compatible with pleural effusion and atelectasis but not specific. No free air identified. " ebd18efc-d1d6498f-096a3cd7-0086c72d-3623348d.jpg,validate/p14/p14552554/s52084140/ebd18efc-d1d6498f-096a3cd7-0086c72d-3623348d.jpg,validation," 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. " e50b821c-005197ea-9df8be1a-9d7f02fd-8b5f536c.jpg,validate/p16/p16449190/s51406866/e50b821c-005197ea-9df8be1a-9d7f02fd-8b5f536c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PNA and empyema s/p VATS now with two chest tubes in place // ?chest tube placement ?chest tube placement IMPRESSION: Compared to chest radiographs ___ through ___. Combination of atelectasis and residual pleural effusion or thickening in the right hemi thorax has not changed appreciably since ___, with a basal and an apical thoracostomy tube in place. Moderate left lower lobe atelectasis and small left pleural effusion have not changed. Upper lungs clear. Moderate cardiomegaly persists. No pulmonary edema. " 8cc34627-ba8ae692-a9ac7ccb-4237d81f-4055feda.jpg,validate/p11/p11849511/s56157509/8cc34627-ba8ae692-a9ac7ccb-4237d81f-4055feda.jpg,validation," WET READ: ___ ___ ___ 10:07 PM Interval extubation. Left IJ terminates in the mid SVC. Interval retraction of the left chest tube with the side port seen out of the chest. Unchanged left basilar opacities and small left pleural effusion. D/w Dr. ___ by phone at 9:45p on the day of the exam. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: Extubation. COMPARISON: ___, 3 a.m. FINDINGS: Interval extubation, the left internal jugular vein catheter terminates in the mid SVC. There has been interval retraction of the left chest tube, with the side port seen outside of the chest. Unchanged left basal opacities and left small pleural effusion. The pigtail catheter on the left has completely been removed. " 5f3764c9-f2f20d43-8d495bbb-83b2c1c0-95778cc6.jpg,validate/p12/p12609816/s59550222/5f3764c9-f2f20d43-8d495bbb-83b2c1c0-95778cc6.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with right rib pain status post fall. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. There is no visualized fracture. IMPRESSION: No acute cardiopulmonary process. No visualized rib fracture based on a non-dedicated exam, if clinical concern, dedicated rib series can be performed. " eced4b96-9b57628b-9c163ad7-c428808e-780ceb3b.jpg,validate/p19/p19683840/s52116947/eced4b96-9b57628b-9c163ad7-c428808e-780ceb3b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough/fever/___ ___ // ___ pna ___ pna TECHNIQUE: Upright PA and lateral chest radiographs were obtained of. COMPARISON: None FINDINGS: The cardiomediastinal silhouette, aorta, and pulmonary vasculature are within normal limits. There is no consolidation or pleural effusion. Degenerative changes of the mid to lower thoracic spine are moderate. IMPRESSION: No acute process. No pneumonia. " 80148ec5-5c84bf44-b97f1385-665ed8c1-a02d1045.jpg,validate/p11/p11914968/s51939269/80148ec5-5c84bf44-b97f1385-665ed8c1-a02d1045.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cardiac arrest, hypoxemic respiratory failure // Evaluate for infection, pulmonary edema Evaluate for infection, pulmonary edema IMPRESSION: Compared to chest radiograph ___ ___ 14:00. Lung volumes have improved, but there has been no real change in moderate cardiomegaly or pulmonary vascular congestion. There is probably no pulmonary edema and pleural effusions are small if any. No pneumothorax. Tip of the endotracheal tube is no more than 2 cm from the carina but the chin is flexed of the position is appropriate. Nasogastric drainage tube passes into the stomach and out of view. " 2c5352d4-92334c11-74e35f27-c30f1cb7-92b331ce.jpg,validate/p12/p12562031/s53059395/2c5352d4-92334c11-74e35f27-c30f1cb7-92b331ce.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with cough and possible right middle lobe collapse. COMPARISON: Chest radiograph from another institution obtained at 15:00 p.m. today. FINDINGS: PA and lateral chest radiographs were obtained. A large left pneumothorax is associated with rightward shift of mediastinal structures and a small amount of pneumomediastinum. The right lung is clear. There is no nodule or effusion. Cardiac and mediastinal contours are normal. IMPRESSION: 1. Large left pneumothorax causes rightward shift of the mediastinum concerning for tension. 2. Small pneumomediastinum. NOTIFICATION: Findings were discovered at 17:05 and immediately disclosed to Dr. ___ ___ telephone at 17:06 on ___ by Dr. ___. " 2a615faa-7956670e-c9266157-f8fd768e-95b05a52.jpg,validate/p19/p19017919/s53328450/2a615faa-7956670e-c9266157-f8fd768e-95b05a52.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p cabg with MRSA PNA // eval for infiltrate eval for infiltrate COMPARISON: Chest radiographs ___ through ___ at 08:26. IMPRESSION: Lung volumes are lower exaggerating new mild pulmonary edema and worsening moderately severe right basal atelectasis, and enlarging moderate bilateral pleural effusion. Left lower lobe collapse and moderate cardiomegaly are long-standing. Feeding tube passes into the stomach and out of view. No pneumothorax. " 9f8e7424-7af7f911-a4d787a0-fb689d1b-a67273ab.jpg,validate/p17/p17089086/s54718170/9f8e7424-7af7f911-a4d787a0-fb689d1b-a67273ab.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain COMPARISON: Chest radiograph from ___ and ___ PA AND LATERAL CHEST RADIOGRAPHS: The lungs are clear. No confluent opacity is identified. There is no pulmonary edema or pleural effusions. No pneumothorax is evident. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: No acute cardiopulmonary process " 30eaff77-ee4344d3-941b33ec-1b2207d4-c721bf5b.jpg,validate/p18/p18655830/s51046595/30eaff77-ee4344d3-941b33ec-1b2207d4-c721bf5b.jpg,validation," FINAL REPORT INDICATION: ___F with abd pain, IDDM, ESRD, s/p cath. Had free air in the past. // r/o free air, pulmonary process TECHNIQUE: PA and lateral views of the chest COMPARISON: ___. FINDINGS: Prior enteric tube is not visualized. The lungs are now clear, prior effusions have essentially resolved. There is no consolidation or pulmonary edema. Cardiac silhouette is mildly enlarged. Median sternotomy wires are again noted. No acute osseous abnormalities. No free intraperitoneal air. IMPRESSION: No free intraperitoneal air or acute cardiopulmonary process. " 7593059d-bad82268-1253a7ae-b7e5d5d7-8ea3134b.jpg,validate/p14/p14474735/s51535239/7593059d-bad82268-1253a7ae-b7e5d5d7-8ea3134b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p tracheal debridement // r/o ptx r/o ptx IMPRESSION: Comparison to ___. The patient has undergone tracheal surgery. There are multiple hyperlucent mediastinal lines paralleling the trachea and strongly suggesting pneumomediastinum. However, no pneumothorax or pneumopericardium is seen. No enlargement of the mediastinum. No focal parenchymal opacities. No pleural effusions. " 93c27299-f44ae80f-73a278ee-ce136696-b3dbdcdc.jpg,validate/p17/p17354468/s51500259/93c27299-f44ae80f-73a278ee-ce136696-b3dbdcdc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ct pull // eval for ptx eval for ptx IMPRESSION: In comparison with the study of ___, all of the monitoring and support devices have been removed with a a right IJ sheath is in place. Following chest tube removal, there is no evidence of pneumothorax. Little change in the appearance of the heart and lungs. " c0ff88a5-5b3f86e4-17b46b72-0b433d85-02257b62.jpg,validate/p10/p10191971/s52938081/c0ff88a5-5b3f86e4-17b46b72-0b433d85-02257b62.jpg,validation," FINAL REPORT HISTORY: ET position. FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. The tip of the endotracheal tube lies approximately 5.2 cm above the carina. Cardiac silhouette remains within normal limits. There is some further improvement in the right basilar opacification as well as a slight improvement in the degree of pulmonary vascular congestion. " 73c80bfe-4250bf75-05eea34a-8b9abed9-6287b0f2.jpg,validate/p17/p17717274/s58528719/73c80bfe-4250bf75-05eea34a-8b9abed9-6287b0f2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with URI, pericardial friction rub // please assess cardiopulmonary architecture, including cardiac silhouette TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Heart size is top-normal. As compared to the prior study there is slight interval increase in cardiac silhouette from ___-13 cm, oval no radiographic signs of pericardial effusion demonstrated, though father assessment with echocardiography is required. Mediastinum is stable. Lungs are clear. No pleural effusion or pneumothorax is seen. Minimal bilateral apical pleural thickening is demonstrated. The findings are similar to previous study. " b59c3209-bc457067-7d672f24-bf1c2acd-cc078ecf.jpg,validate/p11/p11845452/s58114265/b59c3209-bc457067-7d672f24-bf1c2acd-cc078ecf.jpg,validation," WET READ: ___ ___ ___ 7:38 AM Increased right infrahilar opacity may represent focal pneumonia in the appropriate clinical setting. If the patient is going to be treated for pneumonia, recommend follow up radiograph in ___ weeks to ensure resolution. Updated findings after attending review discussed with Dr. ___ by phone at 7:35am ___. ______________________________________________________________________________ FINAL REPORT CLINICAL HISTORY: ___-year-old man with chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. The lungs are well expanded. Increased opacity in the right infrahilar region since ___, seen only on the frontal view, may represent focal pneumonia in the appropriate clinical setting. The remainder of the lungs are clear. No pleural effusion or pneumothorax. Heart size is within normal limits. Mediastinal silhouette and hilar contours are normal. No acute osseous abnormality is identified. IMPRESSION: Subtle right infrahilar opacity may represent focal pneumonia in the appropriate clinical setting. Recommend follow up radiograph in ___ weeks to ensure resolution after antibiotics. If persistent, CT would be recommended. Updated findings after attending review discussed with Dr. ___ by phone at 7:35am ___. " c4ed10ee-e0f14dcb-12e3b52d-379b35c6-933c20b1.jpg,validate/p17/p17845979/s56001527/c4ed10ee-e0f14dcb-12e3b52d-379b35c6-933c20b1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hematemsis // r/o acute process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Again, multiple metallic BBs overlie the left chest and shoulder.No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " e077cdf9-ac3dbfa8-d7ec628f-3555381b-abd22524.jpg,validate/p14/p14641484/s53117240/e077cdf9-ac3dbfa8-d7ec628f-3555381b-abd22524.jpg,validation," FINAL REPORT INDICATION: Evaluate for infiltrate in a patient with cough, congestion, crackles. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___, ___, ___, ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. There is subtle left infrahilar opacity, concerning for pneumonia. No definite focal consolidation, pleural effusion, or pneumothorax is identified. The visualized upper abdomen is unremarkable. IMPRESSION: Left infrahilar opacity concerning for pneumonia. " cd625a51-16e772d5-2dd9ce57-f236c205-df6ddf1c.jpg,validate/p12/p12312578/s51760746/cd625a51-16e772d5-2dd9ce57-f236c205-df6ddf1c.jpg,validation," FINAL REPORT EXAM: Chest, single frontal view. CLINICAL INFORMATION: Chest pain, status post CPR. COMPARISON: None. FINDINGS: Single AP upright portable view of the chest was obtained. The patient is status post median sternotomy and CABG. There is moderate pulmonary edema. Bibasilar opacities are seen, which could relate to prominent vascular structures, although underlying consolidation due to aspiration is not excluded. No large pleural effusion is seen, although a trace right pleural effusion would be difficult to exclude. The cardiac silhouette is top normal to mildly enlarged. The aorta is calcified. Right paratracheal opacity is seen, which could be due to prominent vascular structures; however, underlying consolidation is not excluded. Chronic-appearing deformity of the proximal left humerus is partially imaged. IMPRESSION: 1. Mild-to-moderate pulmonary edema. 2. Right paratracheal opacity could be due to pulmonary vascular structures though underlying consolidation is not excluded. Additionally, bibasilar opacities may relate to prominent vascular structures, although underlying aspiration is not excluded. " b798333a-2eeaeb1f-6ae4843e-e43ee4df-f87ab753.jpg,validate/p12/p12773009/s54877755/b798333a-2eeaeb1f-6ae4843e-e43ee4df-f87ab753.jpg,validation," FINAL REPORT HISTORY: Recurrent bilateral effusions. FINDINGS: In comparison with the study of ___, the costophrenic angles posteriorly are sharp, indicating effective clearing of the pleural effusions. Cardiac silhouette is within normal limits, and there is no evidence of vascular congestion or acute focal pneumonia. " 47572de9-02e5a10e-1e686ae9-603df8c5-aa05c94b.jpg,validate/p17/p17846379/s57111979/47572de9-02e5a10e-1e686ae9-603df8c5-aa05c94b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hypoxic respiratory failure, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is mild improvement of the left parenchymal opacity. On the right, the large pleural effusion and parenchymal opacities persist and are unchanged. Unchanged appearance of the cardiac silhouette. No evidence of focal parenchymal opacity suggesting pneumonia. " edbbbd00-a9552d87-cdb01093-ae2cfe20-12e31ae6.jpg,validate/p15/p15929503/s53906098/edbbbd00-a9552d87-cdb01093-ae2cfe20-12e31ae6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with SOB and weight gain // eval for fluid overload, PNA COMPARISON: ___. FINDINGS: PA and lateral views of the chest provided. Midline sternotomy wires are noted. There has been interval placement of a AICD device with leads extending to the region of the right atrium and right ventricle. Cardiomegaly is again noted. There is probable mild pulmonary edema. No large effusion or pneumothorax is seen. No confluent opacity concerning for pneumonia. Right rib cage deformity is chronic. No acute bony injury. IMPRESSION: Cardiomegaly, mild edema. AICD of appears in appropriate position. " ca32386d-4c1f4f11-be901823-3329602b-bc3674c8.jpg,validate/p11/p11098660/s55199832/ca32386d-4c1f4f11-be901823-3329602b-bc3674c8.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Status post AVR, ascending aorta replacement. There is a severe cardiomegaly. The lungs are grossly clear. There is no pneumothorax, pleural, pulmonary edema or pneumonia. Patient is status post AVR. Sternal wires are aligned. " dbeeaa55-0a6cde7d-bdf9bc45-71aa3011-744171d6.jpg,validate/p17/p17615451/s52817709/dbeeaa55-0a6cde7d-bdf9bc45-71aa3011-744171d6.jpg,validation," WET READ: ___ ___ ___ 8:15 PM Left retrocardiac opacity is unchanged from multiple priors and consistent with atelectasis. No pneumothorax. Blunting of right costophrenic angle may represent small pleural effusion. Cardiomediastinal silhouette is stable. ______________________________________________________________________________ FINAL REPORT HISTORY: Leukemia with fever. FINDINGS: In comparison with the previous study, there are more dense atelectatic changes at the left base. Otherwise, little change. " 7ab7f06b-4d90693a-9039d80a-35685580-1c3ffde8.jpg,validate/p17/p17244595/s58923560/7ab7f06b-4d90693a-9039d80a-35685580-1c3ffde8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with tachypnea // assess for PNA, effusion assess for PNA, effusion IMPRESSION: Comparison to ___. No relevant change is noted. The small focus at the right lung basis is stable in extent and severity. The marked right-sided overinflation is also stable. No change in appearance of the cardiac silhouette, the known left-sided consolidation and the course and position of the left PICC line. " d4c5864e-503e14b7-185476e2-e0cdec40-3f461491.jpg,validate/p18/p18997544/s59890634/d4c5864e-503e14b7-185476e2-e0cdec40-3f461491.jpg,validation," FINAL REPORT INDICATION: History: ___M with cough // ?pnuemonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___ FINDINGS: There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. A 0.6 cm nodular opacity overlying the left lung base is stable since ___. IMPRESSION: No radiographic evidence pneumonia. " 87ad7b2a-bd505d59-216f7d28-db47568c-42309b92.jpg,validate/p15/p15653759/s56232397/87ad7b2a-bd505d59-216f7d28-db47568c-42309b92.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recent ileus // please eval NJT position COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the lung volumes have decreased, causing areas of atelectasis at both the right and the left lung bases. The atelectasis are more severe on the right and on the left. The left Port-A-Cath is unchanged. The previously placed feeding tube has been removed and replaced by a new catheter. The position of this catheter is to I. The tip projects over the gastroesophageal junction. For correct positioning in the stomach that tube requires to be advanced by 8-10 cm. No complications, notably no pneumothorax. " b34cac8e-1c70ec4c-23c767e9-60fd4680-8fdd7bd8.jpg,validate/p19/p19837618/s57700113/b34cac8e-1c70ec4c-23c767e9-60fd4680-8fdd7bd8.jpg,validation," WET READ: ___ ___ ___ 12:11 AM No pneumothorax. S/P left thoracentesis with decreased left effusion and improved left base aeration. Left basal opacity redemonstrated, likely a combination of re-expansion edema and post -obstructive pneumonia. ______________________________________________________________________________ FINAL REPORT PORTABLE AP CHEST FILM ___ AT 18:26 CLINICAL INDICATION: ___-year-old with left lung mass suspicious for cancer and pneumonia, status post thoracentesis, evaluate for pneumothorax. Comparison to prior study of ___ at 4:15. Portable AP upright chest film ___ at 18:26 is submitted. IMPRESSION: There has been interval decrease in size of a left pleural effusion. No right pleural effusion. No pneumothorax is appreciated. There is airspace opacity in the left mid and lower lung which could represent pneumonia. A fullness in the left hilar region raises concern for a post-obstructive pneumonia and could reflect adenopathy. No evidence of pulmonary edema. " 566ecdef-b535c250-ef46ef7c-36dad616-ebf28dfc.jpg,validate/p10/p10296754/s52777980/566ecdef-b535c250-ef46ef7c-36dad616-ebf28dfc.jpg,validation," FINAL REPORT INDICATION: ___F with fever, cough // infiltrate TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: Left chest wall dual lead pacing device is seen with leads projecting over the right atrium and right ventricle. Intact median sternotomy wires and prosthetic valve are noted. There are dense atherosclerotic calcifications at the aortic arch. Cardiac silhouette is within normal limits. The lungs are clear without consolidation, effusion, or edema. Rounded calcific density projecting over the left lung base is likely a calcified granuloma. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " e4657af3-7154d22b-49a8a353-cd2e35f3-fe67f43b.jpg,validate/p12/p12201410/s54660323/e4657af3-7154d22b-49a8a353-cd2e35f3-fe67f43b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with chf vs pna // ? chf COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of minimal retrocardiac atelectasis, at overall low lung volumes. No convincing evidence for the presence of pneumonia. No pleural effusions. Mild elongation of the descending aorta. No pneumothorax. " 5e1a28cb-212a05b3-4fd4ca6d-26838f39-1138a7b1.jpg,validate/p15/p15657398/s50477795/5e1a28cb-212a05b3-4fd4ca6d-26838f39-1138a7b1.jpg,validation," WET READ: ___ ___ ___ 1:01 PM 1. New subtle opacity overlying the left upper lung, could be due to atelectasis versus infection. Recommend followup to resolution. 2. Stable nodular opacity at the left base. 3. Stable mid thoracic vertebral compression deformity. 4. Mild hyperinflation. WET READ VERSION #1 ___ ___ ___ 12:57 PM 1. New subtle opacity overlying the left upper lung, no definite focal consolidation but cannot exclude infectious process. 2. Stable nodular opacity at the left base. 3. Stable mid thoracic vertebral compression deformity. 4. Mild hyperinflation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with fever, evaluate for pneumonia. TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to ___. FINDINGS: The lungs are mildly hyperinflated. A compression deformity of a mid thoracic vertebra is unchanged from prior studies. There is no focal consolidation, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. The previously seen nodular opacity at the left lung base is unchanged from the prior study. A subtle opacity overlying the left upper lung appears new from the prior study. IMPRESSION: 1. New subtle opacity overlying the left upper lung, could be due to atelectasis versus infection. Recommend followup to resolution. 2. Stable nodular opacity at the left base. 3. Stable mid thoracic vertebral compression deformity. 4. Mild hyperinflation. " 2739b21c-e28272ea-83844d98-d026b067-9331a615.jpg,validate/p14/p14435614/s58178390/2739b21c-e28272ea-83844d98-d026b067-9331a615.jpg,validation," FINAL REPORT HISTORY: Left 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 and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 98653368-ac5b0a13-94942013-7480fb53-3227881b.jpg,validate/p11/p11733407/s51592446/98653368-ac5b0a13-94942013-7480fb53-3227881b.jpg,validation," FINAL REPORT HISTORY: Fever and cough for 10 days. COMPARISON: None. 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. " 69bc1eb4-0f842358-6ca533db-742dc714-8966d2c0.jpg,validate/p15/p15658016/s52971902/69bc1eb4-0f842358-6ca533db-742dc714-8966d2c0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with abdominal tube entering through 9th rib; placed to water seal. Please eval position // please eval for PTX TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiograph dated ___. FINDINGS: In comparison with chest radiograph from ___, there is no significant change. Lungs are clear. There is no pneumothorax. Mediastinal and hilar contours are normal. Heart size is normal. Above described abdominal tube is not visualized on this study. IMPRESSION: No pneumothorax. " 38ab7370-abb69d32-16643d30-0090a62a-c7eb351d.jpg,validate/p12/p12450697/s55549715/38ab7370-abb69d32-16643d30-0090a62a-c7eb351d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History of arrhythmias, dyspnea on exertion for 1 month TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___, chest radiograph ___. FINDINGS: Heart size is mild to moderately enlarged, unchanged. Mediastinal and hilar contours are within normal limits. Linear and streaky opacities in the lung bases appear relatively unchanged compared to the previous exam with minimal increased atelectasis noted at the right lung base. No focal consolidation, pleural effusion or pneumothorax is identified. There is no pulmonary edema. No acute osseous abnormality seen. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: Slightly increased right basilar atelectasis. " 866fdac9-c7c06efb-42e06089-96f4a08e-ac0f8a51.jpg,validate/p16/p16036071/s57779234/866fdac9-c7c06efb-42e06089-96f4a08e-ac0f8a51.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: AP and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pneumothorax. Enteric tube is again noted. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 5791e4e6-838e657c-a0aed22c-14b0a61c-6ab29249.jpg,validate/p10/p10272054/s52440482/5791e4e6-838e657c-a0aed22c-14b0a61c-6ab29249.jpg,validation," FINAL REPORT INDICATION: DKA with unknown precipitant and weakness, 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, pleural effusion or pneumothorax. An oblique density projecting over the left lateral lung base likely reflects plate-like atelectasis in the lingula, unchanged. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. There is a hiatal hernia. IMPRESSION: No acute cardiopulmonary process. " 849c8a62-044aeedd-d82807e1-77d0a8f3-b9d0e893.jpg,validate/p13/p13135946/s51924292/849c8a62-044aeedd-d82807e1-77d0a8f3-b9d0e893.jpg,validation," FINAL REPORT AP CHEST, 9:02 A.M. ON ___ HISTORY: Subdural hematoma. Preop for surgery. IMPRESSION: AP chest compared to ___: Mild interstitial pulmonary abnormality is new, and there is hazy opacification in the juxtahilar left mid and lower lung zones which could be due to pneumonia. Heart size is normal. There is no appreciable pleural effusion. Dr. ___ was paged. " 73b0c357-ecace638-d1c04e70-6dd83d6e-5179d676.jpg,validate/p14/p14130631/s50982266/73b0c357-ecace638-d1c04e70-6dd83d6e-5179d676.jpg,validation," 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. " f83b2595-852fed8b-2b6d0612-664b8482-635cac68.jpg,validate/p10/p10406570/s54722646/f83b2595-852fed8b-2b6d0612-664b8482-635cac68.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever POD___ s/p left total knee arthroplasty // please evaluate for pneumonia, atelectasis please evaluate for pneumonia, atelectasis IMPRESSION: In comparison with the study of ___, the patient has taken a better inspiration. Cardiac silhouette is at the upper limits of normal in size and there is no evidence of appreciable vascular congestion. Streaks of atelectasis are seen at both bases and there is blunting of the costophrenic angles. New no evidence of acute focal pneumonia. " 529138df-77f518dc-dfe39216-de286a09-695a45de.jpg,validate/p15/p15907524/s54200021/529138df-77f518dc-dfe39216-de286a09-695a45de.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Osteoarthropathy. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the lung volumes have increased, but there is no evidence of hyperinflation. Normal size of the cardiac silhouette. Minimal tortuosity of the thoracic aorta. No pleural effusions. No pathological parenchymal processes. Unchanged bilateral symmetrical mild apical thickening. No pneumonia, no pulmonary edema. " 6986495b-a0da61ec-c0c25e47-29ad2cb6-a4ec1a57.jpg,validate/p11/p11971081/s59172993/6986495b-a0da61ec-c0c25e47-29ad2cb6-a4ec1a57.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and shortness of breath, history of cancer with lung metastasis, rule out acute process. COMPARISON: Reference chest ___, second opinion torso CT ___. FINDINGS: Two views of the chest demonstrate a left chest MediPort with its tip positioned at the right atrioventricular junction. Massive bilateral hilar lymphadenopathy, and bilateral pulmonary nodules, right greater than left, are again noted. There is no new consolidation, pleural effusion, or pneumothorax. The pulmonary vasculature remains normal. IMPRESSIONS: 1. Bilateral hilar and pulmonary metastases, not significantly changed from ___. 2. Left chest MediPort with its tip at the right atrioventricular junction. " 61d79038-d7f5ae83-f0adaf1a-fb9d5ab2-78da5a86.jpg,validate/p19/p19780620/s55949309/61d79038-d7f5ae83-f0adaf1a-fb9d5ab2-78da5a86.jpg,validation," FINAL REPORT INDICATION: ___ year old man with NGT placement. // Please evaluate for NGT location. TECHNIQUE: Portable COMPARISON: ___ FINDINGS: New nasogastric tube with the first port at the gastroesophageal junction. Dobhoff tube is in the proximal small bowel. Increasing pulmonary vascular congestion and small left pleural effusion. No pneumothorax. IMPRESSION: Nasogastric tube first side port at the gastroesophageal junction. " 9f918e01-ea980630-5cf91132-4e2d6380-cf0c6195.jpg,validate/p12/p12763939/s53925093/9f918e01-ea980630-5cf91132-4e2d6380-cf0c6195.jpg,validation," WET READ: ___ ___ ___ 9:52 PM DHT is in antrum near the pylorus. Otherwise exam is unchanged with satisfactory position of ETT. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with the earlier study of this date, the Dobbhoff tube has been pushed forward so that it lies in the antrum near the pylorus. Otherwise, little change. " a1420122-414481f3-e4c6da59-aaf328a2-539647e4.jpg,validate/p12/p12346583/s59300396/a1420122-414481f3-e4c6da59-aaf328a2-539647e4.jpg,validation," FINAL REPORT INDICATION: ___ year old man with blunt trauma. TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph ___. Chest CT ___. FINDINGS: A Portable view of the chest demonstrates low lung volumes. Bibasilar opacities symmetrically are consistent with atelectasis. There is no pleural effusion or pneumothorax. The cardiomediastinal contour is unchanged. Known bilateral rib fractures are better seen on concurrent CT of the torso. IMPRESSION: Bibasilar symmetric opacities are consistent with atelectasis. No pleural effusion or pneumothorax. " ebb38a2a-c5a7c365-5586dd18-7df79795-a6aa7ea1.jpg,validate/p17/p17501651/s50151328/ebb38a2a-c5a7c365-5586dd18-7df79795-a6aa7ea1.jpg,validation," FINAL REPORT INDICATION: ___ year old man with AMS // eval ett and CVL COMPARISON: The comparison is made with prior studies including ___. IMPRESSION: Endotracheal tube tip is 2 cm above the carina. Right central line tip is in the proximal SVC. The previously noted nasogastric tube has been removed. There is patchy density in the right lower lobe. The left hemidiaphragm is obscured on this could be related to atelectasis or effusion. There may be mild CHF. There is no pneumothorax. " 02baa20a-6bf1ed67-ae2032a1-faf556e3-497d9fe2.jpg,validate/p18/p18624005/s56274967/02baa20a-6bf1ed67-ae2032a1-faf556e3-497d9fe2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe RV failure here for diuresis with worsening dyspnea // r/o PNA and evalute volume overload. TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___. IMPRESSION: Since the prior study there is interval increase in right perihilar opacity as well as left perihilar opacity consistent with progression of pulmonary edema. There is enlarged appearance of cardiomediastinal silhouette, unchanged as well as there is slight increase in bilateral pleural effusions. " 3fa43f1e-066b3abd-8faae357-5d656d9f-d41c8baa.jpg,validate/p19/p19858494/s50770927/3fa43f1e-066b3abd-8faae357-5d656d9f-d41c8baa.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ON ___ AT 3:33 CLINICAL INDICATION: ___-year-old with respiratory failure, evaluate for change. COMPARISON: ___ at 3:10. Portable supine chest film ___ at 3:33 is submitted. IMPRESSION: 1. Right subclavian PICC line continues to have its tip in the distal SVC. An endotracheal tube has its tip approximately 3 cm above the carina, unchanged. 2. Lung volumes remain low with patchy bilateral opacities, left greater than right, with probable small layering effusions. These findings most likely represent compressive atelectasis, although bibasilar pneumonia cannot be excluded. No evidence of pulmonary edema. No large pneumothoraces, although the sensitivity to detect the pneumothorax is diminished given supine technique. Cardiac and mediastinal contours are likely stable given differences in patient positioning. " 376c6711-7e503b91-7959542b-1c47c82b-5b39c038.jpg,validate/p15/p15297415/s52214359/376c6711-7e503b91-7959542b-1c47c82b-5b39c038.jpg,validation," WET READ: ___ ___ ___ 12:01 AM Right central line is in the right atrium. Nasogastric tube courses below the diaphragm into the stomach. Right pleural effusion is smaller than the prior study. Left lower lobe opacity is unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p ___ // s/p thoracentesis rule out PTX TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Dobbhoff tube tip is coiled in the proximal stomach. Right central venous line tip terminates at the distal right atrium. Right pleural effusion is moderate, unchanged. Bibasal atelectasis is present. Upper lungs were excluded from the field of view " c1016405-3f0dea97-b9f2b667-dcebc0d2-67732c57.jpg,validate/p11/p11607628/s52031993/c1016405-3f0dea97-b9f2b667-dcebc0d2-67732c57.jpg,validation," WET READ: ___ ___ ___ 8:08 PM tip of ETT less than 1cm from the carina and pull back indicated. improved left lower lobe atelectasis. stable bilateral effusions which are small. d/w dr. ___ via phone at ___pm on ___ ______________________________________________________________________________ FINAL REPORT SINGLE AP PORTABLE VIEW OF THE CHEST REASON FOR EXAM: hypercarbic respiratory failure. Comparison is made with prior study performed 2 hours earlier. New ET tube tip is 1 cm from the carina and could be withdrawn a couple of centimeters for more standard position. Aeration of the lungs has improved. Small right and small-to-moderate left pleural effusions are unchanged. There is less atelectasis in the left lower lobe. Left IJ catheter tip is in the upper to mid SVC. NG tube tip is out of view below the diaphragm. Cardiomegaly is stable. " 2c504312-326c0225-1b5a3be7-d72a497d-c02f4332.jpg,validate/p16/p16500918/s57988885/2c504312-326c0225-1b5a3be7-d72a497d-c02f4332.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with hyperglycemia // PNA? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and cardiac valve replacement. Dual lead right-sided pacer device is stable in position. The cardiac and mediastinal silhouettes are grossly stable with the cardiac silhouette mildly enlarged. No focal consolidation is seen. There is no pleural effusion or pneumothorax. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " cb433449-ae2ad5f2-b1350e06-3ce32578-22341367.jpg,validate/p14/p14741471/s51901774/cb433449-ae2ad5f2-b1350e06-3ce32578-22341367.jpg,validation," FINAL REPORT HISTORY: Worsening oxygen requirement. TECHNIQUE: Portable frontal chest radiograph. COMPARISON: Multiple studies from ___ through ___. FINDINGS: Lung volumes remain low however with slightly improved aeration compared to yesterday's examination. Moderate pulmonary edema is slightly improved. Bibasilar linear and plate like atelectasis is unchanged. A right PICC is unchanged in position. There is no pleural effusion or pneumothorax. Residual ethiodol from prior TACE projects over the right upper quadrant. IMPRESSION: Slight improvement in moderate pulmonary edema. No evidence of pneumonia. " 25963d60-9f6b0a42-461bb6ff-12b3955f-56b47250.jpg,validate/p16/p16875549/s58201685/25963d60-9f6b0a42-461bb6ff-12b3955f-56b47250.jpg,validation," 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. " ba407501-1d4532b4-7456144a-ec450b6b-17c43709.jpg,validate/p18/p18284792/s54547456/ba407501-1d4532b4-7456144a-ec450b6b-17c43709.jpg,validation," 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. " c6178d3b-e16677a8-94beaf25-04242afc-eb7494ae.jpg,validate/p15/p15935768/s57155347/c6178d3b-e16677a8-94beaf25-04242afc-eb7494ae.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with upper GI bleeding, to evaluate for pneumomediastinum. COMPARISON: Chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear, without consolidation or pulmonary edema. No pneumomediastinum, pleural effusion or pneumothorax is seen. There is no free air under the diaphragm. IMPRESSION: 1. No pneumomediastinum or pneumoperitoneum. 2. No acute cardiopulmonary pathology. " a5a7f695-f5617246-a8738c4f-7cba4825-88838638.jpg,validate/p11/p11535886/s54865491/a5a7f695-f5617246-a8738c4f-7cba4825-88838638.jpg,validation," FINAL REPORT AP CHEST 7:59 A.M., ___ HISTORY: A ___-year-old woman, confirm NG tube placement. IMPRESSION: AP chest compared to ___, 5:58 a.m.: Nasogastric tube still ends in the upper stomach and would need to be advanced 10 cm to move all the side ports beyond the GE junction. Moderate pulmonary edema has improved. Moderate bilateral pleural effusions are still in place. Right PIC line ends in the mid SVC. The heart is moderately enlarged, as before. " e1d55ece-ad13e210-65d448cf-59ba467a-d90e0544.jpg,validate/p10/p10781100/s56415875/e1d55ece-ad13e210-65d448cf-59ba467a-d90e0544.jpg,validation," 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. " 65d2baeb-9cbd7a8a-ff2151bb-94e6a58e-74945d55.jpg,validate/p10/p10364180/s53383509/65d2baeb-9cbd7a8a-ff2151bb-94e6a58e-74945d55.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with resp distress/hypoxia // r/o infiltrate,failure COMPARISON: ___. PET-CT scan from ___. FINDINGS: AP portable upright view of the chest. In this patient with known COPD plans lung cancer, diffuse interstitial opacities are concerning for edema. The known pulmonary nodular opacities are better visualized on the prior PET-CT scan. Small effusions are difficult to exclude. The heart appears mildly enlarged. Aortic atherosclerotic calcifications noted. No acute bony injuries. IMPRESSION: Mild cardiomegaly with interstitial pulmonary edema and probable small bilateral pleural effusions. Pulmonary nodular opacity seen on prior PET-CT scan poorly visualized on this chest radiograph. " a31254d4-b23cb1ee-b94e926b-18540bcf-b5d44775.jpg,validate/p17/p17375734/s55673426/a31254d4-b23cb1ee-b94e926b-18540bcf-b5d44775.jpg,validation," FINAL REPORT INDICATION: ___F with afib w/ RVR // evidence of pneumonia TECHNIQUE: PA and lateral views the chest. COMPARISON: ___. FINDINGS: There is no focal consolidation. Blunting of the right posterior costophrenic angle may represent small effusion. Slightly indistinct pulmonary vascular markings suggest pulmonary vascular congestion. There is no overt edema or focal consolidation. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities, old healed posterior left rib fracture is noted. IMPRESSION: Pulmonary vascular congestion without focal consolidation. " d4e9e727-91d8ac3c-b8491b7e-1d5c06ac-389a59f0.jpg,validate/p15/p15246600/s54973074/d4e9e727-91d8ac3c-b8491b7e-1d5c06ac-389a59f0.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___M with hypotension and SOB // eval for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, as well as chest radiograph and torso CT from ___. FINDINGS: The cardiac silhouette is normal in size. The hilar and mediastinal contours are within normal limits. There is persistent elevation of the right hemidiaphragm with interposition of the colon superior to the liver. The lungs are clear. There is no focal consolidation, pleural effusion or pneumothorax. IMPRESSION: 1. No acute cardiopulmonary process. 2. Persistent elevation of the right hemidiaphragm. " 37fb5a28-21bd6c2b-81ad37e5-e92aeb24-ce6024a5.jpg,validate/p16/p16750031/s53682105/37fb5a28-21bd6c2b-81ad37e5-e92aeb24-ce6024a5.jpg,validation," 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. " 37f9166d-8f7cc8c6-f7829572-9f86698b-093cb394.jpg,validate/p11/p11864106/s58776942/37f9166d-8f7cc8c6-f7829572-9f86698b-093cb394.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Left exploratory thoracoscopy, left thoracotomy, and left lower lobectomy, followup. PA and lateral upright chest radiographs were reviewed in comparison to ___. There is expected left mediastinal shift with interval resolution of pneumothorax and no appreciable pleural effusion demonstrated, although small amount cannot be excluded. Loculated air in the anterior aspect of the pleura is noted. The left lower lobe opacity is seen, still representing post-surgical changes and should be further followed. The right lung is clear. There is no right pleural effusion or pneumothorax. " 2727205c-6bb8d0b9-2aeca25d-461b071c-d706c972.jpg,validate/p12/p12384115/s59769647/2727205c-6bb8d0b9-2aeca25d-461b071c-d706c972.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M otherwise healthy w/ acute onset sharp diffuse chest pain since this AM, moved refrigerator yesterday, ROS neg except for pleuritic 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. " 71b5013b-50c2ab2d-d955a466-f24c2dd8-66387ec7.jpg,validate/p16/p16536493/s56828300/71b5013b-50c2ab2d-d955a466-f24c2dd8-66387ec7.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with cough. COMPARISON: Chest radiograph dated ___. FINDINGS: AP and lateral chest radiographs were obtained. Comparison is made to prior radiograph dated ___. There is persistent shifting to the right of the cardiomediastinal structures which are otherwise unchanged in appearance. Within the left lower lung zone, there is an opacification concerning for pneumonia. Additional note is made of bronchial wall thickening which may reflect a component of bronchitis. Obliteration of bilateral costophrenic angles suggests a pleural effusion. IMPRESSION: Left lower lobe opacity concerning for pneumonia. Thickening of the bronchial walls is additionally suggestive of bronchitis. " eecd86ed-0c064bb0-608a0df8-112185ff-f9244835.jpg,validate/p11/p11639395/s58717644/eecd86ed-0c064bb0-608a0df8-112185ff-f9244835.jpg,validation," FINAL REPORT HISTORY: Chest pain. FINDINGS: In comparison with the study of ___, there are strikingly low lung volumes. What appear to be atelectatic changes are seen at both bases. No definite consolidation is appreciated, though this would be difficult to exclude in the appropriate clinical setting. Cardiac silhouette is essentially within normal limits and there is no definite vascular congestion. " 91ebcb35-32c485b3-04540909-18e761f3-64ed5b43.jpg,validate/p13/p13120691/s59695137/91ebcb35-32c485b3-04540909-18e761f3-64ed5b43.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Confusion. COMPARISONS: Radiographs and chest CT from ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: There is a prominent left cardiac fat pad as before. A round lingular nodule is again suspicious for malignancy. There is no definite pleural effusion or pneumothorax, although a slight new blunting of posterior costophrenic sulci is noted, possibly due to minor atelectasis or trace pleural effusion on the left side. IMPRESSION: Possible trace left-sided pleural effusion, without other significant change, including a persistent suspicious lingular lung nodule. " 92d5a486-b36174ac-cc033026-c833100a-64a42f01.jpg,validate/p19/p19277070/s58892733/92d5a486-b36174ac-cc033026-c833100a-64a42f01.jpg,validation," FINAL REPORT INDICATION: ___M with severe MR ___ endocarditis // ?pulm edema TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without effusion or pulmonary edema. The cardiomediastinal silhouette is within normal limits and unchanged given differences in technique. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 0263cc23-fb88387d-d2ab2270-7800d110-c820c662.jpg,validate/p13/p13286565/s54175074/0263cc23-fb88387d-d2ab2270-7800d110-c820c662.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with weakness, question pneumonia. COMPARISON: Chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion or pneumothorax. Streaky opacities in the right base and in the retrocardiac region are likely atelectasis and similar to the prior study from ___. A left chest wall dual-lead pacemaker is present with leads in the right atrium and right ventricle, unchanged in position since the prior study. The cardiomediastinal silhouette is normal. The bones are intact. The imaged upper abdomen is unremarkable. IMPRESSION: Bibasilar atelectasis, otherwise no acute cardiopulmonary process. " 699ff152-ce1fb011-4025232c-b80342b7-98c16391.jpg,validate/p17/p17932825/s54657116/699ff152-ce1fb011-4025232c-b80342b7-98c16391.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of chest wall 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. " 91a801c2-fc0c599b-5d53497b-4f9ef094-d9518c16.jpg,validate/p13/p13119719/s59394801/91a801c2-fc0c599b-5d53497b-4f9ef094-d9518c16.jpg,validation," 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. " 9a374cac-4612cd41-2da5aa7e-55b1477c-0d98f62e.jpg,validate/p15/p15760813/s57292893/9a374cac-4612cd41-2da5aa7e-55b1477c-0d98f62e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with bleeding post TBBX // penumothorax penumothorax IMPRESSION: Status post transbronchial biopsy. Consolidation of the biopsied lung parenchyma with the lateral hyperlucency that is caused by a bleb documented on the CT examination from ___. No evidence of pneumothorax. " 6dc4d317-05933a1f-f8336626-04aef96a-5bcca031.jpg,validate/p19/p19120008/s59157358/6dc4d317-05933a1f-f8336626-04aef96a-5bcca031.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___M with prostate ca, hematuria, onc admission, performing infectious w/u // eval ? PNA TECHNIQUE: Chest PA and lateral COMPARISON: CT chest dated ___. FINDINGS: There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. There is slight prominence of the bilateral hila and pulmonary arteries. The cardiomediastinal silhouette is otherwise within normal limits. Aortic knob calcifications are noted. IMPRESSION: No evidence of acute cardiopulmonary process. " 72ed1b0c-08a96e67-a5713e09-89a6709d-1fcbad08.jpg,validate/p14/p14653207/s50120181/72ed1b0c-08a96e67-a5713e09-89a6709d-1fcbad08.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, dyspnea TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Mild enlargement of the cardiac silhouette is noted, unchanged. Mediastinal and hilar contours similar. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is seen. Mild multilevel degenerative changes are noted in the thoracic spine. There is a mildly elevated right hemidiaphragm, unchanged. Prior right mastectomy is again seen. IMPRESSION: No acute cardiopulmonary abnormality. " 41392f3f-3a58c851-19d15c74-fbd2a160-873ba2eb.jpg,validate/p11/p11664631/s57479761/41392f3f-3a58c851-19d15c74-fbd2a160-873ba2eb.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever. 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. IMPRESSION: No acute cardiopulmonary process. " 5cf9c712-6304f190-1c84c09e-b620e597-4f0cd925.jpg,validate/p12/p12964757/s58146005/5cf9c712-6304f190-1c84c09e-b620e597-4f0cd925.jpg,validation," FINAL REPORT PORTABLE CHEST ___. HISTORY: ___-year-old with altered mental status. Question pneumonia. FINDINGS: Single portable view of the chest is compared to previous exam from ___. When compared to prior, there has been near complete interval resolution of the patchy opacities projecting over the right upper lung as well as the left upper lung. There is, however, new patchy opacity at the left lung base with blunting of the left costophrenic angle. The cardiomediastinal silhouette is stable as are the osseous and soft tissue structures. IMPRESSION: Overall improvement of the bilateral opacities identified on prior. However, there has been progression of disease at the left lung base suggesting possible new pneumonia and small effusion. Two-view chest x-ray may help further characterize. " 42f357e9-258627aa-34305ff9-1a56d72f-ca7cf544.jpg,validate/p18/p18429024/s58072000/42f357e9-258627aa-34305ff9-1a56d72f-ca7cf544.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Followup of the patient with left pneumothorax. Portable AP radiograph of the chest was reviewed in comparison to ___ obtained at 3:30 p.m. and 2:51 p.m. The ET tube tip is 5 cm above the carina. The right chest tube is in place, but note is made that the side hole is borderline just at the edge of the thoracic cage. Substantial pneumothorax is noted on the right, unchanged as well as potentially present pneumopericardium. The NG tube tip is in the stomach. Right lung opacification appears to be slightly worse as compared to prior studies and there is also substantial interval increase in subcutaneous air in the right hemithorax. " 99d52090-2584f91b-e9844926-576c2f80-2b920f8b.jpg,validate/p13/p13477622/s57593184/99d52090-2584f91b-e9844926-576c2f80-2b920f8b.jpg,validation," 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. " 468406dc-86af8672-b0dab9f5-fa455efc-4bd8032b.jpg,validate/p14/p14871009/s52496918/468406dc-86af8672-b0dab9f5-fa455efc-4bd8032b.jpg,validation," FINAL REPORT HISTORY: Shortness of breath, to assess for pneumonia or pulmonary congestion. FINDINGS: In comparison with the study of ___, there are continued low lung volumes with mild indistinctness of pulmonary vessels consistent with minimal elevation of pulmonary venous pressure. Retrocardiac opacification persists with obscuration of the hemidiaphragms, consistent with volume loss in the lower lobe and pleural effusion. Pacer wires remain essentially unchanged. The opacification in the right upper zone medially persists. " 17c10a59-51316662-eea3eb8b-21e8f19b-f9582a02.jpg,validate/p13/p13019601/s56418536/17c10a59-51316662-eea3eb8b-21e8f19b-f9582a02.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Central venous catheter and permanent pacemaker remain unchanged in position allowing for positional differences of the patient. Cardiac silhouette is enlarged, accompanied by pulmonary vascular engorgement. Previously reported multifocal pulmonary opacities have partially cleared with residual opacities mostly in the perihilar regions. This likely reflects improving pulmonary edema. More confluent opacity in left retrocardiac region has only slightly improved and is likely due to a combination of atelectasis and effusion. Small right pleural effusion has decreased in size. " a22c9308-d091004c-7eba577c-25994a20-ec85dff5.jpg,validate/p16/p16948316/s54477445/a22c9308-d091004c-7eba577c-25994a20-ec85dff5.jpg,validation," FINAL REPORT HISTORY: Left upper lobe VATS. FINDINGS: In comparison with the study of ___, there is again some shift of the mediastinum to the left with elevation of the hemidiaphragm, consistent with the previous surgical procedure. No evidence of acute pneumonia or vascular congestion or pleural effusion. " a74924c3-5c4524a7-e28f5437-e9ae275a-317089e3.jpg,validate/p10/p10018205/s55652312/a74924c3-5c4524a7-e28f5437-e9ae275a-317089e3.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient left-sided chest pain along left border of the sternum, sporadic smoker, rule out lung or pleural abnormality. COMPARISON: None. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: There are no significant cardiopulmonary findings. " 7a391d3e-445ead7e-9f32a802-145f45dd-307908fd.jpg,validate/p13/p13847946/s52425038/7a391d3e-445ead7e-9f32a802-145f45dd-307908fd.jpg,validation," FINAL REPORT EXAMINATION: Chest (AP and lateral) INDICATION: ___-year-old woman status-post motor vehicle collision who presents with mid thoracic spine tenderness; evaluate for fracture. TECHNIQUE: AP and lateral chest radiographs were obtained. COMPARISON: Chest radiograph dated ___. FINDINGS: The lungs are clear. No focal consolidation, pneumothorax, or pleural effusion. Compared to the prior exam, the cardiomediastinal silhouette appears increased in size; however this may be due to lack of full inspiration and different technique on this exam compared to ___. The hila are unremarkable. No displaced fracture is seen. The thoracic spine is appears similar to the prior exam. Probable eventration of the right hemidiaphragm is overall unchanged. IMPRESSION: No acute intrathoracic process. " 9e29d840-659f2dc0-5853f6e1-d558798d-6ede04ab.jpg,validate/p18/p18001762/s52387651/9e29d840-659f2dc0-5853f6e1-d558798d-6ede04ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with wheezing // eval for acute process COMPARISON: Prior exam from ___. FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low and evaluation is somewhat limited due to underpenetrated technique likely in part due to large body habitus. The heart size appears enlarged though a component may be due to AP technique. There is no convincing evidence for pneumonia, large effusion or pneumothorax. Mild congestion difficult to exclude given technique though there is no overt edema. Bony structures are intact. IMPRESSION: Possible mild congestion. Limited exam. " 36a4bde1-a454b7f9-5cb28c24-91b4f7ed-f09deb6b.jpg,validate/p11/p11495809/s55091814/36a4bde1-a454b7f9-5cb28c24-91b4f7ed-f09deb6b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p Left mini thoracotomy and pericardial window // check interval change TECHNIQUE: PA and lateral views COMPARISON: ___ FINDINGS: Bilateral pulmonary effusions left greater than right which have slightly increased in size. Atelectasis bilaterally has slightly increased as well. Otherwise, cardiomediastinal is largely unchanged as compared to previous examination. No pneumothorax is seen. IMPRESSION: Slightly increased atelectasis and bilateral pulmonary effusions. " 68e737c3-1df8dc39-3af7c786-6dacf079-46182bb3.jpg,validate/p13/p13621755/s59931377/68e737c3-1df8dc39-3af7c786-6dacf079-46182bb3.jpg,validation," FINAL REPORT HISTORY: Trauma ET tube position. Interval consolidation. CHEST, SINGLE AP PORTABLE VIEW. An ET tube is present, tip in satisfactory position 3.9 cm above the carina. An NG tube is present, tip extending beneath the diaphragm, off the film. The cardiomediastinal silhouette is within normal limits. No CHF, focal infiltrate, or effusion. No pneumothorax identified. A comminuted right mid clavicular fracture is unchanged. Better seen on the current exam is the displaced right ___ posterolateral fracture. Additional known rib fractures are not well visualized. Slight left convex curvature of the upper thoracic spine is unchanged. " 9e53c04b-bf1ca36d-169b9a8c-527f102b-e77ecbee.jpg,validate/p19/p19729543/s52637488/9e53c04b-bf1ca36d-169b9a8c-527f102b-e77ecbee.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with status post assault. COMPARISON: None available. 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. " f048de7d-80d1e9bd-ad47d2eb-318ccf94-efcdad50.jpg,validate/p14/p14228791/s52853966/f048de7d-80d1e9bd-ad47d2eb-318ccf94-efcdad50.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain and shortness of breath, evaluate for CHF. COMPARISON: CT performed ___. FINDINGS: Frontal and lateral chest radiographs demonstrate clear, well-expanded lungs without pleural effusion or pneumothorax. The cardiac silhouette is ___;. Unchanged hilar prominence is consistent with patient's known lymphadenopathy. IMPRESSION: Unchanged hilar lymphadenopathy, without acute chest abnormality. " 1418d62b-5cbce169-43b49266-dd636737-7c30a989.jpg,validate/p11/p11487605/s50815146/1418d62b-5cbce169-43b49266-dd636737-7c30a989.jpg,validation," FINAL REPORT HISTORY: Exertional dyspnea. FINDINGS: In comparison with study of ___, cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 21a453b4-4dd83eee-5d988108-dc87975e-a9644d6f.jpg,validate/p11/p11147672/s53412103/21a453b4-4dd83eee-5d988108-dc87975e-a9644d6f.jpg,validation," FINAL REPORT INDICATION: ___ year old man with ___, anasarca // ?pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___, ___, ___. CT torso from ___. FINDINGS: Lung volumes are low without pulmonary edema. Bilateral pleural effusions are small and bibasilar atelectasis is mild. No pneumothorax. A right PICC terminates at cavoatrial junction, unchanged. Postoperative mediastinum and cardiac silhouette are normal. IMPRESSION: 1. No pulmonary edema. 2. Small bilateral pleural effusions. " 1f60508b-531d68a3-7176d84a-d9ba0145-28c13e06.jpg,validate/p14/p14508643/s57935306/1f60508b-531d68a3-7176d84a-d9ba0145-28c13e06.jpg,validation," FINAL REPORT HISTORY: Nausea, vomiting, diarrhea, faint right lower lobe. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest radiograph ___. MRCP ___. FINDINGS: The heart size is mildly enlarged but unchanged. The aortic knob is calcified. Mediastinal and hilar contours are within normal limits. The pulmonary vascularity is not engorged. The lungs are hyperinflated with flattening of the diaphragms compatible with COPD. No focal consolidation, pleural effusion or pneumothorax is identified. Diffuse demineralization the osseous structures is noted. Clips in the right upper quadrant of the abdomen are present. On the lateral view, rounded calcifications within the upper abdomen are within a tortuous splenic artery. IMPRESSION: No acute cardiopulmonary abnormality. " 924ee1f2-b4628f80-13244a4a-e74a358f-825abf61.jpg,validate/p16/p16524406/s56536310/924ee1f2-b4628f80-13244a4a-e74a358f-825abf61.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM CLINICAL INDICATION: ___-year-old with shortness of breath and known mitral regurgitation and pulmonary edema, please comment on volume status. Comparison to prior study of ___. Portable AP chest film dated ___ at ___ hours is submitted for interpretation. Note that the patient is markedly rotated to her right on the current examination which limits evaluation of the cardiac and mediastinal contours. IMPRESSION: 1. The lungs appear well inflated. There is prominent pulmonary vascularity suggestive of fluid-replete state, but no evidence of pulmonary or interstitial edema at this time. No pleural effusions. No evidence of pneumothorax. No acute bony abnormality. " 143cb8a8-ad310130-a2093ea5-dd20a0d6-36d4cea6.jpg,validate/p16/p16773288/s56884626/143cb8a8-ad310130-a2093ea5-dd20a0d6-36d4cea6.jpg,validation," WET READ: ___ ___ ___ 5:52 PM New right-sided chest tube. Interval decrease in size of right-sided pneumothorax. Otherwise unchanged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 5:13 P.M., ___ HISTORY: ___-year-old man with new chest tube for pneumothorax, assess position. IMPRESSION: AP chest compared to ___, ___:08 p.m. Despite the new right pleural tube, although the pneumothorax is smaller, there is still a moderate residual. This raises the possibility that the new pleural tube, sharply angulated at the tip could be largely fissural. Careful followup advised to assure continued appropriate tube function. There is no left pneumothorax or appreciable left pleural effusion, with apical and basal pleural tubes still in place. Pulmonary vascular congestion continues, and mediastinal veins are also dilated. Widened mediastinum due to generally large and tortuous thoracic aorta is unchanged. Right jugular sheath is in standard position. " e69eb006-a74f28ed-0b4a2252-4f040dc0-e2d3cb71.jpg,validate/p17/p17653729/s56901951/e69eb006-a74f28ed-0b4a2252-4f040dc0-e2d3cb71.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated with right effusion // Eval for interval change COMPARISON: ___ IMPRESSION: No relevant change as compared to the previous examination. The extent of the known right pleural effusion is constant. Moderate cardiomegaly with minimal fluid overload but without overt pulmonary edema persists. The monitoring and support devices are in unchanged normal position. " ab9d6030-26d5e105-e50553b9-c841a99d-16537744.jpg,validate/p15/p15378890/s57001335/ab9d6030-26d5e105-e50553b9-c841a99d-16537744.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with prostate cancer // please check placement of left side port TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: There is a left Port-A-Cath with the tip 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: Appropriate positioning of left Port-A-Cath. " a4225cd1-b0f8e827-baf04126-72c5b86a-bce9463d.jpg,validate/p19/p19937688/s57869652/a4225cd1-b0f8e827-baf04126-72c5b86a-bce9463d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ legally blind M h/o CAD, hypertension, prostate cancer s/p surgery and laminectomy with residual right foot drop, as well as recent spinal surgery for L5-S1 disc herniation on ___ transferred from ___ ___ with Afib with RVR in setting of likely viral gastroenteritis and sepsis. Sepsis resolved. Now with persistent leukocytosis, most likely from aspiration pneumonia. // Progression vs resolution of RLL infiltrate. If worse or stable, may give empiric abx TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Heart size and mediastinum appear to be unchanged since the prior study. The bibasal atelectasis are unchanged but there is interval improvement in pulmonary edema. Right basal consolidation appears to be improved as well. " 5515c4b2-23f32776-69e56861-66d7d47e-335b250c.jpg,validate/p18/p18869899/s55591273/5515c4b2-23f32776-69e56861-66d7d47e-335b250c.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Status post CABG and chest tube removal. Comparison is made with prior study performed one hour earlier. Left chest tube has been removed. There is no evidence of pneumothorax. There are no other interval changes. " bc64ba6c-29a8e1d1-54614673-972dce2f-1140e050.jpg,validate/p12/p12650009/s58099935/bc64ba6c-29a8e1d1-54614673-972dce2f-1140e050.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough // eval for infiltrate TECHNIQUE: PA and lateral chest COMPARISON: None FINDINGS: Heart size and mediastinal contours appear within normal limits. There is minimal opacity in the medial aspect of the right lung base which could reflect atelectasis although early consolidation cannot be excluded. Apart from minimal bibasilar linear atelectasis, the left lung appears clear. There is no pleural effusion. The osseous structures show degenerative changes of the thoracic spine. IMPRESSION: Minimal opacity, medial right base, for which early consolidation cannot be excluded. " d30c610c-59b65059-626b42be-959efaf0-8f42b1e1.jpg,validate/p19/p19020074/s54556579/d30c610c-59b65059-626b42be-959efaf0-8f42b1e1.jpg,validation," FINAL REPORT HISTORY: Cough, dyspnea COMPARISON: Chest radiograph ___. FINDINGS: Two PA and one lateral view of the chest demonstrate normal heart size and mediastinal contours. There is no pleural effusion or pneumothorax. There are mild to moderate chronic interstitial markings which are stable compared to the prior study. There is no focal consolidation concerning for pneumonia. IMPRESSION: No evidence of pneumonia. " 78260923-ba3d9a28-215618f6-3dcfcffb-842be0b4.jpg,validate/p17/p17477071/s59445574/78260923-ba3d9a28-215618f6-3dcfcffb-842be0b4.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with chest pain // eval for acute 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. " 53528b80-03e6b517-a6c878e0-3bfb44b6-241a60c4.jpg,validate/p12/p12537194/s50365118/53528b80-03e6b517-a6c878e0-3bfb44b6-241a60c4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with CP/backpain found to have R pleural effusion and wide spread mets d/t lung cancer. // Trend R pleural effusion Trend R pleural effusion IMPRESSION: In comparison with the study of ___, there is further filling of the right hemithorax with fluid with pneumothorax above it. Mild indistinctness of pulmonary vessels on the left again could reflect some elevated pulmonary venous pressure. More coalescent opacification is seen in the right upper zone. In the appropriate clinical setting, this could represent development of superimposed pneumonia. " e11d89ef-5f781e75-d701766e-0edd4ea0-9b105e04.jpg,validate/p13/p13247310/s52936188/e11d89ef-5f781e75-d701766e-0edd4ea0-9b105e04.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with hypertension. Evaluate for acute cardiopulmonary process. COMPARISON: None available. FINDINGS: The lungs are hyperinflated but clear. There is mild cardiomegaly. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: No acute cardiopulmonary process. " 7766db28-ed089a15-8328a658-65eb865d-9564243e.jpg,validate/p15/p15501234/s58976764/7766db28-ed089a15-8328a658-65eb865d-9564243e.jpg,validation," 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. " bd718eed-c21478f8-85cc0705-9c9bb362-bea491bd.jpg,validate/p12/p12927341/s58906666/bd718eed-c21478f8-85cc0705-9c9bb362-bea491bd.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___ radiograph. FINDINGS: Right apical pneumothorax has decreased in size with a very small residual pneumothorax remaining. Cardiomediastinal contours are stable. Worsening bibasilar atelectasis and persistent small pleural effusions, left greater than right. IMPRESSION: 1. Decreased right apical pneumothorax. 2. Small pleural effusions with worsening adjacent bibasilar atelectasis. " ee10924f-16163ce3-6039fa53-6b061e94-93b6a447.jpg,validate/p13/p13637248/s58499626/ee10924f-16163ce3-6039fa53-6b061e94-93b6a447.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with productive cough. TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: PA and lateral chest radiograph demonstrates symmetrically expanded and clear lungs. No focal opacity is identified convincing for pneumonia. Cardiomediastinal and hilar contours are within normal limits. There is no pleural effusion or pneumothorax. Visualized osseous structures are without acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " 266c807a-f0832e10-145f539e-effc2e0e-fc2d9c41.jpg,validate/p12/p12953887/s52391346/266c807a-f0832e10-145f539e-effc2e0e-fc2d9c41.jpg,validation," FINAL REPORT HISTORY: Fatigue, malaise. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Subtle opacity projecting over the right lower hemithorax likely relates to overlying nipple shadow. Otherwise, no definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Subtle right lower hemithorax opacity likely represent overlying nipple shadow which could be confirmed with repeat with nipple markers. No evidence of focal consolidation seen otherwise. " 0f45eaeb-bfcfe0d6-17259be5-7f5772a6-6db417cb.jpg,validate/p12/p12054589/s56309854/0f45eaeb-bfcfe0d6-17259be5-7f5772a6-6db417cb.jpg,validation," FINAL REPORT AP CHEST, 1:59 P.M. ON ___ HISTORY: AAA repair. Check Dobbhoff tube. IMPRESSION: AP chest compared to ___, 7:56 a.m. and 10:45 a.m.: New upper enteric feeding tube, with a wire stylet in place, passes into the stomach and out of view. ET tube and left internal jugular line are in standard placements respectively. Right internal jugular sheath ends at the thoracic inlet, as before. Mild bibasilar atelectasis and small left pleural effusion have improved. Pulmonary edema resolved. Heart size normal. No pneumothorax. " e45cd447-93b10e95-991655e0-50bc56d1-d2939d08.jpg,validate/p12/p12938515/s58733135/e45cd447-93b10e95-991655e0-50bc56d1-d2939d08.jpg,validation," WET READ: ___ ___ ___ 7:38 PM R IJ ends in upper SVC. Bilateral pleural effusions are unchanged as well as pulmonary edema that appears to be unchanged. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: Hyperglycemia, to assess for infection. FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Continued enlargement of the cardiac silhouette with pulmonary edema and probable bilateral effusions with compressive atelectasis at the bases. " 4b1b1080-ecec0db7-3111bd15-30a835a7-1387e149.jpg,validate/p16/p16787110/s56915236/4b1b1080-ecec0db7-3111bd15-30a835a7-1387e149.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with dsyuria and prostatis // eval for pna CXR eval for prostatis abscess CT ab 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 the. IMPRESSION: No acute cardiopulmonary process. " 53d587ee-2f9f3600-609510d2-5600c10d-e13fb92b.jpg,validate/p10/p10933807/s58515653/53d587ee-2f9f3600-609510d2-5600c10d-e13fb92b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/ cholangioCA, neoadjuvant chemo/rads s/p right triseg w/ RNY left hepaticojejunostomy (___), now s/p takeback PV thrombectomy w/ ee recon (___), s/p PB stent +lysis cath (___), now s/p lysis chec, cath removal, gelfoam (___) // interval change in NGT placement. ? in esophagus vs gastric vs duodenum interval change in NGT placement. ? in esophagus vs gastric vs duodenum IMPRESSION: Compared to chest radiographs ___ through ___ at 07:25. Feeding tube ends in the third portion of the duodenum. Esophageal drainage tube ends in the mid stomach. Endotracheal tube tip is approximately a cm from the carina an should be withdrawn approximately 2 cm. Right jugular line ends close to the superior cavoatrial junction. Borderline interstitial edema is new, mostly on the right. Small pleural effusions are likely. Heart size is normal. No pneumothorax. " 700fe04a-ea99c49a-b063df6d-45579905-98c168b3.jpg,validate/p14/p14325424/s52683844/700fe04a-ea99c49a-b063df6d-45579905-98c168b3.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with shortness of breath, status post intubation. COMPARISON: None. FINDINGS: Single portable view of the chest. Endotracheal tube is seen with tip at the level of the carina and should be withdrawn several centimeters for optimal positioning. Enteric tube is seen to the level of the GE junction, but not clearly passing off the inferior field of view, although this region is not well seen secondary to technique. Given slight respiratory motion, the lungs are grossly clear. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcification is seen in the thoracic aorta. Degenerative changes are seen at the shoulders. No definite acute osseous abnormality visualized. IMPRESSION: Endotracheal tube tip at the carina and should be withdrawn several centimeters. Enteric tube seen to the region of the GE junction potentially, but not definitely passing off the inferior field of view. This can be followed in subsequent exam. Dr. ___ was paged at 11:35 a.m. on ___. " fb61d5ac-2e511bb7-98fe7afa-fb9fc2ee-28c06ce9.jpg,validate/p14/p14954046/s53515024/fb61d5ac-2e511bb7-98fe7afa-fb9fc2ee-28c06ce9.jpg,validation," FINAL REPORT INDICATION: ___F s/p TAH BSO o n ___, fever and tachycardia without other focal symptoms // Infiltrate, evidence of infection TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Right PICC is seen with tip in the upper SVC. Lung volumes are relatively low. There is bibasilar atelectasis and likely superimposed mild pulmonary edema. Small bilateral pleural effusions are also suspected. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. Right-sided pigtail catheter is no longer visualized. IMPRESSION: Mild pulmonary edema which appears improved since ___. " 8f6e9503-4f477a85-a6736c7e-a94ff1b6-5baa517f.jpg,validate/p19/p19176112/s58750818/8f6e9503-4f477a85-a6736c7e-a94ff1b6-5baa517f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with SOB. Assess for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___ P FINDINGS: Mild bibasilar atelectasis. There is a new small left pleural effusion. No right pleural effusion. Heart size, mediastinal contour, and hila are unremarkable. No pneumothorax. IMPRESSION: 1. Bibasilar atelectasis. 2. Small left pleural effusion. " 773cb827-3efca279-49748b0b-2d25d66b-0313d683.jpg,validate/p16/p16146234/s56264642/773cb827-3efca279-49748b0b-2d25d66b-0313d683.jpg,validation," FINAL REPORT HISTORY: Foot debridement with fever. FINDINGS: Low lung volumes accentuate the transverse diameter of the heart. No radiographic evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 49f76e3f-c388570d-fab2448b-50db034e-e596fde6.jpg,validate/p13/p13594382/s52228738/49f76e3f-c388570d-fab2448b-50db034e-e596fde6.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Cough, congestion, fever. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size and mediastinum are within normal limits. Lungs are essentially clear except for left lower lobe linear atelectasis. There is no pleural effusion or pneumothorax. Hyperinflation is suspected on the lateral view. " 1b1ec3c9-135bb23f-8c0ce42e-b6cb7716-75350d9d.jpg,validate/p12/p12273785/s53714835/1b1ec3c9-135bb23f-8c0ce42e-b6cb7716-75350d9d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-year-old woman with history of uterine cancer with lung metastases, malignant central airway obstruction, post-bronch. COMPARISON: Chest radiograph dated ___. FINDINGS: Overall unchanged appearance compared to the prior exam. Numerous bilateral pulmonary of metastases appear unchanged from the prior exam. Probable persistent collapse of the left upper lobe, although not fully assessed without the lateral view. Stable elevation of the left hemidiaphragm. Stable cardiomediastinal silhouette. No pleural effusion. No pneumothorax. No focal consolidation to suggest pneumonia. No acute osseous abnormality. The stomach is distended. Stable appearance of the staghorn calculus in the right kidney. IMPRESSION: No significant interval change. Stable numerous bilateral pulmonary metastases and left upper lobe collapse. " 71856212-c2a9ca07-fff552d8-050c8318-856a8b6c.jpg,validate/p13/p13131801/s50444640/71856212-c2a9ca07-fff552d8-050c8318-856a8b6c.jpg,validation," FINAL REPORT INDICATION: History: ___M with dry hacking cough x 4 weeks // ? pneumonia COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: The lungs are clear. There is mild hyperinflation. There is no pneumothorax, effusion, consolidation or CHF. Degenerative changes are present in the spine. " bb908acb-4acb18c2-500e893a-dee0edc7-33b8e972.jpg,validate/p15/p15355483/s59861685/bb908acb-4acb18c2-500e893a-dee0edc7-33b8e972.jpg,validation," FINAL REPORT HISTORY: Near syncope, evaluate heart size. COMPARISON: Chest radiograph ___. FINDINGS: Frontal lateral views chest were performed. Cardiac silhouette is normal in size. Mild pectus excavatum is again seen. No pleural effusion, pneumothorax or focal airspace consolidation. Mediastinal contours and hilar structures are unremarkable. No acute osseous abnormalities appreciated. IMPRESSION: Pectus excavatum, unchanged. " 5e2921fb-3481fc70-7027465f-45f8a40e-8cc0cf70.jpg,validate/p18/p18249594/s50575898/5e2921fb-3481fc70-7027465f-45f8a40e-8cc0cf70.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with chest pain // cardiopulm 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. Note is made of a thoracic dextroscoliosis. IMPRESSION: No acute cardiopulmonary abnormality. " 83062f26-d3329a04-3263b926-0b08fade-14a3e4d8.jpg,validate/p10/p10633573/s57055305/83062f26-d3329a04-3263b926-0b08fade-14a3e4d8.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with epigastric pain radiating to the right shoulder. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: None available. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are within normal limits. No free intraperitoneal air detected. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " a477eb10-975d188f-7e3e1965-c8f0b607-0f678a65.jpg,validate/p16/p16092070/s55672549/a477eb10-975d188f-7e3e1965-c8f0b607-0f678a65.jpg,validation," FINAL REPORT HISTORY: Pacer. FINDINGS: In comparison with the study of ___, there has been placement of a dual-channel pacemaker device with leads in the appropriate position in the region of the right atrium and apex of the right ventricle. There are atelectatic changes at the left base, but no evidence of pneumothorax. " 0c63dabf-b8648261-4eb2db45-aa46b736-e50c2e9b.jpg,validate/p15/p15554519/s51958560/0c63dabf-b8648261-4eb2db45-aa46b736-e50c2e9b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p lap chole, ERCP stent placement, ?SB injury, with NGT, please confirm placement // NGT placement NGT placement COMPARISON: Comparison to prior study ___ at 09:12 IMPRESSION: Interval placement of nasogastric tube which is seen to the level of mid esophagus and then more distally projecting over the stomach. There continues to be a left pleural effusion with associated consolidative process at the left base likely reflecting lower lobe atelectasis, although pneumonia cannot be excluded. No pulmonary edema. No pneumothorax. Heart remains stably enlarged. Interval removal of right subclavian PICC line. " 3a6aa302-4d29efd9-50a67aae-e826a027-488a5a0f.jpg,validate/p16/p16578228/s51527859/3a6aa302-4d29efd9-50a67aae-e826a027-488a5a0f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with AS, HEFpef with dyspnea // volume status vs infection IMPRESSION: Compared to ___ chest radiograph, cardiomediastinal contours are stable. Mild pulmonary vascular congestion is new. Interval worsening of bibasilar opacities, right greater than left, as well as increase in size of a small right pleural effusion. No other relevant change. " dc2ef362-1e67ef7d-84db2b0d-5eae3001-444534a1.jpg,validate/p10/p10149624/s56382361/dc2ef362-1e67ef7d-84db2b0d-5eae3001-444534a1.jpg,validation," WET READ: ___ ___ ___ 5:41 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Patient with UC flare not improving, may need to start Remicade. Please evaluate for infectious process. COMPARISON: Multiple chest x-rays from ___ to ___. FINDINGS: The lungs are clear. Mediastinal and cardiac contours are normal. There is no pleural effusion or pneumothorax. CONCLUSION: There are no acute cardiopulmonary findings. There is no evidence of infectious process. " 609f3ae8-54fefe12-24d77242-5349b32b-024765fb.jpg,validate/p13/p13510413/s51224424/609f3ae8-54fefe12-24d77242-5349b32b-024765fb.jpg,validation," FINAL REPORT DATE: ___. TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old male patient with cough, history of smoking, evaluate cough. FINDINGS: PA and lateral chest views were obtained with patient upright position. Analysis is performed in direct comparison with the next preceding similar study of ___. Position and diaphragms obscure partially the heart silhouette, but significant cardiac enlargement is unlikely. The thoracic aorta is mildly widened and elongated but unchanged in comparison. 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 frontal view. Skeletal structures of the thorax are grossly within normal limits. IMPRESSION: Stable chest findings, no evidence of cardiac enlargement, pulmonary congestion or acute infiltrates in this ___-year-old male patient with history of cough. " a9348801-8b5d4d62-93d1168d-1fbe6786-644b0601.jpg,validate/p14/p14944919/s50329616/a9348801-8b5d4d62-93d1168d-1fbe6786-644b0601.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Cough. Evaluate for focal infiltrate. 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. " f63f057b-16392026-d9781d01-7714d146-d995e51d.jpg,validate/p13/p13434398/s56398440/f63f057b-16392026-d9781d01-7714d146-d995e51d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with CHF, dyspnea // eval for pulm edema COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low. The heart remains mildly enlarged with a left ventricular configuration. There is mild interstitial pulmonary edema without large effusion or pneumothorax. Mediastinal contour stable. Bony structures intact. IMPRESSION: Cardiomegaly with mild edema. " 662abd1a-f2fa21b5-d0085ce2-476163f7-f3197336.jpg,validate/p17/p17025650/s52453243/662abd1a-f2fa21b5-d0085ce2-476163f7-f3197336.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with Hepatocellular carcinoma, CHF and now some cough and shortness of breath. Please eval for PNA // ___ year old woman with Hepatocellular carcinoma, CHF and now some cough and shortness of breath. Please eval for PNA ___ year old woman with Hepatocellular carcinoma, CHF and now IMPRESSION: In comparison with the study of ___, there is stable enlargement of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia. Surgical clips are again seen overlying the left apex. " cf481883-8aa1e6f4-4bb06bf3-916058a5-c088e911.jpg,validate/p14/p14206119/s59860103/cf481883-8aa1e6f4-4bb06bf3-916058a5-c088e911.jpg,validation," FINAL REPORT HISTORY: Patient status post mitral valve repair, eval for effusion. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The right IJ central line has been removed. The position of the right chest tube is unchanged. There is no evidence of pneumothorax. The left mid and lower lung opacifications have essentially cleared. A small left pleural effusion persists as well as mild pulmonary vascular congestion. The cardiomediastinal silhouette and pleural surfaces are normal. IMPRESSION: Small left pleural effusion. Chest tube in place with no pneumothorax. " b95ebaa6-37a3a4f1-bd5f1391-ede5b0f6-21325fc9.jpg,validate/p10/p10760672/s57185601/b95ebaa6-37a3a4f1-bd5f1391-ede5b0f6-21325fc9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intraparenchymal bleed // ?possible extubation, respiratory status monitoring ?possible extubation, respiratory status monitoring COMPARISON: Chest radiographs ___. IMPRESSION: Previously right lower lobe has substantially re-expanded. consolidation in that region may be transient, due to residual atelectasis and re-expansion edema, but should be followed to exclude developing pneumonia. Heart size has increased, but still normal and there is greater distention of mediastinal veins and pulmonary vasculature, all pointing to increased intravascular volume. No pneumothorax. " c3e318c3-a1b0bed0-432549f2-e94a1083-e370e103.jpg,validate/p15/p15597371/s56634776/c3e318c3-a1b0bed0-432549f2-e94a1083-e370e103.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain. COMPARISON: Chest radiograph ___. AP AND LATERAL CHEST RADIOGRAPHS: The cardiomediastinal and hilar contours are normal. There has been interval resolution of previously seen small pleural effusions and improved bibasilar atelectasis. No new consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: Interval improvement of previously seen bilateral pleural effusions and atelectasis. No new cardiopulmonary pathology. " 8d4754cc-388ea18e-ca411caf-bf2a624a-4c2a78ae.jpg,validate/p15/p15403852/s56442657/8d4754cc-388ea18e-ca411caf-bf2a624a-4c2a78ae.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with resp distress // ___ year old male with resp distress (need inspiratory film) ___ year old male with resp distress (need inspiratory film) COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Extensive left-sided consolidation which developed on ___ has not worsened, consistent with pneumonia. This stable elevation left hemidiaphragm is an indication of at least some left-sided atelectasis. Moderate widening of the cardiomediastinal silhouette is stable. Aside from linear atelectasis at the base, right lung is clear. There is no pneumothorax. Swan-Ganz catheter ends in the main pulmonary artery. " 689591ab-c8cfc2b6-4bc3e349-d415d0e5-6d59f13b.jpg,validate/p15/p15199994/s59965744/689591ab-c8cfc2b6-4bc3e349-d415d0e5-6d59f13b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with seizures and suspected aspiration event. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are unremarkable. Lungs are slightly hyperinflated with unchanged bilateral predominantly basal opacities. No pleural effusion or pneumothorax is seen. No definite evidence of aspiration event is present. " f719771d-5722f650-3e8d2269-6005e318-6dd1ad3f.jpg,validate/p18/p18116982/s54026285/f719771d-5722f650-3e8d2269-6005e318-6dd1ad3f.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with new onset of AML complicated by neutropenic fever. COMPARISONS: Multiple prior chest radiographs, most recently of ___. FINDINGS: Single portable view of the chest was obtained. There has been interval improvement in the consolidative opacity at the right lung base. The right hemidiaphragm and right heart border remain indistinct, with residual heterogeneous opacities remaining in the right middle and lower lobes. A small right pleural effusion is similar to prior. No pneumothorax. The heart size is at the upper limit of normal, similar to prior. A left subclavian central catheter terminates in the lower SVC. IMPRESSION: Heterogeneous right middle and lower lobe opacities, improved since ___; stable small right pleural effusion. " bcbf18a1-770d2abd-70be659a-56d2a858-b20c2de8.jpg,validate/p11/p11391664/s50321534/bcbf18a1-770d2abd-70be659a-56d2a858-b20c2de8.jpg,validation," 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 " afb85aff-9a47fc54-ba2899ec-101badba-5e5c77c5.jpg,validate/p14/p14827673/s57259744/afb85aff-9a47fc54-ba2899ec-101badba-5e5c77c5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: There are new heterogeneous interstitial opacities in the right mid and lower lung, which do not appear to be confined to one lobe.The cardiac, hilar and mediastinal contours are normal.No pleural abnormality is seen. IMPRESSION: Heterogeneous opacities in the right mid and lower lung are compatible with pneumonia. Given the history of gastrointestinal symptoms, Legionella pneumonia is a possibility. " aaeda252-e70a9746-cc68d572-e3291b09-5c738c03.jpg,validate/p14/p14707155/s57782490/aaeda252-e70a9746-cc68d572-e3291b09-5c738c03.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p dual chamber ICD. // Assess leads placement and r/o PTx. Assess leads placement and r/o PTx. IMPRESSION: Comparison to ___. The patient has received the new left pectoral pacemaker. The position of the leads is unremarkable, in the left atrium and the left ventricle, respectively. Stable elevation of the left hemidiaphragm with platelike areas of atelectasis. No pneumothorax or other complication. No pulmonary edema. " ca82cef5-a8c727d2-2e44ee6d-6a6712ff-c9a83259.jpg,validate/p17/p17530911/s58520847/ca82cef5-a8c727d2-2e44ee6d-6a6712ff-c9a83259.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with 6 weeks of cough // ?consolidation, evidence of pneumonia ?consolidation, evidence of pneumonia IMPRESSION: In comparison with the study of ___, the cardiac silhouette remains within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Hyperexpansion of the lungs suggests some underlying chronic pulmonary disease. Little change in the loss of height of several lower thoracic vertebral bodies. " 0239650e-6d156281-da79fd55-5116c7d1-adb7b002.jpg,validate/p12/p12506963/s58356172/0239650e-6d156281-da79fd55-5116c7d1-adb7b002.jpg,validation," FINAL REPORT HISTORY: Chest tightness. COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: The lungs are hyperinflated and clear. There is stable right lower lobe granuloma. Cardiomediastinal silhouette is unremarkable. There is no pneumothorax or pleural effusion. IMPRESSION: No acute cardiopulmonary process. " b32a25a4-912295c6-1859de61-04296728-06d91d5e.jpg,validate/p15/p15128994/s51115886/b32a25a4-912295c6-1859de61-04296728-06d91d5e.jpg,validation," FINAL REPORT INDICATION: End-stage renal disease, on hemodialysis, rule out pneumonia or CHF. COMPARISONS: Chest radiograph, ___. PA AND LATERAL VIEWS OF THE CHEST: The lungs are clear. There is no focal consolidation to suggest pneumonia. Heart size is top normal, but unchanged. A left-sided hemodialysis catheter is seen terminating in the right atrium. There is no pneumothorax or pleural effusion. The mediastinal silhouette is unremarkable. IMPRESSION: No evidence of acute cardiopulmonary process. " c098eaa1-ea04efd2-374f95e4-6e0ea2cc-38495d8f.jpg,validate/p19/p19209496/s51128086/c098eaa1-ea04efd2-374f95e4-6e0ea2cc-38495d8f.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old woman with history of intracranial hemorrhage and MCA aneurysm. Patient now with fever and possible pneumonia. FINDINGS: Comparison is made to prior study from ___. There is scoliosis. There is new area of consolidation within the left lower lobe suspicious for pneumonia or aspiration given the patient's clinical history. The upper lung fields are clear. Heart size is within normal limits. There are no pneumothoraces. IMPRESSION: Consolidation in the left lower lobe suspicious for pneumonia. " 4b8d46af-cfc5aea9-ebb735db-8b5d2b50-fa6106b1.jpg,validate/p12/p12670557/s58617133/4b8d46af-cfc5aea9-ebb735db-8b5d2b50-fa6106b1.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Hypotension. Question pneumonia. COMPARISONS: ___ and ___. TECHNIQUE: Chest, portable AP upright. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is persistent mild relative elevation of the right hemidiaphragm. There are probably small bilateral pleural effusions. Minimal vague opacity projects over the right upper lung, similar to the prior appearance, although more generalized opacification was present on the prior examination. Compared to earlier radiographs, this area of opacity is similar and so may be a more chronic process. Lines, tubes and drains have been removed. IMPRESSION: Patchy opacity in the right upper lobe, although potentially chronic. If there is clinical concern for pneumonia, short-term followup radiographs may be helpful. Very small suspected pleural effusions. " 486dc03c-f0c9bf66-e513c291-a8808df1-50c2069d.jpg,validate/p14/p14029588/s51308181/486dc03c-f0c9bf66-e513c291-a8808df1-50c2069d.jpg,validation," WET READ: ___ ___ ___ 5:25 AM No large displaced rib fracture. No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___F with back pain after fall // please eval fracture TECHNIQUE: Chest PA and lateral COMPARISON: ___ PA and lateral chest radiographs FINDINGS: This evaluation is not tailored for the assessment of rib fractures. However, no large, displaced rib fracture is seen. Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal. Incidental note is made of probable cholecystectomy clips projecting over the right lower quadrant. IMPRESSION: No large displaced rib fracture. No acute cardiopulmonary abnormality. " fe693921-c50e5ad7-8a15f171-929217d8-4ecffae9.jpg,validate/p18/p18009599/s55936205/fe693921-c50e5ad7-8a15f171-929217d8-4ecffae9.jpg,validation," FINAL REPORT HISTORY: Endocarditis and bacteremia with worsening cough. FINDINGS: In comparison with study of ___, there is little overall change. The large- bore catheter has been removed. Continued opacification at the left base with elevation of hemidiaphragms, most likely reflecting atelectasis and possible small effusion. No discrete pneumonia. " 93d71379-0a2171bb-23da44f1-8b28c15f-a06a2767.jpg,validate/p12/p12040402/s59828321/93d71379-0a2171bb-23da44f1-8b28c15f-a06a2767.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with aspiration, new O2 requirement // ___ year old man with aspiration, new O2 requirement ___ year old man with aspiration, new O2 requirement IMPRESSION: Comparison to ___. No relevant change. Improved ventilation at the left lung basis. No pulmonary edema. Mild to moderate left effusion, better appreciated on the lateral than on the frontal view. " f413e35c-84557736-b9f9d869-40a174d6-d07e583c.jpg,validate/p14/p14073122/s53631233/f413e35c-84557736-b9f9d869-40a174d6-d07e583c.jpg,validation," FINAL REPORT INDICATION: ___F with AMS, found by famiyl this am, stroke hx, pls eval for pna and head bledd/infarct respectively TECHNIQUE: Frontal 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. " cff3392d-bc90e667-08b2988f-b24462f6-db0e99b8.jpg,validate/p18/p18704423/s53962593/cff3392d-bc90e667-08b2988f-b24462f6-db0e99b8.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM INDICATION: ___ year old man with poor nutrition placing dobhoff // dobhoff position TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 10 hours earlier IMPRESSION: Dobhoff tube tip isin the proximal stomach. No other interval change from prior study. " cc0cdfca-f12372ba-08f8a3d5-e05c3100-618d17b1.jpg,validate/p11/p11235666/s53676925/cc0cdfca-f12372ba-08f8a3d5-e05c3100-618d17b1.jpg,validation," FINAL REPORT HISTORY: Dyspnea, rule out CHF. COMPARISON: Chest x-ray dated ___. Rotated positioning. The lungs are hyperinflated and the diaphragms are flattened, consistent with COPD. A left-sided pacemaker is present, with lead tips over the right atrium and right ventricle. The patient is status post sternotomy. There is upper zone redistribution, without overt CHF. Prominence of the right perihilar structures is likely accentuated due to rotated positioning, as these project over the spine in the setting of right convex scoliosis. Clips are noted along the right paratracheal region, with slight leftward deviation of the trachea. There is minimal biapical pleural thickening. Deformity of the right fifth rib raises the question of old trauma or surgery. No focal infiltrate or effusion is identified. Minimal blunting of the right costophrenic angle posteriorly is incidentally noted. Small (18 mm), rounded lucency projecting over the heart anteriorly on the lateral view measuring is seen only on the lateral view and most likely represents artifact due to superimposition of soft tissue structures and vascular markings. IMPRESSION: 1) No significant change compared with ___. Doubt acute pulmonary process. In particular, no CHF, focal infiltrate or effusion. 2) Evidence of right paratracheal surgery for which clinical correlation is requested. " 262dd28d-001ee923-f74691cd-81318f91-d35c436d.jpg,validate/p11/p11244468/s58483234/262dd28d-001ee923-f74691cd-81318f91-d35c436d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough x4 weeks // please evaluate for pneumonia, sarcoid/hilar lymphadenopathy TECHNIQUE: Chest PA and lateral COMPARISON: Prior radiographs 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. " 217d46df-3fc2ed86-1484e5f6-fcfb1a90-63a6868b.jpg,validate/p13/p13561687/s53724088/217d46df-3fc2ed86-1484e5f6-fcfb1a90-63a6868b.jpg,validation," WET READ: ___ ___ ___ 8:07 PM Right picc in the upper svc. No ptx. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:52 P.M., ___ HISTORY: A ___-year-old man with delirium. Possible pneumonia. IMPRESSION: AP chest compared to ___: Mild left basilar plate-like atelectasis has improved since ___. Lungs are otherwise clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. Right PIC line ends at the origin of the SVC. No pneumothorax or appreciable pleural effusion. " 5e14755d-a5f431d7-561dd244-4a8ee184-a2a2b635.jpg,validate/p16/p16500918/s58003193/5e14755d-a5f431d7-561dd244-4a8ee184-a2a2b635.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p Mech MVR with right apical pneumothorax; follow-up for the pneumothorax. COMPARISON: Portable chest radiograph from earlier on the same day, dated ___ at 13:41 hour. FINDINGS: No significant interval change in the last 2 hours. Stable small right apical pneumothorax and tiny left apical pneumothorax without evidence of tension. No focal consolidation, pulmonary edema, or pleural effusion. Stable expected post-operative appearance of the cardiomediastinal silhouette. Unchanged positioning of the support devices and surgical hardware. IMPRESSION: No interval change. Stable small right and tiny left apical pneumothorax. " 371db33a-1039ac5a-6b178a84-0f452ebb-6e00a910.jpg,validate/p12/p12795828/s56039932/371db33a-1039ac5a-6b178a84-0f452ebb-6e00a910.jpg,validation," FINAL REPORT INDICATION: Neuropathy, Sicca syndrome, evaluate for infiltrate. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. There is no focal consolidation or pleural effusion. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " e32977d4-9c72d15d-8d32324f-de37e2d0-cc6ba382.jpg,validate/p18/p18490450/s57885827/e32977d4-9c72d15d-8d32324f-de37e2d0-cc6ba382.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough and fevers. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Per the radiology technologist, the patient was unable to raise head due to back symptoms. The patient's chin obscures the medial very upper lung apices. No focal consolidation is seen. There is no pleural effusion. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 377c6e2e-0086ed76-e156b74f-13d3df68-22249e64.jpg,validate/p12/p12957124/s56403229/377c6e2e-0086ed76-e156b74f-13d3df68-22249e64.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man sp esophagectomy and chest tube placement // Eval for interval changes Eval for interval changes COMPARISON: Comparison to ___ at 12:06 FINDINGS: Portable upright chest film ___ at 17:02 is submitted. IMPRESSION: There is an increasing left pleural effusion with associated consolidation suggestive of partial lower lobe atelectasis. In addition, there has been interval appearance of mild perihilar edema. Pneumoperitoneum is still present but has decreased in conspicuity. Tiny left apical pneumothorax is stable. No right-sided pneumothorax is appreciated. Nasogastric tube is unchanged in position with its tip at the gastroesophageal junction. Right-sided chest tube and right subclavian Port-A-Cath are unchanged in position. " 6be87598-0ea5ef07-6b730817-614f769c-6fdcd67c.jpg,validate/p14/p14637100/s53152913/6be87598-0ea5ef07-6b730817-614f769c-6fdcd67c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Dyspnea and hypoxia, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. Low lung volumes and moderate-to-severe pulmonary edema, associated with substantial cardiomegaly and the likely presence of a left pleural effusion. No new parenchymal opacities. Unchanged valvular annulus calcification. " 735bf173-f3bf7aef-41d9c4ca-cff7ee2c-6d107672.jpg,validate/p16/p16042873/s57418419/735bf173-f3bf7aef-41d9c4ca-cff7ee2c-6d107672.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fluid overload, low sats. // Interval change? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects 2.6 cm above the carinal. The patient has developed moderate pulmonary edema. The presence of a small right pleural effusion is likely. In addition, there is a newly developed retrocardiac atelectasis. Moderate cardiomegaly persists. NOTIFICATION: Dr. ___ was paged for NOTIFICATION at the time of observation and dictation, 08:44, on the ___ " dc094981-aee0bd8f-64a35f21-ff499a9e-86b75fc9.jpg,validate/p17/p17302022/s58983266/dc094981-aee0bd8f-64a35f21-ff499a9e-86b75fc9.jpg,validation," FINAL REPORT INDICATION: Atrial fibrillation, on amiodarone, evaluate for toxicity. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar contours are normal. Right-sided pacemaker leads are in appropriate position. IMPRESSION: No acute cardiopulmonary process. " 30e42b1e-4c48b8ee-0c72eb2a-2c42fe7c-75ffcd9f.jpg,validate/p16/p16512514/s50144549/30e42b1e-4c48b8ee-0c72eb2a-2c42fe7c-75ffcd9f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M w/chest pain, please eval for PNA, PTX, mediastinal widening // ___M w/chest pain, please eval for PNA, PTX, mediastinal widening TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: The cardiomediastinal and hilar contours are within normal limits. Lung volumes are somewhat low. Streaky bibasilar opacities suggest atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. IMPRESSION: Somewhat low lung volumes. Streaky bibasilar opacities suggest atelectasis however infection should be considered in the appropriate setting. " f70648f2-29fea707-383e4f49-c05df94b-6cc6fb32.jpg,validate/p13/p13030288/s54121301/f70648f2-29fea707-383e4f49-c05df94b-6cc6fb32.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain. COMPARISON: None available. FINDINGS: PA and lateral views of the chest. The lungs are clear. No evidence of pneumothorax or pleural effusion. The cardiac, mediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. " ed5b54f7-8b68e85b-d23d8f11-afff3ce5-20ba0d3a.jpg,validate/p10/p10781468/s56816123/ed5b54f7-8b68e85b-d23d8f11-afff3ce5-20ba0d3a.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST. REASON FOR EXAM: Hypoxia, rales, assess for pneumonia. Comparison is made with prior study, ___. Mild interstitial edema is new. Cardiomegaly is stable. There is no pneumothorax. Small bilateral effusions are new. " 69ce574a-07d24cbe-d348d0e5-717d4285-4d902ed9.jpg,validate/p14/p14921998/s58017263/69ce574a-07d24cbe-d348d0e5-717d4285-4d902ed9.jpg,validation," FINAL REPORT HISTORY: Syncope. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, three views. FINDINGS: Heart size is normal with mild tortuosity of the thoracic aorta. Hilar contours are unremarkable. Lung volumes are somewhat low but are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary abnormality. " 77b56895-d7d8d0a6-edc5d728-0e7b4c25-65a51ba6.jpg,validate/p13/p13687044/s54057736/77b56895-d7d8d0a6-edc5d728-0e7b4c25-65a51ba6.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Indwelling support and monitoring devices are unchanged in position. Right pigtail pleural catheter remains in place in the lower right hemithorax with a probable small right pleural effusion. Unusually sharp appearance of right hemidiaphragm is unchanged, and may reflect a basilar pneumothorax. Within the left lung, an area of consolidation in the left lung base has slightly worsened, with new partial obscuration of the left hemidiaphragm. This finding probably represents an area of infectious pneumonia given clinical history of this diagnosis. " 04b17f17-4ff28110-d49443ea-03e4e006-efd3a938.jpg,validate/p10/p10598395/s59561667/04b17f17-4ff28110-d49443ea-03e4e006-efd3a938.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP upright AND LAT) INDICATION: ___M with fall with left sided chest wall tenderness // eval for rib fx, PTX COMPARISON: Prior exam from ___. FINDINGS: AP upright and lateral views of the chest provided. The cardiomediastinal silhouette is unchanged in this patient with known tortuosity of the thoracic aorta accounting for prominence of the mediastinum. Lung volumes are low though lungs appear clear. No pleural effusion or pneumothorax. Bony structures appear intact. IMPRESSION: No acute intrathoracic process. Mediastinal prominence due to unfolded thoracic aorta. " 0dd54b52-6d551c9e-d70f0066-2cc92377-fedb4ac5.jpg,validate/p10/p10577647/s55528956/0dd54b52-6d551c9e-d70f0066-2cc92377-fedb4ac5.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: History: ___F with CP // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: ___. FINDINGS: A left-sided Port-A-Cath terminates within the proximal right atrium. The lungs are clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged. IMPRESSION: No acute cardiopulmonary process. " 24d6bb1c-833e5d7a-e5d20a48-643b7e9d-91c45a2f.jpg,validate/p15/p15220389/s50092068/24d6bb1c-833e5d7a-e5d20a48-643b7e9d-91c45a2f.jpg,validation," WET READ: ___ ___ ___ 9:57 AM Right port ends in the low SVC. Retrocardiac opacity could reflect atelectasis, aspiration or pneumonia. WET READ VERSION #1 ___ ___ 11:10 PM Right port ends in the low SVC. Retrocardiac opacity could reflect atelectasis, aspiration or pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic sarcoma, s/p port placement ___, now febrile // PNA/acute process? COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received right pectoral Port-A-Cath. The tip of the line projects over the mid to lower SVC. There also is a minimal retrocardiac atelectasis. No pneumonia, no pulmonary edema. No pneumothorax. " 1a24a8e6-97236cca-a4ad1646-45aef73f-6b43bbcf.jpg,validate/p10/p10602678/s54005355/1a24a8e6-97236cca-a4ad1646-45aef73f-6b43bbcf.jpg,validation," 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 essentially clear except for one area projecting over the posterior aspect of right atrium and might potentially represent calcified granuloma, although summation of vessels is another possibility. There is no pleural effusion or pneumothorax. Repeated examination of the patient with anterior shallow oblique views, right and left is suggested for precise characterization of the above described findings. " 76061004-bcffaa5c-bf947441-9df35d38-d12dce32.jpg,validate/p14/p14829501/s56292317/76061004-bcffaa5c-bf947441-9df35d38-d12dce32.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with HIV, crackles RLL // Acute process TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Mild linear left basilar atelectasis/scarring is seen. No focal consolidation, Pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No pulmonary edema. No significant change since the prior study. IMPRESSION: No acute cardiopulmonary process. No significant interval change. " 2ea8b4fb-afd8271c-4033e83b-9805c525-d1c74de1.jpg,validate/p12/p12727041/s50562702/2ea8b4fb-afd8271c-4033e83b-9805c525-d1c74de1.jpg,validation," WET READ: ___ ___ ___ 4:38 PM Patchy opacity within the lower lobes on the lateral view only, which could suggest atelectasis or early infection. ______________________________________________________________________________ FINAL REPORT HISTORY: Abnormal chest sensation. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is normal. Aorta is mildly unfolded. Mediastinal and hilar contours are otherwise unremarkable, and there is no pulmonary edema. While the lungs are clear on the frontal view, minimal patchy opacity is noted within the lower lobes on the lateral view, which could suggest atelectasis or early infection. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities are seen. IMPRESSION: Patchy opacity within the lower lobes on the lateral view only, which could suggest atelectasis or early infection. " 0df57b98-cfb57ddd-8e5291f4-6b8b5bd0-b376b13a.jpg,validate/p12/p12240787/s54567514/0df57b98-cfb57ddd-8e5291f4-6b8b5bd0-b376b13a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with tracheal stenosis with T-tube removal and ___ tube placement via rigid bronch // ? PTX ? PTX IMPRESSION: Comparison to ___. No relevant change. The patient has undergone tracheal interventions. The right upper lobe parenchymal opacity in consolidations are stable. The mediastinum continues to be minimally enlarged but no contour abnormalities are noted. A minimal right pleural effusion might be present. No left pleural effusion. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly. No evidence of pneumothorax. " fd64cd14-60bf7370-c573fccd-0b09582d-30c29d8e.jpg,validate/p14/p14714706/s54657537/fd64cd14-60bf7370-c573fccd-0b09582d-30c29d8e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with s/p AVR/CABG // eval postop changes COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the venous introduction sheet on the right. Has been removed. The alignment of the sternal wires is unremarkable. Better seen than on frontal radiograph, the lateral image shows bilateral pleural effusions, moderate on the right and small on the left. Subsequent areas of atelectasis are present. Moderate cardiomegaly persists. No pulmonary edema. No pneumothorax. " 34f22f2b-72415075-667f8acd-5d250746-8b02262a.jpg,validate/p12/p12724735/s59359794/34f22f2b-72415075-667f8acd-5d250746-8b02262a.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with xfer, on BiPAP, pulm edema // Eval for acute process, resolution of pulm edema TECHNIQUE: Chest portable upright radiograph COMPARISON: Chest radiograph from ___, ___. CTA of the chest from, ___. FINDINGS: Right dual lumen central venous catheter is unchanged in position with the tip projecting over the right atrium. Stable cardiomegaly. Decreased pulmonary edema and opacification of the right lung base with persistent bibasilar opacities, left greater than right. No pneumothorax. No large pleural effusion. Metallic clips are seen overlying the left neck. Vascular calcifications are noted. IMPRESSION: Decreased pulmonary edema and opacification of the right lung base with persistent bibasilar opacities which could represent atelectasis or infection. " 92537c25-8f5f7aff-9b1e00c9-9b771de5-dc4328d4.jpg,validate/p18/p18649950/s51419197/92537c25-8f5f7aff-9b1e00c9-9b771de5-dc4328d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with new onset SOB // Eval volume overload Eval volume overload IMPRESSION: Compared to chest radiographs since ___, most recently ___. Lungs are well expanded and clear. Moderate cardiomegaly is chronic. No pleural abnormality. Chronic fullness to the upper mediastinum including rightward displacement of the trachea at the thoracic inlet is due to a large goiter, predominantly in the left lobe. ___, MD " 02c2c9bd-68a30d94-02fbe2fb-bcfac355-5011cd5d.jpg,validate/p16/p16646862/s58501968/02c2c9bd-68a30d94-02fbe2fb-bcfac355-5011cd5d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: CTA chest from ___ as well as a chest radiograph from ___. CLINICAL HISTORY: Weakness and dizziness, assess infection. FINDINGS: PA and lateral views of the chest were provided. The heart is top normal in size, and there is mild central hilar congestion with mild interstitial edema. No large effusion or pneumothorax. Linear density at the level of the minor fissure likely represents atelectasis or scarring. Bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: Mild edema. Top normal heart size. " 81ad84d8-98c3e2ac-91e1cc1b-521ed24a-ea032ef6.jpg,validate/p13/p13210259/s56762591/81ad84d8-98c3e2ac-91e1cc1b-521ed24a-ea032ef6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with SSS s/p pacemaker placement // s/p pacemaker placment COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received a left pectoral pacemaker. The leads project over the right atrium and right ventricle respectively. There is no pneumothorax. Unchanged symmetrical bilateral apical thickening, with small calcifications. Unchanged extent of a pre-existing left pleural effusion with mild retrocardiac atelectasis. No pulmonary edema. No pneumonia. " 2167caad-db2cfd8e-555e20ba-7ccb698f-6a178655.jpg,validate/p18/p18539425/s52135830/2167caad-db2cfd8e-555e20ba-7ccb698f-6a178655.jpg,validation," 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. " 843a00ef-0d557fbb-297e36a4-d4ba57f3-ab58ab7b.jpg,validate/p10/p10877695/s50895793/843a00ef-0d557fbb-297e36a4-d4ba57f3-ab58ab7b.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with cough, wheezing, and bird exposure. Evaluate 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. IMPRESSION: No evidence of an acute cardiopulmonary process. " fd26d44f-ef6141ad-ba4f1b92-d3a1184b-af4fc9e1.jpg,validate/p10/p10169796/s50204785/fd26d44f-ef6141ad-ba4f1b92-d3a1184b-af4fc9e1.jpg,validation," 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. " dcc127cc-9d19966e-956a2346-3b02908c-e2548910.jpg,validate/p10/p10643918/s58685383/dcc127cc-9d19966e-956a2346-3b02908c-e2548910.jpg,validation," FINAL REPORT HISTORY: Cough. COMPARISON: None. FINDINGS: PA and lateral views of chest were viewed. Given low lung volumes, the cardiac ___ are within normal limits. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There are no focal consolidations. Pulmonary vasculature is within normal limits. IMPRESSION: No acute cardiopulmonary process. " 656c4fca-832e4fb2-6b17fe90-fa40a2a2-4071212d.jpg,validate/p11/p11911807/s55403654/656c4fca-832e4fb2-6b17fe90-fa40a2a2-4071212d.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post laminectomy, back pain, cage placement, assessment for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the spinal hardware appears to be in unchanged position. The endotracheal tube, the nasogastric tube and the left-sided chest tube has an unchanged course. The minimal pre-existing areas of basal atelectasis have slightly increased in severity. The left hemithorax shows no pneumothorax. The pre-existing air in the soft tissues of the left chest wall has slightly decreased in extent. Unchanged is the size of the cardiac silhouette. No overt pulmonary edema is present. No larger pleural effusions. " be86f1dc-7e5aae30-e3978f6c-b240aced-887fda92.jpg,validate/p15/p15451291/s55277910/be86f1dc-7e5aae30-e3978f6c-b240aced-887fda92.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Followup. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There are low lung volumes. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There may be right middle lobe atelectasis. No displaced fracture is seen. IMPRESSION: Low lung volumes, which accentuate the bronchovascular markings with possible mild right mid lobe atelectasis. " 4511a483-1aac8378-0d55a47e-781bcd89-35d5077d.jpg,validate/p12/p12176298/s58321502/4511a483-1aac8378-0d55a47e-781bcd89-35d5077d.jpg,validation," FINAL REPORT INDICATION: Status post wedge resection and SVC reconstruction. Assess for interval change. COMPARISON: Multiple prior chest radiographs dating back through ___, including the most recent study from ___. FINDINGS: A right pleural catheter ends along the mid lateral right chest wall, not significantly changed. An enteric catheter courses below the level of the diaphragm and out of the field of view inferiorly, as before. There are midline sternotomy wires and right hemi-thoracic surgical clips. Skin ___ overlie the lateral aspect of the right hemithorax. Widespread heterogeneous opacities throughout the left lung are substantially increased compared to the prior radiograph from ___, new compared to the radiographs from ___, either asymmetric pulmonary edema or widespread infection. Right mid-to-lower lung subsegmental atelectasis is increased. A substantial persistent right pleural space is decreased compared to the most recent study from ___. An unchanged wedge-shaped right upper lobe opacity could be secondary to right middle lobe collapse. The heart size is normal. There is no left pleural effusion. Subcutaneous air along the right lateral chest wall is decreased. Multiple right-sided rib defects/deformities and resection of the medial aspect of the right clavicle are redemonstrated. IMPRESSION: 1. Increased widespread left lung heterogeneous opacities, likely asymmetric pulmonary edema, although widespread infection could have an identical appearance. 2. Unchanged right upper lung wedge-shaped opacity, possibly related to right middle lobe collapse, either with or without torsion. 2. Decreased persisent right pleural space and extent of right lateral chest wall subcutaneous air. 3. Increased mild-to-moderate right mid-to-lower lung atelectasis. Pertinent findings were discussed with Dr. ___ by Dr. ___ at 10:49 a.m. via telephone on the day of the study. Updated findings were then discussed with Dr. ___ by Dr. ___ at 12:59 p.m. via telephone on the day of the study. " 820f69e9-7aa00197-6b2a3502-3811cbd1-9d37f1c3.jpg,validate/p19/p19372257/s57000969/820f69e9-7aa00197-6b2a3502-3811cbd1-9d37f1c3.jpg,validation," WET READ: ___ ___ ___ 10:05 AM 1. Dobbhoff tip in stomach on second radiograph. 2. Persistent small bilateral pleural effusions. WET READ VERSION #1 ___ ___ ___ 8:44 PM 1. Dobbhoff tip in stomach on second radiograph. 2. Persistent small bilateral pleural effusions. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with T-cell lymphoma/leukemia who initially presented for allo SCT, which was initiated ___. Hospital course has been complicated by CMV and HHV-6 viremia // Dobhoff in place? COMPARISON: Radiographs from ___ IMPRESSION: The tip of the Dobbhoff tube is within the body of the stomach on the second image. Bilateral central venous catheters are unchanged position an within the mid SVC. Heart size is within normal limits. There is a persistent left retrocardiac opacity and bilateral pleural effusions. There are no pneumothoraces. " 7fef0164-e85f0ed3-b6b49e11-7c16dd81-25d051cf.jpg,validate/p13/p13219116/s51068342/7fef0164-e85f0ed3-b6b49e11-7c16dd81-25d051cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with LLL pneumonia in ___; clinically resolved // Evaluate for clearance of infiltrate Evaluate for clearance of infiltrate IMPRESSION: Comparison to ___. Pre-existing parenchymal opacity at the left lung bases has completely cleared. No new or recurrent opacities. No pleural effusions. No pulmonary edema. " 2e83ef68-2dd2b590-c1f226b5-ba92b2e7-947d85e4.jpg,validate/p16/p16020842/s52126775/2e83ef68-2dd2b590-c1f226b5-ba92b2e7-947d85e4.jpg,validation," FINAL REPORT EXAMINATION: Portable AP chest radiograph INDICATION: ___ year old man s/p open AAA repair and subsequent colectomy, still intubated ; evaluate for interval change. COMPARISON: Chest radiograph exams dated ___ at 1214h and 913h and ___. FINDINGS: ETT in standard position. The nasogastric tube traverses midline within the tip is not seen. Right internal jugular vein sheath is unchanged in position. Left PICC line ends in the mid SVC. No pneumothorax. Mild pulmonary edema persists. Right perihilar focal opacity is becoming slowly and increasingly more conspicuous since ___, concerning for superimposed pneumonia in the appropriate clinical setting. Moderate dependent right pleural effusion and probably mild left pleural effusion and are overall unchanged. The heart size is normal. IMPRESSION: Slowly developing right perihilar opacity concerning for pneumonia. " 5b92c19a-305d7672-bdc810a4-d77f8efe-722f4ae3.jpg,validate/p12/p12668220/s58011699/5b92c19a-305d7672-bdc810a4-d77f8efe-722f4ae3.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest tightness. Evaluation for cardiomegaly or other pathology. COMPARISON: None available. FINDINGS: PA and lateral views of the chest demonstrate the lungs are well expanded and clear. A slight contour abnormality is noted posterior to the left ventricle on the lateral view, in the expected location of the inferior vena cava. Otherwise, the cardiomediastinal silhouette is unremarkable. The heart is normal in size. There is no pleural effusion, pneumothorax, pulmonary edema, or focal airspace consolidation. IMPRESSION: No acute cardiopulmonary process. Contour abnormality along the inferior heart border, posterior to the left ventricle on the lateral view, is likely due to pericardial cyst or herniation of subdiaphragmatic fat. Correlation with prior chest radiographs is recommended if available. If no prior imaging is available, follow up PA and lateral radiographs are recommended in 3 months to ensure stability. " bd268e85-ff8116fd-55309751-989af5bd-af1836a9.jpg,validate/p16/p16826047/s50405776/bd268e85-ff8116fd-55309751-989af5bd-af1836a9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pleural effusion, status post drainage, questionable improvement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there has been drainage of pleural fluid. The pleural effusion on the right has mildly decreased. There is no evidence of pneumothorax. The extent of the remaining pleural effusion is still substantial. No change in appearance of the left lung and of the cardiac silhouette. " afe0af8f-3904721d-5b04990c-a78ce982-9451b5d0.jpg,validate/p17/p17527219/s55111278/afe0af8f-3904721d-5b04990c-a78ce982-9451b5d0.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with dCMP s/p LVAD and dual-chamber ICD via L cephalic vein // lead position, pneumothorax lead position, pneumothorax IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Again there is substantial enlargement of the cardiac silhouette without definite vascular congestion or acute focal pneumonia. Opacification at the left base is consistent with pleural fluid and volume loss in the lower lobe. No evidence of pneumothorax. " ddc3f4bd-bc06aaee-0289f1e1-996d33b1-0168f3e3.jpg,validate/p11/p11511538/s55131760/ddc3f4bd-bc06aaee-0289f1e1-996d33b1-0168f3e3.jpg,validation," FINAL REPORT INDICATION: Myalgias. TECHNIQUE: Single frontal view of the chest. COMPARISON: ___. FINDINGS: There are new bibasilar opacities, left greater than right. Less conspicuous patchy consolidation also noted in the right mid lung. The cardiomediastinal silhouette is within normal limits. Coronary artery stent is noted. No acute osseous abnormalities. IMPRESSION: Bibasilar regions of consolidation worrisome for infection or aspiration. " d22605d8-e5c4cd2c-843327c8-8cf031ba-bde2d55e.jpg,validate/p16/p16446527/s51586512/d22605d8-e5c4cd2c-843327c8-8cf031ba-bde2d55e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p STEMI, intubated and on cooling protocol, now with asymetrical breath sounds // ? pneumothorax, ? pneumonia COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is a mild increase in extent and severity of the pre-existing right pleural effusion. The basilar atelectasis in the retrocardiac lung region is unchanged. There also is a unchanged minimal left pleural effusion. Mild fluid overload but no overt pulmonary edema. The monitoring and support devices are constant. " 9ab26108-564ed29a-961163e0-50591b7a-87befee5.jpg,validate/p11/p11198021/s52780882/9ab26108-564ed29a-961163e0-50591b7a-87befee5.jpg,validation," FINAL REPORT HISTORY: Cough and fever for ___ days. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest was obtained. The heart size and mediastinal contours are normal. There is elevation of the left hemidiaphragm with the opacification at the left base which may reflect atelectasis; although, an underlying infectious process is possible. No pleural effusion or pneumothorax. " b099f44e-f7033206-3a607c9b-5311bfd6-43bedc45.jpg,validate/p10/p10979480/s52817902/b099f44e-f7033206-3a607c9b-5311bfd6-43bedc45.jpg,validation," FINAL REPORT HISTORY: Evaluation for pneumonia. TECHNIQUE: Frontal view of the chest. COMPARISON: Multiple chest radiographs the most recent on ___. FINDINGS: A right Port-A-Cath is seen terminating at the cavoatrial junction. The lung volumes are low. There is minimal vascular congestion. There is an opacity at the base of the right lung, which partially obscures the right heart border, worse on than on the prior, and is concerning for a pneumonia. The cardiomediastinal silhouette and hilar contours are unchanged. The pleural surfaces are normal without effusion or pneumothorax. Thoracolumbar fusion rods are intact and unchanged. IMPRESSION: Opacity at the base of the right lung suspicious for pneumonia. These findings were communicated to Dr. ___ by telephone on ___ by Dr. ___. " 1572c199-e3e9cc2c-af3bbdf8-6421f641-74d12be7.jpg,validate/p10/p10207925/s53751023/1572c199-e3e9cc2c-af3bbdf8-6421f641-74d12be7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HTN, MGUS, PUD (hx GI bleed), presenting with shortness of breath, suspected CHF exacerbation. // interval change COMPARISON: ___ IMPRESSION: As compared to the previous image, there is increasing cardiomegaly. The the contour of the right heart is apparently enlarged by patient rotation. Mild pulmonary edema and retrocardiac atelectasis is unchanged. The presence of a minimal left pleural effusion cannot be excluded. Unchanged appearance of the chest wall. " dfc91b92-bca4bec0-b4a39635-362ecbac-98286a1c.jpg,validate/p13/p13074701/s55648539/dfc91b92-bca4bec0-b4a39635-362ecbac-98286a1c.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Findings on T-spine recommended chest x-ray. COMPARISON: T-spine ___ ___. FINDINGS: Lungs are clear. The aortic contour is normal. The double line described on the T-spine corresponds to the left paraspinal line which is normal. There is no pleural effusion or pneumothorax. OPINION: There are no significant cardiopulmonary findings. " 3ab1cb7d-55fcce13-a4f0178d-fa571294-561a5cd6.jpg,validate/p13/p13954172/s54460946/3ab1cb7d-55fcce13-a4f0178d-fa571294-561a5cd6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with tachycardia, recent falls // eval for infection, rib injury TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is bibasilar atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.. No displaced fracture is identified. Evidence of DISH is seen along the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " d05cb8ce-303fc18c-a4c6eb1f-1c0fa5fe-d5af6dba.jpg,validate/p14/p14694179/s58220882/d05cb8ce-303fc18c-a4c6eb1f-1c0fa5fe-d5af6dba.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cough and fever, questionable aspiration. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated. As a consequence, the lung volumes have decreased and the pre-existing areas of bilateral atelectasis have decreased in extent and severity. However, no newly appeared parenchymal opacities are present. Borderline size of the cardiac silhouette. No pleural effusions. " 603ff0fb-abd0f4a1-6dbd3392-8adb5ade-cd2c135e.jpg,validate/p14/p14782430/s54078506/603ff0fb-abd0f4a1-6dbd3392-8adb5ade-cd2c135e.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Palpitations. COMPARISONS: None. TECHNIQUE: Chest, PA and lateral. FINDINGS: The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There are horizontal linear opacities in the right costophrenic sulcus which are nonspecific. Possibilities include scarring; an acute process such as vascular congestion, while not entirely excluded, is doubted given the fact that the pulmonary vascularity is otherwise within normal limits. There is a patchy opacity obscuring the left hemidiaphragm but most suggestive of minor atelectasis or scarring. There is mild leftward convex curvature centered at the thoracolumbar junction. IMPRESSION: 1. Septal lines at the lateral right lung base which are nonspecific and could be associated with scarring. Although not entirely excluded, pulmonary congestion is doubted since these are unilateral and not accompanied by generalized interstitial or pulmonary vascular abnormality. 2. Left basilar opacity, probably compatible with atelectasis, although an infectious cause would not be excluded in the appropriate setting. " a62f33e7-9a883546-16203eab-12074b33-cb283d5b.jpg,validate/p18/p18699523/s52873245/a62f33e7-9a883546-16203eab-12074b33-cb283d5b.jpg,validation," 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. " c04d26dc-24e21ea2-5844880a-29e380c1-67735a5c.jpg,validate/p10/p10437948/s54426711/c04d26dc-24e21ea2-5844880a-29e380c1-67735a5c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with possible LLL pna, with persistent cough // eval for 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. " 04ba3d08-13a118d6-4c97e729-adc6064a-bd7c9f35.jpg,validate/p13/p13512048/s51603122/04ba3d08-13a118d6-4c97e729-adc6064a-bd7c9f35.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with ankle fracture // evaluate for CHF 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. " a4cdaf00-5e73c5e5-cb82e8c8-eb3ee1f8-982dae0c.jpg,validate/p15/p15554295/s50264104/a4cdaf00-5e73c5e5-cb82e8c8-eb3ee1f8-982dae0c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p GSW to abdomen // please assess for ETT position please assess for ETT position IMPRESSION: A right central venous line tip is at the level of lower SVC. Mediastinum are unchanged. Right basal consolidation is more conspicuous, concerning for aspiration or pneumonia. Atelectasis is less likely. NG tube tip is in the stomach. No definitive endotracheal tube demonstrated. " 04d9b0b8-a0a8ffc6-eafa2361-ad257150-62aba324.jpg,validate/p17/p17515788/s58409296/04d9b0b8-a0a8ffc6-eafa2361-ad257150-62aba324.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Chest radiograph available from ___. CT available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The heart size is normal. The hilar and mediastinal contours are within normal limits. Linear bibasilar opacities are present, corresponding to epicardial fat seen the CT examinations. There is no pneumothorax or pleural effusion. IMPRESSION: No acute intrathoracic process. " 893f5da9-5455382f-b6f7a88b-8994c5b1-107538e8.jpg,validate/p14/p14295340/s58205345/893f5da9-5455382f-b6f7a88b-8994c5b1-107538e8.jpg,validation," FINAL REPORT INDICATION: History of chest pain, question pneumonia. COMPARISONS: None. FINDINGS: PA and lateral chest radiographs were provided. 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: No acute cardiopulmonary process. " 5f1e87f6-c3fc78bc-ec3e09b9-9b050806-d36314d1.jpg,validate/p16/p16564743/s56834012/5f1e87f6-c3fc78bc-ec3e09b9-9b050806-d36314d1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with one month of a cough // r/o malignancy, pneumonia r/o malignancy, pneumonia IMPRESSION: In comparison with study of ___, there again are lower lung volumes with the cardiac silhouette at the upper limits of normal and mild tortuosity of the aorta. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " e327acd0-3e0a3c71-17578664-4d2f02cb-36d0f0f5.jpg,validate/p11/p11632236/s53575616/e327acd0-3e0a3c71-17578664-4d2f02cb-36d0f0f5.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with pleural effusion. COMPARISON: Chest radiograph from ___ and chest CT from ___ FRONTAL AND LATERAL CHEST RADIOGRAPHS: A known moderate right pleural effusion appears increased from most recent prior and has a convex margin suggesting loculation. Underlying atelectasis appears stable. The remainder of the lungs are clear. There is possible trace left pleural effusion as well. No pneumothorax or pneumomediastinum is evident. Cardiomediastinal and hilar contours are within normal limits. IMPRESSION: Interval increase in right pleural effusion with possible new loculation " 45aed0ef-f3faf691-f99d46fd-02a40812-2a09ca9e.jpg,validate/p15/p15464144/s57702571/45aed0ef-f3faf691-f99d46fd-02a40812-2a09ca9e.jpg,validation," FINAL REPORT INDICATION: Leukocytosis, and poor historian. Evaluate for acute pulmonary process. COMPARISONS: Chest radiograph ___. FINDINGS: In comparison to the prior exam, the lung volumes are lower. Bibasilar hazy opacities, which are likely related to atelectasis, but in the proper clinical setting, pneumonia cannot be fully excluded. There is no evidence of pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: Bibasilar opacities in the setting of low lung volumes is likely due to atelectasis, although in the proper clinical setting, a pneumonia cannot be fully excluded. Results were discussed with Dr. ___ ___ room resident) at 11:50 p.m. on ___ via telephone by Dr. ___. " f809ca7a-0ec43627-6c3dbf03-dded422b-21405005.jpg,validate/p16/p16454913/s56301545/f809ca7a-0ec43627-6c3dbf03-dded422b-21405005.jpg,validation," FINAL REPORT HISTORY: Sepsis with right upper lobe opacity. FINDINGS: In comparison with the study of ___, the area of increased opacification suggests that the right upper zone is not definitely appreciated. There is continued enlargement of the cardiac silhouette with evidence of pulmonary edema and bilateral pleural effusions with compressive atelectasis at the bases. Monitoring and support devices remain in place. " 0efdc6f9-4b268261-88969966-2307b9ed-04283598.jpg,validate/p19/p19353175/s51462592/0efdc6f9-4b268261-88969966-2307b9ed-04283598.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiograph. INDICATION: ___ year old man with cough and rhonchi. COMPARISON: No prior imaging is available. FINDINGS: The anterior lower chest is cut off from the image on the lateral view. Lung volumes are low, likely secondary to lack of full inspiration. No pulmonary edema, pleural effusion, focal consolidation, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila are within normal limits. Multilevel degenerative changes in the thoracic spine with prominent anterior osteophytes are moderate. A prevertebral density likely represents projection artifact from the scapula, but a prevertebral lesion cannot be excluded. IMPRESSION: 1. No pneumonia. 2. Prevertebral density likely represents projection artifact from the scapula, but a prevertebral lesion cannot be excluded. RECOMMENDATION(S): Repeat lateral chest radiograph with appropriate positioning to exclude prevertebral lesion. NOTIFICATION: The impression and recommendation above was entered by Dr. ___ on ___ at 16:40 into the Department of Radiology critical communications system for direct communication to the referring provider. " e4c73433-d9e2751c-a9b83b98-f2fe107d-bb71b210.jpg,validate/p14/p14579200/s59250010/e4c73433-d9e2751c-a9b83b98-f2fe107d-bb71b210.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with tachycardia, OSB // acute process? COMPARISON: None FINDINGS: PA and lateral views of the chest provided. No focal consolidation concerning for pneumonia. Left mid lung linear density likely represent scarring. No edema or congestion. No large effusion or pneumothorax. The heart is likely top-normal in size. Mediastinal contour is unremarkable. Mild biapical pleural parenchymal scarring noted. Bony structures are intact. IMPRESSION: No acute findings. Top-normal heart size. Mild scarring. " 0b7ab545-c2af9860-5aae88b7-7e27fa66-b0c115db.jpg,validate/p10/p10886362/s58072789/0b7ab545-c2af9860-5aae88b7-7e27fa66-b0c115db.jpg,validation," WET READ: ___ ___ 8:00 PM esophageal catheter tip and side-port in stomach. interval removal of ETT. no significant change in the lungs. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:36 P.M., ___ HISTORY: AVR. Check NG tube. IMPRESSION: AP chest compared to ___ at 2:29 p.m.: Lateral aspect left lower chest is excluded from the examination. Remaining pleural surfaces show no pneumothorax and minimal if any pleural effusion. Nasogastric tube passes into the stomach and out of the field of view. Swan-Ganz catheter tip is partially obscured by cardiac motion, but is probably in the right pulmonary artery in standard placement. Right pleural, left pleural, midline drains in place. Pulmonary vascular congestion and moderate postoperative widening of the cardiomediastinal silhouette are unchanged. There is more atelectasis in the right lower lobe, left lower lobe atelectasis is mild-to-moderate. There is probably no pulmonary edema. " 18208618-ac9c0d66-96933503-1e449a9d-5d163a76.jpg,validate/p17/p17653729/s55251484/18208618-ac9c0d66-96933503-1e449a9d-5d163a76.jpg,validation," FINAL REPORT INDICATION: ___F with recent trach decannulation, concern for aspiration, tachypnea/hypoxia // eval pna TECHNIQUE: Single portable view of the chest. COMPARISON: ___. FINDINGS: Left basilar opacity silhouetting the hemidiaphragm is most suggestive of a layering effusion as on prior. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is within normal limits for technique. Atherosclerotic calcifications are noted. Previously seen left central venous catheter is no longer visualized. Tracheostomy tube is also no longer seen. IMPRESSION: Persistent left-sided pleural effusion without superimposed acute cardiopulmonary process. " b1fe84f6-fa7b1883-429bc3de-b970ec1c-2434d00e.jpg,validate/p12/p12938779/s50807935/b1fe84f6-fa7b1883-429bc3de-b970ec1c-2434d00e.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with sepsis, assess for pneumonia. COMPARISONS: ___. Portable AP supine chest radiograph was obtained. The lungs appear well expanded and clear. There may be a trace left pleural effusion or pleural thickening. No focal consolidation is identified. Extensive vascular calcifications are noted along with degenerative changes in both shoulders and the imaged spine. Cardiac size is normal without signs of heart failure. Prominent upper mediastinum is as before and due to vascular structures. IMPRESSION: No acute intrathoracic process. " e066626b-508eb6f0-71a974bf-0780ba8a-7e823b84.jpg,validate/p17/p17995051/s53039287/e066626b-508eb6f0-71a974bf-0780ba8a-7e823b84.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with stroke, s/p trach // ?fluid status ?fluid status IMPRESSION: As compared to ___, the patient is now rotated left warts. Increasing areas of atelectasis, predominantly at the right lung basis. A short term repeat followup radiograph within 12 hr should be performed to exclude developing pneumonia. Low lung volumes and mild cardiomegaly persists. No pulmonary edema. No pleural effusions. " 627dd5ea-772b45d5-9a35678a-24f9b7c2-e4dfe1c9.jpg,validate/p12/p12598850/s50799036/627dd5ea-772b45d5-9a35678a-24f9b7c2-e4dfe1c9.jpg,validation," WET READ: ___ ___ ___ 9:57 PM left base and upper lung (possibly right) areas of consolidation- could be atelectasis give low lung volumes but infection is certainly possible. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fever and cough. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. Low lung volumes are noted. There is somewhat linear opacity at the lung bases, more conspicuous on the left than on the right. In addition, there is a linear opacity projecting over the upper lobes posteriorly, potentially localizing to the right on the frontal view. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. IMPRESSION: Multifocal regions of consolidation particularly at the left lung base and projecting over one of the upper lobes posteriorly, likely on the right. Extremely low lung volumes are seen and these could be due to atelectasis, although infection is certainly possible. " 65dc5a63-f5084e8d-d850fa1a-0243c0ee-9eea1178.jpg,validate/p19/p19120479/s59104642/65dc5a63-f5084e8d-d850fa1a-0243c0ee-9eea1178.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old male with bradycardia. FINDINGS: Single portable view of the chest is compared to previous CT angiogram of the chest from ___. Increased density at the left lung base which silhouettes the left hemidiaphragm laterally is compatible with patient's known biventricular cardiomegaly and configuration of the heart. Lungs are clear of focal consolidation or evidence of pulmonary vascular congestion. Cardiomediastinal silhouette is unchanged compared to prior CT scan scout film. Osseous and soft tissue structures are grossly unremarkable. IMPRESSION: No acute cardiopulmonary process. " 1cadbd98-1bc47c21-f1cf1219-736c0ff2-4ca7a5dc.jpg,validate/p14/p14993494/s57575859/1cadbd98-1bc47c21-f1cf1219-736c0ff2-4ca7a5dc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with h/o ILD and new dry cough arthralgias // ? infiltrate ? infiltrate IMPRESSION: Comparison to ___. Decrease in lung volumes, minimal increase in extent of the pre-existing extensive reticular parenchymal opacities. No new opacities. Moderate cardiomegaly persists. No pleural effusions. No pulmonary edema. " 00f4d07e-a3959167-c387cdfb-6f07216f-5859f056.jpg,validate/p13/p13931432/s55888344/00f4d07e-a3959167-c387cdfb-6f07216f-5859f056.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with liver bleed now w/ new onset afib. // Eval pleural effusion Eval pleural effusion COMPARISON: Chest radiographs ___. IMPRESSION: A new moderate right pleural effusion could be hemothorax. Lungs are clear. Heart is normal size. No pneumothorax. NOTIFICATION: Dr. ___ reported the findings, specifically new right pleural effusion or hemothorax to Dr. ___ by telephone on ___ at 11:01 AM, 1 minutes after discovery of the findings. " f19e42e3-307d8830-d335c45c-a416d4e4-01621abc.jpg,validate/p12/p12933395/s52343526/f19e42e3-307d8830-d335c45c-a416d4e4-01621abc.jpg,validation," FINAL REPORT HISTORY: Right-sided chest pain. Rule rule out pneumothorax, effusion. COMPARISON: Prior chest CT from ___ and chest radiograph from ___. FINDINGS: The heart is normal in size. There is redemonstration of radiation fibrotic changes within the left upper paramediastinal region as seen on prior chest examinations. There is again a leftward shift of mediastinal structures with volume loss in the left lung. No focal consolidation, pleural effusion or pneumothorax is identified. IMPRESSION: No acute cardiopulmonary process. Radiation changes in the left upper paramediastinal region. " 0f2ea270-4298867f-bc6176a4-6dc6d2d3-ef28de6c.jpg,validate/p15/p15606157/s54329182/0f2ea270-4298867f-bc6176a4-6dc6d2d3-ef28de6c.jpg,validation," WET READ: ___ ___ ___ 6:26 PM Single image shows Dobhoff tube with tip in the stomach. Overlying wires limit assessment of the right lung base. No other significant change since the prior exam. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ng tube placed // ng tube placement 2 step ng tube placement 2 step IMPRESSION: Comparison to ___. The patient has received a feeding tube. The tube shows a normal course, the tip projects over the middle parts of the stomach. No complications, notably no pneumothorax. Otherwise unchanged appearance of the lung parenchyma and the heart. " b08ca4b5-59daf18c-b177268c-e86500ec-c6b2b930.jpg,validate/p16/p16679893/s53487701/b08ca4b5-59daf18c-b177268c-e86500ec-c6b2b930.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SCLC, pna, intubation // ?tube position TECHNIQUE: Portable AP radiograph of the chest. COMPARISON: ___. FINDINGS: In comparison to the earlier radiograph, the ET tube has been further advanced into the lower trachea. Mild pulmonary edema is likely unchanged. Bilateral breast implants contribute to the increased density at both lung bases. Right lower lobe collapse, partial left lower lobe collapse, a right pleural effusion, and small layering left pleural effusion are unchanged. IMPRESSION: ET tube in lower trachea. Withdrawal by a 2-3 cm is advised for more optimal ventilation. No other significant interval change. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:13 PM, 20 minutes after discovery of the findings. " 9d561b19-96101469-40729f76-5aa55feb-5b54a048.jpg,validate/p12/p12807272/s53754636/9d561b19-96101469-40729f76-5aa55feb-5b54a048.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: History of right lower lobe pneumonia, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the opacity in the right lower lobe has decreased in extent but is not completely resolved. The opacity is better appreciated on the lateral than on the frontal radiograph. No new parenchymal opacities. No pleural effusion. Unchanged borderline size of the cardiac silhouette and tortuosity of the thoracic aorta. " ec941d9b-e3252dcd-78b2f0bf-9978ec05-1d7daae9.jpg,validate/p17/p17592232/s54691632/ec941d9b-e3252dcd-78b2f0bf-9978ec05-1d7daae9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with L pigtail // pneumothorax? pneumothorax? IMPRESSION: Compared to chest radiographs ___ through ___. Small to moderate left pneumothorax has developed, primarily in the left lower chest. Pigtail drainage catheter still in place. Moderate consolidation of both lung bases is been present for several days. On the right it is largely atelectasis. The left could be pneumonia. Emphysema is severe. Heart size is normal. Tracheostomy tube slightly off midline. Indwelling left PIC line ends in the mid to low SVC, unchanged. No right pneumothorax or pleural effusion. " ba9098d3-efcf8ddc-fa0f2049-b01cb377-31dc0f47.jpg,validate/p18/p18416120/s52322797/ba9098d3-efcf8ddc-fa0f2049-b01cb377-31dc0f47.jpg,validation," 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. " 85a483f0-8fd6c744-4dc4d693-25d314e8-c3114b72.jpg,validate/p10/p10989799/s56002857/85a483f0-8fd6c744-4dc4d693-25d314e8-c3114b72.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old female with fever. COMPARISON: ___. FINDINGS: Right chest wall port is seen with catheter tip at the RA-SVC junction. There are small bilateral pleural effusions which are new since prior. Linear left basilar opacity seen on the frontal view may be due to atelectasis. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. Surgical clips seen in the mid upper abdomen similar to prior. IMPRESSION: New small bilateral effusions. Otherwise, no change. " 2e07f48b-ca9aa932-2c3da51b-c1147ba8-4511e0da.jpg,validate/p15/p15727316/s50904377/2e07f48b-ca9aa932-2c3da51b-c1147ba8-4511e0da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with new atrial fibrillation TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is mildly enlarged. The aorta is diffusely calcified. Lungs are hyperinflated with scarring noted within the lung apices. Streaky atelectasis is seen in both lung bases as well as more focal linear atelectasis noted in the region of the lingula as seen on the lateral view. Blunting of the costophrenic angles could suggest small bilateral pleural effusions or chronic pleural thickening. Pulmonary vasculature is not engorged. There is no focal consolidation. No pneumothorax is detected. Osseous structures are diffusely demineralized with mild multilevel degenerative changes noted in the thoracic spine. IMPRESSION: Bibasilar atelectasis. Blunting of the costophrenic angles bilaterally may reflect trace bilateral pleural effusions versus chronic pleural thickening. COPD. " b30b24fe-aac1c597-938a6fa4-727c8d93-5646e50c.jpg,validate/p16/p16487527/s57008319/b30b24fe-aac1c597-938a6fa4-727c8d93-5646e50c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ams/inc o2 req // ?edema please eval interval change TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: Cardiomegaly is a stable. Increasing faint opacities in the left base likely represent increase in small pleural effusion and adjacent atelectasis. Right lower lobe atelectasis are grossly unchanged. NG tube tip is out of view below the diaphragm. Left IJ catheter tip is in the cavoatrial junction. There is no pneumothorax. " 0feacdf2-b700c758-c86ffdbf-1f7b4176-eed96bc1.jpg,validate/p19/p19929207/s50899262/0feacdf2-b700c758-c86ffdbf-1f7b4176-eed96bc1.jpg,validation," FINAL REPORT INDICATION: ___-year-old with right upper quadrant/flank pain. 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. " e504f327-332333b3-ab413123-f77296fb-bd456035.jpg,validate/p18/p18553055/s55873395/e504f327-332333b3-ab413123-f77296fb-bd456035.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with near syncope, possible angina, cardiac and renal disease // Acute cardiopulmonary process, pulmonary edema TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient is status post median sternotomy and cardiac valve replacement. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No pulmonary edema. IMPRESSION: No significant interval change. No pulmonary edema seen. " a2324915-b6bfec93-65912917-45ba1a15-7450d2f4.jpg,validate/p14/p14912272/s53363678/a2324915-b6bfec93-65912917-45ba1a15-7450d2f4.jpg,validation," 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. " f0f580c1-37e490ca-4553ea37-1b987e6a-91b3bf89.jpg,validate/p17/p17454111/s51054835/f0f580c1-37e490ca-4553ea37-1b987e6a-91b3bf89.jpg,validation," FINAL REPORT HISTORY: Diabetes, coronary artery disease, hypertension with hyperkalemia and elevated white count. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size remains mildly enlarged, unchanged. The aortic knob is calcified. The mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is detected. Minimal peripheral linear opacity within the left mid lung field may reflect an area of subsegmental atelectasis. No acute osseous abnormalities are seen. Old right ___ posterior rib fracture is again noted. IMPRESSION: No acute cardiopulmonary abnormality. " 33c5435f-91e85414-485c0c49-8e1bb2de-38acf35e.jpg,validate/p16/p16889059/s52264425/33c5435f-91e85414-485c0c49-8e1bb2de-38acf35e.jpg,validation," WET READ: ___ ___ 1:08 AM Right sided rib fxs. Low lung volumes and left basilar atx. No ptx. - ___ ______________________________________________________________________________ FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Low saturation, patient is status post trauma with rib fractures and liver contusion. There are low lung volumes. Cardiac size is top normal. There are bibasilar atelectasis. There is no pneumothorax or pleural effusion. Right rib fractures are again noted. " 5d614d1c-0c011e01-92c66ba7-7210348b-5907fad6.jpg,validate/p16/p16530426/s52832489/5d614d1c-0c011e01-92c66ba7-7210348b-5907fad6.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with syncope, trauma // Evidence of acute 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 silhouette is top-normal. Mediastinal contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 59ed0339-597b24d0-c2c5d266-dec6a4ba-afb27de2.jpg,validate/p18/p18416284/s53824567/59ed0339-597b24d0-c2c5d266-dec6a4ba-afb27de2.jpg,validation," FINAL REPORT HISTORY: Stent placement. FINDINGS: In comparison with the study of ___, there is little overall change in the appearance of the combination of volume loss in the right middle and lower lobes, associated with pleural effusion. Left lung remains clear. " 66e44f99-bab01a55-ec831b64-25bb61bc-1ef888d3.jpg,validate/p13/p13358134/s52572618/66e44f99-bab01a55-ec831b64-25bb61bc-1ef888d3.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with CAD, CHF says he has SOB, and is volume overloaded // CHF? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Patient has known pulmonary metastases more conspicuous on the prior study. No pleural effusion or pneumothorax is seen. The cardiac silhouette remains enlarged. The cardiac and mediastinal silhouettes are stable. The patient is status post median sternotomy. There is possible mild pulmonary vascular congestion, not significantly changed from prior study. IMPRESSION: Known pulmonary metastases. Possible mild superimposed vascular congestion. " 2fefa23d-e287a26b-6212f800-434c0d2f-3e32aa0e.jpg,validate/p11/p11675760/s52230919/2fefa23d-e287a26b-6212f800-434c0d2f-3e32aa0e.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Positive PPD. Cardiomediastinal contours are normal. The lungs are hyperinflated consistent with COPD. There is biapical pleural thickening of unknown chronicity. There are no prior studies available for comparison. There is a suture chain in the right perihilar region, likely right middle lobe. There is no pneumothorax or pleural effusion. There is minimal right apical scarring. IMPRESSION: No evidence of acute TB. Biapical pleural thickening is of unknown chronicity. " 8a1c6ca1-a3dd2704-d57dc1e7-4164be51-389913c2.jpg,validate/p14/p14047315/s53265087/8a1c6ca1-a3dd2704-d57dc1e7-4164be51-389913c2.jpg,validation," WET READ: ___ ___ ___ 9:11 PM Continued worsening bibasilar opacities since ___, more noticeable on the left, concerning for progressive infection in the setting of worsening leukocytosis. Cardiomediastinal silhouette within normal limits. No pneumothorax. Support lines and devices are unchanged. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH and HCAP. S/p bronch today. // interval change s/p bronch interval change s/p bronch COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Severe bilateral pulmonary consolidation, sparing only the right upper lobe, has progressed on the left, and although stable on the right now suggests developing cavitation in severe pneumonia. The relatively rapid change in the left lung (and subsequent improvement on the subsequent chest radiograph 05:00 on ___, available the time of this review) suggest a component of either recent aspiration or asymmetric edema in the left lung. Right pleural effusion is likely, but not large. No left pleural abnormality or right pneumothorax. ET tube and left subclavian line are in standard placements. Nasogastric tube passes into the stomach and out of view. " 80b8bcec-e95d81d9-403ec0b7-70ae9996-d2a69ff8.jpg,validate/p10/p10624836/s55179656/80b8bcec-e95d81d9-403ec0b7-70ae9996-d2a69ff8.jpg,validation," 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. " de22d943-6e22cd2d-7da9c40e-ca5b6df0-48becc56.jpg,validate/p18/p18637589/s56588693/de22d943-6e22cd2d-7da9c40e-ca5b6df0-48becc56.jpg,validation," FINAL REPORT INDICATION: Status post colonoscopy with pain. Evaluate for free air. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. No free air under the diaphragm. There is an accessory right cervical rib. No pleural effusion, pneumothorax, or focal airspace consolidation. Cardiac size, mediastinal contours and hilar structures are unremarkable. Pleural surfaces are normal. IMPRESSION: No free air. " cb562262-f573ce64-e823c7e9-58ffe832-0550beb8.jpg,validate/p12/p12750648/s59312807/cb562262-f573ce64-e823c7e9-58ffe832-0550beb8.jpg,validation," 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. " 9aa19889-b5a7d176-ad7527ae-0af2eaa7-276e9c73.jpg,validate/p10/p10492868/s51272081/9aa19889-b5a7d176-ad7527ae-0af2eaa7-276e9c73.jpg,validation," FINAL REPORT HISTORY: Cough. COMPARISON: None. FINDINGS: Lung volumes are low. Interstitial markings are likely accentuated by low lung volumes. There is no consolidation, effusion or pneumothorax. Cardiac and mediastinal contours are normal. IMPRESSION: Low lung volumes accentuate interstitial markings. " 8c24e1ef-1dcaf57b-c6f5eebe-c2fd46a5-dc5d2fa3.jpg,validate/p18/p18859129/s58243699/8c24e1ef-1dcaf57b-c6f5eebe-c2fd46a5-dc5d2fa3.jpg,validation," 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. " c9f21a73-a24ae633-fffa7e3d-81008d5c-555a878e.jpg,validate/p10/p10660342/s52595076/c9f21a73-a24ae633-fffa7e3d-81008d5c-555a878e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with abdominal pain X 2 days // ? pneumonia / effusion TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Minimal left base atelectasis is seen. There is no definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. The aorta is tortuous. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 8ffec5b7-419a7a3f-2bd64dc8-da23ed1e-24e1a884.jpg,validate/p10/p10000980/s54935705/8ffec5b7-419a7a3f-2bd64dc8-da23ed1e-24e1a884.jpg,validation," FINAL REPORT INDICATION: ___F with c/o SOB // ? PNA or CHF TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: There is mild pulmonary edema with superimposed region of more confluent consolidation in the left upper lung. There are possible small bilateral pleural effusions. Moderate cardiomegaly is again seen as well as tortuosity of the descending thoracic aorta. No acute osseous abnormalities. IMPRESSION: Mild pulmonary edema with superimposed left upper lung consolidation, potentially more confluent edema versus superimposed infection. " a54bc3d6-4dc2231b-cb387c8f-0b90a7bc-905ac3d3.jpg,validate/p14/p14246614/s51861742/a54bc3d6-4dc2231b-cb387c8f-0b90a7bc-905ac3d3.jpg,validation," FINAL REPORT PORTABLE CHEST X-___ ___ ___ COMPARISON: ___ radiograph. FINDINGS: Tip of endotracheal tube terminates approximately 2.8 cm above the carina. Nasogastric tube terminates within the stomach, and right internal jugular central venous catheter terminates in the expected location of the right atrium. Allowing for patient's rotation, cardiomediastinal contours are stable compared to prior study. Persistent pulmonary vascular congestion, as well as unchanged left retrocardiac opacity and adjacent small left pleural effusion. " b08256e6-3544928f-4a454089-822bd33a-e9b6b015.jpg,validate/p17/p17574863/s54594702/b08256e6-3544928f-4a454089-822bd33a-e9b6b015.jpg,validation," FINAL REPORT PA AND LATERAL CHEST FILM, ___ AT 20:36 CLINICAL INDICATION: ___-year-old with end-stage renal disease on dialysis, question fluid overload. Comparison to prior study of ___ at 9:54. PA and lateral views of the chest are submitted of ___ at 20:36 and compared to prior study of ___ at 9:54. IMPRESSION: 1. Slightly low lung volumes with no evidence of pulmonary edema, focal airspace consolidation, pleural effusions, or pneumothorax. Overall, cardiac and mediastinal contours are stable. There has been interval placement of a vascular stent likely within the distal left brachiocephalic vein near the junction with the superior vena cava; however, there is no note of an interval procedure in this ___ medical record and therefore clinical correlation is advised. No acute bony abnormality. " 7598557d-a738c875-5a50400e-58f99c0a-40255ff6.jpg,validate/p18/p18123897/s52606675/7598557d-a738c875-5a50400e-58f99c0a-40255ff6.jpg,validation," 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. " 439c30ef-73549f8d-31c87642-7915a2d5-55048da8.jpg,validate/p18/p18423014/s52018615/439c30ef-73549f8d-31c87642-7915a2d5-55048da8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain. Evaluate for pneumonia or 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. IMPRESSION: No acute cardiopulmonary process. " f10e933f-39636a40-2d3fb687-72fa47f0-01a86a47.jpg,validate/p17/p17316172/s50528981/f10e933f-39636a40-2d3fb687-72fa47f0-01a86a47.jpg,validation," FINAL REPORT INDICATION: COPD with acute exacerbation. Exclude possible underlying pneumonia. COMPARISON: ___ through ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Cardiomediastinal silhouette and hilar contours are normal. Lungs are extremely hyperinflated compatible with diagnosis of COPD. There is widespread bronchial wall thickening with subtle increased peribronchial opacities, particularly in the right lower lung, increased from prior study, worrisome for infection. There is no pleural effusion or pneumothorax. IMPRESSION: Subtle increased peribronchial opacities in the right lower lung, worrisome for infection. Results were discussed over the telephone with Dr. ___ by ___ ___ at 4:16 p.m. on ___ at time of initial review. " 6cd42352-5380c835-f9e5a434-4c718f25-611a5477.jpg,validate/p18/p18568518/s59210004/6cd42352-5380c835-f9e5a434-4c718f25-611a5477.jpg,validation," WET READ: ___ ___ 6:27 AM 1. Upper airway not visualized. Clinical correlation is recommended and if concern a dedicated. neck/soft tissue radiograph may be obtained. 2. Metastatic disease with hilar lymphadenopathy, similar to ___. 3. No new focal opacity to suggest pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F previously on hospice, known lung metastases, acute SOB. Assess for acute process. TECHNIQUE: Single portable frontal chest radiograph. COMPARISON: Chest radiograph ___, ___, ___. CT chest ___ and scout film. FINDINGS: Multiple rounded opacities seen within the hilum are consistent with known metastatic lymphadenopathy. Mild asymmetric pulmonary edema within the right lung. No pleural effusion or pneumothorax. No new focal opacity. Upper airway is not well visualized. New left main bronchus compression. Right port tip within the lower SVC. Visualized upper abdomen is unremarkable. IMPRESSION: 1. Upper airway not visualized. Clinical correlation is recommended and if concern a dedicated neck/soft tissue radiograph may be obtained. 2. Metastatic disease with hilar lymphadenopathy and new left main bronchus compression. 3. No new focal opacity to suggest pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 8:45AM, 5 minutes after discovery of updated findings. " 13d33c8b-299962ac-0d66d39c-e8ca5257-02b8de93.jpg,validate/p11/p11244690/s59546266/13d33c8b-299962ac-0d66d39c-e8ca5257-02b8de93.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam dated ___. CLINICAL HISTORY: Hypoxia, tachycardia and cough. FINDINGS: PA and lateral views of the chest were provided demonstrating no focal consolidation, effusion or pneumothorax. The heart and mediastinal contours are normal. The imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute findings in the chest. " 7d1f0286-8db63373-714b45e8-fb6671dc-ee4e085f.jpg,validate/p18/p18828209/s51534439/7d1f0286-8db63373-714b45e8-fb6671dc-ee4e085f.jpg,validation," FINAL REPORT INDICATION: Progressive shock, acute renal failure, with worsening hypoxia. COMPARISON: Radiographs available from ___ through ___ at 1:28 p.m. Comparison CT available from ___. FRONTAL CHEST RADIOGRAPH: Bilateral IJ catheters are unchanged in position. An endotracheal tube terminates 4.1 cm above the carina. An orogastric tube extends to at least the level of the stomach, with the tip excluded on this radiograph. Small bilateral pleural effusions are again seen, unchanged on the right and slightly worsened on the left. There is continued central pulmonary vascular congestion. There is no pneumothorax. IMPRESSION: 1. Increased small left pleural effusion. 2. Unchanged small right pleural effusion. " 55fbd017-36c6661b-5aea0eda-d2217532-a04d41bf.jpg,validate/p17/p17973921/s53676705/55fbd017-36c6661b-5aea0eda-d2217532-a04d41bf.jpg,validation," 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. " d23f472c-42eb964c-8c4b1585-848e2257-e6fc812f.jpg,validate/p10/p10747985/s57507156/d23f472c-42eb964c-8c4b1585-848e2257-e6fc812f.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. FINDINGS: In comparison with the study of ___, the left base has essentially cleared. Continued enlargement of the cardiac silhouette with only mild elevation of pulmonary pressure, raises the possibility of cardiomyopathy or pericardial effusion. There is evidence of chronic pulmonary disease without acute focal pneumonia. " 25633c8e-168d29cb-b6236fd5-af288715-89d4640b.jpg,validate/p19/p19497735/s58327605/25633c8e-168d29cb-b6236fd5-af288715-89d4640b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___-y/o male with stage 4 cholangiocarcinoma c/b DVT and PEs on lovenox with IVC filter and transfusion-dependent anemia (likely AIHA) presented with AMS and hypotension requiring pressors and intubation. // eval for interval change TECHNIQUE: Portable chest COMPARISON: ___ FINDINGS: There is interval decrease in the right effusion which is now small. There continues to be dense retrocardiac opacification compatible with volume loss/infiltrate/ effusion. There is some residual volume loss/ infiltrate the right lower lung. There is mild pulmonary vascular redistribution. The heart continues to be moderately enlarged. The ET tube NG tube and right-sided central line are unchanged IMPRESSION: Decreased right effusion " f6249024-b88b220a-834f7047-7cdb969c-f5abded4.jpg,validate/p11/p11822564/s50697152/f6249024-b88b220a-834f7047-7cdb969c-f5abded4.jpg,validation," 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. " f319ba51-f8bcdac6-14ea2f44-11181e40-323e487a.jpg,validate/p16/p16960206/s52206190/f319ba51-f8bcdac6-14ea2f44-11181e40-323e487a.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with left-sided chest pain, assess for infiltrate, pleural effusion. COMPARISON: None. TECHNIQUE: PA and lateral chest radiograph were provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous structures are intact. There is no free air under the hemidiaphragm. IMPRESSION: No acute intrathoracic process. " be7dfe4f-1f1b42fe-e20ff912-d4e168a0-0fc4e2eb.jpg,validate/p13/p13158011/s57031514/be7dfe4f-1f1b42fe-e20ff912-d4e168a0-0fc4e2eb.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with cough // 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. Some degenerative changes are seen along the spine. IMPRESSION: No acute cardiopulmonary process. " 6c802b6b-a5f10108-d9afee21-a00eb27a-57b0b056.jpg,validate/p12/p12745171/s51370216/6c802b6b-a5f10108-d9afee21-a00eb27a-57b0b056.jpg,validation," WET READ: ___ ___ ___ 5:29 PM 1. Cardiomegaly with new mild-moderate pulmonary edema. 2. Possible new left lower lobe pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with shortness of breath, acute process? COMPARISON: Chest radiograph from ___. FINDINGS: PA and lateral views of the chest provided. Bilateral pulmonary interstitial edema is mild-moderate, associated with engorgement of the vascular pedicle. Increased opacity in the left lower lobe may represent atelectasis, potentially pneumonia. Small coinciding pleural effusion and/or atelectasis cannot be excluded. Heart size is enlarged. IMPRESSION: 1. Cardiomegaly with new mild-moderate pulmonary edema. 2. Possible new left lower lobe pneumonia versus atelectasis; coinciding small pleural effusion is not excluded. NOTIFICATION: Updated findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 5:20 PM. " 2c699122-efee7018-c1fa48a0-0682d0e2-cf1b17f8.jpg,validate/p15/p15251948/s57811764/2c699122-efee7018-c1fa48a0-0682d0e2-cf1b17f8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with Head and Neck Cancer s/p port placement in ___. Port removed ___. Confirm no FB s/p port removal. // Assess for foreign body Assess for foreign body IMPRESSION: In comparison with the study of ___, the right subclavian Port-A-Cath has been removed. No evidence of residual opaque foreign body. The patient has taken a much better inspiration and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " c010904e-06dea206-258c025d-6c06d115-b0eda883.jpg,validate/p14/p14309697/s52811701/c010904e-06dea206-258c025d-6c06d115-b0eda883.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with CAD, ESRD on HD, HFpEF, admitted with GIB s/p unrevealing EGD, now with cough and rhonchi on exam. // Assess for ?pneumonia vs pulmonary edema in setting of rhonchi on exam IMPRESSION: As compared to ___ chest radiograph, left pleural effusion and adjacent left basilar atelectasis have decreased. No new regions of consolidation in the lungs to suggest presence of pneumonia. " 9367b100-a7a0afff-943d155e-be050317-86dce692.jpg,validate/p16/p16508811/s52215519/9367b100-a7a0afff-943d155e-be050317-86dce692.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with renal txp and pvd // preop eval pna or effusion Surg: ___ (angio) COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, bilateral perihilar and right basal parenchymal opacities have completely resolved. The lung parenchyma is now free of infectious changes or atelectasis. No pulmonary edema. No pleural effusions, valvular calcifications. No pulmonary nodules or other neoplastic or infectious lesions. " 59ea4e98-975fd9a9-81a2a90b-3792f9c8-f88b6f8b.jpg,validate/p11/p11214363/s50352136/59ea4e98-975fd9a9-81a2a90b-3792f9c8-f88b6f8b.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with hemoptysis. 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 or pneumothorax. Visualized osseous structures are without an acute abnormality. IMPRESSION: No acute intrathoracic abnormality. " c6a279a4-85ff85b0-371816ca-97a1b345-fd9ba2a9.jpg,validate/p16/p16259867/s54512450/c6a279a4-85ff85b0-371816ca-97a1b345-fd9ba2a9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the nasogastric tube has been changed. The current tube shows a normal course and is positioned in the middle parts of the stomach. No complications, notably no pneumothorax. Otherwise, the appearance of the chest radiograph is unchanged. " 1c2f5a09-a83312b3-a03f4043-13822dac-70571dc6.jpg,validate/p15/p15117526/s56767144/1c2f5a09-a83312b3-a03f4043-13822dac-70571dc6.jpg,validation," FINAL REPORT HISTORY: Mild hypotension. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: Left-sided AICD/pacemaker device is noted with leads terminating in the right atrium and right ventricle. The heart size is top normal. The mediastinal contour is unremarkable. Severe enlargement of the pulmonary arteries bilaterally is compatible with pulmonary arterial hypertension. Lungs are hyperinflated with mild emphysematous changes again seen. Chronic interstitial abnormality is most pronounced within the periphery of the right upper and mid lung fields, slightly progressed compared to the prior radiograph. No focal consolidation, pleural effusion or pneumothorax is identified. There is no pulmonary edema. No acute osseous abnormalities are seen. IMPRESSION: No radiographic evidence for pneumonia. Mild emphysema with chronic interstitial abnormality most pronounced within the periphery of the right upper and mid lung fields. Pulmonary arterial hypertension. " 1eb8e1f0-ea398128-07b5ffeb-2e909f45-af84eba9.jpg,validate/p14/p14651162/s56016699/1eb8e1f0-ea398128-07b5ffeb-2e909f45-af84eba9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, low grade fever. History of 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. Mild degenerative changes are noted in the lower thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 31493b7e-78b6f603-9ed05828-25165587-25ad61f9.jpg,validate/p18/p18599567/s56563008/31493b7e-78b6f603-9ed05828-25165587-25ad61f9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETT, NGT, R chest tube // eval interval change eval interval change COMPARISON: Comparison to prior study ___ at 05:46 FINDINGS: Portable semi-erect chest film ___ at 06:36 is submitted. IMPRESSION: Endotracheal tube has its tip 5 cm above the carina. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. A right pleural catheter remains in place. There is persistent retrocardiac consolidation likely reflecting lower lobe collapse with associated layering effusion. Clinical correlation is advised as superimposed infection cannot be excluded. No pulmonary edema. Small right apical pneumothorax. Multiple right-sided rib fractures are again seen. Air within the right lateral chest wall soft tissues consistent with subcutaneous emphysema. Overall cardiac and mediastinal contours are stable. NOTIFICATION: The patient's nurse was notified of these findings by phone on ___ at 12:30 at the time of discovery. " 52f6d51e-c46f438b-e009ea9d-585ed41b-dc3a779e.jpg,validate/p18/p18553055/s58140301/52f6d51e-c46f438b-e009ea9d-585ed41b-dc3a779e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypotension // eval for infection TECHNIQUE: Single frontal view of the chest COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is mild right base atelectasis. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable. IMPRESSION: Mild enlargement of the cardiac silhouette without overt pulmonary edema. Mild right base atelectasis. " 6a6e8582-f9b49f5b-94732220-123bba50-5b8d567e.jpg,validate/p12/p12951207/s56927410/6a6e8582-f9b49f5b-94732220-123bba50-5b8d567e.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with chest pain, hypoxia // eval infiltrate, CHF TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: There is mild basilar atelectasis without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable, with the cardiac silhouette mildly enlarged. Hilar contours are stable. There is no pulmonary edema. . IMPRESSION: No acute cardiopulmonary process. " f38b6379-67b282ce-776506c3-95aa645b-6dd8bbe9.jpg,validate/p12/p12468091/s54416601/f38b6379-67b282ce-776506c3-95aa645b-6dd8bbe9.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with subarachnoid hemorrhage. Evaluate nasogastric tube placement. COMPARISON: Prior radiographs of the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is bibasilar atelectasis, which is not significantly changed from the prior study. The heart is not enlarged. The mediastinum remains stably widened. A nasogastric tube is seen with the tip ending in the stomach and the last side port above the GE junction. There is no pneumothorax. IMPRESSION: Nasogastric tube ends in the stomach with the last side port above the GE junction, and should be advanced prior to use. " 5d60e19c-674f9e04-9c7ad697-38d0712c-c23e1c41.jpg,validate/p15/p15835176/s50685816/5d60e19c-674f9e04-9c7ad697-38d0712c-c23e1c41.jpg,validation," FINAL REPORT INDICATION: Severe pulmonary edema. Evaluation of ET tube placement. COMPARISON: ___ at 10:33 a.m. FINDINGS: Portal AP chest radiograph. The patient has been intubated and the ET tube terminates in the satisfactory position. An NG tube courses below the diaphragm and terminates outside the field of view. Severe pulmonary edema is again noted with patchy alveolar opacities and a moderate right pleural effusion. " c6388202-b37ce100-efac32e0-08005c45-c456ad29.jpg,validate/p14/p14287925/s55550419/c6388202-b37ce100-efac32e0-08005c45-c456ad29.jpg,validation," FINAL REPORT HISTORY: History of Crohn's disease about began Remicade. Evaluate for prior tuberculosis. 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 contours are normal. Incidentally noted is mild scoliosis with rightward convexity of the mid thoracic spine. IMPRESSION: No radiographic evidence for acute cardiopulmonary or chronic granulomatous disease. " cd577b92-a2c19299-255dcf04-4cc0a471-24b0801c.jpg,validate/p10/p10625923/s55446013/cd577b92-a2c19299-255dcf04-4cc0a471-24b0801c.jpg,validation," WET READ: ___ ___ ___ 10:22 AM Streaky retrocardiac atelectasis in the left base, similar to prior, most compatible with atelectasis. No definite focal consolidation. Likely small right pleural effusion. No evidence of pneumothorax. COMPARISON: Chest radiograph ___. Impression: WET READ VERSION #1 ___ ___ 8:21 PM Streaky retrocardiac atelectasis in the left base, similar to prior, most compatible with atelectasis. No definite focal consolidation. Likely small right pleural effusion. No evidence of pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F h/o colon polyps p/w likely perforated diverticulitis s/p IR drainage // Rule out upper respirator tract infection Rule out upper respirator tract infection IMPRESSION: Previous heterogeneous opacification in the right mid end infra hilar lung is still present, possibly improved. Findings could be due to scarring or acute pneumonia. Careful radiographic followup is advised. Pleural effusion is small on the right if any. Subsegmental atelectasis stable at the left lung base. Both upper lungs are clear. Normal cardiomediastinal silhouette. " e96ad257-6c383f69-4e2e4019-d0401bff-bf14d41b.jpg,validate/p18/p18701681/s59797246/e96ad257-6c383f69-4e2e4019-d0401bff-bf14d41b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with renal transplant, rejecting, and on pulse steroids with cough. // PNA eval COMPARISON: ___ FINDINGS: The lungs are well inflated. 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 areas concerning for consolidation seen. No destructive bony lesions seen. IMPRESSION: No acute cardiopulmonary abnormality. " 600cf594-6f5a47e1-72d8d368-0c51c8d3-92d15a83.jpg,validate/p14/p14309697/s56299475/600cf594-6f5a47e1-72d8d368-0c51c8d3-92d15a83.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with dyspnea on exertion, abdominal pain, melanic stools. TECHNIQUE: Upright AP view of the chest COMPARISON: ___ FINDINGS: Lung volumes are lower compared to the previous exam, which accounts for the slight increase in size of the cardiac silhouette. Heart size does appear mildly enlarged. The aorta is calcified at the aortic knob. Mediastinal and hilar contours are normal. Pulmonary vasculature is not engorged. Patchy retrocardiac opacity may reflect atelectasis. There are likely small bilateral pleural effusions. No pneumothorax is present. There are no acute osseous abnormalities. No subdiaphragmatic free air is identified. IMPRESSION: Retrocardiac patchy opacity is likely reflective of atelectasis. Probable small bilateral pleural effusions. " 40650a9c-92c55408-af7f542b-cc60b764-c26c0095.jpg,validate/p17/p17739770/s57980012/40650a9c-92c55408-af7f542b-cc60b764-c26c0095.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: To evaluate for nasogastric tube placement. TECHNIQUE: Single semi-erect portable chest view was read in comparison with prior chest radiograph from ___. FINDINGS: A newly placed feeding tube tip ends just below the gastroesophageal junction. Consider advancing the tube by additional 8-9 cm which will position the distal end into the stomach. Right subclavian line tip is at mid SVC. Bilateral pleural effusions, moderate right and minimal left accompanying adjacent lower lung atelectasis are stable since ___. Heart size is normal, mediastinal and hilar contours are unremarkable. Dr. ___ ___ communicated the findings regarding the feeding tube to ___ (RN) on ___ between 1:45 and 2:15 PM. " 560a1b2f-765df9cb-b8def580-05ad8ebd-d6edc6b3.jpg,validate/p17/p17437534/s50987704/560a1b2f-765df9cb-b8def580-05ad8ebd-d6edc6b3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ptx // Ptx, pls perform @ 5am Ptx, pls perform @ 5am IMPRESSION: No comparison. A minimal left-sided pneumothorax, previously visualized on the CT examination from ___, is not visible on the chest radiograph. Minimal atelectasis at the left lung basis. Normal size of the heart. No pneumonia, no pulmonary edema. " b6cf9a66-268933ce-41a2bb36-cf967f75-a90ccf43.jpg,validate/p13/p13358528/s56110125/b6cf9a66-268933ce-41a2bb36-cf967f75-a90ccf43.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with fever // ? infectious 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. IMPRESSION: No evidence of pneumonia. No acute cardiopulmonary process. " 2789ba93-122c5a36-8b573c2a-f6272c32-fea4e38b.jpg,validate/p19/p19398915/s59755957/2789ba93-122c5a36-8b573c2a-f6272c32-fea4e38b.jpg,validation," 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. " 21bc9678-35f52603-c7dd3164-2eb7952b-61406218.jpg,validate/p10/p10232271/s53505118/21bc9678-35f52603-c7dd3164-2eb7952b-61406218.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pneumonia, septic shock // interval change interval change IMPRESSION: Compared to chest radiographs ___ through ___. No recent change in moderate bilateral pleural effusions, left lower lobe collapse, and large scale consolidation in the right mid and lower lungs, some combination of pneumonia and collapse. Borderline cardiomegaly is stable. Mediastinal caliber does not suggest volume overload. Right PIC line ends in the low right atrium. Other indwelling cardiopulmonary support devices are in standard placements respectively. " c0fb8571-6b1e05d9-ad636bc3-c2b63222-9c4516bb.jpg,validate/p14/p14105374/s51179864/c0fb8571-6b1e05d9-ad636bc3-c2b63222-9c4516bb.jpg,validation," FINAL REPORT INDICATION: Intractable hiccups, assess for cardiopulmonary disease or mass. COMPARISONS: None. Two views are obtained of the chest. No focal consolidation, pleural effusion or pneumothorax is seen. Linear bibasilar opacities are likely scarring and atelectasis. Cardiac size and mediastinal contours are unremarkable. Old rib fractures are seen in the left lateral ribs. IMPRESSION: No acute intrathoracic process. " 77757d8b-88da017f-ebb22f33-f62de210-8683b441.jpg,validate/p17/p17085388/s53456778/77757d8b-88da017f-ebb22f33-f62de210-8683b441.jpg,validation," 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 " 236c02b5-bac07066-8751aa36-28d1c949-d5351d6b.jpg,validate/p13/p13058213/s55676902/236c02b5-bac07066-8751aa36-28d1c949-d5351d6b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever and SOB // ? Pna TECHNIQUE: Chest Frontal and Lateral COMPARISON: ___ FINDINGS: Right lower lobe opacity is worrisome for pneumonia. The left lung is clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Thoracic scoliosis is again noted. Partially imaged cervical spine hardware is also noted. IMPRESSION: Right mid to lower lung opacity, worrisome for pneumonia. " a26fa7e8-a540c706-d4528944-678a6bd7-597d8e59.jpg,validate/p18/p18416120/s52802311/a26fa7e8-a540c706-d4528944-678a6bd7-597d8e59.jpg,validation," FINAL REPORT INDICATION: Chest and back pain, evaluate for acute process. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___ FINDINGS: The lungs are well inflated and clear. The cardiomediastinal silhouette, hila contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. Included upper abdomen is unremarkable. Osseous structures are grossly intact. IMPRESSION: No evidence of acute cardiopulmonary process. " cc8c64e1-e013dc26-f8f18913-df9a92f4-6c7a710f.jpg,validate/p10/p10940509/s51918551/cc8c64e1-e013dc26-f8f18913-df9a92f4-6c7a710f.jpg,validation," FINAL REPORT HISTORY: ___-year-old woman with chest pain. COMPARISON: Chest radiograph ___ and CT chest ___. FINDINGS: The cardio mediastinal and hilar contours are stable, with hear size in the upper limits of normal. Tortuous thoracic aorta is unchanged. The lungs are clear, without consolidation, pulmonary edema, pleural effusion or pneumothorax. Linear right lower lobe scarring is unchanged. IMPRESSION: No acute cardiopulmonary pathology. " bfdf6bd8-5a051b5d-d5b3b8a1-896e8e8c-a4f1dc78.jpg,validate/p19/p19960115/s50127652/bfdf6bd8-5a051b5d-d5b3b8a1-896e8e8c-a4f1dc78.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // interval change interval change COMPARISON: Prior chest radiographs ___ through ___. IMPRESSION: Large right pleural effusion has increased. Lungs are diffusely opacified, most likely due to edema, but the lower lungs really cannot be assessed. On ___, on abdomen CT, the right lower lobe was collapsed, and the left lower lobe showed somewhat milder atelectasis in the setting of small to moderate bilateral pleural effusion. There is no pneumothorax. Heart is moderately enlarged. ET tube is in standard placement and a transesophageal drainage tube can be traced to the low esophagus but the tip is indistinct. " 3aa2a25c-0139be8c-4b100b85-311f566c-eb52609e.jpg,validate/p17/p17964313/s51625639/3aa2a25c-0139be8c-4b100b85-311f566c-eb52609e.jpg,validation," WET READ: ___ ___ 3:17 PM Interval development of pulmonary vascular congestion and mild to moderate pulmonary edema. No focal consolidation. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with valvular heart dz, afib, with worsening doe past ___ days, evaluate for cardiopulmonary process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___. FINDINGS: Compared with the immediate prior study there is increased pulmonary vascular congestion and mild to moderate pulmonary edema. Cardiomegaly has also increased compatible with volume overload. There is no focal consolidation, pleural effusion, or pneumothorax the osseous structures and partially visualized upper are unremarkable. IMPRESSION: Interval development of pulmonary vascular congestion and mild to moderate pulmonary edema. No focal consolidation. " 3b060cf2-d8e1509b-b70ddd66-a8c54260-bef67438.jpg,validate/p14/p14113035/s51752848/3b060cf2-d8e1509b-b70ddd66-a8c54260-bef67438.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. TECHNIQUE: Chest, semi-upright AP portable. COMPARISON: Earlier on the same day. FINDINGS: The patient remains intubated. The cardiac, mediastinal and hilar contours appear stable. There is a persistent extensive opacity in the left mid to upper lung that appears decreased. Specifically, this film is centered on the hemidiaphragms in order to assess for nasogastric tube placement. The nasogastric tube terminates in the distal esophagus where it makes a half coil. The stomach is mild to moderately distended. There is no free air. IMPRESSION: Nasogastric tube terminating in the esophagus. Persistent but decreased left lung opacity. " e2a315d3-02ae3798-7051a9f2-4f3ba4b6-a0ed2197.jpg,validate/p10/p10541305/s59891703/e2a315d3-02ae3798-7051a9f2-4f3ba4b6-a0ed2197.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CP, recvent URI // 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 and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 97224667-1edb222d-453e72b3-5230f097-b1cfc963.jpg,validate/p18/p18883935/s52733840/97224667-1edb222d-453e72b3-5230f097-b1cfc963.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ Comparison is made with prior chest radiograph from ___ as well as a CT torso from ___. CLINICAL HISTORY: Chest pain, shortness of breath, fever, history of metastatic melanoma. FINDINGS: AP upright portable chest radiograph is obtained. There is increasing opacity at the left lung base concerning for effusion and consolidation. Right lung appears clear. Overall, low lung volumes limit evaluation. No pneumothorax. Heart size cannot be reliably assessed. The mediastinal contour is unremarkable. Bony structures appear grossly stable in this patient with known diffuse metastatic disease. IMPRESSION: Increasing opacity at the left lung base concerning for pneumonia and effusion. " b984ceef-aa0f7598-456f12ad-50caeffd-ae64f60e.jpg,validate/p17/p17334175/s59385431/b984ceef-aa0f7598-456f12ad-50caeffd-ae64f60e.jpg,validation," WET READ: ___ ___ ___ 2:45 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with cough // PNA TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Lungs are clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. No focal consolidations are noted. No pneumothorax, pleural effusion, or pulmonary edema. IMPRESSION: No acute intrathoracic process. " d321a8c6-0716054a-89eb3978-e093a69f-a35ce487.jpg,validate/p17/p17107992/s55127499/d321a8c6-0716054a-89eb3978-e093a69f-a35ce487.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old woman with new dyspnea on exertion. FINDINGS: Comparison is made to previous study from ___. There has been some improvement of the pleural effusion since the previous study. However, this may be partially due to patient positioning. These effusions remain moderate in size. There is cardiomegaly. There are no signs for overt pulmonary edema. No pneumothoraces are seen. " bcf4e7d3-99f41e42-9b619a1c-ea3d13ca-9bd19280.jpg,validate/p16/p16346361/s56724570/bcf4e7d3-99f41e42-9b619a1c-ea3d13ca-9bd19280.jpg,validation," FINAL REPORT HISTORY: LUL wedge resection, to assess for pneumothorax. FINDINGS: In comparison with the operative study, wedge resection has been performed and there is a small left apical pneumothorax with chest tube in place. Substantially lower lung volumes. Bibasilar opacifications probably reflect atelectasis and small effusions. Subcutaneous gas is seen along the left lateral chest wall and upper abdomen. " a3c6daf4-a1f8a440-b76bea37-642515bf-da5c72bd.jpg,validate/p19/p19358609/s53962747/a3c6daf4-a1f8a440-b76bea37-642515bf-da5c72bd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with cough and fever // r/o acute infectious process TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Substantial distortion of the chest in particular left hemi thorax with chronic changes in the right apex and in the left upper lung are noted. On the other hand there is new right basal and to lesser extent left basal opacity, findings concerning for pneumonia. No definitive evidence of pulmonary edema is present. No pleural effusion demonstrated. Nodular opacity as part of the scarring is demonstrated in the right apex, slightly more conspicuous on current examination and should be reassessed with chest CT to exclude the possibility of growing malignancy " e6a96e8d-aeceb130-342948ec-1dac1a0e-9daaf79b.jpg,validate/p17/p17223183/s50616707/e6a96e8d-aeceb130-342948ec-1dac1a0e-9daaf79b.jpg,validation," FINAL REPORT AP CHEST, 11:25 A.M., ___ HISTORY: A ___-year-old female with worsening secretions. IMPRESSION: AP chest compared to ___: Large scale consolidation involves most of the left lung. Smaller region of consolidation occupies the infrahilar right lower lung. Findings are most consistent with severe pneumonia or very severe pulmonary hemorrhage. There is also the suggestion of nodules in the left lung, difficult to separate from the consolidation. This could be a feature of acute infection, and should be re-examined after initial treatment. Heart size is top normal. There is no appreciable pleural effusion, no pneumothorax. ET tube in standard placement. Air in the esophagus may reflect attempts at tracheal intubation. Dr. ___ was paged at 12:50 p.m. as soon as the findings were recognized. " b947d072-f56c64dc-74314379-52ce73d8-c1f460b6.jpg,validate/p11/p11410429/s52894293/b947d072-f56c64dc-74314379-52ce73d8-c1f460b6.jpg,validation," WET READ: ___ ___ ___ 4:43 PM 1. Mild cardiomegaly. 2. 1.3 cm density at the left lung base may represent a nipple shadow, however a dedicated oblique view is recommended for further evaluation. WET READ VERSION #1 ___ ___ ___ 3:23 PM 1. Mild fluid overload.2. 1.3 cm density at the left lung base may represent a nipple shadow, however a dedicated oblique view is recommended for further evaluation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History: ___M with frequent falls, weakness // eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Cardiomegaly is mild. There is mild kyphosis of the thoracic spine. Probably trace pleural effusions. A 1.3 cm rounded density at the cardiac apex may represent nipple shadow. No pneumothorax. IMPRESSION: 1. Mild cardiomegaly. 2. 1.3 cm density at the left lung base may represent a nipple shadow, however a dedicated oblique view or repeat with nipple markers is recommended for further evaluation. " b5592cc4-5c79ddcd-78b1253f-1a7390ad-9059f775.jpg,validate/p10/p10364180/s59382532/b5592cc4-5c79ddcd-78b1253f-1a7390ad-9059f775.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with severe COPD now with SOB // interval change? TECHNIQUE: Single frontal view of the chest COMPARISON: PET-CT ___ and chest x-ray ___ FINDINGS: Moderate cardiomegaly is stable. Patient has known emphysema. Nodules and irregular opacities in the left upper lobe and right lower lobe are better seen in prior CT. Increase opacities in the right lower lobe could be atelectasis but superimposed infection cannot be excluded in the appropriate clinical setting. There is no pneumothorax or effusion. IMPRESSION: Emphysema Left upper and right lower lobe nodules better seen in prior PET-CT New right lower lobe opacity could be atelectasis or pneumonia in the appropriate clinical setting " 3439232a-9f181910-43ad9eb6-5c258a4a-7ec02ebc.jpg,validate/p17/p17165725/s52189926/3439232a-9f181910-43ad9eb6-5c258a4a-7ec02ebc.jpg,validation," FINAL REPORT HISTORY: Pericardial effusion bilateral pleural effusions and ventilator associated pneumonia. TECHNIQUE: Portable frontal chest radiograph single-view. COMPARISON: ___. FINDINGS: The endotracheal tube remains in position with tip 5 cm cranial to the carina. A right internal jugular central venous catheter terminates in the mid SVC. A left internal jugular introducer remains at the confluence of the brachiocephalic. An upper enteric tube passes through the upper stomach and outside of the field of imaging. The cardiac silhouette remains massively enlarged but not significantly changed compared to prior study despite pericardial drainage catheter remaining in place though quite improved compared to ___. Layering right-greater-than-left pleural effusions are unchanged in volume. There is no pneumothorax. Mild to moderate pulmonary edema is unchanged. IMPRESSION: Overall no significant change compared to prior examination with persistent massive enlargement of the cardiac silhouette, mild pulmonary edema and bilateral layering pleural effusions. " d410ca71-ede5ebe2-9b641126-64068db2-2240d94c.jpg,validate/p13/p13040755/s56862374/d410ca71-ede5ebe2-9b641126-64068db2-2240d94c.jpg,validation," 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. " 5647da0d-52eadee5-ee406fe6-007be4f8-9f4f14e4.jpg,validate/p19/p19998350/s51819111/5647da0d-52eadee5-ee406fe6-007be4f8-9f4f14e4.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with chest pain, evaluate for cardiopulmonary process. COMPARISON: None. FINDINGS: PA and lateral chest radiographs are provided. Lung volumes are low. There is no focal consolidation, pleural effusion or pneumothorax. The heart size is mildly enlarged. There is no evidence of CHF. IMPRESSION: No acute cardiopulmonary process. " f6bc1ff4-6d4fe060-ca5cf8ad-b7957030-0ff85c58.jpg,validate/p14/p14044459/s57937162/f6bc1ff4-6d4fe060-ca5cf8ad-b7957030-0ff85c58.jpg,validation," FINAL REPORT CLINICAL HISTORY: ___-year-old woman with chest pain. Please evaluate for widened mediastinum. COMPARISON: None. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear. Cardiomediastinal silhouette is unremarkable. There is no widening of the mediastinum. There are no pleural effusions or pneumothorax. IMPRESSION: No acute intrathoracic process. " d814ee96-450a2eee-9d39c19a-809a7121-8d9a50a8.jpg,validate/p14/p14303757/s50938845/d814ee96-450a2eee-9d39c19a-809a7121-8d9a50a8.jpg,validation," FINAL REPORT INDICATION: New onset atrial fibrillation. COMPARISON: Chest radiographs, ___. FINDINGS: PA and lateral views of the chest were reviewed. Severe cardiomegaly is unchanged since the prior study. The mediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. Lungs are clear with no focal consolidation concerning for pneumonia. IMPRESSION: No acute cardiopulmonary process. " 6f0a5904-bc773ef9-79c8202f-aa8903c3-aea9a9cd.jpg,validate/p11/p11543542/s56630396/6f0a5904-bc773ef9-79c8202f-aa8903c3-aea9a9cd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever with no clear source. 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. IMPRESSION: No signs of pneumonia in the chest. " 17062943-c29c9df7-5a5cdd7b-dc533e4d-8b2a1573.jpg,validate/p15/p15485853/s57979161/17062943-c29c9df7-5a5cdd7b-dc533e4d-8b2a1573.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p tracheobronchoplasty and prolonged intubation and pulmonary edema // interval change COMPARISON: ___ IMPRESSION: As compared to the previous image, the clips in the right chest wall have been removed. The right Port-A-Cath and the right PICC line are in unchanged position. Unchanged right pleural thickening and increased radiodensity of the lung parenchyma. The cardiac silhouette and the left lung are normal. " fca714de-be3fedd7-d92dd4ab-d9eae5d0-5bc0fae0.jpg,validate/p14/p14906095/s55650949/fca714de-be3fedd7-d92dd4ab-d9eae5d0-5bc0fae0.jpg,validation," FINAL REPORT HISTORY: Cough. FINDINGS: In comparison with the study of ___, there is again some hyperexpansion of the lungs with mild prominence of interstitial markings consistent with chronic pulmonary disease. However, no acute pneumonia or vascular congestion. " 62e58785-340bfa7b-d0f6de5b-fab28bb8-835aa806.jpg,validate/p18/p18777781/s58845531/62e58785-340bfa7b-d0f6de5b-fab28bb8-835aa806.jpg,validation," FINAL REPORT INDICATION: Dyspnea on exertion. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 6137e470-045abfd0-9fd02460-86dea952-a5867f0a.jpg,validate/p14/p14354835/s52916037/6137e470-045abfd0-9fd02460-86dea952-a5867f0a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with resp failure, intubated. Metastatic ovarian cancer. Concern for pneumonia, aspiration. // Interval change? Interval change? COMPARISON: Chest radiographs ___ through ___:33. Previously large right pleural effusion decreased slightly between ___ and ___, currently unchanged. At the same time severe consolidation developed in the central portions of both lungs and on the left extends all way to the lung periphery. The rapid development is typical of edema, but the early nodular quality is more suggestive of pneumonia. Both processes may be con current, but I suspect pneumonia is quite severe. Heart borders are obscured and heart size is indeterminate. ET tube and right PIC line are in standard placements. Esophageal feeding in drainage tubes both pass into the stomach and out of view. No pneumothorax. IMPRESSION: Previously large right pleural effusion decreased slightly between ___ and ___, currently unchanged. At the same time severe consolidation developed in the central portions of both lungs and on the left extends all way to the lung periphery. The rapid development is typical of edema, but the early nodular quality is more suggestive of pneumonia. Both processes may be con current, but I suspect pneumonia is quite severe. Heart borders are obscured and heart size is indeterminate. ET tube and right PIC line are in standard placements. Esophageal feeding in drainage tubes both pass into the stomach and out of view. No pneumothorax. " d44ec4ca-91e5f7b3-111126ab-d0535794-2d69cc07.jpg,validate/p15/p15851682/s50876950/d44ec4ca-91e5f7b3-111126ab-d0535794-2d69cc07.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with inc crackles, tachypnea, s/p extubation and chest tube pull yesterday // please assess for pulmonary congestion, atelectasis, ptx IMPRESSION: As compared to ___ chest radiograph, subcutaneous emphysema in the right chest wall has improved. Cardiomediastinal contours are stable. Worsening bibasilar lung opacities accompanied by increasing pleural effusions, small on the left and moderate on the right. No visible pneumothorax. " ad45f7a7-a096dec6-7022756c-0e50817f-8ca30843.jpg,validate/p10/p10667056/s56803473/ad45f7a7-a096dec6-7022756c-0e50817f-8ca30843.jpg,validation," FINAL REPORT EXAMINATION: CR - CHEST (PA AND LAT) INDICATION: History: ___M with diaphoresis. On chemo // Pna? TECHNIQUE: Chest PA and lateral COMPARISON: None available. FINDINGS: The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. There is no pleural effusion or pneumothorax. No definite focal consolidation is identified. IMPRESSION: No acute intrathoracic abnormality. " f9690fb3-61c15a08-319a090a-04686311-659f02b9.jpg,validate/p19/p19261730/s50605380/f9690fb3-61c15a08-319a090a-04686311-659f02b9.jpg,validation," FINAL REPORT HISTORY: History of breast cancer with dyspnea on exertion. COMPARISON: Chest radiograph from ___ and CT chest from ___. FINDINGS: Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette. A density overlying the right mid lung is likely within the soft tissue. A left lower lobe hyperdensity was previously evaluated with CT chest in ___ and corresponds with a clinical history of retained/dislodged metal forceps tip. The lungs are well-aerated and clear without pulmonary edema or focal consolidation. There is no pleural effusion or pneumothorax. IMPRESSION: Clear lungs without pulmonary edema or focal consolidation. " cd6e78dc-5b3df220-1661ae83-b0df6aef-8fd95886.jpg,validate/p19/p19828823/s50966183/cd6e78dc-5b3df220-1661ae83-b0df6aef-8fd95886.jpg,validation," FINAL REPORT INDICATION: Patient with shortness of breath following bicycle accident. Assess for pneumothorax. 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. Clavicular fracuture seen on the shoulder radiographs of the same date is obscured. IMPRESSION: No evidence of acute cardiopulmonary process, including no evidence of pneumothorax. " f27c3b8b-e52bcc58-452c756b-e7e066f6-17e1a48b.jpg,validate/p17/p17574863/s56818945/f27c3b8b-e52bcc58-452c756b-e7e066f6-17e1a48b.jpg,validation," 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. " 7f1a30df-dcde9ad4-790494a9-64c0f884-fd674c06.jpg,validate/p17/p17726962/s51752874/7f1a30df-dcde9ad4-790494a9-64c0f884-fd674c06.jpg,validation," FINAL REPORT INDICATION: Evaluate ET tube position. FINDINGS: Single portable upright chest radiograph was obtained. In additon to bibasilar atelectasis, a right lower lobe opacity may represent additonal consolidation or aspiration. There is no effusion or pneumothorax. Cardiac and mediastinal contours are normal. The endotracheal tube is 2.4 cm above the carina. IMPRESSION: 1. Slight low position of endotracheal tube. 2. Right lower lobe opacity may represent some combination of atelectasis, consolidation, and / or aspiration. " 12e2988d-64f2799b-59f90f2e-09ddf7e8-03cad349.jpg,validate/p18/p18170119/s50677133/12e2988d-64f2799b-59f90f2e-09ddf7e8-03cad349.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with Crohn's and celiac disease as well as ischemic colitis, presenting with abdominal pain and hypoxia. // ?PNA, pulm edema TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: None IMPRESSION: Heart size is normal. Mediastinal silhouette is unremarkable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. " 0868506a-9a3222ea-a5f60b44-60ddfe4f-9d906606.jpg,validate/p13/p13350579/s59364612/0868506a-9a3222ea-a5f60b44-60ddfe4f-9d906606.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with COPD and bilateral upper lobectomy with right middle lobe resection due to bronchiectasis, currently with increased cough. COMPARISON: ___. Since prior examination, the position of the mediastinum with slight right mediastinal shift is unchanged. Lungs are essentially clear except for unchanged post-surgical areas of scarring. There is no appreciable pleural effusion. There are no new consolidations that might suggest interval development of acute process. " d6c8fc95-db4e47ab-b8a577b8-9f9e6462-0ea4e5db.jpg,validate/p14/p14834560/s51692301/d6c8fc95-db4e47ab-b8a577b8-9f9e6462-0ea4e5db.jpg,validation," 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. " aaae9561-40ae2a39-061c9d2b-daef1d86-3bdbf2fe.jpg,validate/p17/p17446597/s59618727/aaae9561-40ae2a39-061c9d2b-daef1d86-3bdbf2fe.jpg,validation," FINAL REPORT AP CHEST 9:58 p.m., ___ HISTORY: ___-year-old man after intubation. IMPRESSION: AP chest compared to ___: ET tube in standard placement. Mild pulmonary edema, most readily evaluated in the left lung, has improved, while moderate right pleural effusion is larger and severe cardiomegaly is at least as large as it was on ___. There is no pneumothorax. " cece00d2-3b50ed80-25450aab-01b689a7-19ad7f94.jpg,validate/p14/p14504982/s54998246/cece00d2-3b50ed80-25450aab-01b689a7-19ad7f94.jpg,validation," FINAL REPORT AP CHEST, 2:32 A.M., ___ HISTORY: Evaluate possible mediastinal widening, in an ___-year-old woman with sudden onset of front to back chest pain. IMPRESSION: AP chest compared to ___: There has been no change in the caliber of the mediastinum, with mild widening at the level of the carina or in the contour of the thoracic aorta which is not dilated. The heart is normal size, and there is no pleural effusion. Lungs are clear, and there is no pneumothorax. It is important to note that aortic dissection can occur without any change in contours recognizable on conventional chest radiographs, and therefore, CT scanning is recommended to assess any reasonable concern about acute aortic dissection. " 068e7320-5e26758a-8dca8818-a4b7c701-96eee06d.jpg,validate/p11/p11431685/s55008119/068e7320-5e26758a-8dca8818-a4b7c701-96eee06d.jpg,validation," 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: Moderate to severe cardiomegaly is re- demonstrated. The aorta is dilated and tortuous, unchanged. Multiple calcified mediastinal and bilateral hilar lymph nodes are compatible with prior granulomatous infection. Pulmonary vasculature is not engorged. Minimal atelectasis is seen in the lung bases without focal consolidation. No pleural effusion or pneumothorax is detected. No acute osseous abnormality is visualized. Clips are again noted within the midline lower neck. IMPRESSION: No acute cardiopulmonary abnormality. " bed4f451-c695a05e-d9071d11-eff7b232-f47a6a90.jpg,validate/p18/p18279430/s50336713/bed4f451-c695a05e-d9071d11-eff7b232-f47a6a90.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ___ HISTORY: Persistent cough. History of CHF and biventricular ICD. IMPRESSION: PA and lateral chest compared to ___: Lungs are clear, mildly hyperinflated raising possibility of obstructive airways disease or emphysema. Pulmonary vasculature is normal and there is no edema or appreciable pleural effusion. Moderate cardiomegaly is essentially unchanged. Transvenous right atrial and left ventricular pacer leads and right ventricular pacer defibrillator leads follow their expected courses from the left pectoral pacemaker, unchanged since ___. " 40dc9290-9a260ee3-d39bc9ca-9a80981a-ca659255.jpg,validate/p11/p11778596/s50523025/40dc9290-9a260ee3-d39bc9ca-9a80981a-ca659255.jpg,validation," FINAL REPORT INDICATION: ___F with pericarditis recurrent pericardial effusions p/w chest pain and dyspnea // any cpd 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. " d5555071-d7434dd5-8c8210f0-39de5b09-3a3bbc53.jpg,validate/p19/p19865505/s55068590/d5555071-d7434dd5-8c8210f0-39de5b09-3a3bbc53.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with sinonasal malignancy // h/o head neck cancer, now with cough congestion 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 evidence of pneumonia. " 5562a0e7-11e42416-df4f0af8-29912000-5e468d4b.jpg,validate/p11/p11583852/s54308957/5562a0e7-11e42416-df4f0af8-29912000-5e468d4b.jpg,validation," FINAL REPORT INDICATION: ___M with pancreatic CA on chemo p/w generalized weakness // r/o PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: CT chest from ___. FINDINGS: Right chest wall port is seen with catheter tip in the right atrium. The lungs are clear without focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities identified. No free air seen below the diaphragm. Stent is partially visualized in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 0b84ce7a-b25af3ed-486d492a-b35d4342-769b1f63.jpg,validate/p13/p13204581/s53847969/0b84ce7a-b25af3ed-486d492a-b35d4342-769b1f63.jpg,validation," FINAL REPORT HISTORY: Intubated. TECHNIQUE: Semi-upright AP view of the chest. COMPARISON: None. FINDINGS: Endotracheal tube tip terminates 5.2 cm from the carina. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acutely displaced fractures are seen. IMPRESSION: No acute cardiopulmonary abnormality. Standard position of the endotracheal tube. " 3063fefa-19c17307-b873e001-4512111f-8a620446.jpg,validate/p18/p18429449/s58984392/3063fefa-19c17307-b873e001-4512111f-8a620446.jpg,validation," 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. " 6abb75b1-a5f3a19b-342357c1-5bbaed68-e98b225d.jpg,validate/p14/p14908226/s59234559/6abb75b1-a5f3a19b-342357c1-5bbaed68-e98b225d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with newly diagnosed pancreatic cancer. Port placed yesterday. Now with rigors this morning. // r/o infection. port check. TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiograph from ___ CT chest with contrast from ___ FINDINGS: Since ___, new patchy opacities are seen in the mid and lower lung base, correlating to the left lower lung on lateral view, concerning for infection. The right lung is essentially clear. The tip of the right Port-a-Cath is seen in the low SVC. The heart size is normal. No pneumothorax. IMPRESSION: Left lower lobe pneumonia. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ on the telephoneon ___ at 11:06 AM, 5 minutes after discovery of the findings. " dcbe28ce-410ecf2d-c462088a-de0f5c5d-6d6d9529.jpg,validate/p17/p17576829/s57989384/dcbe28ce-410ecf2d-c462088a-de0f5c5d-6d6d9529.jpg,validation," FINAL REPORT HISTORY: Bicycle accident, rib fracture. TECHNIQUE: Single AP upright portable view of the chest. COMPARISON: Reference made to outside hospital chest radiograph performed earlier today, ___ at 12:47 as well as to CT performed at outside institution today, ___ at 16:24. FINDINGS: Subtle left basilar opacity likely corresponds to atelectasis/possible pulmonary contusion as seen on CT earlier today. No large pleural effusion is seen. There are no findings to suggest pneumothorax. There are multiple left-sided rib fractures, better assessed on CT, however, 1 reasonably well seen involves the posterior left 4th rib is, which is minimally displaced. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Multiple left-sided rib fractures, better assessed on CT. Subtle possibly left lung base opacity likely relates to atelectasis/pulmonary contusion as seen on CT. " d268b046-796b9774-16c4bbd2-34ce49ca-2929c78d.jpg,validate/p19/p19644467/s53741734/d268b046-796b9774-16c4bbd2-34ce49ca-2929c78d.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Shortness of breath and right shoulder pain. Probable COPD flare. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion or evidence or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Hilar contours are stable. There has been no significant interval change since the prior study. IMPRESSION: No acute cardiopulmonary process. No significant change since the prior study. " 4308b324-34a6e24e-169581b1-4758fadb-cbeba3a6.jpg,validate/p16/p16151261/s59323648/4308b324-34a6e24e-169581b1-4758fadb-cbeba3a6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with C5 fracture, s/p trach // cardiopulmonary process cardiopulmonary process COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Left lower lobe consolidation has been present since ___, unchanged, probably left lower lobe collapse. Lungs are otherwise clear. Mild enlargement of cardiac silhouette has been variable, probably a function of intravascular volume. Today there is no pulmonary edema or appreciable pleural effusion. Tracheostomy tube is midline. Left PIC line ends in the region of the superior cavoatrial junction. " af197871-a813083d-b97d9a13-ee4ef423-9c9aa390.jpg,validate/p13/p13841130/s57803715/af197871-a813083d-b97d9a13-ee4ef423-9c9aa390.jpg,validation," FINAL REPORT INDICATION: Patient with history of prostate cancer, status post robotic radical prostatectomy, who now presents with trouble swallowing. Assess for air-fluid level in the esophagus. COMPARISONS: none 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. IMPRESSION: No evidence of acute cardiopulmonary process. " 9a01f6a6-a116ff9f-7d8af46d-cfd7249f-4fd9a0a6.jpg,validate/p11/p11473627/s56956442/9a01f6a6-a116ff9f-7d8af46d-cfd7249f-4fd9a0a6.jpg,validation," FINAL REPORT INDICATION: Epigastric pain, chest pain, rule out pneumonia. COMPARISONS: None. TECHNIQUE: PA and lateral chest radiographs were provided. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unremarkable. There is no free air under the diaphragm. Osseous structures are intact. IMPRESSION: No acute cardiopulmonary process. " 03d8a81f-29aee625-3260a6f6-c3081ceb-a932dc44.jpg,validate/p14/p14376938/s51293946/03d8a81f-29aee625-3260a6f6-c3081ceb-a932dc44.jpg,validation," WET READ: ___ ___ ___ 10:32 AM Opacity projecting over the anterior left first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation is seen elsewhere ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with presyncope // eval heart and lungs TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: Opacity projecting over the anterior left first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation is seen elsewhere. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: Opacity projecting over the anterior left first rib is likely due to overlapping structures however, this could be confirmed with apical lordotic view. No focal consolidation seen elsewhere " 5597c27e-f00dc310-eec10745-59335bf0-680eaecd.jpg,validate/p17/p17904720/s58010534/5597c27e-f00dc310-eec10745-59335bf0-680eaecd.jpg,validation," FINAL REPORT PORTABLE CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest radiograph dated ___. CLINICAL HISTORY: Epigastric pain, assess for free air. FINDINGS: Frontal AP upright portable view of the chest provided. No free air is clearly seen below the right hemidiaphragm. The heart is top normal in size. The aorta appears unfolded, though patient is slightly rotated to his right. There is mild pulmonary edema with mild left basal scarring versus atelectasis. No large effusion or pneumothorax is seen. The bony structures are intact. IMPRESSION: Mild pulmonary edema. No signs of free air below the right hemidiaphragm. " 3ceb8d0e-3d5f839f-7fe091fd-97842f91-be1b4f6d.jpg,validate/p18/p18777009/s53538756/3ceb8d0e-3d5f839f-7fe091fd-97842f91-be1b4f6d.jpg,validation," FINAL REPORT STUDY: PA and lateral chest, ___. CLINICAL HISTORY: ___-year-old man status post right middle lobectomy. FINDINGS: Comparison is made to previous study from ___. There remains a very tiny right apical pneumothorax projecting over the third rib. There has been development of a small right-sided pleural effusion. The left lung is clear. Heart size is within normal limits. " b8abcde3-64c3335c-1d52e298-d6892ef1-f0e220c0.jpg,validate/p15/p15154302/s50709170/b8abcde3-64c3335c-1d52e298-d6892ef1-f0e220c0.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST 2 VIEW PICC LINE PLACEMENT INDICATION: ___ year old man with PICC line, ?4cm out // eval for PICC placement IMPRESSION: In comparison to ___ chest radiograph, a right PICC has been repositioned, now terminating approximately 3 cm above its previous location. It now terminates within the proximal to mid superior vena cava. Exam is otherwise unchanged. " bcae5a92-8076d76e-2fb51b07-6c2016f8-7a8fee56.jpg,validate/p17/p17556194/s58029833/bcae5a92-8076d76e-2fb51b07-6c2016f8-7a8fee56.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with hyponatremia. Evaluate for pneumonia. TECHNIQUE: Portable AP chest radiograph COMPARISON: No prior chest radiographs. FINDINGS: Large, calcific opacity in the right lower lung involving the pleura and parenchyma may reflect remote infection, possibly tuberculosis, or prior hemothorax. Superimposed pneumonia cannot be excluded. Heart size is at the upper limits of normal and thoracic aorta is enlarged. IMPRESSION: Calcific opacity in the right lower lung may reflect remote infection or hemothorax. Recommend CT chest to evaluate for superimposed, acute pneumonia. RECOMMENDATION(S): CT chest to evaluate for superimposed, acute pneumonia and for better characterization of thoracic aortic enlargement. " ab58003e-08f8ec7f-a3af3a0b-41f81174-6627b2f6.jpg,validate/p11/p11146299/s59363009/ab58003e-08f8ec7f-a3af3a0b-41f81174-6627b2f6.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pleural effusion. COMPARISON: Chest x-ray from ___. FINDINGS: As compared to the previous radiograph, no relevant change is noted. The lung volumes are normal. Status post sternotomy. Plate-like atelectasis at the left lung bases. No larger pleural effusions. No pulmonary edema. No pneumonia. " 818162a7-c6b6d6aa-db1e799c-628e384c-673f6fa4.jpg,validate/p18/p18692222/s55462208/818162a7-c6b6d6aa-db1e799c-628e384c-673f6fa4.jpg,validation," FINAL REPORT HISTORY: Fatigue, cough. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Dual lead left-sided AICD is stable in position, with leads extending to the expected positions of the right atrium and right ventricle. The cardiac and mediastinal silhouettes are stable. Overall, there has been no significant interval change. No new focal consolidation is seen. There is no pleural effusion or pneumothorax. IMPRESSION: No significant interval change. No acute cardiopulmonary process. " 50f7a754-0ebebec2-e87379ab-77e483e8-a1692586.jpg,validate/p17/p17733460/s51267043/50f7a754-0ebebec2-e87379ab-77e483e8-a1692586.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with wheeze on exam. + sick contact. + chills. Hx of HCC metastatic to lymph nodes s/p liver directed treatment. // r/o pneumonia. COMPARISON: Chest radiographs one ___. IMPRESSION: Small region peribronchial opacification in the right middle lobe could be early pneumonia. Lungs are otherwise clear. There is no pleural effusion. Cardiomediastinal and hilar silhouettes are normal. " 52839c56-0a83d8e8-64158d35-9395e24a-abee7991.jpg,validate/p17/p17062932/s54133235/52839c56-0a83d8e8-64158d35-9395e24a-abee7991.jpg,validation," FINAL REPORT INDICATION: History of gallstone pancreatitis, location of Dobbhoff. COMPARISONS: Chest radiograph from ___. TECHNIQUE: Two AP chest radiographs are provided. FINDINGS: The Dobbhoff feeding tube is in the distal esophagus. A right PICC terminates at the low SVC. Again seen are small bilateral pleural effusions, right greater than left, with overlying atelectasis. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is unchanged. Retained contrast is seen within the colon. IMPRESSION: 1. Dobbhoff tube in the distal esophagus and should be advanced. 2. Small bilateral pleural effusions with overlying atelectasis. These findings were discussed with ___ by Dr. ___ ___ telephone at 1:40 p.m. " 304c2908-9d9e2fd3-1e819b57-eac5934d-c75fce0a.jpg,validate/p15/p15239201/s56227795/304c2908-9d9e2fd3-1e819b57-eac5934d-c75fce0a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ yo man with h/o alcoholic cirrhosis, Childs C, c/b grade 1 varices, prior SBP, hepatic encephalopathy, recurrent hydrothorax presents from ___ with altered mental status concerning for hepatic encephalopathy. // Evaluate for interval change in setting of increased tbili and concern for infectious process Evaluate for interval change in setting of increased tbili a IMPRESSION: In comparison with the study of ___, there is extensive opacification at the left base consistent with moderate pleural effusion an underlying compressive atelectasis. In the appropriate clinical setting, it would be difficult to unequivocally exclude superimposed pneumonia. Cardiac silhouette remains at the upper limits of normal in size and there is some indistinctness pulmonary vessels that could reflect some elevation of pulmonary venous pressure. " 79017211-1141a13c-9cb13881-f9fc8271-0d7514a5.jpg,validate/p11/p11712537/s52933279/79017211-1141a13c-9cb13881-f9fc8271-0d7514a5.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after CABG. PA and lateral upright chest radiographs were reviewed in comparison to ___. Heart size and mediastinum are stable. There is improved aeration of the lungs bilaterally. There is no appreciable pleural effusion. There is minimal right apical pneumothorax noted, unchanged since the prior study. The right internal jugular line has been removed in the interim. " de7d345e-94ee627f-e75abab9-72f7f966-cc86ea4c.jpg,validate/p13/p13182319/s58199471/de7d345e-94ee627f-e75abab9-72f7f966-cc86ea4c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___M with HIV and cirrhosis, c/o cough // ?PNA TECHNIQUE: Chest: Frontal and Lateral COMPARISON: CT chest performed earlier on same day ___ 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. " 765eae9a-1c211a15-bf3be168-539b4c96-e07f20ef.jpg,validate/p19/p19013230/s51120930/765eae9a-1c211a15-bf3be168-539b4c96-e07f20ef.jpg,validation," 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. " 03d811b6-14b4b122-c05549ac-11751364-c7246ec5.jpg,validate/p13/p13272752/s58596574/03d811b6-14b4b122-c05549ac-11751364-c7246ec5.jpg,validation," WET READ: ___ ___ ___ 12:22 AM Moderate left pneumothorax is slightly increased compared to 5 hr prior. The findings were discussed by Dr. ___ with Interventional ___ fellow x___on the telephone on ___ at 1:43 PM. WET READ VERSION #1 ___ ___ ___ 1:46 PM Moderate left pneumothorax is slightly increased compared to 5 hr prior. The findings were discussed by Dr. ___ with Interventional ___ fellow x___on the telephone on ___ at 1:43 PM. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ y/o female with hx of MI s/p RCA stent, HTN, present with chief complaint of dyspnea on exertion as well as loss of appetite. Large L pleural effusion s/p chest tube placement. On water seal as of 9AM. // please repeat CXR at ___ to evaluate for interval change, PTX. Thank you EXAMINATION: CHEST (PORTABLE AP) TECHNIQUE: Chest radiograph, frontal view COMPARISON: Chest radiograph ___ FINDINGS: Moderate left pneumothorax is minimally increased compared to 5 hr prior. Left basal pleural drain is shifted in position and possibly slightly pulled out by 1 cm or less compared to before. No new consolidation is identified. There is no large pleural effusion. Cardiomediastinal silhouette is normal size. IMPRESSION: Moderate left pneumothorax is minimally increased compared to 5 hr prior. Left basal pleural drain is shifted in position and possibly slightly pulled out by 1 cm or less compared to before. " 22626212-038a564e-86e62d8b-9d61ea9c-daa48afc.jpg,validate/p10/p10886362/s58072789/22626212-038a564e-86e62d8b-9d61ea9c-daa48afc.jpg,validation," WET READ: ___ ___ 8:00 PM esophageal catheter tip and side-port in stomach. interval removal of ETT. no significant change in the lungs. ______________________________________________________________________________ FINAL REPORT AP CHEST, 6:36 P.M., ___ HISTORY: AVR. Check NG tube. IMPRESSION: AP chest compared to ___ at 2:29 p.m.: Lateral aspect left lower chest is excluded from the examination. Remaining pleural surfaces show no pneumothorax and minimal if any pleural effusion. Nasogastric tube passes into the stomach and out of the field of view. Swan-Ganz catheter tip is partially obscured by cardiac motion, but is probably in the right pulmonary artery in standard placement. Right pleural, left pleural, midline drains in place. Pulmonary vascular congestion and moderate postoperative widening of the cardiomediastinal silhouette are unchanged. There is more atelectasis in the right lower lobe, left lower lobe atelectasis is mild-to-moderate. There is probably no pulmonary edema. " 18a3c3cf-7731f859-c17d952d-233dffc7-c3c63d4e.jpg,validate/p17/p17427285/s50610253/18a3c3cf-7731f859-c17d952d-233dffc7-c3c63d4e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with breast Ca, MPE. s/p thoracentesis // PTX? Resid fluid? PTX? Resid fluid? IMPRESSION: In comparison with the study of ___, there has been removal of substantial pleural fluid from the right hemithorax. No evidence of pneumothorax. No acute pneumonia or vascular congestion. ___, MD " 8489b034-e0220341-b5c9237c-2023c1cc-30ff13b3.jpg,validate/p19/p19277070/s56949195/8489b034-e0220341-b5c9237c-2023c1cc-30ff13b3.jpg,validation," 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. " cbd09e34-8fe43417-efe3a2a9-260b211b-ed2c997d.jpg,validate/p14/p14359057/s53728744/cbd09e34-8fe43417-efe3a2a9-260b211b-ed2c997d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with septic shock failed extubation, now re-intubated // ETT position ETT position COMPARISON: Comparison to ___ at 04:11 FINDINGS: Portable supine chest film ___ at 16:50 is submitted. IMPRESSION: Endotracheal tube has its tip approximately 6 cm above the carina. Right central venous line with its tip in the mid SVC. Interval removal of the nasogastric tube. The right lung is relatively well inflated. There is a layering left effusion with retrocardiac consolidation likely reflecting partial lower lobe atelectasis. No large pneumothorax is seen, although the sensitivity to detect pneumothorax is diminished given supine technique. Overall cardiac and mediastinal contours are stable. " f95f19a8-1a447bac-91d0c8a9-92114ffd-81b6ba1d.jpg,validate/p11/p11434374/s59927507/f95f19a8-1a447bac-91d0c8a9-92114ffd-81b6ba1d.jpg,validation," WET READ: ___ ___ ___ 11:11 AM A pneumothorax at the right lung bases is very small and significantly decreased from the prior examination. Otherwise, stable heart and lungs from the examination 1 hour prior. WET READ VERSION #1 ___ ___ 10:46 PM A pneumothorax at the right lung bases is very small and significantly decreased from the prior examination. Otherwise, stable heart and lungs from the examination 1 hour prior. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with worsened R sided PTX after lying on chest tube and kinking it // Assess for PTX on Right side COMPARISON: The comparison is made with prior studies including same date at 17:31. IMPRESSION: The right pneumothorax has decreased in size. Pigtail catheter is at the right lung base. Central line is unchanged. There is stable patchy density in both bases. No new consolidation is present. There is no CHF. " 1644de22-5e8e5e66-603a2a58-2ff16b3e-3a82efa2.jpg,validate/p11/p11184688/s59136564/1644de22-5e8e5e66-603a2a58-2ff16b3e-3a82efa2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pulmonary edema, history of amiodarone toxicity, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the previously massively enlarged cardiac silhouette has further increased in size. The position of the pacemaker lines is unchanged. No evidence of pleural effusions. No overt pulmonary edema. No pneumonia. Unchanged tortuosity of the thoracic aorta. " c14da864-4de21eed-63499e5f-9b9a9139-9b89e8e4.jpg,validate/p12/p12176298/s55663769/c14da864-4de21eed-63499e5f-9b9a9139-9b89e8e4.jpg,validation," FINAL REPORT HISTORY: ___-year-old female, status post wedge resection and SVC reconstruction with occasional oxygen desaturation. COMPARISON: ___. FINDINGS: Portable upright chest radiograph demonstrates no change in a moderate apical right pneumothorax. The pleural catheter is unchanged in position along the right lateral thoracic wall. An NG tube tip and side hole are visualized within the stomach. Median sternotomy wires and right thoracic surgical clips are unchanged. Bilateral moderate alveolar and interstitial lung opacities, with superimposed bibasilar atelectasis are increased from the ___ film and similar to ___ film. Moderate right pleural effusion is increasing. The heart size is normal, the mediastinal contours show an unchanged right upper mediastinal triangular opacity adjacent to the suture margin. Partial clavicle resection and right-sided rib deformities with adjacent surgical ___ are again noted. IMPRESSION: Bilateral moderate lung opacities are worsened, previously waxing and waning course, are likely pulmonary edema, though infection, drug reaction or even hemorrhage could account for this appearance in the appropriate clinical setting. Moderate right apical pneumothorax is unchanged. " 3ad0e384-ad8f70d9-83b68941-19dabbfc-88b810e0.jpg,validate/p10/p10564444/s58546187/3ad0e384-ad8f70d9-83b68941-19dabbfc-88b810e0.jpg,validation," FINAL REPORT INDICATION: History: ___F with syncope // R/O CHF, pneumonia TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Chest radiograph partially ___ 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. " edacb98d-b3995f33-b4cbce13-4a665c19-d5352370.jpg,validate/p16/p16260564/s52142096/edacb98d-b3995f33-b4cbce13-4a665c19-d5352370.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: ___ chest radiograph. FINDINGS: Right internal jugular central venous catheter continues to terminate deep within the right atrium, and is overlying the expected location of the tricuspid valve plane. This finding was communicated by phone with Dr. ___ at 8:30 a.m. at the time of discovery. Other indwelling devices are in standard position, and cardiomediastinal contours are stable in appearance. Persistent pulmonary vascular congestion, but slight improvement in asymmetrically distributed perihilar opacities, which may reflect mild pulmonary edema. Patchy and linear atelectasis in the right juxtahilar and basilar region are again demonstrated with associated mild elevation of right hemidiaphragm. " e1186f74-6de70099-7315f343-ac48ffd2-d5ece268.jpg,validate/p19/p19961925/s53168342/e1186f74-6de70099-7315f343-ac48ffd2-d5ece268.jpg,validation," WET READ: ___ ___ ___ 10:59 PM bibasilar atelectasis is new since ___ -___ d/w ___ by phone at 10:58pm on ___. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT AP CHEST, 10:24 P.M., ___ HISTORY: ___-year-old man with altered mental status and hypoxia. IMPRESSION: AP chest compared to ___: Lungs are minimally lower and there is a new linear region of atelectasis at the left base, and more of the same at the right. Upper lungs are clear. Heart size is normal. This examination neither suggests nor excludes the diagnosis of acute pulmonary embolism which could be responsible for hypoxia and/or atelectasis. " 84df1ec3-1dd844fb-5ca22fbf-1955d5d0-a80e421e.jpg,validate/p15/p15159712/s56434326/84df1ec3-1dd844fb-5ca22fbf-1955d5d0-a80e421e.jpg,validation," 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. " 45cd8ce9-9f70fead-f6ecb6b5-edb266a7-fe57a8cd.jpg,validate/p12/p12850832/s57272354/45cd8ce9-9f70fead-f6ecb6b5-edb266a7-fe57a8cd.jpg,validation," FINAL REPORT HISTORY: Prior right lower lobe pneumonia. FINDINGS: In comparison with the study of ___, there is no evidence of acute focal pneumonia or vascular congestion or pleural effusion. The slight impression on the lower cervical trachea on the right seen previously is not apparent at this time. " a2912c04-d19d3646-ac9c02a1-1861d7a9-00bcd146.jpg,validate/p12/p12244016/s52294035/a2912c04-d19d3646-ac9c02a1-1861d7a9-00bcd146.jpg,validation," 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. " b3866ba3-91466807-c211e25a-1abe94c6-94c7e4ae.jpg,validate/p17/p17206954/s55012439/b3866ba3-91466807-c211e25a-1abe94c6-94c7e4ae.jpg,validation," 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. " 36751927-f7767d33-b3869af7-62595936-d92d6f35.jpg,validate/p14/p14453887/s52377134/36751927-f7767d33-b3869af7-62595936-d92d6f35.jpg,validation," WET READ: ___ ___ 7:54 AM Difficult to interpret radiograph in the setting of prior pleurodesis with dense calcification of the pleura of the right hemithorax. Bilateral opacities concerning for multifocal pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with hypotension and fever // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Right shoulder radiograph dated ___ FINDINGS: Dense calcification along the pleura of the right hemithorax consistent with history of pleurodesis somewhat limits evaluation of the right lung. There are patchy opacities in the left mid and upper lung and likely in the right mid lung. There may be small effusions. There are severe degenerative changes of the right shoulder with deformity of the right humeral head related to prior healed fracture. IMPRESSION: Difficult to interpret radiograph in the setting of prior pleurodesis with dense calcification of the pleura of the right hemithorax. Bilateral opacities concerning for multifocal pneumonia. " e5c77e8e-b68d073f-d89bb1a7-18422e05-f1fd722c.jpg,validate/p14/p14219343/s51991927/e5c77e8e-b68d073f-d89bb1a7-18422e05-f1fd722c.jpg,validation," WET READ: ___ ___ ___ 5:24 AM 1. Stable opacity in the right lower lung, which likely represents a combination of pleural effusion and consolidation. 2. Mild stable pulmonary edema. WET READ VERSION #1 ___ ___ 6:17 AM 1. Stable opacity in the right lower lung, which likely represents a combination of pleural effusion and consolidation. 2. Mild stable pulmonary edema. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with productive cough and dyspnea. // Please eval for progression of R atelectasis vs. infiltrate TECHNIQUE: Portable chest x-ray. COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes, which results in bronchovascular crowding. Cardiomegaly is unchanged. Again seen is an opacity in the right lower lung, which is similar to slightly improved from the prior study, and likely represents a combination of pleural effusion and pneumonia. Increased opacification at the left base is also concerning for pneumonia. Mild pulmonary edema is stable. IMPRESSION: 1. Bibasilar opacities are concerning for pneumonia. 2. Mild stable pulmonary edema. 3. Large right pleural effusion. NOTIFICATION: Updated read discussed with Dr. ___ By Dr. ___ ___ telephone at 8:03am on ___, 10 minutes after discovery. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at 6:14am on ___, 5 minutes after discovery. " 82007ada-82d706c5-9da184b2-0798a872-6e828d21.jpg,validate/p17/p17658281/s50802666/82007ada-82d706c5-9da184b2-0798a872-6e828d21.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with altered mental status TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ chest radiograph ___ FINDINGS: Right-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. Previously demonstrated pulmonary nodules on CT are not well assessed on the current exam. Lungs are clear. Trace left pleural effusion is similar compared to the prior CT and chest radiograph. No pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Trace left pleural effusion appears chronic. No acute cardiopulmonary abnormality otherwise demonstrated. Known pulmonary nodules are better assessed on the previous CT. " d970744d-2f6cf959-c3226f6d-ce20b39c-b4e07a3b.jpg,validate/p13/p13480812/s56678610/d970744d-2f6cf959-c3226f6d-ce20b39c-b4e07a3b.jpg,validation," 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. " 526e37a7-7f7b7e1a-391233f9-76dc38a1-5f2222a1.jpg,validate/p18/p18005830/s57413377/526e37a7-7f7b7e1a-391233f9-76dc38a1-5f2222a1.jpg,validation," WET READ: ___ ___ ___ 6:23 AM 1. No acute process 2. Unchanged 5 mm nodular opacity projecting over the left mid lung.Chest CT to evaluate the nodular opacity is again recommended on a nonemergent outpatient basis if not previously performed elsewhere. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___M with palpitations, chest discomfort // eval for pna TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Normal heart size, mediastinal and hilar contours. The 5 mm nodular opacity projecting over the left mid lung is again visualized not significantly changed from prior. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: 1. No acute process 2. Unchanged 5 mm nodular opacity projecting over the left mid lung. RECOMMENDATION(S): Chest CT to evaluate the nodular opacity is again recommended on a nonemergent outpatient basis if not previously performed elsewhere. " c12feb32-5dcce363-2d93d222-7f32e7fc-d95f0120.jpg,validate/p10/p10338508/s59788877/c12feb32-5dcce363-2d93d222-7f32e7fc-d95f0120.jpg,validation," 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 " 75a5ada0-97ae615d-5e6f50bb-3ad6a888-0073ea8c.jpg,validate/p14/p14216260/s56113929/75a5ada0-97ae615d-5e6f50bb-3ad6a888-0073ea8c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with multiple falls here s/p fall, occipital head strike COMPARISON: ___ FINDINGS: AP upright and lateral views of the chest provided. Lung volumes are low limiting evaluation. There is mild hilar congestion and mild interstitial pulmonary edema. No large effusion or pneumothorax. No acute bony abnormalities. Vague nodular opacity in the left mid lung is equivocal and followup post diuresis is advised. IMPRESSION: As above. " 615b6de8-c24229df-a7045887-45ee611c-79627b93.jpg,validate/p11/p11847776/s59347112/615b6de8-c24229df-a7045887-45ee611c-79627b93.jpg,validation," 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. " 77fd4f50-145c3ad3-c3818381-84ebceb8-95364cd9.jpg,validate/p10/p10380149/s55144390/77fd4f50-145c3ad3-c3818381-84ebceb8-95364cd9.jpg,validation," FINAL REPORT HISTORY: Pacemaker placement. FINDINGS: Single-lead pacer extends to the region of the apex of the right ventricle. No evidence of post-procedure pneumothorax. In comparison with the study of ___, there is again hyperexpansion of the lungs with flattening of the hemidiaphragms, consistent with chronic pulmonary disease. Small bilateral pleural effusions persist. Pulmonary vasculature is essentially within normal limits. No definite acute focal pneumonia. " b1f6d8a4-284d74be-b0f9d247-131bd1d2-d4b1490c.jpg,validate/p15/p15088280/s58751761/b1f6d8a4-284d74be-b0f9d247-131bd1d2-d4b1490c.jpg,validation," 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 unchanged. The pulmonary vasculature is not engorged. Patchy opacities are seen within the lung bases. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: Bibasilar patchy opacities, likely atelectasis. " cfa91638-03139714-aeefb4e8-e24eb7b5-471febfb.jpg,validate/p15/p15068871/s59660317/cfa91638-03139714-aeefb4e8-e24eb7b5-471febfb.jpg,validation," FINAL REPORT PATIENT HISTORY: ___-year-old woman with SLE and positive PPD, history of BCG as a child. Please assess for cavitary TB. COMPARISON: Exam is compared to chest x-ray of ___. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Lungs are well inflated and clear. There are no consolidations or nodules. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Normal chest x-ray without sign of acute or chronic tuberculosis. " 0b4ba97b-feddc6b8-a55f692b-8265bb7b-412ab406.jpg,validate/p10/p10855190/s51043653/0b4ba97b-feddc6b8-a55f692b-8265bb7b-412ab406.jpg,validation," 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 ___. " e0a464d4-a4997ae4-22825605-3dd54a23-563ff1e1.jpg,validate/p19/p19566772/s59935370/e0a464d4-a4997ae4-22825605-3dd54a23-563ff1e1.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ HISTORY: ___-year-old male intubated, transfer. COMPARISON: None. FINDINGS: Single portable view of the chest. Endotracheal tube is approximately 3.2 cm from the carina. Enteric tube passes below the inferior field of view, tip not clearly identified. Relatively low lung volumes are noted with crowding of the bronchovascular markings. Lungs are grossly clear. The cardiac silhouette appears enlarged but this is likely accentuated due to technique and low inspiratory effort. IMPRESSION: ET and enteric tubes in appropriate position. " c0102d60-9e61efdf-10385c17-fce58047-b6d769bc.jpg,validate/p13/p13151145/s58719879/c0102d60-9e61efdf-10385c17-fce58047-b6d769bc.jpg,validation," FINAL REPORT HISTORY: Family history of lung cancer with six weeks of coughing. FINDINGS: No previous images. Cardiac silhouette is within normal limits and there is no vascular congestion or pleural effusion. No acute focal pneumonia. Of incidental note is cervical fusion device. " d1e52ffa-c95b7dff-4e2b295d-965d36f9-aa748dc5.jpg,validate/p11/p11448985/s55340147/d1e52ffa-c95b7dff-4e2b295d-965d36f9-aa748dc5.jpg,validation," 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. " 571f32cf-e9a39307-17b3a20a-f6f199b4-11c9cb1b.jpg,validate/p18/p18370560/s58753545/571f32cf-e9a39307-17b3a20a-f6f199b4-11c9cb1b.jpg,validation," WET READ: ___ ___ ___ 4:24 AM Small left apical pneumothorax is increased compared to 13:00. WET READ VERSION #1 ___ ___ ___ 12:11 AM Known left pneumothorax is not appreciated in this exam. WET READ VERSION #2 ___ ___ ___ 12:23 AM Small left apical pneumothorax is increased compared to 13:00. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M s/p fall off bike, helmeted, +LOC with L clavicle fx, L ___ rib fx, and occult L pneumothorax // Interval change. Please perform at ___ ___. TECHNIQUE: Chest radiograph PA and lateral views COMPARISON: Chest radiograph ___ 12:46 FINDINGS: Left apical pneumothorax is increased compared to 8 hr prior. Depth of the pneumothorax measures approximately 2 cm from the chest wall. Displaced left midclavicular fracture is similar to before. There is no consolidation, pleural effusion, or pulmonary edema. Cardiomediastinal silhouette is normal size. Small amount of left-sided subcutaneous emphysema is noted. IMPRESSION: Left apical pneumothorax is increased compared to 8 hr prior. " 20feff6a-206451d7-bd72524a-938979b5-7b8a128e.jpg,validate/p13/p13946847/s58823187/20feff6a-206451d7-bd72524a-938979b5-7b8a128e.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The patient is status post median sternotomy. The heart size demonstrates a left ventricular configuration and is top normal in size. The mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is visualized. There are mild degenerative changes in the thoracic spine with anterior osteophyte formation. IMPRESSION: No acute cardiopulmonary process. " 3f433107-65c39359-badb9c0e-1cd528d2-a0c1b496.jpg,validate/p10/p10286475/s50678161/3f433107-65c39359-badb9c0e-1cd528d2-a0c1b496.jpg,validation," 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. " 61931ac7-7f960e11-0dac6dd7-a0720a56-8f2382e3.jpg,validate/p11/p11548762/s53708101/61931ac7-7f960e11-0dac6dd7-a0720a56-8f2382e3.jpg,validation," FINAL REPORT INDICATION: ___ year old man with respiratory distress // Evaluate for volume overload, pneumonia TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: Persisting but mildly decreased bibasilar opacities likely a combination of layering pleural effusions and overlying atelectasis. Underlying pneumonia can't be excluded. Mild persisting central vascular congestion without pulmonary edema. The patient is status post prior right upper lobe VATS wedge resection of the expected right upper lobe volume loss. The appearance of the cardiac silhouette is. Unchanged IMPRESSION: Mild interval decrease in EM bibasilar opacities, likely reflecting a combination of pleural effusions and atelectasis. Mild central vascular congestion without frank pulmonary edema. " c6b79f42-cad70990-8a11c2bd-7a92e81c-481c64b4.jpg,validate/p15/p15648678/s55607271/c6b79f42-cad70990-8a11c2bd-7a92e81c-481c64b4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with ILI // eval infiltrate COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. The heart is mildly enlarged. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Mediastinal contour is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Mild cardiomegaly without evidence of pneumonia or edema. " a47fb624-9d05dad6-25bba4e9-9d741f63-eb860812.jpg,validate/p19/p19055351/s53214308/a47fb624-9d05dad6-25bba4e9-9d741f63-eb860812.jpg,validation," FINAL REPORT INDICATION: ___M with HIV, fever, cough // eval for pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 4eeeac79-23138ef9-9f6c798b-f550e8b8-ed7e2b00.jpg,validate/p11/p11200755/s50270705/4eeeac79-23138ef9-9f6c798b-f550e8b8-ed7e2b00.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with status asthmaticus. Question pneumonia. COMPARISONS: None. FINDINGS: The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 5ab28963-01526e05-88841e02-e6dc110f-8742c925.jpg,validate/p16/p16274419/s57115327/5ab28963-01526e05-88841e02-e6dc110f-8742c925.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypoxia, shortness of breath TECHNIQUE: Portable upright AP view of the chest COMPARISON: CT abdomen pelvis ___ FINDINGS: Status post median sternotomy and CABG. Mild enlargement of the cardiac silhouette is re- demonstrated. Atherosclerotic calcifications are noted at the aortic knob. Widening of the superior mediastinal contour may be due to the presence of mediastinal fat and slightly low lung volumes. There is crowding of bronchovascular structures likely attributable to low lung volumes without overt pulmonary edema. Persistent small to moderate size left pleural effusion is present with left basilar opacification likely reflective of compressive atelectasis. Mild interstitial abnormality in the right lower lobe likely reflects chronic changes and atelectasis. No pneumothorax. No acute osseous abnormalities detected. IMPRESSION: 1. Persistent small to moderate size left pleural effusion with left basilar opacification, likely compressive atelectasis. 2. Low lung volumes. Mild interstitial abnormality in the right lung base may reflect chronic changes and atelectasis. " 2e907338-3047e980-c4c3ac97-1017a254-f4718bfb.jpg,validate/p12/p12080376/s52111074/2e907338-3047e980-c4c3ac97-1017a254-f4718bfb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with rib fractures R ___ s/p fall with nontender swelling over ribs // Please evaluate swelling COMPARISON: ___ IMPRESSION: As compared to the previous image, the known rib fractures of ribs ___ on the right are less well appreciated. Local pleural thickening is minimal, there is no pleural effusion. Minimal retrocardiac atelectasis, minimal fluid overload but no overt pulmonary edema and no pneumonia. The clips at the level of the right hilus are constant in position. " cc42a4b8-b702e5ed-51f6e23e-6cb592e9-2edebfaf.jpg,validate/p13/p13749969/s53967933/cc42a4b8-b702e5ed-51f6e23e-6cb592e9-2edebfaf.jpg,validation," FINAL REPORT INDICATION: ___F with s/p fall with head lac w/ unequal pupils // acute process TECHNIQUE: Single supine view of the chest. COMPARISON: None. FINDINGS: There is relative elevation of the left hemidiaphragm. The lungs are grossly clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " bafd3dd6-8e68a1f9-fec3a918-88231ee7-91164150.jpg,validate/p13/p13577794/s54338708/bafd3dd6-8e68a1f9-fec3a918-88231ee7-91164150.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with malaise, hx of lymphoma // r/o infiltrate COMPARISON: ___. PET-CT from ___. FINDINGS: PA and lateral views of the chest provided. Since the prior exam, there is decrease conspicuity of the left pulmonary hilum suggesting decreased hilar lymphadenopathy. 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. " 3eb5ecf2-f66cf3ca-4dbb0629-2ee75227-ea561a3c.jpg,validate/p12/p12730395/s56058196/3eb5ecf2-f66cf3ca-4dbb0629-2ee75227-ea561a3c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with large right effusion s/p chest tube placement (high suspicion for trapped lung) // ? PTX COMPARISON: ___. IMPRESSION: Status post right chest tube insertion. At the level of the lung basis, there is a moderate right basolateral pneumothorax. However, the extent of the pre-existing pleural effusion has decreased. There is no evidence of tension. Unchanged appearance of the right lung and of the cardiac silhouette. " 51c4e6a6-afeb7d63-6ef6560b-d5996208-959c2792.jpg,validate/p10/p10375099/s51581422/51c4e6a6-afeb7d63-6ef6560b-d5996208-959c2792.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with PNA, retrocardiac // f/u PNA f/u PNA IMPRESSION: Compared to chest radiographs ___. Previous left lower lobe pneumonia has resolved. Small region of atelectasis in the lingula. Lungs otherwise clear. Heart size normal. Mediastinal and hilar contours and pleural surfaces are normal. " 903f2f7a-a9d440a4-af500209-d980d597-27245e60.jpg,validate/p14/p14246614/s56521641/903f2f7a-a9d440a4-af500209-d980d597-27245e60.jpg,validation," FINAL REPORT HISTORY: Intubated question interval change. COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. " 523db987-d0978a19-c8725d72-5e091b8d-9564d8d9.jpg,validate/p11/p11052935/s50457087/523db987-d0978a19-c8725d72-5e091b8d-9564d8d9.jpg,validation," FINAL REPORT PORTABLE CHEST X-___ ___ ___ COMPARISON: ___. FINDINGS: A new area of consolidation has developed in the left lower lobe, and is concerning for developing pneumonia considering the clinical suspicion for this entity. Additional nonspecific patchy opacity at the periphery of the right lung base could reflect focal atelectasis, or an additional site of infection. Severe upper lobe predominant emphysema is again demonstrated. Cardiomediastinal contours are normal. No pleural effusion or pneumothorax is evident. " 2c9972ff-b900fbeb-7d73920b-eb9b6c18-c9d97f0e.jpg,validate/p10/p10757917/s53189337/2c9972ff-b900fbeb-7d73920b-eb9b6c18-c9d97f0e.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Hypertension, diabetes mellitus. PA and lateral upright chest radiographs were reviewed with comparison to ___. Heart size is normal. Mediastinum is normal. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. " ebb73c61-d1fe1cbb-62cf60ae-6a2b322d-182c9664.jpg,validate/p15/p15753678/s52778866/ebb73c61-d1fe1cbb-62cf60ae-6a2b322d-182c9664.jpg,validation," FINAL REPORT HISTORY: Patient with fever and dry cough, assess for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. There is a new mass-like consolidation which originates from the left hilum and extends into the left upper lobe. There is associated mild upper lobe volume loss, manifested by mild leftward tracheal deviation, upward displacement of the left hilum, and slight tenting of the left hemidiaphragm. There is also some mild streaky atelectasis in the left lower lobe. The right lung is essentially clear. No pleural effusion, pneumothorax, or pulmonary edema is seen. A small granuloma is again visualized in the right lung overlying the fifth posterior rib laterally. The heart size is normal. There is a small hiatal hernia, unchanged from prior study. IMPRESSION: Mass-like consolidation in the left upper lobe as described above. This may represent an infectious pneumonia given clinical suspicion for infection. Recommend short-term radiograph followup to assess for response to antibiotics in order to ensure resolution and to exclude underlying malignancy. " 9363136d-91227db7-e84c07e9-280e392a-52473f9c.jpg,validate/p11/p11632236/s56367849/9363136d-91227db7-e84c07e9-280e392a-52473f9c.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory distress, evaluation for pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, no relevant changes seen in extent and appearance of the relatively generalized left sided and right basal parenchymal opacity, both with rather extensive air bronchograms. No new parenchymal opacities. Unchanged size of the cardiac silhouette. Unchanged monitoring and support devices. " f12b0344-2161663c-3cdd7b28-16c1cc32-a71bddf1.jpg,validate/p12/p12800545/s57823458/f12b0344-2161663c-3cdd7b28-16c1cc32-a71bddf1.jpg,validation," FINAL REPORT HISTORY: Aphasia. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is mildly enlarged. The aorta is mildly unfolded but unchanged. Mediastinal and hilar contours are normal, and there is no pulmonary vascular congestion. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is identified. Remote left-sided rib fractures are present. IMPRESSION: No acute cardiopulmonary abnormality. " 067ad08e-c33e2aa4-b9391b83-88383718-0daaf701.jpg,validate/p17/p17592232/s50044149/067ad08e-c33e2aa4-b9391b83-88383718-0daaf701.jpg,validation," FINAL REPORT EXAMINATION: CHEST INDICATION: ___M with s/p fall severl days ago // eval for trumatic injury COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Clips the right upper quadrant noted. The lungs are clear and hyperinflated. No focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. IMPRESSION: No acute findings. " 776aa6df-a9c5ac27-f14203e9-015239b6-ecc30201.jpg,validate/p16/p16209892/s50970749/776aa6df-a9c5ac27-f14203e9-015239b6-ecc30201.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ y/o F w/ recent hx of falls who presented with spinal compression on MRI, here for C5-6 ACDF // Assess for infiltrate Assess for infiltrate IMPRESSION: Compared to chest radiographs since ___, most recently had ___. Lung volumes are lower exaggerating increase in mild cardiomegaly. Atelectasis at the right lung base is new. Upper lungs clear. No appreciable pleural effusion or pneumothorax. " 76274ffc-4b953db1-5cfa44db-f683a574-5ac99758.jpg,validate/p13/p13972513/s59861477/76274ffc-4b953db1-5cfa44db-f683a574-5ac99758.jpg,validation," 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. " c6f49c86-4c84e658-926cd13d-15c7e070-ca332c48.jpg,validate/p13/p13439409/s53787065/c6f49c86-4c84e658-926cd13d-15c7e070-ca332c48.jpg,validation," 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. " b9d43a06-87b1ed2c-7887e589-90f0442d-d55fbfec.jpg,validate/p13/p13383910/s59387783/b9d43a06-87b1ed2c-7887e589-90f0442d-d55fbfec.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac silhouette size is mildly enlarged. The aorta is slightly unfolded. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary abnormality. " c9364140-fdb33489-a9e3bd3a-031e435b-6dc93cfe.jpg,validate/p13/p13757356/s50636210/c9364140-fdb33489-a9e3bd3a-031e435b-6dc93cfe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with syncope // acute process? TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Patient is status post median sternotomy and aortic valve replacement. Heart size is normal. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is visualized. IMPRESSION: No acute cardiopulmonary abnormality. " 7f4a737b-10e4bfd2-cabd5ead-2b716f62-adcff7da.jpg,validate/p12/p12180682/s51137249/7f4a737b-10e4bfd2-cabd5ead-2b716f62-adcff7da.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Change of intubation, evaluation for interval change. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, patient has received a new endotracheal tube with the tip projects 5 cm above the carina. The other monitoring and support devices are constant. Unchanged lung volumes. Unchanged size of the cardiac silhouette. The right hilus appears a little more prominent, likely because of patient rotation. No new parenchymal opacities, pleural effusion or other lung parenchymal abnormalities. " 623a9e44-93ced832-bdcd5276-a887ca9f-238d2599.jpg,validate/p16/p16662264/s55808828/623a9e44-93ced832-bdcd5276-a887ca9f-238d2599.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Chest congestion, fatigue. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Subtle basilar opacities seen similar to the prior study may relate to nipple shadows and are not appreciated on the lateral view. No definite 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. " d322f162-9297b3c0-ca6c0e1e-4f96934e-a83d7d8c.jpg,validate/p12/p12747817/s52210855/d322f162-9297b3c0-ca6c0e1e-4f96934e-a83d7d8c.jpg,validation," FINAL REPORT AP CHEST, 8:39 A.M., ___ HISTORY: Cholangitis. Check ET tube. IMPRESSION: AP chest compared to ___ and ___: New endotracheal tube is in standard placement. Nasogastric tube passes into the stomach and out of view. Transvenous right atrial and right ventricular pacer leads are in standard placements. Elevation of the right hemidiaphragm is unchanged since ___, but moderate right pleural effusion has increased. Moderate cardiomegaly is stable. There is no pulmonary edema or left pleural effusion. No pneumothorax. " 2234c059-7bb41e2f-23151781-390df16b-cd6ea8b3.jpg,validate/p11/p11278703/s51460029/2234c059-7bb41e2f-23151781-390df16b-cd6ea8b3.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Cough, congestion and fever with acute shortness of breath since 5:00 p.m. tonight. 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 pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process. " 7bcfb4c7-40de7cdc-63ac0905-7d782746-45c74e60.jpg,validate/p12/p12869059/s51127333/7bcfb4c7-40de7cdc-63ac0905-7d782746-45c74e60.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old homeless man with productive cough, rattling breath sounds, ___ on RA // ?PNA TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is bilateral diffuse reticular interstitial thickening, without prior imaging for comparison. The right hila appears prominent. Heart size is normal. The mediastinal contour is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: 1. Bilateral diffuse interstitial thickening, which could represent viral, atypical bacterial, or less likely fungal pneumonia. This could also represent interstitial pulmonary edema, although there are no other findings to suggest congestive heart failure. 2. Prominence of right hilum, which suggests pulmonary hypertension. " ee9f5aa3-bdc30926-1614e2ad-f571197b-462a2818.jpg,validate/p12/p12823036/s59251206/ee9f5aa3-bdc30926-1614e2ad-f571197b-462a2818.jpg,validation," WET READ: ___ ___ ___ 3:59 PM Hyperinflated lungs. No focal consolidation to suggest pneumonia. Concern for pneumomediastinum. Difficult to exclude tiny left apical pneumothorax. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with asthma exacerbation now w/ L sided chest pain EKG WNL // eval ? PTX, hyperinflation TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lungs are hyperinflated and clear. No pleural effusion is seen. Linear lucency along the left mediastinum, and possibly along the left aspect of the cardiac silhouette raises concern for pneumomediastinum. Pleural line at the left apex is seen, and a tiny left apical pneumothorax may be present. The cardiac silhouette is not enlarged. Prominence of the AP window can be seen with underlying lymphadenopathy versus prominent pulmonary artery. IMPRESSION: Hyperinflated lungs. No focal consolidation to suggest pneumonia. Concern for pneumomediastinum. Tiny left apical pneumothorax may be present. NOTIFICATION: Findings discussed with Dr. ___ on ___ at 17:42 via telephone. " c08a735e-cc745e53-41069fbc-35293846-fa5c24f9.jpg,validate/p14/p14944455/s51349932/c08a735e-cc745e53-41069fbc-35293846-fa5c24f9.jpg,validation," WET READ: ___ ___ 8:34 AM No evidence of pneumonia no change from the prior radiograph. WET READ VERSION #1 ___ ___ ___ 10:28 PM No evidence of pneumonia no change from the prior radiograph. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with fever, MI // pneumonia? COMPARISON: Chest radiographs ___. IMPRESSION: Low lung volumes exaggerate heart size which is probably normal. Lungs grossly clear. No pleural abnormality. " a6a3dd7b-192324ba-21cc5987-0721ac6e-2cf80781.jpg,validate/p18/p18225062/s54945538/a6a3dd7b-192324ba-21cc5987-0721ac6e-2cf80781.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain on the right side 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. " 67c0474f-b760872d-a97a4cc4-c06177a2-91e072be.jpg,validate/p14/p14042163/s56626273/67c0474f-b760872d-a97a4cc4-c06177a2-91e072be.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recurrent grey zone lymphoma s/p L pleurex // r/o L PTX r/o L PTX IMPRESSION: Compared to prior chest radiographs, ___ through ___. Moderate right hydro pneumothorax, probably loculated in the lower right hemi thorax, not appreciably changed over the past 2 days. Moderate left pleural effusion minimally smaller. No left pneumothorax. Interstitial edema is mild. Heart is partially obscured by pleural effusion and heart size hard to assess. Mediastinal veins are still distended. Right jugular infusion catheter ends in the mid SVC. " b587f579-e1cdc4be-507004bc-707ba172-276f2011.jpg,validate/p16/p16918051/s59796917/b587f579-e1cdc4be-507004bc-707ba172-276f2011.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left facial droop, left arm/leg weakness // eval for ICH, pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Minor basilar atelectasis is seen without definite focal consolidation. No large pleural effusion is seen. Trace left pleural effusion is difficult to entirely exclude. Cardiac and mediastinal silhouettes are stable. There is no overt pulmonary edema. IMPRESSION: Minor basilar atelectasis without definite focal consolidation. Difficult to exclude trace left pleural effusion. " f0562cf3-372dc654-3808d25c-9521aefb-fda72231.jpg,validate/p16/p16897596/s50460168/f0562cf3-372dc654-3808d25c-9521aefb-fda72231.jpg,validation," FINAL REPORT CHEST RADIOGRAPH. INDICATION: Followup of pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing left lower lobe pneumonia has almost completely resolved. Only at the immediately posterior retrocardiac areas and the left costophrenic sinus are minimal remnant opacities still visible. There is no reactive pleural effusion. No other parenchymal abnormalities. Normal size of the cardiac silhouette. No reactive lymphadenopathy. " 4640de22-b9a7531f-7ed9c251-03b7fc9c-607b4ea6.jpg,validate/p16/p16057835/s55659159/4640de22-b9a7531f-7ed9c251-03b7fc9c-607b4ea6.jpg,validation," FINAL REPORT HISTORY: Hypoxia, COPD and, abdominal pain and copious diarrhea. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The heart size is top normal but unchanged. Mediastinal and hilar contours are similar with aortic knob calcifications again demonstrated. There is no pulmonary vascular congestion. Bibasilar streaky airspace opacities are worse in the interval, and could reflect atelectasis or infection. No pleural effusion or pneumothorax is seen. Kyphosis of the mid thoracic spine with evidence of prior kyphoplasty of 2 adjacent compression fractures in the mid thoracic spine is re- demonstrated. Clips are noted in the left upper quadrant of the abdomen. IMPRESSION: Bibasilar airspace opacities could reflect worsening atelectasis or infection. " e243283f-f2da940e-83e4655b-f7273a3d-cddab7da.jpg,validate/p15/p15958819/s58220220/e243283f-f2da940e-83e4655b-f7273a3d-cddab7da.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain. Evaluate for acute cardiopulmonary process. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The lungs are mildly hyperinflated with no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is normal. IMPRESSION: Mildly hyperinflated lungs, which are clear. " e8584b02-c0d5babf-9cd3a65b-8db784e0-82c2a9a2.jpg,validate/p15/p15137973/s54734358/e8584b02-c0d5babf-9cd3a65b-8db784e0-82c2a9a2.jpg,validation," FINAL REPORT INDICATION: Status post CABG. COMPARISON: Chest radiograph, ___. Chest radiograph, ___. Chest radiograph, ___. FINDINGS: A right internal jugular central line ends in the upper SVC. A small apical pneumothorax is stable or slightly larger in comparison to the prior chest radiograph from one day prior. The bibasilar atelectasis has resolved. There is no consolidation or edema. There is no pleural effusion. Sternal wires are intact. The cardiomediastinal silhouette is stable and has a normal postoperative appearance. IMPRESSION: 1. Stable-to-slightly larger right apical pneumothorax. 2. Resolution of bibasilar atelectasis. " 7026fe67-85be48cb-111be23d-acc70de9-489b3081.jpg,validate/p18/p18208732/s52432247/7026fe67-85be48cb-111be23d-acc70de9-489b3081.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with chest pain with suspected rib fractures. PA and lateral upright chest radiographs were reviewed with comparison to multiple prior studies dating back to ___. Heart size is normal. Mediastinum is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No definitive rib fractures are noted on the current radiograph, although they were seen posteriorly in the right ribs. " 81129f1c-28abc293-abadb6a7-e529e927-45556967.jpg,validate/p14/p14470386/s57110458/81129f1c-28abc293-abadb6a7-e529e927-45556967.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old male with history polysubstance abuse and Hepatitis C, admitted to ___ after trauma of unclear etiology s/p craniotomy for large epidural hematoma with midline shift. // lower lobe consolidation? TECHNIQUE: CHEST SINGLE VIEW COMPARISON: ___ 02:48 FINDINGS: Endotracheal tube tip 5.5 cm above carina. Bibasilar pulmonary opacities have resolved. No effusion. Normal heart size, pulmonary vascularity IMPRESSION: No infiltrates. " b58f9e71-eeedd3fd-1f7b3848-6c8db70e-076cf778.jpg,validate/p18/p18859129/s55634780/b58f9e71-eeedd3fd-1f7b3848-6c8db70e-076cf778.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SAH, LMCA stroke, intubated // ETT ETT IMPRESSION: Comparison to ___. The tip of the endotracheal tube projects approximately 2.5 cm above the carinal. The other monitoring and support devices are constant. New right medial and basal parenchymal opacity with air bronchograms, suggestive of aspiration pneumonia. Mild elevation of the left hemidiaphragm. Stable borderline size of the cardiac silhouette. No pleural effusions. No pulmonary edema. " 01cf6688-36eef6f8-c901376a-c3a42ff2-20da2a47.jpg,validate/p17/p17876274/s53044059/01cf6688-36eef6f8-c901376a-c3a42ff2-20da2a47.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with lung cancer presents for recent hospitalization follow-up. Pt receives his care in ___, recently underwent a CT guided needle biopsy of the left upper lung with an accidental puncture of the lung itself. Pt developed a 'bubble' in the left upper lung that remained stable during his hospitalization, he is now due for repeat chest x-ray. Awaiting medical records from ___. // eval (as below) COMPARISON: CT chest with contrast ___ FINDINGS: PA and lateral views of the chest provided. Re- demonstrated central left upper lobe pulmonary mass with probable left hilar and mediastinal nodes. There is no focal consolidation or effusion. Equivocal left pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: 1. Re-demonstrated central left upper lobe pulmonary mass with left hilar and mediastinal lymphadenopathy. 2. Equivocal left pneumothorax. Consider follow-up radiograph to assess for resolution. NOTIFICATION: The findings were discussed by Dr. ___ with ___ ___ NP on the telephoneon ___ at 4:22 PM, 3 minutes after discovery of the findings. " 1dc0adaf-e5ba3a5a-c44f4ab6-4f23eec7-e5395812.jpg,validate/p12/p12822417/s55946215/1dc0adaf-e5ba3a5a-c44f4ab6-4f23eec7-e5395812.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with cardiogenic shock // Eval ETT, pulmonary edema COMPARISON: Chest radiographs ___. IMPRESSION: Mild interstitial edema continues to improve. The previously airless left lower lobe has partially cleared. Whether this is pneumonia or resolving atelectasis is radiographically indeterminate. No appreciable pleural effusion. Tip of the endotracheal tube at the thoracic inlet, 7 cm from the carina could be advanced 2 cm for more secure seating. Left internal jugular line ends in the upper SVC. Nasogastric tube passes into the stomach and out of view. " ff486fe6-05216897-95f9b5cb-836bcb14-fcd278fb.jpg,validate/p10/p10948410/s56232729/ff486fe6-05216897-95f9b5cb-836bcb14-fcd278fb.jpg,validation," 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. " 9f5ed265-42d35760-7a07ab20-2eb01bd9-3b7a9df1.jpg,validate/p14/p14504631/s55272611/9f5ed265-42d35760-7a07ab20-2eb01bd9-3b7a9df1.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p VATS RLL // check right PTX TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Low lung volumes. Cardiomegaly. The cardiomediastinal contour is unchanged. Small right hydro pneumothorax is essentially unchanged in size, but some of the the loculated components show interval decrease in size. The left lung is clear. IMPRESSION: Small right hydropneumothorax is essentially unchanged in size, but some of the non-apical loculated components show interval decrease in size. " 84b8771c-b82b7cff-5f820be9-629f8245-74efdf66.jpg,validate/p11/p11020337/s50848971/84b8771c-b82b7cff-5f820be9-629f8245-74efdf66.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: ___-year-old man with pain status post fall, assess pneumothorax. FINDINGS: AP portable supine view of the chest provided. The lungs are clear. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures demonstrate no acute injury. Chronic left rib deformities are again noted. IMPRESSION: Chronic left-sided rib deformities. No signs of acute injury. " 976527bb-f9c1adea-85ee5d78-4457fe87-1dedab36.jpg,validate/p17/p17652927/s59950004/976527bb-f9c1adea-85ee5d78-4457fe87-1dedab36.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of cough, shortness of breath for two months. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Single lead left-sided AICD is again seen with leads extending to the expected position of the right ventricle. Moderate cardiomegaly persists. There is no overt pulmonary edema. Mediastinal and hilar contours are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. IMPRESSION: No significant interval change. Persistent cardiomegaly, without overt pulmonary edema. " f39acd12-1ada9e72-13dd9f79-133089d7-273925e7.jpg,validate/p19/p19124748/s54623406/f39acd12-1ada9e72-13dd9f79-133089d7-273925e7.jpg,validation," 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. IMPRESSION: No evidence of acute cardiopulmonary disease. " b1380cb5-e1511c4f-ed6717da-4387948c-a36f91d0.jpg,validate/p15/p15160240/s56217047/b1380cb5-e1511c4f-ed6717da-4387948c-a36f91d0.jpg,validation," 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. " adc791dd-48b6540f-332eaf61-bd2a262b-0e1f82e3.jpg,validate/p17/p17250703/s57522252/adc791dd-48b6540f-332eaf61-bd2a262b-0e1f82e3.jpg,validation," FINAL REPORT HISTORY: ICD implantation. FINDINGS: In comparison with study of ___, there is little overall change in the appearance of the biventricular pacer leads terminating in the right atrium, right ventricle and probably a venous structure adjacent to the left ventricle. Specifically, no evidence of pneumothorax. " 5adbae47-1d17e49f-c5d070d2-8f5f507b-f896df65.jpg,validate/p11/p11104709/s53258541/5adbae47-1d17e49f-c5d070d2-8f5f507b-f896df65.jpg,validation," FINAL REPORT INDICATION: History of metastatic melanoma, now with difficulty swallowing solids and liquids. TECHNIQUE: Two views of the chest. COMPARISON: Multiple prior examinations, most recent CT of the torso dated ___ and most recent radiographs of the chest dated ___. FINDINGS: A left hilar and left infrahilar opacity corresponds to known lesions seen on CT examination of ___. No new focal consolidation is seen to suggest pneumonia. No pleural effusion or pneumothorax is present. The heart size is normal. There is mild tortuosity of the aorta. IMPRESSION: 1. Known left perihilar as seen on prior CT examination. Other smaller lesions seen by CT are not well appreciated on this examination. 2. No evidence of acute superimposed intrathoracic process. " ccc67492-24a1cffc-5d761052-bcf6b242-51a68e8f.jpg,validate/p17/p17452296/s57730255/ccc67492-24a1cffc-5d761052-bcf6b242-51a68e8f.jpg,validation," FINAL REPORT HISTORY: Recent ICD placement, chest pain times 5 for a few seconds. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Dual lead left-sided pacer device is seen with leads extending to 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 unremarkable. Evidence of a large hiatal hernia is redemonstrated. Degenerative changes are again seen along the spine including DISH. IMPRESSION: No acute cardiopulmonary process. Large hiatal hernia. " 66b1fa55-a8091d7f-13fb6d2a-0f93f927-a387f78f.jpg,validate/p14/p14887088/s59216357/66b1fa55-a8091d7f-13fb6d2a-0f93f927-a387f78f.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Lung contusions, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The monitoring and support devices, including the left pigtail catheter and the pleural space are in constant position. There is no evidence of pneumothorax. The minimal right pleural effusion might be present. No pneumonia, no overt pulmonary edema. " 6492e793-a26d7f5f-e648fba2-18ec964c-04e8d111.jpg,validate/p11/p11296029/s57670536/6492e793-a26d7f5f-e648fba2-18ec964c-04e8d111.jpg,validation," FINAL REPORT INDICATION: ___F with high grade SBO s/p NGT, evaluate NG tube position. COMPARISON: Abdomen and pelvic CT from ___. TECHNIQUE Two portable views of the chest. FINDINGS: The initial view of the chest demonstrate a nasoenteric tube coiled in the mid esophagus. Subsequent view demonstrates the nasoenteric tube at the GE junction with the tip pointing superiorly. The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal consolidation. The stomach is dilated. An apparent lucency under the right hemidiaphragm represents superimposed large bowel loops. IMPRESSION: Nasoenteric tube at the GE junction with the tip pointing superiorly. " dfb01a58-2306433b-a294f1de-b11f1711-ae018407.jpg,validate/p12/p12668116/s53365110/dfb01a58-2306433b-a294f1de-b11f1711-ae018407.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with pleural effusion status post thoracentesis last ___. Evaluate for recurrence. COMPARISON: Chest radiographs ___, PET-CT ___, chest CT from ___ ___. FINDINGS: Frontal and lateral views of the chest were obtained. Since ___, there has been interval reaccumulation of the right pleural effusion with adjacent associated atelectasis as seen on PET-CT from yesterday. The right upper lung zone and left lung are clear. No pneumothorax. Bilateral pulmonary nodules are better seen on recent CTs. Heart size is normal. Mediastinal silhouette is normal. The right hilus is mildly enlarged compared to contralateral side, but on CT ___, no morphological explanation for this is seen. IMPRESSION: Reaccumulation of right pleural effusion since ___ as seen on PET-CT ___. Bilateral pulmonary nodules are better assessed on prior CTs. " 1ddc5eee-2ac4f190-340ac71c-f900e6d4-ef949693.jpg,validate/p18/p18985761/s59228596/1ddc5eee-2ac4f190-340ac71c-f900e6d4-ef949693.jpg,validation," FINAL REPORT HISTORY: White count. 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 visualized. There are no acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary abnormality. " a68a0332-5c1b0aae-8e4839bd-a94062fb-df473b06.jpg,validate/p14/p14117743/s56678264/a68a0332-5c1b0aae-8e4839bd-a94062fb-df473b06.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with staph endocarditis with pulmonary septic emboli // Assess for interval change Assess for interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Heterogeneous pulmonary opacification which worsened from ___ through ___ has improved, accompanied by decrease in mild cardiac enlargement and mediastinal venous engorgement. Interval change is most likely due to improving pulmonary edema. Concurrent pneumonia and septic emboli are present. Pleural effusion small if any. ET tube and right jugular catheter are in standard placements and esophageal drainage tube ends in the upper stomach. No pneumothorax. " 16b6c70f-6d36bd77-89d2fef4-9c4b8b0a-79c69135.jpg,validate/p19/p19999442/s58708861/16b6c70f-6d36bd77-89d2fef4-9c4b8b0a-79c69135.jpg,validation," FINAL REPORT PORTABLE AP CHEST X-RAY INDICATION: Patient with intubation, evaluation for ETT placement. COMPARISON: None. FINDINGS: ET tube ends 4.7 cm above the carina. NG tube is in the stomach. The lungs are otherwise clear. Elevation of right hemidiaphragm is mild. There is no pneumothorax or pleural effusion. Mediastinal and cardiac contours are normal. CONCLUSION: 1. Lines and tubes are in adequate position. 2. The rest of the exam is unremarkable. " b0768c34-48f9dd0d-227c6381-17d37e88-69de0694.jpg,validate/p17/p17793701/s53553544/b0768c34-48f9dd0d-227c6381-17d37e88-69de0694.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___ HISTORY: ___-year-old male with new onset of atrial fibrillation and history of mitral valve repair. Cough and shortness of breath. FINDINGS: Frontal and lateral views of the chest were compared to previous exam from ___. Somewhat linear opacity at the right lung base medially is unchanged from prior and potentially due to scarring versus atelectasis. Elsewhere, the lungs remain clear and there is no effusion. Cardiac silhouette is stable. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " a45a5d82-9ff80111-6e0f0a39-118c76a9-02a06f0f.jpg,validate/p12/p12043129/s55711431/a45a5d82-9ff80111-6e0f0a39-118c76a9-02a06f0f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cough, fever, leukocytosis // eval for PNA COMPARISON: No comparison IMPRESSION: The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of pneumonia or other pathologic changes in the lung parenchyma. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions. Calcified granuloma in the right lung apex. " da051ca4-ad49cfb3-5e4b0cc6-bc783f80-202ace98.jpg,validate/p19/p19921217/s54405682/da051ca4-ad49cfb3-5e4b0cc6-bc783f80-202ace98.jpg,validation," FINAL REPORT INDICATION: Significant vascular disease and non-healing wound in left toe with progressive worsening with episodic chest pain and presyncope. Assess for cardiomegaly. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiographs from ___. FINDINGS: Lungs are low in volume but appear clear. There is no pleural effusion or vascular congestion. The heart is likely top normal in size with normal cardiomediastinal silhouette. IMPRESSION: No acute intrathoracic process with top normal heart size. " 1826b992-ff6b1235-5077313a-61429f55-bdb20996.jpg,validate/p17/p17290849/s56720536/1826b992-ff6b1235-5077313a-61429f55-bdb20996.jpg,validation," FINAL REPORT INDICATION: ___F with cough, 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 acute cardiopulmonary process. " 046ce322-892788ee-56a6be0a-27098d43-38605d4b.jpg,validate/p10/p10543486/s51765725/046ce322-892788ee-56a6be0a-27098d43-38605d4b.jpg,validation," FINAL REPORT HISTORY: NG placement. FINDINGS: In comparison with study of ___, there is little change in the appearance of the heart and lungs. There has been placement of an enteric tube that extends well into the stomach. " 9e2e0cac-a01f8a7d-dea0a6d5-7ea1fdb5-6b2c3855.jpg,validate/p17/p17192910/s54489815/9e2e0cac-a01f8a7d-dea0a6d5-7ea1fdb5-6b2c3855.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with dyspnea with exertion and cough. Assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: The lungs are hyperinflated with flattening of diaphragms. Right lower lobe peribronchial wall thickening is noted. Small left pleural effusion. No right pleural effusion. No pneumothorax. Moderate aortic knob calcifications with tortuous aorta. Stable mild cardiomegaly. Mediastinal contour and hila are unremarkable. A left pacer device lead tips are in the right atrium and right ventricle. Limited evaluation of the osseous structures are notable for multilevel degenerative changes IMPRESSION: 1. Early right lower lobe pneumonia. 2. Emphysema or chronic obstructive pulmonary disease. 3. Small left pleural effusion. " fdff70a3-1f820ce2-8890f98c-cd72f7c7-af64f751.jpg,validate/p10/p10193065/s57829729/fdff70a3-1f820ce2-8890f98c-cd72f7c7-af64f751.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with decompensated heart failure // ? volume overload TECHNIQUE: Chest single view COMPARISON: ___ FINDINGS: There is increased heart size and pulmonary vascularity, mildly improved since prior exam. No consolidations. Probable tiny right pleural effusion. Acities. IMPRESSION: Decreased heart size, pulmonary vascularity since prior exam. " bd7d73d1-88ace5d0-5861c95a-f3c80293-fcbaf525.jpg,validate/p17/p17055354/s51988526/bd7d73d1-88ace5d0-5861c95a-f3c80293-fcbaf525.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with a history of primary effusion lymphoma. Please evaluate for residual effusion following chemotherapy. // ___ year old man with a history of primary effusion lymphoma. Please evaluate for residual effusion following chemotherapy. ___ year old man with a history of primary effusion lymphoma. Please evaluate for residual effusion following chemotherapy. COMPARISON: Chest radiographs one ___ through ___. IMPRESSION: Small left pleural effusion and left basal atelectasis unchanged. Right lung clear. Heart size normal. Right supraclavicular central venous infusion port and left trans subclavian right atrial ventricular pacer leads all in standard placements unchanged. No pneumothorax. " f33c43a7-18a60929-f1da46ee-82487a86-1d2e0c06.jpg,validate/p12/p12964757/s53429004/f33c43a7-18a60929-f1da46ee-82487a86-1d2e0c06.jpg,validation," FINAL REPORT HISTORY: Shortness of breath, question pneumonia. REFERENCE EXAM: ___. Compared to the prior study there has been interval partial clearing of the diffuse alveolar infiltrates, though patchy areas of alveolar infiltrates are still present. There is still ill-defined vasculature with pulmonary vascular redistribution. There is a small left effusion. Findings are compatible with improved but persistent CHF. " f73baeef-9c34293a-aefa129f-033aacc9-dcec2dfd.jpg,validate/p10/p10696430/s54845571/f73baeef-9c34293a-aefa129f-033aacc9-dcec2dfd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with RA // ? hilar ___ or infiltrate 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 " e219433e-d1c06410-05b41c01-2f144325-3e738463.jpg,validate/p11/p11258835/s58620025/e219433e-d1c06410-05b41c01-2f144325-3e738463.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with tachycardia // eval for congestion TECHNIQUE: PA and lateral chest films COMPARISON: ___ FINDINGS: Aside from a tortuous or aorta unchanged in position, the cardiomediastinal silhouette is unremarkable. The lungs are clear bilaterally. No pleural effusion or pneumothorax is seen. IMPRESSION: No radiographic evidence for congestion is seen. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ On the telephone on ___ at 2:16 PM, 1 minutes after discovery of the findings. " 1ff411f3-152c4021-276f6c5d-68342677-0b81f544.jpg,validate/p19/p19449400/s56735175/1ff411f3-152c4021-276f6c5d-68342677-0b81f544.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p stroke w copious secretions // eval for PNA TECHNIQUE: Chest portable FINDINGS: As compared to 1 day prior, Dobhoff tube has been advanced with the tip in the pylorus region. The lungs are clear. The cardiomediastinal contours are unremarkable. No pleural effusions or pneumothorax. IMPRESSION: No acute cardiopulmonary process. Dobhoff tube in the region of the pylorus now. " bd313562-f57b4cc9-19c41681-eabb3127-49ed1ea1.jpg,validate/p13/p13204640/s54956737/bd313562-f57b4cc9-19c41681-eabb3127-49ed1ea1.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever // please evaluate for evidence of pneumonia please evaluate for evidence of pneumonia COMPARISON: Chest radiographs ___. IMPRESSION: Lung volumes have improved and previous mild interstitial abnormality, presumably edema, cleared. Heart size is normal. There is no pleural abnormality. Mediastinal and hilar contours are unremarkable. " 98909f98-6039feaf-d719b80c-44a6c11d-09084e51.jpg,validate/p16/p16387539/s57888280/98909f98-6039feaf-d719b80c-44a6c11d-09084e51.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxemia // hypoxemia hypoxemia IMPRESSION: Comparison to ___. The feeding tube is now in correct position, the tip projects over the middle parts of the stomach. No complications, otherwise unchanged radiograph. " a66cb7b3-926150d1-e11c5b71-c4bf8357-1a0433cd.jpg,validate/p11/p11586698/s59137337/a66cb7b3-926150d1-e11c5b71-c4bf8357-1a0433cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // eval for infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, chest CT ___ FINDINGS: Heart size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Lung volumes are low with chronic interstitial opacities and bronchiectasis at the lung bases and periphery bilaterally, similar to prior. Increased patchy opacities in the lung bases compared to the previous radiograph may reflect superimposed atelectasis. Chronic blunting of the right costophrenic angle suggests chronic pleural thickening. No focal consolidation, pleural effusion or pneumothorax is present. There are moderate degenerative changes in the thoracic spine. IMPRESSION: Chronic fibrosing interstitial lung disease, similar to the previous study. Patchy opacities in lung bases may reflect superimposed atelectasis. " ff153ce2-3c34760c-ab7605eb-60931b60-31cd4998.jpg,validate/p15/p15754509/s53903781/ff153ce2-3c34760c-ab7605eb-60931b60-31cd4998.jpg,validation," FINAL REPORT HISTORY: Desaturation to mid 70s, on oxygen, rule out pneumothorax. CHEST, SINGLE AP PORTABLE VIEW. There is markedly rotated positioning. Allowing for this, no pneumothorax is detected. Probable prominence of the cardiomediastinal silhouette, similar to ___. There is upper zone re-distribution, mild diffuse vascular blurring, small bilateral effusions and underlying collapse and/or consolidation, consistent with CHF. The lungs are hyperinflated, suggesting background COPD. Surgical clips overlie the lower chest and upper abdomen in the midline. Surgical ___ are also present over the upper abdomen in the midline. An NG tube is present, tip extending beneath diaphragm off film. The sideport appears to lie in the region of GE junction. A left subclavian central line is present, tip over mid/distal SVC. Irregular lucency overlying the right shoulder may represent subcutaneous emphysema -- this was better seen on the ___ radiograph. Deformity of the left proximal humerus again noted. IMPRESSION: 1. Cardiomegaly and probable background COPD. 2. CHF with bilateral effusions and underlying collapse and/or consolidation. 3. No pneumothorax detected. " 1b56f7c1-ae9dbf63-55d5b608-8f02702c-77d3a8f7.jpg,validate/p19/p19697164/s51764467/1b56f7c1-ae9dbf63-55d5b608-8f02702c-77d3a8f7.jpg,validation," WET READ: ___ ___ ___ 11:27 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with numbness in fingers/toes // eval for consolidation 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. A small indentation is noted along the right side of the trachea, which could reflect a prominent right thyroid lobe. IMPRESSION: No acute cardiopulmonary process. " 7e70faa1-e99397cf-0b36f706-6a4be900-26e4caa2.jpg,validate/p15/p15690303/s59840981/7e70faa1-e99397cf-0b36f706-6a4be900-26e4caa2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Left pneumothorax, concern for pneumonia. FINDINGS: As compared to the previous radiograph, the position of the left chest tube is unchanged, the sidehole is still slightly outside the thorax. On today's image, the presence of a left pneumothorax cannot be safely confirmed. Increasing opacities on the right, likely caused by atelectasis. Overall, the lung volume is decreased. The endotracheal tube has been slightly advanced. Its tip is now projecting 1.7 cm above the carina. Unchanged extensive air collection in the soft tissues. " 8861985b-e58f8f76-8694f8ff-be0cede0-288c9c18.jpg,validate/p16/p16967171/s58460044/8861985b-e58f8f76-8694f8ff-be0cede0-288c9c18.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough, fever // r/o PNA COMPARISON: ___ and prior portable radiograph performed earlier today. FINDINGS: PA and lateral views of the chest provided. Evaluation is markedly limited due to large body habitus and low lung volumes. There is mild hilar engorgement and possible mild pulmonary edema. No convincing signs of pneumonia, effusion or pneumothorax. The heart is mildly enlarged. The mediastinal contour appears somewhat prominent likely due to position and AP technique. Otherwise no change IMPRESSION: Mild congestion/edema. No convincing evidence for pneumonia. " c4765de1-edc98332-75865fcf-3126df46-b0e536ea.jpg,validate/p18/p18570637/s55381436/c4765de1-edc98332-75865fcf-3126df46-b0e536ea.jpg,validation," 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. " 73d7eec3-146885f8-5ccc1adb-264ae5b7-cfbff4fa.jpg,validate/p15/p15727316/s50904377/73d7eec3-146885f8-5ccc1adb-264ae5b7-cfbff4fa.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with new atrial fibrillation TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is mildly enlarged. The aorta is diffusely calcified. Lungs are hyperinflated with scarring noted within the lung apices. Streaky atelectasis is seen in both lung bases as well as more focal linear atelectasis noted in the region of the lingula as seen on the lateral view. Blunting of the costophrenic angles could suggest small bilateral pleural effusions or chronic pleural thickening. Pulmonary vasculature is not engorged. There is no focal consolidation. No pneumothorax is detected. Osseous structures are diffusely demineralized with mild multilevel degenerative changes noted in the thoracic spine. IMPRESSION: Bibasilar atelectasis. Blunting of the costophrenic angles bilaterally may reflect trace bilateral pleural effusions versus chronic pleural thickening. COPD. " 221f73d8-53a34a34-2fc6047a-0d1cad47-dbbb85c5.jpg,validate/p17/p17631949/s50187284/221f73d8-53a34a34-2fc6047a-0d1cad47-dbbb85c5.jpg,validation," FINAL REPORT EXAM: Chest AP portable views. CLINICAL INFORMATION: New chest tube with end-aspiration, question tube placement. COMPARISON: ___ at 12:49. FINDINGS: There has been interval placement of an endotracheal tube, terminating approximately 4.5 cm above the level of the carina. A left-sided Port-A-Cath is seen; its distal aspect not well seen but with catheter likely terminating in the region of the cavoatrial junction. There has also been interval placement of a nasogastric tube which courses below level of the diaphragm extending into the left upper quadrant in the presumed location of the stomach. A right-sided chest tube has also been placed in the interval, which appears to course inferior to level of the diaphragm. In the interval since the prior study, there has been development of lucency projecting over the right inferolateral hemithorax highly worrisome for pneumothorax. Additionally, there has been increase in diffuse bilateral pulmonary opacities worrisome for worsening aspiration and edema. Imaging of the upper abdomen demonstrates dilated bowel. There is subcutaneous edema tracking along the right chest wall. IMPRESSION: 1. Small right-sided pneumothorax status post right chest tube placement. The chest tube extends to what appears to be inferior to the diaphragm on the right, not well assessed. This finding was discussed with Dr. ___ at 3:30 p.m. on ___ via telephone, 5 minutes after discovery. 2. Appropriate position of endotracheal and nasogastric tubes. 3. Interval severe worsening of diffuse bilateral pulmonary opacities likely representing combination of marked aspiration and possibly pulmonary edema. 4. Partially imaged dilated bowel. CT pending. " ea0a160b-7c91e8f4-5545030e-b3422a56-e9856a27.jpg,validate/p19/p19948788/s54253734/ea0a160b-7c91e8f4-5545030e-b3422a56-e9856a27.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: No prior chest radiographs available for comparison. Reference made to CT torso from ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Please note that tiny millimetric pulmonary nodules seen on prior CT are better assessed on CT. IMPRESSION: No acute cardiopulmonary process. " 06560d1c-a874416e-c9331544-4d4edaa1-7531db58.jpg,validate/p14/p14634689/s51020071/06560d1c-a874416e-c9331544-4d4edaa1-7531db58.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___ HISTORY: ___-year-old male with fever. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. Lungs are clear of consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 0830b277-4baaee79-539f828e-1eba2630-ba957cd3.jpg,validate/p10/p10684181/s55801391/0830b277-4baaee79-539f828e-1eba2630-ba957cd3.jpg,validation," 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. " 8c5b4701-197ca691-5ee7b035-13ac0808-b915436e.jpg,validate/p16/p16559111/s53354569/8c5b4701-197ca691-5ee7b035-13ac0808-b915436e.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with AIDS with cough and fever. COMPARISON: None available. FINDINGS: Faint opacity is visualized overlying the right lower lobe. Otherwise, the remainder of the lungs are clear with no evidence of consolidations or effusions. There is no pneumothorax. The cardiomediastinal silhouette is normal. No acute fractures are identified. IMPRESSION: Increased opacity overlying the right lower lobe which may be developing pneumonia in the proper clinical setting. " 0c265a49-97f77bb6-09abdd64-339ef0d6-8158cb3d.jpg,validate/p14/p14347948/s58491697/0c265a49-97f77bb6-09abdd64-339ef0d6-8158cb3d.jpg,validation," WET READ: ___ ___ ___ 8:24 PM No pneumothorax. Stable moderate right pleural effusion with pigtail catheter in place. ______________________________________________________________________________ FINAL REPORT HISTORY: Chest tube disconnected, question pneumothorax. CHEST, 2 VWS Compared with earlier the same day (17:09 p.m.), no significant change is detected. No pneumothorax is identified. Again seen is a small right effusion with underlying collapse and/or consolidation, with a pigtail catheter tightly coiled, overlying the right costophrenic angle posteriorly. Minimal atelectasis at the left base again noted. " 0627cfa2-ddd3d811-b52d11f8-97ea8714-10fb502f.jpg,validate/p17/p17591410/s50246017/0627cfa2-ddd3d811-b52d11f8-97ea8714-10fb502f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: Compared to chest radiographs ___ through ___. Moderate to large left hydro pneumothorax, roughly ___ air and ___ fluid, has probably increased since ___. Since mediastinal position is still shifted slightly to the left, that means there is an equivalent volume of atelectasis in the left lung. Right lung is clear. The contours of the mediastinum in the right hemi thorax and the right hilus are normal. Transvenous right ventricular pacer lead follows the expected course from the left axillary generator. " 7b107a90-d120ca8a-5c33e2d0-90122e7b-e3f82771.jpg,validate/p14/p14885862/s57739906/7b107a90-d120ca8a-5c33e2d0-90122e7b-e3f82771.jpg,validation," 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. " d872bdd5-71f41be4-3ab2c54b-c9b11ab2-67d23573.jpg,validate/p16/p16646670/s56388191/d872bdd5-71f41be4-3ab2c54b-c9b11ab2-67d23573.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p distal femur ressection for osteosarcoma now with fever 24hrs after surgery // r/o PNA TECHNIQUE: Portable upright chest radiograph COMPARISON: ___ FINDINGS: Since the prior radiograph there is no relevant change. Moderate cardiomegaly is unchanged. Spinal stabilization hardware is partially imaged. No new focal consolidation or pleural effusion. IMPRESSION: No evidence of pneumonia compared to ___. " 650f60e4-6620f15b-6dc7a764-9175cf5e-4d6c025b.jpg,validate/p19/p19606555/s50779135/650f60e4-6620f15b-6dc7a764-9175cf5e-4d6c025b.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of productive cough for a week. Rule out pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are 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. " f429a847-a955f08f-79356a07-dbd9a4f9-00053660.jpg,validate/p17/p17010065/s50598946/f429a847-a955f08f-79356a07-dbd9a4f9-00053660.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after right lower lobe wedge resection. PA and lateral upright chest radiographs were reviewed in comparison to ___. There is substantial interval improvement in the hilar opacity, consistent with resolution of surgical hematoma. There is no pneumothorax or pleural effusion demonstrated. Severe emphysema is seen mostly affecting upper lungs. There is evidence of bilateral rib fractures, old. There is no evidence of apical pneumothorax on the current study on the right. " 057622a5-ea603bcb-30ed5927-8f41d703-8dcb1bb6.jpg,validate/p10/p10398981/s50802923/057622a5-ea603bcb-30ed5927-8f41d703-8dcb1bb6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ARDS, septic shock please eval for interval change // eval for interval change eval for interval change IMPRESSION: Right internal jugular line tip is at the level of superior SVC. Left internal jugular line tip is in the right atrium, terminating 2 cm below the cavoatrial junction. NG tube tip is in the stomach. There is interval improvement in widespread parenchymal opacities. " 520dc8a9-03457eaf-0b1c4305-ef727f00-f17b3f70.jpg,validate/p12/p12911421/s54324825/520dc8a9-03457eaf-0b1c4305-ef727f00-f17b3f70.jpg,validation," FINAL REPORT PA AND LATERAL CHEST OF ___ COMPARISON: ___. FINDINGS: Heart size, mediastinal and hilar contours are normal. Lungs are well expanded and grossly clear except for unchanged biapical pleural and parenchymal scarring. No new areas of consolidation are identified, and there are no pleural effusions. Mild compression deformity in the mid thoracic spine is unchanged. IMPRESSION: No radiographic evidence of pneumonia. " 6b585fb8-c5b80aec-245d1f04-8e5e9663-b64f6798.jpg,validate/p18/p18039782/s53855742/6b585fb8-c5b80aec-245d1f04-8e5e9663-b64f6798.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with syncope. TECHNIQUE: Single AP radiograph. COMPARISON: None available. FINDINGS: Single upright portable chest radiograph demonstrates clear lungs bilaterally. Cardiomediastinal silhouette is within normal limits. There is no pneumothorax or pleural effusion. Imaged osseous structures demonstrates no acute abnormality. Upper abdomen is unremarkable. IMPRESSION: No acute intrathoracic abnormality. " 97b0dbde-6da90ef9-50f889e2-f1fed72d-4b2d08a9.jpg,validate/p10/p10229323/s53094232/97b0dbde-6da90ef9-50f889e2-f1fed72d-4b2d08a9.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Prolonged intubation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the tracheostomy tube has been re-positioned. The tube is in correct position. The patient is rotated. The patient also has a left PICC line and a nasogastric tube. The tibial fixation devices are in unchanged position. Small bilateral pleural effusions with areas of atelectasis at both right lung bases as well as mild fluid overload is present in unchanged manner. No evidence of pneumothorax. Unchanged appearance of the cardiac silhouette. " 4034c822-80809f2b-9f2cf534-96c2df91-9b6fd00f.jpg,validate/p11/p11055521/s59403706/4034c822-80809f2b-9f2cf534-96c2df91-9b6fd00f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with PTX s/p chest tube // compare with before compare with before COMPARISON: Chest radiographs on ___, through 22:31. IMPRESSION: Small biapical pneumothorax unchanged for several hr. Little left pleural effusion if any subcutaneous emphysema in the left chest wall is unchanged. The anterior left pleural drain impinging on the prevascular mediastinum is grossly unchanged in position. There may be atelectasis developing at the base of the right lung. Normal cardiomediastinal silhouette. Small left pleural or extrapleural bleeding associated with multiple left rib fractures, also unchanged for several hours. Transvenous right atrial right ventricular pacer leads in standard placement. " c96b04f9-571bb841-b4d1d067-56b11892-b99ed27c.jpg,validate/p18/p18416284/s53973607/c96b04f9-571bb841-b4d1d067-56b11892-b99ed27c.jpg,validation," FINAL REPORT STUDY: PA and lateral chest; ___. CLINICAL HISTORY: Patient with lung cancer, status post rigid bronchoscopy and right-sided stent. Evaluate for any reexpansion of the lung. FINDINGS: Comparison is made to the prior radiograph from ___. There is unchanged of collapse involving the right middle and lower lobes. Findings are stable compared to multiple films. The left lung is clear. There is no pneumothoraces. Bony structures demonstrate mild wedging of a lower thoracic vertebral body, likely T9. " a57f3ac7-292e533b-acf4fa17-228a5516-0e741781.jpg,validate/p14/p14347948/s57709533/a57f3ac7-292e533b-acf4fa17-228a5516-0e741781.jpg,validation," FINAL REPORT INDICATION: Right pleural effusion. COMPARISON: Chest radiographs ___ and ___, CT chest ___. FINDINGS: There is a right pleural catheter with tip terminating in the right lung base. There is a slight decrease in the right pleural effusion with atelectasis. There is no left pleural effusion. There is no pneumothorax or focal consolidation concerning for pneumonia. Cardiomediastinal and hilar contours are stable. There is stable appearance of a right upper quadrant abdominal drain. IMPRESSION: Slight decrease in right pleural effusion. " 973121a3-b1ddc2e0-1ab543e7-897c69dd-34c3cf6d.jpg,validate/p14/p14021217/s51057549/973121a3-b1ddc2e0-1ab543e7-897c69dd-34c3cf6d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with AMS and cirrhosis // Eval for pneumonia COMPARISON: ___ FINDINGS: AP portable semi upright view of the chest. Lung volumes are markedly low limiting assessment. Overlying EKG leads are present. Again noted is a right upper extremity PICC line with its tip in the region of the low SVC. Allowing for study limitations, no definite focal consolidation, large effusion or pneumothorax. No overt signs of CHF. Heart size is difficult to assess. Bony structures are intact. IMPRESSION: Limited, negative. PICC line terminates in the low SVC. " f10b81e3-1058541a-481a8cc7-b16d920e-ffd4e479.jpg,validate/p12/p12177591/s55652699/f10b81e3-1058541a-481a8cc7-b16d920e-ffd4e479.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior study from ___. CLINICAL HISTORY: Right upper quadrant pain, assess for free air or pneumonia. FINDINGS: PA and lateral views of the chest provided demonstrate unchanged scarring at the right lung apex with upward retraction of the right pulmonary hilum. There is no definite sign of pneumonia, CHF, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is stable. Atherosclerotic calcifications are noted along the aortic knob. Bony structures appear grossly intact with a stable scoliosis and kyphotic angulation of the T-spine. IMPRESSION: No acute findings. " f8bb9072-96a5992a-37bd5da0-b07cfea4-c2dda81c.jpg,validate/p12/p12503315/s53398906/f8bb9072-96a5992a-37bd5da0-b07cfea4-c2dda81c.jpg,validation," FINAL ADDENDUM ADDENDUM Discussed with Dr. ___ ___ phone by Dr. ___ on ___ at 12:17 p.m., approximately 10 minutes after the findings were made. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with metastatic adenocarcinoma and chronic Rt pleural effusion p/w hypoxia s/p chest tube placement // eval for pneumothorax TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Right pigtail catheter is in place. Right apical pneumothorax is moderate. Right pleural effusion appears to be decreased since the prior study. Left basal consolidation has increased. Left upper lung is essentially clear. " eac3c8eb-d10cbf19-0e840384-55026e5e-594624f6.jpg,validate/p19/p19920125/s59069578/eac3c8eb-d10cbf19-0e840384-55026e5e-594624f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with cough for 3 days. Evaluate for cardiopulmonary process. COMPARISON: None. 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. " ad1ec059-744bc20a-6b6b9a02-2064c18a-b67df63f.jpg,validate/p11/p11700849/s51513309/ad1ec059-744bc20a-6b6b9a02-2064c18a-b67df63f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with history of taking down ileostomy, currently with fever. Portable AP radiograph of the chest was compared to ___. Heart size and mediastinum are stable. Left retrocardiac opacity appears to be slightly increased since the prior study as well as there is new linear atelectasis in the right lung base. Those findings might potentially represent infectious process, in particular in the left lung base and should be further closely followed. No pneumothorax or appreciable interval increase in pleural effusion demonstrated. " 68df4015-f7b0ff52-d61e2996-1b571f67-25c3159c.jpg,validate/p13/p13204581/s57113320/68df4015-f7b0ff52-d61e2996-1b571f67-25c3159c.jpg,validation," FINAL REPORT INDICATION: ___ year old woman s/p esophagectomy // R/O inf, check for dilated neoesophagus TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___ at 04:27. FINDINGS: The cardiomediastinal silhouette is unchanged from this morning. The neo esophagus is unchanged. Left lower lobe atelectasis has improved. Right lower lobe atelectasis is about the same. Right pleural effusion is stable. No new consolidation. No pulmonary venous congestion or pulmonary edema. No pneumothorax. IMPRESSION: 1. Unchanged neo esophagus contour. 2. Improved left lower lobe atelectasis. " d1da439d-5b0103ed-36dfddc7-351b2173-bee37e04.jpg,validate/p11/p11485993/s56833213/d1da439d-5b0103ed-36dfddc7-351b2173-bee37e04.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with abdominal distention, prior pneumonia // assess for partial SBO, r/o free air under diaphragm, and follow up on pneumonia from ___ TECHNIQUE: AP upright and lateral views of the chest provided. COMPARISON: Chest radiographs from ___ to ___. FINDINGS: In comparison with chest radiograph from ___, left lower lobe consolidation has resolved. Spiculated right apical nodule is unchanged since ___. Biapical fibrotic changes, right greater than left, are unchanged. Hyperinflated lungs and upper lobe vascular deficiency suggest emphysema. Mediastinal and hilar contours are normal. Moderate cardiomegaly is chronic. Visualized bowel loops appear nondistended. There is no pneumoperitoneum, though a true upright radiograph is much more sensitive for detection of intra-abdominal free air. IMPRESSION: Resolved left lower lobe pneumonia. " fdb26ac3-93eb8cb1-a31c5415-33e8c4ce-af0fb773.jpg,validate/p12/p12663866/s56536246/fdb26ac3-93eb8cb1-a31c5415-33e8c4ce-af0fb773.jpg,validation," FINAL REPORT INDICATION: Chest pain in a patient status post cardiac catheterization three days ago. COMPARISON: None available. FINDINGS: Chest, PA and lateral. The lungs are clear. There is minimal left basilar atelectasis. The hilar and cardiomediastinal contours are normal. There is no pneumothorax or pleural effusion. A coronary arterial stent is evident on the lateral view. IMPRESSION: No acute cardiopulmonary process. " 94460b85-5672611f-fb0574ce-8657fb22-87223a79.jpg,validate/p16/p16330662/s58854162/94460b85-5672611f-fb0574ce-8657fb22-87223a79.jpg,validation," FINAL REPORT HISTORY: Pericardial effusion status post bronchoscopy. FINDINGS: In comparison with the study of ___, there is again substantial opacification in the right hemithorax with elevation of the hemidiaphragm consistent with a combination of post-surgical changes, volume loss, and possible pleural fluid. In the appropriate clinical setting, supervening pneumonia would have to be considered. The left lung is essentially clear. " 6ce5d825-57b75390-b9feacf0-380275cd-5c91479d.jpg,validate/p12/p12310399/s58900923/6ce5d825-57b75390-b9feacf0-380275cd-5c91479d.jpg,validation," FINAL REPORT INDICATION: Status post pacemaker placement. TECHNIQUE: Frontal lateral chest radiographs. COMPARISON: CTA chest dated ___ FINDINGS: A right-sided dual lead pacemaker is noted with tips overlying the expected location of the right atrium and right ventricle. The cardiac silhouette is normal. There is no focal consolidation, pneumothorax, or pleural effusion. Osseous structures demonstrate bridging osteophytes over multiple levels in the thoracic spine suggesting DISH. " 8860864a-eb08f6bf-29bbb3b0-3dcfc231-84157a7d.jpg,validate/p15/p15863098/s58927975/8860864a-eb08f6bf-29bbb3b0-3dcfc231-84157a7d.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old man with left VATS blebectomy and pleurodesis for pneumothorax, now after chest tube removal. IMPRESSION: PA and lateral chest compared to postoperative radiographs, ___: There is small left apical pneumothorax, is unchanged since ___, 2:13 p.m. following removal of left pleural drains. A very small left pleural effusion and mild pleural thickening also stable. Left upper lung is clear. Lower lung is mildly atelectatic, as expected. There is also mild atelectasis at the right lung base, generally due to splinting. Cardiomediastinal silhouette is normal. " 35726b79-2857f583-df3c4139-f5885423-4c96b86a.jpg,validate/p13/p13748151/s50745729/35726b79-2857f583-df3c4139-f5885423-4c96b86a.jpg,validation," FINAL REPORT HISTORY: Stroke-like symptoms question pneumonia. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are relatively hyperinflated, suggesting chronic obstructive pulmonary disease. The patient is status post median sternotomy and cardiac valve replacements. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. IMPRESSION: No acute cardiopulmonary process. " 644a679c-4bb4fab7-70af507b-9a525f3f-869566f9.jpg,validate/p18/p18026405/s55053791/644a679c-4bb4fab7-70af507b-9a525f3f-869566f9.jpg,validation," WET READ: ___ ___ ___ 4:24 PM No focal parenchymal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with ___'s disease, dementia, AMS // infiltrate? TECHNIQUE: AP and lateral radiographs. COMPARISON: Chest x-ray dated ___. FINDINGS: The cardiomediastinal silhouette is unchanged. There is no pleural effusion or pneumothorax. There is no focal consolidation. Degenerative changes of bilateral shoulders are identified. IMPRESSION: No focal parenchymal consolidation. " 730d4193-c7a56633-33ade7b4-90224399-6700b867.jpg,validate/p12/p12849577/s55698398/730d4193-c7a56633-33ade7b4-90224399-6700b867.jpg,validation," FINAL REPORT HISTORY: Cough. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is seen. Mild dextroscoliosis of the thoracic spine is present. IMPRESSION: No acute cardiopulmonary abnormality. " dfd751b8-38868c4e-d45b67c2-f09a42e5-e847de4d.jpg,validate/p19/p19116441/s57675742/dfd751b8-38868c4e-d45b67c2-f09a42e5-e847de4d.jpg,validation," FINAL REPORT INDICATION: ___F with bradycardia, generalized weakness // eval for acute process TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear without focal consolidation, effusion, or edema. Mild cardiac enlargement is noted. Tortuosity of descending thoracic aorta is noted. No acute osseous abnormalities. IMPRESSION: Mild cardiomegaly without acute cardiopulmonary process. " 6c8781b7-7e59dd29-38889261-0023b5df-548236b4.jpg,validate/p16/p16578717/s56190816/6c8781b7-7e59dd29-38889261-0023b5df-548236b4.jpg,validation," FINAL REPORT INDICATION: Cough. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: None. FINDINGS: The lungs are clear. There is no pneumothorax or pleural effusion. The heart size is normal. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9b67dbe1-ae1b6945-6bf8a8f4-83f731bf-9ed1686b.jpg,validate/p14/p14943190/s58753768/9b67dbe1-ae1b6945-6bf8a8f4-83f731bf-9ed1686b.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with new hypoxia with recent ERCP. AP chest radiograph. As compared to the prior study, there is continuous increase in right lung opacity that might reflect interval development of aspiration. No free intraperitoneal air is demonstrated. No pleural effusion is seen. No pneumothorax is seen. " 761c1a89-5fbe4c5b-be2ea180-13516306-044af7ba.jpg,validate/p19/p19858208/s57479264/761c1a89-5fbe4c5b-be2ea180-13516306-044af7ba.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pleural effusion // eval eval IMPRESSION: In comparison with the study of ___, there has been clearing of the bilateral pleural effusions with compressive atelectasis at the bases. Cardiac silhouette is within upper limits of normal and there is no vascular congestion or acute focal pneumonia. Mild hyperexpansion suggests underlying chronic pulmonary disease. " d4bc96ec-1cbb3ad0-68427024-ad789b33-1564441a.jpg,validate/p17/p17069014/s57655710/d4bc96ec-1cbb3ad0-68427024-ad789b33-1564441a.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough and low-grade fever. Evaluate for pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well inflated. There is bilateral diffuse increase in the interstitial thickening, with upper vascular redistribution, ___ B lines, and bilateral hilar prominence suggesting pulmonary edema. The heart is moderately enlarged but not significantly changed compared with prior study. There is a tiny left-sided pleural effusion, but no pleural effusion in the right. There is no pneumothorax. IMPRESSION: Mild pulmonary edema. " 7c2523a4-b43f9754-95535691-ff2e9287-9d4a5080.jpg,validate/p10/p10803460/s56452240/7c2523a4-b43f9754-95535691-ff2e9287-9d4a5080.jpg,validation," FINAL REPORT INDICATION: Palpitations. COMPARISON: None. PA AND LATERAL VIEWS OF THE CHEST: The cardiac, mediastinal and hilar contours are within normal limits. The pulmonary vascularity is normal. Lungs demonstrate no focal consolidation. No pleural effusion or pneumothorax is visualized. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary process. " 1436de2e-c25277a7-372dc3ad-d4f4d34a-e23983fa.jpg,validate/p13/p13350579/s50135360/1436de2e-c25277a7-372dc3ad-d4f4d34a-e23983fa.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Right back pain, history of recent pneumonia, evidence of right lower lung opacity. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, opacity at the right lung base has minimally decreased in extent. The lateral radiograph shows that the opacity is dominant in the anterior lung regions. However, the radiograph also shows a new parenchymal consolidation in the posterior parts of the right lung, not evident on the previous image. This opacity is likely to represent a new focus of pneumonia. Unchanged scarring and postoperative changes at the right apex and the level of the left hilus. No pleural effusions. Unchanged size of the cardiac silhouette. The referring physician, ___. ___ was pageable at the time of dictation. The telephone number was not operational. Therefore, an E-mail was sent at the time of dictation and observation, 8:11 a.m., on ___. " 2db1c70e-42a70b4c-b0f24e2d-e1dceaa3-05cccca4.jpg,validate/p14/p14199690/s50468997/2db1c70e-42a70b4c-b0f24e2d-e1dceaa3-05cccca4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post CABG, rule out infection. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, all monitoring and support devices have been removed. The patient shows cardiomegaly after CABG. The sternal wires are in correct position. Better seen than on the previous examination is a retrocardiac atelectasis, projecting over the dorsal parts of the left dorsal sinus on the lateral radiograph. Imaging within 24 hours should be repeated to exclude potential co-existing pneumonia. No pulmonary edema. No pneumothorax. " 32dee765-a376016e-7362a17d-fb513a91-ef47e7e2.jpg,validate/p15/p15516557/s54626895/32dee765-a376016e-7362a17d-fb513a91-ef47e7e2.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with epigastric pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear. Cardiomediastinal silhouette is normal. No acute osseous abnormalities detected. No free air seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " 97ab105d-cf8d9412-b56dd07a-806974b9-129a0a2e.jpg,validate/p15/p15100208/s52417183/97ab105d-cf8d9412-b56dd07a-806974b9-129a0a2e.jpg,validation," FINAL REPORT CHEST, TWO VIEWS Comparison with the previous study done ___. There is ill-defined focal area of increased density in the retrocardiac area, silhouetting the descending aorta. There is persistent streaky density in the lingula. The lungs are otherwise essentially clear. The cardiac silhouette is prominent but may be exaggerated by AP technique. The aorta is tortuous and calcified, as demonstrated earlier. The bony thorax is grossly intact. IMPRESSION: Persistent focal area of increased density in the left lower lobe suspicious for pneumonia or partial atelectasis. Subsegmental atelectasis left mid lung. " 7881c9eb-72344348-b2d7af44-286a3cca-56e3f7c6.jpg,validate/p19/p19500641/s59690802/7881c9eb-72344348-b2d7af44-286a3cca-56e3f7c6.jpg,validation," PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:48 AM IMPRESSION: Small bilateral pleural effusions with associated atelectasis, similar to the prior week's radiograph. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male status post exploratory laparotomy and ___ patch for perforated pyloric ulcer. This has been complicated by intra-abdominal abscesses that were drained by IR on ___; now with fever, altered mental status, and abdominal pain. STUDY: PA and lateral upright chest radiographs. COMPARISON: ___. FINDINGS: A pigtail catheter sits in the right upper quadrant of the abdomen. The cardiomediastinal contours are normal and unchanged. Bibasilar opacities reflect components of atelectasis and pleural effusion which is seen tracking up along the major fissures on the lateral view. There is no pneumothorax. There is no subdiaphragmatic free air. IMPRESSION: Small bilateral pleural effusions with associated atelectasis, similar to the prior week's radiograph. " 9b758253-80ad8a8f-d25e950f-982c09c8-421cf5f4.jpg,validate/p16/p16454913/s50988468/9b758253-80ad8a8f-d25e950f-982c09c8-421cf5f4.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Failed kidney pancreatic transplant with mesenteric ischemia. Comparison is made with prior study ___. Severe cardiomegaly and widened mediastinum are unchanged. Large left and small right pleural effusions with adjacent atelectasis are grossly unchanged. Pulmonary edema has minimally improved. There are no lung abnormalities. Tracheostomy tube is in a standard position. Left IJ catheter tip is in the left brachiocephalic vein as before. A catheter projects in the right upper quadrant. " f697b138-df87e673-0f000c36-2ac308b9-65061b8d.jpg,validate/p10/p10153503/s55687808/f697b138-df87e673-0f000c36-2ac308b9-65061b8d.jpg,validation," FINAL REPORT INDICATION: History: ___M with fall, cp // PTX? TECHNIQUE: Chest PA and lateral COMPARISON: None FINDINGS: Redemonstration of the left clavicular fracture seen on the prior radiograph. The lungs are clear and there is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. IMPRESSION: Left clavicular fracture. No acute cardiopulmonary process. " ee04be52-6f5fb49d-97387f63-e554053b-e8805ff4.jpg,validate/p19/p19839844/s59045383/ee04be52-6f5fb49d-97387f63-e554053b-e8805ff4.jpg,validation," FINAL ADDENDUM ADDENDUM The findings were discussed by Dr. ___ with ___ on ___ at 4:54 PM, 25 minutes after discovery of the findings. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p MV ring // eval for pleural effusions eval for pleural effusions IMPRESSION: Heart size is top-normal. Mediastinum is stable. Post sternotomy wires are unchanged. There is right apical pneumothorax, small but not minimal. There is small right pleural effusion. There is no pulmonary edema. " 2b151432-58e39454-56769cf0-e8a1441b-55f3df74.jpg,validate/p15/p15625104/s56268996/2b151432-58e39454-56769cf0-e8a1441b-55f3df74.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with severe COPD and downed left lundg on 4L NC at baseline, now with worsening hypoxia despite neb treatments, exaclating O2 // please evaluate for interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: Left PICC line tip is at the level of lower SVC. Opacification of the left hemi thorax is re- demonstrated including extensive air bronchogram. Multifocal opacities in the right lung. Appear to be slightly improved since the prior study. Otherwise no substantial change demonstrated. " 62d40089-0de6770c-5667648e-4553a703-9cba9989.jpg,validate/p12/p12414328/s54064897/62d40089-0de6770c-5667648e-4553a703-9cba9989.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Atrial tachycardia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest are obtained. The patient is status post median sternotomy. There is persistent enlargement of the cardiac silhouette. Mediastinal contours are stable. There is no focal consolidation, pleural effusion, or evidence of pneumothorax. COMPARISON: Persistent enlargement of the cardiac silhouette. Minimal central pulmonary vascular engorgement. " b8f8a226-dd442151-edfd7f3b-ed838600-9416eb25.jpg,validate/p19/p19960115/s59581431/b8f8a226-dd442151-edfd7f3b-ed838600-9416eb25.jpg,validation," WET READ: ___ ___ 8:22 AM Interval removal of right base pigtail catheter with no appreciable change in small to moderate right pleural effusion. A small left pleural effusion is likely, also unchanged. Tracheostomy and enteric tube project in unchanged expected positions. WET READ VERSION #1 ___ ___ ___ 6:57 PM Interval removal of right base pigtail catheter with no appreciable change in small to moderate right pleural effusion. A small left pleural effusion is likely, also unchanged. Tracheostomy and enteric tube project in unchanged expected positions. ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old man with pigtail removed // Re-collection of effusion? IMPRESSION: Interval removal of right pigtail catheter. No change in appearance of the right pleural effusion. No pneumothorax. Minimally improved ventilation of the lung bases. " 6f9a94a4-85b0501f-93b976bf-01cb566a-265474bc.jpg,validate/p17/p17192910/s54489815/6f9a94a4-85b0501f-93b976bf-01cb566a-265474bc.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with dyspnea with exertion and cough. Assess for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___, ___. FINDINGS: The lungs are hyperinflated with flattening of diaphragms. Right lower lobe peribronchial wall thickening is noted. Small left pleural effusion. No right pleural effusion. No pneumothorax. Moderate aortic knob calcifications with tortuous aorta. Stable mild cardiomegaly. Mediastinal contour and hila are unremarkable. A left pacer device lead tips are in the right atrium and right ventricle. Limited evaluation of the osseous structures are notable for multilevel degenerative changes IMPRESSION: 1. Early right lower lobe pneumonia. 2. Emphysema or chronic obstructive pulmonary disease. 3. Small left pleural effusion. " 8857e9da-844c3413-45c19e85-90b30a1f-ba1309a5.jpg,validate/p15/p15945590/s57191382/8857e9da-844c3413-45c19e85-90b30a1f-ba1309a5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with intubation // interval imaging TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ IMPRESSION: The ET tube tip is 4.3 cm above the carinal. Right central venous line tip is at the cavoatrial junction. Bilateral pleural effusions are extensive. Prominence of main pulmonary artery is re- demonstrated. Pulmonary edema is at least moderate. " 27b8a8eb-902d1279-9bcb6a53-2cd3927f-b11f3cdf.jpg,validate/p14/p14766138/s55834360/27b8a8eb-902d1279-9bcb6a53-2cd3927f-b11f3cdf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with HIV, hepatitis C, ESRD on HD, IgG kappa myeloma presenting with lethargy, hypoglycemia, hypotension. CXR showed PNA. She was intubated for ?AMS/tachypnea. Has R IJ in place. She is on norepi, neo, fent/midaz. Receiving cefepime/clindamycin for bacterial PNA, atovaquone/prednisone for ?PJP PNA // interval change IMPRESSION: In comparison to ___ radiograph, left upper lobe airspace consolidation has minimally decreased in extent, but an area of consolidation in the left retrocardiac region has worsened. Additionally, areas of peribronchial thickening in adjacent peribronchiolar opacification in right juxta hilar region persist. These findings are likely due to multifocal infection. Exam is otherwise remarkable for tip of endotracheal tube terminating within 1.5 cm above the carina with the neck in a flexed position. " e90b4a7e-f62078e0-ff6df0f8-42642ea3-9189492c.jpg,validate/p17/p17071231/s54522270/e90b4a7e-f62078e0-ff6df0f8-42642ea3-9189492c.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ COMPARISON: ___. FINDINGS: AP view of the chest, there is increased pulmonary vascular congestion. Based on the frontal view, there is no evidence of a large pleural effusion. The cardiac silhouette is top normal. No acute osseous abnormalities. IMPRESSION: Increased pulmonary vascular congestion without focal consolidation. " 8f35ef14-a264c1e9-bfdd48db-887f24a3-13cc219b.jpg,validate/p10/p10361825/s58370755/8f35ef14-a264c1e9-bfdd48db-887f24a3-13cc219b.jpg,validation," FINAL REPORT INDICATION: Anterior chest wall crepitus. COMPARISON: Chest radiograph, ___. FINDINGS: There has been interval development of pneumoperitoneum with free air seen under both hemidiaphragms. The cardiomediastinal and hilar contours are stable. There is no pleural effusion, pneumothorax, or pneumomediastinum. There is no focal consolidation concerning for pneumonia. Again demonstrated are median sternotomy wires and aortic valve replacement. IMPRESSION: New pneumoperitoneum. In the absence of recent abdominal surgery, this finding is concerning for an acute abdominal process. CT abdomen and pelvis is recommended for further evaluation. Dr. ___ ___ these findings with Dr. ___ on ___ at 3 p.m., at the time of discovery, via telephone. " 5be1e61c-05ed04dd-47f05892-3bbfacbf-cde97a1b.jpg,validate/p16/p16625317/s55120461/5be1e61c-05ed04dd-47f05892-3bbfacbf-cde97a1b.jpg,validation," WET READ: ___ ___ 11:17 PM Stable appearence of right upper lobe opacity. Small bilateral effusions. Tunneled dialysis line tip at the cavo-atrial junction ______________________________________________________________________________ FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old woman with end-stage renal disease. IMPRESSION: PA and lateral chest compared to ___ and ___: Though interstitial pulmonary edema has almost cleared and small bilateral pleural effusions have decreased over the past five days, the irregular right juxtahilar mass-like consolidation is unchanged. This needs to be investigated as possible infection or malignancy. Mild cardiomegaly persists. Dual-channel dialysis catheter ends in the SVC. No pneumothorax. " 9b32230c-1a431785-a5cf793f-231aa945-4fa23d93.jpg,validate/p16/p16646585/s51866201/9b32230c-1a431785-a5cf793f-231aa945-4fa23d93.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old female patient with end-stage renal disease, on hemodialysis with calciphylaxis, infectious workup for increasing white blood count. Evaluate for pneumonia. FINDINGS: A single view AP chest view has been obtained with the patient in semi-upright position. There is considerable cardiac enlargement, although this may be exaggerated by the portable technique. No typical configurational abnormalities identified. Thoracic aorta of ordinary ___ but calcium deposits are present in the wall at the level of the arch. The pulmonary vasculature shows a mild degree of perivascular haze, but there is no evidence of interstitial alveolar edema. Large soft tissue structures are overlying the lung bases, but no gross pulmonary abnormalities can be identified and the lateral pleural sinuses appear free. Our records do not include a previous chest examination available for comparison. IMPRESSION: No conclusive evidence for pneumonic infiltrate on portable single view chest examination. Review of the most recent abdominal CT has been performed and the lung bases are inspected. There were bilateral atelectasis and some pleural densities , probably scar formations but no acute pneumonic infiltrate was present on ___. " 1aa903e0-ec03fe7d-02590510-8e173f9b-8d251021.jpg,validate/p13/p13384632/s55932167/1aa903e0-ec03fe7d-02590510-8e173f9b-8d251021.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with crackles on exam and missed dialysis TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Patient is status post median sternotomy and CABG. Heart size is mildly enlarged. The aorta is diffusely calcified. Mediastinal and hilar contours are unremarkable. Increased interstitial opacities bilaterally are compatible with mild interstitial pulmonary edema. Small bilateral pleural effusions are present, larger on the left. There is atelectasis in the left lung base. No pneumothorax is present. There are moderate multilevel degenerative changes present in the thoracic spine. IMPRESSION: Mild interstitial pulmonary edema and small bilateral pleural effusions, larger on the left. " ca817a3c-ebeaa2c9-9a32c7bf-d3477848-a668bb3e.jpg,validate/p11/p11543398/s59982274/ca817a3c-ebeaa2c9-9a32c7bf-d3477848-a668bb3e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory failure, LIJ CVL noted to be withdrawn somewhat. // Recheck CVL placmenet TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 4 hours earlier IMPRESSION: Left IJ catheter tip is in theupper SVC. In unchanged position. There are no other interval changes " df4fca8d-175227c8-9602dbe5-281d40c4-7dfd3ccd.jpg,validate/p13/p13050559/s52657655/df4fca8d-175227c8-9602dbe5-281d40c4-7dfd3ccd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old man with mediastinal non-Hodgkin's lymphoma, status-post right thoracotomy and right upper lobectomy with hand-sewn closure and intercostal muscle buttress; evaluate for interval changes. COMPARISON: Portable chest radiographs dated ___ and ___. FINDINGS: No significant interval change. Stable radiographic appearance and size of the right paratracheal opacity. Stable loss of right lung volume. The large opacity at the right lung base probably reflects a combination of a subpulmonic right pleural effusion with lateral-shift of the right diaphragm apex and adjacent atelectasis. Stable small right apical pneumothorax. No new focal consolidation. No left pleural effusion. The cardiomediastinal silhouette is unchanged. No change in the position of the right Port-A-Cath or mediastinal surgical clips. Small amount of sub-cutaneous emphysema in the right lower lateral thoracic wall at the prior site of chest tube insertion. No acute osseous abnormality. IMPRESSION: 1. Stable radiographic appearance of the right paratracheal opacity. 2. Stable, large right subpulmonic pleural effusion and atelectasis. 3. Stable, small right apical pneumothorax. " 2bb41009-c3f7f456-73cd71af-8c39819a-2fe49656.jpg,validate/p11/p11494804/s59922077/2bb41009-c3f7f456-73cd71af-8c39819a-2fe49656.jpg,validation," 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. " abd4ad41-4c6f47a8-6cd01ee5-8f12b7ff-cdf13390.jpg,validate/p16/p16831093/s53062737/abd4ad41-4c6f47a8-6cd01ee5-8f12b7ff-cdf13390.jpg,validation," FINAL REPORT INDICATION: MVA. No prior examinations for comparison. CHEST, AP: Lungs are well expanded and clear. Cardiomediastinal and hilar contours are normal. No significant pleural effusions or pneumothorax. No vertebral compression deformities or displaced rib fractures. IMPRESSION: Normal chest. Please note that radiography is not sensitive for chest wall trauma. " f11a05fd-7b4beea9-648353b0-dddd5103-a66d6b91.jpg,validate/p17/p17574863/s56871538/f11a05fd-7b4beea9-648353b0-dddd5103-a66d6b91.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM, ___ AT 14:08 CLINICAL INDICATION: ___-year-old with OLT, on CVVH, question pulmonary edema, question pneumonia. Comparison is made to the patient's prior study ___ at 3:44. A portable semi-erect chest film on ___ at 14:08 is submitted. IMPRESSION: 1. Left internal jugular central line and left subclavian central lines both have their tips in the proximal SVC, unchanged in position. A feeding tube courses below the diaphragm with the tip not identified. Lung volumes remain markedly diminished with some crowding of pulmonary vasculature and some patchy opacity at both bases, which likely reflects bibasilar atelectasis. No evidence of pulmonary edema or pneumothorax. Stable cardiac and mediastinal contours, given differences in positioning. " 9f9ace63-55cfdd27-3c340a83-836d188b-66802f19.jpg,validate/p16/p16143265/s57167113/9f9ace63-55cfdd27-3c340a83-836d188b-66802f19.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Bacteremia, evidence of pneumonia on chest x-ray, evaluation for interval change, evaluation for free intra-abdominal air. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is improved ventilation at the left lung base, with subsequent decrease in severity of the pre-existing parenchymal opacity. This opacity, mainly reticular in appearance, however, is still clearly visible. It could reflect pneumonia. Unchanged moderate cardiomegaly, unchanged appearance of the right lung base, with persisting blunting of the costophrenic sinus, potentially reflecting a minimal right pleural effusion. Unchanged minimal focal right apical thickening. No evidence of free intra-abdominal air. " 04f60e26-26d3412f-0061558d-41981e82-6aa918e3.jpg,validate/p11/p11753870/s53062225/04f60e26-26d3412f-0061558d-41981e82-6aa918e3.jpg,validation," FINAL REPORT INDICATION: Recent bronchoscopy with gastropulmonary fistula and persistent cough. COMPARISON: ___ chest radiograph and chest CT ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is normal. Patient is status post esophagectomy and gastric pull-through, with relatively unchanged contour of the mediastinum. There is worsening consolidative opacity within the right lung base and right mid lung field, compatible with worsening infection. Streaky opacity in the left lower lobe likely reflects atelectasis. No pneumothorax is seen. A trace right pleural effusion is likely present. No acute osseous abnormality is seen. IMPRESSION: Worsening airspace opacities within the right lung base and right mid lung field likely reflecting worsening infection, possibly aspiration pneumonia. " eed20f68-2df330e9-2d59aeac-95286908-fcdd1586.jpg,validate/p19/p19963140/s56828395/eed20f68-2df330e9-2d59aeac-95286908-fcdd1586.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP)i INDICATION: ___ year old man with lung CA, s/p exploratary L thoracotomy // s/p L thoracotomy POD 1 COMPARISON: Chest radiographs ___ and postoperatively ___. IMPRESSION: Greater generalize infiltration in the left lung is most likely due either to bleeding or lymphatic congestion. New consolidation at the base of the left lower lobe probably atelectasis. Left apical pleural drain still in place. No appreciable pleural effusion or pneumothorax. Right lung clear. " b44c48e8-f99f0bd1-dd0d6c22-34fa7ba7-efe1500d.jpg,validate/p19/p19711702/s55031465/b44c48e8-f99f0bd1-dd0d6c22-34fa7ba7-efe1500d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with lymphoma // No blood draw form port. Assess placement. No blood draw form port. Assess placement. IMPRESSION: In comparison to study of ___, the tip of the Port-A-Cath again extends to the lower portion of the SVC. No evidence of kinking is seen. Continued mild elevation of the left hemidiaphragm with no evidence of acute pneumonia, vascular congestion, or pleural effusion. " 89144cab-142e191c-397d9076-a3f5c04c-3ebef87c.jpg,validate/p19/p19724309/s50425201/89144cab-142e191c-397d9076-a3f5c04c-3ebef87c.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F 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. " 0abacfef-41fa1195-6ec0d2f2-c7aedca8-4a6fd6e4.jpg,validate/p14/p14733367/s51483035/0abacfef-41fa1195-6ec0d2f2-c7aedca8-4a6fd6e4.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with increasing lethargy. Rule out pneumonia. COMPARISONS: Multiple prior chest radiographs, most recently ___ ___. FINDINGS: Frontal and lateral views of the chest were obtained. The heart is moderately enlarged, similar to prior. There is calcification of the aortic knob. A right lung opacity silhouettes the right heart border. Opacity is also seen at the left lung base. There are new bilateral small pleural effusions. Osseous structures are unremarkable. No radiopaque foreign body. IMPRESSION: Bilateral parenchymal opacities, most prominent at right middle lobe, with new bilateral pleural effusions, compatible with edema or multifocal infection. " 574e12ae-a53cbdca-9c3616a6-75ba7dc1-b70dff91.jpg,validate/p16/p16861367/s59398356/574e12ae-a53cbdca-9c3616a6-75ba7dc1-b70dff91.jpg,validation," FINAL REPORT AP CHEST, 1:19 P.M., ___ HISTORY: ___-year-old man with subarachnoid hemorrhage and fever. Evaluate for possible infectious process. IMPRESSION: AP chest compared to coarse reticulation in the lower lungs, present since ___, is presumably pulmonary fibrosis. Alternatively, since lung volumes are normal to slightly increased, this could be a combination of emphysema and interstitial pulmonary fibrosis, but there are no findings to suggest current infection. There is no pleural effusion or evidence of central adenopathy. Heart size is normal. ET tube and a left subclavian line are in standard placements, and an upper enteric drainage tube ends in the upper portion of non-distended stomach, should be advanced 4 cm to move all the side ports beyond the gastroesophageal junction. " e0c2c886-2c0b964a-a4ed5576-ac072930-77fe8cea.jpg,validate/p19/p19054167/s56575488/e0c2c886-2c0b964a-a4ed5576-ac072930-77fe8cea.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are clear of consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 20759d76-47cf0483-cf0a7f8e-6a964ee9-39fe700a.jpg,validate/p11/p11255297/s55626392/20759d76-47cf0483-cf0a7f8e-6a964ee9-39fe700a.jpg,validation," 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. " 2751c294-cda763b1-2a512931-f6acc587-758d5764.jpg,validate/p19/p19600190/s51171905/2751c294-cda763b1-2a512931-f6acc587-758d5764.jpg,validation," 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. " ae9ebfcd-07441067-d15b1b55-c694920a-a7e3a7ac.jpg,validate/p15/p15878234/s58783304/ae9ebfcd-07441067-d15b1b55-c694920a-a7e3a7ac.jpg,validation," WET READ: ___ ___ ___ 11:34 AM Persistent small bilateral pleural effusions, left worse than right. There is mild pulmonary vascular congestion. No significant pneumothorax seen on this portable chest radiograph. NSR WET READ VERSION #1 ___ ___ ___ 12:15 AM Persistent small bilateral pleural effusions, left worse than right. There is mild pulmonary vascular congestion. No significant pneumothorax seen on this portable chest radiograph. NSR ______________________________________________________________________________ FINAL REPORT INDICATION: ___ year old woman with pericardial effusion s/p drain // pneumo? COMPARISON: Radiographs from ___. IMPRESSION: Left-sided pacemaker is unchanged in position. There is again seen bilateral pleural effusions which are moderate in size, left worse than right, and have increased slightly since the prior study. There is mild prominence of the pulmonary interstitial markings without overt pulmonary edema. No pneumothoraces are seen. " c3469580-59c2df32-73601757-2b9e4f01-b4c44dd2.jpg,validate/p13/p13060009/s50912136/c3469580-59c2df32-73601757-2b9e4f01-b4c44dd2.jpg,validation," FINAL REPORT HISTORY: Cough x 2 weeks with developing wheezing and decreased bibasilar breath sounds. COMPARISON: Chest radiographs from ___ and ___. FINDINGS: Given the patient's body habitus, evaluation is extremely limited. Frontal and lateral chest radiographs demonstrate chronic scoliosis and a mildly enlarged cardiac silhouette which is unchanged from prior radiographs. Low lung volumes make evaluation difficult, but a focal opacity in the left lower lung probably represents atelectasis. There is no pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: A left lower lung opacity probably represents atelectasis. " 2a554625-fa0a44a9-e1c769aa-9ae3846b-b6f2b918.jpg,validate/p13/p13201526/s56873814/2a554625-fa0a44a9-e1c769aa-9ae3846b-b6f2b918.jpg,validation," FINAL REPORT INDICATION: Abdominal pain, worse in epigastrium. Please evaluate for acute process. COMPARISON: No prior studies available for comparison. FINDINGS: Frontal and lateral chest radiographs demonstrate unremarkable cardiomediastinal, hilar and cardiac contours. Lungs are clear. No pleural effusion or pneumothorax. No osseous abnormalities evident. IMPRESSION: No acute intrathoracic process. " 49bb1d71-7b5382df-e9e78bf9-52a8df64-699048d8.jpg,validate/p12/p12881468/s54312252/49bb1d71-7b5382df-e9e78bf9-52a8df64-699048d8.jpg,validation," FINAL REPORT HISTORY: Metastatic lung cancer and cough, assess right pleural effusion. COMPARISON: CT of the chest performed on ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The right lung is nearly completely collapsed due to central obstruction and a large pleural effusion. Multiple nodules are present in the left lung, consistent with known metastatic disease. There is no pleural effusion on the left. There is no pneumothorax. Heart size difficult to assess due to intraparenchymal abnormalities. IMPRESSION: Near-complete collapse of the right lung secondary to central obstruction and large pleural effusion. Findings were communicated with Dr. ___ at time of discovery at 11:00 a.m. on ___. " b04c0d4d-f4fa3a80-de4fa6f2-4b16f06e-bf9da2d1.jpg,validate/p13/p13137769/s56315002/b04c0d4d-f4fa3a80-de4fa6f2-4b16f06e-bf9da2d1.jpg,validation," FINAL REPORT INDICATION: ___-year-old with altered mental status. COMPARISON: Chest radiograph, ___, ___. TECHNIQUE: Frontal and lateral views of the chest were obtained. FINDINGS: The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are hypoinflated but clear without focal consolidation. The upper abdomen is unremarkable. IMPRESSION: Low lung volumes with no acute cardiopulmonary process. " a5ac2b20-2b398e60-b12b8f56-f7e58422-b0343e2b.jpg,validate/p14/p14260816/s58011209/a5ac2b20-2b398e60-b12b8f56-f7e58422-b0343e2b.jpg,validation," FINAL REPORT INDICATION: ___ year old diabetic man with recent sinus infection and pneumonia, treated with antibiotic for a week // follow up infiltrate on left TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: New nodular opacities in the right upper and left upper lobes when compared to the prior. The lingular opacity is slightly less conspicuous. The heart is not enlarged. No adenopathy. No pleural effusions or pneumothorax. IMPRESSION: Slight improvement of left lingular opacity with new opacities in the right and left upper lobe, suggestive of worsening bronchopneumonia. " 3a0ddd6b-6f512843-37b729b9-290c845e-f528a646.jpg,validate/p14/p14630468/s53585855/3a0ddd6b-6f512843-37b729b9-290c845e-f528a646.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with history of laryngeal cancer, presenting with shortness of breath. COMPARISON: ___. FINDINGS: Single AP view of the chest. Tracheostomy tube remains in place. The lungs are grossly clear noting limitation due to positioning. The cardiomediastinal silhouette is within normal limits. IMPRESSION: No definite acute cardiopulmonary process noting limitation due to positioning with the lung apices obscured by the patient's face and the bases not well evaluated. " 43a9b5cc-90231c96-79c96e2b-283d868c-dd0a0fcf.jpg,validate/p18/p18532425/s56018474/43a9b5cc-90231c96-79c96e2b-283d868c-dd0a0fcf.jpg,validation," FINAL REPORT INDICATION: ___ year old man s/p OG placement // OG placement COMPARISON: Radiographs from ___. IMPRESSION: There has been placement of a new enteric tube with the distal tip and side port within the body of the stomach. Endotracheal tube and right IJ central line are appropriately sited in unchanged position. There is unchanged cardiomegaly. There are low lung volumes with mild to moderate pulmonary edema. There is likely a small left-sided pleural effusion. No pneumothoraces are identified. " 3a2d7ae7-9f1464b9-9b513377-7025d21c-7ba0279c.jpg,validate/p15/p15370226/s54484849/3a2d7ae7-9f1464b9-9b513377-7025d21c-7ba0279c.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of syncope, malaise 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. Hilar contours are also stable. IMPRESSION: No acute cardiopulmonary process. " 4edfdba2-406f76f2-3885c143-bd7d698b-c6cd6775.jpg,validate/p12/p12694700/s52281534/4edfdba2-406f76f2-3885c143-bd7d698b-c6cd6775.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest AP portable single view. INDICATION: ___-year-old male patient status post attempted internal jugular approach for placement of central venous line. Assess for pneumo or acute cardiopulmonary process. FINDINGS: AP single view of the upper chest was obtained. Available for comparison is the next preceding portable chest examination of ___ with patient in supine position. On the present examination, the patient is extubated. Multiple lines apparently external, are overlying the upper chest. Status post sternotomy and previous bypass surgery appears unchanged. Pulmonary vasculature is not congested. There is no evidence of pneumothorax on either side in the apical areas nor is there evidence of any widening of the superior mediastinum and the aortic arch contour is unchanged in comparison with the previous study. IMPRESSION: Considering that the patient has been partially elevated, this study eliminates the possibility of a pneumothorax on either side. " b409c661-1971022c-76d2cc91-8271f882-36978c52.jpg,validate/p11/p11596519/s57208279/b409c661-1971022c-76d2cc91-8271f882-36978c52.jpg,validation," FINAL REPORT PORTABLE CHEST: ___ HISTORY: ___-year-old female with rapid AFib. FINDINGS: Single portable view of the chest. No prior. The lungs are clear. There is no consolidation or pulmonary vascular congestion. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable. IMPRESSION: No acute cardiopulmonary process. " ef03d757-24a4486a-307dc2cd-72200466-d98ae4c5.jpg,validate/p12/p12176298/s56883651/ef03d757-24a4486a-307dc2cd-72200466-d98ae4c5.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Respiratory distress, right lower lobe consolidation. COMPARISON: ___, 5:46 a.m. FINDINGS: As compared to the previous radiograph, the pre-existing opacity with air-fluid levels, partly pleural and partly parenchymal, has increased in extent and severity. The mediastinal shift towards the right is more extensive than before, suggesting increasing volume loss on the right. On the left, the image is unchanged. No evidence of acute left lung disease. " 5955c287-e9ec1af0-cb91b3bb-870ed80f-cb92f3f3.jpg,validate/p13/p13884635/s54576261/5955c287-e9ec1af0-cb91b3bb-870ed80f-cb92f3f3.jpg,validation," FINAL REPORT INDICATION: ___F with cough x 1 week, productive // pneumonia TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 1bfe44ca-65cfd3f7-2763c4d0-3b3c695f-c6259fdf.jpg,validate/p19/p19262736/s55244913/1bfe44ca-65cfd3f7-2763c4d0-3b3c695f-c6259fdf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with TTP, pna // any interval change? any interval change? IMPRESSION: In comparison with the study of ___, the monitoring and support devices are stable. Little change in the appearance of the bilateral consolidations, especially in the lateral aspect of the mid right lung, consistent with the CT diagnosis of bilateral pneumonia. " 73ebbd4b-2c5ee95f-5364dddd-4bc88497-a04d821e.jpg,validate/p14/p14532362/s56771272/73ebbd4b-2c5ee95f-5364dddd-4bc88497-a04d821e.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. COMPARISON: ___. 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. Moderate-sized hiatal hernia is similar to prior. IMPRESSION: No acute cardiopulmonary process. " 2742c120-3858f166-8c1f3adf-b9b702ab-1b888e28.jpg,validate/p12/p12006266/s59572801/2742c120-3858f166-8c1f3adf-b9b702ab-1b888e28.jpg,validation," FINAL REPORT PORTABLE CHEST ___, ___. COMPARISON: ___ radiograph. FINDINGS: Left pigtail pleural catheter remains in place with apparent slight increase in size of a small left pleural effusion. No evidence of pneumothorax. Moderate layering right pleural effusion is not appreciably changed. Cardiac silhouette remains enlarged, and ___ reflect the provided history of a pericardial effusion. " 934eb3bd-d197cfbb-c5914d52-b39e2bb1-44d5972c.jpg,validate/p16/p16403658/s50406770/934eb3bd-d197cfbb-c5914d52-b39e2bb1-44d5972c.jpg,validation," FINAL REPORT EXAMINATION: Chest x-ray INDICATION: ___ year old woman s/p R thoracotomy with revision of esophagogastric anastomosis s/p ___ removal // Interval change TECHNIQUE: Frontal AP radiograph of the chest. COMPARISON: Compared to prior dated ___. FINDINGS: Small left pleural effusion and left basilar atelectasis, stable from prior. A right chest tube is noted, unchanged in position from prior. Presumed small right pleural effusion. No focal consolidations. Interval removal of the feeding tube and a right mediastinal drain. Left subclavian central venous infusion catheter ends in the distal SVC, unchanged from prior. This preliminary report was reviewed with Dr. ___, ___ radiologist. " 538fae05-c9fdc46f-d9b2da74-e2f74525-138334eb.jpg,validate/p13/p13968659/s57398355/538fae05-c9fdc46f-d9b2da74-e2f74525-138334eb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___. COMPARISON: None. CLINICAL HISTORY: Altered mental status, question pneumonia. FINDINGS: AP upright and lateral views of the chest were provided. Lungs are clear. Heart size appears top normal. Mediastinal contour is normal. Tiny clips project over the lung apex. No large effusion or pneumothorax seen. Bony structures appear intact. " 2c786e36-d11fb7a1-c5097312-4c04a53b-75b4a0d3.jpg,validate/p15/p15023390/s53250361/2c786e36-d11fb7a1-c5097312-4c04a53b-75b4a0d3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cirrhosis s/p transplant, recurrent HCV cirrhosis, here with fevers // Evaluate for infiltrate TECHNIQUE: CHEST (PA AND LAT) COMPARISON: ___ IMPRESSION: Right central venous line tip is at the level of superior SVC. Heart size and mediastinum are stable in appearance. Scoliosis is extensive. Linear area of atelectasis is noted. No pleural effusion or pneumothorax is seen. No definitive focal consolidation to suggest infectious process present " a42f7f34-8d402b3f-d7527ace-1dac8cf5-4a870140.jpg,validate/p16/p16760293/s50930625/a42f7f34-8d402b3f-d7527ace-1dac8cf5-4a870140.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with a right middle lobe mass and right pleural effusion. Assess for interval change. TECHNIQUE: Chest PA and lateral COMPARISON: Multiple prior chest radiographs, most recent from ___. FINDINGS: Unchanged right middle lobe mass and small right pleural effusion. Mild, right basilar atelectasis. Normal cardiomediastinal and hilar contours. IMPRESSION: Unchanged right middle lobe mass and small right pleural effusion with mild right basilar atelectasis. " 20943078-62570d93-a252526b-bf37b3d2-d2fbb927.jpg,validate/p15/p15006805/s53553338/20943078-62570d93-a252526b-bf37b3d2-d2fbb927.jpg,validation," FINAL REPORT INDICATION: ___F with fever and malaise // r/o infiltrate TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without consolidation, effusion or pulmonary edema. Moderate cardiomegaly is again noted as well as an aortic core valve device. Atherosclerotic calcifications are seen at the aortic arch. IMPRESSION: No acute cardiopulmonary process. " 1d024405-bd43f23d-e3c9ea72-036e1e3b-953ff3ea.jpg,validate/p14/p14887088/s54365238/1d024405-bd43f23d-e3c9ea72-036e1e3b-953ff3ea.jpg,validation," FINAL REPORT HISTORY: Newly placed nasogastric tube. COMPARISON: ___. FINDINGS: Single portable radiograph of the chest demonstrates interval placement of a new nasogastric tube which coils in the stomach and the proximal side port is projecting over the stomach. The support and monitoring tubes are otherwise unchanged. Compared to the prior radiograph, there is no other relevant change. IMPRESSION: Satisfactory position of nasogastric tube with proximal side port prjecting over the stomach. " 09b501c2-12e83549-95aa617f-c97752f6-6e736a18.jpg,validate/p14/p14330727/s50913521/09b501c2-12e83549-95aa617f-c97752f6-6e736a18.jpg,validation," FINAL REPORT INDICATION: New cough, wheezing and fever. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ and ___. FINDINGS: There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. Heart is normal size. There is no pulmonary edema. The mediastinal and hilar contours are unremarkable. There are mild degenerative changes of the thoracic spine, marked by loss in disk space height. IMPRESSION: No acute cardiopulmonary process. " 133262ff-84ae9841-0015322d-b9ae8dcf-fc404c80.jpg,validate/p18/p18082575/s51503645/133262ff-84ae9841-0015322d-b9ae8dcf-fc404c80.jpg,validation," FINAL REPORT INDICATION: Productive cough and hemoptysis in a patient status post pneumonectomy for lung cancer. COMPARISON: Multiple chest radiographs, the most recent ___ ___. FINDINGS: PA and lateral views of the chest are reviewed and compared to the prior studies. The patient is status post left pneumonectomy and clips are seen in the region of the left hilus. Fluid and air filled bowel loops project over the left hemithorax. There is left diaphragmatic elevation or eventration, which can be expected post-operatively. Contraction of the left pneumothorax and compensatory expansion of the right lung and minimal mediastinal shift to the left is expected post-operatively. The right lung is clear without focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. The cardiac contour could not be evaluated due to the overlying fluid. IMPRESSION: Clear right lung and expected left post pneumonectomy changes. " cafdc918-59b89ee9-a8e16947-a34c61b8-8f721dd1.jpg,validate/p15/p15160240/s56217047/cafdc918-59b89ee9-a8e16947-a34c61b8-8f721dd1.jpg,validation," 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. " 34a10323-881113ce-bd77fb85-f57b5c48-160f4e7b.jpg,validate/p18/p18517718/s55049074/34a10323-881113ce-bd77fb85-f57b5c48-160f4e7b.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: ___ radiograph. FINDINGS: Nasogastric tube terminates within the stomach. Side port is just below the expected gastroesophageal junction level. Endotracheal tube has been removed. Cardiomediastinal contours are stable in appearance. Mild pulmonary vascular congestion is new. Minimal patchy right basilar opacity has slightly worsened, and left basilar atelectasis has improved. " acb96549-93c495b6-579c19a8-7c2b044a-98dec302.jpg,validate/p10/p10900906/s54676559/acb96549-93c495b6-579c19a8-7c2b044a-98dec302.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with chest pain, to rule out pneumothorax. 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. Bibasilar opacities suggestive of atelectasis are noted. IMPRESSION: No acute cardiopulmonary pathology, especially no pneumothorax. " 7ef08f8b-a9ce9b3e-ca93968d-fa922b4f-096b5e5c.jpg,validate/p15/p15116656/s51567701/7ef08f8b-a9ce9b3e-ca93968d-fa922b4f-096b5e5c.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with crackles in R base and BLE // CHF TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: The patient is significantly rotated. The lung volume is small. No consolidation. No pulmonary edema. Mild pleural effusion on the right is unchanged. No pneumothorax. The cardiomediastinal silhouette is unchanged. The left hemidiaphragm is elevated with early dilated colon underneath. IMPRESSION: No pulmonary edema or pneumonia. " a5b92573-e1c804bd-06b9ba5e-556e5492-2f956816.jpg,validate/p14/p14642407/s54427285/a5b92573-e1c804bd-06b9ba5e-556e5492-2f956816.jpg,validation," FINAL REPORT HISTORY: COPD exacerbation. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Subcentimeter calcified nodular density projecting over the right upper lung likely represents a calcified granuloma. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. Mild compression of the superior endplate of a lower thoracic vertebral body is stable since at least ___. IMPRESSION: No significant interval change. " f9dbd066-ffbec959-9429493c-ae3b9855-0d6ed3b9.jpg,validate/p15/p15914421/s56855866/f9dbd066-ffbec959-9429493c-ae3b9855-0d6ed3b9.jpg,validation," FINAL ADDENDUM ADDENDUM Bibasilar opacities are present, which may correspond to the patient's previous diagnosis of NSIP, however superimposed infection cannot be completely excluded. There is no evidence of pulmonary edema. There has been slight interval enlargement of the cardiac silhouette, which may represent enlarging pericardial effusion, or actual worsening cardiomegaly. These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at 5:22 p.m. on ___, approximately 3 hr after discovery. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with cough and shortness of breath. History of breast cancer on active chemotherapy currently // please evaluate for pneumonia 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. Bibasilar opacities are similar to the prior study, and are most consistent with chronic interstitial changes in the setting of known an SI P. the heart remains enlarged. A Port-A-Cath ends in the right atrium. There is no pneumothorax or pleural effusion. IMPRESSION: No pneumothorax. NOTIFICATION: These findings were discussed with Dr. ___ by Dr. ___ ___ telephone at " 741811fe-d3a0f32c-0f5c16f2-5ab6eace-f84f5233.jpg,validate/p11/p11413236/s50494220/741811fe-d3a0f32c-0f5c16f2-5ab6eace-f84f5233.jpg,validation," FINAL REPORT AP CHEST, 12:11 A.M., ON ___ HISTORY: ___-year-old woman with chest pain, question CHF. IMPRESSION: AP chest compared to ___ and ___: Aside from granulomatous lymph node calcifications in the aortopulmonic window node, cardiomediastinal silhouette is normal. Linear scarring in the left mid lung is longstanding. Lungs are otherwise clear. Infusion port catheter tip projects over the region of the superior cavoatrial junction. No pleural abnormality. " da992078-b5df0bb2-33198e6c-3a0c4e70-559dbe24.jpg,validate/p19/p19041368/s50320476/da992078-b5df0bb2-33198e6c-3a0c4e70-559dbe24.jpg,validation," FINAL REPORT PA AND LATERAL CHEST ON ___ HISTORY: ___-year-old woman with hemoptysis. Rule out lung mass. 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. It should be noted that this study does not constitute a thorough evaluation of the airway, which could be a source of hemoptysis. " 905fa487-3eb0edb0-ba1a6b93-79420137-2ef91e91.jpg,validate/p15/p15676084/s53740618/905fa487-3eb0edb0-ba1a6b93-79420137-2ef91e91.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with minimally invasive esophagectomy and intrathoracic anastomosis. Portable AP radiograph of the chest was reviewed in comparison to ___. The cardiomediastinal appearance is similar, including the right contour created by ___. Bibasilar areas of atelectasis are stable. There is interval decrease in right apical pneumothorax, currently minimal. Subcutaneous air within the right neck is minimal. Small amount of pleural effusion cannot be excluded. " bf139e1b-8e725e9c-2db9cdc9-744e5f2a-81c4cdbf.jpg,validate/p15/p15127507/s50848736/bf139e1b-8e725e9c-2db9cdc9-744e5f2a-81c4cdbf.jpg,validation," FINAL REPORT HISTORY: Weakness. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: The severe cardiomegaly and tortuosity of the thoracic aorta is unchanged. Hilar contours are unremarkable. A focus of retrocardiac opacity seen only on the lateral view could represent either atelectasis or infection. The lungs are otherwise clear. There is no large effusion or pneumothorax. " 1ce77d36-51941075-83b676b6-93f9296a-9b24bab4.jpg,validate/p14/p14644600/s59209988/1ce77d36-51941075-83b676b6-93f9296a-9b24bab4.jpg,validation," FINAL REPORT HISTORY: Cough x5 months. TECHNIQUE: Frontal and lateral chest radiographs were obtained. COMPARISON: Comparison is made 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. The heart size is normal. Mediastinal and hilar contours are normal. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 499a0d0d-4a328b69-8a6eb5d4-b3b5cc2b-8484d545.jpg,validate/p18/p18663902/s59745422/499a0d0d-4a328b69-8a6eb5d4-b3b5cc2b-8484d545.jpg,validation," FINAL REPORT HISTORY: Endotracheal tube, evalaute for re-expansion with positive pressure. COMPARISON: Chest radiograph 4:30 today. FRONTAL CHEST RADIOGRAPH: The PICC terminates in the upper SVC. The endotracheal tube is positioned 4.7 cm above the carina. Enteric tube terminates within the stomach. The lung volumes are improved from prior, however, there is now complete collapse of the left lower lobe. The right upper lobe is better aerated and the opacity in the right lower lobe is improving. A small left pleural effusion is unchanged. Heart size remains normal. No pneumothorax. Findings discussed with Dr. ___ by Dr. ___ at 14:40 on ___ by telephone at the time of discovery. " 129376e9-77b5ea1f-541b12fb-735d9c83-350cd810.jpg,validate/p10/p10203883/s53048846/129376e9-77b5ea1f-541b12fb-735d9c83-350cd810.jpg,validation," 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. " b27f5815-d03e6a60-46400fcb-88b36b5c-f7d2a3ab.jpg,validate/p14/p14916430/s56607168/b27f5815-d03e6a60-46400fcb-88b36b5c-f7d2a3ab.jpg,validation," 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. " 826ada1b-64a13778-2ca8d6e2-1d7cf772-3b869253.jpg,validate/p10/p10670085/s51364386/826ada1b-64a13778-2ca8d6e2-1d7cf772-3b869253.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Possible infected hip wound. Question acute cardiopulmonary process. COMPARISONS: ___. TECHNIQUE: Chest, PA and lateral. FINDINGS: The patient is status post aortic valve replacement and probably coronary artery bypass graft surgery as well as placement of fixation plates along the sternum. The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. A mild background interstitial abnormality appears unchanged. The bones appear demineralized. Mild superior endplate compression deformity along an upper thoracic vertebral body with sclerosis is also unchanged. IMPRESSION: No evidence of acute cardiopulmonary disease. " f202fd6d-5f096790-a9a0acd5-707a9539-0018ffbb.jpg,validate/p13/p13163471/s50505193/f202fd6d-5f096790-a9a0acd5-707a9539-0018ffbb.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with psoriatic arthritis and psoriasis with PICC placement. TECHNIQUE: Semi-erect frontal chest radiograph was obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Right PICC line has been repositioned and ends in the midclavicular region, not within the SVC. No complications including pneumothorax are seen. Continued low lung volumes are seen with atelectatic changes at the lung bases. No consolidation, pleural effusion or pulmonary edema is seen. IMPRESSION: Malpositioned right PICC line ends within the midclavicular region, not within the SVC. No complications including pneumothorax are seen. Findings conveyed to Dr. ___ ___ telephone at approximately 2:30 p.m. on ___ by Dr. ___. " ca7adcf5-4c136c08-dccbff31-d7c21b05-15fa21ac.jpg,validate/p12/p12503315/s57344242/ca7adcf5-4c136c08-dccbff31-d7c21b05-15fa21ac.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R pleural effusion s/p adhesiolysis, chest tube and pleurX placement // chest tube placement TECHNIQUE: AP view of the chest. COMPARISON: Radiographs on ___. FINDINGS: New from the prior examination is a right-sided chest tube. Lung volumes are somewhat low A moderate layering pleural effusion on the right is decreased from the prior examination. Adjacent pulmonary opacities suggest compressive atelectasis. There is a small left pleural effusion, not significantly increased from the prior examination. Scattered left basal opacities are demonstrated and are increased from the prior examination. There is a small right apicalpneumothorax. IMPRESSION: Small right apical pneumothorax. Moderate right layering pleural effusion is decreased from the prior examination status post right chest tube placement. Adjacent pulmonary opacities at the base of the right lung suggests atelectasis however infection should be considered in the appropriate setting. Scattered left basal pulmonary opacities are new and suggest atelectasis. " c44d97d7-d7a7bc60-5c803d1a-3bc7ba72-424d9488.jpg,validate/p10/p10380616/s56732299/c44d97d7-d7a7bc60-5c803d1a-3bc7ba72-424d9488.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with TBM s/p flex bronch/BAL for atelectasis // eval atelectasis COMPARISON: None. FINDINGS: Compared with ___ at 10:06, there is now elevation of the right minor fissure, with increased opacity in the right upper zone. A small right effusion and minimal atelectasis at the right base is again seen. There is minimal opacity at the left lung base, improved, and possible minimal left pleural effusion. Mild vascular plethora may be more pronounced. IMPRESSION: 1. Increased opacity in the right upper zone with elevation of the right minor fissure is compatible with right upper lobe atelectasis. 2. Small right effusion and right base atelectasis is overall similar to the prior film. Retrocardiac opacity has improved. 3. Mild vascular plethora may be more pronounced. " 0e9073a3-e5f071fe-cfebde7e-7333fa03-f6d1d304.jpg,validate/p16/p16796158/s58013238/0e9073a3-e5f071fe-cfebde7e-7333fa03-f6d1d304.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with obstruction, ETT, OG tube // acute process IMPRESSION: In comparison to ___ chest radiograph, a nasogastric tube has apparently been withdrawn, now terminating above the level of the diaphragm with side-port at approximately the T8 vertebral body level. This could be advanced for standard positioning. Distension of the proximal esophagus likely accounts for a rounded lucency in the superior mediastinum extending superiorly into the cervical region. Exam is otherwise remarkable for increasing moderate sized partially layering pleural effusions with adjacent bibasilar atelectasis and or consolidation. " 30fad1c6-30140359-022463b8-b750e8e3-a6a06057.jpg,validate/p19/p19391089/s59537796/30fad1c6-30140359-022463b8-b750e8e3-a6a06057.jpg,validation," 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. " 32d517a7-95ca1a56-8376a60a-a0677ec9-e768c458.jpg,validate/p14/p14246614/s51135452/32d517a7-95ca1a56-8376a60a-a0677ec9-e768c458.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Hypoxic respiratory failure. AP radiograph of the chest was reviewed in comparison to ___ obtained at 02:42 a.m. The ET tube tip is 4.7 cm above the carina. The right internal jugular line tip terminates at the level of cavoatrial junction. The NG tube tip is in the stomach. The heart size and mediastinum are unchanged, enlarged. There is unchanged appearance and maybe a slight interval progression of pulmonary edema. There is definitely worsening in the right lower lobe opacities that might reflect interval aspiration or atelectasis. " e28b25b0-f786ff28-4f2e217a-6809e0b4-4483ad32.jpg,validate/p11/p11648387/s59415575/e28b25b0-f786ff28-4f2e217a-6809e0b4-4483ad32.jpg,validation," FINAL REPORT HISTORY: Cystic fibrosis with hemoptysis. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and chest radiograph ___. FINDINGS: The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. Faint nodular opacities within the right lower lobe persist, but appear less apparent compared to the previous radiographic exam, and correspond to the regions of infection as seen on the prior chest CT. No new areas of focal consolidation are present. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Faint nodular opacities in the right lung base likely correspond to the previously seen regions of infection better seen on the chest CT from ___ but appear improved. No new areas of pneumonia identified. " 2f7338fe-53a15071-cfed21a0-3f11120b-fc12515b.jpg,validate/p16/p16289699/s56150818/2f7338fe-53a15071-cfed21a0-3f11120b-fc12515b.jpg,validation," FINAL REPORT INDICATION: Persistent cough and sputum. Possible right middle lobe atelectasis or pneumonia identified on prior chest radiograph. Evaluation for evolution of pneumonia. TECHNIQUE: AP and lateral chest radiographs. COMPARISON: Multiple priors, most recently ___. FINDINGS: There is continued obscuration of the right heart border consistent with right middle lobe atelectasis. ___ in appearance when compared to ___ is likely due to diffence in lung volumes. Biventricular pacer leads are in standard position. Median sternotomy wires are noted. There is no pleural effusion or pneumothorax. The borders of the cardiomediastinal silhouette are not well visualized. IMPRESSION: Persistent right middle lobe atelectasis, pneumonia is still a possibility. " df129f05-7fadb327-112b438c-e77689d8-e35d7042.jpg,validate/p12/p12168922/s52062551/df129f05-7fadb327-112b438c-e77689d8-e35d7042.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with lightheadedness, question acute process. COMPARISONS: PA and lateral chest radiograph from ___, ___. FINDINGS: PA and lateral chest radiographs are provided. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiac silhouette is top normal. A left chest wall pacemaker is seen with leads in the right atrium and right ventricle. Patient is status post valve replacement. Median sternotomy wires are intact. Patient is status post shoulder arthroplasty. There are no acute skeletal abnormalities. IMPRESSION: No acute cardiothoracic process. " 427f8507-1e514234-dc37e589-0a4f5af4-5a9d1d4a.jpg,validate/p16/p16449190/s54122712/427f8507-1e514234-dc37e589-0a4f5af4-5a9d1d4a.jpg,validation," WET READ: ___ ___ ___ 12:10 AM 1. Since the recent chest CT, there has been interval placement of a chest tube which terminates at the right lung base. The chest tube may be kinked skin entry site, although evaluation is limited on this single frontal view. Clinical correlation is recommended. 2. There has otherwise been little significant interval change. Re- demonstrated loculated right pleural effusion and right basilar parenchymal opacities. 3. Left lung is essentially clear. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o M with PMHx DM and HTN presents with progressively worsening cough and SOB, found to have large R side PNA and ___. // Evaluate chest tube placement Evaluate chest tube placement IMPRESSION: Compared to prior chest radiographs ___. New right pleural drainage catheter projects over the medial right lower chest and mediastinum, sharply folded, could be partially obstructed. Decrease in the volume of partially loculated right pleural effusion is small. Pneumothorax, tiny if any, at the lung base. Left lung grossly clear. Heart size top-normal. No left pleural abnormality. " 693ed88a-84a59073-1343795c-8dfd89d7-2936813b.jpg,validate/p16/p16556728/s51757482/693ed88a-84a59073-1343795c-8dfd89d7-2936813b.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Cough. Cardiomediastinal contours are normal. The lungs are clear. There is no pleural effusion. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 27182dae-cce38414-04030d71-a955bb76-2aea47ac.jpg,validate/p18/p18347925/s55972904/27182dae-cce38414-04030d71-a955bb76-2aea47ac.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Urinary tract infection, questionable pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a preexisting small left pleural effusion has minimally increased in extent (at the occasion of the last examination the patient was after-left-thoracocentesis). Today, however, the effusion is less than on ___, before thoracocentesis. Mild atelectasis in the retrocardiac lung areas but no evidence of recent pneumonia. Unremarkable right hemithorax. A right PICC line is in unchanged position. Unchanged alignment of the sternal wires. Unchanged clips after CABG. " d4c5127b-a0608912-6a106c1a-f96627a3-be547e63.jpg,validate/p18/p18418794/s50997536/d4c5127b-a0608912-6a106c1a-f96627a3-be547e63.jpg,validation," FINAL REPORT INDICATION: Status post NG tube placement, please evaluate position. COMPARISON: Comparison is made to multiple chest radiographs, most recently dated ___, time 11 hours earlier. FINDINGS: There has been interval placement of a nasogastric tube with tip within the stomach. Stable bilateral low lung volumes with left lower, and bilateral upper lung atelectasis. Compared to next preceding study, there has been a slight increase in interstitial pulmonary edema, particularly on the right. Possible small left pleural effusion developing. The cardiomediastinal contours are unchanged. IMPRESSION: NG tube with tip in the stomach. Interval increased mild pulmonary edema. Possible small left pleural effusion. " 33edabf0-82a638c1-e72a9b64-da3e8557-1e4ff8eb.jpg,validate/p18/p18238066/s56728081/33edabf0-82a638c1-e72a9b64-da3e8557-1e4ff8eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ILD // baseline CXR before discharge COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is unchanged evidence of low lung volumes. The extent and distribution of the fibrotic changes bilaterally has not substantially changed. No new focal parenchymal opacities. Moderate cardiomegaly without pulmonary edema. " 7abbd075-c9bddab0-5009df28-8c7e432c-1aaf6757.jpg,validate/p17/p17699605/s50427784/7abbd075-c9bddab0-5009df28-8c7e432c-1aaf6757.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hypoxic respiratory failure // ___ year old woman with hypoxic respiratory failure COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the pre-existing bilateral parenchymal opacities have decreased in extent and severity but are still clearly visible lung volumes remain very low and there is unchanged evidence of mild to moderate pulmonary edema. Borderline size of the cardiac silhouette. The monitoring and support devices are in correct position. " 004d6ca2-556a6a07-349848e0-b2fc4cc1-47ad89e0.jpg,validate/p13/p13479418/s58042247/004d6ca2-556a6a07-349848e0-b2fc4cc1-47ad89e0.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Post-lung cancer, COP. Evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the parenchymal opacity at the right lung base has minimally increased in density but decreased in extent. This suggests the presence of a retractile component or a fibrotic organization. No new parenchymal opacities. Unchanged staple lines after surgery and unchanged right paramediastinal post-surgical changes. Unchanged size of the cardiac silhouette. Unchanged minimal left basal atelectasis. " 45d87786-7e1630f5-f615c1c7-eb3c6131-2a67dc9f.jpg,validate/p16/p16826765/s51127447/45d87786-7e1630f5-f615c1c7-eb3c6131-2a67dc9f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with increased work of breathing. Evaluate for volume overload, acute process. COMPARISON: A series of chest radiographs, most recently from ___ at 14:53. FINDINGS: Support Devices: A nasogastric tube courses through the esophagus, into the stomach, and inferiorly at of field of view. The left costophrenic sulcus is not included on any of the supplied images. Bilateral diffuse and perihilar alveolar opacities consistent with moderate pulmonary edema is worse than on the prior study. There is no pneumothorax or pleural effusion. There is no airspace consolidation. Moderate cardiomegaly is unchanged. IMPRESSION: Moderate pulmonary edema is worse than on the prior studies. " 9c768e3a-f6045a0d-9320f664-e5139271-e4c43d9e.jpg,validate/p13/p13725781/s50783227/9c768e3a-f6045a0d-9320f664-e5139271-e4c43d9e.jpg,validation," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Low lung volumes are present. The heart size is normal. The aorta remains tortuous and diffusely calcified. There is crowding of the bronchovascular structures, and an element of mild pulmonary vascular congestion cannot be completely excluded. Streaky opacities in the lung bases are similar compared to the prior study, and likely reflect atelectasis. No pleural effusion or pneumothorax is present, and no focal consolidation is demonstrated. Cholecystectomy clips are seen in the right upper quadrant of the abdomen. IMPRESSION: Low lung volumes with probable bibasilar atelectasis. Pneumonia in the lung bases, however, cannot be completely excluded. " 2c153ec5-03c62b68-07c54b23-938a7ed8-be1e00a9.jpg,validate/p19/p19372257/s50549242/2c153ec5-03c62b68-07c54b23-938a7ed8-be1e00a9.jpg,validation," FINAL REPORT INDICATION: Concern for pneumonia. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal and lateral chest radiographs. IMPRESSION: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. A right-sided Port-A-Cath terminates at the mid SVC. " 0ac1f98e-e7227557-2b295217-6b4fcc31-66c01f96.jpg,validate/p16/p16286577/s53845585/0ac1f98e-e7227557-2b295217-6b4fcc31-66c01f96.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever/cough // 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. " 4c3bd321-f7fbf46f-f806b02a-ff6b7ff4-906f0ff6.jpg,validate/p15/p15023390/s58158162/4c3bd321-f7fbf46f-f806b02a-ff6b7ff4-906f0ff6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with cough, fever. Evaluate for pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs from ___ FINDINGS: Heterogeneous opacification at the left lung base may represent a developing infection. Otherwise, the lungs are clear. Left upper extremity PICC line terminates in the lower SVC. Cardiomediastinal silhouette is normal. Again seen is a mild rightward curvature of thoracic spine. No pleural effusion or pneumothorax. IMPRESSION: Subtle heterogeneous opacification of the left lung base may represent a developing infection, possibly atypical pneumonia. " 046f9746-22ab2ec1-43516960-3777c09f-05712fae.jpg,validate/p17/p17355193/s51152879/046f9746-22ab2ec1-43516960-3777c09f-05712fae.jpg,validation," FINAL REPORT INDICATION: History of left breast cancer with pain in the left upper back. Evaluate for rib fracture, bone lesions. COMPARISON: Chest radiograph ___. FINDINGS: Clips in the right axilla are unchanged in position. There is mild demineralization of the thoracic spine, but no vertebral compression fractures. There are no visualized rib fractures. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: 1. No compression fractures or visualized rib fractures. 2. No acute cardiopulmonary process. " bcb44519-565a8cb2-79ac55a6-48dc6d36-7c8b8224.jpg,validate/p10/p10842371/s56148807/bcb44519-565a8cb2-79ac55a6-48dc6d36-7c8b8224.jpg,validation," WET READ: ___ ___ ___ 8:34 PM Equivocal rounded opacity over right lung base is likely summation of superimposed structures. No definite consolidation. Slight blunting of right costophrenic angle is compatible with a small pleural effusion. - ___ p_________________________________________________________________________________ FINAL REPORT REASON FOR EXAMINATION: Hepatitis C, assessment before hemodialysis initiation. PA and lateral upright chest radiographs were reviewed with no prior studies available for comparison. Heart size and mediastinum are unremarkable. Lungs are essentially clear. Minimal pleural thickening in the right costophrenic angle is noted. No overt infection is currently seen. " 43854123-1b38a5c3-59196b8c-afb728bb-8818e340.jpg,validate/p14/p14642879/s53717851/43854123-1b38a5c3-59196b8c-afb728bb-8818e340.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dizziness // infection? IMPRESSION: As compared to recent chest radiograph from several hr earlier, there has not been an appreciable change in the appearance of the chest. " 74f148be-b66553f7-738b0fa3-c1585951-1dc98c5f.jpg,validate/p16/p16528352/s58950166/74f148be-b66553f7-738b0fa3-c1585951-1dc98c5f.jpg,validation," FINAL REPORT INDICATION: Increased oxygen requirement and chest tightness suspicious for pneumothorax. TECHNIQUE: Upright AP chest view was read in comparison with multiple prior radiographs with the most recent from ___. FINDINGS: Right-sided PICC line ends at mid SVC. A pleural pigtail catheter is present at right lung base. No significant interval changes in the chest since ___. Opacity at the right lung base which is likely atelectasis and presumed small residual effusion are stable. Left lung is clear. There is an evidence of prior median sternotomy. Sternal sutures are intact. Heart size, mediastinal and hilar contours are normal. No pneumothorax. IMPRESSION: 1. No pneumothorax. 2. Small right lung base atelectasis and presumed small right pleural effusions are unchanged. " 14cd1bd4-377f89d0-9bc94ec9-14198dc4-00eb1c16.jpg,validate/p10/p10250159/s58366619/14cd1bd4-377f89d0-9bc94ec9-14198dc4-00eb1c16.jpg,validation," FINAL REPORT INDICATION: Cough and chest pain. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Cardiac silhouette size is top normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is visualized. No acute osseous abnormalities are seen. IMPRESSION: No acute cardiopulmonary process. " a857fe7e-af4665e6-4ee7186a-9b827a38-a51bbbbf.jpg,validate/p17/p17967970/s51763316/a857fe7e-af4665e6-4ee7186a-9b827a38-a51bbbbf.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with loculated fluid collections, pigtail catheter placement // after d/c of chest tube at 3:30PM TECHNIQUE: AP portable chest radiograph COMPARISON: ___ from earlier in the day FINDINGS: A tracheostomy tube is present. The tip of the right the PICC line extends to the right atrium. There has been interval removal of the right apical pigtail catheter. Surgical clips project over the lateral right hemithorax in addition to chain sutures in the right suprahilar region and left apex. There is a persisting right apical hydropneumothorax. The left lower lobe atelectasis and layering pleural effusion are unchanged. Unchanged nodular opacities throughout the right lung. The size of the cardiac silhouette is within normal limits. IMPRESSION: Interval removal of the right apical pigtail catheter. Persisting right hydropneumothorax. " ae53748f-4ef49916-00706c24-7aee586b-98cf5492.jpg,validate/p16/p16815189/s50794958/ae53748f-4ef49916-00706c24-7aee586b-98cf5492.jpg,validation," FINAL REPORT INDICATION: Subdural hematoma, intubated, evaluate for tube migration. COMPARISON: Comparison is made to chest radiograph performed the same day. FINDINGS: Endotracheal tube terminates 4 cm above the carina. Enteric catheter courses below the left hemidiaphragm and out of view. There is stable cardiomegaly with slight prominence of the azygos vein and perihilar vessels suggestive of mild pulmonary vascular congestion. Multiple right posterolateral likely healed rib fractures identified. No pneumothorax or pleural effusion present. IMPRESSION: Well-positioned endotracheal tube and enteric catheter. Cardiomegaly with mild prominence of the pulmonary vasculature and azygos vein. No overt pulmonary edema. Multiple healed right rib fractures. " 50c30931-83f440d4-72fac0c1-58dffe59-7ec06a41.jpg,validate/p11/p11304916/s53785697/50c30931-83f440d4-72fac0c1-58dffe59-7ec06a41.jpg,validation," WET READ: ___ ___ ___ 3:11 PM No evidence of subdiaphragmatic free air. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with colonoscopy this am presenting with persistent vomiting // free air under diaphragm TECHNIQUE: Semi-upright portable AP radiograph the chest COMPARISON: None available FINDINGS: Lung volumes are low with vascular crowding but no focal airspace opacity. There is no pleural effusion or pneumothorax. Heart size is normal. The mediastinal and hilar contours are normal. There is no evidence of subdiaphragmatic free air. IMPRESSION: No evidence of subdiaphragmatic free air. " ecf4d144-176f682e-dcbac5cf-c8991211-68ee6356.jpg,validate/p15/p15854896/s55583503/ecf4d144-176f682e-dcbac5cf-c8991211-68ee6356.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Lymphoma, postop care, now presenting with shortness of breath. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There has been interval development in small-to-moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation cannot be excluded. Additionally, there is area of opacity in the right upper lung which could be due to infection, aspiration, or even an underlying pulmonary lesion. Slight prominence of the hila may be due to underlying minimal pulmonary vascular engorgement. The cardiac silhouette appears mildly enlarged. IMPRESSION: Bilateral pleural effusions with overlying atelectasis, underlying consolidation cannot be excluded. Additional opacity in the right upper lung could be due to consolidation due to infection, aspiration. However, underlying pulmonary mass is not excluded, most recent priors from ___. Recommend followup to resolution after appropriate treatment. " 738f95f1-36944ea2-0b8ee2f5-a7dfb78b-3b1aa970.jpg,validate/p14/p14388050/s59707541/738f95f1-36944ea2-0b8ee2f5-a7dfb78b-3b1aa970.jpg,validation," FINAL REPORT INDICATION: History: ___F with pulm edema, SOB // eval for pulm edema and possible LLL consolidation TECHNIQUE: Single portable upright AP images chest. COMPARISON: Comparison is made with chest radiographs from earlier the same day, ___, ___, and ___. FINDINGS: The lungs are moderately well-expanded. There is pulmonary edema of at least moderate severity. Opacity in the left lung base likely represents a layering pleural effusion, possibly with some degree of loculation. Coinciding opacity is probably present and compatible with atelectasis. There is a small to moderate right pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is stable from prior exam. Aortic arch calcifications are again noted. Results are similar to the examination from earlier on the same day. IMPRESSION: 1. Opacity in the left lung base likely represents layering pleural effusion, possibly loculated to some extent. Coinciding parenchymal opacity is probably compatible with atelectasis, but cannot rule out an underlying infectious process. 2. Small to moderate right pleural effusion. 3. Moderate to severe pulmonary edema. " 067e11c7-dbd21a55-0cde1c37-480a61eb-8de8e40a.jpg,validate/p14/p14199690/s50280368/067e11c7-dbd21a55-0cde1c37-480a61eb-8de8e40a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with L chronic SDH with MLS. Preoperative evaluation prior to subdural hematoma evacuation. TECHNIQUE: Single portable AP view of the chest. COMPARISON: Chest radiograph from earlier on the same date. FINDINGS: The endotracheal tube tip terminates 5.2 cm above the carina. A nasogastric tube projects in the left upper quadrant in the region of the stomach. Patient is post CABG, denoted by intact median sternotomy wires and mediastinal surgical clips. There is persistent atelectasis in the left lower lobe with a probable small pleural effusion. Right lower lobe opacification has progressed since the prior study, likely due to developing pleural effusion. No new focal consolidation, or pneumothorax. IMPRESSION: 1. Progressing right lower lobe opacification is likely due to developing pleural effusion. No pneumothorax. 2. Persistent left lower lobe atelectasis and probable small pleural effusion. " 959655b1-bb1bbc58-0dffde1d-ceaa560b-365932cb.jpg,validate/p17/p17373149/s59235381/959655b1-bb1bbc58-0dffde1d-ceaa560b-365932cb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M w/sob, please eval for pulm edema or pna // ___M w/sob, please eval for pulm edema or pna TECHNIQUE: Single portable erect AP chest radiograph COMPARISON: ___ FINDINGS: Heart size is top-normal. The aorta is calcified, indicating atherosclerosis. The mediastinal and hilar contours are normal. There is diffuse hazy opacity in the perihilar and lower lung fields, concerning for moderate pulmonary edema. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. IMPRESSION: Moderate pulmonary edema. " 2f2d58ba-5c759c5a-8491aa5e-ce10e0f5-c3c91a0d.jpg,validate/p17/p17782175/s53235072/2f2d58ba-5c759c5a-8491aa5e-ce10e0f5-c3c91a0d.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: 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. The lungs appear clear aside from an unchange linear opacity in the right upper lobe suggesting minor atelectasis or scarring. There are no pleural effusions or pneumothorax. Small osteophytes are similar along the thoracic spine. IMPRESSION: No evidence of acute disease. " 850be1a0-55c6e583-59c14eac-fb1d2f0d-8646cf10.jpg,validate/p13/p13140362/s52567077/850be1a0-55c6e583-59c14eac-fb1d2f0d-8646cf10.jpg,validation," FINAL REPORT INDICATION: Evaluate for pneumonia in a ___-year-old woman with a history of cancer and biopsy, presenting with left breast pain. 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. The visualized upper abdomen is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 94f3ee3f-e8815c30-76e6b513-38093d71-c76c5d80.jpg,validate/p16/p16723173/s51227962/94f3ee3f-e8815c30-76e6b513-38093d71-c76c5d80.jpg,validation," WET READ: ___ ___ ___ 11:52 PM Moderate left pleural effusion has slightly decreased since the study of ___. Lung volumes are low. There is no evidence of pneumothorax. There is chronic elevation of the right hemidiaphragm. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with pleural effusion s/p thoracentesis // eval for PNTX eval for PNTX IMPRESSION: Compared to chest radiographs since ___, most recently ___ and ___. Lung volumes remain quite low moderate left pleural effusion may be slightly smaller but moderate right pleural effusion has increased. There is no pneumothorax. Aside from expected basal atelectasis, lungs are grossly clear. Heart size top-normal. " 5501992b-905c85e8-b46d7d66-18e5d747-e1ee45d1.jpg,validate/p19/p19622824/s52591926/5501992b-905c85e8-b46d7d66-18e5d747-e1ee45d1.jpg,validation," WET READ: ___ ___ ___ 4:23 AM 1. Lentiform opacity projecting over the left lung base is nonspecific and may represent loculated pleural fluid. 2. Retrocardiac opacity is worrisome for pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with ? syncopal episode/AMS. Assess for acute process, attn to PNA TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The lungs are well-expanded. Right lung is clear. A heterogeneous retrocardiac opacity is noted. A well demarcated lentiform opacity within the left lower lobe is best seen on frontal view. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: 1. Lentiform opacity projecting over the left lung base is nonspecific and may represent loculated pleural fluid. 2. Retrocardiac opacity is worrisome for pneumonia. " cb8ef84f-b919235c-f267a480-9bf22ee2-27c9c5c6.jpg,validate/p15/p15835816/s51467155/cb8ef84f-b919235c-f267a480-9bf22ee2-27c9c5c6.jpg,validation," FINAL REPORT INDICATION: History: ___M with dyspnea, abd distention // Please eval for any evidence of infection. Please eval for any evidence of obstruction TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: CT abdomen and pelvis ___. Chest radiograph ___. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. Opacity silhouetting the left heart border represents an epicardial fat pad. The cardiac and mediastinal contours are normal. There is no free air beneath the right hemidiaphragm. IMPRESSION: No acute intrathoracic process. " b70ca30f-031ab44d-b68bbafe-ea603f22-f01c760d.jpg,validate/p18/p18329975/s52092283/b70ca30f-031ab44d-b68bbafe-ea603f22-f01c760d.jpg,validation," 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. " b2b1b7e8-19db0538-b0b4836a-e3d672db-f0272125.jpg,validate/p19/p19457417/s59885886/b2b1b7e8-19db0538-b0b4836a-e3d672db-f0272125.jpg,validation," WET READ: ___ ___ 9:47 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___F with cough and fevers evaluate for infectious process TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs dated ___. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Cardiomediastinal silhouette is within normal limits. IMPRESSION: No acute cardiopulmonary process. " c538b84f-79022534-23b8f547-2e2b9c26-146f8696.jpg,validate/p10/p10313272/s54813518/c538b84f-79022534-23b8f547-2e2b9c26-146f8696.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 2 weeks of non productive cough for 2 weeks following operation // ? infiltrate ? infiltrate IMPRESSION: In comparison with study of ___, there is a dense streak of atelectasis in the right middle lobe. No definite infectious focus or evidence of vascular congestion or pleural effusion. " 7e70e355-6acc7bed-ea9b5e24-4472e53b-4c4cbe9c.jpg,validate/p11/p11779216/s57226903/7e70e355-6acc7bed-ea9b5e24-4472e53b-4c4cbe9c.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with mental status change. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___. CT of the chest from ___. FINDINGS: There is mild-to-moderate cardiomegaly but no pulmonary edema. Mediastinum and hila are normal. There is no pleural effusion and no pneumothorax. Patchy left basilar opacity suggests minor atelectasis. Osseous structures appear unchanged. IMPRESSION: No acute cardiothoracic process. " 7fb3348e-73f283a1-fa01b2f2-88088ea5-f7518b5d.jpg,validate/p16/p16428261/s50599046/7fb3348e-73f283a1-fa01b2f2-88088ea5-f7518b5d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiographs. INDICATION: ___F w/substernal CP, please eval for occult PNA, PTX, wide mediastinum *** WARNING *** Multiple patients with same last name! // ___F w/substernal CP, please eval for occult PNA, PTX, wide mediastinum TECHNIQUE: Chest AP and lateral COMPARISON: ___. FINDINGS: The lungs are well expanded and clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits allowing for AP projection. IMPRESSION: No acute cardiopulmonary process. " 461407ac-c0ee4763-6833dfa4-8456a53b-803ce18a.jpg,validate/p16/p16830155/s50452607/461407ac-c0ee4763-6833dfa4-8456a53b-803ce18a.jpg,validation," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Chest radiograph of ___ and CT chest of the same date. FINDINGS: Single portable view of the chest demonstrates low lung volumes. Moderate cardiomegaly is unchanged. Sternotomy wires and aortic valve prosthesis is in place. Perihilar vascular congestion and mild interstitial pulmonary edema is apparent. Hilar and mediastinal silhouettes are unremarkable. No pneumothorax. Moderate bilateral pleural effusions of ___ have resolved. IMPRESSION: 1. Moderate cardiomegaly, perihilar vascular congestion, and mild interstitial pulmonary edema. 2. Moderate bilateral pleural effusions seen on ___ exam, have resolved. " f769f774-c319e33f-0bda4c66-6a23f23c-62f08d3a.jpg,validate/p15/p15621186/s53052766/f769f774-c319e33f-0bda4c66-6a23f23c-62f08d3a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old gentleman with prostate cancer metastatic to bone and a recent history of proteus and e.coli pyelonephritis on meropenem who presents with hypotension and concern for septic shock with concern for pulmonary source // please assess for interval worsening in pleural effusion or consolidation please assess for interval worsening in pleural effusion or COMPARISON: Chest radiographs temp ___ second through ___. IMPRESSION: Large right pleural effusion has increased, shifting the mediastinum leftward and obscuring much of the right lung. Lung volumes are very low and there is probably perihilar edema in the left lung. There is no pneumothorax. Heart is normal size. Mediastinal venous engorgement reflects elevated central venous pressure or volume. Right jugular line ends in the right brachiocephalic vein. There is no pneumothorax. Ascending thoracic aorta is heavily calcified. " bb8a7c75-16a68e4e-7dbc61fa-889ad668-44bc2527.jpg,validate/p19/p19733656/s53978720/bb8a7c75-16a68e4e-7dbc61fa-889ad668-44bc2527.jpg,validation," FINAL REPORT INDICATION: ___F with MVC, eval for PTX // eval for PTX TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no effusion, consolidation, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No displaced fractures identified. IMPRESSION: No acute cardiopulmonary process. " c6ac320f-cae300c0-c1f381e3-3b1eaf81-56b2edb5.jpg,validate/p18/p18591791/s52533478/c6ac320f-cae300c0-c1f381e3-3b1eaf81-56b2edb5.jpg,validation," 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. " b1061341-916cabb3-b948a723-2438587d-8e82d256.jpg,validate/p13/p13821814/s55152391/b1061341-916cabb3-b948a723-2438587d-8e82d256.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with lymphoma and fever to 102, evaluate for infiltrate. COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is unremarkable. The osseous structures are unremarkable except for mild degenerative changes in the thoracic spine. IMPRESSION: No acute cardiopulmonary process. " 9b56ac77-7464466a-a41f500f-ba1c0ae6-b0621028.jpg,validate/p10/p10763729/s59368186/9b56ac77-7464466a-a41f500f-ba1c0ae6-b0621028.jpg,validation," FINAL REPORT HISTORY: ___-year-old man found down with fever. Evaluation for pneumonia. COMPARISON: Comparison is made to CT of the torso from ___ and radiograph of the chest from ___. FINDINGS: Supine portable radiograph of the chest demonstrates hazy multifocal opacities involving the right upper and lower lobes as well as the left lower lobe which have increased in density since the prior study. The endotracheal and nasogastric tubes are in appropriate position. A right subclavian central venous catheter is unchanged in position, terminating in the low SVC. There is no pneumothorax or pleural effusion. IMPRESSION: Multifocal opacities are concerning for aspiration or bronchopneumonia. The above findings were communicated to Dr. ___ by Dr. ___ ___ telephone at 10:15 am, ___ min after discovery. " fa0a402f-ccab8321-5302a0f2-ec58b1c1-56132c18.jpg,validate/p17/p17846379/s56882969/fa0a402f-ccab8321-5302a0f2-ec58b1c1-56132c18.jpg,validation," FINAL REPORT HISTORY: ET tube placement. FINDINGS: In comparison with the study of ___, there has been placement of an endotracheal tube with its tip above the clavicular level, approximately 9 cm above the carina. Nasogastric tube is in place though the lower margin of the image is above the esophagogastric junction. The diffuse bilateral pulmonary opacifications have increased in severity in the interim. " 487a6199-cc6fe167-57fdf429-f59b2598-d32ca2d3.jpg,validate/p12/p12047910/s50477575/487a6199-cc6fe167-57fdf429-f59b2598-d32ca2d3.jpg,validation," FINAL REPORT INDICATION: ___M with worsening dyspnea after discharge // evaluate for acute process TECHNIQUE: AP and lateral views the chest. COMPARISON: ___ chest x-ray and chest CT. FINDINGS: Lungs are clear without consolidation worrisome for pneumonia. Streaky left basilar opacity is most likely atelectasis. Hiatal hernia is again noted. The cardiomediastinal silhouette is within normal limits. Median sternotomy wires are again noted. Compression deformity in the lower thoracic spine is unchanged. Lumbar posterior disc fixation hardware is partially visualized. IMPRESSION: No acute cardiopulmonary process. " 60aa236d-9a50a92e-604bd125-86d5628e-a30a4112.jpg,validate/p19/p19685014/s59063238/60aa236d-9a50a92e-604bd125-86d5628e-a30a4112.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with transplanted kidney and pancreas, and currently with fever. Portable AP radiograph of the chest was reviewed in comparison to ___. Heart size is mildly enlarged but stable. Mediastinal calcified lymph nodes are unchanged. Lungs are clear except for minimal opacity at the left lower lung adjacent to the left heart border that although might represent atelectasis, in relatively immunosuppressed patients might reflect developing infectious process. In this specific case, correlation with chest CT is recommended. " e803cb3f-9cbe9a52-5ce5792a-18554065-be321309.jpg,validate/p14/p14192743/s54460809/e803cb3f-9cbe9a52-5ce5792a-18554065-be321309.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with multiple myeloma with SOB // Pre-assessment for V/Q scan Pre-assessment for V/Q scan IMPRESSION: In comparison with the study of ___, there is no interval change or evidence of acute cardiopulmonary disease. No pneumonia, vascular congestion, or pleural effusion. No evident abnormality in the thoracic spine. " 0bbdd472-0f368740-f0b7ea5d-a09096a7-892a7eb9.jpg,validate/p16/p16645602/s57875591/0bbdd472-0f368740-f0b7ea5d-a09096a7-892a7eb9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with s/p RIJ // eval line placement TECHNIQUE: Chest single view COMPARISON: ___ at 17:29 FINDINGS: Right IJ central line tip in the mid SVC, new since prior exam. No pneumothorax. Shallow inspiration accentuates heart size, pulmonary vascularity. Electronic device projected over left chest, with lead extending over the left neck. Left lower lobe consolidation, likely from atelectasis, similar. There are small bilateral pleural effusions, more apparent. Probably mildly prominent pulmonary vascularity, similar. Degenerative arthritis bilateral shoulders. Enteric tube tip is in the proximal stomach. IMPRESSION: Right IJ central line tip in the mid SVC. No pneumothorax. " f75a34ee-2ec18092-898384f5-687d2992-d11c5367.jpg,validate/p11/p11655748/s53271964/f75a34ee-2ec18092-898384f5-687d2992-d11c5367.jpg,validation," 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. " 6357a120-aeb6c6b4-daa98db4-2c6b1402-8155d484.jpg,validate/p10/p10494089/s57123798/6357a120-aeb6c6b4-daa98db4-2c6b1402-8155d484.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with septic shock worsening O2 requirement, clear anterior exam, but ?ARDS // please evaluate for acute change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Borderline size of the cardiac silhouette. No pulmonary edema. No pneumonia, no pleural effusions. The policyclic mildly enlarged right hilus is seen in unchanged manner. " b155ef7f-d8155f05-6e1d4ad6-ff9ca130-827e6153.jpg,validate/p18/p18238066/s52034443/b155ef7f-d8155f05-6e1d4ad6-ff9ca130-827e6153.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with IPF s/p R VATS wedge // ? interval change **6AM MICU ROUNDS PLEASE** COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient continues to be intubated and still carries the right chest tube. There is no pneumothorax. The pre-existing parenchymal opacities are still widespread an extensive but have decreased in severity as compared to the previous image. Moderate cardiomegaly persists. Gastric overinflation could be alleviated by a nasogastric tube. " 89ac4c48-743ebeaf-a59aac66-9d8b14be-7fd16509.jpg,validate/p17/p17983733/s57502926/89ac4c48-743ebeaf-a59aac66-9d8b14be-7fd16509.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Heart size is top normal. Mediastinal and hilar contours are within normal limits. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary abnormality. " d870d41f-163edb20-145c107e-a78a2701-44d02fbb.jpg,validate/p15/p15103276/s56445234/d870d41f-163edb20-145c107e-a78a2701-44d02fbb.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: ___. FINDINGS: PA and lateral chest radiographs demonstrate no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. IMPRESSION: No acute cardiopulmonary process. " 222a49a1-b7064d85-1599ccaa-cb0608f1-40096836.jpg,validate/p13/p13462065/s57505091/222a49a1-b7064d85-1599ccaa-cb0608f1-40096836.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated postop // eval ett placement eval ett placement IMPRESSION: In comparison with the study of ___, there is an placement of an endotracheal tube with its tip at the clavicular level, approximately 6 cm above the carina. Dobhoff tube extends to the third portion of the duodenum. Nasogastric tube extends to the upper stomach with the side port in the lower esophagus. Right IJ catheter extends to the mid portion of the SVC. There is hazy opacification silhouetting the hemidiaphragm on the left, consistent with pleural fluid and mild atelectatic changes. " 0118e62c-6302ba87-08abd0d6-67144191-87813b1f.jpg,validate/p12/p12668116/s52789592/0118e62c-6302ba87-08abd0d6-67144191-87813b1f.jpg,validation," 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. " 7dd48ae0-1639556a-e2a4bf0e-86ef040b-4ebcd705.jpg,validate/p18/p18982058/s57846850/7dd48ae0-1639556a-e2a4bf0e-86ef040b-4ebcd705.jpg,validation," FINAL REPORT INDICATION: Fevers and cough. COMPARISON: None available. FINDINGS: Frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. IMPRESSION: Normal chest radiograph. " 281131ce-6bf9157d-ba6f82cf-5d8075b3-58af43d9.jpg,validate/p11/p11875773/s56439455/281131ce-6bf9157d-ba6f82cf-5d8075b3-58af43d9.jpg,validation," 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. " 7e8bcf4a-a99bc3d4-17579924-939783df-4228e52e.jpg,validate/p17/p17201534/s58404111/7e8bcf4a-a99bc3d4-17579924-939783df-4228e52e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p emerg AVR(___ tiss Trifecta)MVr(___ ring)___ w/ new increasing O2 requirement // intrapulmonary process? intrapulmonary process? IMPRESSION: Compared to chest radiographs ___ through ___. Moderately severe pulmonary edema was previously distributed relatively evenly throughout the lungs, has now improved in the right upper lung. Left lower lobe consolidation is substantially more pronounced and there is more edema in the left lower lung. Left lower lobe collapse is more likely than pneumonia, and either could be responsible for new hypoxia. Small pleural effusion on the left has increased. No pneumothorax. Heart size normal and mediastinal vasculature is not engorged. Right PIC line passes as far as the upper SVC where it is obscured by spinal hardware. " 010fe84e-3c0f843f-e4b14c6b-9b42579f-26dd992a.jpg,validate/p15/p15776043/s59332320/010fe84e-3c0f843f-e4b14c6b-9b42579f-26dd992a.jpg,validation," FINAL REPORT INDICATION: ___F with confusion // PNA? COMPARISON: None. TECHNIQUE: Frontal and lateral views of the chest. FINDINGS: The heart size is mildly enlarged. Upper mediastinal contours are unremarkable. Sternotomy wires and mediastinal clips are intact. Low lung volumes. Streaky left base opacity is consistent with atelectasis though infection cannot be entirely excluded. No substantial pleural effusion or pneumothorax. Chronic right rib fractures. IMPRESSION: Mild cardiomegaly with streaky left base opacity most consistent with atelectasis, though infection cannot be excluded. " 8dbfa9ea-fe23201e-7782c6cd-3e459ab8-b94b1330.jpg,validate/p14/p14888722/s52896433/8dbfa9ea-fe23201e-7782c6cd-3e459ab8-b94b1330.jpg,validation," WET READ: ___ ___ 8:08 AM Interval placement of a Dobbhoff feeding tube with the tip projecting over the left upper quadrant. Low lung volumes, bilateral parenchymal opacities, cardiomegaly, and central pulmonary vascular congestion are unchanged from prior examination. WET READ VERSION #1 ___ ___ ___ 7:23 PM Interval placement of a Dobbhoff feeding tube with the tip projecting over the left upper quadrant. Low lung volumes, bilateral parenchymal opacities, cardiomegaly, and central pulmonary vascular congestion are unchanged from prior examination. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F w/ IPH s/p decompression and now s/p dobhoff placement // Confirm dobhoff placement COMPARISON: ___ IMPRESSION: Interval placement of a Dobbhoff feeding tube with the tip terminating in the distal stomach. Low lung volumes, bilateral parenchymal opacities, cardiomegaly, bilateral pleural effusion and pulmonary vascular congestion persist. Overall appearance is similar except for slight worsening of opacification at the right lung base. " e07400ff-e28e43f2-1c17eb10-88cb0d07-04916fb5.jpg,validate/p16/p16218486/s55817037/e07400ff-e28e43f2-1c17eb10-88cb0d07-04916fb5.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with central venous line placement. COMPARISON: ___ and ___. FINDINGS: Single supine view of the chest. There is a left central venous catheter with tip in the upper SVC. There is persistent elevation of the right hemidiaphragm which is unchanged. There is no large confluent consolidation. Cardiomediastinal silhouette is unchanged. Atherosclerotic calcifications seen at the aortic arch. IMPRESSION: Left central venous catheter with tip in the upper SVC. No evidence of pneumothorax based on this supine film. " 121f47c5-a95accaa-7b85c78e-6f91d02b-8290efd0.jpg,validate/p16/p16454913/s58168648/121f47c5-a95accaa-7b85c78e-6f91d02b-8290efd0.jpg,validation," FINAL REPORT AP CHEST, 10:52 A.M., ___ HISTORY: ___-year-old man with fever and gram-negative rods in his sputum. IMPRESSION: AP chest compared to ___ through ___: Left lower lobe has been intermittently consolidated, partially reexpanded on ___, subsequently consolidated again. Whether this is due to pneumonia or collapse is radiographically indeterminate. Most of the increased radiopacity throughout the right lung is due to a combination of edema and pleural effusion on that side. Small amount of pleural effusion is present on the left. Left supraclavicular central venous catheters all end in the mid-to-low SVC. No pneumothorax. " ea444a2c-65aa6cf2-d7cae1cc-05e8a7b7-5f6b6342.jpg,validate/p11/p11856988/s58296885/ea444a2c-65aa6cf2-d7cae1cc-05e8a7b7-5f6b6342.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with lower extremity edema and increasing shortness of breath. Assess for CHF. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs demonstrate unchanged hyperexpansion of the lungs, with new opacity seen in the lingula. There is no pleural effusion, or pneumothorax. The cardiac silhouette remains mildly enlarged, the mediastinal contours are normal with the exception of calcification of the aortic knob. The pulmonary vasculature is normal. IMPRESSION: 1. No CHF. 2. Increased lingular opacity likely atelectasis. As there is no explanation for this, further evaluation with CT is recommended to exclude an obstructive mass. Findings were entered into the radiology web-based results reporting tool for clinician notification. " 8c9ab6f1-5a8bdf21-21b803d0-af375dcd-f406b65f.jpg,validate/p19/p19821643/s50505499/8c9ab6f1-5a8bdf21-21b803d0-af375dcd-f406b65f.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with a history of cancer presenting with bilateral lower extremity edema and abdominal pain, found avenue pancreatic mass. Evaluate for mass/mets, cardiomegaly, pulm edema. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph dated ___. FINDINGS: A right subclavian approach Port-A-Cath tip is new and its tip projects over the expected region of the distal left brachiocephalic vein just at its confluence with the SVC. The lungs are hyperexpanded and hyperlucent, consistent with emphysema. No pneumothorax, pleural effusion, or focal consolidation. The heart is mildly enlarged, increased from the prior exam. There is pulmonary vascular congestion but no over pulmonary edema. Prominent reticular scarring at the bilateral apices is probably similar to the prior exam and better characterized on the prior chest CT. No obvious pulmonary mass. No acute osseous abnormality. IMPRESSION: 1. Right Port-A-Cath tip ends in the left brachiocephalic vein just prior to the SVC confluence. 2. No obvious pulmonary mass. Given the patient's history, dedicated Chest CT would be recommended evaluate for metastatic lesions. 3. Persistent prominently biapical calcified micronodular pattern, better characterized on the prior chest CT from ___. 4. Emphysema. 5. Mild cardiomegaly and pulmonary vascular congestion but no overt edema. " 93856583-5f5939dc-628fbc10-f2f948ea-fb5275a5.jpg,validate/p19/p19774071/s52142104/93856583-5f5939dc-628fbc10-f2f948ea-fb5275a5.jpg,validation," WET READ: ___ ___ 8:20 AM Endotracheal tube with the tip projecting approximately 1.7 cm above the level carina. WET READ VERSION #1 ___ ___ ___ 7:19 PM Endotracheal tube with the tip projecting approximately 1.7 cm above the level carina. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with cancer, cerebellar mets/bleed // Tube positioning COMPARISON: No comparison IMPRESSION: The patient is intubated. The tip of the endotracheal tube projects approximately 1.7 cm above the carina, the tube could be pulled back by 1-2 cm. The tip of the nasogastric tube is not visualized on the image. Low lung volumes. Mild bilateral areas of atelectasis. No overt pulmonary edema. No pleural effusions. No pneumonia. " bceb52b7-b675646d-64d949f0-970cc58d-3c55fd8c.jpg,validate/p12/p12595468/s58901891/bceb52b7-b675646d-64d949f0-970cc58d-3c55fd8c.jpg,validation," 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. " 47cd2682-8cf3b5fd-f10f4b0f-3b4767dc-4c26e8cf.jpg,validate/p12/p12479159/s57789644/47cd2682-8cf3b5fd-f10f4b0f-3b4767dc-4c26e8cf.jpg,validation," 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. " 89e64056-bbbcfb3f-853e2b24-ea34a882-497f0993.jpg,validate/p14/p14042492/s53633383/89e64056-bbbcfb3f-853e2b24-ea34a882-497f0993.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with shortness of breath and lower extremity edema. COMPARISON: None. FINDINGS: AP and lateral views of the chest. There are diffuse bilateral parenchymal opacities sparing the periphery of the lungs. There are small bilateral pleural effusions. Moderate cardiomegaly is noted. No acute osseous abnormalities detected. IMPRESSION: Small bilateral effusions and bilateral parenchymal opacities most suggestive of moderate pulmonary edema. " d371081c-a0a78b39-229e6eaf-dcb0bdb5-62232f8e.jpg,validate/p10/p10785570/s50421224/d371081c-a0a78b39-229e6eaf-dcb0bdb5-62232f8e.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: ___-year-old woman with history of breast cancer on chemo now w fever, productive cough TECHNIQUE: AP upright 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. Mild degenerative spurring noted in the thoracic spine. Surgical clips project over the left axillary region and along the left chest wall. Orthopedic screws are noted in the head of the left humerus. IMPRESSION: No acute intrathoracic process. " 524dfaa3-0ad8a79f-294ce89c-f5c9b859-1fee708d.jpg,validate/p16/p16514111/s58711390/524dfaa3-0ad8a79f-294ce89c-f5c9b859-1fee708d.jpg,validation," FINAL REPORT INDICATION: ___ year old man with productive cough X 2 weeks. Denies fever or chills. Is s/p liver transplant. // Pt with productive cough X 2 weeks. He has had a liver transplant EXAMINATION: CHEST (PA AND LAT) TECHNIQUE: Chest radiograph, PA and lateral views COMPARISON: Chest radiograph ___ FINDINGS: There is opacity in the right lower lobe silhouetting posterior aspect of right hemidiaphragm on lateral view. This may be atelectasis, however pneumonia as possible in correct clinical setting. There is no pulmonary edema or pleural effusion. Borderline enlarged cardiac silhouette is smaller compared to ___. IMPRESSION: There is opacity in the right lower lobe silhouetting posterior aspect of right hemidiaphragm on lateral view. This may be atelectasis, however pneumonia as possible in correct clinical setting. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:00 PM. " 796d7212-f7d31a55-039c32d4-82ac3d79-f7a7b7e6.jpg,validate/p13/p13471464/s53976577/796d7212-f7d31a55-039c32d4-82ac3d79-f7a7b7e6.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after mitral valve ring replacement with bilateral pneumothorax, followup. AP and lateral radiographs of the chest were reviewed in comparison to ___. Currently, there is still present bilateral apical pneumothorax, minimal and unchanged since the prior study. Left retrocardiac opacity is unchanged, associated with small-to-moderate amount of bilateral pleural effusion. The mitral valve ring is in expected position and orientation. There is no evidence of pulmonary edema. " f9c4dfb6-7bbaccc5-1975ba46-30fdb4a5-24d5763b.jpg,validate/p18/p18539425/s54573027/f9c4dfb6-7bbaccc5-1975ba46-30fdb4a5-24d5763b.jpg,validation," 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. " 66b6b97e-59793595-aa9d2484-a46e1b68-ebfa24a1.jpg,validate/p13/p13153210/s57633590/66b6b97e-59793595-aa9d2484-a46e1b68-ebfa24a1.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with cough and chills. Evaluate for pulmonary infiltrate. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The lungs are well expanded and clear. The cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. IMPRESSION: Unremarkable chest radiographic examination. " e52a8810-8570761e-d59e0a63-9e248aec-e8c731d4.jpg,validate/p11/p11504637/s55266525/e52a8810-8570761e-d59e0a63-9e248aec-e8c731d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with pleuritic L sided chest pain, Hx PE 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. " 212059c4-acd8deeb-f384d299-54d6b1be-d5fce371.jpg,validate/p19/p19297678/s54124489/212059c4-acd8deeb-f384d299-54d6b1be-d5fce371.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pAfib and presents with new onset heart failure symptoms. // Assess for pulmonary edema FINDINGS: As compared to ___ radiograph, with mild cardiomegaly has slightly increased, and is accompanied by pulmonary vascular congestion, interstitial edema and small bilateral pleural effusions. Focal opacity in right lower lobe partially obscures the posterior right hemidiaphragm. IMPRESSION: Congestive heart failure with interstitial edema and small pleural effusions. Focal right basilar opacity could reflect atelectasis or aspiration, but followup radiographs after diuresis may be helpful to exclude a developing pneumonia at the site if warranted clinically. " 80b4377b-2c25de62-0a57bf2d-407421c7-24f629e9.jpg,validate/p17/p17469778/s55474034/80b4377b-2c25de62-0a57bf2d-407421c7-24f629e9.jpg,validation," FINAL REPORT HISTORY: Strep pneumonia with intubation. FINDINGS: In comparison with the study of ___, there has been placement of a large-bore catheter from the right IJ region that extends into the right atrium. Otherwise, the monitoring and support devices are essentially unchanged. Hazy opacification in the left hemithorax is consistent with substantial volume loss in the left lower lobe with some layering pleural effusion. Mild atelectatic changes are again seen at the right base. Cardiomediastinal silhouette is unchanged. " 77cb6858-2c5fec56-095891b1-21a0671f-a30cc7b5.jpg,validate/p14/p14328661/s54671241/77cb6858-2c5fec56-095891b1-21a0671f-a30cc7b5.jpg,validation," FINAL REPORT INDICATION: History: ___M with fever s/p ERCP // evaluate for free, air, stent migration, pneumonia 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. The right hemidiaphragm is elevated, unchanged since ___. Two overlapping stents project over the right upper quadrant. There is no free air, pneumatosis or portal venous gas identified. The bowel gas pattern is non-obstructive. IMPRESSION: No pneumonia or free air. Two overlapping stents project over the right upper quadrant. " 212002f7-735a1cc7-027b55c8-590e6303-79badc3d.jpg,validate/p12/p12907787/s58362414/212002f7-735a1cc7-027b55c8-590e6303-79badc3d.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient, questionable bilateral pneumonia and new history of left-sided breast cancer. FINDINGS: PA and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar PA and lateral chest examination of ___. The heart size is normal. No configurational abnormality is seen. Thoracic aorta of ordinary ___ and without local contour abnormalities. No mediastinal abnormalities are present. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are seen, and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area. Skeletal structures of the thorax grossly unremarkable but noted is a straight back configuration in the thoracic spine resulting in a relatively low depth diameter of the chest. IMPRESSION: Stable chest findings, no evidence of acute pulmonary infiltrates, pleural abnormalities or pneumothorax in this ___-year-old female patient with newly diagnosed left-sided breast cancer. " 18cfeead-2f7d2167-1740fa9f-94b33fd2-d730d2db.jpg,validate/p10/p10570398/s52416758/18cfeead-2f7d2167-1740fa9f-94b33fd2-d730d2db.jpg,validation," FINAL REPORT PA AND LATERAL VIEWS OF THE CHEST REASON FOR EXAM: Preop evaluation patient with severe AS and CAD. Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. Moderate degenerative changes in the thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary abnormality. " 80ef46ef-dfb91c05-e53b5ac6-a4f9f0da-7d94bea7.jpg,validate/p18/p18734362/s56377156/80ef46ef-dfb91c05-e53b5ac6-a4f9f0da-7d94bea7.jpg,validation," WET READ: ___ ___ ___ 12:42 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT HISTORY: Dyspnea and cough. COMPARISON: Multiple prior chest radiographs from ___ to ___. CT-Chest, ___. FINDINGS: PA and lateral chest radiographs again demonstrate mild hyperexpansion. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Old healed left lateral rib fractures again seen. IMPRESSION: No acute cardiopulmonary process. " 2cae120e-54fcd7b2-551b2c6a-929a72fc-2e34ac71.jpg,validate/p17/p17981107/s59287920/2cae120e-54fcd7b2-551b2c6a-929a72fc-2e34ac71.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Metastatic lung cancer, history of bilateral pulmonary embolism, chest pain. PA and lateral upright chest radiographs were reviewed in comparison to prior study obtained the same day earlier on ___. Heart size and mediastinum are unchanged in contour. Hilar mass and left linear atelectasis are unchanged. Left lower lung posterior opacity is better appreciated on the lateral view projecting over the spine. Although findings may potentially represent cavitating pulmonary infarct, infectious process in this patient is a possibility. This finding corresponds to previously seen opacity in this location on the prior scan, but an infarct should be resolved within a month's period of time unless the current pulmonary embolism is expected. Correlation with patient's symptoms is recommended. " 0857da58-bec12116-51f04fa4-1f3979b5-ea29007d.jpg,validate/p11/p11084559/s54297915/0857da58-bec12116-51f04fa4-1f3979b5-ea29007d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with sob // any pulmonary edema? TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: Compared with prior radiographs on ___, there is no significant change.The lungs are clear without focal consolidation. There is no vascular congestion or pulmonary edema. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No pulmonary edema or other acute cardiopulmonary process. " 1d031536-80da553d-e9e02a6f-2ac68f1f-fb88d1d6.jpg,validate/p17/p17595027/s55698219/1d031536-80da553d-e9e02a6f-2ac68f1f-fb88d1d6.jpg,validation," FINAL REPORT HISTORY: Seizures, intubated with pneumonia, hypoxia and volume overload. COMPARISON: Chest radiograph ___, ___ through ___. FINDINGS AND IMPRESSION: A frontal semi upright view of the chest was obtained portably. The endotracheal tube ends 6.8 cm above the carina and could be advanced for better seating. The oral gastric tube ends in the stomach with the side port at the gastroesophageal junction and could be advanced. The left PICC ends in the upper SVC. Low lung volumes results in bronchovascular crowding. Bibasilar atelectasis has improved, but persists. Pulmonary edema has improved. Cardiac and mediastinal silhouettes are stable. No pneumothorax. " 411c6152-40796dde-feb6417f-c139f7a3-374d98dd.jpg,validate/p10/p10420821/s51415099/411c6152-40796dde-feb6417f-c139f7a3-374d98dd.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Comparison is made with a prior chest radiograph from ___. CLINICAL HISTORY: Chest pain and dyspnea. Assess pulmonary edema. FINDINGS: Portable upright AP chest radiograph obtained. Dual-lead pacer is unchanged in position. Lung volumes are similar to prior with interval development of mild interstitial edema. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact. IMPRESSION: Mild interstitial edema, new from prior. " c9b856bc-37e4590d-4226ac37-31e95780-a71888e5.jpg,validate/p16/p16074678/s56574143/c9b856bc-37e4590d-4226ac37-31e95780-a71888e5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M 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. // ?interval change ?interval change COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Severe enlargement of the cardiac silhouette and distension of mediastinal vasculature has worsened. Low lung volumes exaggerates what is probably mild pulmonary edema. ET tube, nasogastric drainage tube, left jugular central venous catheter are in standard placements respectively. " fee2d6b0-54933743-089a5a1d-11c1255c-c9ee8e5a.jpg,validate/p17/p17237809/s55969425/fee2d6b0-54933743-089a5a1d-11c1255c-c9ee8e5a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IPH // Interval changes Interval changes IMPRESSION: Compared to chest radiographs since ___, most recently ___. Diminished aeration in the left lower lobe did not improve between ___ and ___. Therefore today's appearance of substantial atelectasis is probably chronic. The new or increased accompanying left pleural effusion is moderate size and could be due to the chronic atelectasis. Moderate to severe cardiomegaly is also long-standing. There is however no evidence of cardiac decompensation. No pneumothorax. ET tube in standard placement. Nasogastric drainage tube can be traced as far as the lower esophagus but the tip is not seen. " eae8a230-6f27c378-9d9addfc-aa5f6cd9-d59289f2.jpg,validate/p15/p15743476/s52043354/eae8a230-6f27c378-9d9addfc-aa5f6cd9-d59289f2.jpg,validation," FINAL REPORT INDICATION: ___M with fever, IVDU, lives in shelters. TECHNIQUE: Chest PA and lateral. COMPARISON: None. FINDINGS: The lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. No acute osseous abnormality. IMPRESSION: No acute intrathoracic process. " a59b0674-afceb0fd-18370440-56f167d9-d1e329c1.jpg,validate/p10/p10775272/s55252968/a59b0674-afceb0fd-18370440-56f167d9-d1e329c1.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with left sided CP // 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. " e4392dee-cf5b2e77-6f9c0cc1-03acb25d-d867c843.jpg,validate/p16/p16505949/s56269295/e4392dee-cf5b2e77-6f9c0cc1-03acb25d-d867c843.jpg,validation," WET READ: ___ ___ ___ 2:55 PM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: ___M with right arm weakness, evaluate for pneumonia, vessel occlusion. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. No triangular opacity to suggest pulmonary infarct. The cardiomediastinal silhouette is within normal limits. Background hyperinflation is noted. IMPRESSION: No acute pulmonary process identified. Please note that presence or absence of venous thrombosis cannot be assessed based on radiographs. " 2ada43bf-5bbd1f98-bc0bcc11-c3aad42f-544c259e.jpg,validate/p14/p14310346/s58012557/2ada43bf-5bbd1f98-bc0bcc11-c3aad42f-544c259e.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old female with left chest wall pain after sneezing. Question pneumothorax. FINDINGS: PA and lateral views of the chest are compared to previous exam from ___. The lungs are clear of focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are again notable for wedge deformity of likely the L1 vertebral body. IMPRESSION: No acute cardiopulmonary process. No pneumothorax. " 7fb53d14-ba44bff3-e0668ba8-0a1309ae-77d733ee.jpg,validate/p11/p11826927/s54383535/7fb53d14-ba44bff3-e0668ba8-0a1309ae-77d733ee.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: ___-year-old female with HIV, feeling unwell, hypotensive, assess pneumonia. FINDINGS: AP and lateral views of the chest were provided. A dialysis catheter is seen extending from the level of the IVC into the right atrium. Patient is slightly rotated to her right on the frontal projection, limiting evaluation. Allowing for this, the lungs appear clear. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette appears grossly within normal limits. A vascular stent is seen in the left axilla adjacent to a hyperdense tubular structure in the left upper arm, likely an old AV fistula. IMPRESSION: No acute findings in the chest. " a98a3b91-a36e03e7-693e7fe9-4737d551-ba155724.jpg,validate/p12/p12450697/s54970628/a98a3b91-a36e03e7-693e7fe9-4737d551-ba155724.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent CABG and hospitalization, h/o recurrent aspiration pneumonia and presents with Afib with RVR and found to have leukocytosis and thrombocytosis. // eval for infection COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the opacity at the right lung base has substantially improved. Small remnant basal right atelectasis. Unchanged extent of the left pleural effusion and the subsequent atelectasis. The alignment of the sternal wires is constant. Removal of the right internal jugular vein catheter. No pulmonary edema. No pneumothorax. " f2dc1105-448281de-64abcb38-b8557efe-25470b50.jpg,validate/p19/p19143018/s59815903/f2dc1105-448281de-64abcb38-b8557efe-25470b50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with hematemesis now s/p intubation. // please evaluate for ET tube placement and intraparenchymal process. TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: ET tube is in standard position. Cardiac size is top-normal. Bibasilar opacities consistent with atelectasis are larger on the left side. There is no pneumothorax or pleural effusion. " b09e8cb2-d3ce586b-382aca6f-77a50e23-fa673758.jpg,validate/p12/p12722192/s52681022/b09e8cb2-d3ce586b-382aca6f-77a50e23-fa673758.jpg,validation," FINAL REPORT HISTORY: On chemotherapy with cough. History of myeloma. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph and PET-CT ___. FINDINGS: Heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vasculature is not engorged. Minimal patchy opacity in the left lower lobe likely reflects atelectasis and appears similar compared to the prior radiograph. The right lung is clear. There is no pneumothorax or pleural effusion. Compression fracture of a low thoracic vertebral body is unchanged as are expansile lesions involving the left 8th rib posteriorly. Additionally, deformity of the right clavicular head is unchanged and compatible with known myeloma. Clips from prior cholecystectomy are noted in the right upper quadrant of the abdomen. IMPRESSION: Left lower lobe patchy opacity, likely atelectasis. Multiple osseous lesions compatible with known myeloma, better demonstrated on the PET-CT from ___. " 34ed6dc3-1c80f136-84453814-1dc69673-2a8299ce.jpg,validate/p17/p17451713/s58389209/34ed6dc3-1c80f136-84453814-1dc69673-2a8299ce.jpg,validation," FINAL REPORT HISTORY: Nausea. TECHNIQUE: AP upright and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are quite hyperinflated, as was also seen previously, suggesting chronic obstructive pulmonary disease. Right greater than left biapical pleural thickening is again seen. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Thoracic dextroscoliosis is seen. Surgical clips are again seen projecting over the right lower hemi thorax. IMPRESSION: No acute cardiopulmonary process. COPD. " fe7fcf8a-81b6ee31-13249343-abea3a4e-3edf773e.jpg,validate/p17/p17347760/s59493834/fe7fcf8a-81b6ee31-13249343-abea3a4e-3edf773e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old female with CHF (EF ___%), CAD (s/p stent in ___ at ___), atrial fibrillation on Coumadin, and Alzheimer's Dementia who presents as a transfer from ___ with worsening dyspnea, fatigue, and lower extremity swelling, hypotension and bradycardia found to have a unilateral effusion with concern for malignancy. // reaccumulation of effusion? COMPARISON: ___ at 14:10. ___ at 10:08 FINDINGS: Compared with ___, retrocardiac opacity with may have increased slightly, consistent with increased left lower lobe collapse and/or consolidation. There is also slight blunting of left costophrenic angle which is more pronounced and could reflect an accumulating small left pleural effusion. Minimal blunting of the right costophrenic angle is similar to the prior study. There is upper zone redistribution, but no overt CHF. Previously seen vascular plethora is slightly improved. Cardiomediastinal silhouette is grossly unchanged. Known left-sided rib fractures are not well visualized sclerotic density overlying the T12 or L1 vertebral body could reflect prior vertebroplasty. IMPRESSION: Slight worsening of left lower lobe collapse and/or consolidation. Suspected small left effusion may be slightly larger. No gross effusion. Interval improvement in CHF findings, now with upper zone redistribution, but improved vascular plethora. Small right pleural effusion is similar to prior. " 7b230ed5-381369db-0c4b4d1e-a14d27e3-c91987aa.jpg,validate/p10/p10239196/s51094097/7b230ed5-381369db-0c4b4d1e-a14d27e3-c91987aa.jpg,validation," WET READ: ___ ___ 9:33 PM No pneumothorax. Right pleural effusion and pulmonary edema are stable. D/W Dr. ___ by Dr. ___ ___ telephone at 9:15pm, ___ min after discovery. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old man with empyema, status post thoracentesis. Evaluate for pneumothorax. FINDINGS: No pneumothoraces are seen. There is a left-sided central venous line with distal lead tip in the distal SVC. There is improved aeration at the right base. There remains a moderate right pleural effusion and a tiny left pleural effusion. Areas of consolidation within the right base are present. " d5d08f0a-f32f1ae1-e745047f-56e0a852-a40d0a9b.jpg,validate/p18/p18996877/s53251084/d5d08f0a-f32f1ae1-e745047f-56e0a852-a40d0a9b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with all the risk factors and vertigo // eval pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. IMPRESSION: The cardiac silhouette is normal. The aorta is unfolded. There is hazy increased opacity at the left base that could represent area of volume loss or early infiltrate. There is no effusion. The remainder of the lungs are clear " 6dcc460e-44897413-8557b90c-46f1ef58-5219a4af.jpg,validate/p15/p15506863/s56309919/6dcc460e-44897413-8557b90c-46f1ef58-5219a4af.jpg,validation," FINAL REPORT PA AND LATERAL RADIOGRAPH OF THE CHEST CLINICAL INDICATION: ___-year-old male with cough and hypoxia. TECHNIQUE: PA and lateral radiographs of the chest were obtained. COMPARISON: ___. FINDINGS: Redemonstration of a calcified granuloma in the right upper lobe is again noted. There is basilar atelectasis at the left lung base, not significantly changed. The lungs and pleural surfaces are otherwise clear, without pneumothorax or pleural effusions. Heart size is normal. Osseous structures are grossly unchanged. IMPRESSION: No acute intrathoracic process. " d21dc62b-2c9b3921-58c50dca-eea186b6-5a12c047.jpg,validate/p16/p16723173/s56761240/d21dc62b-2c9b3921-58c50dca-eea186b6-5a12c047.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with dyspnea, bipap requirement s/p IVF // pulm edema vs infection pulm edema vs infection IMPRESSION: Compared to chest radiographs since ___, most recently ___. Mild pulmonary edema has improved. Combination of left lower lobe atelectasis and pleural effusion has improved slightly but atelectasis is worse on the right common lung volumes remain quite low. Wide mediastinum in the region of the ascending thoracic aorta is unchanged since ___ and the heart is not enlarged. " ced59496-e807f5ba-25df071f-ede1cff3-2b84cd11.jpg,validate/p11/p11100454/s52983444/ced59496-e807f5ba-25df071f-ede1cff3-2b84cd11.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___-year-old woman with cough and fever. COMPARISON: None available. FINDINGS: There is a heterogeneous opacity in the right middle lobe as well as more linear opacity in the left lower lobe. There is mild cardiomegaly. The hilar and mediastinal contours are normal. There is no pneumothorax. There is no pleural effusion. Pulmonary vascularity is normal. IMPRESSION: Heterogeneous right middle lobe opacity concerning for early pneumonia. More linear left basilar opacity is likely atelectasis. " 4833be35-93dde731-887457ba-79a75134-5a55eb32.jpg,validate/p15/p15199994/s59694300/4833be35-93dde731-887457ba-79a75134-5a55eb32.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with epilepsy // decreased R sided breath sounds decreased R sided breath sounds TECHNIQUE: Single portable AP view radiograph of the chest. COMPARISON: Prior chest radiographs dating back to___. FINDINGS: Compared with the immediate prior study of ___, mild pulmonary edema has resolved. Persistent heterogeneous opacification of the left base is most likely atelectasis related to low lung volumes. If infectious symptoms develop, repeat radiographs to assess for developing pneumonia are recommended. There is mild atelectasis at the right base. Multiple, bilateral, old, well healed rib fractures are noted. There is no pleural effusion, pneumothorax, or pulmonary edema. The heart size is stably top-normal. IMPRESSION: 1. Resolved mild pulmonary edema. 2. Persistent left base opacification is likely atelectasis, although superimposed pneumonia cannot be fully excluded. " ac191b16-34db23a6-b408e90d-2fb25f9b-03495d3e.jpg,validate/p10/p10229323/s52514144/ac191b16-34db23a6-b408e90d-2fb25f9b-03495d3e.jpg,validation," FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with the study of ___, the tip of the Dobbhoff tube is within the lower body of the stomach. Otherwise, little change. " e9a96b5f-b5ad309d-58a09d8f-ec05b0ae-3dfb11d3.jpg,validate/p11/p11543542/s56630396/e9a96b5f-b5ad309d-58a09d8f-ec05b0ae-3dfb11d3.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Fever with no clear source. 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. IMPRESSION: No signs of pneumonia in the chest. " 5e4d647f-7f04cb14-8ce1cc2b-f36c30ab-c4df984e.jpg,validate/p10/p10735843/s53963340/5e4d647f-7f04cb14-8ce1cc2b-f36c30ab-c4df984e.jpg,validation," 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. " 7f2a6b0f-8756e840-d425dcf3-8d75b3e6-f77a0219.jpg,validate/p15/p15228822/s53591069/7f2a6b0f-8756e840-d425dcf3-8d75b3e6-f77a0219.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with palpitations, left sided pleuritic chest pain, 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. " c800ba5a-c465e072-a9a90211-04f68438-4a91400d.jpg,validate/p15/p15382782/s53255719/c800ba5a-c465e072-a9a90211-04f68438-4a91400d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ?pneumonia // evidence of infection COMPARISON: ___. IMPRESSION: No relevant change is seen as compared to the previous radiograph from ___. The lung volumes are high but there is no evidence of overinflation. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. There currently is no evidence of pneumonia or other infectious lung disease. No lung nodules or masses. No pleural effusions. " c55efbbc-1bf95da7-0637dd30-8a8094ea-370094b8.jpg,validate/p16/p16180157/s58905280/c55efbbc-1bf95da7-0637dd30-8a8094ea-370094b8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with VT on and ICD on amiodarone // evaluate for amiodarone effect evaluate for amiodarone effect IMPRESSION: In comparison with study of ___, there is little change. Continued enlargement of the cardiac silhouette with well -placed pacer leads. No evidence of acute pneumonia, vascular congestion, or pleural effusion. Specifically, no interstitial lung " a5aee672-0607cd5d-aca97dbb-f4b3952c-30a054fe.jpg,validate/p17/p17951860/s51753296/a5aee672-0607cd5d-aca97dbb-f4b3952c-30a054fe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with RUQ abd pain, shortness of breath // eval for 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. " aaf85bdd-516b3964-d696daf3-2840b988-68e6fdda.jpg,validate/p12/p12738736/s54182938/aaf85bdd-516b3964-d696daf3-2840b988-68e6fdda.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Cough, sputum. 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 stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8b8dfdf2-35fdb992-1197b2ac-55aa4272-5923c299.jpg,validate/p11/p11296936/s52375071/8b8dfdf2-35fdb992-1197b2ac-55aa4272-5923c299.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: Radiograph ___. FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion and improving pulmonary edema. More confluent opacities at the bases have worsened, and are concerning for possible infectious or aspiration pneumonia given history of fever. Small pleural effusions are present, but there is no visible pneumothorax. " ec789a64-47756a34-12d96e66-370a6daa-6249c403.jpg,validate/p14/p14480817/s51520211/ec789a64-47756a34-12d96e66-370a6daa-6249c403.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with altered mental status// Eval for acute process TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Consolidative opacities are noted in both lung bases, more so on the right. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are detected. IMPRESSION: Bibasilar consolidative airspace opacities concerning for multifocal pneumonia. " 1da5d59f-414d9ffc-dfdeee17-05f62fc4-d4c90e28.jpg,validate/p14/p14736565/s54191759/1da5d59f-414d9ffc-dfdeee17-05f62fc4-d4c90e28.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with B/L armpit pain, radiating pain, r/o pancoast tumor, other process // r/o pna, tumor, other process r/o pna, tumor, other process IMPRESSION: Heart size is normal. Mediastinum is normal. Lungs are clear. There is no pleural effusion. There is no pneumothorax. Pain control devise is projecting over the mid thoracic spine. " b015d8da-6cf8b730-da236e27-65e00d06-0c3d8b90.jpg,validate/p16/p16848121/s57333943/b015d8da-6cf8b730-da236e27-65e00d06-0c3d8b90.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Fever of unknown origin. 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. Lungs are clear with interval resolution of interstitial pulmonary edema. There is no pleural effusion or pneumothorax demonstrated except for minimal blunting of the left costophrenic sulcus on the lateral view, most likely reflecting lobulation of the diaphragm and unlikely to reflect pleural effusion. There is no pneumothorax. " fb07fdfc-4688b9bd-5e81d10f-1a6b7ca9-52800567.jpg,validate/p19/p19982872/s51618808/fb07fdfc-4688b9bd-5e81d10f-1a6b7ca9-52800567.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with chest pain. Please evaluate for pneumonia. TECHNIQUE: Frontal and lateral radiographs of the chest were obtained. COMPARISON: Chest radiograph from ___ and from ___. FINDINGS: The lungs are clear. The mediastinal silhouette and hila are normal. There is mild cardiomegaly. There is no pleural effusion and there is no pneumothorax. IMPRESSION: No acute cardiothoracic process. Mild cardiomegaly. " bc288d41-5bc930db-779df05c-17feed67-9875a213.jpg,validate/p18/p18152226/s54793244/bc288d41-5bc930db-779df05c-17feed67-9875a213.jpg,validation," WET READ: ___ ___ ___ 5:47 PM Severe cardiomegaly. Atelectasis at the right lung base. No new focal consolidation. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with PMH of achalasia and esophageal stricture, CAD, HTN, spinal stenosis, CHF, CKD, hyperlipidemia, tremor, admitted to ___ with nausea and vomiting found to have retained food in esophagus now s/p esophageal dilation and botox injections but still aspirating // Eval for aspiration, pulm congestion Eval for aspiration, pulm congestion IMPRESSION: Compared to chest radiographs since ___, most recently ___. Previous mild pulmonary edema has improved. Peribronchial opacification in the right lower lobe medially is chronic, present since at least ___. Severe cardiomegaly is chronic. No appreciable pleural effusion or pneumothorax. No change in mediastinal contours or pneumomediastinum. Heavy calcification of the ascending thoracic aorta is chronic. " c4f88339-87ae8722-acb1cd77-268d604d-cd4cbf7f.jpg,validate/p17/p17169964/s54024760/c4f88339-87ae8722-acb1cd77-268d604d-cd4cbf7f.jpg,validation," FINAL REPORT INDICATION: History: ___M with fevers, productive cough, and weight loss for the past 3 weeks. // ? pneumonia COMPARISON: Comparison is made with prior studies including ___. IMPRESSION: There is increased consolidation in the right lower lobe. There are small patchy areas of density in the left lower and left upper lobes. There is no pneumothorax or CHF. While these findings could represent multifocal infection, including opportunistic infection, a followup exam is recommended when the symptoms have cleared to exclude underlying malignancy, especially with history of weight loss. Degenerative changes are present in the spine. " 8e9769cc-f3c4b2b2-8da616e5-a3f58527-ab4ebd43.jpg,validate/p12/p12763939/s59067308/8e9769cc-f3c4b2b2-8da616e5-a3f58527-ab4ebd43.jpg,validation," FINAL REPORT HISTORY: Closure of open abdomen. TECHNIQUE: Supine AP view of the chest, abdomen, and pelvis. COMPARISON: CT torso ___ and chest radiograph ___. FINDINGS: Within the chest, a tracheostomy tube terminates in standard position. A post pyloric feeding tube terminates within the proximal duodenum. Heart size is normal. Pulmonary vascularity is not engorged. Linear opacities in the medial aspect of the right lung likely reflect atelectasis. Retrocardiac opacity also likely reflects atelectasis. No large pleural effusion or pneumothorax is identified. Nondisplaced right 8th rib fracture is again noted. No radiopaque foreign bodies are otherwise noted. Within the abdomen and pelvis, an inferior vena cava filter is identified in unchanged position. Oral contrast material is seen within the descending colon and rectum. No radiopaque foreign bodies are otherwise demonstrated. Widened right sacroiliac joint is noted as well as diastasis of the pubic symphysis. Again seen are fractures of the left L1 and L2 transverse processes. IMPRESSION: No retained radiopaque foreign body identified. Findings discussed with Dr. ___ at 22:40, ___. " 6a61156a-647e53bd-fd7e9f19-7f54b340-276f86d5.jpg,validate/p17/p17866120/s54923513/6a61156a-647e53bd-fd7e9f19-7f54b340-276f86d5.jpg,validation," FINAL REPORT INDICATION: Chest pain. COMPARISON: Radiographs 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. " a0d4ac07-99705c30-acc53086-b316e3e6-31a83ab9.jpg,validate/p16/p16887109/s53206309/a0d4ac07-99705c30-acc53086-b316e3e6-31a83ab9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 3 day cough, DOE, no fever, had chills. non-smoker. h/o pneumonia // r/o pneumonia r/o pneumonia IMPRESSION: There are no prior chest radiographs available for review. 2 areas of abnormality or unexplained. On the frontal view of the left paraspinal and para-aortic lines are obscured and there is greater than expected radiodensity projecting over the descending thoracic aorta. On the lateral view there is greater than the expected radiodensity projecting over the mid thoracic spine at the level of the carina. Since the patient has acute symptomatology, would be reasonable to repeat the chest radiographs in 2 weeks. Alternatively, chest CT could be performed now. Lungs are clear elsewhere. Heart size is normal and there is no pleural effusion. RECOMMENDATION(S): Repeat chest radiographs in 2 weeks, to see if chest CT is indicated at that time. NOTIFICATION: Pertinent critical findings were posted by Dr. ___ on ___ at 11:49 to the Department of Radiology online critical communications system for direct communication to the referring provider. " 92b609c1-a1d6caaf-8c6cbe4a-355f90d7-8e1b0c43.jpg,validate/p17/p17169964/s56922021/92b609c1-a1d6caaf-8c6cbe4a-355f90d7-8e1b0c43.jpg,validation," FINAL REPORT HISTORY: Hypoxia and shortness of breath. TECHNIQUE: Upright AP and lateral views of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size appears mildly enlarged, perhaps slightly increased in size compared to the previous study. The mediastinal and hilar contours are unremarkable. Consolidative opacity within the left lower lobe is worse compared to the previous exam, with a small pleural effusion likely present. The right lung is clear. No pneumothorax is identified. No acute osseous abnormality seen. IMPRESSION: Findings concerning for recurrent left lower lobe aspiration pneumonia and trace left pleural effusion. " 123b67a9-59d2ac11-4ad143c2-d20cd7b3-66418012.jpg,validate/p11/p11583852/s54308957/123b67a9-59d2ac11-4ad143c2-d20cd7b3-66418012.jpg,validation," FINAL REPORT INDICATION: ___M with pancreatic CA on chemo p/w generalized weakness // r/o PNA TECHNIQUE: PA and lateral views of the chest. COMPARISON: CT chest from ___. FINDINGS: Right chest wall port is seen with catheter tip in the right atrium. The lungs are clear without focal consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities identified. No free air seen below the diaphragm. Stent is partially visualized in the upper abdomen. IMPRESSION: No acute cardiopulmonary process. " 89b485bb-b23152ca-7e6a959a-9a090215-c970857f.jpg,validate/p14/p14566045/s51732714/89b485bb-b23152ca-7e6a959a-9a090215-c970857f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with active bleeding // eval for accumulation in left chest and widened mediastinum eval for accumulation in left chest and widened mediastinum IMPRESSION: In comparison with the earlier study of this date, the haziness in the left hemithorax is less apparent. The area of the pneumothorax is somewhat difficult to see due to overlying bony structures, but is probably quite similar to the previous examination. When discussing this case with Dr.___, ___ indicated that ___ would the contacting Dr. ___, ___ has just replaced him in coverage for the cardiothoracic Surgery service. " 00454f0b-2d77b234-618b06da-e2d47e1c-08275286.jpg,validate/p11/p11079199/s54396441/00454f0b-2d77b234-618b06da-e2d47e1c-08275286.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old woman with indeterminate quant gold on remicade. // Assess for evidence of old tb COMPARISON: No prior chest radiographs for available. IMPRESSION: Normal heart, lungs, hila, mediastinum, and pleural surfaces. No evidence of intrathoracic malignancy or infection. Thoracolumbar scoliosis is mild. " e6488101-6edecaf2-4ebfae86-c456b4f7-bbd1490d.jpg,validate/p17/p17118056/s50491222/e6488101-6edecaf2-4ebfae86-c456b4f7-bbd1490d.jpg,validation," 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. " 0b5762fa-0df55299-41f36976-05a064c2-948cddcd.jpg,validate/p18/p18221337/s54938412/0b5762fa-0df55299-41f36976-05a064c2-948cddcd.jpg,validation," FINAL REPORT INDICATION: ___M with cough, weakness TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___. FINDINGS: The lung volumes are low with associated bronchovascular crowding. Bilateral peripheral opacities are seen, which may represent atelectasis given lower lung volumes. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable. IMPRESSION: Bilateral peripheral pulmonary opacities, potentially representing atelectasis. Repeat radiographs with increased inspiratory effort would allow for further clarification as infection is also possible. " f5f551cc-9aa4ccc7-87c7a1a0-99d2753e-33e980c7.jpg,validate/p12/p12278812/s50608908/f5f551cc-9aa4ccc7-87c7a1a0-99d2753e-33e980c7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with pacemaker, brain tumor // check placement of pacemaker check placement of pacemaker IMPRESSION: In comparison with the study of ___, there is no change in the appearance of the dual-channel pacer device with leads in the right atrium and apex of the right ventricle. Cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. " 76af7f6e-72bd6433-c16d8ee1-adb0464a-187f48e1.jpg,validate/p16/p16039497/s54414643/76af7f6e-72bd6433-c16d8ee1-adb0464a-187f48e1.jpg,validation," FINAL REPORT HISTORY: Status post CABG with chest tube removal. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph, two views. FINDINGS: Normal postoperative appearance of the cardiomediastinum. Substantial left base atelectasis is new, with associated elevation of the left hemidiaphragm. Right lung is clear. Interval removal of the endotracheal tube, intra-aortic balloon pump, Swan-Ganz catheter and left chest tube is not associated with pneumothorax. Small left effusion is new. IMPRESSION: 1. Removal of various support tubes and lines without atelectasis. 2. Substantial left base atelectasis with small effusion. " b169edee-7236f3d5-01787158-5adb36c8-0321de8f.jpg,validate/p10/p10113898/s54907208/b169edee-7236f3d5-01787158-5adb36c8-0321de8f.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Mediastinal mass after stent removal. AP radiograph of the chest was reviewed in comparison to ___. The previously present, most likely endotracheal stent has been removed. The right chest tubes are in place. The mediastinum appears to be wider than on the prior study, which might be related to post-procedure appearance, but continued surveillance is recommended to exclude the possibility of mediastinal hemorrhage. No appreciable pneumothorax is seen. Elevated right hemidiaphragm is redemonstrated, but there is potentially worsening of the right lower lung atelectasis. " 86f054f2-2348cc33-7fb59126-6a2e7ebb-d5a83bfd.jpg,validate/p14/p14785541/s53402238/86f054f2-2348cc33-7fb59126-6a2e7ebb-d5a83bfd.jpg,validation," FINAL REPORT INDICATION: Chest pain with dyspnea. Evaluate for an acute process. COMPARISON: Chest radiograph ___. FRONTAL AND LATERAL VIEWS OF THE CHEST: There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. Irregular linear opacities are consistent with emphysema changes. The heart is normal size and the mediastinal contours are unremarkable. " cdbaba24-e0cf4baa-3e301841-91b6cfb0-5bb1f0aa.jpg,validate/p10/p10337761/s59340699/cdbaba24-e0cf4baa-3e301841-91b6cfb0-5bb1f0aa.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of CHF. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Since the prior study, there has been interval development of a small-to-moderate right pleural effusion with overlying atelectasis. Underlying consolidation is not excluded. The left lung is clear. The cardiac silhouette remains moderately enlarged. No overt pulmonary edema is seen. Mediastinal and hilar contours are stable. IMPRESSION: Interval development of small-to-moderate right pleural effusion with overlying atelectasis, underlying consolidation not excluded. Persistent enlargement of the cardiac silhouette. " a43323bf-5f7f2dd7-5446564c-8552040a-06ff9a95.jpg,validate/p13/p13184831/s53628234/a43323bf-5f7f2dd7-5446564c-8552040a-06ff9a95.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with dyspnea on exertion*** WARNING *** Multiple patients with same last name! // r/o acute infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: There is severe enlargement of the cardiac silhouette. Mediastinum is widened. Left base opacity is seen worrisome for large consolidation, underlying pleural effusion or pulmonary mass not excluded. No pleural effusion seen on the right. Biapical pleural thickening seen. Dual lead left-sided pacer device is seen with leads extending to the expected positions of the right atrium and right ventricle. IMPRESSION: Severely enlarged cardiac silhouette. Widened mediastinum. Left lower lobe consolidation may be due to infection, aspiration, underlying pulmonary mass not excluded. Chest CT may help further assess the above findings. " 69297ae1-fce7c9fc-2f50451a-f0bf6aa2-a97fd026.jpg,validate/p13/p13940027/s53316203/69297ae1-fce7c9fc-2f50451a-f0bf6aa2-a97fd026.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with CODP and 1 day of Chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Lungs are hyperinflated consistent with severe emphysema. No focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette is unchanged in within normal limits. Bony structures appear grossly intact. IMPRESSION: Emphysema without superimposed acute process. " 2db9e390-f7c88f0f-afb3683a-0eb7b1c0-902dcfed.jpg,validate/p17/p17001135/s52699387/2db9e390-f7c88f0f-afb3683a-0eb7b1c0-902dcfed.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with dyspnea. Evaluation for infectious process. COMPARISON: Comparison is made to radiographs of the chest from ___. FINDINGS: PA and lateral views of the chest demonstrate unchanged S-shaped scoliosis of the thoracic spine. The lungs are well expanded and clear, with no evidence of pleural effusion, pulmonary edema, pneumothorax or focal consolidation. The cardiomediastinal silhouette is unremarkable. IMPRESSION: No acute cardiopulmonary process. " 98961569-e3ec8d71-735da258-571dd15a-1e41c0d8.jpg,validate/p10/p10822525/s59812160/98961569-e3ec8d71-735da258-571dd15a-1e41c0d8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: None. CLINICAL HISTORY: Decreased flatus, right lower quadrant pain, one week post-ERCP, question free air. FINDINGS: PA and lateral views of the chest are provided. No free air below the right hemidiaphragm is seen. The lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. IMPRESSION: No acute findings, including no signs of free intraperitoneal air. " 466fa67a-3839bfb1-2d6fdb42-56c163b2-2c6c5647.jpg,validate/p16/p16880382/s52046789/466fa67a-3839bfb1-2d6fdb42-56c163b2-2c6c5647.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with IVDU and possible history of endocarditis presenting with weakness and rhonchi auscultated on exam 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. " 3d5c4927-0764e0c7-b3faf76c-10e56d78-e7e6ed9d.jpg,validate/p17/p17175276/s56743651/3d5c4927-0764e0c7-b3faf76c-10e56d78-e7e6ed9d.jpg,validation," WET READ: ___ ___ ___ 5:39 PM No pleural effusion but new peripheral opacity in the right lung base. ______________________________________________________________________________ FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, no pleural effusion, evaluation. COMPARISON: Portable chest radiograph from ___. FINDINGS: As compared to the previous radiograph, there is better visualization of subtle parenchymal opacity in the peripheral and basal zones of the right lung. In the appropriate clinical setting, the change could represent early pneumonia. There is no pulmonary edema and no larger pleural effusion. Healed rib fractures on the left. Moderate tortuosity of the thoracic aorta and borderline size of the cardiac silhouette without pulmonary edema. " 2eca59ad-12806cab-9b72c3ca-76b02ba7-4003bd51.jpg,validate/p12/p12831242/s51368639/2eca59ad-12806cab-9b72c3ca-76b02ba7-4003bd51.jpg,validation," FINAL REPORT PORTABLE AP CHEST FILM ___ AT 15:25 CLINICAL INDICATION: New Dobbhoff feeding tube, evaluate position. Comparison is made to the patient's prior study of ___ at 12:37. Portable AP upright chest from ___ at 15:25 is submitted. IMPRESSION: 1. Right internal jugular central line has its tip in the mid superior vena cava. The Dobbhoff feeding tube now has its tip beneath the diaphragm likely positioned within the stomach. Part of the feeding tube appears to be coiled over the upper thorax/neck but this may be extrinsic to the patient. Clinical correlation is advised. 2. Persistent bibasilar airspace opacity with likely layering effusions, right greater than left, suggestive of compressive atelectasis, although bibasilar pneumonia cannot be excluded. No evidence of pulmonary edema. Overall cardiac and mediastinal contours are unchanged. No evidence of pneumothorax. " 38119667-e7387fec-0402381f-13cb2818-86739ed0.jpg,validate/p16/p16282297/s53223727/38119667-e7387fec-0402381f-13cb2818-86739ed0.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with weakness. Prior left lower lobe pneumonia. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest. Region of consolidation identified in the retrocardiac region which silhouettes the descending thoracic aorta. Blunting of posterior costophrenic angle suggests small effusions. Elsewhere, the lungs are clear. Cardiac silhouette is the mildly enlarged. No acute osseous abnormalities detected. IMPRESSION: Retrocardiac opacity potentially due to atelectasis however lower lobe pneumonia is also possible. Small bilateral effusions. " 9b5a084d-ae6f9680-50821255-b15c8047-f95fa75f.jpg,validate/p12/p12639585/s56009950/9b5a084d-ae6f9680-50821255-b15c8047-f95fa75f.jpg,validation," WET READ: ___ ___ 9:13 AM Right PICC terminates at the cavoatrial junction. -___ WET READ VERSION #1 ___ ___ ___ 5:58 PM Right PICC terminates at the cavoatrial junction. -___ ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ETOH cirrhosis admitted post sphincterotomy/ERCP. // PICC line in situ; for confirmation of placement COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a new PICC line. The tip of the line projects over the right atrium, the line should be pulled back by approximately 2 cm. No pneumothorax or other complications. Mild cardiomegaly without pulmonary edema. No pleural effusions. " 0bdce04b-5a704109-28e59d0b-fa8129ae-ac2020a0.jpg,validate/p16/p16370208/s53438151/0bdce04b-5a704109-28e59d0b-fa8129ae-ac2020a0.jpg,validation," FINAL REPORT INDICATION: History: ___M with metastatic bladder cancer and h/o fever. // r/o pneumonia in presence of known paratracheal mass TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Right upper paratracheal mass is similar to before. No consolidation, pneumothorax, or pleural effusion is identified. Cardiac silhouette and hilar silhouette are normal size. IMPRESSION: No radiographic evidence of pneumonia. " 4642a810-ae901d5d-c66df8e2-4ff8d612-f041006f.jpg,validate/p17/p17653729/s55238660/4642a810-ae901d5d-c66df8e2-4ff8d612-f041006f.jpg,validation," FINAL REPORT INDICATION: Status post bronchoscopy for mucus plugging of the right mainstem bronchus, now with stable respiratory status. Evaluate right lung atelectasis. COMPARISON: Chest radiographs ___ and ___, chest CT ___. TECHNIQUE: Semi-upright bedside frontal chest radiograph. FINDINGS: A right PICC courses into the upper SVC. An enteric tube terminates in the stomach. There has been further reduction in the volume of bilateral pleural effusions, now small. Increased opacity at the right lung base is likely in part atelectasis, but early consolidation cannot be excluded. There is no pneumothorax or focal airspace consolidation worrisome for pneumonia. No pulmonary edema. Cardiac silhouette is normal size. Mediastinal contours are unchanged. IMPRESSION: Decreasing bilateral pleural effusions, now small. Continued density in the right base partially improved " a13dce43-36c21679-3bb43138-60a1bbaa-79508878.jpg,validate/p11/p11505655/s55653606/a13dce43-36c21679-3bb43138-60a1bbaa-79508878.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with UGIB s/p TIPS. // Is there displacement of the PICC line? COMPARISON: ___ IMPRESSION: As compared to the previous image, the right PICC line has been minimally pulled back. The tip now projects over the upper SVC, at the level of the confluence with the brachiocephalic vein. No evidence of complication. In the interval the patient has been extubated. The bilateral areas of atelectasis are unchanged. Mild cardiomegaly. No larger pleural effusion. No new parenchymal opacity. " e90be928-779ba2ef-ae79b01b-71472c09-226e78bc.jpg,validate/p18/p18303550/s51566050/e90be928-779ba2ef-ae79b01b-71472c09-226e78bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with met renal cell CA with loculated pleural effusions - with L pleurex catheter in place // assess baseline prior to putting chest tube on suction COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a minimal increase in extent and severity of the left parenchymal opacities. The left PleurX catheter is in unchanged position. The extent of the left pleural fluid collection is constant. Unchanged appearance of the right lung and the right cardiac border. " 7250de15-f56c1834-4cdaf8ae-d888f14a-e0f460d0.jpg,validate/p15/p15501289/s53671890/7250de15-f56c1834-4cdaf8ae-d888f14a-e0f460d0.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. 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. " 8bfd6192-cd925f8b-517bdbdd-43f4d690-81a0e1cf.jpg,validate/p18/p18656167/s59917054/8bfd6192-cd925f8b-517bdbdd-43f4d690-81a0e1cf.jpg,validation," FINAL REPORT INDICATION: Shortness of breath, cough, and chills. Evaluate for pneumonia. COMPARISONS: Chest radiograph from ___. CTA of the chest 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. " 807a28e9-aadb7646-30c29724-7c46a6f1-832ce72f.jpg,validate/p12/p12080376/s53937860/807a28e9-aadb7646-30c29724-7c46a6f1-832ce72f.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with near syncope // eval for pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Chest radiograph on ___ FINDINGS: The lungs are clear without focal consolidation. No pleural effusion, edema or pneumothorax is seen. Mild cardiomegaly is not significantly changed. IMPRESSION: No acute cardiopulmonary process. " 082c9c89-597de1fe-cb5d6b4a-31ea5a72-2489daab.jpg,validate/p18/p18750620/s57478915/082c9c89-597de1fe-cb5d6b4a-31ea5a72-2489daab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cad // r/o inf, eff TECHNIQUE: Chest two views COMPARISON: None FINDINGS: Normal heart size, pulmonary vascularity. Lungs are clear. There are no pleural effusions. IMPRESSION: No infiltrates " ba580cd6-aff8d520-9b02fcd3-781cbe7f-f099f411.jpg,validate/p17/p17015391/s57595323/ba580cd6-aff8d520-9b02fcd3-781cbe7f-f099f411.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with tingling in arms and legs and cough. Evaluate for pneumonia. COMPARISONS: Chest x-ray from ___. FINDINGS: PA and lateral views of the chest. Lungs are hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Vagal nerve stimulator in the left chest wall is noted. IMPRESSION: Hyperinflation, but no acute cardiopulmonary process. " 3711a0ce-78b4f388-a9b72f41-52949f71-ef0786da.jpg,validate/p19/p19442084/s57119002/3711a0ce-78b4f388-a9b72f41-52949f71-ef0786da.jpg,validation," 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. " 01651557-e04f9eab-e0408049-31e07bed-607d18f6.jpg,validate/p19/p19894181/s50520066/01651557-e04f9eab-e0408049-31e07bed-607d18f6.jpg,validation," FINAL REPORT HISTORY: History: Fever and cough TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: Comparison: none FINDINGS: No focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen. IMPRESSION: No acute cardiopulmonary process " e5be3da8-1ea41650-b4178705-53a31d21-7470acb1.jpg,validate/p10/p10603629/s52809135/e5be3da8-1ea41650-b4178705-53a31d21-7470acb1.jpg,validation," FINAL REPORT EXAMINATION: PA AND LATERAL CHEST RADIOGRAPHS INDICATION: Patient with shortness of breath and fever. 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. IMPRESSION: No evidence of acute cardiopulmonary process. " 06cfad8a-9926f7be-f2cbdfb0-87744279-28fdb4ec.jpg,validate/p19/p19239122/s57552818/06cfad8a-9926f7be-f2cbdfb0-87744279-28fdb4ec.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post esophageal biopsies. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. No pneumomediastinum, no other pathological air collections. Normal chest radiograph with normal size of the cardiac silhouette. " aa524235-e6b638f5-ed2345e7-2734d62f-09d1bd13.jpg,validate/p14/p14003502/s57309660/aa524235-e6b638f5-ed2345e7-2734d62f-09d1bd13.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p left thoracotomy, gastroesophegeal repair, intercostal muscle flap, and bilateral chest tubes. // post chest tube removal on left chest TECHNIQUE: Chest single view COMPARISON: ___ IMPRESSION: Left-sided chest tube is been removed. There is a tiny left apical pneumothorax. Otherwise the appearance of the lungs are unchanged " 5b682ab7-574cc579-3a744393-39a857cb-d42bffe7.jpg,validate/p14/p14860633/s52743984/5b682ab7-574cc579-3a744393-39a857cb-d42bffe7.jpg,validation," FINAL REPORT INDICATION: Fever and cough, here to evaluate for pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are clear without focal consolidation concerning for pneumonia, 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. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 961f584d-f3e16d44-8e0b6510-3d70a8e4-0c605438.jpg,validate/p13/p13273041/s50262991/961f584d-f3e16d44-8e0b6510-3d70a8e4-0c605438.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fall, R ear laceration // Eval for injury TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: There is moderate pulmonary edema. Small moderate right pleural effusion persist. More focal somewhat rounded opacity at the lateral right lung base may represent combination of pleural effusion and atelectasis, however, underlying consolidation or pulmonary lesion not excluded. Small left pleural effusion is re- demonstrated. The cardiac silhouette remains enlarged. Patient is status post aortic valve replacement. No displaced fracture is identified. IMPRESSION: Moderate pulmonary edema, cardiomegaly, and bilateral pleural effusions, right greater than left. For focal somewhat rounded opacity at the lateral right lung base may represent combination of pleural effusion and atelectasis, however, underlying consolidation, contusion or other pulmonary lesion not excluded. " d30c9e8b-f98859de-867fe9cd-627d6430-e0cd1fce.jpg,validate/p17/p17945297/s55046392/d30c9e8b-f98859de-867fe9cd-627d6430-e0cd1fce.jpg,validation," 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. " 6c97b052-7cdcc952-d151ac03-3514a417-b16c803d.jpg,validate/p19/p19972786/s50099236/6c97b052-7cdcc952-d151ac03-3514a417-b16c803d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with sob // Pneumonia TECHNIQUE: PA and lateral chest radiograph. COMPARISON: Chest x-ray ___. FINDINGS: MILD TO MODERATE CARDIOMEGALY AND PULMONARY VASCULAR CONGESTION ARE CHRONIC. THERE IS NO GOOD EVIDENCE FOR PULMONARY EDEMA LEFT PLEURAL THICKENING AND ASSOCIATED LOWER LOBE ATELECTASIS ARE LONG-STANDING. SMALL RIGHT PLEURAL EFFUSION HAS RECURRED. NO PNEUMOTHORAX. IMPRESSION: 1. PERSISTENT LEFT LOWER LOBE ATELECTASIS ASSOCIATED WITH CHRONIC LEFT PLEURAL SCARRING. 2. Pulmonary vascular congestion AND MILD TO MODERATE CARDIOMEGALY OR CHRONIC. ALTHOUGH THERE IS RECURRENT SMALL RIGHT PLEURAL EFFUSION THERE IS NO PULMONARY EDEMA. " c33b0eb9-c463697e-330c7a37-37a72ec9-5f263b9b.jpg,validate/p18/p18656167/s54380560/c33b0eb9-c463697e-330c7a37-37a72ec9-5f263b9b.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dysphagia. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. There is left basilar atelectasis. Mild lingular atelectasis/scarring is also seen. There is no definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. Hilar contours are stable. IMPRESSION: Left basilar atelectasis. " 01bae2ff-4875e68c-453af993-848a4ca4-1895e6cd.jpg,validate/p14/p14493762/s53969487/01bae2ff-4875e68c-453af993-848a4ca4-1895e6cd.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old woman with b/l pleural effusiosn // change in pleural effusiosn COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Since ___ there has been substantial change, particularly in the lungs. Multi focal heterogeneous consolidation has developed, particularly in the right mid and upper lung and left lower lung zones. This is probably pneumonia or pulmonary hemorrhage. Moderate right pleural effusion has increased. Small to moderate left pleural effusion less so. Severe low left lower lobe consolidation has worsened since ___, previously called atelectasis this could be a another focus of pneumonia. Low lung volumes exaggerate mild cardiomegaly. There is no pneumothorax. Right jugular line ends in the region of the superior cavoatrial junction, nasogastric tube ends in the upper part of a nondistended stomach. There may be a new left jugular line, terminating at the thoracic inlet, not in a central vein. Alternatively this could be the age of a face mask or other external device. Clinical correlation advised. NOTIFICATION: Dr. ___ paged on-call transplant resident to discuss the findings on ___ 12:33 1minutes after discovery of the findings, ultimately reported by telephone to on-call transplant resident on ___ at 12:30 " dc26b61b-b4e74c00-8082ac85-373f3d26-48692d0f.jpg,validate/p14/p14641639/s55074777/dc26b61b-b4e74c00-8082ac85-373f3d26-48692d0f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with RUQ pleuritic pain and productive cough // r/o PNA TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The heart size, mediastinal, and hilar contours are unremarkable. Again noted is left basilar atelectasis. The left hemidiaphragm appears somewhat obscured, but no definite consolidation is identified. There is no pleural effusion or pneumothorax. IMPRESSION: Small atelectasis at the left lung basis. Otherwise unremarkable chest radiograph. . " a821bd7f-ace85dac-e93a772d-9bbe0c20-a8164156.jpg,validate/p11/p11962176/s54940809/a821bd7f-ace85dac-e93a772d-9bbe0c20-a8164156.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with ?aspiration event while immunosupressed // new consolidation new consolidation IMPRESSION: Heart size is normal. Mediastinum is normal. Right PICC line tip is at the level of mid SVC. Lungs are clear. There is no appreciable pleural effusion. There is no pneumothorax. Substantial calcifications are demonstrated in the ascending aorta. " cb4d2556-ab7b5b0a-ea90e271-9956fd1f-e0df82ca.jpg,validate/p16/p16202057/s53377126/cb4d2556-ab7b5b0a-ea90e271-9956fd1f-e0df82ca.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman intubated // lines, interval eval lines, interval eval IMPRESSION: Comparison to ___. Unchanged bilateral pleural effusions of moderate extent. Subsequent bilateral areas of atelectasis. The monitoring and support devices are in constant position. Mild cardiomegaly. No pneumothorax. " 30cd72bb-057160be-01601760-362bb1aa-66c46c37.jpg,validate/p11/p11069386/s57679853/30cd72bb-057160be-01601760-362bb1aa-66c46c37.jpg,validation," FINAL REPORT HISTORY: Hypoxia, to assess for aspiration or pulmonary edema. FINDINGS: In comparison with the study of ___, there is increased prominence of the pulmonary vessels. This is consistent with developing vascular congestion on a substrate of chronic pulmonary disease. Given the extensive parenchymal changes, it is difficult to definitely exclude supervening pneumonia in the appropriate clinical setting. Otherwise, little change. " ce612681-cfd1162b-b2f9c726-d849710d-53ab26e6.jpg,validate/p15/p15324459/s54692584/ce612681-cfd1162b-b2f9c726-d849710d-53ab26e6.jpg,validation," FINAL REPORT INDICATION: Chronic cough. No fever shortness breath. Evaluate for pneumonia. TECHNIQUE: PA and lateral views the chest. COMPARISON: Chest radiograph from ___. 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. " 54b915e6-cf048e54-fac349a9-235c5b63-16df7641.jpg,validate/p18/p18614648/s56244336/54b915e6-cf048e54-fac349a9-235c5b63-16df7641.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with new NG tube placement // Please eval for position COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, the patient has received a nasogastric tube. The tip terminates in the proximal parts of the stomach. There is no evidence of complication, notably no pneumothorax. Unchanged moderate cardiomegaly at very low lung volumes. Left pleural effusion with subsequent left atelectasis. " 268b7c8e-1a5982d2-c946ccab-26c58977-c8067504.jpg,validate/p18/p18039866/s50926815/268b7c8e-1a5982d2-c946ccab-26c58977-c8067504.jpg,validation," 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. " ac44cecf-09e97c27-f89c6bb2-d8ab7c5e-0117804d.jpg,validate/p12/p12429414/s59341352/ac44cecf-09e97c27-f89c6bb2-d8ab7c5e-0117804d.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with hypoxia. COMPARISON: ___. Lumbar spine radiographs ___. FINDINGS: AP and lateral views of the chest. Lower lung volumes seen on the current exam with secondary crowding of the bronchovascular markings. Superimposed mild pulmonary vascular congestion is also suspected. Cardiac silhouette is moderately enlarged, similar to prior. Atherosclerotic calcifications noted at the aortic arch. Small bilateral effusions are also identified with blunting of the posterior costophrenic angles. Vertebral body height loss in upper lumbar vertebral body has not significantly changed given differences in technique compared to lumbar spine radiographs from ___. IMPRESSION: Low lung volumes with mild pulmonary vascular congestion. Small bilateral effusions and moderate cardiomegaly. " a1cfaa41-7129a579-0aecb880-db096b2e-4a2c3668.jpg,validate/p17/p17653729/s57459197/a1cfaa41-7129a579-0aecb880-db096b2e-4a2c3668.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F h/o asthma/COPD, Afib, CVA with residual left sided weakness, PAD s/p left AKA in ___, seizure disorder and recurrent C. Diff w/ recent sigmoid perforation s/p exlap, repair of sigmoid perforation and small bowel resection now with respiratory distress and right lung collapse now s/p intubation with persistent pulmonary edema, cholecystitis: // interval changes? TECHNIQUE: Portable chest COMPARISON: ___. FINDINGS: Compared to the prior study there is no significant interval change. IMPRESSION: No change. " b82ab4e4-e76bfd73-fcfe160d-cee97b4c-309fc35c.jpg,validate/p14/p14886127/s57598766/b82ab4e4-e76bfd73-fcfe160d-cee97b4c-309fc35c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ALL // Increasing shortness of breath; assess for effusion/ abnormalities. Increasing shortness of breath; assess for effusion/ abnormalities. IMPRESSION: In comparison with the study of ___, the left subclavian PICC line is been removed. Cardiac silhouette remains within normal limits and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. " 6b033e20-d8260484-45fcdedd-f7d96390-8f0ae26a.jpg,validate/p15/p15159712/s58148108/6b033e20-d8260484-45fcdedd-f7d96390-8f0ae26a.jpg,validation," FINAL REPORT INDICATION: Altered mental status, assess for pneumonia. COMPARISONS: ___, ___, ___. FINDINGS: Frontal and lateral views of the chest demonstrate left PIC catheter tip projecting over mid SVC. Right-sided PIC catheter has been removed. Lung volumes are low, exaggerating the caliber of normal vessels. Lungs are clear except right basal scarring or atelectasis around bronchiectasis. Moderate cardiomegaly and a generally large and tortuous aorta are chronic. No pleural effusion or pneumothorax is seen. Right lung base opacities are noted. IMPRESSION: 1. Stable moderate cardiomegaly and aortic tortuousity. 2. Right lung basal scarring or bronchiectasis. " a71a6de5-d213fdb3-22ec2c3f-1e390296-874f8cdf.jpg,validate/p13/p13736930/s52042243/a71a6de5-d213fdb3-22ec2c3f-1e390296-874f8cdf.jpg,validation," 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. " 48b2f327-a63bd2d6-f5958e0a-5c662eb0-0abacd46.jpg,validate/p18/p18866492/s52573211/48b2f327-a63bd2d6-f5958e0a-5c662eb0-0abacd46.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with incarcerated hernia // pre op Surg: ___ (hernia repair) TECHNIQUE: Chest two views COMPARISON: ___ FINDINGS: Mild right basilar atelectasis. Trace left pleural effusion or thickening stable. Heart size at the upper limits are normal. Normal pulmonary vascularity. No pneumothorax. Degenerative arthritis bilateral shoulders, with probable loose bodies in left subcoracoid recess. IMPRESSION: Mild atelectasis right lung base. " 12984889-61497a6e-67c1076a-92daf1df-89efffec.jpg,validate/p13/p13479418/s56953657/12984889-61497a6e-67c1076a-92daf1df-89efffec.jpg,validation," FINAL REPORT HISTORY: To assess for pneumothorax after procedure. FINDINGS: In comparison with the earlier study of this date, there is no evidence of pneumothorax. Little change from the previous study. " dc1e8bb0-e9c0885f-1eb5805b-42d9e0a3-936f1144.jpg,validate/p10/p10963896/s58688227/dc1e8bb0-e9c0885f-1eb5805b-42d9e0a3-936f1144.jpg,validation," FINAL REPORT INDICATION: History of ulcerative colitis, presenting clinically with pancreatitis. Evaluate for evidence of effusions or signs of adult respiratory distress syndrome. COMPARISON: Chest radiograph from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Lung volumes are low, limiting assessment for mild vascular congestion secondary to crowding of the bronchovasculature. The lungs are clear. The heart size is normal. The mediastinal contours are normal. Note is made of an azygos lobe, a normal anatomic variant. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: Low lung volumes. No acute cardiac or pulmonary process. " 1367d8da-e7eed371-a04940af-9ce4a3da-7c96bda7.jpg,validate/p19/p19601036/s53398977/1367d8da-e7eed371-a04940af-9ce4a3da-7c96bda7.jpg,validation," 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. " fec1022a-688a0979-2db04165-aa27102c-838daaf3.jpg,validate/p18/p18734362/s55461696/fec1022a-688a0979-2db04165-aa27102c-838daaf3.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Study of earlier the same date. FINDINGS: Interval placement of endotracheal tube, with tip terminating about 5.4 cm above the carina. Nasogastric tube terminates below the diaphragm. Previously reported right upper lobe opacity has resolved, but there is now worsening heterogeneous consolidation in the right lower lobe which may correspond to the clinical history of pneumonia. Heart is mildly enlarged and accompanied by pulmonary vascular congestion. No definite pleural effusion. " 66b04607-c38848b3-077ba470-5f4e03c9-9a09a553.jpg,validate/p16/p16680046/s54707769/66b04607-c38848b3-077ba470-5f4e03c9-9a09a553.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___M with fall, head injury TECHNIQUE: Upright AP and lateral views of the chest COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size remains mildly enlarged. The aorta is unfolded, unchanged. The mediastinal and hilar contours are otherwise unremarkable. Streaky bibasilar atelectasis is re- demonstrated. No focal consolidation, pleural effusion or pneumothorax is present. There are moderate degenerative changes noted in the imaged thoracolumbar spine with fusion hardware in the lumbar spine partially imaged. IMPRESSION: No acute cardiopulmonary abnormality. " 3e08888f-8736df87-a5e5b18c-bf00d068-c3514e1c.jpg,validate/p18/p18648878/s54849261/3e08888f-8736df87-a5e5b18c-bf00d068-c3514e1c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with back pain and fever, incidental mri finding, sent for brain mri // cerebellar enhancement. Pneumonia? 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 not engorged. Patchy right lower lobe opacity is concerning for pneumonia. Minimal streaky opacities also seen in the retrocardiac region. No pleural effusion or pneumothorax is detected. There are no acute osseous abnormalities. IMPRESSION: Patchy right lower lobe opacity concerning for pneumonia. Followup radiographs after treatment are recommended to ensure resolution of this finding. " ef09b1c8-07aa8e36-a0af6ece-5a412fca-aec50637.jpg,validate/p16/p16557374/s59441469/ef09b1c8-07aa8e36-a0af6ece-5a412fca-aec50637.jpg,validation," FINAL REPORT PORTABLE CHEST, ___ HISTORY: ___-year-old male with abdominal pain and chest pain and back pain. History of vasculitis. FINDINGS: Two portable AP views of the chest are compared to previous exam from ___. The lungs remain clear. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable. No free air is seen below the diaphragm. IMPRESSION: No acute cardiopulmonary process. " a4c2652b-7e9adc04-6a7482a5-5e31c9f7-73b5e5f1.jpg,validate/p12/p12006266/s57928637/a4c2652b-7e9adc04-6a7482a5-5e31c9f7-73b5e5f1.jpg,validation," FINAL REPORT HISTORY: CHF with left thoracentesis. FINDINGS: In comparison with the study of ___, there is little overall change. Again there are bilateral pleural effusions with compressive atelectasis at the bases and enlargement of the cardiac silhouette. No evidence of pneumothorax. PICC line is unchanged. " 5f85714c-d3dc6ad2-039a4da0-b9e39f5f-288244e2.jpg,validate/p13/p13637699/s59071056/5f85714c-d3dc6ad2-039a4da0-b9e39f5f-288244e2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man w/ need for preop CXR, recent postop pleural effusions // preop CXR Surg: ___ (RLE washout) COMPARISON: ___ IMPRESSION: As compared to the previous image, the bilateral pleural effusions and the subsequent areas of atelectasis are unchanged. Unchanged drain projecting over the right upper quadrant. No overt pulmonary edema. No pneumothorax. The tip of a right PICC line projects over the subclavian vein on the right and should be repositioned. " b90e2964-c0109f3b-83680b0c-f5212e28-c667c19b.jpg,validate/p14/p14421594/s54991649/b90e2964-c0109f3b-83680b0c-f5212e28-c667c19b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough -prob. bronchitis. Hypertension--___ Ace. GERD--___ PPI // R/o 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 subtly increased opacity involving the left upper lobe which could represent infection in the appropriate clinical setting. . No pleural effusion or pneumothorax is seen. IMPRESSION: Subtly increased opacity involving the left upper lobe which could represent an area of infection in the appropriate clinical setting. " 5166e2b6-5df18f38-066cfb33-85a0fd0a-92c55cee.jpg,validate/p18/p18511074/s51269812/5166e2b6-5df18f38-066cfb33-85a0fd0a-92c55cee.jpg,validation," FINAL REPORT INDICATION: Chest pain. Rule out pneumothorax or infiltration. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. Mediastinal and hilar contours are unremarkable. IMPRESSION: No acute cardiopulmonary process. " d629aa30-915e4e7d-1f67992d-b4939db9-9574a309.jpg,validate/p16/p16911517/s55352646/d629aa30-915e4e7d-1f67992d-b4939db9-9574a309.jpg,validation," WET READ: ___ ___ ___ 2:43 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with cough, SOB. Assess for pneumonia TECHNIQUE: Single portable frontal semi upright chest radiograph. COMPARISON: None. FINDINGS: The lungs are well-expanded and clear. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No pneumonia. " e7daa54b-fb0d043b-57ff682d-3d983de1-3086f4db.jpg,validate/p17/p17841596/s54226104/e7daa54b-fb0d043b-57ff682d-3d983de1-3086f4db.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F post-intubation // confirm ET tube placement COMPARISON: Prior exam from ___. FINDINGS: AP portable supine view of the chest. Endotracheal tube is seen positioned with its tip 1.9 cm above the carina. An NG tube courses into the left upper abdomen. Bilateral pleural effusions are noted, small to moderate in size. Gas-filled loops of bowel in the upper abdomen noted. IMPRESSION: As above. " a1dd011c-f568ea85-76fb8161-244882e3-105614ae.jpg,validate/p15/p15465911/s58225877/a1dd011c-f568ea85-76fb8161-244882e3-105614ae.jpg,validation," 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. " 5927b6b6-246b9c31-9c3fb56b-7fded648-7f2f6313.jpg,validate/p16/p16576541/s51975558/5927b6b6-246b9c31-9c3fb56b-7fded648-7f2f6313.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with syncope and chest pain. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. The lungs are hyperinflated. Right apical scarring is again seen and unchanged. The cardiomediastinal silhouette is unchanged. No visualized acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 81209ace-954ad511-357c8f81-fe917425-bae4d3bc.jpg,validate/p14/p14325424/s51500277/81209ace-954ad511-357c8f81-fe917425-bae4d3bc.jpg,validation," 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. " 16c9551e-0c94b02b-cfc07997-e4740862-ae8dd849.jpg,validate/p18/p18375523/s55658121/16c9551e-0c94b02b-cfc07997-e4740862-ae8dd849.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with chest and abdominal pain. COMPARISON: ___. TECHNIQUE: PA and lateral views of the chest. FINDINGS: The lungs are clear. The cardiac silhouette is normal size. The patient is status post median sternotomy and aortic valve repair. Pulmonary vascularity is normal. No pleural effusion, pneumothorax, or pneumonia. IMPRESSION: No acute cardiopulmonary process. " c275a32f-356c6e5a-0e5bce25-96ad3ec1-916fc9d7.jpg,validate/p13/p13103745/s56741001/c275a32f-356c6e5a-0e5bce25-96ad3ec1-916fc9d7.jpg,validation," 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. " 8dd33325-fc979c0d-a1d0d5d7-49f65170-f5b27ba1.jpg,validate/p13/p13738282/s57097438/8dd33325-fc979c0d-a1d0d5d7-49f65170-f5b27ba1.jpg,validation," FINAL REPORT INDICATION: Cough. COMPARISON: ___. FINDINGS: The lungs are well expanded and clear. There is no focal consolidation, effusion, pneumothorax. Median sternotomy wires are intact. Mediastinal vascular clips are in stable position. IMPRESSION: No acute cardiopulmonary process. " b92d471d-b7464d3a-979c2252-dafb54f0-470214c8.jpg,validate/p18/p18632133/s51703559/b92d471d-b7464d3a-979c2252-dafb54f0-470214c8.jpg,validation," 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. " 55fcc2e4-bef5df52-b51ea30e-fbff0352-a196ec82.jpg,validate/p18/p18065780/s55634643/55fcc2e4-bef5df52-b51ea30e-fbff0352-a196ec82.jpg,validation," WET READ: ___ ___ ___ 10:51 PM No evidence of pneumonia or pulmonary edema. Right mid lung scarring is unchanged. A small right pleural effusion is unchanged. ______________________________________________________________________________ FINAL REPORT HISTORY: Allergic reaction, to assess for consolidation or edema. FINDINGS: In comparison with the study of ___, there is little change and no evidence of acute pneumonia or vascular congestion. Chronic changes are again seen at the right base. " 6e9281ea-ccd8957a-c3807fab-3e60b74a-9c0abc77.jpg,validate/p16/p16004600/s50995867/6e9281ea-ccd8957a-c3807fab-3e60b74a-9c0abc77.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Nasogastric tube placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has received a new nasogastric tube. The course of the Dobbhoff catheter is unremarkable, the tip is projecting over the proximal to middle parts of the stomach. There is no evidence of complications. No pneumothorax. Normal size of the cardiac silhouette. Pre-existing minimal right basal areas of atelectasis are resolved in the interval. " 9ce26ce4-446743a6-8264516a-6c995f05-3640c462.jpg,validate/p10/p10814905/s53833166/9ce26ce4-446743a6-8264516a-6c995f05-3640c462.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with pancreatic CA with new L sided pleural effusion with CT to suction // status of effusion TECHNIQUE: Portable upright view of the chest. COMPARISON: Multiple chest radiographs, the most recent prior from ___. Chest CT ___. FINDINGS: A right PICC is present with tip terminating in the mid SVC. There has been a change in contour of the left pleural drainage catheter, with slight retraction of the distal aspect of the tube and an area of kinking, which may be outside the patient. A small left pleural effusion is slightly smaller than on the most recent prior study. There has been improved aeration in the left lower lobe. Increased haziness in the left mid lung may also reflect some pleural fluid. Small right pleural effusion slightly increased compared to prior, and mild right base atelectasis persist. The cardiomediastinal and hilar contours are normal. There is no pneumothorax. Lung volumes are normal, and there is no new focal consolidation concerning for pneumonia. There is no pneumoperitoneum. Gaseous distension of the stomach is again noted. A CBD stent is in stable position. IMPRESSION: 1. Slight interval decrease in left pleural effusion, still small, with interval improvement in aeration of the left lung. No other acute change. 2. Slight change in position of the left pleural drainage catheter with partial uncoiling of the pigtail and kinking of the tube. " db80cc8b-3033fbcb-f1735c59-f0df7e6c-1ccd66eb.jpg,validate/p17/p17270077/s58033071/db80cc8b-3033fbcb-f1735c59-f0df7e6c-1ccd66eb.jpg,validation," FINAL REPORT AP CHEST, 8:29 A.M., ___ HISTORY: ___-year-old hypoxic woman. IMPRESSION: AP chest compared to ___: Moderately severe cardiomegaly is stable, and small-to-moderate bilateral pleural effusion, right greater than left, which developed between ___ and ___, is subsequently stable while pulmonary vascular engorgement has improved. Left PIC line ends in the mid-to-low SVC. No pneumothorax. Extremely heavy mitral annulus calcification makes this patient prone to mitral regurgitation. " dffdb21c-6cf86cfd-de2bf185-3cd2486f-ca08f06b.jpg,validate/p11/p11845452/s56470409/dffdb21c-6cf86cfd-de2bf185-3cd2486f-ca08f06b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___M with chest pain // eval heart and lungs COMPARISON: ___ PA FINDINGS: AP upright and lateral views of the chest provided. Cardiomegaly is again noted with a coronary stent projecting over the left heart border. No focal consolidation, large effusion or pneumothorax. Mild hilar congestion is noted. No frank edema. Mediastinal contours unremarkable. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Cardiomegaly with mild hilar congestion. " 76a12f7b-f396d847-6f3811d5-98630e94-8c076097.jpg,validate/p16/p16352630/s57067582/76a12f7b-f396d847-6f3811d5-98630e94-8c076097.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with recent hx pna, today more cough and sob // please evaluate for infectious process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: Single a left-sided pacer is seen with lead extending to the expected location of the right ventricle. There is mild basilar atelectasis without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Degenerative changes are again seen along the spine. IMPRESSION: No acute cardiopulmonary process. " ca0ad21b-c0924385-da4bc9a5-546e42ad-1c3520c2.jpg,validate/p16/p16633648/s53767300/ca0ad21b-c0924385-da4bc9a5-546e42ad-1c3520c2.jpg,validation," 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. " 39a915d9-d88ad51c-e26c2031-a8003fc5-475a7948.jpg,validate/p11/p11291823/s54377162/39a915d9-d88ad51c-e26c2031-a8003fc5-475a7948.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with acute respiratory failure, intubated. // interval change, pneumonia interval change, pneumonia IMPRESSION: In comparison with the study ___ ___, there is again substantial enlargement of the cardiac silhouette with pulmonary edema, bilateral pleural effusions, and compressive basilar atelectasis. In the appropriate clinical setting, it would be difficult to exclude superimposed pneumonia. Monitoring and support devices are essentially unchanged. " f95e122d-ca160cec-70d44207-b23dd81e-57ac042e.jpg,validate/p13/p13103526/s52280352/f95e122d-ca160cec-70d44207-b23dd81e-57ac042e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP)CHEST (PORTABLE AP) INDICATION: ___ year old man with rib fx // eval for ptx, hemotx, pleural effusions COMPARISON: Chest radiograph ___:47. IMPRESSION: Widely separated right clavicle fracture not appreciably changed. Left humerus fracture not imaged. With the displacement is not obvious at the site of multiple rib fractures reported on the torso CT ___. No pneumothorax pleural effusion or evidence of contusion. Moderate cardiomegaly mild pulmonary vascular engorgement persists. Right jugular line ends in the low SVC. Stable caliber of the mediastinum widened by fat. " ee0562e9-a2d5b238-c146b24c-3cd88952-11438c50.jpg,validate/p19/p19845120/s53871684/ee0562e9-a2d5b238-c146b24c-3cd88952-11438c50.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with dobhoff movement // ? below diaphram COMPARISON: ___. IMPRESSION: As compared to the previous image, the Dobbhoff catheter is now projecting with its tip over the proximal parts of the stomach. The course of the catheter appears unremarkable. No change in appearance of the lung bases. " e24c468e-864a85d1-2ed24017-83b475aa-ece12cc7.jpg,validate/p14/p14707910/s52822890/e24c468e-864a85d1-2ed24017-83b475aa-ece12cc7.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with s/p RLE angio, fem cutdown, patch angioplasty now with acute desat // pneumo, pna pneumo, pna IMPRESSION: In comparison with the study of ___, the patient has taken a much better inspiration. Continued enlargement of the cardiac silhouette, without definite vascular congestion or acute pneumonia. " 76ff6afa-97e55259-3d5246fd-00ef99f6-125f2187.jpg,validate/p17/p17055354/s51517847/76ff6afa-97e55259-3d5246fd-00ef99f6-125f2187.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with pleural effusion // eval eval IMPRESSION: Comparison to ___. No relevant change. The extent of a pre-existing left pleural effusion is constant. Mild retrocardiac atelectasis. Normal size of the cardiac silhouette. The right pectoral Port-A-Cath and the left pectoral pacemaker are in constant position. " c13b16e9-5ab0d61f-219db733-bfb87fda-1ad95b04.jpg,validate/p13/p13382386/s52645275/c13b16e9-5ab0d61f-219db733-bfb87fda-1ad95b04.jpg,validation," FINAL REPORT INDICATION: ___M with Dizziness and chest pain x2 days. // Rule out pulmonary problems TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Stable normal heart size and mediastinal contours. No focal consolidation, pleural effusion or pneumothorax. Low lung volumes results in bronchovascular crowding. IMPRESSION: No acute process. " 630f9a3c-5a36985c-54f77655-f0a018ca-e3d94309.jpg,validate/p13/p13073519/s59498117/630f9a3c-5a36985c-54f77655-f0a018ca-e3d94309.jpg,validation," FINAL REPORT STUDY: AP chest, ___. HISTORY: ___-year-old woman with shortness of breath and fluid overload. Evaluate for interval changes. FINDINGS: Comparison is made to prior study from ___. There has been worsening of the pulmonary edema since the previous study, there is a cardiomegaly and increased size of the vascular pedicle. There are more confluent opacities within the lung bases that is likely due to pulmonary edema; however, underlying infiltrate is not entirely excluded. No pneumothoraces are seen. IMPRESSION: Marked worsening of the pulmonary edema. " f71e9603-6a7d4b4c-73988361-cccefd62-d7010169.jpg,validate/p18/p18909627/s59984699/f71e9603-6a7d4b4c-73988361-cccefd62-d7010169.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Chest pain. FINDINGS: PA and lateral views of the chest were provided demonstrating spinal fusion hardware at the cervicothoracic junction. Sternal wires are noted. Lungs are clear. No focal consolidation, effusion or definite signs of pneumothorax. The cardiomediastinal silhouette is normal. Bony structures appear intact. No free air below the right hemidiaphragm. " e26454ef-35e96ce7-fcdb357d-cd2af334-24d50853.jpg,validate/p11/p11799619/s52388473/e26454ef-35e96ce7-fcdb357d-cd2af334-24d50853.jpg,validation," 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. " 01e8d16b-0e265089-de4ca69d-15275ccc-221cf7ac.jpg,validate/p13/p13613806/s54429072/01e8d16b-0e265089-de4ca69d-15275ccc-221cf7ac.jpg,validation," FINAL REPORT HISTORY: Chemotherapy and surgery for right thoracic mass. FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. Any residual right pneumothorax would be tiny. The right pleural effusion and atelectasis are essentially unchanged. The atelectatic change at the left base has essentially cleared. " 9fc3f7a0-16f8a6ff-d085921f-205c6cd8-53fe40c0.jpg,validate/p10/p10106434/s54165915/9fc3f7a0-16f8a6ff-d085921f-205c6cd8-53fe40c0.jpg,validation," FINAL REPORT HISTORY: Shortness of breath and effusion. FINDINGS: No previous images. There is a large right pleural effusion with the opacification extending upward to the level of the hilum. No vascular congestion or evidence of acute focal pneumonia. In the absence of shift of the mediastinum, this implies substantial volume loss in the right lower lung. " 6cfb20bd-82c632d5-b959dd8b-f55c8fc2-02ff414c.jpg,validate/p16/p16023137/s51477211/6cfb20bd-82c632d5-b959dd8b-f55c8fc2-02ff414c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with new onset aflutter. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Cardiac silhouette size is moderate to severely enlarged. Mediastinal contours are unremarkable. There is mild pulmonary edema. No pleural effusion, focal consolidation or pneumothorax is present. Streaky opacities in lung bases likely reflect areas of atelectasis. Multiple clips are noted within the neck likely reflective prior thyroidectomy. No acute osseous abnormalities detected. IMPRESSION: Mild pulmonary edema. " a999fdd3-c5338833-8a698dbd-110bc115-0da7eabe.jpg,validate/p17/p17391510/s58833187/a999fdd3-c5338833-8a698dbd-110bc115-0da7eabe.jpg,validation," WET READ: ___ ___ ___ 12:37 AM No acute cardiopulmonary process. Of note CT may be more sensitive for atypical infection in immunocompromised patients. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: History of pancreatic cancer on chemotherapy presenting with fever and chills. Assess for pneumonia. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrates a right porta cath tip in the lower SVC, unchanged in appearance since previous examination. Intact median sternotomy wires as well as a prosthetic aortic valve are noted. The lungs are moderately well expanded and clear. No focal opacity. No pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. IMPRESSION: No radiographic evidence of pneumonia. " bed39e13-9ca73e8c-754feb35-93dd3870-e6686536.jpg,validate/p16/p16117641/s54679404/bed39e13-9ca73e8c-754feb35-93dd3870-e6686536.jpg,validation," FINAL REPORT PA AND LATERAL CHEST X-RAY INDICATION: Pneumonia; patient with cough, congestion. COMPARISON: ___. FINDINGS: New ill-defined alveolar opacities in the left lower lobe that are more visible on the lateral view. No pleural effusion. No pneumothorax. Cardiac contour and mediastinal contours are stable. CONCLUSION: Pneumonia of the left lower lobe. A followup chest x-ray is recommended to assess the resolution of the pneumonia. " 6153679c-b167f98e-a5226e4a-ea26be84-dda8d3f3.jpg,validate/p17/p17642642/s50012979/6153679c-b167f98e-a5226e4a-ea26be84-dda8d3f3.jpg,validation," 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. " 671337bf-4c25c5f5-ae2e964a-93366b4c-4ad697db.jpg,validate/p17/p17454111/s51733336/671337bf-4c25c5f5-ae2e964a-93366b4c-4ad697db.jpg,validation," FINAL REPORT INDICATION: ___M with fall, orthopnea // r/o CHF, fx, ich TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: Lungs are relatively hyperinflated. Left midlung pleural-based scarring is again seen. The lungs are clear of consolidation effusion, or vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 5fa24c98-b6f04a23-5078ddca-55afc72d-a2a07a9f.jpg,validate/p11/p11057136/s53791560/5fa24c98-b6f04a23-5078ddca-55afc72d-a2a07a9f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with copd ptx and air leak // New chest tube interval change COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, the patient has received another right-sided pigtail catheter in the pleural space. The right lung seems better expanded than on the previous image. However, the basal opacities are still present. No evidence of tension. Unchanged postoperative appearance of the cardiac silhouette. Unchanged extent of the massive air collection in the soft tissues. " 41f1a6bf-76290672-e4bd0f45-0c4c9a99-eb695b47.jpg,validate/p19/p19620193/s54053042/41f1a6bf-76290672-e4bd0f45-0c4c9a99-eb695b47.jpg,validation," FINAL REPORT INDICATION: Bilateral pneumonia diagnosed on prior chest radiograph on ___. Evaluation for resolution. TECHNIQUE: PA and lateral chest radiographs. COMPARISONS: ___. FINDINGS: Study is technically limited by the patient's hair overlying both lungs. However, diffuse parenchymal opacities noted on ___ have resolved. There is no new focal consolidation, pleural effusion, vascular congestion, or pneumothorax. The heart size is normal. The cardiac, hilar and mediastinal contours are within normal limits. IMPRESSION: Resolved multifocal pneumonia. " 9596d0de-2bb3c1ed-eb7fc158-f55e988c-c636cabb.jpg,validate/p16/p16800796/s58948578/9596d0de-2bb3c1ed-eb7fc158-f55e988c-c636cabb.jpg,validation," FINAL REPORT INDICATION: Cough, rule out pneumonia. COMPARISON: Chest radiograph ___. FINDINGS: PA and lateral views of the chest were reviewed. Cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. Lungs are well expanded and clear. There is no focal consolidation concerning for pneumonia. IMPRESSION: No acute cardiopulmonary process. " 872c953c-1d1e8457-4abb0b23-609f4618-b7e4bd7b.jpg,validate/p12/p12902262/s50289240/872c953c-1d1e8457-4abb0b23-609f4618-b7e4bd7b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain and bibasilar crackles. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: The appearance of the lungs is distorted by marked kyphosis of the thoracic spine.The heart is moderately enlarged, stable. Moderate size hiatal hernia with air-fluid level is seen. Opacification at the left lung base is likely a function of technique and patient positioning, rather than true pathology. No evidence of pneumonia or pleural effusion. IMPRESSION: 1. Moderate hiatal hernia. 2. Moderate cardiomegaly, stable. 3. No pulmonary edema or pneumonia. " da070496-1d0d7b75-5f4809a3-9678fb22-36ad8f62.jpg,validate/p13/p13762124/s57967607/da070496-1d0d7b75-5f4809a3-9678fb22-36ad8f62.jpg,validation," FINAL REPORT HISTORY: Tube placement. FINDINGS: In comparison with the study of ___, the central catheters and nasogastric tube remain in position. There are slightly lower lung volumes. The cardiac silhouette is within normal limits. Some poor definition of pulmonary markings could reflect some elevated pulmonary venous pressure. There is increased opacification at the left base. Although this could merely reflect atelectatic changes or even chronic pulmonary disease, the possibility of supervening pneumonia would have to be considered in the appropriate clinical setting. " ecd4e159-19084a31-7dda578e-4c417f61-3d848abc.jpg,validate/p13/p13891491/s57966712/ecd4e159-19084a31-7dda578e-4c417f61-3d848abc.jpg,validation," WET READ: ___ ___ ___ 5:11 AM Pulmonary vascular congestion without frank edema. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with chf, edema // eval for pulm edema TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs dated ___ through ___. FINDINGS: Lung volumes are slightly low, resulting in bronchovascular crowding. The cardiac silhouette is unchanged. Hilar contours are mildly indistinct. No pneumothorax, pleural effusion, or consolidation. IMPRESSION: Pulmonary vascular congestion without frank edema. " 3bf52eb5-bdeeb4f0-0ff42e15-cf833f1c-572f5802.jpg,validate/p10/p10089922/s58498202/3bf52eb5-bdeeb4f0-0ff42e15-cf833f1c-572f5802.jpg,validation," WET READ: ___ ___ ___ 12:03 AM No pneumonia. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with weakness // ? pna TECHNIQUE: Chest PA and lateral COMPARISON: None. 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 pneumonia. " 8d3a63d3-e2ae3f7f-778b72b3-f4267375-9cd9fde2.jpg,validate/p14/p14851663/s58713762/8d3a63d3-e2ae3f7f-778b72b3-f4267375-9cd9fde2.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior chest CT from ___ and chest radiograph from ___. CLINICAL HISTORY: Palpitations, question fluid overload or pneumonia. FINDINGS: PA and lateral views of the chest provided. Lungs appear clear without focal consolidation, effusion or pneumothorax. The heart and mediastinal contour appear normal, though the aorta is slightly unfolded. The bony structures are intact. No free air below the right hemidiaphragm. IMPRESSION: No acute findings in the chest. " 18b76584-2ac30a3c-c89be638-c26dad84-db3951dc.jpg,validate/p17/p17051517/s52581243/18b76584-2ac30a3c-c89be638-c26dad84-db3951dc.jpg,validation," FINAL REPORT HISTORY: Patient with history of CHF, now with cough, congestion, swelling, evaluate for cause. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is in the upper limit of normal with an apparent increase in size, likely related to timing of the cardiac cycle. Mediastinal contours are normal. No bony abnormality is detected. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 7676cb62-eebbdb94-0ded3107-9c01b842-22385bcd.jpg,validate/p16/p16718855/s57941629/7676cb62-eebbdb94-0ded3107-9c01b842-22385bcd.jpg,validation," FINAL REPORT INDICATION: Panic attacks, presenting with chest pain. Ambulatory O2 saturation in the high 80s. Evaluate for acute process. COMPARISON: None. 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. " 69d730c6-6a4b0d1b-38ff19e3-2ea40b9c-1be51d71.jpg,validate/p14/p14663808/s57651022/69d730c6-6a4b0d1b-38ff19e3-2ea40b9c-1be51d71.jpg,validation," FINAL REPORT HISTORY: Fever and drooling. COMPARISON: ___. FINDINGS: AP upright and lateral chest radiograph was obtained. The lungs are well expanded and clear without pleural effusion or pneumothorax. The heart is normal in size with normal cardiomediastinal contours aside from mildly tortuous aorta. Right Port-A-Cath is unchanged in appearance. IMPRESSION: No acute intrathoracic process. " b1c15d4f-642601fd-7ff9d457-2caf08c7-2b865300.jpg,validate/p17/p17875858/s55325836/b1c15d4f-642601fd-7ff9d457-2caf08c7-2b865300.jpg,validation," FINAL REPORT HISTORY: Abdominal pain. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___ chest radiograph. FINDINGS: The heart is normal size with normal cardiomediastinal contours. Pulmonary vascular markings are minimally prominent, though no overt pulmonary edema is present. No focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body. IMPRESSION: Minimal pulmonary vascular congestion without overt edema. " e477e499-60fcb573-7aa80d29-892df4f3-7bb543a8.jpg,validate/p17/p17791026/s55437345/e477e499-60fcb573-7aa80d29-892df4f3-7bb543a8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M 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. " 25e52e58-2de520b2-b4c3041c-b2c66ca8-7c5a80d3.jpg,validate/p18/p18719719/s57663732/25e52e58-2de520b2-b4c3041c-b2c66ca8-7c5a80d3.jpg,validation," FINAL REPORT HISTORY: Baseline chest radiograph prior to initiation of amiodarone. TECHNIQUE: Frontal and lateral chest radiographs. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Pacemaker projects over left pectoral region with lead tips in the right atrium and right ventricle. Sternotomy wires are intact, and vascular clips noted. Clear lungs without pneumothorax or pleural effusion. Heart size, mediastinal contour and hila are normal. No bony abnormality. There is a mildly distended stomach with air-fluid level. IMPRESSION: No radiographic evidence of acute cardiopulmonary disease. " 20405f83-47dcf3db-8afa5eff-b899cd76-1bef1c32.jpg,validate/p15/p15287107/s56446985/20405f83-47dcf3db-8afa5eff-b899cd76-1bef1c32.jpg,validation," FINAL REPORT STUDY: PA and lateral chest radiograph. COMPARISON EXAM: PA and lateral chest radiograph, ___. INDICATION: ___-year-old woman with shortness of breath. FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are well expanded and clear. Pectus carinatum accounts for the appearance of a large perceived retrosternal airspace on the lateral film, and this should not be interpreted as a sign of hyperinflation. There is no pulmonary edema, pleural effusion, or pneumothorax. IMPRESSION: No pneumonia, pleural effusion, or pulmonary edema. " 87ffdab6-709009ae-478a22d4-c17199d4-74acbaea.jpg,validate/p14/p14258645/s55811268/87ffdab6-709009ae-478a22d4-c17199d4-74acbaea.jpg,validation," FINAL REPORT INDICATION: ___M with AMS // Eval for infiltrate TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph ___. FINDINGS: The cardiomediastinal and hilar contours are stable with top-normal heart size. Extensive pleural calcifications limits assessment of the lung fields. Within this limitation, there is no obvious new focal consolidation concerning for pneumonia. There is no pneumothorax or large pleural effusion. IMPRESSION: Extensive pleural calcifications limiting assessment. No obvious superimposed acute cardiopulmonary process. " b199bffc-78a7e6a6-82338211-ea8fa8d8-3792d9cf.jpg,validate/p16/p16839550/s51105103/b199bffc-78a7e6a6-82338211-ea8fa8d8-3792d9cf.jpg,validation," FINAL REPORT CHEST ON ___ HISTORY: Chest pain. REFERENCE EXAM: ___. FINDINGS: Again seen is a dual-lead pacemaker, moderate cardiomegaly, sternal wires, mediastinal clips, patchy areas of volume loss and bilateral small effusions, small pulmonary vascular redistribution. Compared to the study from five days prior, the effusions are slightly smaller and the aeration of the right lower lung is slightly larger, but the vascular plethora is more pronounced. The overall impression is that of persistent CHF. " 55dd6590-b5964d1e-50d98102-6d573261-b8fc9d9a.jpg,validate/p15/p15058800/s54157213/55dd6590-b5964d1e-50d98102-6d573261-b8fc9d9a.jpg,validation," 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. " 4f27a066-422159ee-7d138bf7-a97343ae-c3bfcb15.jpg,validate/p14/p14865329/s50888742/4f27a066-422159ee-7d138bf7-a97343ae-c3bfcb15.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man intubated, with pneumonia // interval change? COMPARISON: ___ IMPRESSION: As compared to the previous radiograph, there is improvement of the pre-existing mild pulmonary edema. The pleural effusions, notably on the right, have minimally increased. Moderate cardiomegaly with bilateral retrocardiac atelectasis persists. " e4205ed1-41507ca5-83414da4-595ab008-f7fb085f.jpg,validate/p10/p10688397/s59570530/e4205ed1-41507ca5-83414da4-595ab008-f7fb085f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple injuries s/p fall // Please eval for any edema/infiltrates Please eval for any edema/infiltrates IMPRESSION: No relevant change as compared to ___. Constant monitoring and support devices. Constant low lung volumes. Moderate cardiomegaly. Bilateral pleural effusions and pulmonary edema, basal right and retrocardiac atelectasis. " 5f737c1c-ff05e0e5-3f0a956e-34d52896-ad10d7db.jpg,validate/p18/p18179428/s59431233/5f737c1c-ff05e0e5-3f0a956e-34d52896-ad10d7db.jpg,validation," FINAL REPORT AP CHEST, 10:20 A.M., ___ HISTORY: Hemothorax after a fall. Evaluate chest tube placement. IMPRESSION: AP chest compared to ___: The right pleural tube obliquely oriented upward to the level of the azygos vein is unchanged in position. There has been no improvement in the combination of residual right pleural effusion and substantial atelectasis. Left lung is clear, and the heart size is normal. No pneumothorax. " 5e5ef9e9-7f169043-5a8a68c0-6c1d66ce-679e185c.jpg,validate/p14/p14325424/s59266160/5e5ef9e9-7f169043-5a8a68c0-6c1d66ce-679e185c.jpg,validation," FINAL REPORT HISTORY: Left pneumothorax. COMPARISON: ___. FINDINGS: Left-sided pigtail chest tube is again visualized projecting over the left mid chest. There is a large left pneumothorax that is increased in size compared to prior. There is a large amount of left-sided subcutaneous emphysema which has also increased in size. This is a rotated film and therefore it is difficult to assess for mediastinal shift. The ET tube, NG tube and left subclavian line are unchanged. There compressive changes in the right lung and it is difficult to assess for alveolar infiltrate due to the patient positioning and volume loss. There is a small right effusion. IMPRESSION: Large left pneumothorax despite CT. These findings were called to Dr. ___ at the time of dictating this report by Dr. ___ 9:00 a.m. on ___. " fc9dc9df-ec251b11-5ce7540f-c75b36ef-eaf6c7e6.jpg,validate/p10/p10702059/s57962844/fc9dc9df-ec251b11-5ce7540f-c75b36ef-eaf6c7e6.jpg,validation," WET READ: ___ ___ 5:16 PM Right lower lobe pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph (PA and lateral) INDICATION: ___-year-old woman with MCTD on immunosuppresion with cough and fever for a week; evaluate for pneumonia. TECHNIQUE: Chest PA and lateral radiograph views were obtained. COMPARISON: AP chest radiograph dated ___. PA and lateral chest radiograph dated ___. Left shoulder radiograph dated ___. FINDINGS: Right lower lobe opacity seen on the lateral view in the posterior costophrenic angle suggests pneumonia given the provided clinical history. Otherwise, no significant change in the radiographic appearance of the chest since ___. No pulmonary edema, pleural effusion, or pneumothorax. Slight blunting of the right costophrenic angle is overall unchanged. The cardiomediastinal silhouette and hila are also overall similar in appearance. Stable moderate enlargement of the heart. Stable mild degenerative changes of the thoracic spine. Scattered calcifications are unchanged and compatible with MCTD. The left shoulder surgical hardware is new from ___ but similar in appearance to the shoulder radiograph in ___. Degenerative changes are noted in the right shoulder. IMPRESSION: Region of consolidation in the right lower lobe in the posterior costophrenic angle suggestive of pneumonia. " 2d792a51-e09786c8-dbe00c2b-81533632-082f633f.jpg,validate/p17/p17933557/s58581630/2d792a51-e09786c8-dbe00c2b-81533632-082f633f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT)CHEST (PA AND LAT)i INDICATION: ___ year old man with CAP - oddly non-chest presentation // assess for resolution COMPARISON: Chest radiographs ___. IMPRESSION: Previous right lower lobe pneumonia has nearly entirely resolved, radiographically. No followup is necessary. Lungs are well expanded and otherwise clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " e329558c-1e49c7cc-d619e6f1-bf47b62b-29a79585.jpg,validate/p17/p17967970/s50469813/e329558c-1e49c7cc-d619e6f1-bf47b62b-29a79585.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F s/p RUL lobectomy, intubated, please eval for interval change // ___F s/p RUL lobectomy, intubated, please eval for interval change ___F s/p RUL lobectomy, intubated, please eval for interval change IMPRESSION: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Continued elevation of the right hemidiaphragmatic contour with postoperative changes in the right hemithorax. Chest tube remains in place and there is no evidence of pneumothorax. " 0bc0a180-2d722380-6ad6831f-d34469b3-00a4afe3.jpg,validate/p11/p11247835/s50189039/0bc0a180-2d722380-6ad6831f-d34469b3-00a4afe3.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: Desaturation after abdominal surgery. IMPRESSION: PA and lateral chest reviewed in the absence of prior chest imaging: Small bilateral pleural effusions layer posteriorly. Aside from moderate left basal atelectasis, lungs are clear. The right hilus may be enlarged, but there is no evidence elsewhere of central lymph node enlargement. Prior CXR should be obtained for side for side comparison. Heart size is normal. This examination neither suggests nor excludes the diagnosis of pulmonary embolism. " ece336c1-bf927cfc-d985a95c-6db35b4a-929a74c8.jpg,validate/p15/p15226510/s50576237/ece336c1-bf927cfc-d985a95c-6db35b4a-929a74c8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for interval changes. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the patient has been extubated, and the nasogastric tube has been removed. The lung volumes have minimally decreased. The right lung base is now clear. On the left, a remnant atelectatic opacity with a mild pleural effusion is seen in almost unchanged manner. The diameter of the vascular structures suggests mild fluid overload. Unchanged size of the cardiac silhouette. No evidence of interval appearance of pneumonia. " e2644d7a-fa99bfeb-a9481a76-a41904c9-7f4ed304.jpg,validate/p19/p19738569/s51408231/e2644d7a-fa99bfeb-a9481a76-a41904c9-7f4ed304.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with sharp chest pain radiating to sides towards back. COMPARISON: None. FINDINGS: PA and lateral views of the chest provided. Lung volumes are somewhat low. 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. " 0417647c-c6530bfc-024286bd-fdc11e74-d3da39fb.jpg,validate/p10/p10110764/s55080133/0417647c-c6530bfc-024286bd-fdc11e74-d3da39fb.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Perforated esophagus, free air, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The bilateral pleural effusions and signs of mild fluid overload are unchanged. Retrocardiac atelectasis of unchanged extent but no evidence of new focal parenchymal opacity suggesting pneumonia. " 92746050-23f6b33f-ea1e8368-112e30b9-e7643127.jpg,validate/p15/p15923118/s57573285/92746050-23f6b33f-ea1e8368-112e30b9-e7643127.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with AML in remission. Now with cough and slight increase in WBC // h/o AML. Cough with slight increase in WBC h/o AML. Cough with slight increase in WBC IMPRESSION: Comparison to ___. New parenchymal opacity at the bases of the left lung, seen on both the frontal and the lateral radiograph. In the appropriate clinical setting, this opacity reflects pneumonia. Unchanged moderate cardiomegaly. No pulmonary edema. Unchanged normal alignment of the sternal wires. " f9220c31-64197838-7cfea044-6dc7f606-bd01f068.jpg,validate/p14/p14117743/s53723148/f9220c31-64197838-7cfea044-6dc7f606-bd01f068.jpg,validation," 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. " 381b1a5b-f16fa798-a8e6ce58-c9e6b218-58b5bdd3.jpg,validate/p10/p10745810/s56291826/381b1a5b-f16fa798-a8e6ce58-c9e6b218-58b5bdd3.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with CAD, HTN, severe valvular disease who presents with weakness. // evaluate for acute cardiopulmonary process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: No focal consolidation is seen. There is no pleural effusion or pneumothorax. Aortic calcifications are seen. The cardiac silhouette is top-normal. Ovoid right infrahilar density, stable, may represent calcified lymph node. Severe compression of a mid thoracic vertebral body is stable since at least ___. . IMPRESSION: No acute cardiopulmonary process. " d936eb03-eeaddfcc-c669d1ed-bfe25eaa-f1e982f7.jpg,validate/p10/p10596874/s57103837/d936eb03-eeaddfcc-c669d1ed-bfe25eaa-f1e982f7.jpg,validation," 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. " cf073cad-fdc62fc9-ee786e08-dbf7c30c-157566f2.jpg,validate/p15/p15255120/s51290187/cf073cad-fdc62fc9-ee786e08-dbf7c30c-157566f2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with IVH // intubated, interval changes intubated, interval changes IMPRESSION: Comparison to ___, 04:36. No relevant change is noted. Monitoring and support devices are stable. The retrocardiac lung area is better ventilated than on the previous images. No pneumonia, no pulmonary edema, no pleural effusions. " 7dc565c4-a8322cba-8e500957-db7bd86e-87a5c005.jpg,validate/p11/p11079199/s53250911/7dc565c4-a8322cba-8e500957-db7bd86e-87a5c005.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent fevers, previously dx LLL PNA, evaluate changes, complications // ___ year old woman with persistent fevers, previously dx LLL PNA, evaluate changes, complications ___ year old woman with persistent fevers, previously dx LLL PNA, evaluate changes, complications COMPARISON: Chest radiographs ___ and most recently ___. IMPRESSION: Small region of consolidation at the base the left lung is larger today than on ___ indicating pneumonia has not improved, and there may also be a new tiny left pleural effusion. Right lung and right pleural space are normal. Moderate to severe cardiomegaly is unchanged since ___, worsened since ___. Pulmonary vasculature is normal and there is no edema. " ec4b6b54-248f6b0d-47260a8e-42bc0c19-15e7442e.jpg,validate/p16/p16817189/s52914952/ec4b6b54-248f6b0d-47260a8e-42bc0c19-15e7442e.jpg,validation," 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. " 71005061-33eb778b-937f93fa-c108d47b-bae8bac2.jpg,validate/p12/p12147671/s56817792/71005061-33eb778b-937f93fa-c108d47b-bae8bac2.jpg,validation," 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. " 9be9de1a-57f75c79-076cad74-c084ccd5-3d770fe6.jpg,validate/p17/p17595027/s58960546/9be9de1a-57f75c79-076cad74-c084ccd5-3d770fe6.jpg,validation," FINAL REPORT STUDY: AP chest ___. CLINICAL HISTORY: ___-year-old man with seizures, fevers and leukocytosis. FINDINGS: Comparison is made to prior study from ___. There is a left-sided PICC line with distal lead tip in the distal SVC. Heart size is within normal limits. There are low lung volumes with crowding of the pulmonary vascular markings and atelectasis at the lung bases. No focal consolidations or overt pulmonary edema is seen. " d71ef3af-b2cb314a-8a4c01c9-4b18f430-14207ae6.jpg,validate/p14/p14482820/s55715115/d71ef3af-b2cb314a-8a4c01c9-4b18f430-14207ae6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with DKA status post cardiac arrest // central line placement TECHNIQUE: Portable chest COMPARISON: None. IMPRESSION: The ET tube is 3.5 cm above the carina. Right IJ line tip is in the right atrium. NG tube tip is in the stomach. Heart is mildly enlarged. There is volume loss at both bases. There is no focal infiltrate. There is no pneumothorax. . " 919c96f9-cbb72633-c6b7cfcc-5dbdb812-23d83a18.jpg,validate/p19/p19017438/s52450792/919c96f9-cbb72633-c6b7cfcc-5dbdb812-23d83a18.jpg,validation," 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. " 6edd5960-4028d9f1-6f2353cb-61d0c6bf-5048c68e.jpg,validate/p11/p11413236/s58006032/6edd5960-4028d9f1-6f2353cb-61d0c6bf-5048c68e.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: History: ___F with chest pain // r/o pnmeumothorax TECHNIQUE: Single, AP, portable view of the chest. COMPARISON: ___. FINDINGS: A left Port-A-Cath terminates within the mid SVC. Lower lung volumes are noted, leading to crowding of the bronchovascular structures. Mild atelectasis is seen at the left lung base. A calcified lymph node is again noted within the aorticopulmonary window. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The patient is status post median sternotomy, and cardiomediastinal silhouette is within normal limits. IMPRESSION: No evidence of acute cardiopulmonary process. " baca4b7b-efde034e-c5a89f7d-dad69eb1-05062cd9.jpg,validate/p19/p19095472/s55025385/baca4b7b-efde034e-c5a89f7d-dad69eb1-05062cd9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with mitral valve endocarditis with persistent fevers // evidence of infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiomediastinal contours are normal. Opacities in the left base have resolved. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable. Right PICC tip remains in standard position. IMPRESSION: No acute cardiopulmonary abnormalities " 28843da5-02c73c5a-0285d13a-dd829f82-40c4d864.jpg,validate/p11/p11434374/s56858695/28843da5-02c73c5a-0285d13a-dd829f82-40c4d864.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with b/l pneumothorax s/p right ct and s/p right endobronchial valve placement ___ // resolution PTX, effusion? change in cardiac size? (prior trace effusion) resolution PTX, effusion? change in cardiac size? (prior trace effusion) IMPRESSION: In comparison with the study of ___, there is little change in the right chest tube ends small apical pneumothorax. The cardiac silhouette is within normal limits and there has been improvement in the pulmonary vascular congestion. Continued opacification at the left base, which could well represent pleural fluid and atelectasis. In the appropriate clinical setting, superimposed pneumonia would have to be seriously considered. " d5cdbaa9-d2f3cb83-e2d8a0c5-2c16ca7d-92f291d8.jpg,validate/p19/p19772766/s50451984/d5cdbaa9-d2f3cb83-e2d8a0c5-2c16ca7d-92f291d8.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with fever, cough // eval pna TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: The lungs are relatively hyperinflated. Right lower lobe opacity is worrisome for pneumonia. The left lung is clear. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: Right lower lobe pneumonia. Recommend followup to resolution. " f343fdc2-219fde2e-f35e939c-6400e6df-cf14595a.jpg,validate/p12/p12711845/s59707983/f343fdc2-219fde2e-f35e939c-6400e6df-cf14595a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with respiratory distress, now intubated // interval change COMPARISON: Chest exam examination from ___ at ___ rotated positioning. An ET tube is in place, tip 4.8 cm above the carina. An NG tube is present, tip and probably also side-port the on the GE junction. Right IJ central line tip most likely overlies the distal SVC. No pneumothorax is detected. Cardiomediastinal silhouette is not well delineated, but is probably unchanged. Opacity at the right base is overall similar to the prior study and could represent a combination of atelectasis and/or consolidation. Small right effusion cannot be excluded. There is subsegmental atelectasis/scarring at the left lung base, similar to prior. No gross left-sided effusion. There is upper zone redistribution and vascular plethora, consistent with CHF. Linear opacity traversing the upper left chest probably represents artifact such as a soft tissue fold. FINDINGS: 1. Lines and tubes as described. 2. Mild CHF, may be slightly more pronounced. 3. Right base opacity is overall similar to the prior study. The possibility that this represents an aspiration pneumonia was raised on the ___ CT scan. 4. Left base subsegmental atelectasis and/or scarring is unchanged. 5. Small right effusion would be difficult to exclude. 6. The left upper lobe spiculated nodule identified on the ___ chest CT , which raise concern for neoplasm, is not well visualized by radiograph. " f250093a-8159489a-dad76242-29c66f12-7a963b04.jpg,validate/p16/p16454913/s58942777/f250093a-8159489a-dad76242-29c66f12-7a963b04.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Rule out pneumonia. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change, the monitoring and support devices are in constant position. Tracheostomy tube, nasogastric tube and left jugular vein catheter are constant. Minimally increased is the retrocardiac atelectasis but no evidence of pneumonia is seen in the well-ventilated lung parenchyma. An apparent increase in density at the level of the right upper lobe is due to patient's rotation. Minimal fluid overload but no overt pulmonary edema. No pneumothorax. " fb5b7f94-ffd8d52b-4933454e-0969b8aa-b3851138.jpg,validate/p14/p14875942/s50597890/fb5b7f94-ffd8d52b-4933454e-0969b8aa-b3851138.jpg,validation," FINAL REPORT HISTORY: Altered mental status. Evaluate for pneumonia. COMPARISON: Prior chest radiograph from ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiograph, lung volumes are decreased, accentuating the cardiac silhouette, which however still remains significantly enlarged. Increased retrocardiac opacity likely refelcts atelectasis. There is no overt pulmonary edema. There is no focal consolidation, pneumothorax or large pleural effusion. A right ventricular pacemaker and adjacent epicardial leads are in unchanged position. IMPRESSION: No focal abnormality to suggest pneumonia. Increased retrocardiac opacity likely reflects atelectatic changes. " c4fd8304-2c13e511-903d5627-be974d02-1a27960d.jpg,validate/p13/p13902721/s53747649/c4fd8304-2c13e511-903d5627-be974d02-1a27960d.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old man with recent URI, dyspnea, wheezing/rhonchi on exam // eval for infiltrate TECHNIQUE: Chest: Frontal and Lateral COMPARISON: Prior radiographs on ___ FINDINGS: The lungs are clear without focal consolidation. Small benign-appearing rounded opacity in the right upper lobe is stable in appearance since prior radiographs since ___. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No acute cardiopulmonary process. " 8a634303-f8f80aa1-252580af-d695db8d-612f5067.jpg,validate/p10/p10899387/s59098831/8a634303-f8f80aa1-252580af-d695db8d-612f5067.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with cirrhosis, hepatopulmonary syndrome, PNA // Interval change Interval change IMPRESSION: Compared to chest radiographs ___ through ___. Mild pulmonary edema has changed in distribution but not in overall severity. Mild cardiomegaly is worse. High mediastinal and pulmonary vasculature are borderline engorged. No pneumothorax. Left PIC line ends in the upper SVC. " 138f2e12-13773265-be6d6e81-8d58bc3f-847ba1f4.jpg,validate/p17/p17886228/s51074994/138f2e12-13773265-be6d6e81-8d58bc3f-847ba1f4.jpg,validation," FINAL REPORT INDICATION: ___F with DVT, started on lovenox yesterday now w/ Hg ___-> 6 in 24 hours // evaluate for retroperitoneal vs rectus hematoma vs intraabdominal bleeding 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 identified IMPRESSION: No acute cardiopulmonary process. " 94001e0b-c018fef7-2e79645f-139685a5-a7c92811.jpg,validate/p16/p16454913/s58196474/94001e0b-c018fef7-2e79645f-139685a5-a7c92811.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Status post tracheoplasty, evaluation. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, there is no relevant change. The patient has received a tracheostomy tube. The tube appears to be in correct position. There is no evidence of pneumothorax. The appearance of the cardiac silhouette and the lung parenchyma are otherwise constant. " 235cbdcd-5f0a6d13-5f2a351a-97b7d9b9-5a87122e.jpg,validate/p19/p19557250/s52811374/235cbdcd-5f0a6d13-5f2a351a-97b7d9b9-5a87122e.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with pneumothorax. // evolution of pneumothorax evolution of pneumothorax COMPARISON: Prior chest radiographs ___. IMPRESSION: Small volume of pneumo mediastinum is unchanged, but there is more subcutaneous emphysema in the left chest wall and neck and supraclavicular regions. There is no appreciable pneumothorax. Heart is slightly larger but still normal size. Lungs are grossly clear. No appreciable pleural effusion. " 1b73afdd-6e179476-369721c0-cf8569dc-bc0d900b.jpg,validate/p10/p10882916/s59309137/1b73afdd-6e179476-369721c0-cf8569dc-bc0d900b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman s/p surgical pinning of right hip, now with fever // infection, other acute change IMPRESSION: In comparison to ___ chest radiograph, patchy bibasilar opacities are new as well as a poorly defined opacity in the right upper lobe. These findings may be due to multifocal atelectasis, aspiration, or pneumonia. " 5fcb0170-45ac21c1-e7223876-c791a6e6-ca54dac2.jpg,validate/p13/p13450064/s58864626/5fcb0170-45ac21c1-e7223876-c791a6e6-ca54dac2.jpg,validation," FINAL REPORT CHEST TWO VIEWS, ___ HISTORY: ___-year-old male with cough and sore throat, tachycardia to 120. 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. No acute osseous abnormality is identified. IMPRESSION: No acute cardiopulmonary process. " 2034aa95-1c3eaa2b-8835437a-70b2ed76-b45355f8.jpg,validate/p16/p16326143/s56817166/2034aa95-1c3eaa2b-8835437a-70b2ed76-b45355f8.jpg,validation," FINAL REPORT HISTORY: Cough. FINDINGS: In comparison with the study of ___, there are slightly lower lung volumes. However, there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. " a01f29f2-151ef547-473e4281-93fae675-45519c75.jpg,validate/p18/p18264198/s57849834/a01f29f2-151ef547-473e4281-93fae675-45519c75.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Obesity, hypoventilation, evidence of infection. COMPARISON: ___, 9:12 a.m. FINDINGS: As compared to the previous radiograph, there is unchanged evidence of a small left pleural effusion. On the right, there is now mild blunting of the costophrenic sinus, potentially suggesting a new small right pleural effusion. The areas of basal atelectasis are constant. Also unchanged are the signs indicative of mild pulmonary edema. Constant appearance of the hilar and mediastinal structures. " dccd1317-e8ce7d06-3a3061b7-f9623c31-86e1b8eb.jpg,validate/p13/p13383248/s57743302/dccd1317-e8ce7d06-3a3061b7-f9623c31-86e1b8eb.jpg,validation," FINAL REPORT INDICATION: Evaluation of patient with cough with a recently diagnosis of shingles. COMPARISON: Chest radiograph from ___. FINDINGS: The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette remains mildly enlarged but stable. Tortuosity of the aorta is again noted. Again visualized is mild-to-moderate dextroscoliosis of the upper thoracic spine as well as degenerative changes involving the mid thoracic spine and calcifications of the costochondral cartilages. IMPRESSION: No acute cardiopulmonary process. " 6dc5a727-5ff20d79-e452e511-355c6c35-251a9c1a.jpg,validate/p13/p13551362/s59623939/6dc5a727-5ff20d79-e452e511-355c6c35-251a9c1a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman sp R VATS sp chest tube pull // ptx? ptx? IMPRESSION: Comparison to ___. The right postoperative chest tube has been removed. No pneumothorax. Lung volumes remain low. Borderline size of the cardiac silhouette. Minimal over distension of the stomach. " 83674941-ab3d95ca-4e9153b6-b15f497b-af57b724.jpg,validate/p11/p11864106/s58834194/83674941-ab3d95ca-4e9153b6-b15f497b-af57b724.jpg,validation," WET READ: ___ ___ ___ 3:08 PM 1. No acute cardiopulmonary process. 2. Left hilum is enlarged and was found to have FDG avid lymph node on PET CT on ___. Suggest Chest CT to better assess. ______________________________________________________________________________ FINAL REPORT INDICATION: Dizziness and shortness of breath, assess for infiltrate or effusion. COMPARISON: Chest radiograph on ___, Chest CT on ___ and PET CT on ___. FINDINGS: PA and lateral views of the chest. There is mild left lower lobe plate-like linear atelectasis. No evidence of pneumonia. The heart size is normal. The left hilum is enlarged. No pleural effusion or pneumothorax. IMPRESSION: 1. No acute cardiopulmonary process. 2. Left hilum is enlarged and was found to have FDG avid lymph node on PET CT on ___. Suggest Chest CT to better assess. " 87dd13c0-24dd5ee7-cc0a216d-f72fedd3-26114a19.jpg,validate/p16/p16640201/s55687110/87dd13c0-24dd5ee7-cc0a216d-f72fedd3-26114a19.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man s/p mediatinotomy for biopsy anterior mediastinal mass // rule out ptx rule out ptx TECHNIQUE: Portable upright frontal chest radiograph was obtained. COMPARISON: CT chest ___. FINDINGS: Left hemidiaphragm elevation is unchanged. The cardiac silhouette is enlarged, and accounting for differences in technique is larger than CT ___. There is widening of the mediastinal silhouette obscuring portions of the the aortic shadow secondary to known mediastinal mass. There is no pneumothorax. There is no area of consolidation. IMPRESSION: 1. Enlarged cardiac silhouette compared to CT ___. Given the presence of pericardial effusion on prior CT, enlarging pericardial should be considered . Correlate for cardiac tamponade. 2. Widened mediastinal silhouette consistent with known mediastinal mass. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 4:33 PM, 5 minutes after discovery of the findings. " 9d35bc0d-8b296027-a53b9d47-3c0f04a4-0c38161f.jpg,validate/p12/p12724735/s56052563/9d35bc0d-8b296027-a53b9d47-3c0f04a4-0c38161f.jpg,validation," FINAL ADDENDUM ADDENDUM Please ignore the previous report that belongs to different patient The report on this patient chest radiograph is as following Comparison: ___ The ET tube tip is approximately 3 cm above the carinal. NG tube tip is in the stomach. Cardiac silhouette appears to be substantially increased as compared to the previous examination, by more than 1 cm that might potentially represent different phases of inspiration but interval accumulation of pericardial effusion is a possibility. Patient continues to be in pulmonary edema, interstitial that appears to be progressed since the prior study. No pneumothorax is seen. Bilateral pleural effusions are present. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___F with h/o HTN, Alport's syndrome s/p 2 renal transplants with chronic graft failure, presenting in hypertensive urgency with respiratory distress. // interval change TECHNIQUE: CHEST (PORTABLE AP) COMPARISON: ___ FINDINGS: Since the prior study the has been insertion of pigtail catheter in the left pleural space at the mid aspect. As a consequence there has been interval substantial decrease in the amount of pleural effusion in particular at the basal aspect of the pleura. Currently the effusion continues to be loculated containing multiple foci of air, most likely trapped within the effusion. The prior study there has been interval elevation of the hemidiaphragm, slight potentially due to decrease in the amount of pleural fluid with subsequent slight right mediastinal shift. Left chest wall air is demonstrated along the tract of the catheter. No pneumothorax seen outside of the fluid collection. No appreciable pericardial effusion is seen. Minimal amount of right pleural fluid is demonstrated, increased since the prior study. Imaged portion of the upper abdomen demonstrate large cortical cyst in the left kidney as well as gallbladder sludge and foci of calcification in the right kidney. Airways are patent to the subsegmental level bilaterally except fall left lower lobe and lingula where atelectasis is noted most likely due to combination of effusion and elevated left hemidiaphragm. Except for minimal a right lower lung atelectasis right lung is clear. Off note is soft tissue lesion, 2.3 x 1.7 cm, pleural or extrapleural based, series 4, image 148, unchanged in appearance since previous CT obtained 2 days ago. No lytic or sclerotic lesions worrisome for infection or neoplasm demonstrated. Erosive changes at the manubrial sternal joint suggesting prior inflammation as previously. Septal thickening in the left upper lobe is minimal. Besides left lower lobe atelectasis no new findings demonstrated. IMPRESSION: Interval decrease in size in loculated left pleural effusion after placement of the pigtail catheter. Multiple loculated bubbles of air. Subcutaneous air. Left lower lobe consolidation, most likely a combination of atelectasis or infection with no possibility to exclude underlying mass. Unchanged appearance of the right chest wall/pleural lesion. Potentially as previously suggested 8 might be related to previous fracture of the left seventh rib but followup is required to exclude the possibility of neoplastic origin. No changes in the intra-abdominal findings demonstrated but there is higher elevation of left hemidiaphragm potentially due to drainage of pleural effusion with more pronounced right mediastinal shift. " 86c2d040-709b477a-8a40a1cb-2745cd8d-e421c540.jpg,validate/p18/p18458646/s55620405/86c2d040-709b477a-8a40a1cb-2745cd8d-e421c540.jpg,validation," FINAL REPORT HISTORY: Dyspnea, to assess for pulmonary edema. FINDINGS: In comparison with study of ___, the patient has taken a somewhat better inspiration. Cardiac silhouette remains within overall normal limits. Pulmonary vascularity is essentially within normal limits and there is no evidence of pleural effusion. Opacification in the right cardiophrenic angle again may merely reflect crowding of vessels, though in the appropriate clinical setting, supervening pneumonia would have to be considered. " f0905cc9-09df4b41-12ab36a8-d263d851-877d52ad.jpg,validate/p18/p18686554/s51906889/f0905cc9-09df4b41-12ab36a8-d263d851-877d52ad.jpg,validation," WET READ: ___ ___ 1:36 PM Bilateral lower lobe ill-defined opacities, right greater than left, concerning for infection. ______________________________________________________________________________ FINAL REPORT INDICATION: Chest pain and shortness of breath. COMPARISON: Chest radiographs from ___. FINDINGS: Frontal and lateral radiographs of the chest were acquired. Lung volumes are slightly low, causing crowding of the bronchovasculature. There are bilateral lower lobe ill-defined opacities, right greater than left, concerning for infection. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: Findings concerning for bilateral lower lobe infection, worse on the right. " 1f2275bb-ac5f8d82-810cbdae-3af7f3ed-77c43950.jpg,validate/p10/p10633758/s57842516/1f2275bb-ac5f8d82-810cbdae-3af7f3ed-77c43950.jpg,validation," FINAL REPORT INDICATION: ___M with pmhx of DM, HTN who presents with fevers and leukocytosis // r/o pna TECHNIQUE: AP and lateral views of the chest. COMPARISON: None. FINDINGS: Low lung volumes are noted with secondary crowding of the bronchovascular markings. Based on this and AP lordotic positioning, visualized lungs are grossly clear. Left chest wall triple lead pacing device is noted. Cardiac silhouette appears enlarged but likely exaggerated by factors described above. IMPRESSION: Limited exam without definite acute cardiopulmonary process. " 7e2bca2b-b1193514-5df90d19-6c064411-289d7084.jpg,validate/p15/p15794450/s59772404/7e2bca2b-b1193514-5df90d19-6c064411-289d7084.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient after intubation for interval change. Portable AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 3.8 cm above the carina. The NG tube passes below the diaphragm terminating in the stomach. Heart size and mediastinum are unchanged. There is interval improvement in pulmonary edema. Lung volumes remain low and there is minimal improvement in bibasilar atelectasis. " 4eca93e3-79af18fe-4d822893-4dda9f5b-c0169a27.jpg,validate/p14/p14068639/s56128416/4eca93e3-79af18fe-4d822893-4dda9f5b-c0169a27.jpg,validation," FINAL REPORT INDICATION: History of shortness of breath. Evaluate for COPD/infiltrate. COMPARISONS: Chest radiographs from ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: Left-sided AICD device is again noted with the lead terminating in the right ventricle, unchanged in position compared to the prior exam. The lung volumes are low. There is stable mild cardiomegaly. The aorta is tortuous. However, the mediastinal contours are otherwise unremarkable. The lungs demonstrate a new right lower lobe opacity, concerning for infection. There is also a streaky opacity along the mid-right lung, likely secondary to fluid along the fissures. No pneumothoraces or pleural effusions are identified. Numerous clips are again seen in the left upper quadrant. Multilevel degenerative changes are seen within the thoracic spine, mild-to-moderate in degree, overall stable compared to the prior exam. IMPRESSION: New right lower lobe opacity concerning for infection. ___ d/w Dr. ___ by Dr. ___ by telephone at 3:___p on the day of the exam. " 2a8e4776-a41d2318-350c6f6d-77218903-3f18e000.jpg,validate/p19/p19737892/s55010857/2a8e4776-a41d2318-350c6f6d-77218903-3f18e000.jpg,validation," FINAL REPORT INDICATION: ___-year-old gentleman status post left upper lobe wedge, rule out pneumothorax post-chest tube removal. COMPARISON: Chest radiograph dated ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: There is interval removal of the left-sided chest tube. There is no evidence of a pneumothorax. Sternotomy wires and surgical clips overlying the heart shadow are again noted. Cardiomediastinal contours remain unchanged. There is blunting of the left costophrenic angle with a small amount of pleural effusion, an overlying consolidation cannot be excluded which in the proper clinical context could represent pneumonia. Lung fields are otherwise clear. Bony structures are intact. IMPRESSION: 1. Interval removal of the left-sided chest tube with no evidence of pneumothorax. 2. Small left-sided pleural effusion, an overlying consolidation cannot be excluded. " 23e9fe32-1e9810dd-2af80485-42fdef90-03218a68.jpg,validate/p15/p15753678/s52778866/23e9fe32-1e9810dd-2af80485-42fdef90-03218a68.jpg,validation," FINAL REPORT HISTORY: Patient with fever and dry cough, assess for pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. There is a new mass-like consolidation which originates from the left hilum and extends into the left upper lobe. There is associated mild upper lobe volume loss, manifested by mild leftward tracheal deviation, upward displacement of the left hilum, and slight tenting of the left hemidiaphragm. There is also some mild streaky atelectasis in the left lower lobe. The right lung is essentially clear. No pleural effusion, pneumothorax, or pulmonary edema is seen. A small granuloma is again visualized in the right lung overlying the fifth posterior rib laterally. The heart size is normal. There is a small hiatal hernia, unchanged from prior study. IMPRESSION: Mass-like consolidation in the left upper lobe as described above. This may represent an infectious pneumonia given clinical suspicion for infection. Recommend short-term radiograph followup to assess for response to antibiotics in order to ensure resolution and to exclude underlying malignancy. " b1edde8d-106dc9d6-bc007ff3-68398c00-d96ca941.jpg,validate/p19/p19338803/s55943357/b1edde8d-106dc9d6-bc007ff3-68398c00-d96ca941.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with left spontaneous pneumothorax. COMPARISON: PA and lateral chest radiograph, ___, 11:06. PA AND LATERAL CHEST RADIOGRAPH: The cardiac, mediastinal and hilar contours are normal. Both lungs are clear with no focal consolidation, pleural effusion. No pneumothorax is evident. IMPRESSION: No acute cardiopulmonary process. " 5cb56bc1-b3ac9420-22906201-7324dd35-524babd9.jpg,validate/p16/p16343839/s58204157/5cb56bc1-b3ac9420-22906201-7324dd35-524babd9.jpg,validation," FINAL REPORT INDICATION: History of renal cell carcinoma, for evaluation for interval change. COMPARISON: CTA chest from ___ and chest radiograph from ___. Previously visualized 8-mm left upper lobe nodule is stable. Previously noted second left upper lobe pulmonary nodule is not clearly delineated on this study. The patient is status post right upper lobectomy with stable post-surgical changes. Pleural scarring is again noted along the apex and costophrenic junction of the pleura on the right. Cardiomediastinal silhouette appears unchanged. Mild atherosclerotic calcifications are again noted at the aortic arch. Post-surgical changes are noted overlying the posterior column of the lower thoracic/upper lumbar vertebral body. IMPRESSION: Stable appearance of the known 8-mm left upper lobe pulmonary nodule with lack of clear delineation of second known left upper lobe pulmonary nodule. Stable pleural plaques. " 2d1176f5-11fcf537-5325bc28-cbf9e7fa-80588434.jpg,validate/p18/p18699864/s59572687/2d1176f5-11fcf537-5325bc28-cbf9e7fa-80588434.jpg,validation," FINAL REPORT EXAMINATION: PA and lateral chest radiographs INDICATION: ___ year old man with spontaneous R PTX. // Assess for progression of PTX. Please time for 03:00am ___. TECHNIQUE: Chest PA and lateral COMPARISON: ___ and ___ chest radiographs FINDINGS: Compared to the chest radiograph obtained 4 hours prior, a moderate right pneumothorax is increased in size. Apparent leftward mediastinal shift is less conspicuous, however. Right lower lobe atelectasis is more prominent. No pleural effusion. Heart size is normal. Cardiomediastinal hilar silhouettes are unremarkable. IMPRESSION: Increased, moderate right pneumothorax with less conspicuous leftward mediastinal shift, still raising the possibility of tension. NOTIFICATION: This study was interpreted after a subsequent radiograph demonstrated interval placement of a chest tube with marked improvement of the right pneumothorax without evidence of tension. " c8e20c5c-ffa353fc-289a0d3f-d017c56b-af2c6772.jpg,validate/p10/p10504635/s51970713/c8e20c5c-ffa353fc-289a0d3f-d017c56b-af2c6772.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with neutropenic fever and questionable pneumonia. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: Heart is normal size and cardiomediastinal contours are unremarkable. Lungs are well expanded and clear. No evidence of focal consolidation to suggest pneumonia. No pleural effusions and no pneumothorax. Left PICC is noted to terminate in the lower SVC. IMPRESSION: No radiographic evidence of pneumonia. " 26191e77-8f3778ae-07c17f06-4fadd67b-976fe96a.jpg,validate/p13/p13769924/s56930801/26191e77-8f3778ae-07c17f06-4fadd67b-976fe96a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with decompensated heart failure // evaluate for interval change IMPRESSION: In comparison to ___, bilateral pleural effusions have increased in size and are accompanied by worsening bibasilar atelectasis. No other relevant changes since recent study. " 22dfb0f5-66cf844d-f771a35b-911906f5-d49fb0d4.jpg,validate/p19/p19895478/s51035869/22dfb0f5-66cf844d-f771a35b-911906f5-d49fb0d4.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with chest pain // ?pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: There is a 10 mm round opacity projecting over the left lower lung, which likely represents a nipple shadow. Otherwise, the lungs are hyperinflated but clear. No focal consolidations. No pulmonary edema. Normal appearance of the cardiomediastinal silhouette. No pleural effusion. No pneumothorax. Degenerative changes are seen within the right shoulder. There is pectus excavatum. IMPRESSION: 1. Hyperinflation, but no evidence of pneumonia. 2. 10 mm round opacity projecting over the left lower lung, likely a nipple shadow, however a repeat chest radiograph with nipple markers is recommended. NOTIFICATION: The findings were communicated with ___, M.D. by ___, M.D. via page on ___ at 8:16 AM, 30 minutes after discovery of the findings. " 65107a75-93b177f5-2b3a2517-c9895c4e-af6bdd26.jpg,validate/p11/p11932386/s56059090/65107a75-93b177f5-2b3a2517-c9895c4e-af6bdd26.jpg,validation," FINAL REPORT HISTORY: Fall, hit head with loss of consciousness. TECHNIQUE: PA and lateral views of the chest. COMPARISON: None. FINDINGS: Heart size is mildly enlarged. Aorta is slightly unfolded. Mediastinal and hilar contours otherwise are unremarkable. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormalities detected. IMPRESSION: No acute cardiopulmonary process. " 8dc08730-b5d3792e-6599eb9a-74d248f0-f0dac3a3.jpg,validate/p17/p17001135/s50466893/8dc08730-b5d3792e-6599eb9a-74d248f0-f0dac3a3.jpg,validation," FINAL REPORT HISTORY: Chest pain. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___ chest radiograph. Chest CTA ___ at 20: ___. FINDINGS: S-shaped thoracolumbar scoliosis is again demonstrated. Heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion or pneumothorax is identified. Pulmonary vascularity is normal. No acute osseous abnormality is seen. IMPRESSION: No acute cardiopulmonary abnormality. " 7071d7e6-6b659af8-0aa1ac21-f8991af5-fa963ca3.jpg,validate/p14/p14477152/s51686924/7071d7e6-6b659af8-0aa1ac21-f8991af5-fa963ca3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with cough for 4 months, some mild rhonchi at left base. evaluate. // ___ year old woman with cough for 4 months, some mild rhonchi at left base. evaluate. ___ year old woman with cough for 4 months, some mild rhonchi 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. " d21cf487-9d611f51-03801f5b-3f3c2645-b579d9d0.jpg,validate/p18/p18702043/s57087871/d21cf487-9d611f51-03801f5b-3f3c2645-b579d9d0.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with throat discomfort after eating ribs last night // r/o foreign body 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 radiopaque foreign body is seen. IMPRESSION: No acute cardiopulmonary process. No radiopaque foreign body. " fa72a36c-deb8547f-8970651d-d26e540b-681089f0.jpg,validate/p14/p14246614/s54266458/fa72a36c-deb8547f-8970651d-d26e540b-681089f0.jpg,validation," FINAL REPORT HISTORY: Treated pneumonia, awaiting dialysis, interval change in pulmonary edema. COMPARISON: ___ to ___. TECHNIQUE: Portable frontal chest radiograph, single view. FINDINGS: Lung volumes are persistently low. There has been interval increase in size of the cardiomediastinal silhouette consistent with increasing cardiomegaly or small pericardial effusion, although there is no radiographic evidence of tamponade. Mild pulmonary edema is increased from prior study. A small left-sided effusion is unchanged. There is no pneumothorax. A right internal jugular central venous catheter, left internal jugular dialysis catheter, endotracheal tube and upper enteric tube remain in unchanged position. IMPRESSION: Increased size of the cardiac silhouette suggestive of pericardial effusion without radiographic evidence of tamponade. Mildly increased pulmonary edema. " fd0131db-641579e5-c10d964b-9593d9be-06a26075.jpg,validate/p12/p12385857/s55876031/fd0131db-641579e5-c10d964b-9593d9be-06a26075.jpg,validation," FINAL REPORT HISTORY: Patient with vomiting, evaluate for pneumonia. COMPARISON: Chest radiograph and chest CT from ___. FINDINGS: Frontal and lateral chest radiographs were obtained. Again noted is a rounded opacity in in the superior left lower lobe, better evaluated on CT scan from ___. There is mild linear atelectasis/scarring bilaterally. There is no evidence of pneumonia. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: 1. Redemonstration of rounded opacity in in the superior left lower lobe, better evaluated on prior CT from ___. 2. No evidence of pneumonia. " d71f6d25-ee976135-293e4a3f-2cce32b9-af63f7e9.jpg,validate/p13/p13339319/s55196281/d71f6d25-ee976135-293e4a3f-2cce32b9-af63f7e9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with ongoing oxygen requirment // evaluation of pulmonary process evaluation of pulmonary process COMPARISON: Chest radiographs since ___ most recently ___. IMPRESSION: Lung volumes are exceedingly low. The diaphragm is severely elevated, particular the right. Bibasilar atelectasis is presumed. On the left, I cannot exclude concurrent pneumonia as well as a small pleural effusion. However hypoxia is best explained by extremely low lung volumes. The heart is at least mildly enlarged but there is no pulmonary edema, and no pneumothorax. " 517af022-123cff9a-2f038174-938a5c12-97622dab.jpg,validate/p16/p16503587/s51032137/517af022-123cff9a-2f038174-938a5c12-97622dab.jpg,validation," FINAL REPORT INDICATION: ___ year old man with s/p AVR // f/u effusions, atx TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Low lung volumes with persistent bilateral pleural effusions, new compared to the prior radiograph. Persistent cardiomegaly and mild pulmonary edema. . Right PICC terminates at the cavoatrial junction. Sternal sutures, prosthetic cardiac valve, bony thorax remain unchanged. No pneumothorax. IMPRESSION: Bilateral new pleural effusions. Right PICC terminates at the cavoatrial junction. Stable cardiomegaly and mild pulmonary edema. " eb41167c-629342df-9cc37703-02b7eacd-c63db3be.jpg,validate/p16/p16527956/s54513586/eb41167c-629342df-9cc37703-02b7eacd-c63db3be.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with hx of HIV, current smoker presents with ___ weakness. Would like CXR to evaluate for cough and coarse lung sounds b/l . // Pt with cough and coarse lung sounds b/l Pt with cough and coarse lung sounds b/l IMPRESSION: No comparison. The lung volumes are normal. Mild scoliosis with subsequent asymmetry of the ribcage. Mild elongation of the descending aorta. Normal size of the cardiac silhouette. No pneumonia, no pulmonary edema, no pleural effusions. " 31f14632-630740c3-3e5bf93d-d4a33883-33d41108.jpg,validate/p10/p10165779/s57631762/31f14632-630740c3-3e5bf93d-d4a33883-33d41108.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: History: ___F with fever and recent intubation // ?pneumonia TECHNIQUE: Upright AP and lateral views 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. Partial resection of the left sixth rib is re- demonstrated. IMPRESSION: No acute cardiopulmonary abnormality. " 1541d08d-70296c85-d4c90c24-9f932c90-faeaf5e1.jpg,validate/p14/p14353305/s55553860/1541d08d-70296c85-d4c90c24-9f932c90-faeaf5e1.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Pneumothorax, pigtail placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the pre-existing right pneumothorax has been treated with an inserted pigtail catheter. The catheter is in correct position, the right lung is again almost fully expanded. There is no evidence of tension or re-expansion edema. The left lung has normal appearance. " b25360f6-189df102-7d79cb24-3aa625a4-6975b5cf.jpg,validate/p13/p13299285/s59550042/b25360f6-189df102-7d79cb24-3aa625a4-6975b5cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M PMHx Afib on Coumadin, Hodgkin's lymphoma, periampullary pancreatic adenocarcinoma s/p pylorus-preserving whipple in ___, adjuvant gemcitabine now with isolated liver met s/p right hepatectomy ___ s/p removal of R pigtail cath d/t dislodgement for pleural effusion; assess for interval change of effusion ** please preform at radiology rounds ___ at ___** // assess for interval worsening of R pleural effusion s/p pigtail removal COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, no relevant change is seen. Parts of the right pleural pigtail catheter are still visualized. The extent of the known right pleural effusion is constant. Minimal left pleural effusion. Moderate cardiomegaly. No overt pulmonary edema. Unchanged alignment of the sternotomy wires. " 2333f8e2-a30d730e-046db2fc-3c955522-1811a4cb.jpg,validate/p17/p17465349/s59544755/2333f8e2-a30d730e-046db2fc-3c955522-1811a4cb.jpg,validation," FINAL REPORT HISTORY: Cough and fever, evaluate for pneumonia. TECHNIQUE: Portable frontal chest radiograph was obtained. COMPARISON: Chest radiograph from ___. FINDINGS: Bibasilar linear opacities likely represent atelectasis. The lungs are clear without any focal opacities, pleural effusion, pulmonary edema or pneumothorax. The heart and mediastinal contours are within normal limits. IMPRESSION: No acute cardiopulmonary process. " 5b78fd38-880678e3-62150235-3aaf7b4f-9013bb7c.jpg,validate/p11/p11849511/s58750395/5b78fd38-880678e3-62150235-3aaf7b4f-9013bb7c.jpg,validation," FINAL REPORT INDICATION: Intubated with empyema, evaluate for interval change. COMPARISON: ___. FINDINGS: Portable frontal radiograph of the chest demonstrates ET tube, NG tube and right internal jugular central venous catheter in unchanged position. The pigtail catheter and left basilar chest tube are also unchanged. There is stable appearance of the left pleural opacity with poor aeration of the left lower lobe as well as the left lower lobe bronchus which may be obstructed. Lung volumes are lower with crowding of the bronchovascular markings which could just be related to low lung volumes versus mild edema. No large right pleural effusion or pneumothorax. " 105718e1-ff24466e-131b462d-cc982287-2d78cc00.jpg,validate/p16/p16520522/s54308981/105718e1-ff24466e-131b462d-cc982287-2d78cc00.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: CHEST, PA AND LATERAL. INDICATION: ___-year-old male patient with weight loss, night sweats, fevers, and cough. Prior exposure to prison setting. Evaluate for pneumonia and TB. FINDINGS: PA and lateral chest views were obtained with patient in upright position. The heart size is normal. No configurational abnormality is identified. Unremarkable presentation of thoracic aortic contours. No mediastinal abnormalities are seen. The pulmonary vasculature is normal. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. Skeletal structures of the thorax grossly unremarkable. Next preceding chest examination is dated ___. The patient was examined on a trauma board at that time with grossly normal chest findings. IMPRESSION: Stable, normal chest findings. No evidence of active or latent specific infection. No acute pneumonia, pleural effusions. " 15a9db75-0bc8bc82-5d4d4b69-61b5d91c-1a4fc772.jpg,validate/p14/p14371035/s56403360/15a9db75-0bc8bc82-5d4d4b69-61b5d91c-1a4fc772.jpg,validation," WET READ: ___ ___ ___ 7:50 AM 1. Interval replacement of the nasogastric tube, which terminates in the stomach. The NG tube side-hole appears to be past the gastroesophageal junction, but is very near, and may benefit from advancement of several cm. 2. Persistently low lung volumes with bibasilar atelectasis. WET READ VERSION #1 ___ ___ ___ 7:42 PM 1. Interval replacement of the nasogastric tube, which terminates in the stomach. The NG tube side-hole appears to be past the gastroesophageal junction, but is very near, and may benefit from advancement of several cm. 2. Persistently low lung volumes with bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with SBO and NGT that has been replaced. // NGT location IMPRESSION: Interval replacement of nasogastric tube with tip now terminating in the body of the stomach. Cardiomediastinal contours are stable. Improving bibasilar opacities and persistent small right pleural effusion. " 88fc909d-fb11d91b-dc1a7f64-3b67ec46-8af25278.jpg,validate/p12/p12775391/s56005190/88fc909d-fb11d91b-dc1a7f64-3b67ec46-8af25278.jpg,validation," FINAL REPORT INDICATION: ___ year old man with left knee infection. // pre-op for possible knee washout Surg: ___ (left knee washout) TECHNIQUE: Chest PA and lateral COMPARISON: None 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 " 05a87594-2b4f5a95-d18f8955-86735606-3a873878.jpg,validate/p14/p14296543/s50810695/05a87594-2b4f5a95-d18f8955-86735606-3a873878.jpg,validation," FINAL REPORT HISTORY: Shortness of breath. TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. There is no pulmonary edema. The cardiac and mediastinal silhouettes are stable and unremarkable. IMPRESSION: No acute cardiopulmonary process. " 9c9b301d-bd619568-16cb9e33-f742536c-4692fa96.jpg,validate/p11/p11758392/s51379744/9c9b301d-bd619568-16cb9e33-f742536c-4692fa96.jpg,validation," 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. " de45d764-5c1977db-e5072ebf-b44293fe-b8ea6972.jpg,validate/p17/p17288913/s56710962/de45d764-5c1977db-e5072ebf-b44293fe-b8ea6972.jpg,validation," 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. " 7886a321-9013d8fa-69a78e99-36c77098-dc443da7.jpg,validate/p13/p13021959/s55162639/7886a321-9013d8fa-69a78e99-36c77098-dc443da7.jpg,validation," WET READ: ___ ___ 3:44 PM 1. Probable right lower lobe pneumonia. 2. Severe cardiomegaly without evidence of congestion or edema. *** ED URGENT ATTENTION *** ______________________________________________________________________________ FINAL REPORT EXAMINATION: Portable chest radiograph INDICATION: ___F with altered mental status. TECHNIQUE: Chest PA and lateral COMPARISON: ___ portable chest radiograph FINDINGS: Lung volumes are low. There is opacification of the right lower lobe silhouetting the diaphragm. The lungs are otherwise clear. There is severe cardiomegaly with unchanged mild pulmonary vascular congestion but no pulmonary edema. Cardiomediastinal hilar silhouettes are grossly unremarkable. Incidental note is made of superior subluxation of the right humeral head, which is unchanged and likely related to chronic rotator cuff pathology. IMPRESSION: 1. Probable right lower lobe pneumonia. 2. Severe cardiomegaly without evidence of pulmonary edemaedema. " 6038d51b-6b7569e1-ce1c8f2c-65dec3aa-272dde71.jpg,validate/p13/p13745545/s51233537/6038d51b-6b7569e1-ce1c8f2c-65dec3aa-272dde71.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: COPD, progressive dyspnea on exertion, and diastolic heart failure, right lower lobe opacity on chest CT, for assessment. TECHNIQUE: PA and lateral chest views were reviewed in comparison with prior chest radiographs through ___ to ___. Concurrently, chest CT from ___ was reviewed. FINDINGS: Since ___, mild pulmonary interstitial edema has improved. Small right pleural effusion and accompanying right lower lung opacity, mostly atelectasis is overall similar. Moderate left pleural effusion appears minimally worse, while increased retrocardiac density and lower lung opacity, which is atelectasis and/or consolidation has improved. No new discrete opacities. Discrete, right lower lobe soft tissue density opacity, appreciated on chest CT dated ___ is beyond the resolution of chest radiograph. Moderately enlarged heart size is unchanged. Mediastinal and hilar contours are unremarkable. Two leads from the left pectoral ICD device end in the right atrium and right ventricle respectively. " 2fdbf100-93eb02fe-b5b46de6-6bec5993-6a8558ef.jpg,validate/p13/p13706528/s51331030/2fdbf100-93eb02fe-b5b46de6-6bec5993-6a8558ef.jpg,validation," FINAL REPORT INDICATION: ___M with 9 foot fall. // ?fracture, ptx TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " e99e2ba2-d2d5cbb8-86d0fcaa-968d2b22-4bc4296c.jpg,validate/p15/p15112357/s58030545/e99e2ba2-d2d5cbb8-86d0fcaa-968d2b22-4bc4296c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with lethargy // eval for infiltrate COMPARISON: ___. FINDINGS: AP upright and lateral views of the chest provided. Patient's chin obscures the superior mediastinum. On the lateral view the patient's arm overlaps with the chest limiting assessment. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with mild to moderate cardiomegaly re- demonstrated. Imaged osseous structures are demineralized though intact with left shoulder arthroplasty again noted. High riding right humeral head is indicative of chronic rotator cuff disease, unchanged. No free air below the right hemidiaphragm is seen. IMPRESSION: Cardiomegaly, no overt signs of pneumonia or edema. " a781083b-e5a8aa5f-873b567d-00463fcd-76a8ef39.jpg,validate/p13/p13665754/s59561274/a781083b-e5a8aa5f-873b567d-00463fcd-76a8ef39.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with 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 no pneumothorax, focal consolidation, or pleural effusion. Old left anterior rib fractures are present. IMPRESSION: No acute intrathoracic process. " b9eeb3dd-98a18103-1fbc66fc-17a4adb2-71c40fc8.jpg,validate/p11/p11275268/s56660169/b9eeb3dd-98a18103-1fbc66fc-17a4adb2-71c40fc8.jpg,validation," 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. " a2e963d2-2d4a0a50-c31d0d74-aea168a6-f9c008bc.jpg,validate/p16/p16023100/s55731346/a2e963d2-2d4a0a50-c31d0d74-aea168a6-f9c008bc.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F with persistent fevers. // assess for pneumonia COMPARISON: None 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. Nipple jewelry present bilaterally. IMPRESSION: No acute intrathoracic process. " 56112caf-112b9555-dcfa6330-3e90b85c-5d882081.jpg,validate/p19/p19991135/s56587463/56112caf-112b9555-dcfa6330-3e90b85c-5d882081.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with severe COPD now with dyspnea and cough // Eval for PNA Eval for PNA IMPRESSION: In comparison to ___, no relevant change is seen. Old right rib fracture. Known COPD. Mild overinflation. No pneumonia, no pleural effusions, no pulmonary edema. " a737599b-6b194622-21989fda-a6908d2e-5d81b0f6.jpg,validate/p15/p15255120/s55257184/a737599b-6b194622-21989fda-a6908d2e-5d81b0f6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with fever and respiratory distress // r/o acute cardiopulmonary process r/o acute cardiopulmonary process IMPRESSION: Comparison to ___, 17:00. No relevant change in extent and severity of the pre-existing bilateral parenchymal opacities. Stable moderate cardiomegaly without pleural effusions. No pneumothorax. Stable correct position of the right internal jugular vein catheter. " 5015561e-9a4b498a-74e9c030-abedacaa-e283d947.jpg,validate/p13/p13031024/s55333498/5015561e-9a4b498a-74e9c030-abedacaa-e283d947.jpg,validation," FINAL REPORT INDICATION: History: ___F with ?pna // eval for pna 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 " c891f949-d764fdfc-d8f16847-cc77b12d-0a259f1e.jpg,validate/p13/p13679831/s50063490/c891f949-d764fdfc-d8f16847-cc77b12d-0a259f1e.jpg,validation," 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. " 48d9f961-445db46b-712e996a-5e493995-584c1d55.jpg,validate/p19/p19096912/s52085980/48d9f961-445db46b-712e996a-5e493995-584c1d55.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with midsternal chest pain radiating to the back. COMPARISON: None. FINDINGS: PA and lateral views of the chest. The lungs are essentially clear noting minimal left basilar atelectasis. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 55e11343-20b19b57-be0ec82e-695383f6-abd09cfc.jpg,validate/p16/p16332400/s57640857/55e11343-20b19b57-be0ec82e-695383f6-abd09cfc.jpg,validation," FINAL REPORT INDICATION: ___F with fever, cough // pna? TECHNIQUE: Single portable view of the chest. COMPARISON: None. FINDINGS: Tracheostomy tube is in appropriate position. Right PICC tip is at the cavoatrial junction. There are bibasilar opacities, left greater than right suggestive of effusions, larger on the left and moderate to large on the right. Superimposed parenchymal opacities are likely in part due to atelectasis although infection or aspiration would be possible. PEG tube is noted is posterior cervical fixation hardware. " 011aa39f-c58145ba-b739edfc-5b5eb1b0-8990fb30.jpg,validate/p13/p13688556/s54659107/011aa39f-c58145ba-b739edfc-5b5eb1b0-8990fb30.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___M with several episodes syncope, palpitations over prior month COMPARISON: Prior study from ___ FINDINGS: PA and lateral views of the chest provided. Spinal hardware projects over the lower T-spine and upper lumbar spine and is only partially 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. IMPRESSION: No acute intrathoracic process. " c63ff6c4-7e345970-0f9eeb93-aed45b9c-01ad6117.jpg,validate/p13/p13881247/s58513137/c63ff6c4-7e345970-0f9eeb93-aed45b9c-01ad6117.jpg,validation," FINAL REPORT HISTORY: ___-year-old male with fatigue, weakness, dyspnea on exertion as well as weight loss and insomnia. STUDY: PA and lateral chest radiograph. COMPARISON: ___. FINDINGS: The heart size is within normal limits and the mediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. IMPRESSION: No acute cardiopulmonary process. " baaa0434-943d1ead-935a633e-bbee9583-35f8bfdd.jpg,validate/p19/p19711702/s50771008/baaa0434-943d1ead-935a633e-bbee9583-35f8bfdd.jpg,validation," FINAL REPORT INDICATION: Lymphoma with no blood return from MediPort. Assess placement. COMPARISON: Chest radiograph ___. TECHNIQUE: Chest PA and lateral FINDINGS: A right MediPort is unchanged in configuration from ___. There is no evidence of catheter fracture, kinking or migration. The tip terminates in the low SVC. The lungs are clear. No pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. Mediastinal hilar structures are unremarkable. Clips are again noted in the upper abdomen. IMPRESSION: Unchanged appearance of the right MediPort from ___. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ ___ telephone on ___ at 11:31 AM, 2 minutes after discovery of the findings. " cf02b3f3-f10a051b-f9eb3126-84d69794-b7241a5d.jpg,validate/p16/p16151261/s52345634/cf02b3f3-f10a051b-f9eb3126-84d69794-b7241a5d.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___-year-old woman with cough and fever quadriplegic, evaluate for pneumonia. TECHNIQUE: Portable chest radiograph. COMPARISON: Chest radiograph ___. FINDINGS: There are patchy bibasilar opacities. Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. IMPRESSION: Patchy bibasilar opacities concerning for multifocal pneumonia. " 8aad76f6-fde503fa-d272e106-608d1704-3bb29830.jpg,validate/p15/p15002678/s54481740/8aad76f6-fde503fa-d272e106-608d1704-3bb29830.jpg,validation," 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. " 88482f13-2da366eb-443ac305-f0a7d11b-c4ba8c0b.jpg,validate/p16/p16787268/s59030291/88482f13-2da366eb-443ac305-f0a7d11b-c4ba8c0b.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hx of hemorragic stroke presenting with worsening dysphagia, cough // ? cardiopulmonary process TECHNIQUE: Chest: Frontal and Lateral COMPARISON: ___ FINDINGS: The lateral view is suboptimal due to the patient's overlying arm and low lung volumes. The lungs are clear without focal consolidation. There is mild elevation of the right hemidiaphragm. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Chronic appearing deformity projecting projecting over the anterior left first rib. IMPRESSION: No acute cardiopulmonary process. " 56a134f7-2406459b-67481402-7571dbdc-2610ef36.jpg,validate/p16/p16667413/s52362638/56a134f7-2406459b-67481402-7571dbdc-2610ef36.jpg,validation," FINAL REPORT CHEST, TWO VIEWS, ___. HISTORY: ___-year-old man with shortness of breath. COMPARISON: ___. 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. " 00b81270-5355916c-9ad575e2-6ed89e7d-164dfb4a.jpg,validate/p13/p13750116/s54382694/00b81270-5355916c-9ad575e2-6ed89e7d-164dfb4a.jpg,validation," 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. " 7f7c60d2-76f16398-cf18072d-738641d2-d59901c6.jpg,validate/p10/p10398981/s50114318/7f7c60d2-76f16398-cf18072d-738641d2-d59901c6.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with resp failure s/p intubation with rising leukocytosis please. Evaluate for interval change TECHNIQUE: Portable semi-upright AP chest COMPARISON: Chest radiographs ___ through ___. FINDINGS: ET tube is 4.3 cm from the carina. Left internal jugular central venous catheter remains in the low SVC at about the superior cavoatrial junction. Right internal jugular central venous catheter remains in the mid SVC. Enteric tube terminates in the stomach. There is persistent irregular high density material projecting over the left upper quadrant overall unchanged since ___ Small to moderate layering left pleural effusion with associated atelectasis is unchanged. The lungs are otherwise clear. Heart size is normal. The mediastinal and hilar contours are normal. There is no large pneumothorax. IMPRESSION: 1. Unchanged small to moderate layering left pleural effusion and atelectasis. 2. Again there is indeterminate irregular high density material projecting over the left upper quadrant. If further evaluation is desired a CT would be necessary. " 5b6e787f-434a5764-ec1997f3-a10d433e-4aad698e.jpg,validate/p10/p10542587/s59717662/5b6e787f-434a5764-ec1997f3-a10d433e-4aad698e.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPHS INDICATION: Tachypnea and elevated white blood cell count. Question pneumonia. 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. There is similar mild rightward convex curvature centered along the mid thoracic spine. IMPRESSION: No evidence of acute cardiopulmonary disease. " e029920e-b678026c-148fddf5-67a1c985-b56198a5.jpg,validate/p13/p13364910/s56286729/e029920e-b678026c-148fddf5-67a1c985-b56198a5.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with pneumonia and hypoxia. COMPARISON: Comparison is made to radiograph of the chest obtained earlier this morning. FINDINGS: Upright AP and lateral views of the chest demonstrate more confluent appearance of previously identified right upper, right lower, and left lower lobe opacities, compatible with multifocal pneumonia. There is no pneumothorax. The cardiomediastinal silhouette is unchanged. No large pleural effusion is identified. IMPRESSION: More conspicuous consolidations compatible with multifocal pneumonia since the recent prior study from 10:26 a.m. this morning. IV hydration may contribute to radiographic changes. " 43d0d710-1d0dc974-8afb4c10-9188abbc-a3511cdb.jpg,validate/p16/p16818299/s56214279/43d0d710-1d0dc974-8afb4c10-9188abbc-a3511cdb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with major rib trauma, left pleural effusion. Question hemothorax. TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Sternal wires and aortic valve replacement are again seen. New since the prior study is a moderate left apicalpneumothorax with a small left pleural effusion. Additionally, there is a displaced mid clavicular fracture. Given the trauma, the pleural effusion is concerning for a hemothorax. IMPRESSION: Displaced left mid clavicle fracture and moderate left hemopneumothorax. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 3:29 PM, 2 minutes after discovery of the findings. " 70534634-761cd40b-21d516c0-ad1fcfbc-905b999f.jpg,validate/p10/p10390732/s51054747/70534634-761cd40b-21d516c0-ad1fcfbc-905b999f.jpg,validation," 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. " 77072427-0666d1b4-4e345169-1e22c7f0-33efd606.jpg,validate/p12/p12997545/s58428312/77072427-0666d1b4-4e345169-1e22c7f0-33efd606.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: evaluate for interval change Weakness. TECHNIQUE: Chest PA and Lateral COMPARISON: ___ FINDINGS: There is dextroscoliosis of the thoracic spine. The patient is status post median sternotomy. A 7 mm nodule overlying the right lower hemi thorax is stable dating back to ___. On today's exam the lungs appear clear. There is no pleural effusion. There is no pneumonia, no pneumothorax and no pulmonary edema. A sclerotic focus is noted in a mid thoracic vertebral body measuring approximately 7 mm but this is also stable dating back to ___. IMPRESSION: No evidence of pneumonia. " 848ba337-be0d79ba-e4181e81-60d384c3-5fe897c5.jpg,validate/p11/p11708854/s58720567/848ba337-be0d79ba-e4181e81-60d384c3-5fe897c5.jpg,validation," FINAL REPORT INDICATION: ___ year old woman with possible malignant pleural effusion s/p thoracentesis ___ with chest tube still in place on water seal // evaluate pleural effusion, r/o pneumothoraxPlease do at 500 am per IP request TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiographs ___ 13:47 FINDINGS: Since ___, the right pleural effusion has increased in size. The moderate left effusion is worsening since ___. A loculated pleural effusion borders the posterior pleura. Bibasilar atelectasis is stable. The right chest tube is in place without evidence of pneumothorax. Mediastinum is normal and hilar structures are normal. Cardiac borders are partially obscured by pleural effusions. IMPRESSION: Moderate right pleural effusion and new moderate left effusion are both worse since ___. Posteriorly located loculated pleural effusion which may be better characterized on chest CT. " 478243ba-edd1d77d-e37a8613-65064a2d-79d6a29a.jpg,validate/p10/p10900906/s51826814/478243ba-edd1d77d-e37a8613-65064a2d-79d6a29a.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ COMPARISON: ___. FINDINGS: The cardiomediastinal contours are stable in appearance allowing for slightly greater lung volumes on the current study compared to the prior. Improving aeration at the right lung base with residual patchy opacity, likely due to patchy atelectasis. Minor atelectasis is also demonstrated in the left retrocardiac area. No new areas of consolidation to suggest the presence of pneumonia, and no evidence of pleural effusion or pneumothorax. " 6bfa2671-9d7b7603-c8e18d9d-7bb6c3b0-ececf191.jpg,validate/p18/p18704423/s54024370/6bfa2671-9d7b7603-c8e18d9d-7bb6c3b0-ececf191.jpg,validation," FINAL REPORT INDICATION: ___ year old man coughing with po intake, ? aspiration. // ___ year old man coughing with po intake, ? aspiration. TECHNIQUE: Portable COMPARISON: ___ FINDINGS: Left-sided PICC and the Dobhoff tube have been removed. Subtle increase in bibasilar opacities, right greater than left. No pulmonary edema. No pleural effusions or pneumothorax. Mild cardiomegaly. Barium in the colon of the upper abdomen. IMPRESSION: Subtle increase in bibasal opacities may reflect aspiration in this setting. " d2838910-6ab9e88c-52dab722-87aee5e0-a8ff011a.jpg,validate/p12/p12844527/s51903524/d2838910-6ab9e88c-52dab722-87aee5e0-a8ff011a.jpg,validation," 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. " 14775ff0-b2fd680b-b06a9c4a-bd98d628-8612dc70.jpg,validate/p12/p12903881/s54203173/14775ff0-b2fd680b-b06a9c4a-bd98d628-8612dc70.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. CLINICAL HISTORY: ___-year-old male with cough and high fevers. Question pneumonia. FINDINGS: PA 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 abnormality detected. IMPRESSION: No acute cardiopulmonary process. " a3429dc4-9e9eeadc-5b76f139-bcbd2086-38658e45.jpg,validate/p17/p17440770/s51650056/a3429dc4-9e9eeadc-5b76f139-bcbd2086-38658e45.jpg,validation," FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: Since the ___ examination, there has been interval development of mild cardiomegaly. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. ORIF rods within the left humerus are unchanged in position. IMPRESSION: Mild cardiomegaly, new since ___. No superimposed acute process. " e43ee85f-dee9df6e-e671188e-1403c9fe-3ecc578d.jpg,validate/p16/p16441183/s51634094/e43ee85f-dee9df6e-e671188e-1403c9fe-3ecc578d.jpg,validation," 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. " 2bfa6776-82006387-b68fd945-7e9c35e7-88ca7aa3.jpg,validate/p18/p18497141/s54568174/2bfa6776-82006387-b68fd945-7e9c35e7-88ca7aa3.jpg,validation," FINAL REPORT INDICATION: Respiratory distress and concern for bibasilar pneumonia versus aspiration, assess interval change. COMPARISON: Chest radiograph, ___. FINDINGS: The cardiomediastinal and hilar contours are stable with moderate cardiomegaly and calcification of the aortic knob. There is no pneumothorax. Small bilateral pleural effusions are worsened compared to the prior study. Bibasilar opacities have also progressed, consistent with aspiration or pneumonia. Mild-to-moderate pulmonary edema is present. IMPRESSION: Progression of bibasilar opacities, small bilateral pleural effusions, and moderate pulmonary edema. " 797a6cd8-c80397bc-216d02e8-54efe5ad-f8fa5d7c.jpg,validate/p10/p10354217/s50486647/797a6cd8-c80397bc-216d02e8-54efe5ad-f8fa5d7c.jpg,validation," FINAL REPORT AP CHEST, 8:32 A.M., ___ HISTORY: ___-year-old woman with acute-on-chronic diastolic heart failure. Assess pulmonary edema. IMPRESSION: AP chest compared to ___: Both vascular congestion and mild pulmonary edema have improved. Moderate-to-severe chronic cardiomegaly has not, and there is still a small volume of bilateral pleural effusion. No pneumothorax. " d726112f-42e0b188-10b126c9-e6afcb4b-c2e24bd3.jpg,validate/p16/p16425310/s55156072/d726112f-42e0b188-10b126c9-e6afcb4b-c2e24bd3.jpg,validation," FINAL REPORT HISTORY: End stage renal disease, prerenal transplant evaluation, assess for cardiopulmonary abnormalities. COMPARISON: ___. FINDINGS: The heart size is normal. There is no change in the tortuous aorta. The lungs are clear. There is no pleural effusion or pneumothorax. There is no evidence of pulmonary vascular congestion. Mild thoracolumbar scoliosis is unchanged. IMPRESSION: No acute cardiopulmonary abnormalities. No change in the tortuous aorta. " 34b94f61-d0bb1a98-c242c211-e63c5cc1-a01ea803.jpg,validate/p15/p15184004/s55407951/34b94f61-d0bb1a98-c242c211-e63c5cc1-a01ea803.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with cough and fever. COMPARISON: ___ chest x-ray and CT abdomen from ___. FINDINGS: PA and lateral views of the chest. As on prior, there are coarse interstitial markings seen throughout the lungs particularly identified at the periphery and at the bases. There is no superimposed new consolidation nor effusion. Cardiomediastinal silhouette is unchanged. No acute osseous abnormality detected. IMPRESSION: Diffuse and peripheral interstitial abnormality suggestive of fibrosis without definite superimposed confluent consolidation. Subtle or atypical infection cannot be excluded. " df49b4cb-992176fc-6e05538a-27b84f7b-993feaf2.jpg,validate/p18/p18333201/s59555309/df49b4cb-992176fc-6e05538a-27b84f7b-993feaf2.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with cough and fever for 5 days, hx of idiopathic pulm fibrosis. COMPARISON: None FINDINGS: Diffuse interstitial fibrosis is present compatible with provided history of idiopathic pulmonary fibrosis. Difficult to exclude a superimposed pneumonia especially in the absence of baseline prior chest radiograph. No large effusion or pneumothorax. Heart size is difficult to assess. Bony structures appear grossly intact. IMPRESSION: Interstitial fibrosis. Difficult to exclude a superimposed pneumonia. " d08fca4b-6da58cc3-2b882b9a-e02ea693-dc3ad1ee.jpg,validate/p16/p16181203/s52256378/d08fca4b-6da58cc3-2b882b9a-e02ea693-dc3ad1ee.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NG tube in place, clinical ileus // confirm NGT placement TECHNIQUE: Single frontal view of the chest COMPARISON: ___ IMPRESSION: NG tube tip isin the stomach. There are low lung volumes with minimal atelectasis in the left base. The aorta is tortuous. Cardiac size is top-normal. There is no pneumothorax. If any there is small left effusion. " 2f5a43f5-aa4a20ae-34bd3f06-270a2233-ef057c2d.jpg,validate/p16/p16131849/s52183262/2f5a43f5-aa4a20ae-34bd3f06-270a2233-ef057c2d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with with left pneumo // interval changes? COMPARISON: ___, IMPRESSION: As compared to the previous image, there is a minimal reduction of the left probe basal components of the known left pneumothorax. Otherwise the image is unchanged. " fef0fefc-18b5f2c6-5aec0a2a-483a83fc-73a0ea68.jpg,validate/p11/p11699353/s56857277/fef0fefc-18b5f2c6-5aec0a2a-483a83fc-73a0ea68.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with dyspnea. Evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph from ___. FINDINGS: Patient is post right breast surgery, with surgical clips identified overlying the right chest. Cardiomediastinal and hilar contours are normal. Lungs are clear without pleural effusion, pneumothorax, or focal consolidation. IMPRESSION: No acute cardiopulmonary process. " 9a952df7-9c22a0af-c23dd7ec-5f73f968-de01a16b.jpg,validate/p14/p14062965/s55920247/9a952df7-9c22a0af-c23dd7ec-5f73f968-de01a16b.jpg,validation," FINAL REPORT AP CHEST, 4:18 A.M., ___ HISTORY: An ___-year-old woman with respiratory distress. IMPRESSION: AP chest compared to ___ through ___: Severe pulmonary consolidation is asymmetrically distributed, predominantly right upper lobe and left perihilar and lower lung. This would raise some concern for pneumonia, except that these findings appeared over course of 24 hours, a little rapid for pneumonia, though I cannot exclude that. Alternatively asymmetric pulmonary edema could explain all the findings, and there is clearly at least moderate edema present elsewhere in the lungs, as well as an increasing moderate right pleural effusion. The heart size is difficult to assess, probably not greatly enlarged though mediastinal and pulmonary vessels are engorged. " 893b465b-8e568947-58f9cd12-ff957843-74bf7d5f.jpg,validate/p13/p13623501/s53859199/893b465b-8e568947-58f9cd12-ff957843-74bf7d5f.jpg,validation," FINAL REPORT PA AND LATERAL CHEST, ___ HISTORY: ___-year-old male with multiple myeloma. Line placement. Evaluate possible pneumothorax. IMPRESSION: PA and lateral chest compared to chest radiographs since ___, most recently ___: Right internal jugular dual-channel catheter ends in the mid SVC. No pneumothorax, pleural effusion, or mediastinal widening. Heart size normal. Lungs clear. Soft tissue surrounding expansile destructive lesion in the right seventh rib little changed since ___. No pleural effusion. " 8247f3e4-edad5c66-9f38072d-57e65bf7-67ea444b.jpg,validate/p12/p12791752/s59902252/8247f3e4-edad5c66-9f38072d-57e65bf7-67ea444b.jpg,validation," 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. " 31843e44-2373a006-29c98e9c-6136adcf-d26fb632.jpg,validate/p12/p12706696/s58960427/31843e44-2373a006-29c98e9c-6136adcf-d26fb632.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man s/p left sided dual chamber pacemaker implant // r/o pneumothorax, check lead positions r/o pneumothorax, check lead positions COMPARISON: Comparison to ___ at 16:18 FINDINGS: PA and lateral views of the chest ___ at 10:56 are submitted. IMPRESSION: Interval placement of left-sided dual lead pacing device with the leads terminating over the expected location of the right atrium and right ventricle, respectively. The heart remains enlarged. Mediastinal contours are stable. Lungs are well inflated without evidence of focal airspace consolidation, pulmonary edema or pneumothorax. No pleural effusions. " 58d2d0b4-438c52bc-73a26d05-1bdb5e39-4c68f588.jpg,validate/p17/p17648652/s57696227/58d2d0b4-438c52bc-73a26d05-1bdb5e39-4c68f588.jpg,validation," 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. " 34ea4862-69b56c27-eea2acfb-63230bb2-63c5d575.jpg,validate/p14/p14501307/s51916515/34ea4862-69b56c27-eea2acfb-63230bb2-63c5d575.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Hypertensive urgency. FINDINGS: PA and lateral views of the chest are provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The heart appears top normal in size. Mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: Top normal heart size. Otherwise, unremarkable. Clinical correlation is advised given patient's age. " 8eaa124c-cfcb5143-9c5c3faa-021435b2-3d599997.jpg,validate/p10/p10877695/s54323790/8eaa124c-cfcb5143-9c5c3faa-021435b2-3d599997.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___F with fever and 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. Evidence of a hiatal hernia is seen with a retrocardiac air-fluid level. IMPRESSION: No acute cardiopulmonary process. " 5ece955b-c8863dce-13524627-dfa6f571-fc77f5cf.jpg,validate/p17/p17649217/s54442489/5ece955b-c8863dce-13524627-dfa6f571-fc77f5cf.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: status post PEA arrest and with anoxic brain injury. Post intubation. . TECHNIQUE: Single semi-erect portable chest view was reviewed in comparison with prior chest radiographs through ___ to ___. FINDINGS: The orogastric tube is partially coiled in the cervical esophagus; however, the rest of its course can be traced below the diaphragm into the body of the stomach, but its tip is beyond the radiographic view. Endotracheal tube ends 7 cm above the carina at the level of the clavicles. Consider advancing the ET tube by 2 cm for better seating. Subclavian line through the right side ends at the lower SVC. Bilateral lungs are remarkable for opacities in the lower medial lungs, likely from aspiration. Upper lungs are clear. Heart size, mediastinal and hilar contours are normal. IMPRESSION: 1. Bilateral lower medial lung opacities, likely aspiration. 2. Orogastric tube ends into the stomach, but is partially coiled in the cervical esophagus. The findings were communicated to Dr ___ on ___ at approximately 10:28 a.m. " 543e8392-3af24efc-317d3664-cfb2d84a-058eac8d.jpg,validate/p17/p17915506/s50113036/543e8392-3af24efc-317d3664-cfb2d84a-058eac8d.jpg,validation," 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. " 7ca99828-5d9afc86-b3d1be06-0a117080-df31c53d.jpg,validate/p17/p17945297/s50308396/7ca99828-5d9afc86-b3d1be06-0a117080-df31c53d.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with fever up to 101.2. cough, decreased breath sounds in right base. non-smoker. // r/o pneumonia r/o pneumonia IMPRESSION: In comparison with the study of ___, there is little change and no evidence of acute focal pneumonia, vascular congestion, or pleural effusion. " 7d43518d-3decf1ae-ea647931-ae09c56a-f3cf50ef.jpg,validate/p13/p13604162/s55337814/7d43518d-3decf1ae-ea647931-ae09c56a-f3cf50ef.jpg,validation," FINAL REPORT AP CHEST, 5:08 A.M., ___ HISTORY: ___-year-old woman with ischemic bowel. Intubated. IMPRESSION: AP chest compared to ___: It is difficult to distinguish whether changes in the opacity of the left mid and lower lung zone, worsened between ___, minimally improved today is due to intrinsic changes in the lung or pleural effusion layering with differences in patient position. Consistently upright views are recommended for purposes of serial comparison. If more definitive discrimination between lung and pleural findings is needed, then CT scanning would need to be performed. There has clearly been a decrease in mediastinal venous caliber and heart size reflecting decrease in volume overload. The right lung is entirely clear. ET tube in standard placement. There appear to be three catheters extending into the stomach. Feeding tube probably goes to the third or fourth portion of the duodenum. The other two end in the upper stomach. Right jugular line ends in the low SVC. There is no pneumothorax. " 2af78c4c-487d0394-5423a7b1-f5332d8d-3b6d34b4.jpg,validate/p14/p14880550/s52043841/2af78c4c-487d0394-5423a7b1-f5332d8d-3b6d34b4.jpg,validation," FINAL REPORT CHEST RADIOGRAPH HISTORY: Low-grade fever following recent right total knee replacement. COMPARISONS: ___. TECHNIQUE: Chest, AP portable upright. FINDINGS: The lung volumes are low. Allowing for differences in technique, the cardiac, mediastinal and hilar contours are probably unchanged. There is similar mild relative elevation of the left hemidiaphragm compared to the right. Although there are patchy opacities at the left lung base, these are not probably out of proportion to what could be expected with post-operative volume loss. It is difficult to exclude pleural effusions, particularly on the left. There is no pneumothorax. IMPRESSION: No definite findings to suggest acute cardiopulmonary disease. However, if there is persistent clinical concern for possible pneumonia, standard PA and lateral radiography may be helpful to assess the lungs with greater sensitivity for any possible infection. " 5e4c8ab7-81725ab7-22c43eb7-83b2f5af-c17e1d69.jpg,validate/p15/p15043588/s50130308/5e4c8ab7-81725ab7-22c43eb7-83b2f5af-c17e1d69.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with chest pain. Evaluation for pneumonia. 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 pleural effusion, pulmonary edema or focal consolidation. IMPRESSION: No acute cardiopulmonary process. " 95463c72-a31363a0-52715897-a35b9712-3d7fcc28.jpg,validate/p19/p19442789/s53046897/95463c72-a31363a0-52715897-a35b9712-3d7fcc28.jpg,validation," FINAL REPORT INDICATION: Chest pain, evaluate for infiltrate. COMPARISON: Chest CT from ___. FINDINGS: PA and lateral radiographs of the chest were acquired. Lung volumes are slightly low. There is chronic elevation of the right hemidiaphragm. The lungs are clear aside from minimal right basilar atelectasis. Heart size is within normal limits. Mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. IMPRESSION: No acute cardiac or pulmonary process. " 233e90f2-75930088-f5dbd08d-c3d483c6-95782d33.jpg,validate/p19/p19349785/s52597664/233e90f2-75930088-f5dbd08d-c3d483c6-95782d33.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___-year-old man with chest pain and elevated troponin. TECHNIQUE: Portable chest radiograph. COMPARISON: None available. FINDINGS: Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is patchy bibasilar opacities, which may represent atelectasis. There is no acute osseous abnormality. IMPRESSION: Patchy bibasilar opacities, most consistent with atelectasis. " 92be5957-4c4a4aa8-b0677f9c-810e8151-1bae0981.jpg,validate/p18/p18961420/s57501863/92be5957-4c4a4aa8-b0677f9c-810e8151-1bae0981.jpg,validation," 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. " 4c128bc9-3edd03c9-d654efd4-3df927c4-c27af6d5.jpg,validate/p12/p12742310/s52425228/4c128bc9-3edd03c9-d654efd4-3df927c4-c27af6d5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with recent dx of pneumonia on ___ // pneumonia resolution pneumonia resolution IMPRESSION: Most recent prior chest radiograph available to me was ___, when the patient had pulmonary and mediastinal vascular engorgement and a small right pleural effusion. Today lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal. " 2c216d0d-68048f2a-fe5523ff-ee3e7b5e-1ff822a3.jpg,validate/p12/p12995087/s53961848/2c216d0d-68048f2a-fe5523ff-ee3e7b5e-1ff822a3.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with cough for two weeks with fatigue // r/o pneumonia 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 " cd144b87-792cfb68-880f89c0-d692d4ea-4d1324f2.jpg,validate/p12/p12381289/s59708723/cd144b87-792cfb68-880f89c0-d692d4ea-4d1324f2.jpg,validation," FINAL REPORT HISTORY: Anorexia nervosa, eating disorder brick. COMPARISON: None available. FINDINGS: Normal heart, lungs, mediastinum, hila and pleural surfaces. IMPRESSION: Normal chest radiograph. " 11e33f9e-e8128923-aaad27e7-3945b0ef-d8d65bab.jpg,validate/p12/p12780512/s52059922/11e33f9e-e8128923-aaad27e7-3945b0ef-d8d65bab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with b/l chest tubes // any progression of empyema or infiltrates? TECHNIQUE: Single frontal view of the chest. COMPARISON: Chest radiographs dated ___. FINDINGS: Compared to left radiographs from ___, bilateral loculated effusions with associated mild bibasilar atelectasis have improved, right greater than left. Lung volumes remain low. Bilateral chest tubes are in unchanged position, though are coiled and may provide suboptimal function. Esophageal drainage tube extends beyond the diaphragm and terminates in the stomach. No new focal consolidation. No new pneumothoraces. No central vascular congestion or overt pulmonary edema. Cardiomediastinal silhouette is stable. IMPRESSION: 1. Improved bilateral loculated effusions, right greater than left, and associated mild bibasilar atelectasis. 2. Unchanged placement of bilateral chest tubes, which appear coiled and may provide suboptimal function. " bdc41fbc-3be3c204-51291933-8abd285e-9284acf5.jpg,validate/p10/p10374990/s50820775/bdc41fbc-3be3c204-51291933-8abd285e-9284acf5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with R loculated pleural effusion of unknown etiology, s/p chest tube placement. Please eval for chest tube positioning, interval change in effusion size. TECHNIQUE: Portable AP view of the chest. COMPARISON: Chest radiograph of the prior day. FINDINGS: Compared with the prior radiograph, the right-sided pigtail catheter has been moved more superiorly, with interval decrease in the size of the right pleural effusion. Patient is post aortic graft placement, with unchanged left subclavian line. The left lung continues to be essentially clear. Cardiomediastinal silhouette is unchanged. No evidence of pneumothorax. Surgical fixation hardware is unchanged. IMPRESSION: Interval decrease in the right-sided pleural effusion. " 73d7cecb-cb80b059-716117d6-3d17a04e-dcd90d2d.jpg,validate/p13/p13031024/s52753211/73d7cecb-cb80b059-716117d6-3d17a04e-dcd90d2d.jpg,validation," FINAL REPORT INDICATION: ___F with fever, cough // infiltrate? TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: ___. FINDINGS: The lungs are clear. There is no focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities. IMPRESSION: No acute cardiopulmonary process. " 7a817afd-acda7c7f-89f81cee-48417f53-c25129b8.jpg,validate/p13/p13110443/s51755131/7a817afd-acda7c7f-89f81cee-48417f53-c25129b8.jpg,validation," FINAL REPORT EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 2 EXAMS INDICATION: ___ year old man with AMS s/p pontine, subthalamic hemorrhage // ? appropriate NGT placement. ? signs of aspiration TECHNIQUE: Chest 2 portable views during NG tube insertion COMPARISON: ___ IMPRESSION: The appearance of the lungs is unchanged with right-sided PICC line in compressive changes at the bases and mild pulmonary vascular redistribution with mild cardiomegaly. The NG tube is not visualized in the chest. It is visualized coiled over the region of the patient's neck likely in the oropharynx NOTIFICATION: This finding was discussed with Dr. ___ at the time of dictating this report by Dr. ___ at 13:18 " 864bc615-28adc6fc-96a8cb74-227870b3-d171ab96.jpg,validate/p11/p11354186/s55715153/864bc615-28adc6fc-96a8cb74-227870b3-d171ab96.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: History: ___M with hypoxia // ?pneumonia TECHNIQUE: Chest: Frontal and Lateral COMPARISON: None. FINDINGS: No focal consolidation is seen. Scattered calcified subcentimeter nodular opacities most likely represent calcified granulomas. No large pleural effusion or pneumothorax is seen. No pulmonary edema is seen. The cardiac silhouette is top-normal to mildly enlarged. Mediastinal contours are unremarkable. IMPRESSION: No focal consolidation to suggest pneumonia. " 454d8341-da5e8496-c5c986fe-b3b74e3b-f36c30e0.jpg,validate/p12/p12343156/s51345959/454d8341-da5e8496-c5c986fe-b3b74e3b-f36c30e0.jpg,validation," FINAL REPORT CHEST, TWO VIEWS; ___ HISTORY: ___-year-old female with acute onset of chest pain. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion or pulmonary vascular congestion. Cardiac silhouette is stable. Atherosclerotic calcification is again noted at the aortic arch. No acute osseous abnormality is detected. IMPRESSION: No acute cardiopulmonary process. " 7c89bd47-91b5f1e9-10878cdf-c71bf305-be0f2c1c.jpg,validate/p10/p10514375/s56144727/7c89bd47-91b5f1e9-10878cdf-c71bf305-be0f2c1c.jpg,validation," FINAL REPORT HISTORY: Lung cancer with Pleurx catheter and chest tube, to assess for change. FINDINGS: In comparison with the study of ___, there is little overall change, the left pleural effusion that is partially loculated is again seen. There may be slight increase in opacification at the left base that could reflect some increasing atelectasis. " e15db5c7-1fd668b5-e317fec8-90b22440-d050852b.jpg,validate/p13/p13562477/s55559177/e15db5c7-1fd668b5-e317fec8-90b22440-d050852b.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: To evaluate placement and position of the Dobhoff tube. TECHNIQUE: Single upright portable chest view was read in comparison with the most recent radiograph done on the same day approximately 8 hours apart. FINDINGS: A Dobhoff tube is coiled in the hypopharynx and its distal end is looped in the stomach. Consider repositioning the Dobhoff tube. Mild pleural effusion on the right side and mild-to-moderate left pleural effusion are unchanged. Given the low lung volumes, presence of mild pulmonary edema may be exaggerated. Mild-to-moderately enlarged heart size and widened mediastinal contour is unchanged since at least ___. There is retrocardiac density in the left lower lung reflecting atelectasis is similar. There is a left-sided PICC line, with its tip in the subclavian vein, unchanged since at least ___. " 36597bca-0c34190b-76cd5ea4-a83e4369-5cddf6be.jpg,validate/p17/p17459404/s58765563/36597bca-0c34190b-76cd5ea4-a83e4369-5cddf6be.jpg,validation," WET READ: ___ ___ ___ 7:52 AM Left-sided hydro pneumothorax. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiographs INDICATION: History: ___M with NSCLC, left lung pathology // PNA, effusion? TECHNIQUE: Chest PA and lateral COMPARISON: Comparison is made with chest radiographs from ___ and ___. FINDINGS: There is a large air-fluid level in the left hemi thorax with near complete white out of the lung. Findings are concerning for left-sided hydropneumothorax. The right lung is well expanded and clear. There is no right pleural effusion or pneumothorax. The cardiomediastinal silhouette displaced to the right secondary to the hydropneumothorax. IMPRESSION: Left-sided hydropneumothorax NOTIFICATION: Findings were communicated to the patient's ED team at 7:08 a.m. on ___ by phone ___ min after the time discovery. " 90534d92-2c0cdf30-0725f9de-fecc5d30-81fc0fab.jpg,validate/p16/p16365002/s50144522/90534d92-2c0cdf30-0725f9de-fecc5d30-81fc0fab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___M with left sided weakness TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. 4 mm nodular opacity projecting over the left upper lobe, overlying the left fifth posterior rib, may be within the osseous structures or reflect a pulmonary nodule. 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. 4 mm nodular opacity projecting over the left upper lobe may be within the bone or within the lung parenchyma. Consider shallow oblique imaging or comparison with prior radiographs for further assessment. " faa9170d-19182f8f-3f6dfe46-40977e01-a8bd5c0b.jpg,validate/p12/p12724735/s57025667/faa9170d-19182f8f-3f6dfe46-40977e01-a8bd5c0b.jpg,validation," FINAL REPORT INDICATION: Patient with renal failure. Assess for CHF. COMPARISONS: Chest radiograph of ___ and CT abdomen and pelvis of same date. FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Heart is mildly enlarged. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Perihilar vascular congestion is noted. Partially imaged upper abdomen is unremarkable. IMPRESSION: Low lung volumes. Mild cardiomegaly and perihilar vascular congestion, slightly progressed since ___ exam. " 1bc7e468-7d7c294a-70aa1d2a-625d21a9-7ca88acb.jpg,validate/p15/p15914798/s58043908/1bc7e468-7d7c294a-70aa1d2a-625d21a9-7ca88acb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with shortness of breath TECHNIQUE: Portable upright AP view of the chest COMPARISON: ___ FINDINGS: Lung volumes are low. Heart size is mildly enlarged, unchanged. Mediastinal and hilar contours are similar. Patchy opacities in the lung bases likely reflect areas of atelectasis. No pulmonary edema is present, and there is no pleural effusion. No pneumothorax is identified. No acute osseous abnormality is detected. IMPRESSION: Bibasilar patchy opacities, likely atelectasis. Infection is not completely excluded. " 847bf9e1-42da8d8a-0a4cfd76-fb5a8388-4962a0ce.jpg,validate/p16/p16254738/s56952033/847bf9e1-42da8d8a-0a4cfd76-fb5a8388-4962a0ce.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY, ___ COMPARISON: Radiographs between ___ and ___. FINDINGS: Right upper lobe opacity is improving with associated decrease in volume loss, with minor fissure now in the expected anatomic position. Low lung volumes accentuate the cardiac silhouette and bronchovascular structures, limiting assessment of cardiovascular status of the patient. Patchy atelectasis is present in the right lower lobe. Left lung is grossly clear allowing for the low lung volumes. " 2939cd91-48607077-31fc6024-fb38355b-1d6f8f00.jpg,validate/p10/p10983866/s50732129/2939cd91-48607077-31fc6024-fb38355b-1d6f8f00.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with fever, question pneumonia. COMPARISON: Chest radiograph on ___ and CT chest on ___. FINDINGS: PA and lateral views of the chest. Again seen is the biapical calcified scarring compatible with prior granulomatous disease and emphysematous changes involving mainly the apices. Mild chronic interstitial changes are seen in the lower lobes bilaterally, better assessed on the prior CT. There is an opacity in the left lower lobe which may represent a superimposed pneumonia. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette is normal. The median sternotomy wires and mediastinal clips are stable. Clips are seen in the right upper quadrant. There is no free air. The osseous structures appear unremarkable. IMPRESSION: Left lower lobe opacity concerning for pneumonia. " e374b015-6b5fd387-71972ac2-e37cc71a-0936bcdd.jpg,validate/p16/p16374934/s56798558/e374b015-6b5fd387-71972ac2-e37cc71a-0936bcdd.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with recent ILI, persistent fevers, who presents for evaluation. COMPARISON: Chest x-ray from ___, ___ and ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: The heart is normal in size. There are focal opacities in the right middle lobe, right lower lobe and left lower lobe, all of which are new compared to the prior exam. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. There is no evidence of reactive lymphadenopathy. The visualized osseous structures are unremarkable. IMPRESSION: Evidence of pneumonia in the right middle lobe, right lower lobe and left lower lobe, new compared to the prior exam. No evidence of a reactive pleural effusion or reactive lymphadenopathy. These findings were discussed with Dr. ___ at 10:55 p.m. by Dr. ___ ___ by telephone. " 6e747f1a-098ed9f5-1d9becc5-f299b1e5-60e4c0bd.jpg,validate/p10/p10570398/s54351062/6e747f1a-098ed9f5-1d9becc5-f299b1e5-60e4c0bd.jpg,validation," FINAL REPORT INDICATION: ___-year-old man status post CABG with postoperative bleeding. Evaluate for effusion versus hemothorax. COMPARISON: ___ and ___. FINDINGS: A small right and moderate-to-large left pleural effusion are unchanged since the prior exam yesterday. Central pulmonary vascular congestion has significantly improved. Sternotomy wires are intact and mediastinal clips are in unchanged position. A right-sided internal jugular catheter tip remains in the low SVC. IMPRESSION: Stable small right and moderate-to-large left effusions. " f892b56c-d9eea4df-744c9041-6829802d-bce02967.jpg,validate/p14/p14681474/s59879872/f892b56c-d9eea4df-744c9041-6829802d-bce02967.jpg,validation," FINAL REPORT HISTORY: Patient with history of pneumonia, question resolution. COMPARISON: ___. FINDINGS: Frontal and lateral chest radiographs were obtained. The previous left lower lobe and left upper lobe opacities are almost completely resolved with only a small area of opacification remaining. The right lung is fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. IMPRESSION: Interval partial resolution of left lower and left upper lobe pneumonia. " 8bb9274a-642c7f64-c49ac415-a907ff76-98eb0470.jpg,validate/p15/p15874317/s57669135/8bb9274a-642c7f64-c49ac415-a907ff76-98eb0470.jpg,validation," FINAL REPORT TYPE OF EXAMINATION: Chest PA and lateral. INDICATION: ___-year-old female patient with dyspnea. 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 overall heart size is at the upper limit of normal variation. No typical configurational abnormality is identified. There is a relative prominence of the left ventricular contour to the left and posteriorly but no signs of significant left atrial enlargement is present. The thoracic aorta is generally moderately widened and shows extensive wall calcifications predominantly in the arch, but also extending into the descending aorta. On the lateral view, the typical calcifications in the aortic valve are identified. A permanent pacer is located in left anterior axillary position that is connected to two intracavitary electrodes, one of which terminates towards the right atrial appendage, the second terminates in the apical portion of the right ventricle. These findings are stable when compared with the next preceding examination when the patient had to be examined in sitting semi-upright position using AP frontal projection view. The latter finding explains that the heart shadow appeared somewhat larger than it is now. Pulmonary vasculature is not congested and there is no evidence of any acute or chronic parenchymal infiltrates. Lateral and posterior pleural sinuses are free and no pneumothorax is identified in the apical area. IMPRESSION: Stable chest findings in elderly female patient with permanent pacer, dual electrodes in place, borderline heart size but no evidence of pulmonary vascular congestion or any acute infiltrates. Extensive aortic wall calcifications and calcium deposits in the aortic valve area already seen on previous examinations. " 9b9c5ea9-3957f9ca-fe2e504e-5ebbe946-97e8b181.jpg,validate/p17/p17270077/s58475660/9b9c5ea9-3957f9ca-fe2e504e-5ebbe946-97e8b181.jpg,validation," FINAL REPORT PORTABLE CHEST X-RAY ___ No prior studies for comparison. FINDINGS: Heart is upper limits of normal in size, and note is made of mitral annular calcifications. The lungs are clear except for minimal areas of patchy atelectasis at both lung bases. No definite pleural effusion. " 91b223f3-96fb975f-f523dbe2-ef27ee34-201bdd2f.jpg,validate/p11/p11968677/s54579619/91b223f3-96fb975f-f523dbe2-ef27ee34-201bdd2f.jpg,validation," WET READ: ___ ___ 11:18 PM 1. interval extubation; endogastric tube in stomach. 2. mild fluid overload persists. 3. calcified splenic artery. ______________________________________________________________________________ FINAL REPORT AP CHEST 6:25 P.M., ___ HISTORY: CHF. Concern for volume ove IMPRESSION: AP chest compared to ___ through ___ at 10:13 a.m.: Mild pulmonary vascular congestion which developed over the course of the day has persisted. Moderate cardiomegaly unchanged. No focal findings to suggest pneumonia. Right apical pleural parenchymal opacification is also chronic. Nasogastric tube loops in the stom " 1639585f-c1dc4877-61275ebb-bf48bca2-c375239b.jpg,validate/p16/p16568324/s57848508/1639585f-c1dc4877-61275ebb-bf48bca2-c375239b.jpg,validation," WET READ: ___ ___ ___ 3:14 PM 1. Endotracheal tube in standard position. 2. Enteric tube tip within the distal esophagus and should be advanced by at least 15 cm for appropriate positioning. 3. Probable mild bibasilar atelectasis. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with endotracheal tube placement TECHNIQUE: Supine AP view of the chest COMPARISON: None. Patient is currently listed as EU critical. FINDINGS: Endotracheal tube tip terminates approximately 5.9 cm from the carina. An enteric tube tip is noted within the distal esophagus. Heart size is top normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. Minimal streaky bibasilar opacities likely reflect areas of atelectasis. No large pleural effusion or pneumothorax is seen on this supine exam. There are no acute osseous abnormalities. IMPRESSION: 1. Endotracheal tube in standard position. 2. Enteric tube tip within the distal esophagus and should be advanced by at least 15 cm for appropriate positioning. 3. Probable mild bibasilar atelectasis. " c742b233-0f43ccb5-436b842e-dc11106f-d9eed087.jpg,validate/p15/p15035611/s57917958/c742b233-0f43ccb5-436b842e-dc11106f-d9eed087.jpg,validation," FINAL REPORT CHEST RADIOGRAPHS HISTORY: Status post fall with scapular pain on the right. Question pneumothorax. COMPARISONS: ___. TECHNIQUE: Chest, AP and lateral. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. The left acromioclavicular interval is at the upper limits of normal. The right acromioclavicular joint appears narrowed. There is no evidence for fracture, dislocation or bone destruction. IMPRESSION: No evidence of injury. " 44da97ce-dd2b7a2a-fe25dc28-0377ff77-3318d443.jpg,validate/p19/p19228312/s53211236/44da97ce-dd2b7a2a-fe25dc28-0377ff77-3318d443.jpg,validation," FINAL REPORT PORTABLE CHEST FILM, ___ AT 6:14 CLINICAL INDICATION: ___-year-old status post endovascular AAA repair. Comparison to prior study of ___ at 15:51. A portable AP upright chest film ___ at 6:14 a.m. is submitted. IMPRESSION: 1. Interval extubation. Right internal jugular introducer remains in place with the tip in the right brachiocephalic seen. There is a graft within the ascending aorta in this patient status post endovascular repair of an aneurysm. Left superior mediastinal opacity likely corresponds to a dilated tortuous aorta as demonstrated on the CT dated ___. There is worsening pulmonary edema with increasing consolidation at the left base with an associated effusion which likely represents compressive atelectasis. No pneumothorax is appreciated. Overall, heart remains stably enlarged. Bilateral shoulder replacements. " c52cd52a-ed3351f3-3a6daafb-8400c741-b077fbbe.jpg,validate/p12/p12521370/s54543125/c52cd52a-ed3351f3-3a6daafb-8400c741-b077fbbe.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multiple myeloma and fever // r/o new infiltrate r/o new infiltrate COMPARISON: Chest radiographs since ___, most recently ___. IMPRESSION: Lung volumes are lower exaggerating mild pulmonary vascular engorgement, probable mild cardiomegaly and mediastinal venous engorgement, and making it difficult to assess the lungs. There is no pneumothorax. Pleural effusions are small if any. Right supraclavicular central venous line ends in the low SVC. " 696e1579-40b18509-be3d4e55-8a6e5d36-4e03c6eb.jpg,validate/p13/p13801616/s58292841/696e1579-40b18509-be3d4e55-8a6e5d36-4e03c6eb.jpg,validation," FINAL REPORT EXAMINATION: CHEST RADIOGRAPH INDICATION: Fever and leukocytosis. Status post tissue AVR. TECHNIQUE: Chest, portable AP upright. COMPARISON: ___. FINDINGS: The cardiac, mediastinal and hilar contours appear stable. A central line has been removed. There is probably a trace pleural effusion on the left. Opacity has decreased in the right cardiophrenic angle and patchy retrocardiac opacity, probably due to atelectasis although not specific, is similar to slightly decreased. IMPRESSION: Persistent but decreasing opacities at the lung bases. Removal of central line. " daa22662-08fb9c97-d7fe7be0-e1a1ab36-0c4436b9.jpg,validate/p11/p11394025/s57526428/daa22662-08fb9c97-d7fe7be0-e1a1ab36-0c4436b9.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with persistent cough, sputum production. // Any infiltrates? IMPRESSION: In comparison with the study ___ ___ is ___, there is little change. No evidence of acute pneumonia, vascular congestion, or pleural effusion. " dd958cf0-3c25e395-951ab3ec-830fc892-a82c1b8d.jpg,validate/p19/p19751455/s55676558/dd958cf0-3c25e395-951ab3ec-830fc892-a82c1b8d.jpg,validation," FINAL REPORT INDICATION: Hypoxic respiratory failure. COMPARISON: Chest radiograph from ___. TECHNIQUE: Frontal chest radiograph. IMPRESSION: A right PICC terminates at the upper SVC. The heart size remains normal. The hilar and mediastinal contours are unchanged. Postsurgical changes are again seen at the left apex. An ill-defined left basilar opacity is unchanged. There is no pneumothorax or pleural effusion. " 605ca3e4-efd99a18-539de55a-af9e4c2c-3fc332d8.jpg,validate/p19/p19960115/s55474132/605ca3e4-efd99a18-539de55a-af9e4c2c-3fc332d8.jpg,validation," FINAL REPORT INDICATION: ___M s/p Whipple for pancreatic adenocarcinoma c/b postop aspiration PNA leading to septic shock, ARF, reintubation, trach s/p Dobhoff placement now c/b anemia/fever. // pneumonia work-up COMPARISON: Radiographs from ___ IMPRESSION: Support lines and tubes are unchanged in position. There is unchanged cardiomegaly. There is again seen bilateral pleural effusions and markedly low lung volumes. There is mild pulmonary edema. No pneumothoraces are seen. " 11e36fa7-56edfe86-02885c6b-6b99c7cc-7ae549de.jpg,validate/p12/p12455922/s59386609/11e36fa7-56edfe86-02885c6b-6b99c7cc-7ae549de.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with GOLD II COPD with bronchitis in ___ now much better, assess for any worsening of previously noted chronic changes. // any change in previously noted atelectatic changes any change in previously noted atelectatic changes IMPRESSION: Compared to prior chest radiographs ___. Lungs are still hyperinflated suggesting emphysema or small airway obstruction. At least one irregular 11 mm nodule projecting over the left third rib requires chest CT evaluation to see if it is calcified. There may be additional nodules, difficult to separate from the anterior costal calcifications. Heart size is normal, decreased since the prior study. Pulmonary vasculature is not engorged and there is no edema or pleural effusion. Lateral view shows considerable atherosclerotic calcification in the aorta and at the origin of head neck vessels. As before, the trachea trachea is displaced to the right and posteriorly by a a large left pretracheal mass, most commonly thyroid. RECOMMENDATION(S): Chest CT to evaluate pulmonary nodules. Clinical evaluation of the significance of a possible large left goiter or other while are other cervicothoracic mass. " 864a2505-9f5b75e8-7b30bea5-2382e8f4-f7bca361.jpg,validate/p11/p11868667/s54743151/864a2505-9f5b75e8-7b30bea5-2382e8f4-f7bca361.jpg,validation," FINAL REPORT HISTORY: Dyspnea. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Mild to moderate cardiomegaly is again noted, with marked calcification of the aortic knob. The mediastinal and hilar contours are otherwise similar. There is minimal atelectasis in the left lung base. No focal consolidation, pleural effusion or pneumothorax is identified. Multiple clips are seen in the right upper quadrant the abdomen. There are multilevel degenerative changes in the thoracolumbar spine. IMPRESSION: No acute cardiopulmonary abnormality. " 00d44b47-2484ebdf-755bdbb7-d4d49c3a-8b35233d.jpg,validate/p11/p11842879/s56233040/00d44b47-2484ebdf-755bdbb7-d4d49c3a-8b35233d.jpg,validation," FINAL REPORT INDICATION: Immunosuppression and acute desaturation. COMPARISON: ___ at 5:36 a.m. FINDINGS: A right jugular central venous line ends in the upper right atrium. An enteric tube ends likely in the stomach. The apical portions of the lungs were not imaged, but no large pneumothorax is seen. Bibasilar consolidations are again seen. There is slight increase in atelectasis at the right lung base. No large pleural effusion. Cardiomediastinal and hilar contours are stable. IMPRESSION: Unchanged bibasilar consolidations which may represent pneumonia. Slight increase in right basilar atelectasis. The apices of the lungs were not imaged, so small pneumothorax cannot be excluded, but there is no large pneumothorax. " fc031fa9-79a1b8a4-af0c470d-43c92983-a1e21e5f.jpg,validate/p19/p19398915/s57855308/fc031fa9-79a1b8a4-af0c470d-43c92983-a1e21e5f.jpg,validation," FINAL REPORT PORTABLE CHEST ___ COMPARISON: Radiograph of earlier the same date. FINDINGS: Allowing for differences in technique and projection, there has been little change in the appearance of the chest since the recent study performed earlier the same date. " 2cec2acc-c2520dd8-7a34ecb0-6f3877dd-19ed5741.jpg,validate/p10/p10345452/s59828182/2cec2acc-c2520dd8-7a34ecb0-6f3877dd-19ed5741.jpg,validation," FINAL REPORT HISTORY: Worsening cough, shortness of breath. TECHNIQUE: PA and lateral views of the chest. COMPARISON: Chest CT ___ and report from chest radiograph ___ (images are not available for direct comparison at this time). FINDINGS: Lung volumes are low. Heart size is at least mildly enlarged. The aorta is unfolded. There is crowding of the bronchovascular structures with possible mild pulmonary vascular congestion, but no overt pulmonary edema is present. Bibasilar airspace opacities likely reflect the patient's known of fibrosing NSIP, as seen on the prior chest CT. Blunting of the left costophrenic angle could suggest a small left pleural effusion. No pneumothorax is identified. No acute osseous abnormalities are visualized. IMPRESSION: Low lung volumes with bibasilar airspace opacities likely reflective of the patient's known fibrosing NSIP. Blunting of the left costophrenic angle suggests a small effusion. Superimposed process at the lung bases is difficult to exclude. Possible mild pulmonary vascular congestion. " 1bb3bc2d-6c48384b-946a1d6e-c9dc8460-189cae8b.jpg,validate/p12/p12083427/s55556688/1bb3bc2d-6c48384b-946a1d6e-c9dc8460-189cae8b.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with disseminated zoster, scalp cellulitis on broad antibiotics and acyclovir w/ new fever // Please eval for consolidation TECHNIQUE: AP and lateral chest radiographs. COMPARISON: CT chest ___ FINDINGS: Lung volumes are within normal limits. The trachea is central. Even allowing for the projection, the heart is mildly enlarged. Left lower lobe atelectasis, cannot exclude superimposed infection. No pleural effusions seen. No pneumothorax. IMPRESSION: Left lower lobe atelectasis, cannot exclude superimposed infection. " 366bcdc5-c2cfd8e2-3b8ae58b-29472669-1b9a36fe.jpg,validate/p11/p11599292/s56327595/366bcdc5-c2cfd8e2-3b8ae58b-29472669-1b9a36fe.jpg,validation," FINAL REPORT INDICATION: ___ year old man with lung cancer s/p LLL superior segmentectomy. **PLEASE PERFORM CXR AT 5AM ON ___** // Assess interval change COMPARISON: Radiographs from ___ IMPRESSION: There is an unchanged left-sided chest tube. Heart size is enlarged but stable. There is atelectasis at the right base. There are bilateral pleural effusions which are stable. There are no pneumothoraces. " e2cdc555-daa0bbde-214f722c-fe067bb6-fc0d6629.jpg,validate/p12/p12293631/s59354463/e2cdc555-daa0bbde-214f722c-fe067bb6-fc0d6629.jpg,validation," FINAL REPORT HISTORY: Fall, dementia. COMPARISON: Chest radiograph ___, ___. FINDINGS: AP and lateral views the chest were viewed. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The lungs are well expanded without focal consolidations. The previously noted nodular opacity at the right lung base is not clearly seen on the current study. Interstitial markings are again prominent, likely indicative of chronic lung disease. No displaced rib fractures are seen. IMPRESSION: No pneumothorax or displaced rib fractures. " a8c79dc4-60aa5a2b-ad51920f-ec991fa1-824b6602.jpg,validate/p14/p14090374/s52908715/a8c79dc4-60aa5a2b-ad51920f-ec991fa1-824b6602.jpg,validation," FINAL REPORT HISTORY: Altered mental status. TECHNIQUE: Upright AP view of the chest. COMPARISON: ___. FINDINGS: The cardiac silhouette size is top normal. The aorta is slightly tortuous with aortic not calcifications again noted. The pulmonary vascularity is normal and the lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are present. IMPRESSION: No acute cardiopulmonary process. " d668aebf-50dfd261-675045d7-5a4940ba-97f3c8d0.jpg,validate/p13/p13561991/s59415176/d668aebf-50dfd261-675045d7-5a4940ba-97f3c8d0.jpg,validation," FINAL REPORT INDICATION: ___F with thyoid myxedema pschosis pls eval for pna or thyopird enlargement TECHNIQUE: AP and lateral views of the chest. COMPARISON: ___. FINDINGS: Patient is rotated to the left. The lungs remain clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " 89dbec43-325a5b2e-4713b6b9-f68bb07b-99a783ab.jpg,validate/p12/p12107588/s56949751/89dbec43-325a5b2e-4713b6b9-f68bb07b-99a783ab.jpg,validation," FINAL REPORT CHEST, TWO VIEWS: ___. HISTORY: ___-year-old female with chest pain. COMPARISON: ___. FINDINGS: Frontal 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. " b20621a3-62a10427-8a9fa6df-2a0d2eb4-99d13893.jpg,validate/p13/p13872674/s58097797/b20621a3-62a10427-8a9fa6df-2a0d2eb4-99d13893.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Chest pain and shortness of breath, evaluate for pneumothorax. Comparison is made with prior study, ___. Cardiac size is top normal. There is mild-to-moderate interstitial pulmonary edema. There is no pneumothorax. Multiple lung nodules seen in prior PET-CT from ___ are below the resolution of this radiograph. Subdiaphragmatic air is probably still present. " dbe65df6-c8a537d4-64636a7f-d1a63cb8-9d4d50cf.jpg,validate/p17/p17702558/s55270996/dbe65df6-c8a537d4-64636a7f-d1a63cb8-9d4d50cf.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with NSCLC w/ left pleural effusion s/p left pleurex with slightly worsening hypoxia // eval for PTX eval for PTX IMPRESSION: ___ ___ ___ with the earlier study of this date, there has been further aeration of the left upper lung with the PleurX catheter in place, though a substantial effusion and volume loss in the left lung process. No definite pneumothorax. The right lung remains clear. " 32a8936b-7928a40f-affb556e-af4dc545-7d684b42.jpg,validate/p17/p17775867/s55418461/32a8936b-7928a40f-affb556e-af4dc545-7d684b42.jpg,validation," FINAL REPORT INDICATION: Weakness. Evaluate for occult pneumonia. COMPARISONS: None. FINDINGS: The lungs are clear without consolidation or edema; streaky left medial basilar opacity suggests minor atelectasis or scarring. There is no pleural effusion or pneumothorax. There is an eventration of the right hemidiaphragm. The cardiac silhouette is moderately enlarged. The mediastinal contours are unremarkable within the limitations of technique. IMPRESSION: 1. No acute cardiopulmonary process; streaky left basilar opacity is likely to represent minor atelectasis or scarring. 2. Moderate cardiomegaly. 3. Right diaphragmatic eventration. " dbdb7b39-50998f61-b305a8f1-8de0793c-5751dde3.jpg,validate/p16/p16697958/s56182087/dbdb7b39-50998f61-b305a8f1-8de0793c-5751dde3.jpg,validation," 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. " dc70519c-46487029-a2b570f7-5ea185e6-94166b75.jpg,validate/p10/p10180652/s58478780/dc70519c-46487029-a2b570f7-5ea185e6-94166b75.jpg,validation," FINAL REPORT INDICATION: Chest pain, evaluate for pneumothorax and pneumonia. COMPARISON: ___. FINDINGS: Frontal and lateral radiographs of the chest show no acute intrathoracic process. The cardiomediastinal, pleural and pulmonary structures are unremarkable. There is no pleural effusion or pneumothorax. The heart size is normal. A MediPort is seen terminating in the distal SVC. There are no suspicious osseous lesions. The patient is status post right arm amputation. IMPRESSION: No acute intrathoracic process. " 75b38774-141f3db9-3560c4fe-8224c076-51a7fcd1.jpg,validate/p13/p13706528/s51331030/75b38774-141f3db9-3560c4fe-8224c076-51a7fcd1.jpg,validation," FINAL REPORT INDICATION: ___M with 9 foot fall. // ?fracture, ptx TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None. FINDINGS: The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. IMPRESSION: No acute cardiopulmonary process. " c1e36f4e-43ef2dde-28bc8982-22087162-24ea1fff.jpg,validate/p12/p12670178/s51917934/c1e36f4e-43ef2dde-28bc8982-22087162-24ea1fff.jpg,validation," 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. " a7793833-1c1fdd94-2d178552-dfc6850e-b7444f6c.jpg,validate/p14/p14325285/s59591618/a7793833-1c1fdd94-2d178552-dfc6850e-b7444f6c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with metastatic cancer, likely lung primary, s/p rigid bronch on ___ with LLL stenting. // Evaluate interval change. COMPARISON: ___ IMPRESSION: As compared to the previous image, the lung volumes have increased. The left bronchial stent continues to be visualized in unchanged position. However, the parenchymal opacities in the right upper lobe and the left lower lobe are unchanged in extent and severity. No new parenchymal opacities. No larger pleural effusions. No pneumothorax. " 822ab920-460b1094-9b9f00e9-b0721d2b-93d0ee00.jpg,validate/p14/p14947303/s52557529/822ab920-460b1094-9b9f00e9-b0721d2b-93d0ee00.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with 2 weeks of fever/chills and sputum production. TECHNIQUE: Chest PA and lateral COMPARISON: Chest radiograph ___ FINDINGS: Cardiac silhouette size is normal. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacity within the retrocardiac region is concerning for pneumonia. Right lung is clear. No pleural effusion or pneumothorax is seen. No acute osseous abnormality is detected. IMPRESSION: Patchy retrocardiac opacity concerning for pneumonia. " d5db817a-fd7888f3-e11272e9-90a8cfbf-7b48b7f6.jpg,validate/p16/p16800398/s57362424/d5db817a-fd7888f3-e11272e9-90a8cfbf-7b48b7f6.jpg,validation," FINAL REPORT INDICATION: Postop day 1 fever after a total knee replacement, productive cough, rule out infiltrate. COMPARISON: Chest radiographs on ___. FINDINGS: PA and lateral views of the chest. Compared to prior study, there is new mild pulmonary vascular congestion. A left lower lobe heterogeneous opacity is consistent with atelectasis. No evidence of consolidation, pleural effusion, or pneumothorax. The heart size is normal. IMPRESSION: 1. Mild pulmonary vascular congestion. 2. Left lower lobe atelectasis. 3. No evidence of pneumonia. " 684d785a-1db5ad52-42435a58-365d2364-9763d011.jpg,validate/p12/p12806035/s50262615/684d785a-1db5ad52-42435a58-365d2364-9763d011.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with rigors. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: There is no focal consolidation, pleural effusion, or pneumothorax. Heart and mediastinal contours are within normal limits, except for mild tortuosity of the aorta. Lateral view suggests an element of hyperinflation anteriorly. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. Possible hyperinflation. " 67a1d283-52bbbf78-0bdd899f-68ba60c3-50824441.jpg,validate/p16/p16971503/s57457949/67a1d283-52bbbf78-0bdd899f-68ba60c3-50824441.jpg,validation," FINAL REPORT AP CHEST, 9:27 AM, ___ HISTORY: ___-year-old man with a right lung cavity, bronchoscopic biopsies and lavage in the right upper and lower lobe. IMPRESSION: AP chest compared to pre-operative chest CT on ___: There is no pneumothorax, pleural effusion, or mediastinal widening. The large lesion in the right mid lung is grossly comparable to its appearance of the pre-bronchoscopy chest CT, which also showed right middle lobe atelectasis, probably not present on this study, which shows right basal atelectasis instead. Heart size is top normal. Left lung is clear. " ddc96439-7dba5021-2664980e-00ae3e2c-dfdd07f9.jpg,validate/p12/p12390274/s51983961/ddc96439-7dba5021-2664980e-00ae3e2c-dfdd07f9.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old woman with increased cough and wheeze with crackles left>right // eval for pna, worsened chf, other abn TECHNIQUE: Chest AP and lateral COMPARISON: Chest radiograph ___ FINDINGS: Moderate cardiomegaly is chronic. Interstitial lung disease is unchanged and extensive. Increased opacities, best seen on the lateral view at the lung bases may represent underlying pneumonia. No pleural effusion. IMPRESSION: Increased focal opacities at the lung bases may represent pneumonia in the setting of extensive interstitial lung disease. " d1c4e1f4-54e5fd85-9bac2018-7c12091d-4f369549.jpg,validate/p18/p18927189/s59812603/d1c4e1f4-54e5fd85-9bac2018-7c12091d-4f369549.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man found unresponsive // ?acute pulmonary process ?acute pulmonary process IMPRESSION: Heart size and mediastinum are stable. Port-A-Cath catheter tip is at the level of mid SVC. Masses projecting over the left lower hemithorax are unchanged since the prior study. No pleural effusion. No pneumothorax. " 93699d27-0577ae29-d4cf9c90-639dee7c-aa8acc94.jpg,validate/p18/p18531540/s51332242/93699d27-0577ae29-d4cf9c90-639dee7c-aa8acc94.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman from ___ with multiple lesions on abdomen and spleen // Evidence of pulmonary lesions, granulomas? 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 " b172f5f5-6bf8b943-11c001c1-b9d11e80-8007053d.jpg,validate/p18/p18204141/s52263496/b172f5f5-6bf8b943-11c001c1-b9d11e80-8007053d.jpg,validation," WET READ: ___ ___ ___ 1:18 AM Accessed left port-A-cath terminates in the right atrium. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with longstanding poor PO intake, G tube, and a port. Want to make sure port properly in place // is port in proper place? is port in proper place? IMPRESSION: There is a G-tube in place, although the precise position cannot be determined without a contrast study. Port-A-Cath extends to the right atrium. Mild atelectatic changes are seen at the bases in this patient with low lung volumes. " 9fd88cc6-cdbc3bb4-700a2931-c079946b-c03e7d58.jpg,validate/p16/p16753060/s52866958/9fd88cc6-cdbc3bb4-700a2931-c079946b-c03e7d58.jpg,validation," FINAL REPORT INDICATION: Chest pain and confusion, here to evaluate for acute cardiopulmonary process. COMPARISONS: ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs appear hyperinflated, suggesting underlying COPD. There is no focal consolidation concerning for pneumonia, 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. IMPRESSION: No acute cardiopulmonary process. " 8c573e2e-5b78311e-f109274b-aef4b970-4a3fc160.jpg,validate/p16/p16924201/s52871387/8c573e2e-5b78311e-f109274b-aef4b970-4a3fc160.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old man with two weeks of prod cough and reported hypoxia // r/o acute process COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. Lung volumes are low. Bibasilar linear opacities likely represent atelectasis or scarring. There is no effusion or pneumothorax. Unfolded aorta is similar to prior. Cardiomediastinal silhouette is stable. Ossific densities inferior to the humeral heads bilaterally may represent intraarticular bodies. Incidentally noted is colonic interposition between the right hemidiaphragm and the liver. IMPRESSION: No acute intrathoracic process. " 87183898-3e810ee8-fe549704-6ee7d8a6-e62c9b7c.jpg,validate/p15/p15289580/s54110232/87183898-3e810ee8-fe549704-6ee7d8a6-e62c9b7c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with multifocal pna, neutropenic fever and likely underlying pulm edema // ?evolution of pulm edema COMPARISON: ___. IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent and severity of the pre-existing parenchymal opacities. In particular, the vascular component appears to have slightly decreased. No new opacities. Unchanged moderate cardiomegaly. Unchanged position of the right central venous access line. " 4aa412e2-e5ebd728-e1741605-9878e0fe-9cdfc311.jpg,validate/p18/p18454049/s52416806/4aa412e2-e5ebd728-e1741605-9878e0fe-9cdfc311.jpg,validation," FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___F with shortness of breath. Evaluate for pneumonia. TECHNIQUE: PA and lateral COMPARISON: ___, ___, CT chest without contrast ___ FINDINGS: PA and lateral views of the chest were provided. Overlying EKG leads are present. Left left basal opacities most compatible with atelectasis though difficult to exclude a subtle early pneumonia/ aspiration. No large effusion or pneumothorax. Cardiomediastinal silhouette appears stable. Bony structures are intact. IMPRESSION: Left basal opacity most compatible with atelectasis though difficult to exclude an early pneumonia/aspiration. " 3ec4a2b2-d7ebed55-ed060979-deeb88f0-df15056c.jpg,validate/p14/p14767018/s55383764/3ec4a2b2-d7ebed55-ed060979-deeb88f0-df15056c.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ___, hepatic injury, recent extubation // eval interval change eval interval change COMPARISON: Chest radiographs ___ through ___ IMPRESSION: Extensive infiltrative pulmonary abnormality has not changed for several days. Heart size top-normal. Pleural effusion small any. No pneumothorax. Right PIC line can be traced as far as the origin of the right brachiocephalic vein, obscured by the right jugular introducer that ends in the mid to low SVC. Nasogastric tube in standard placement. " cf680d09-29d543fd-27e9cda7-7a6b1d58-fdc87ef1.jpg,validate/p18/p18688402/s51065220/cf680d09-29d543fd-27e9cda7-7a6b1d58-fdc87ef1.jpg,validation," FINAL REPORT HISTORY: Dobbhoff placement. FINDINGS: In comparison with study of ___, the Dobbhoff tube tip initially was in the mid esophagus, though on later study it is within the stomach. Enlargement of the cardiac silhouette with increasing bilateral pulmonary opacifications bilaterally. This could reflect pulmonary vascular congestion with a combination of bilateral pleural effusions and compressive atelectasis at the bases. In the appropriate clinical setting, supervening pneumonia or even ARDS would have to be considered. The endotracheal tube has been removed. Left subclavian catheter remains in place. " 08f920be-59fd242a-2adf8244-2fdb8d7f-c94d0bc8.jpg,validate/p13/p13855132/s55066018/08f920be-59fd242a-2adf8244-2fdb8d7f-c94d0bc8.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with ettube // ettube ettube IMPRESSION: Compared to chest radiographs ___ through ___. Moderate pulmonary edema an accompanying small pleural effusions have increased. Left lower lobe consolidation has worsened, probably atelectasis. Pleural effusions are presumed but not large. Heart size top-normal. No pneumothorax. Indwelling ET tube, right internal jugular line are in standard placements and a nasogastric drainage tube passes into the stomach and out of view. " a9a66120-7dc2f5df-9c431333-74a991c1-a58cbb2f.jpg,validate/p12/p12468091/s55383743/a9a66120-7dc2f5df-9c431333-74a991c1-a58cbb2f.jpg,validation," FINAL REPORT HISTORY: ___-year-old man with subdural hematoma and change in behavior. Evaluate for pneumonia. COMPARISON: Prior radiographs of the chest dated ___ through ___. FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax or significant pleural effusion. IMPRESSION: No pneumonia. " d65606ba-ad8fe27e-6f5a19f8-1370bc62-23f7f256.jpg,validate/p18/p18378406/s51775434/d65606ba-ad8fe27e-6f5a19f8-1370bc62-23f7f256.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: COPD, patient with worsening shortness of breath. Comparison is made with prior study ___. Increase in interstitial markings is consistent with new interstitial pulmonary edema. Patient has known emphysema. Cardiomediastinal contours are unchanged. There is no pneumothorax. Bilateral pleural effusions are small, larger on the right side, associated adjacent atelectasis. " 47f4f971-b6407e41-33c22a35-4e9e62bf-3aa57e44.jpg,validate/p10/p10251182/s53950288/47f4f971-b6407e41-33c22a35-4e9e62bf-3aa57e44.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Cough and weakness, question pneumonia. FINDINGS: AP upright and lateral views of the chest were provided demonstrating midline sternotomy wires and mediastinal clips. Cardiomediastinal silhouette is stable. The lungs appear essentially clear, without focal consolidation, effusion or pneumothorax. There is DISH-related change of the thoracic spine with anterior flowing ossification. There is no free air below the right hemidiaphragm. Bilateral AC joint arthropathy is incidentally noted. IMPRESSION: No acute findings in the chest. " e7fa4bc1-ca2ecba4-45413120-e40a449f-953ff855.jpg,validate/p17/p17937211/s51400778/e7fa4bc1-ca2ecba4-45413120-e40a449f-953ff855.jpg,validation," FINAL REPORT HISTORY: Cough, asthma exacerbation. TECHNIQUE: PA and lateral views of the chest. COMPARISON: ___. FINDINGS: Lung volumes are low. The heart size is top normal. Mediastinal and hilar contours are unchanged with calcification of the aortic knob re- demonstrated. The pulmonary vascularity is normal. Minimal atelectasis is seen in the retrocardiac region. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities. IMPRESSION: Minimal retrocardiac atelectasis in the setting of low lung volumes. No focal consolidation to indicate pneumonia. " 3722202c-fa4bf458-5bac1d34-66d6141f-d9bfa339.jpg,validate/p11/p11005665/s51394420/3722202c-fa4bf458-5bac1d34-66d6141f-d9bfa339.jpg,validation," 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.now CTs out // eval for interval changes? eval for interval changes? IMPRESSION: In comparison with the study of ___, the left chest tubes have been removed. No evidence of pneumothorax. Opacification in the left hemithorax is essentially unchanged. Right IJ sheath has been removed and the right lung is clear. " 4208913f-99e16096-ed19a255-19c8f9a4-17b79030.jpg,validate/p12/p12180204/s59246949/4208913f-99e16096-ed19a255-19c8f9a4-17b79030.jpg,validation," FINAL REPORT CLINICAL HISTORY: Single-chamber pacemaker placed, check position. CHEST, PA AND LATERAL The tip of the pacemaker wire lies in the right ventricle. No pneumothorax is identified. The lung fields are clear. Small bilateral pleural effusions are present. IMPRESSION: Pacemaker tip in right ventricle. " 92418a72-b9648259-51ec038a-c722b3b1-d286da94.jpg,validate/p15/p15618507/s52306054/92418a72-b9648259-51ec038a-c722b3b1-d286da94.jpg,validation," WET READ: ___ ___ 4:28 PM 1. Stable chest. No evidence of pneumonia or pulmonary edema. 2. Left mid lung laterally pleural based density is unchanged since ___, suggesting benign etiology. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___F with shortness of breath, chest pain. Assess for pneumonia and pulmonary edema. COMPARISON: Chest radiograph ___, ___, ___. FINDINGS: Frontal and lateral chest radiograph demonstrates well expanded lungs with bibasilar atelectasis. No focal opacity. Mild prominence of the left hilum is stable from previous examinations. No pleural effusion or pneumothorax. Stable mild cardiomegaly. Mediastinal contour and hila are otherwise unremarkable. Left mid lung laterally pleural based density is unchanged since ___. Tortuous aorta again noted. Limited assessment of the osseous structures demonstrate right-sided dextroscoliosis as well as kyphosis of the thoracic spine. Visualized upper abdomen is within normal limits. IMPRESSION: 1. Stable chest. No evidence of pneumonia or pulmonary edema. 2. Left mid lung laterally pleural based density is unchanged since ___, suggesting benign etiology. " fd5a0ef1-e438028b-58322119-5576474d-b557c925.jpg,validate/p10/p10717732/s53035222/fd5a0ef1-e438028b-58322119-5576474d-b557c925.jpg,validation," WET READ: ___ ___ ___ 4:28 AM Mild edema. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with dyspnea // r/o acute process TECHNIQUE: Chest PA and lateral COMPARISON: Radiographs dated ___ through ___. . FINDINGS: Lung volumes are low, resulting in bronchovascular crowding. The cardiac silhouette remains enlarged. There is mild edema. No pneumothorax. Small pleural effusion. Status post median sternotomy, with stable fracture of the superior most sternotomy wire. IMPRESSION: Mild pulmonary edema. " 9c52a381-0dd99e6b-3f004d7e-90964339-0051dc7e.jpg,validate/p10/p10979480/s55423999/9c52a381-0dd99e6b-3f004d7e-90964339-0051dc7e.jpg,validation," FINAL REPORT HISTORY: Cough and fever. COMPARISON: ___ through ___. FINDINGS: A single portable frontal chest radiograph was obtained. Lung volumes are low. Predominantly horizontal opacity in at the right base has become increasingly conspicuous since the prior studies in ___. A retrocardiac opacity has also increased in association with decrease in lung volumes. Central pulmonary vascular congestion is mild. There is no effusion or pneumothorax. There are no new abnormal cardiac or mediastinal contours. Aortic arch calcifications are mild. The tip of a right chest Port-A-Cath terminates at the cavoatrial junction. Spinal fusion hardware is intact. IMPRESSION: 1. Central pulmonary vascular congestion. 2. Basilar opacities likely represents a combination of central pulmonary vascular congestion and atelectasis. However a focus of infection cannot be excluded in the correct clinical context. " c1d71007-4065c0aa-a6b5be0d-8b74f695-ba9671ac.jpg,validate/p16/p16907362/s56326956/c1d71007-4065c0aa-a6b5be0d-8b74f695-ba9671ac.jpg,validation," FINAL REPORT HISTORY: Multiple myeloma, pre-BMT evaluation. 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. No acute bony abnormalities are detected. IMPRESSION: No radiographic evidence for acute cardiopulmonary process. " 252eabf2-14d4cc66-1ce0f072-57d7c116-83e1b4f2.jpg,validate/p15/p15588831/s54844817/252eabf2-14d4cc66-1ce0f072-57d7c116-83e1b4f2.jpg,validation," 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. " 725904df-f64c703f-7083b600-13a3701a-daebfd27.jpg,validate/p13/p13594376/s58311691/725904df-f64c703f-7083b600-13a3701a-daebfd27.jpg,validation," WET READ: ___ ___ ___ 11:01 PM No acute cardiopulmonary abnormality. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph. INDICATION: ___M with R upper back pain x 6 months, history of NAFLD // ___M with R upper back pain x 6 months, worsening in the past week, history of NAFLD 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. " c44c8dad-fc78fa3e-43c7adf0-c4dacf7a-bba661c3.jpg,validate/p18/p18639045/s55732177/c44c8dad-fc78fa3e-43c7adf0-c4dacf7a-bba661c3.jpg,validation," FINAL REPORT INDICATION: ___F with CP // r/o occult infiltrate TECHNIQUE: Chest PA and lateral COMPARISON: CT chest from ___ FINDINGS: Lung volumes are low. Linear opacities in the right lung base likely represent atelectasis. Mediastinal contours, hila, and cardiac silhouette are normal. There is no pleural effusion or pneumothorax. IMPRESSION: No pneumonia. " 8cbdd00c-ad7b0a4b-a24acd77-da61c444-0f203346.jpg,validate/p16/p16644826/s52622138/8cbdd00c-ad7b0a4b-a24acd77-da61c444-0f203346.jpg,validation," FINAL REPORT HISTORY: ___-year-old female with generalized weakness and fall. COMPARISON: Chest CT from ___ and chest x-ray from ___. FINDINGS: Frontal and lateral views of the chest. Left PICC is no longer visualized. Linear opacity in the left mid lung and right lung base most likely atelectasis or scarring. Surgical clips again noted at the right lung base. Blunting of the right costophrenic angle may be due to small effusion or pleural thickening. The lungs are clear of focal consolidation. Cardiomegaly is stable. Right mediastinal contour is unchanged and compatible with adenopathy. Right axillary surgical clips again noted. No displaced rib fractures identified. IMPRESSION: No acute cardiopulmonary process. " 8854ac17-02cbb55b-6797803e-0247f114-8e114394.jpg,validate/p11/p11893091/s53024166/8854ac17-02cbb55b-6797803e-0247f114-8e114394.jpg,validation," FINAL REPORT INDICATION: Malaise, here to evaluate for pneumonia. COMPARISON: Chest radiograph dated ___, ___ and ___. TECHNIQUE: PA and lateral radiographs of the chest. FINDINGS: The lungs are relatively hyperinflated. There is no focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is detected. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardiac silhouette is top normal in size, as before. A left pectoral pacemaker is in place with dual leads terminating in the right atrium and right ventricle. The mediastinal and hilar contours are within normal limits. IMPRESSION: No focal consolidation concerning for pneumonia. " 410d4967-ed9a2f83-3d2e58df-25285641-f5cc2317.jpg,validate/p17/p17737168/s51172781/410d4967-ed9a2f83-3d2e58df-25285641-f5cc2317.jpg,validation," FINAL REPORT INDICATION: ___-year-old woman with bilateral flank and RUQ/LUQ pain TECHNIQUE: Chest PA and lateral COMPARISON: Chest CT ___ and chest radiograph ___. . FINDINGS: Heart is top-normal in size. There is no focal lung consolidation. There is no pleural effusion or pneumothorax. There is no acute osseous abnormality. Surgical clips are noted in the right upper quadrant. IMPRESSION: No acute cardiopulmonary process. " 00c25b0a-5a5fe405-73382328-28555beb-6281aa97.jpg,validate/p10/p10675468/s58098985/00c25b0a-5a5fe405-73382328-28555beb-6281aa97.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman with 10 day h/o productive cough and low grade fever // rule out pneumonia rule out pneumonia COMPARISON: Prior chest radiographs since ___, most recently ___. IMPRESSION: Right hemidiaphragm is chronically elevated. Cardiomegaly is mild, also chronic, but there is no pulmonary vascular congestion, edema, or pleural effusion. There is no consolidation to suggest pneumonia. Mitral annulus calcification is extremely severe. Transvenous right ventricular pacer lead unchanged in position. " 5adf0976-c34c54b1-d107c6a4-33d66515-b5f0e29f.jpg,validate/p15/p15245907/s50818576/5adf0976-c34c54b1-d107c6a4-33d66515-b5f0e29f.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with LIJ TLC recently withdrawn // Central line placement Central line placement IMPRESSION: In comparison with the earlier study of this date, the left IJ catheter has been pulled back so that the tip is at the level of the midportion of the SVC. Otherwise no change. " 0bb344b3-b0b00e4a-c81feb7d-9e4b7582-a0128c77.jpg,validate/p14/p14398566/s52323174/0bb344b3-b0b00e4a-c81feb7d-9e4b7582-a0128c77.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with hypoxemic respiratory failure. // ? interval change COMPARISON: ___ at 551 FINDINGS: Allowing for technical differences, there may have been slight improvement in CHF findings. Otherwise, doubt significant interval change. ET tube tip lies 4.6 cm above the carina. NG tube tip extends beneath diaphragm overlying the upper stomach. The sideport lies in the region of the GE junction, probably slightly distal to it. There is mild cardiomegaly. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF, with possible slight interval improvement. Retrocardiac opacities improved, though remains faintly present, with suggestion of air bronchograms, consistent with left lower lobe collapse and/or consolidation. No gross effusion. No pneumothorax detected. Fixation hardware of the lower cervical and upper thoracic spine again noted. IMPRESSION: CHF, possibly very slightly improved compared with 1 day earlier. Residual left lower lobe collapse and/or consolidation, though with interval improvement. NG tube tip over upper stomach. The sideport lies near the GE junction, probably slightly distal to it. " 331bd202-3ad46cb5-b3e5802f-bbdc1c76-0f549c67.jpg,validate/p16/p16638793/s57748293/331bd202-3ad46cb5-b3e5802f-bbdc1c76-0f549c67.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___F with lightheadedness // evaluate for vascular congestion TECHNIQUE: Portable upright AP view of the chest COMPARISON: None. FINDINGS: Mild enlargement of the cardiac silhouette is demonstrated. There is at least a moderate to large hiatal hernia noted. Diffuse atherosclerotic calcifications are noted within a mildly tortuous thoracic aorta. Mediastinal and hilar contours are otherwise unremarkable. There is mild pulmonary vascular congestion without frank pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. Any electronic device projects over the left lung base. Remote appearing right-sided rib fractures are noted. Clips in the right upper quadrant of the abdomen likely indicate prior cholecystectomy. IMPRESSION: Mild pulmonary vascular congestion without frank pulmonary edema. Moderate to large hiatal hernia. " 537a8c01-626b8aef-3b6beb26-22e5df3e-5689be69.jpg,validate/p13/p13165667/s58988416/537a8c01-626b8aef-3b6beb26-22e5df3e-5689be69.jpg,validation," FINAL REPORT INDICATION: ___ year man with fever, cough, evaluate for pneumonia. TECHNIQUE: Chest PA and lateral COMPARISON: None. FINDINGS: The cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no pleural effusion or pneumothorax. There is no pulmonary vascular congestion. IMPRESSION: No acute cardiopulmonary process. " bcbd131f-51996d8b-775c3631-b0b50a00-b28637fe.jpg,validate/p15/p15340094/s59978465/bcbd131f-51996d8b-775c3631-b0b50a00-b28637fe.jpg,validation," WET READ: ___ ___ ___ 7:55 AM No acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT INDICATION: History: ___F with palpitations // cardiopulmonary process? 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. IMPRESSION: No acute cardiopulmonary process. " f58a2124-d18eeec8-9224f41a-9a000e83-3ea41fc6.jpg,validate/p10/p10104732/s56671882/f58a2124-d18eeec8-9224f41a-9a000e83-3ea41fc6.jpg,validation," FINAL REPORT PORTABLE CHEST FILM ___ AT ___ CLINICAL INDICATION: ___-year-old with HIV and lethargy and tachypnea, question pneumonia, edema or effusion. Comparison is made to the patient's prior study of ___. A portable AP upright chest film ___ at ___ is submitted. IMPRESSION: 1. Overall cardiac and mediastinal contours are stable. The lungs remain well inflated without evidence of focal airspace consolidation to suggest pneumonia. No evidence of pulmonary edema, pneumothorax or pleural effusions. " 53260a23-5878a171-97061820-6c159b3b-c0fd6fad.jpg,validate/p15/p15709718/s55021588/53260a23-5878a171-97061820-6c159b3b-c0fd6fad.jpg,validation," FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: Prior exam from ___. CLINICAL HISTORY: Increasing swelling in the legs, orthopnea, question pulmonary edema or effusion. FINDINGS: PA and lateral views of the chest were provided. There is mild pulmonary interstitial edema with bibasilar atelectasis and small bilateral pleural effusions. The heart size is top normal. Hilar congestion is present. No pneumothorax. Bony structures intact. IMPRESSION: Pulmonary edema with small bilateral pleural effusions. " 437eb499-44d9e359-84788494-41e05d2c-19794a15.jpg,validate/p16/p16019229/s55579470/437eb499-44d9e359-84788494-41e05d2c-19794a15.jpg,validation," FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Shortness of breath, pain on inspiration. COMPARISON: ___. FINDINGS: Frontal and lateral views of the chest were obtained. Small right pleural effusion has increased in the interval. There may be a trace left pleural effusion. There is bibasilar atelectasis without definite focal consolidation. The cardiac, mediastinal, and hilar contours are stable. IMPRESSION: Interval increase in right pleural effusion. Possible trace left pleural effusion. Bibasilar atelectasis. " 2afad67e-9f803c27-f4efd5c8-bb1ca08d-0bbacc23.jpg,validate/p15/p15811084/s52501336/2afad67e-9f803c27-f4efd5c8-bb1ca08d-0bbacc23.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ M POD ___ s/p lap esophagogastrectomy w leukocytosis // ? infiltrate TECHNIQUE: Single frontal view of the chest COMPARISON: ___. IMPRESSION: There has been marked increase of now total collapse of right lower and right middle lobes Right port a cath tip is in the cavoatrial junction. Enteric tube tip is in the mid chest. Cardiac silhouette cannot be evaluated. There is no pneumothorax. Right apical chest tube is in unchanged position. There are no pleural effusions. A small area of atelectasis in the left lower lobe is stable. NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:50 PM, 10 minutes after discovery of the findings. " 0275e68d-088f1b04-b7d666aa-8e8a8dc4-d45702d5.jpg,validate/p10/p10236222/s56624950/0275e68d-088f1b04-b7d666aa-8e8a8dc4-d45702d5.jpg,validation," WET READ: ___ ___ ___ 10:12 AM 6 mm nodule in the right lower lung, possibly a calcified granuloma, is unchanged in size since ___. Otherwise, no acute cardiopulmonary process. ______________________________________________________________________________ FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___M with left-sided chest pain TECHNIQUE: Chest PA and lateral COMPARISON: Prior chest radiographs ___, ___, ___ FINDINGS: A prominent right lower lung nipple shadow is noted. Lungs are clear without focal consolidation, large effusion or pneumothorax. There is unchanged mild prominence of the main pulmonary artery mogul which could indicate enlargement of the main PA. No signs of edema or congestion. Bony structures are intact. IMPRESSION: As above. " 0eb0744a-c0ea6629-9d71c0a5-d2df2a20-1df4ab7b.jpg,validate/p14/p14887088/s50436188/0eb0744a-c0ea6629-9d71c0a5-d2df2a20-1df4ab7b.jpg,validation," FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Respiratory failure. Patient on ventilation. Comparison is made with prior study ___. Cardiomegaly is stable. Widened mediastinum has improved. There are persistent low lung volumes. There are no interval changes in right pleural effusion with adjacent atelectasis and mild vascular congestion. There is small left effusion. There is no pneumothorax. Supporting devices are in standard position. A spinal hardware is again noted. " 7af4c2da-bcfc7aa5-e7959134-cfb54bf3-f1766d67.jpg,validate/p11/p11658675/s51088898/7af4c2da-bcfc7aa5-e7959134-cfb54bf3-f1766d67.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with recurrent aspiration, pneumonia, COPD and cough. PA and lateral upright chest radiographs were reviewed in comparison to ___. Bibasilar areas of atelectasis appear to be unchanged though potentially progressed on the left. The patient is rotated, thus the comparison is more difficult. Upper lungs are essentially clear. Minimal interstitial pulmonary edema is unchanged. The pulmonary nodule suspected on the prior radiograph cannot be clearly seen on the current examination. " 3e8851ef-86ce344e-4dd4ba73-98e7fd00-230fd49c.jpg,validate/p18/p18199379/s58219607/3e8851ef-86ce344e-4dd4ba73-98e7fd00-230fd49c.jpg,validation," 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. " e3eeab51-3a630a70-7872a1ec-d3b72240-93bd3e9a.jpg,validate/p15/p15700497/s50652212/e3eeab51-3a630a70-7872a1ec-d3b72240-93bd3e9a.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman s/p ex-lap SBR, ileostomy revision POD#7, now with increasing WBC // Please eval for intrathoracic pathology to explain uptrending WBC Please eval for intrathoracic pathology to explain uptrending WBC IMPRESSION: Compared to chest radiographs ___ through ___. Lungs are grossly clear. Small bilateral pleural effusions stable on the right, increased on the left since ___. Mild cardiomegaly increased since ___. " 0336ad72-89ab4911-18fdcaab-4d4ab1fb-b7ca108d.jpg,validate/p11/p11647908/s55848467/0336ad72-89ab4911-18fdcaab-4d4ab1fb-b7ca108d.jpg,validation," FINAL REPORT HISTORY: History of dyspnea, wheezing, history of asthma but no exacerbation in the past ___ years. Question pneumonia. COMPARISON: Prior chest radiographs from ___, ___ and ___. TECHNIQUE: PA and lateral chest radiographs. FINDINGS: As compared to prior chest radiographs from ___, there is persistent elevation of the right hemidiaphragm. Increased focal opacity at the right lung base likely reflects atelectasis as it has not significantly changed since prior examination from ___. No focal abnormality to suggest pneumonia is identified. There is no large pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal. IMPRESSION: No acute cardiopulmonary process. Recent development of elevated right hemidiaphragm, could be secondary to diaphragmatic injury or phrenic palsy. " 16be06d3-b51bc53d-0ec20e46-2856ca41-ea34a5c2.jpg,validate/p18/p18617883/s52847614/16be06d3-b51bc53d-0ec20e46-2856ca41-ea34a5c2.jpg,validation," FINAL REPORT INDICATION: ___-year-old male with MS flare, evaluate for pneumonia. TECHNIQUE: Frontal and lateral chest radiographs were obtained with the patient in the upright position. COMPARISON: None available. FINDINGS: The lungs are clear without focal consolidation, pleural effusion or pulmonary edema. There is linear atelectasis at the left lung base. The heart size and mediastinal contours are normal. IMPRESSION: No acute cardiopulmonary process. " b4a997ff-6468bd38-01145ccd-99896283-491e1355.jpg,validate/p19/p19718601/s51118389/b4a997ff-6468bd38-01145ccd-99896283-491e1355.jpg,validation," FINAL REPORT HISTORY: Lymphoma and weakness. COMPARISON: Chest radiograph available from ___. FRONTAL AND LATERAL CHEST RADIOGRAPHS: The lung volumes are very low in comparison to the ___ examination, resulting in bronchovascular crowding. Bibasilar linear opacities are most compatible with atelectasis. A right-sided Port-A-Cath remains unchanged in position, terminating at the upper right atrium. There is no pneumothorax or pleural effusion. The heart size is top normal, and the hilar and mediastinal contours remain within normal limits. IMPRESSION: Very low lung volumes resulting in the bibasilar linear opacities, likely atelectasis. A repeat chest radiograph with greater inspiratory effort could be obtained if there remains high clinical concern for basilar consolidation. " 16e8486e-d0786569-92782d88-5a1ffd83-66535aec.jpg,validate/p10/p10449408/s51626981/16e8486e-d0786569-92782d88-5a1ffd83-66535aec.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Hematochromatosis, renal failure, pulmonary edema. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, a pre-existing parenchymal opacity at the right lung base is minimally more extensive than on the previous exam. The pre-existing signs of combined fluid overload and areas of parenchymal opacities, predominating in the right upper lobe, are constant. Unchanged left lower lobe atelectasis. Unchanged bilateral blunting of the costophrenic sinuses, potentially indicative of small pleural effusions. " 7ffa43e8-c89201b4-53d8cf97-a3f1edb7-6c07ee3a.jpg,validate/p18/p18032181/s57526263/7ffa43e8-c89201b4-53d8cf97-a3f1edb7-6c07ee3a.jpg,validation," WET READ: ___ ___ ___ 8:56 PM moderate left pneumothorax. no mediastinal shift, but the left rib interspaces are wider than the right (which could relate to patient's scoliosis, but tension not excluded). possible small left pleural effusion. left posterolateral 6th rib fracture. d/w Dr. ___ at 8:55pm. WET READ VERSION #1 WET READ VERSION #2 ___ ___ ___ 8:52 PM moderate left pneumothorax. Dr. ___ paged. ______________________________________________________________________________ FINAL REPORT EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Upper back pain after fall, pleuritic pain. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest are obtained. There is a moderate left pneumothorax. Lucency along the left mediastinum/pericardial region could be due to the pneumothorax; however, a pneumomediastinum is not excluded. There is no shift of the mediastinum. Left-sided rib interspaces appear widened as compared to the right, although this could relate to patient's scoliosis. Otherwise, the lungs are hyperinflated. There is left base atelectasis, small left pleural effusion not excluded. The cardiac silhouette is not enlarged. Mediastinal contours are unremarkable. There is a minimally displaced fracture of the posterolateral left sixth rib. Mild bi-apical pleural thickening is seen. IMPRESSION: 1. Moderate left pneumothorax. No mediastinal shift; however, the left-sided rib interspaces are wide as compared to the right side and while this could relate to patient's scoliosis, tension is not excluded. Lucency along the left heart border and left mediastinum may relate to pneumothorax, although pneumomediastinum can have the same appearance. 2. Left base opacity may be due to atelectasis, although a small left pleural effusion is not excluded. 3. Minimally displaced left posterolateral sixth rib fracture. The above findings were discussed with Dr. ___ at 8:55 p.m. on ___, 6 minutes after discovery. " 7ea23c0d-098bc790-05df95c9-acfebcd0-1e631353.jpg,validate/p13/p13364829/s52162132/7ea23c0d-098bc790-05df95c9-acfebcd0-1e631353.jpg,validation," FINAL REPORT EXAMINATION: Chest: Frontal and lateral views INDICATION: ___ year old woman with alcoholic hepatitis // r/o PNA TECHNIQUE: Chest: AP and Lateral COMPARISON: Chest radiograph ___. FINDINGS: Left PICC terminates in the lower SVC.The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable . IMPRESSION: Left PICC now terminates in the lower SVC. Otherwise no significant change compared to chest radiograph on ___. " 3c91dd96-55d4b072-57e12b46-74a162e2-4fab0afb.jpg,validate/p15/p15922911/s51433399/3c91dd96-55d4b072-57e12b46-74a162e2-4fab0afb.jpg,validation," 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. " 1935e6ff-d260a53a-83c60693-5807318c-3953e8b1.jpg,validate/p19/p19341743/s54615922/1935e6ff-d260a53a-83c60693-5807318c-3953e8b1.jpg,validation," FINAL REPORT CLINICAL INDICATION: Hypotension. Evaluate for infiltrates. COMPARISON: Chest radiograph, ___. PORTABLE SUPINE FRONTAL VIEW OF THE CHEST: The lungs are clear without focal opacity, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: No focal opacity concerning for an infiltrate. " a62dce61-71179cf6-46541cf5-64f46291-f7c66d9a.jpg,validate/p17/p17454111/s52618147/a62dce61-71179cf6-46541cf5-64f46291-f7c66d9a.jpg,validation," 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. " 46866ad4-2c9771df-30d6f25a-32a3eaca-89e06ed6.jpg,validate/p19/p19731371/s53903536/46866ad4-2c9771df-30d6f25a-32a3eaca-89e06ed6.jpg,validation," FINAL REPORT EXAMINATION: CHEST (AP AND LAT) INDICATION: ___F dementia with back pain AMS cough // r/o pna COMPARISON: None FINDINGS: AP upright and lateral views of the chest provided. Right hemidiaphragm is mildly elevated. No focal consolidation concerning for pneumonia. No effusion or pneumothorax. The heart is mildly enlarged. The aorta appears unfolded. No convincing evidence for edema. No free air below the right hemidiaphragm. Bony structures appear intact. IMPRESSION: Cardiomegaly without evidence of pneumonia or overt edema. " 9f870e2f-0472271a-5e7dad5a-c5786d9d-f3b0b967.jpg,validate/p13/p13152426/s58082418/9f870e2f-0472271a-5e7dad5a-c5786d9d-f3b0b967.jpg,validation," 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. " db571e0d-9186de06-d3d0d68a-fa1aa5f3-4aba8acb.jpg,validate/p11/p11725800/s53960800/db571e0d-9186de06-d3d0d68a-fa1aa5f3-4aba8acb.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___ year old woman oligomet SCLL s/p chemo/rads, VATS LUL wedge resection in ___, w/ enlarging LLL nodule now s/p VATS LLL wedge resection // Dc'ed chest tube ?pneumoPlease do at 2pm Dc'ed chest tube ?pneumoPlease do at 2pm COMPARISON: Comparison to ___ at 09:11 FINDINGS: PA and lateral views of the chest ___ at 13:14 are submitted. IMPRESSION: Interval removal of the left chest tube with a stable small left apical pneumothorax. Persistent small left pleural effusion. Stable bilateral post radiation and postsurgical changes. Deformity of a lower posterolateral left rib consistent with old trauma. Left lateral chest wall subcutaneous emphysema. No pulmonary edema. Stable mid thoracic vertebral compression fractures. " 61c03eed-9a80fccd-0b67ac6b-c26277d8-b37adc42.jpg,validate/p19/p19455517/s58588862/61c03eed-9a80fccd-0b67ac6b-c26277d8-b37adc42.jpg,validation," FINAL REPORT HISTORY: Cirrhosis and ataxia with weakness. COMPARISON: None. FINDINGS: AP upright and lateral chest radiographs were obtained. The lungs are well expanded and clear without pleural effusion or pneumothorax. The heart is top-normal in size with normal cardiomediastinal and hilar contours. IMPRESSION: No acute intrathoracic process. " 3b3abb07-07b6e063-5f1c32cf-45b65581-b0f1dd43.jpg,validate/p19/p19218701/s56009599/3b3abb07-07b6e063-5f1c32cf-45b65581-b0f1dd43.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: History: ___F with chest pain TECHNIQUE: Chest PA and lateral COMPARISON: ___ FINDINGS: Cardiac silhouette size is normal. The aorta remains tortuous and diffusely calcified. Mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Linear opacities within the periphery of the right lung base likely reflect areas of scarring. No focal consolidation, pleural effusion or pneumothorax is present. Mild degenerative changes are noted in the thoracic spine. IMPRESSION: No acute cardiopulmonary abnormality. " 5f456c80-d2444168-36d9c0b2-653466fb-ae191905.jpg,validate/p11/p11124675/s54667879/5f456c80-d2444168-36d9c0b2-653466fb-ae191905.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with ? infiltrate on admission, flu positive - eval for interval change/evolution please // ___ year old woman with ? infiltrate on admission, flu positive - eval for interval change/evolution please ___ year old woman with ? infiltrate on admission, flu positi COMPARISON: Chest radiographs ___ through ___. IMPRESSION: Previous mild pulmonary edema is resolved. Mild to moderate cardiomegaly is chronic, but improved compared to ___. Pulmonary arteries are chronically enlarged as well. No appreciable pleural effusion. Lateral view would be helpful in assessing pleural surfaces and lung bases. " 5eafb9d8-c691c24a-64df2cae-9bafa5a1-44cbbca8.jpg,validate/p16/p16259867/s52851077/5eafb9d8-c691c24a-64df2cae-9bafa5a1-44cbbca8.jpg,validation," FINAL REPORT CHEST RADIOGRAPH INDICATION: Cirrhosis, hematemesis, Dobbhoff catheter placement. COMPARISON: ___. FINDINGS: The Dobbhoff catheter of the patient shows a normal course. In pre-pyloric location, however, the catheter is coiled. No complications. The hemodialysis catheter on the right is in unchanged position. Low lung volumes. No pulmonary edema. No pleural effusions. No pneumonia. " 0675380f-09fc3ff0-56ad7906-cebb6840-1aae1e15.jpg,validate/p14/p14806126/s50263597/0675380f-09fc3ff0-56ad7906-cebb6840-1aae1e15.jpg,validation," FINAL REPORT REASON FOR EXAMINATION: Acute 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 clear. There is no pleural effusion or pneumothorax. " a0a60510-75cee02a-1fb11241-23dfd259-de37babe.jpg,validate/p11/p11291881/s50321697/a0a60510-75cee02a-1fb11241-23dfd259-de37babe.jpg,validation," FINAL REPORT INDICATION: ___-year-old female with fatigue. Patient with history of metastatic melanoma. TECHNIQUE: AP and lateral COMPARISON: Chest radiograph dated ___ as well as CT chest dated ___. FINDINGS: AP upright and lateral chest radiograph demonstrates a 6.4 cm biopsy proven metastatic melanoma lung nodule which when compared to prior study dated ___ is increased in size and relative to CT chest dated ___ is additionally increased in size, previously 5.6 cm on most recent study. Additional opacity projects over the left mid to upper lung overlying the left posterior sixth rib in a similar location to prior peripheral nodular opacities on prior chest CT. No focal opacity convincing for pneumonia is identified. There is likely atelectasis at the left lung base. Cardiomediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. A right chest port is identified, its tip terminating within the inferior superior vena cava. No air is identified under the hemidiaphragm. IMPRESSION: Enlarging left lower pole biopsy proven metastatic melanoma nodule. Interval enlargement of opacities in left mid to upper lung in a similar location to prior clustered nodules on prior CT. While infection is possible, underlying metastatic lesions are not excluded. No new focal opacity convincing for pneumonia. " 6951d0ad-95500c47-9af1307b-21c40266-19fe64f5.jpg,validate/p15/p15199994/s56292777/6951d0ad-95500c47-9af1307b-21c40266-19fe64f5.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with NGT too high // assess NGT TECHNIQUE: Single frontal view of the chest COMPARISON: Study performed 5 hours before. IMPRESSION: NG tube tip is in the stomach. No other interval change from prior study. " 7953e878-fde325a5-692a267d-7f584df2-0650290a.jpg,validate/p10/p10641782/s51673708/7953e878-fde325a5-692a267d-7f584df2-0650290a.jpg,validation," FINAL REPORT HISTORY: ___-year-old man status post self removal of PICC. COMPARISON: ___. FINDINGS: PA and lateral views of the chest. Ventriculoperitoneal shunt courses over the right anterior chest wall. Left PICC is no longer visualized. The lungs are essentially clear noting calcific densities project over the right lung apex which could potentially be vascular in nature, unchanged. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected. IMPRESSION: No acute cardiopulmonary process. " fb59b2de-1df12583-effbe8fd-d4028a07-013552ab.jpg,validate/p15/p15154432/s55303066/fb59b2de-1df12583-effbe8fd-d4028a07-013552ab.jpg,validation," FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with intra-abdominal sepsis // interval change interval change IMPRESSION: Compared to chest radiographs since ___, most recently ___ ___. Pulmonary edema improved on ___, worsened on ___, and there is still mild pulmonary edema today. Severe cardiomegaly is chronic. Left pleural effusion is small. No pneumothorax. Tracheostomy tube midline, ends approximately a cm from the carina. Right jugular line ends in the right atrium. " a476c846-56b5ca03-f2a77dfe-ee29dcd1-0ef8b007.jpg,validate/p11/p11010999/s52078874/a476c846-56b5ca03-f2a77dfe-ee29dcd1-0ef8b007.jpg,validation," FINAL REPORT INDICATION: History: ___F with mild cough, diminished right sided breath sounds // effusions, PNA TECHNIQUE: Chest PA and lateral COMPARISON: Intra operative spot view of the chest ___ FINDINGS: Right pectoral infusion port terminates in low SVC. Minimal left lung base atelectasis is noted. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal size. IMPRESSION: No radiographic evidence of pneumonia. " ae98c7e2-2f42dce6-dacec1b2-e7b1815f-eebffa65.jpg,validate/p11/p11218867/s50395674/ae98c7e2-2f42dce6-dacec1b2-e7b1815f-eebffa65.jpg,validation," FINAL REPORT INDICATION: Right IJ port placement, with palpitations. COMPARISON: Port placement fluoroscopy available from 8:52 a.m. FRONTAL CHEST RADIOGRAPH WITH THE PATIENT IN SUPINE AND UPRIGHT POSITIONS: The heart size is normal. The hilar and mediastinal contours are within normal limits. There is no pneumothorax, focal consolidation, or pleural effusion. A right-sided Port-A-Cath terminates at the right upper atrium. IMPRESSION: Right Port-A-Cath terminating at the right upper atrium, unchanged in position since the spot fluorographs from this morning. " 0b812a7b-8fb38e54-e7e93f1e-6b8b8ad8-087da699.jpg,validate/p13/p13098392/s51181384/0b812a7b-8fb38e54-e7e93f1e-6b8b8ad8-087da699.jpg,validation," FINAL REPORT EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old male with history of cough and fever. COMPARISON: None. FINDINGS: Frontal and lateral views of the chest were obtained. There are slightly low lung volumes. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. IMPRESSION: No focal consolidation to suggest pneumonia. " 19cc2ed0-8363dcd9-569390ef-edfaaf34-f97c25b3.jpg,validate/p19/p19313943/s58951101/19cc2ed0-8363dcd9-569390ef-edfaaf34-f97c25b3.jpg,validation," FINAL REPORT INDICATION: ___ year old man with atypical chest pain // eval for acute cardiopulmonary pathology COMPARISON: 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. " 54b44bbd-beaba007-fb163a97-142179d3-7a7d868b.jpg,validate/p14/p14912272/s56173786/54b44bbd-beaba007-fb163a97-142179d3-7a7d868b.jpg,validation," FINAL REPORT INDICATION: ___-year-old man with newly diagnosed metastatic lung cancer with right-sided pleural effusion status post thoracentesis. COMPARISONS: PA and lateral chest radiograph from ___, CT chest from ___, PA and lateral radiograph from ___. FINDINGS: Since the most recent prior radiograph, there has been a decrease in right-sided pleural effusion. Small left-sided pleural effusion persists. Again seen are large masses within the right upper lobe and multiple nodular densities within the lower lobes, all of which are better characterized on the recent CT from ___. There is no definite focal consolidation or pneumothorax. Cardiomediastinal silhouette is stable. IMPRESSION: 1. Slight decrease in right pleural effusion, small persistent left pleural effusion. No pneumothorax 2. Right upper lobe masses and multiple nodules, better characterized on a recent CT. " 59cffb93-ff811f92-1bf13d58-dac457a2-37863c13.jpg,validate/p14/p14400261/s53247258/59cffb93-ff811f92-1bf13d58-dac457a2-37863c13.jpg,validation," FINAL REPORT INDICATION: ___ year old man with acute pancreactitis // Eval for acute process TECHNIQUE: AP and lateral views 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. Hypertrophic changes noted in the spine. IMPRESSION: No acute cardiopulmonary process. " 23cb3ab3-a1a8c9b6-12d39b85-2d052129-127c276b.jpg,validate/p10/p10488031/s50124490/23cb3ab3-a1a8c9b6-12d39b85-2d052129-127c276b.jpg,validation," FINAL REPORT INDICATION: ___ year old man with on daily diuretics with pulmonary edema // assess pulmonary edema FINDINGS: As compared to ___, interval improvement of the interstitial pulmonary edema which is now mild. Small left greater than right pleural effusions are stable. Mild cardiomegaly. No pneumothorax. IMPRESSION: Interval improvement of the interstitial pulmonary edema. NOTIFICATION: The findings were discussed by Dr. ___ with ___ NP on the telephone on ___ at 4:16 PM, 15 minutes after discovery of the findings. " dd8f2410-3f783162-31a03147-57b7b6c6-e0c5f385.jpg,validate/p19/p19104292/s50931182/dd8f2410-3f783162-31a03147-57b7b6c6-e0c5f385.jpg,validation," FINAL REPORT PORTABLE CHEST ON ___ AT 11:04 CLINICAL INDICATION: ___-year-old with CHF and alcohol abuse, mild dyspnea, question aspiration or CHF. No comparison studies. Please note that comparison to old films can be helpful to detect subtle interval change. Portable AP upright chest film ___ at 11:10 a.m. is submitted. Note that the time is labeled p.m. on the study, but the images were acquired in the morning. IMPRESSION: 1. Lungs appear well inflated without evidence of focal airspace consolidation, pleural effusions, pulmonary edema or pneumothorax. Heart is mildly enlarged. Mediastinal contours are likely within normal limits given lordotic technique. No acute bony abnormality appreciated. "